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Home My WebLink About16501-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certil:icate Of Occupancy No. Z16545 Date December 29, 1987 THIS CERTIFIES that the building . .A. 1..t .e.r.a. ~..i .o.n, .................................. Locati nnfPrn tv 1075 New Suffolk Ave. Mattituck o v vper.~ ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section . ] .I .4 ........ Block . . ! .I ........... Lot 24 . 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 0 c t. 5, 19 8 7 pursuant to which Building Permit No. 165 0 1 Z - dated . .0.c.t.:..7 .,.. [ 9. .8 .7 .............. was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... A], ~.e,r.a. ~ .i.o.n..w. 9.r.k' . t. 9..c.a..r p.e.n.t..e.r..s.h. 9 p.. .................................... The certificate is issued to David L. Reeve ..................... ?o¥o'o) , ~,~i~,~?r X .................... of the aforesaid building. Suffolk County Department of Health Approval ........ .N./.A. .................... UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FOBM NO. S TOWN OF SOIJTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 16501 z Permission is hereby granted to: .../..~..~.~:..-:..~ .~...~..~~z~ . . ...~f.....~..,...._, ~.. o~ ~,.~,o~o~ o~ ..... ~..~..~..>.~.~......~.~~..~ ............ County Tax Map No. 1000 Section .... ./.../....~., ...... Block ....~.../ ........... Lot No .....~..,.'.~'.."...Z. pursuont to opplicotion doted .... ...~...~ ......... ~ .............. , 19 .~.~ .7, ond opproved by the Building Inspector. Fee ~../..~.,p...../..~.,~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - t802 APPLICATION FOR CERTIFICATE 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: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposel--(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-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- t/on required to prepare a certificate. C. Fees: Additions $25.00 lo 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 $ years $]0.00 4.Vacant Land C.O. $ 20.00 ~ ~ ~ 7 5.Updated C.O. $ 50.00~ Date .... '~.i...~.=.~ ........... NewCOnstructiOn ...... ~~g ............ Vacant Land ........... Location of Property ... House No. /~ ~ Street Nam/et Owner or Owners of Property ..... ¥~, (,t,,~.... ~..~, .~ ./... ........................... ''' County Tax Map No. 000 Sect,on. Subdivision ........................... Filed Map No ........... Lot No .............. PermitNo.~'..I;~;; ..~-DateofPermJt [g:7:~.~...Applicant .... .~.Ov~-~..~. .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~ ............... Construction on above described building and r~nlit meets all applicable codes and regulations. Rev, Ia-la-78 THE NEW YORK.u~_,~uBOARDoF .,~-==n~cn~OF FIRE UNDERWRITERS ~' 85 JOHN STREET. NEW YORK. NIiW YORK 10038 THIS CE~IFIE$ THAT ATT] (' ~ exami~ on ~OV~ ~0 ~ ~ ~ and~nd to ~ in compliance with the ~ui~men~s o~ this RX~ RX~ SIRVlCl OISCONNICT S ! R V I C I cc. C~". return to the office of · This certificate must ret be ahetdBcl in any ~ ~C~(X~_~_BUIU){~ DEl) ~/~1. ~. ~S~ M~ ~TIF~T_E )AJ~T:NO? .Mi &L~. IN~A#y .MI44R~ _. TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OFSOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. NOTIFY MAIL TO: No../. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOB BUILDING PERMIT TOW~-8 F 'Sb~JTI~OLD Date .... 1.0 :~,~. ....... ,19~.~. 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 Inppector 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 purpos~ 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. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is. owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ' . 9.0,3~ .... .~A3~..~a.,~:vtg~ .... r~~ ...................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co, orate 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...-~.~. ~ .% . [4~t~..-7...'~-[r~ C~c ecy ~v~) 0~0,xaa-y 1. Location of land on which proposed work will be done .................................................. ............... ............... House Num bet Street Hamlet County TaxMapNo. 1000Section ...t..I...q ........ Block .... t..t(. ........... Lot. .q.,.l .... . ..... 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 ..... .~.~'r6q .Jr~... 4 ¢0(~ "' . b. Intended use and occupancy ...... . .~. ' .p~. i .~ .'~. ~/i iiiiiiiiiiiiii iiiiiiiiiiiiiiiiiiii.ii $. Nature o£work (check wh:ch apphcable)~ New Building ..... ' ..... Addition Alteration ........ Repair .............. Removal .............. Demolition ..... · ........ Other Work .~.~../.? /~ (Description) 4. Estimated Cos ~ ...................... .... Fee. f'f.'./ft~.~..t.~.~. ...................... (to be paid on filing this application) 5. If dwelling, number of dwallinglunits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... :..., ........... 7. Dimensions ofexis, tjng structures ffany: Front .... ; .......... Rear .............. Depth ............... Heigh~ ' ' . ' Number of Stories ' Dimensions of same structure ~vith alterations or additions: Front ................. Rear .................. D pth ' Hight Nub of St les e ................... i · · e ...................... m er or ...................... ". 8. Dimensi6ns ofentire riew const ction: Front .......... . ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9 :Size of lot: Front [ ' ~ Rear Depth 10. ])ate of Purchase .......... ; ...... Name of Former Owner ............................. 1 1. Zone or use districJ ~n which premises are situated ..................................................... 12. Does proposed construction vioIate any zoning law, orcfinance or regulation: ................................ 13. Will lot be regraded ........ i ................... 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 L Address .... :. .. Phone No. 15. :£s this property located [within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town TrUstees Permit maybe requxred. ' PLOT DIAGRAM Locate clearly and distinctly alI buildings, whether existing or proposed, and, indicate all set-back dimensions from prop6rty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. . S.S i ..... being duly sworn, deposes and says that he is the applicant. (Name of individual sig~ing contract) above named. He is the . ~ . , ................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application ;x . that all statements, contained, in this. application, are. true. to the best. of his knowledge and belief; and that thel work Will be p. erfoaned m the manner set forth ~n the apphcatmn file~d therewith. ' Swo~rn tb, xbefore me this j .... · ~. ......... .~ ........ day olf. · ·, .O..C~.. ..... ; ......19 ....... County . .. 7o7878; Sulfolk Count,~¢ (Signature of applicant)I i~rm r. xpires l~rch ~, 1,~ ~! I ?'iELD FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY CODE {1st) FINAL CO~£~T~ (2nd) YJ ADDITIONAL COMMENTS: