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Home My WebLink About16430-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Braiding Inspector Town Hall 5outhold, N.Y Certificate Of Occupancy No. Z-16877 Date May 17, ]988 THIS CERTIFIES that the building . REP.AIR EX. IS.T. IN.G.O.N.E..F.A:M. IL.Y D.W[?L.LIN.G. ......... Location of Property 5.3.5 S.z. gsbee .... Road . Mattztuck, N.Y. House No Street Hamlet County Tax Map No 1000 Section 143 Block 02 ..Lot 10 Subd~wston ....... Filed Map No .. Lot No ........ conforms substantially to the Application for Budding Pernut heretofore filed in this office dated Se. pt. emb. er 2, I9.8.7 pursuant to Much Budding Permit No 16430 Z dated . .Sept. e. mber. 7,.. 1987. . was ~ssued, and conforms to ail of the requirements of the apphcable provisions of the law The occupancy for which this certificate is issued is . REPAIR EXISTING ONE FAMILY DWELLING DUE TO FIRE AS APPLIED FOR JULIA LAMAKA The certificate is ~ssued to ' ' ' (owner, I~~X ..... of the aforesaid building Suffolk County Department of Health Approval .... .N./.A. ............................... UNDERWRITERS CERTIFICATE NO , .N012.Ip5 7 May 1 I:, .19.88 ................. PLUMBERS CERTIFICATION DATED: Aprzl 1, I988 - Perfection Plumbing & Heating / 12fl~Jl'ld mg Inspector Rev 1181 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~AIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 16430 z Fee $.~..z .............. Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold. N.Y. 11971 765- 1802. APPLICATION FOR CER'I'IFICATE OF OCCUPANCY instructions A. This application must be filled ~n typewmter OR ~nk, and submitted I~ to the Building Inspec- tor w~th the following; for new buddings or new use: 1. Final survey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topographm features. 2.Final approval of Health Dept. of water supply and sewerage dmposal--(S-9 form or equal). 3.Approval of electrical ~nstallation from Board of F~re Underwmters. 4. Commermal buddings, Industrml buddings, Multiple Remdences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engmeer responsible for the building. 5.Submit Plannmg Board approval of completed, site plan requirements where applicable. B. For existmg buddmgs {proof to Apml 1957), Non-conforming uses, or buildmgs and ' prmex~sting" land uses: 1. Accurate survey of p~operty showing all property lines, streets, bullrings and unusual natural or topograph ~c featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildmgs. 3. Date of any housmg code or safety inspection of buildings or premises, or other pertinent ~nforma- t~on required to prepare a certificate. C. Fees' Additions 825.00 POOLS $25.00 ALTERATION $25.00 1. Cert~f[cate of occupancy New Dwellzng $25.00, Accessory ,$]0.00 Business $50.00 2. Certlfmate of occupancy on pre-existmg dwelhng $ 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 ..... .~. ................ NewConstruct,z°n ... Old or Pre-existing Buddmg .......... Vacant Land .......... Locat,on of Property. S~i~ ................... House No. ~1 Street Nam/et Owner or Owners of Property "~'~ J .m . L .0,. Jr'o.. ¢~ k . CountyTax Map No 1000Section ... I.Z~3 ..... Block .... .O.~¢. ....... Lot .... 1..~. ........ Subd~ws~on ......................... Filed Map r~n , Lot Nc .............. Perm,tNo. ].~..1~.O.?'DateofPerm,t ?/7./fZApphcant_. ........... Health Dept Approval Labor Dept Approval ~ Underwmters Approval ........................ Planmng Board Approval ...................... Request for Temporary Certificate ................... Fmal Certificate ....................... Fee Submitted $....~'O.: .O.Q .................... Construct,on on above descrlbed buddlng anl p~er_~lt meets all applicable codes and regulations. Applicant. ~¢4~-. J~..~'~ ......................... Rev 10-10-78 TOWN OF SOUTLIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 TEL 765-1802 To Whom This May Concern, We are unable to complete your Certiflcate of Occupancy because of the following reasons. /_~/ An application for Certificate of Occupancy is not on file. ~ /~ No Underwriters Certificate on file. /5/ The check Is(outdated/not on file.) ~2~-- /~/ No Health Dept. Approval on file. /-~/ No final inspecLmon has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit Building Dept. ***/_~%Io Plumber Solder Certificate on file. ( all permits involving plumblBg being ~ssued after April 1,1984 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTHOLD, N ¥ 11971 TEL. 765-1802 CERTIFICATION Date Building Permzt No. Owner J~ ~ ~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this [~ day of . Notary Public,~~County Notary Publzc '{I-IERESA L BouCHARD Notary Pubhc, State of New No. 4859804-Qualdmd in Suffo? ~ rl£LD iLS-r"~- ' FOU~DATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING w INSULATtO~ PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~ ] FINAL DATE ~ INSPE~OR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL ,NS," CTO*, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~SU~TION FRAMING FINAL - BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / . [~]~NAL DATE/~~ INSPECTO~~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1O01071 BUREAU OF ELECTRICITY T--- 85 JOHN STREET. NEW YORK. NEW YORK 10038 MAY 11,1988 50631787/87 N 012195 Date Application No. on file THIS CERTIFIES THAT mdy the ~trteM equipment as d~cribed b~do~ and i~troduced by tl~ .ppdieaat waHu~d on the ~ ~ ~umber in the ~ examin~ off and~nd to be in ~m~ian~ with the r~ui~n~ of th~ ~. FIXTUIm RXTUII~S RANGI~ ~ ~9 27 SIRVIC] ~ S E R V I C E S/{O]<g DIiTIECTOR; - 2 G & S CONTRACTOR BOX 215 $OUT[{OLD, NY, 11971 This certificate must not be altered in any manner; return to the office of the Board /f incorrect. Inspectors be ide~ti~l by ~ credentials. BOARD OF HEALTH;7!''' 3 SETS OF PLANS 0:.~',.. Fo. No survEY -'4 .... TOWN OF SOUTHOLD CHECK ~- -~,'-~- - BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, NY 11971 CALL MAIL 70':''~'3~ ~- TEL.: 765-1802 Disapproved a/c ........................ .............. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This applicabon must be completely filled ~n by typewnter or ~n ~nk and submitted to the Budding Inspector, wi sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showmg location of lot and of bmldmgs on premises, relationship to adjommg premises or pubhc st, or areas, and g~vmg a detailed description of layout of property must be drawn on the d~agram which is part of thru a cation. c. The work covered by this application may not be commenced before ~ssuance of Budding Permit d. Upon approval of this apphcabon, the Budding Inspector will ~ssued a Buddmg Permit to the apphcant Such pe shall be kept on the premises available for mspectmn throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occup: shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Buddmg Department for the issuance of a Bmldmg Permit pursuant t, Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc Regulations, for the construction of buildings, add~tlons or alteranons, or for removal or demolition, as hereto desc~ The applicant agrees to comply w~th all apphcable laws, ordinances, bufldmg code, housmg code, and regulations, an admlt authorlzed inspectors on premises and mbulldmg for necessary~lon~ ~Slg~ature of apphcanl, or name, ff a corporanon) GREENPORT, NY 11944 it) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bm Name of owner of premises [~lP,¢' L~.m~.~ .. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) co. Ac o 's M ST SUF OL Builder's License No. [ ~0 3 Plumber's License No Electrician's License No Other Trade's License No Location of land on which proposed work wilt be done House Number ~5-- ~...5" 3; O~-!e~e? ~ County Tax Map No 1000 Section /~7/xfl Block Hamlet · c~ .. Lot. Ad. ....... 2 Subd~wsion (Nan~) ' .. Filed },lap No Lot . State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy . . .~~. -----~-~v . Z~-,4-~ .............. ;. b. Intended use and occupancy ~ ~ .................. 3..~t,~of work (check which applicable) New Budding .. Addition ...... Alteranon ~ ..... Removal ......... Demohtlon ....... Other Work ...... ~r (Descnp~tlo~ 4, Estimated Cost .,. ~,./~../y/~ ~o. .............. Fee ......................... ' (to be paid on filing this application) 5. If dwelling, number of dwelling umts ! . Number of dwelling units on each floor ........ If garage, number of cars . 6 If business, commercial or mixed occupancy, specff~ nature and extent of each type of use ...--"~'.. ........ 7. D~'nenslonsofexlstingstractures, lfany Front ~(~.~ ..... Rear. 1.~~. ..... Depth .~.~ ... Height ........ Number of Stones 0,~ .......................... D~nens~ons of same structure with alterations or additions Front ........... Rear ......... Depth ............ Height ............... Number of Stones ............... 8. Dlmensmns ofenbre new construchon Front )/~.~- .... Rear ........... Depth ........ Height ......... Number of Stones ................................... 9 Size of lot Front ............. Rear ......... Depth ........ 10 Date of Purchase .............. Name of Former Owner ................... 11 Zone or use d~stnct in which premises are situated ......................... 12. Does proposed construction violate any zonmg law, ordnance or regulation ...................... 13 Will lot be regraded .... Will excess fill be removed from premises' Yes 14 Name of Owner of premises ~1¢~..C~.~.2~k] .'.. Address .............. Phone No ......... Name of Architect .. · 0 a. ,0~ i~0¥[~£~rs ~ress ........ Phone No ......... Name of Contractor · - GRE~SPORI, NY 11~44 tress .......... Phone No ....... 15. Is this property loc .................... tidal wetland? *Yes ..... No ..... mil yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distmctly ail bufldmgs, whether existing or proposed, and indicate ail set-beak dimensions fn property hnes. G~ve street and block number or descnphon accordmg to deed, and show street names and mdwate whet] interior or corner lot. STATE OF NEW YORK, S S COUNTY OF ........ ............... bemg duly sworn, deposes and says that he is the apphca (Name of individual signing contract) above named tie is the ............................. (Contractor, agent, corporate officer, otc ) of smd owner or owners, and is duly anthonzed to perform or have performed the said work and to make and file ti~ apphcatlon, that all statements contained m this application are true to the best of his knowledge and behef, and that ti work wall be performed m the manner set forth tn the apphcatton filed therewith. Sworn to before me th~s ..... c~. ,.¢- ..... dayof . .~4~¢ ...... Notary Pubhc ............... ~~~ ~ County I C, V C