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Home My WebLink About16561-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24990 Date APRIL 18, 1997 THIS CERTIFIES that the building Location of Propert~ 6105 WICKHAMAVE. House No. County Tax Map No. 1000 Section 107 Subdivision ACCESSORY MATTITUCK, N.Y. Street Hamlet Block 4 Lot 2.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 21, 1987 ~ursuant to which Building Permit No. 16561-Z dated OCTOBER 23, 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 ACCESSORY BUILDING ~ RENOVATION OF EXISTING ACCESSORY BUILDING AS A~PLIED FOR. The certificate is issued to of the aforesaid building. LAURIE WHITE SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PENDING - APRIL 11, 1997 N/A //B~lding-Inspector ~0~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-16561 Z Permission is hereby grunted to: /~ ....... .......... ...~,~..~,...L~,.~. ............................................. .~_..... .......................... : ........... :: .......... .:.....,.....~ ............ ~.........~ ..................... ~ : o, prem,ses,ocoted o,...~..!.~ ....... ~.....~.....~' ~~&. ........... County Tax Mop No. 1000 Section .... ..~...0.....'~. ........ Block ....... .~..~ ....... Lot No...,'~t..?....~ ...... pursuant to application doted ..... ..C~...~....~....:~.~ ................ , 19..~....'], and approved by the Building Inspector, .ee Rev. 6/30/80 Form No. 6 BUILDING DEPARTMENT TOWN HALL ~.~, APR 1 5/997 ~ ,, 765-~802 BLDG. DE,~I APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF $O v~'lOI ~ This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. Final Approval from HealtE Dept. of water supply and sewerage-disposal(S-9 fo~). 3. Approval of electrical installation from Board of Flre Unde~iters. 4. Sworn statement from plumber certifying that :he solder used im system contains less than 2/10 of i% lead. 5. Co~ercial building, ~dustrial buildimg, multiple resiAemces and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. S~bmit Plannimg Board Approval of c&mpletad si~e pla~ requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect sigmed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in w-~iting to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, ALterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-~xistin~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - , 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.p0, Cgmmercial $15.00 ...... ...................... New Construction... Old,Or Pre-exi~ting Building.. ~oeation of Propert~.:~.'~.~:/~...~ ........ :::::::::~.ZT~..~..C/C ..... House No. Street HamLet Onwer or Owners of Property ................................ .. .... · · ,/ ~ounty T,= ~p ~o ~0o0, Section .... --"'"~..~./ .... Bloo~ ...... ~.. ....... ~ot .... .~'.............Z'' .. Health Dept. Approval. ;'. ~ ............. Underwriters Approval ......................... Planning Board Approval .................. .. . ... Request for: Temporary Certificate ........... Final Cer~icate ........... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY / DATE ,INSPECTOR z.S~ ~ ~ zO~ IIDATE COMM£NTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~c't~- RS THE NEW YORK BOARD OF FIRE UNDERWRITE WE ARE IN THE PROCESS OF ISSUING A CEFfflFICATE OF COMPLIANCE FOR THE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: ROUGH PLBG. INSULATION [ ~']~NAL ~~::~ DATE INSPECTOR ~~,/~/~---~ LD6S'~802 lNG DEPT. INSPECTION ] FOUNDATION ZST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL REMARKS: I NSPECTOR~:2/ BOARD OF 3 SETS FORM NO. 1 SURVEY TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. O~.~. ~-,. .~..~, t9 .~.? Approved .~:>..~...~l~.... ~ .~., 19~..~. Permit No./..~.~..~../..'1~. HEALTH ...... OF PLANS ....... FORM ............. : CALL ................ MAIL TO: DisapproVed a/c ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT IN STRUCTION S a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stree' or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl 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 perm 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 Occupanc 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 ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ( Regulations, for the construction of buildings, additions or alterations; or for removal or demolition, as herein describe{ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspections. . b'(Si}nature of applicant, or name, if a corpo at'on) .4...o. , , . . . . .f . / ...... (Mailing address o~ appucal~t) . State whether applicant is.owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of premises . .~0.¢.~(.~,../~., .~.. LO*t/k~'.{.e,-, .'~.~..,....~.[CI t .~ ......................... (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 MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber s License No ................ I. ...... '.. Electrician s License No ......... /'.. L :.~· ........ Other Trade's License No ...................... I. Location of land on which proposed work will be done ................................................. (~ [ 0 ~' '/~ulnoer~)~se ', ~,~,-.~')J ~["h' ' ~'czFl ~'' ~'' J~--'"~ "~'C 1(-' 'r Ct O~-. Street ' ']'~' ' *' ................... Hamlet ; ........... County 'fax Map No. 1000 Section ..... /.0.7 ....... Block .... .~. .......... Lot..~',~ :'~, ....... Subdivision ..................................... Filed Map No ............... Lot .............. ' (Name) ~ 2. State existing use and occupancy of premises and intended use aBd occupancy of proposed construction: a. Existing use and occupancy ~.~ .Q ~-~ ..... '~'i\ ,* ~'.i..'.k~; ~ .. ............. b. Intended use and occupancy ...... .: ,..,?...,:...?.,!-;-w) ;,.. ;::,. ......... 3. Nature of work (check which ~pplicable): New Building Addition ...... Alteration ........... :Repair ............... Removal .............. Demolition .............. Other Work ............... ~ ~.~ (.Description) 4. Estimated Cost...].~.01~,. i .......................... Fee ..................................... I " (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 mix'ed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structm'es, if any: Front ............... Rear .............. Depth ............... Ndmber of Stories Height ............... . .................................................... Dimensions'of same structure with alterations or additions: Front Rear Depth ...................... Height ...................... Number of Stories ...................... '-8. Dimensions of entire new conitruction: Front .... [.(~./... ..... Rear .. J~ ~ ......... Depth . ]~7¢.f .......... Height ............ Nh'tuber of gtoriaq . . ~ ................... . . . 9. Size of lot: Front ......... } ............ Rear ...}.~! ................ Depth . 10. Date of Purchase ...... l ~J. ~'.(o ................ Name of Former Owner .~J~rr~¢~..~y.c~q .~./'o@ ~ ....... 11. Zone or use cmtnct m which premises are mtuated. 12. Does proposed construction violate any zoning law, ordinanceoffregulation: ...~.(.9., ......................... 13. Will lot be regraded ....~0. .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .~.rFC.a. 5. .a'.~.fflt'C~.~7~. Address .................. Phone No. ~g.'.~.~ .... Name of Architect ........ i ................... Address ................... Phone No ................ Name of Contractor ....... ~ .................. Address .... : .............. Phone No ................ 15. Is this property locate~ within 300 feet of a tidal wetland? *Yes ..... No .~.. *If yes, Southold Town Trustees Permit may be required. ~ PLOT DIAGKAM 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. STATE OF NE e ~ . .... ° ~'t;ic'ti ' being duly sworn, d~poses and says that he is the applichnt above named. 0 r" . He is the .................... ~ .............................................................. (Contractor, agent, corporate officer, etc.) of said owner, or owners, ad is duly authorized to perform or have performed the said work and to m~e and file this application; that ~II statements cohtalned ~ this application ~re true to the best oehis know]ed8e and belief; ~d that the work w~l be perfo~ed in the m~.ner set ¢orth in the ~pplication ~l~d therewith. Swo~ to before me this ............. S ............. ~;ta, Pablic, .~~.~.,.. County . . ~ ~ ~ ~ ~ ·.. F~,~ ~.~..~ ..... ~.: ............. n~ ~7~ ~ / ~ I (~]gna~ure of applicant: QuaI~ In 8u~lk CouflW ~mf~n Explre= ~. ~.:~. ~ t~olll~ for th~s lo~attO~ ~e been ~n~oot~d bF this de~rt~t ~ f~d j ~:'. ~ SUPF. CO. DEPT. OF HEALTH $[RVICE~B .... , , , ~ ~0~ APPROVAL OF CONSTRUCTION only APPROVED: