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HomeMy WebLinkAbout15783-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...ZT.1.6657 Date February 18,. 1988 THIS CERTIFIES that the building . .C. 9.n.s.t.r..u.c.t..A..d.d.i.t..i 9.n..~...r.e.n.o.y.a.t.i.o..n ......... L~o~*' ~¢p~,,~t,, 855 Soundview Avenue Mattituck New York .... 10 .......~,v,...,House .............................................. No. Street ' ........... h~r~/e~ County Tax Map No. 1000 Section 094 .Block 0 1 ........... Lot 07 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 17, 1987 pursuant to which Building Permit No. 15783 Z . dated ...i~.a..r.c.....h 2 1 ......., 1987. ......... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITION & RENOVATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to HOSNY SELIM ..................... ?o¥ k 'C .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .................... N. 8..5.1.8.8. 9. ...................... PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOB~ NO. O 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~ ~5783 Z Permission is hereby granted to:, .................... ......... .u... .~.r.=.~f ......................... t ................... ': ..... ; ........ ~"~,' "~< ...... ~';'; ............ '; at premiX/~ee IocateUd at ....~....~.:~.C......~.~~-'~r~,~...(-~..*- ......... County Tax Map ~o. 1000 Section ..... ..~.....~j.....I.1~ ...... Bkx;k ...... ...~.....1 ....... Lot No ....... ..(~....3 ......... to ~~. ~ .... ~ ~.d by pursuant application dated ....-t.~.~ ...................... 19.~..;., approv~ the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 OF SOUT O[ o APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-g form or equal), 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable, B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.0.0, Accessory!S10.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 / 0~/. 5,Updated C.O. $ 50.00 Date ..j~.2 ~.7. .......... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...... House No. Street Hamlet Owner or Owners of Property .......... ~ ................................... 94 ] 7 County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. 15783Z Date of Permit Applicant Ho,shy S.e.Lim. Health Dept. Approval NA Labor Dept. Approval NA Underwriters Approval ,~ 85 ! 889 . .Planning Board Approval NA Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~ ,4- OO Construction on above described bu ilding and permit meets all app~JZ:abl~ codes and regulations. Applicant ........ ~,~~ ........................... Rev. 10-10-78 Co & 8LDG. DEFT, TOWN OF $OUTHOLD Dr. Hosny Selim 671 Vandam St. N. Woodmere. N. Y. 11581 Building Department lewn of Southo].d Town Hal 1 Southold~N.Y. 11971 Feb. 19~1988 Oear sirv Please find enclosed a copy of the Underwriter certificate for the electrical inspection done on my home at: 129J Soundview Avenue~Mattituck~N.Y. I've already sent you my application for a certificate ef oc:cupancy with a check for the fee. .[ would appreciate if you seed the certi¥icate to my p~.~rmanent address l:i. sted above. You~ trul ,/.~, H. Sel i m THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY Feb['uery ]..~ ~.9,~885 JOHN STREET, NEW YORK, NEW YORK 10038 ..... THIS CERTIFIES THAT only the electrical ~uipmo~t ~ ~scr~b~ be{~ and introdaced by t~ applicant ~med on the a~ve application nu tuber in the prem~es of Horny Selim, 129-~J Soundvi~ Arena, ~ttic~ck, ~ in the following location; ~ Basement ~ Ist f~, ~ 2,~d fi. Section Bilk Lot ~sex~minedon ~ December 17,1987 andfou~tdtobeincomplioncewlththereq.lretnentsofthisBoard, FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 18 DRYERS SYSTEMS NO. OF FEET Track Lighting 20' 0" 3 Lites E R C E A. WG OF NEUTRAL Shea Electric 87 Cladetone Aven~e West Imlip~ ~0Y. 11795 Lic. 5409-E GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ide~tified by their credentials. COPY FOR ~UILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUS~T NOT BE ALTERED N ANY MANNER. OUND^T!ON (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING ~NSULATION PER N. STATE ENERGY CODE FI~AL ADDITIONAL COMMENTS: G O ' cO'soo ~ D~SCRIBED PROPERTY AT MATTITUCK Town OF $OUTHOLD sUFFOLK CO, N Y. donack associates land surveyors and consulting engineers $1~ west main street riverhead,new york 11901 (516) 369-1717 (212) 746-302_.0 Oct 1,1983 Job N-° 83~33T !r©0-094~). 1-07 Scale I" - 40' SOUTIIOLD 'tLDING INSPECTOR BOX 728 ~'N IIALL LD, N.Y. 11971 October 21, 1987 Contracting 8 Re: Hosuy Selim TEL. 765-180~ mplete your Certificate of Occupancy because .of tile following reasons. /~--_7~/ An application for Certificate of Occupancy i.~-; nor. on fi].~. /~ N~ un¢ler,griters Certificate on file. /_~/ Thc check is(outdated/Do_~t o1__~ fi_~ele.)~'~,~-O / / I!o llealth Dept. Approval on file. /~/ ~o final inspection has been made. I']ea.qr3 contact ()ur office Thank you for your cooperation. Building Bu i ].d in~f on this matter. permit tt 3_ .~ _~ _% ..3 z r)cp t. Plumber Solder Certificate on file. ail p~-~rmit'.~ involving plumbing being it;sued after April 1,19B4 ) 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH~.,~... 3 SETS OF PLANS ~.~I'.''.. SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: Approved ~..~..~ .... 19~.. Permit No. Disapproved a/c ..................................... .......................... (Building inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19 .~... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the 'construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, builPtlin~ code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~.n.s. ~ (Si~iature of applicant, or name, if a corporation) . / .'!. j ¢. .,?. ./c. N 4 7. . :' : . . . (Mailing address 6fapplicant) //~d O'~ State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............ ( ·: ......................................... -- (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 NUST BE SUF. FOLK COUNTY LICENSED Builder's License No.././.. ~.z/.JZ'.. ff.~. ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land which proposed work will be done.., e.:.. House Number Street Hamlet County Tax Map No. 1000 Section ....... ~.~. ....... Block ...... { ........... Lot .... ~ .............. ' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguse and occupancy b. Intended use and occupancy ~& ~g' L .................... 3. Nature of work (check which applicable): New Building ' Addition. · .,~ ..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ...................................... Fee ...................................... · (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..................................................... -... 7 ............... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .......... · ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? ~Yes ..... No ..... ~If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 3TATE OF NEW YORK, S.S 2OUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) tbove named. te is the ......................................................................................... (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this ............... /. ?.f ...... day of..~. ~-ff-- .......... 19 ?,,7. 4otary Public .... ~....'.~.'....~.'.~..~..~. County .~. ~~ .I. F