HomeMy WebLinkAbout15844-zFORM NO. 4
TO~N OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19022
Date MAY 7, 1990
THIS CERTIFIES that the buildin~
Location of Property 795 SALTAIRE WAY
House No.
County Tax Map No. 1000 Section I00
Subdivision
ACCESSORY
MATTITUCK, N.Y.
Street
Block 1 Lot
Filed Map No. Lot No.
Hamlet
2O
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 27, 1987 pursuant to which
Building Permit No. 15844-Z dated APRIL 3, 198-7
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 ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
WILLI~ & BARBARA MEYRAN
No Z-19023
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date MAY 7~ 1990
THIS CERTIFIES that the building.
Location of Property 795 SALTAIRE WAY
House No.
County Tax Map No. 1000 Section 100
Subdivision
ADDITION
MATTITUCK, N.Y.
Street Hamlet
Block 1 Lot 20
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 27, 1987 pursuant to which
Building Permit No. 15844-Z dated APRIL 3~ 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 DECK ADDtTION TO EXISTING ONE FAMILY D~ELLING AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
WILLIAM & BARBARA MEYRAN
Rev. 1/81
1~0~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
No
.U~LD~N~ PE~T
CGMPLETION OF THE WOR~ ^UTHORIZED)
Z ~ote ...~.....~. .................. . ~ ~.7.
5
8
4
4'
Permission is hereby granted to:
........
i ., ,".'.') ,.,.,,,,,.. .. ~ '~._ i ,
at premises located at ...~..~..~......~......~,..~ ...... ~~ .................
County Tax Map No. 1000 Section ..... ./...~ ....... Block ....... ..C)...( ........ Lot No. ,...~....~..U...,~ ......
pursuant to application dated ..~.~........~.~. .............. , 19..~...'~.., and approved by the
Building Inspector.
Fee $ ........................
Baildlng Inspector
Rev. 6/30/80
TOWN OF SOUTROLD
BUILDING DEPART}lENT
TOWN HALL
SOUTROLD, NEW YORK
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING gUILDING ...... ~ACANT LAND
EOUSE NO. TR HAMLET
County Tax Map No. I000 Section ...... Block ....... Lot' . ........
Subdivision ....................... Filed Map ........ Lot ..........
~er~t Ho. ~8.4:~..Z..~a~ o~ ~er~t .......... App~ic~ ...................
Health Dept. Approval .................. Underwriters Approval ..............
Plamning Board Approval ................
Request for Temporary Cerclficate ....... Final Certificate
~e~ Sabm~cd: ~ .... .Z.p:?.~ .........
rev. 10/14/88/
FORM NO.
TOWN OF SOUTIIOLD
BUILDING DEFARTMENT
TOWN IlALL
765 ~ 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. Ihls application must he]filed in typewriter OR ink and submitted to the Building
Inspector with the following; for new buildings or new use:
]. Final survey of property with accurate location of all buildings, pXoperty lines,
streets, and unusual ~atural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electricai installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that s~older used in system contains less'
than 2/I0 of IZ lead.;
5. Commercial buildings,lindustrial buildings., multiple residences and similar.
buildings and installations, a certificate of code compliance from the Architect
o= Engineer responsible for the hull'ding.
6. Submit Planning Board]Approval of completed site plan requirements,
B. For existing buildings (~rior to April 9, 1957~ non-conforming uses, or buildings
and "pre-existing" land Uses:
I. Accurate survey of prbperty showing all property lines, streets, buildings amd
unusual natural or topographic features.
2. A properly completed :application, a consent to inspect signed by the applicant
and a certified abstr.act of title issued by a title company which shall
show single and separ!ate ownership of the entire lot prior to April 9, 1957.
. If a Certificate of ~ceupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
]. An application for v~cant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership o9 the entire lot prior to April 9, ]957 shall also accompany
the application. If.la Certificate of Occupancy is denied, the Building Inspector
shall state the reas6ns therefor in ~rriting to the applicant.
D.., FFE~
I.
CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swim--lng Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Ogcupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land CertSficate of Occupancy - $20.00
5. Updated Certificgte of Occupancy - $50.00
6. Temporary Certificate of Occupancy -$15.00 Residential
Commercial
TOWN OF SOUTUOLD
BUILDING DEPARTHENT
TOWN HALL
SOUTHOLD. NEW YORK
765 - 1802
11971
- -,,,i OF souTHOfD ~,~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE ..... J ........
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
HOUSE NO. HAMLET
co...~ ~ ..~ .o. ,000 ~=.~o...(P~. ~o=~ ..t .... ~o....~9 ......
Subdivision ....................... Filed Map ........ Lot ..........
Permit
Health
Planning
~o. l~8.4+.&.Date of Pcrmi= .......... Ap~liean= ...........
Dept. Approval .................. Under~riters Approval ..............
Board Approval ................
Request for Temporary Certificate ....... Final Certificate .~.. ...........
~ee Su~ca: ~.. 2d.o? .
rev. 10/14/88
FORM NO. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. This application must beifiled in typewriter OR ink and submitted to the Building
Inspector with the following; for sew buildings or new use:
I. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual ~atural or topographic features.
2. Final approval of Uea~th Dept. of water supply and sewerage-disposal(S-9 form).
~. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that solder used in system contains less'
than 2/10 of ]Z lead. i
5. Comercial buildings,!industrial buildings, multiple residences and similar.
buildings and Installations, a certificate of code Compliance from the Architect
er, Engineer resDonsible for the hull'ding.
(~. Submit Planning BoardlApproval of completed site plan requirements.
B. For existing buildings (~rior to April 9, 1957] non-conforming uses, or buildings
sod "pre-existing" land ~ses:
I. Accurate survey of property showing all property lines, streets, buildlnEs and
unusual natural or topographic features.
2. A properly completed ~pplica£ion, a Consent to inspect signed by the applicant
and a certified abstrlact of title issued by a title company which shall
show single and separlate ownership of the entire lot prior to April 9, ]957.
· If a Certificate of Oiacupaucy is denied, the Build/nC Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent informatio~ required to prepare a certificate.
For Vacant Land Certifidate of Occupancy:
I. An application for vgcaut laud Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire 10t prior to April 9, ]957 shall also accompany
the application. Ifla Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in wrlting to the applicant.
]. CERTIFICATE OF O~CUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 -Businesses $50.00.
2. Certificate of O~cnpancy on pre-existing dwelling - $]00.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy -$]5.00 Residential
Commercial
er.
OU~;DATIO~3 ( 1 s t)
OUNDAT I O:~( 2nd )
OUGH FRAME &
PLUMBING
NSULATION PER N. Y.
STATE ENERGY
CODE
. ADDI
COMMEN'I'S:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ I .~iSULATION
/
FRAMING ,rd FINAL
REMARKS:
DATE
INSPECTOR~
765-1802
BUILDING DEPT.
INSPECTION
REM. ARKS:
DATE ~~~__ INSPECTOR ~
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-I 802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because.of the following reasons.
An application for Certificate of Occupancy
is not on file.
/~/ No Underwriters Certificate on file.
~ Tile check is(outdated/n~ot
/5/ No IIealth Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit t~ _~ 3 ~ ~] k_~ Z ~J~ ~,
Building Dept.
***/~/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
OCCUPANCY OR USE IS UNLAWFUL WITHOUT A ~EHTIFICATE OF OCCUPANCY.
CLEAR UP THIS MATTER AS SOON AS POSSIBLE SO THAT LEGAL ACTION DOES NOT
IIAVE TO BE TAKEN.
Thank you.
TOWN OF SOUTtIOLD
OI:FICE OF BUILDING INSPECTOR
P.O. BOX 1179
TOWN IIALL
$OUTIIOLD, N.Y. 11971
May 26, 1989
TEL. 765-1802
William & Barbara Meyran
20 Sintsink Drive West
Port Washington, New York
11050
To Whom This May Concern,
We are unable v.o complete your Certificate
of Occupancy because .of the following reasons.
/_--/ An application for Certificate of Occupancy
is ;lot on file. (ENCLOSED FOR DECK ONLY)
/_--/ No Underwriters Certificate on file.
/~/ The c]lec:k .it;(qSX~i,l[k~g/not On file, )
/_/ No Heal. th Dept. Approval on file.
/-_~/ No final inspection has been made.
$25.00
P]ea:;e contact ()ur office on this matter.
Thank you for your cooperation.
Ih~ildir,,g PermJ. t # ! 5 8 4 4 Z
Dtli ld i~]g Dept.
*.~/~/ Ho Plumber solder Certificate on file.
( a].l permits involving plumbing being
issued after April 1,1984 }
NOTE: BP #15844Z has expired. We will issue CO for deck
addition only.
Please renew permit for accessory garage and commence, fence
or fill excavation.
20~int ~inlt ~rilar-~r ~t
~Por! lDa~ hinllton..~.~). 11050
August, 1988
Office of Building Iinspector
Town of Southold
Dear Sir:
Re: 795 Saltaire Way
Mattituck
Enclosed please find a check for $344.24 for building permit at the
above address.
Please also extend the building permit for garage.
Thank you.
William J bfeyran~
795 Saltaire Way
Mattituck, New York
..... TOWN OF 'so/J'fi~OLD
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
.(~.~ .6 .... , 19~.~.. Permit No. )..~..~..~..~--..
Approved
Disapproved a/c .....................................
...... ....... . ...................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY '
CHECK ..........
SEPTIC FORM
NOTIFY
CALL - 3.:29Tf.s7
MAIL T 0: &~,'//,'~ ~.~ ~'-,
TOWN OF
INSTRUCTIONS
a. This application must be completely filled in by typewriter 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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signatu/iof applicffnt, or name, if a corporation)
(Mailing address of applicant) //
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Name of owner of premises . ..~'. r'f./(.°-.'t'...t~.,~..e-d/~.e~..,-~...~../.~..a.'7..~.~..~.,.,..,~...~.~.~.~. ....................
,/
(as on the tax roll or latest de4d)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) .
ALL CONTRACTOR'S :MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done[ .................................................
. .,CAvff.,. ?. . ..... : .........
· ..k) ....................... Street' Hamlet
House Number
County Tax Map No. 1000 Section . ./..O.o...q.q ........ Block . p./.,..o.D. .......... Lot.. ?..2..O...Q.o..c.,~ .....
Subdivision· ~a. f.q'.~.~i .r'.e. , ~.a-f..~.5. ............. Filed Map No. g'f.~ · ~-. ........ Lot .~.2..o.,..ca..~. .....
(Name)
2. State existing use and occupancy of premises and intended use and occupancy/of proposed construction:
a. Existing use and occupancy ................................................... ;'., .... ~:'..) ........
b. Intended use and occupancy . .~: ....................................................
'
3. Nature of work (check which applicable): New Building .. ~ .... Addition : Altaration ,. .........
Repair .............. Removal .............. Demolition ............ Other Work ...............
, ., /~,~ ~ (Description)
4. Estimated Cost ..'>".~ . .O. ?.· .~. · ' · ................. 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 .........................................................................
6. If business, commercial or mixed ~ccupancy, specify nature and extent of each type'of use ... ': ..... ' .... ' ........
7. Dimensions of existing structures, if any: Front, . ~ .~.. ~ .... . . Rear .... .~. ocr'....... Depth ..~.i ..........
Height ............... Number of Stories ................... ' ............................. ] .......
Dimensions'of same structure withl alterations or additions: Front ................. Rear ..................
Depth ...................... i Height ...................... Number of Stories .......................
,& Dimensions of el~,t~e~neW construciion: Front i.~i! i .2~.iii'iii'' Rear.../. 7~ ........ Depth ....~..o. .........
Height .... '.. ?..*. { ':":'.. Number of Stories ....... . ..................................
9. Size oflot: Front ... o. .....i ......... Rear.~../&~ .... ;. .....: ..... Depth ..~.2..c-~.. ..............
10. Date of Purchase t~ ac' .~./~,~../. ~ .~ ............ Name of Former Owner .7.'~-~,~,,~ aa..J .--~.~¢~-. ~ ~...~.q .r-5
11. Zone or use &strict in which premises are situated .....................................................
12. Does proposed construction violat~ any zoning law, ordinance or regulation: ...............................
13. Will lot be regraded ........... : ................. Will excess fill be removed from premises:
14. Name of Owner of premises ..~/'/6'c~.T.,~..,+/~.~.,t,,,-. Address4O. $,?.~..~(q./.~., .~.,. .. Phone No..~.~.957/. ~'... ·
Name of Architect ..,..--L-7.. ..... I ............... Address ................... Phone No ................
Name of Contractor : ne3~o
........................... Address .... : .............. Phc ................
15. Is this property located wi!thin 300 feet of a tidal wetland? *Yes ..... (~)~ .....
· If yes, Southold Town Trustlees Permit maybe required.
' PLOT DIAGRAM
Locate clearly and distinctly all b¢ildings, 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. -~
STATE OF NE~yORK, S.~
cou v OF r ......
. .~dff~ ~q ~., .~.~.~ ~ ..... ~ .................. being duly sworn, deposes
(Name of i~vidual signin~ contract)
ttbove named.
and says that he is the applicant
~e is the .........................................................................................
~ (Contractor, agent, corporate officer, etc.)
)f said owner or owners, and is duly uthorized to perform or have performed the said work and t~m~ke and file this
lpplication; that all statements contained in this application are true to the best of his knowledge~d~ef; and that the
~:~ork will be performed in the manner set forth in the application filed therewith.
~worn to before me this i t, /
....... ~.~...(./.~4.~./ .... day of. 'I, '(~}: '~' '~'' '~' ~." ~/~,~.~,~.'~/'~
q~tary P
....
,~ NOlIW P~blt.~J!~lt of N~ ¥~ ...... ra.,~ · I..'. · ;-.../.~ · .- ...........
No, ~0-4~04609 ~/ - ~' t~i,,-ature of applicant)
, Qualified in Nassau County ~.?/
Commiss;on Expires March 30, tO ~
?
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