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Home My WebLink About16192-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-]6549 Date December 29, 1987 THIS CERTIFIES that the building ..... .C,o.n.s. ,t .r .u.c.t., .B.a. t, h. .r .o.o.m., ,A.d.d. ~. ~, .i .o.n. .......... Location of Property 2455 Westphalia Road Mattituck, New York /:/~t)S[" ~0~ ........................................................ Street Hamlet County Tax Map No. 1000 Section 114 ...Block I 0 ,Lot 2 3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Ju..n.e..30, I987 pursuant to which Building Permit No. 16192 z dated ....J.u, 1. y.'..8.,.. ! .9.8.7. .......... 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 ......... BATHROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APFLIED FOR The certificate is issued to RICHARD E. & EILEEN E. ODDON (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N8 108 I 6 PLUMBERS CERTIFICATION DATED: December 29, I987 Richard Oddon B~dlding Inspector Rev. 1/81 TOWN Of: SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BI:: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ...~ ....... ..o....~ ........................ ..~.~.~.~.~...~.~~....~..: ......... .... ..~q.~..~..:~.,...t.!.~.~.~. · at premisesUllocate' Ilar ..~.~..~...~.....JL.....~I/, ,.~.~.......~....:......~..~ ........ County Tax Map No. lO00 Section ...... J~.(..~. .......... Block ....... L.,Q. ....... Lot No, ....~...'~ ............ and approved by the pursuant to application dated ....... .....~j..~...~l,d~ ............. , 19~..L.,'~"~ / Building Inspector. Fee ,.o~.:......../..... Buff-ding 'Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 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 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-existing" land uses: 1. Accurate survey of property 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- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 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 O0 . 5.Updated C.O.~ ~ 50[00 Date ?"i~.-~,~ ~./ .... .... ,. ..... New C on s t r u c t ~ o n ,.~ .... Old (~r Pre-ex isting Building . . ~'~' ........ Vacant Land ............. Location of PropertyT/~.. . .... (/. House No. Street ' Ham/et Owner or Owners of Property ~.~.~.~.;~ .~.r~. .~.7.~.~¢/~/...,.~. ........................ ~...0'/..0(.~,, .....~. County Tax Map No. 1000 Section ...//.ff ....... Block ..... ./. ~ ...... Lot ................ Subdivision ................................. Filed Map No ........... Lot No ............... Permit No. /.b/.~.'.J'.~_Date of Permit ~.7.Applicant., ./,~,4,'~,(?,, ,(~,C'}/~I(fO,'O ........ He Ith pt App I /~/~. Labo D pt Approval a De . rova ................... r e ......................... Underwriters Approval ./~. ................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Su bm itted $,,, .C~,. ~"~. ................. Construction on above described building and per~!~eets all applicabl%c/~,des and regulations, Applicant .... , ,~, '?, ~'~_~,~.~ ............ Rev. 10-10-78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No./_~ Owner Plumber (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead, (plunLber' s signature) Sworn to before me this ~ day of Notary Public, --'--/ Notary/Public ~f~__County · ADDITIONAL COMMENTS: UNDATION ~ UNDATION UGH FRAME & (1st) (2nd) PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... FORM ............. 'FORM NO. 1 TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.:765-1802 CALL MAIL Examined...~. ~. · .~. ·., 19 .'~.7. Approved ........~ ~.., 19~..'7. Permit No. ].~.l. ~.~....~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT TO: Date .................. , 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 Inspector will issued a Building Permit to the applicant. Such permit shhll 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 sh~ll have been granted by the Building Inspector. APPLICATION 1S 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 auth°rized inspect°rs °n premises and in building f°r necesi~~. ~.~ .............. (Signature of applicant, or name, if a corporation) .../z .". ,:¥... (Mailin~ address of applicant) //~ State whether applicant i lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises d~>! ~. ~...~.(~... ~.. · .~/--'.//..~.~.(~.....~..~. d.~. ·~- .................................. (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 BF. SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No.. ~.~.O.../. 7. :~. ......... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on wlfich proposed work will be done~ .... ~ · · .~..~-. ?'..~.~..~.4.~. f?- .... .~. · · .~'-~. ......... House Number r Hamlet County Tax Map No. 1000 Section ...... Z Z .~ ...... Block .... Z~ .......... 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 ~S / O~.~7~/~ ~ . b. Intended use and occupancy ......... .~( 0 .~.~/~ .'/:~.~~ ............... 3. Nature of work (check which applicable): New Building ' Addition . Alteration ~t ~&~ ~d t~- (Descriplion) 4 Estimated Cost //~t~ ~ r___ Fee (to be paid on filing this application) 5. If dwelling, number o f dwelling units '/ 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 of existing st~ctures, if any: Front 4~.0 , ,Rear ~ ... Height . t. ~_X~.,~k...~;, Numbei' of Storie's .... ~.~ ........ '..'.. } ..................................... D,menJ~-f~a~l~lRtruc~¢re w~th alterations or add~tmns Front . ?...O ............ Rear .../P'.~i ............. Depth ........... ~ ......... :Height .. .................. Number of Stories ...................... 8. Dimensions of entire ne~v copstruc!ion: Front .... c,2..d).... ..... Rear ..... /..~ ........ Depth ..~.. ........... Height . ~... J.¢..T~t~. Number of Stories .-~ .................................................... 9. Size of lot: Front ./.~;3 .,ill~l~. ........ , Rear ... ,/.,~.4~ .P'.~..-~ ..........Depth .e~d..~. ~.2-3 .......... 10. Date o f Purchase .... ~.../,/~.~./(./~. ~' .,~. ........... Name of FormFr Owner .~.~'t. ¢...~.C~..~,.~. t~' ......... 11. Zone or use district in wt{ich premises are situated..,t'~.~ ?.W.q,..~...,~./ ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ,.'/rC.q ............................ 13. Will lot be regraded ........ ,,,'Z, eS.., .......... ~ ....... W~ll excess fill be removed from premises: Yes N~ 14. Name of Owner of premises . .A~.( ?..~.~..~..~. ~c~Address ( ?~-.~..lq..~.~.,(~..~..'... Phone No. Nmne of Architect ............ : ............... Address ................... Phone No ................ Name of Contractor /~ .c~.,.od.. f'..~(tfO:.~L/ ....... Address Phone No .............. [5. Is th±s property located w±'th±n 300 feet of a t±dal wetland? ~¥es ..... ~ ..... *If yes~ Southoid Town Trustees Perm±t ma~be roqu±red. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and, indicate all set-back dimensions from )roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. .~ O ~TATE OF NEW YORK, S.S 2OUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) ~bove named. is the .................................................. ~, ...................................... ~ (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or 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 york will be performed in the manner set forth in the application filed therewith. ~worn to before me this ................., .... day of .... ' NOT~,y PUBUC, Sta~ of New ~11~ No. 4707878, .,S~f~. ~!k ~4~i~~' (Signature of applicant) Term Expires