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Home My WebLink About15916-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of' the Building Inspector Town Hall Southold, N Y. Certificate O[ Occupancy Date . August 21, 1987 THIS CERTIFIES that the bmldmg Accessqr. y ................ 1145 RUTH ROAD MATTITUCK Location of Property H[~u~e ~o ............. 'Street ................. ~lat~/e~ County Tax Map No. 1000Sectlon . 106 .... Block .07 ......... Lot ..15 .......... Subdivision ................... Filed Map No ........ Lot No .......... conforms substantially to the Apphcation for Building Permit heretofore filed in ttus office dated Aprzl 8, 1987 pursuanttowtuchBmldlngPermltNo 15916Z dated . Ap r i 1 17:. 1 .9.8.7. .... was issued, and conforms to a~ of the requirements of the apphcable provisions of the law The occupancy for wluch tlus certificate m issued is ....... A.cce. sso.ry,.t.a.nni.s c.o.u.rt .as..a.p. pl.~e.d .for. . .............. The certificate is issued to ANTHONY NICOVIC ............ x ............. of the aforesaid building Suffolk County Department of Health Approval N / A ........................... UNDERWRITERS C~RTIFICATE NO.. N / A PLUMBERS CERTIFICATION DATED: N/A Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o_ 15 916 · .... ' .... /..~. .......... ......... , ,,.~.~. Z Dote Permission is hereby granted to: ', .~_C~L~....~ .......................... 2'~;:';'":~: ............ :;;'"'¥~~ .............................................. ~ ..................................... ,p , ~ redo, ..... .~ .............................. ~ ....... .~~ .................... p, rsuont to oppllcotion doted ....~//. ~....~ ............... . lO.~J~..7., ond approYed by the Building Inspector. Fee $ ~..~...: ............. Rec. 6/30/80 TO'WN OF SOdYPC_D '~ ........ ~APPLIOATION FOR CERTIFICATE OF OC01JPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor w~th the following; for new buddings or new use' 1, F~nal survey of property with accurate location of all buddtngs, property lines, streets, and unusual natural or topograph m featu res. 2.Final approval of H~ealth Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrmal installation from Board of F~re Underwmters. 4. Commercml buddings, Industrml buildings, Multiple Residences and mmilar buddings and installa- tions, a certffmate of Code complmnce from the Architect or Engineer responmble for the building. .5.Submit Planning B6ard approval of completed rote plan requirements where apphcable. B. For existing buddings {prior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses. I. Accurate survey of property showing all property hnes, streets, buildings and unusual natural or topograph m featu res 2Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buildings or premmes, or other pertinent mforma- t~on required to prepare a certificate. C. Fees' Addzt zons $25.00 r~ 1. Certlficate of occupancy New Dwellzng $25.00, Accesso~,$.~0~.)Buszness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certlfmate'of occupancy $ 5.00, over 5 years $10.00 / 5.Updated C.O. $ 50.00 Date ..........././~/./,~.//..~. ~.. NewConstructzon ',' .. Old orPre-exmtmgBulldlng .......... Vacant Land ............. Location of Property .... ~.~....~..&..r-~ ..... ~¢~). .... / .................... /~./ ....... C... House No. / Street Nam/et Owner or Owners of ,ropbrty ./..~./?-~..2~/~..../¢.//.¢.¢..~.~.~-z. .......................... CountyZax Map No. 1000 Section //(:~) ~:2 Block ~)2 Lot /'~' Subd~v,mon .... . ~./4.~..F,ledMapNo ........ Lot No ........... Permit No. Da ~¢/~.Z Apphcant ................................ Health Dept Approval ............... Labor Dept. Approval ....................... Underwmters Approval ................. Planmng Board Approval ..................... Request for Temporary Cbrt~flcate .............. Final Certificate ...................... Fee Submitted $ .................... Construct,on on above described bu,ldmg and p~//~ts ~app'~,~able*odes and regulations. Apphcant OUNDATION ( ls t) OUNDATION ( 2nd ) OUGH FRAME & PLUMBING NSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~NAL DATE .~///?/.d,~ ? INSPECTOR Examined .~. I.~ .., 191il.-/ FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y 11971 TEL.: 765-1802 Approved ~ .! .(,o.., !91~q Permit No. I i,-.ql .k :~ Disapproved a/c .............. (Bluldlng Inqpector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ................ MAILo~0: ¢/.Date ...... 19 ¢ a Ttus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wltl sets of plans,~accurate plot plan to scale. Fee according to schedule b Plot plan showing location of lot and of bmldmgs on premises, relationship to,adjoining premises or pubhc stre or areas, and giving a~detaildii dbscnptlon of layout of property must be drawn on the diagram which is part of this ap cation c. The work covered by thl~ application may not be commenced before Issuance of Building Permit d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such pea! shall be kept on the premises available for inspection throughout the work. e. No building shall be occtipied or used in whole or m part for any purpose whatever until a Certificate of Occupm shah have been granted by the Bmlding Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance- Regulations, for the construction of buildings, additions or alterations The applicant agrees to comply with all apphcable laws, ordinances, bi admit authorized inspectors on premises and m building for necessary/fil~ , or for rem. oval or demolition, as hereto describ ~mg code, h/ous~mg code, and regulations, and jctions ~ fiature of apphcant, or name, if a corporation) (Mmhng address of apphcant) State whether applicant is_ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build Nameofownerofpremises ~). J.J~/'~'?c/2ff ~4f/ ~--O L/ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Plumber's License No ~ . . Electrician's License No ...... Other Trade's License No ... I Location of land on which proposed work will be done ...... / House Number Street Hamlet County Tax MapNo 1000Sect,on / ff ~ Block ..J7 .. Lot .7 ~ .. Subd~wsmn ' .... Fried Map No .... Lot (Name) 2 State ex~shng use and occupancy of premmes and tntended use and occupancy of proposed constructmn a. Existing use and occupancy / ~/Z~ . .~4~~ ................ b Intended use and occupapcy ................................ 3. Nature of work (check which applicable) New Building . Addition Repmr ......... Removal ...... Demolition ......... 5. If dwelhng, number of dwelhng units If garage, number of cars ... ~ .... ..... Alterat.~, fi . Other Work./.~>c"°"~r (Descnption) · .. Fee ...................... ~ (to be paid on filing this apphcation) ·.. Number of dwelling units on each floor ......... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................ 7 Dimensions of ex~stmg structures, if any Front Rear ........ Depth .... Height .... Number of Stories .................... D~nenmons of same structure with alterations or additions Front ........ Rear ........... Depth ............. Height ..... Number of Stones ............... 8. Dimensions of entire new construction Front . Rear ........ Depth ........ Height ...... Number of Stones ....................................... 9 Size of lot: Front ...... Rear ........... Depth ................. I0. Date of Purchase ...... ~ ....... Name of Former Owner ......................... 11 Zone or use distract m4vhichprpm~ses4mmtuated - -: ~..-- ~ ......................... 12 Does proposed construction wolate any ZOmhg law, ordinance or regulation .................... 13. Will lot be regraded ................. Will excess fill be removed from premises Yes No - Name of Architect ............ Address; .......... Phone No. ~.~t~ ....... Name of Contractor .............. Address .... Phone No,,l~S ~. 33 L~. .... 15. Is this property located'wzth~n 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dnnenslons from *roperty hnes Give street and block number or description accordmg to deed, and show street names and indicate whether tntenor or corner lot. STATE OF NEW YORK, S S ?OUNTY OF (Name of ~ndwldual signing contract) lbove named. te ,s the .... .~.&~t~' .'~. (Contractor~corporate officer, etc.) ff said owner or owners, and zs d,uly authorized to perfom or have perfomed the smd wor~ ~ and file tins ~pphcatmn; that all statements contamed m thzs apphcat~on are true to the best of his knowledge and behef, and that the york will be perfomed m the m~ner set forth ~ the apphcatmn filed therewzth. IT°.~ t~ ~.e~th~s , ~y,f.~~ ........ 19f~ FRED .KAELIN, JR. .~..~/....--..--.~. ......... t'":u"f-'' Corem ~pl~s 8/31/88 Omo$ Constantouri$ $1~.$0 ' -/