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Home My WebLink About15491-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Off~ce of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.., .Z.1.5.1.0. 7 ...... Date ..... N.o.v.?.mb.~/...1.7 .............. ]9. 86. THIS CERTIFIES that the bmldmg , R¢~oq~ .~gges~Q.~y..]~u~.~lng ............. Location of Property 2850 Deephole Drive Mattituck House No Street Hamlet County Tax Map No. 1000 Section . 3.2.3. ...Block .0.4. ........ Lot ...~.3. .......... Subdtvtston .................. Filed Map No ....... Lot No ............ conforms substantially to the Apphcat~on for Bmldmg Penmt heretofore filed ~n this office dated .... .M.a~c.h..31 . .. , 1986 pursuant to wluch Braiding Permit No .... 1.~4~.1g. ........... dated , .Ng.ve, n~r 13 ....... 19 J3(;, was ~ssued, and conforms to all of the reqmrements of the apphcable provisions of the law. The occupancy for which this certfficate is ~ssued ~s ........ ·.. R~.loca~a .acc~s$or~ .bu;~lc~ .............................. The certxficate m ~ssued to . CP~ISTJ. N~ &. J~D~D VI.O. LSy ........................ of the aforesaid building. N/~ Suffolk County Department of Health Approval ...................................... UNDERWRITERS CERTIFICATE NO N/A Rev 1/81 I~OWM NO. J~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permms~on ~s hereby granted to' ~.~;,~.'~-~... ................ ~ .......... ~ :,~--~'~ ....................................................... premises located at ..,e~.~...~."J~.,,..~...~~.,--.~/,....:, .......................................................... Count~ Tax Map No 1000 Sect,on .. )..~ '~ . . Block ...... ..C~...~. ..... Lot No ..... )...~.. .......... pursuant to apphcatm, dated . .)~.~ ~ ~ .., 19.? k and approved by the Bumldlng Inspector, Rev 6/30/,90 OUNDATION ( ls t) OUNDATION (2nd) ~OUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N,Y, 11973 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~==~ to the Building Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of property w~th 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 simdar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buddings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing al~ 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 mspacUon of buildings or premises, or other pertinent informa- Uon required to prepare a certihcate. C. Fees: /"~ ~') 1. Certlfmate of occupancy ~. $5.0~0// 2 Certificate of occupancy on p'Te-ex~stmg dwelling $1 5.00 3 Copy ofcert,flcateofoccupancy $1,00 ~ ~1~. / /~y~ 4.Vacant Land C.O. $5.00 ~ ~ 5. Updated C.O. $15.00 Date ................. f. ....... NewConstruction ...U~.Oldor reexmt~ng ~ m ...... ant an ........... ..... P - Buld g ...... Vac L d . . Location of Property ....-=-~.,-.~, .......................................... .. ... .. .. O,,ner or Owners of Property Lot.. 1.~, ...... -- /z: County Tax Map No. 1000 Section ............... Block ............. Subd~v~mon ............................. Filed Map No, . -- - .. ,Lot No. ~. ,.~7 ........ Permit No .......... Date of Permit .......... Applicant .................................. Health Dept Approval /t'///~t .Labor De reval .. ,/?./:,/~, ........... ........................ pt. App ...... Underwr,ters Approva~ ..... ~//4 .............. Planning Board Approval ..... ./C///~ ............ Request for Temporary Cert~fmate .................. Final Cert~fmate ....................... Fee Submitted $ ........................... J~m ble~..pdes and regulations, Construction on above descmbed budding an ~t mee~l~a, pphc/( .......................... Approved FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.. 7654802 1 ~ , 19g.~ Permit No - 7 Ins Recemved ........... ,19. Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins application must be completely filled m by typewriter or in ink and submitted to the Budding Inspector, wltl sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stm. or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of thls apl cation. c. The work covered by tins apphcatmn may not be commenced before issuance of Budding Permit d. Upon approval of tins apphcation, the Budding Inspector wall issued a Bmldmg Permit to the apphcant Such peru shall be kept on the premises avadable for inspection throughout the work. e. No budding shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmldmg Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulations, for the construction of bmldmgs, ad&hons or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply with all apphcable laws, ordinances, bmldm~g code, housing code, and regulations, and i admit authorized inspectors on premises and m building for necessary msp~flgns //] I /J ........ (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 bmldm .. Name of owner ofpremises .~.~ .q'~/~tiJ~ ~?d~4~.O-~ ~/dr~.~i .. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No Plumber's License No · Electrician's License No Other Trade's License No. .2\. .. Location of land on which proposed work will be done Ho~e Numbe~ Stree~ County Tax Map No. 1000 Section Hamlet . .. Subdivision (Na~ne) . . Filed Map No . . Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use arid occupancy b Intended use and occupancy 7~O& ~J//~-~) ...... 3. Nature of work (check which apphcable) New Bmlding . .x;{ Addition ..... Alteration .... Repmr Removal .... Demolition .... Other Work.. ~--d? (Descnptmn) 4. Estimated Cost .. ~9 ............... Fee ..... (to be paid on fihng th~s application) 5. If dwelling, number of dwelhng umts ...... Number of dwelhng units on each floor ~ ..... If garage, number of cars .. 6. If business, commercial or mixed occupancy, specffy~e and extent of each t~.~j(~ of use . .'----w~.. .... 7. Dtmenslons ofe,x)stmg structures, ffany Front .~ ...... Rear .. ~... Depth ' .~.' f Height . .~ . . Number of Stones . .. .Z~ ............... D~menslons of same structure w~th alteratmns or additions Front ~ ..... Rear - . ....... Depth ....-W. .......... Height W ........ Number of Stones .... ~ ......... ?~ '~" /.,?'Z~" ~"'cO ', 8. Dlmensmns of entire new construction Front . /. ...... Rear ........... Depth .......... Height ~.~ ~' Number of Stones . . . t~ .............................. 9. Size of lot Front ................ Depth .......... 10 DateofPurchase fi/~9.f.., 2~'~g~ ...... Rear ............... Name of Former Owner k~.~ ./~.)f. ~..~. ~v~.~..'. ..... 11 Zone or use district in which premises are s~tuated ........... 12 Does proposed construction violate any zomng law, ordinance or regulatmn .. .'~'/~ ....... 13. Will lot be regraded ............. Will excess .fi~ll b,e removed from premises Yes Nt 14. Name of Owner of premlses . b~/)Z~. ...... Address ..'SF_~ ./~.df? . .PhoneNo ' Name of Architect ~ ........ Address . .'f2'~... .... Phone No Name of Contractor ..... ..~ .......... Address .....~. . Phone No...x~x. ~'' . PLOT DIAGRAM Locate clearly and dlstmctly all buddings, whether existing or proposed, and indicate all set-back d~rnens~ons fron property hnes. Gwe street and block number or descnptlon according to deed, and show street names and indicate whethe interior or corner lot STATE OF NEW YORK, S S COUNTY OF .. (Name of individual s~gmng contract) above named · bemg duly sworn, deposes and says that he is the apphcan 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 apphcatmn, that all statements contained m this apphcatmn are true to the best of his knowledge and behef, and that th work wdl be performed in the manner set forth m the application filed therewith Sworn to before me this Notary Public, ~/c .~,,_....~.../~. f .~.~... County HrlEN K. DE NOTARY PUBLIC, State o~ New Yerk Ne 4707818, Suffolk County~ Term Expires M~rch 30, l~ ,~-/ ........... y' iklgn~tt~ie' ;f al}Plilln'i