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Home My WebLink About15930-zNo Z17119 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date JULY 27~ 1988 THIS CERTIFIES that the building SOLID FUEL STOVE Location of Property 365 FREEMAN ROAD MATTITUCK House No. Street Hamlet County Tax Map Nb. 1000 Section 139 Block 03 Lot 38 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Bulld~ng Permit heretofore filed in this office dated APRIL 16, 1987 pursuant to which Building Permit No. 15930Z dated APRIL 25, 1987 was issued, and conforms to all of the requirements of the applicable provisions of th~ law. The occupancy for which this certificate is issued is INSTALL A SOLID FUEL STOVE AS APPLIED FOR. The certificate ls issued to ~HOMAS & M~T,~.N FOX (owner, of the aforesaidI buIld,ns. SU~mffOLK COUNTY D~P.I~ENT OF HE/~TE APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building Inspector Rev. 1/81 TOWN OF SOUTHOLD 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~ 15930 Z Permission is hereby granted to: ................ ....................... at premises ,ocoted ut ....~.~a.~.....~...~J):~..6~:~....~. ....... ~.~ ............... County Tox Map No '1000 Sect,on . .~.....~.~ ..... Block ...... ...~....~ ...... Lot No .... .~.~. .......... pursuant to application dated ..... ~" ' '(~-'~' -"~ ~' ......... , 19'~-'-- 7', and approved by the Budding Inspector. Building Inspector Rev 6/30/80 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru apphcation must be filled m typewmter OR ~nk, and submitted I ~ to the Building Inspec- tor w~th the following; for new buddmgs or new use' 1. Fmal survey of property with accurate location of all buddmgs, property hnes, streets, and unusual natural or topographm features. 2.Fmal approval of Health Depto of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installatmn from Board of Ftre Underwmters. 4. Commermal buddings, Industmal buddmgs, Multiple Residences and simdar build,ngs and instaila- tions, a certlhcate, of Code comphance from the Architect or Engmeer responsible for the buildmg. §.Submit Plannmg B?ard approval of completed rote plan requirements where applicable. B. For existmg braidings (prior to April 1957), Non-conformmg uses, or bullrings and "pre-existing" land uses' 1 Accurate survey (Jr property showing all property lines, streets, buddmgs and unusual natural or topographic featur,es 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housmg code or safety mspect~on of buddmgs or premmes, or other pertment informa- t~on reqmred to prepare a certificate. C Fees- Additions $25.00 1. Cert~ficate of occupancy New Dwelling $25.00, Accessory ,$t0.00 Business $50.00 2. Cemhcate of occupancy on pre-existing dwelhng $ 50 00 3. Copy of cert~flcate of occupancy $ 5.00, over ~ years $10.00 4.Vacant Land C.O. $ 20.00 / ~ .~.Z 5.Updated C.O. $ 50.00 Date 4z~ ............ NewConstpuctlon.; .... Old or Pre-existing Building .......... Vacant Land ............ Locat,on of Property /..~..~.: ................. ''~J~. 2'¢0~. ~...~... ......... House lVo Hamlet . . / /;Strf~t Owner or Owners of .ro e y ........................... County Tax Map No 1000Section . /.~..?. ....... Block .... ,~.3. ........ Lot 3 ~? ,Subdwm~on ....... : ................. FdedMapNo .~...?.?... LotNo ............. Perm,tNo. /..5'?~O ~. IDateofPerm,t .¥~../F~.Appl,cant .'~..~../.~--~...~. ........ Health Dept. Approval ................ Labor Dept. Approval ........................ Underwr,ters Approval ...................... Planmng Board Approval ..................... Request for TemporaW Cart~hcate ................... Final Certificate ....................... Fee Submitted $ ' Construction on above d~scmbed buddmg and perD[:~t meets all apphcable codes and regulations. z- C TOWN OF SOUTIIOLD OFI'ICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tlALL SOUTIIOLD, N.Y. 11971 TEL 765-1802 To WhomiThis May Concern, We are unable to complete your Certificate of Occu)ancy because of the following reasons. Anl application for Certificate of Occupancy is not on file. /Z/ Nol Underwriters Certificate on file. The check ~s(outdated/not 9n fil~.~o oo /~/ No. Health Dept. Approval on file. /~/ No' final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Buildin~ Permit I~ ~_ f 9. '~ O__ Z Buildin~ Dept. ***/Z/ No Plumber Solder Certificate on f±le. I( all permits involving plumbing being issued after April 1,1984 ) 765-].802 BUILDING DEPT. INSPECTION FOUNDATION ].ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~/J FINAL REMARKS: ~/~ ~ TOW' ' ' Examined .~....2.~.. -, 191~ 7. Approve~' '- c~..~' ,'19f-/ PermltNol ~0~. Dmapproved a/c .... (Bml&ng Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO 1 SURVEY · TOWN OF SOUTROLD CHECK BUILDING DEPABTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y 11971 TEL.. 765-1802 CALL ................ MAIL TO: ~d~ /d~_~ INSTRUCTIONS a This application must bp completely filled m by Wpewriter or in ink and submitted to the Building Inspector, wit sets of plans, accurate plot plan to scale Fee according t.q, schedule · b. Plot plan showing location of lot and of buflih~4~on l~mlses, r.9tatlonship to adjoining premises or public str- or areas, and g~vmg a detmled description of la iq/lit o~r*.~}oilel~g~tdsk4~}Xl~liawn on the diagram which is part of this ap cation. ; ~.~ -'~%~'~ v c. The work covered by this apphcat~.~ ~'~T~oi~~fore issuance of Budding Permit, d Upon approval of this applicatlq,r]k'~h~[ ~ll~l,~p. et~ll issued a Building Pe~lt to the applicant Such pez shall be kept on the premises avada a e No budding shall be occur, ~s~ .~wh~ ~~any purpose whatever until a Ce~zficate of Occupa shall have been granted by me Bu~ ~c3 [~X~N ~ Budding Zone Ordinance of the Town--~ ~6~k County, New York, ~d other apphoable Laws, Ordm~c~ Regulations, for the ~onstmc~pn of bu~ a~fis or alterations, or for removal or demoli~on, as hereto deson~ The apphcant agrees to comply w~th all ap~ ~bl~aws, ordinances, buJdmg code, housing code, and reg~ahons, ant admit authorized mspectom on premises and~ %tiding for necossa~ ~n~ns ........... (S~gnature of apphcant, or name, if a corporation) (Mmlmg address of applicant) State whether applicant ~ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bulk o..o.,, '" ........ OVto/0/{ 'NOTED" Name of owner of premises .7'"/o-~-~a:_ 0~..,~?ff. c~..//~ ,'/~/7 ~o'o ,~ la.~e.s;/ilced/_d ~l;P ~', (as on the tax roi1 or Ifapphcantisacorporatlon, slgilatureofdulyauthorlzedofficel CF.t~,_.~~' '~, BY' ~ ~OTI~ ~lkDtNG OEPARTM~T A (Name and title of cgrporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No, . , ~Q co ,,.~. .. Plumber's License No Electrician's License No Other Trade's License No 1. Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section /'ff~ Block Subdlvis~on Filed Map No , (Name) FOU,~DATIO~ ~O ~Q~RED ~0~ oOUR~O ~ONCHE; ~ ftamlet ....... Lot .... . rot .. State exmtmg use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy /7'/'~ b Intended use and occupancy C~/. 3. Nature of work (check which aPrPhcable) New Budding Repmr . .. Removal . Demolition 4 Estimated Cost 5. If dwelling, number of dwelling units Addition .... Alteration ...... Other Work .C .o~../. (Description) · .. .. .. .. Fee ..... ... .. . ....... (to be paid on filing this apphcahon) · Number of dwelling units on each floor ....... If garage, number of cars .. ~ .............................................. 6 If business, commercml or m~xed occupancy, specify nature and extent of each type of use ...... 7. Danenslons of exmtmg structures, ~f any Front ..... Rear .......... Depth ....... Height . . Number of Stones ............. Dzmensmns of same structure w~th alterations or add~tmns Front .......... Rear ............ Depth .......... Height ........... Number of Stones ........ 8 Dlmensmns of entire new construction Front ..... Rear ............ Depth .... · Number of Stones ..................................... Height ........ 9. Size of lot Front .......... Rear ............... Depth ............... 10. Date of Purchase ..... ~ .......... Name of Former Owner ................... I 1 Zone or use-d~stnct m4vhichq3rermse~are~ttmted - . .... ~ :-- .............................. 12 Does proposed construction violate any zonlnglaw, ordinance or regulation ~(.~ ................. 13. Will lot be regraded ............. Will excess fill be removed from premmes. Yes No - Name of Architect ......... Address ............... Phone No ......... Name of Contractor ..... r ........ Address .......... Phone No ........ 15. Is this property located,wzthzn 300 feet of a txdal wetland? *Yes ..... No ..... *If yes, Southold Town Trfistees Permit maybe required. I PLO'r DI AG tLMVI Locate clearly and d~stmctly ali buddings, whether existing or proposed, and indicate all set-back dimensmns from oroperty hnes Give street and block number or description according to deed, and show street names and indicate whether ~ntenor or corner lot. STATE OF NEW YORK, S S ~ OUNTY OF .... (Name of individual sigmng contract) ~bove named being duly sworn, deposes and says that he is the applicant te is the .............. , ..................................................... (Contractor, agent, corporate officer, etc.) )f said owner or owners, and ~s dt~ly authorized to perform or have performed the sa~d work and to make and file this ~pphcatlon, that all statemerrts'contmned' m this application are true to the best ofhm knowledge and belief; and that the york will be performed ~n the manner set forth m the apphcataon filed therewith. ]worn to before me this ' 81~1~i ~[ ~ ~0~ (Signature of apphcant) Term ~xp~es Ita~h 30, Lg-..~/