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HomeMy WebLinkAbout16075-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16729 Date March 21, 1988 THIS CERTIFIES that the building ...... ,A ,C.C.E.S..S 9.R.Y.../3 ,U.I.L, D..I .N.G, .................... Loc, atlnnnCPm~rtv 4365 Wickham Avenue Mattituck, N.Y. House No. Street Ham/et County Tax Map No. 1000 Section . . , [ .0 .7 ...... Block 04 ..... Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 2 I , 1987 pursuant to which Building Permit No. 16075 Z dated ......J un ....... e 14 ,. .............. I 987 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 The certificate is issued to ........ T.H..E.O.D.O..R .g..J.: . .C .O.N. L. .O .N .............................. (ownerXl~sY~ J[tIX~I~ of the aforesaid building. Suffolk County Department of Health Approval .......... .N/.A ............................. UNDERWRITERS CERTIFICATE NO .................. .N/.A ............................. PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FORM NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne_1~075 z Date / 19..~...7 Permission is hereby granted to: .... ......... at remises located at .0 :. Coun~ To× Mop No. ,000 Sec,on ..... 1....0...7. ......... B,ock ..... .~.~. ........ '~ No ...... L.~ ............ pursuant ,o application dated ...... ...~.......~....~. ................, ,9.~..~., and approved by the Building Inspector. Building Insl>ector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall BLDG. DEPT. Southold, N.Y, 11971 TOWN OF SOUTHOLD 765 - 1802 APPLICATION FOR CERTIFICAT5 OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted .= ~ to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accgrate 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-9 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-existir~g" ~and uses: 1. Accurate survey of pz~perty showing all property lines, streets, buildings and unusual natural or topographic features. 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 POOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$]0.00 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 5.Updated C.O. $ 50.00 Date ,.. NewCons truc tt on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property House NO. Street Ham/et Owner or Owners of Property ....... J'~..~.O.~. (~...(~. .... ~..~.; ....C.O. ~. EON .......... ' ........ County Tax Map No. 1000 Section ...... lp..-7. ..... Block .... ~ .......... Lot ..... ! .("~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. k(~,Q ,~, .... Date of Permit ~. l!fl.(~.'7...Applicant...~..C.o.~...L~. ~k~ ................ Health Dept. Approval ................ ' ........ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ,/0. '. ......................... Construction on above described building and per. m,i¢ meets all applicable codes andE~,~u I¢.~%~SkoME$ 7/ // ~, // EAST -~ . ' .......... .... R.~.~O40-Z~ ~effituck, N, Y. 11952 OUNDATIO.U ( ls t) OUI~DATION ( 2nd ) OUGH FRAME & ?LUMBING X;SULATION PER N. Y. STATE ENERGY CODE FILIAL i ADDITIONA'L COMME~;TS: TOWN OF SOUTHOLD OFFICE OF BU1LDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTtlOLI), N.Y. 11971 March 17, 1988 TEL, 765-1802 Theodore J. Conlon 4365 Wickham Ave. Mattituck, N.Y. 11952 To Whom This May Concern, We are unable to compl~.te your Certificate of Occupancy because ,of the following reasons. /~/ Ail appl~ca~iot~ for Certificate of Occupancy i.~; n©t o~ file. (ENCLOSED) /'_-_/ :,,~ Underwri~rs Certificate on.file. /~/ 'lhe chec~(o~{;~7~not on file.) $10.00 /~/ No lI(~alth Dept. Approval on file. /~_'/ No final itlspectio~l has been made. Please contact our office on this matter. Thank you for your cooperation.' Building Permit I~ ! 6 0 7 5 Z Bu J. ldin[; Dept. *~/_~/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1~1984 ) TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTtlOLD, N.Y. 119'/1 March 17, 1988 TEL. 765-1802 Theodore J. Conloh 4365 Wickham Ave. Mattituck, N.Y. 11952 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /~/ An ;tpplication for Certificate of Occupancy is not on fil~.. (ENCLOSED) /5/ :~o Underwriters Certificate on file. /~/ The check is(oDg~PYa~Ye~not on file.) $10.00 /_-/ No Health Dept. Approval on file. /_~/ No final inspection has been made. Plea:;e contact our office o~ Thank you for your cooperation.' Building Permit t~ 1 6 0 7 5 Z Buildin~f [)opt. ,~'~*/~/ this matter. ~;o Plumber Solder Certificate on file. ( all permits involving plumbing being .[ssned after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] R/I~UGH PLBG. / FRAMING FOUNDATION 2ND ; :SULATION . FINAL ~_~~ DATE 765,.1802 BUILDING DEPT. INSPECTION  FOUNDATION 1ST [ ] ROUGH PLBG. OUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: , / NOTIFY ~lt.[MNG DEPARTM~T AT '?~5,.1~2 9 A~ TO ~ P~ FOR THE ~ATE CONSTRUCTI~ & ENERGY ~IGN OR CO~STRUUT~O~ ERRORS J ! PLAN :E w terns not nc uded n the basic log home items include cabinets, counters.vanities and shelves~ appliances, f ,1airs and ra rigs; non-bearing i,nterior pal rater, Jar doors, and ceiling finishes; pl!4mbing an~ electrical eqmpment; found( tps, and other masonry toms; decks and ?ames; aaa other items specificotly'marked by others. substitution of materials or modification aT plans will voio oil relevant warranties, promises or other agreements expressed or, ). or its representatives Design and engineering .resp?s!bilitie.s of LINCOLN LOGS LTD. ar.e limited to those buildin~ structures J~wings are furnished. Drawings may not be rosa o or aupicoteo without express permission from LINCOLN LOGS LTD. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765~1802 ~Examined...¢A.,t,~.I. ~ .... 19 7. Approved . . ./.~.., 19~.7. Permit No. ~...~..O.~..~..~. bisapproved a/c .................................. .~.. .......... ..................... (Building Inspector) ~APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH . ".~ 3 SETS OF P~A~ .~-;~."./ ~~''~' ~ ::x' . SEPTIC FORM .............. NOTIFY CALL ................ MAIL TO: EAST END LOG HOMES & CONSTRUCTION, INC. 4465 Wickham Ave. Mattituck, N.Y. 11952 T. Conlon (516) 298-9127 Date .... .~./.Z.! .......... 19 ~.7 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 inspectio~,~,~,~, ~,~ ~ ~ (Signature of applic'~uJt, or name, if a corporation) (Mailing address of applicant) State whether applicant i~ lessee, agent, architect, engineer, general contractor, electrician, plumber or~ Name of owner of premises ...... i . .'~. ~O1)O.e~....~.:....~...~..LO.hJ ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . A~TRACTOR'S MUST BE. SUFFOLK COUNTY LICENSED License No. ~.O~'C~D..~....:~...tO.{.cl ..... 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 Hamlet County Tax Map No. 1000 Section ...... [0~ ........ 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. Existing use and occupancy.. ~[.~¢.~..~ [¢~..~...~P~5. ~P~. i~. ,~.~~.. b. Intended use and occupancy ...................................... ,r .... . ..... 4., ................ 3. Nature of work icheck which appli~able)(New Bu'fldin~g.d ..... ' ..... Addition .......... Alteration Repair .............. Removal~ ...... ~r,Demolition .............. Other Work ............... i -~ - (Description) 4. Estimated Cost..........lt 1.0l.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 ohcupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................ :.;-. ............................. Din~ensions of same structure with alterations or additions: Front ................. Rear .................. Depth iHeight ' Number of Stories 8. Dimensions of entire new construc!ion: Front .....Z.~... ..... Rear ..... 2, t~. ....... Depth ...~,.~.... Height ....J.'/.'.(o.'l ..... Number of Stories". ~az. ~, OreO06 ~'*O~OE ...... 9. Size of lot: Front ...... I.qS .... ! ......... Rear ....... I.-] .O. ........... Depth ...~..O. ............ 10 Date of Purchase ,' Name of Former Owner 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violat~ any zoning law, ordinance or regulation: ...~.0. .......................... 13. '. Will lot be regraddd ........ ~ ............. Will excess fill be removed from premises: Yes No 14 Name of Owner of premises Address Phone No Name of Architect ............ i ........... Address ............. Phone No ........ Name of Contractor ........... I ............... Address .... : .............. Phone No .............. 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No . ~. ~es Permit may be required. PLO~f DIAGRAM ildings, whether existing or proposed, and~ indicate ail set-back dimensions from nber or description according to deed, and show street names and indicate whether *If yes, Southold Town Trust Locate clearly and distinctly all b~ property lines. Give street and block nu: inter/or or corner lot. STATE OF NEW YORK, COUNTY OF... ' being duly sworn, deposes and says that he is the applicant (Name o f individual signingicontract) ~bove named. ~e is the ........................ (Contractor, agent, corporate officer, etc.. ) )f said owner or owners, and is duly authorized to'perform 6r 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 a, ork will be performed in the manner se~t forth in the application filed therewith. ]worn to before me this .c~...~ ....... day of...../j .?~. ..................... , 19 .~.? SUFFOI~.K CO. DEPT. OF HEALTH ~RVI'ClES. 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