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Home My WebLink About15394-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y, Certificate Of Occupancy No. Z15428 Date N..ov.e.m. ber 26 ............. 1986 THIS CERTIFIES that the building ..... .A.c..cg.s.s.Q .fY ................................ Location of Property ... 420 ,BAYER ROAD MATTITUCK House No. Street Ham(et County Tax Map No. 1000 Section L3p ...... Block ..... 3 ......... Lot .... 2]. .... ~.- ...... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated oce. 3 .9.8.6 5. 3 ..................... , 1 . pursuant to which Building Permit No .............. dated . . .O.c..t.,..9. .................. 19..8.6, 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; shed. The certificate is issued to GEORGE AND PATRICIA KRISS. (owner, of the aforesaid building. Suffolk County Department of Health Approval ..... N/A UNDERWRITERS CERTIFICATE NO .............. N/A ................................ Rev. 1/81 I5 UlI(II? inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDII~IG PERi, IT t"I'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 15394 Z Permission is hereby granted to: ..~...~.~.~..~:.~..~....~i ......... .... ~.~...o......~....~.......,~.........~... .............................. ......~.~....~.~.~..,..J.~.~.~..~ ..... . ~ ...... . ~. ~.~ ..~.~ ......... ~.:~ ........................ ot pr~m~o* I~oted ~t ........ ~. County Tax Map No, 1000 Section .... ./...,,~...~. ........ Block ...... .i~...4~. ...... Lot No ...... -,'~,..! ............ pursuant to appJicotion doted ..... ~....~...T~...~...~,......~ .................... , 19.,~...~.., and approved by the Building Inspector. Building 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 iprior 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 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 inspection of bui{dings or premises, or'other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of oc_cupancy $5.00 , 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.U.odated C.O. $15.00 Date ..... NewC°nat~ucti°n . Oki or Pre-existing Building ............ Vacant Land ........ Location of Property ..................... House No. St/~ Hamlet OwnerorO.nersofPrope.y County Tax M ap No. 1000 Section .../~..~ ....... Block ...... ~ ....... Lot .... .~-~.../ ........ Subdivision ..................... -~ ........... Fired Map No .... ~-~..-....Lot No ....... ~, .--~,,,. , //- Permit NO. ~-¢¢, ~.~.¢,..~-Date of Permit ,/ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Subm,tted :. ...... Construction on above described buildin~C-C'~mit meets all a~/~icable ,codes and ragu lations. Apphcant~~ ......................... ~'IELD I ,S, aC,iON 1. FOUNDATION {1st) FOUNDATION (2nd) --~ ROUGH FRAME & ,PLUMBING INSULATION PER N. Y. '' ~ STATE ENERGY CODE .. FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .O.~..C~. .... , 19 ~>.[,. Approved .~..~..~...~. · ·., 19~.G.. Permit No.]..~.~.~.q.~.. Disapproved a/c .................................... (Bmlding nspecror) APPLICATION FOIl BUILDING PEIIMIT Received .......... ,19... Date ...0.~..l;.o.b.e.r.. 3 ...... 19 ..8.6 INSTRUCTIONS · ~ a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 qets 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 tins 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 shall be kept on the premises available for inspection throughout the work. e. No building shail be occupied or used in whole or in part for any purpose 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. ............. .fij (raai2L±ng address of app ±cant:) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0~ er (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 ...................... 1. Location of land on which proposed work will be done .... ./4,.2.0...~.87.e.~...~.o..1~. ?..M?.~.t? .[ .~.u.o..R ................ .... ...................... .................. ...................... House Number Street Hamlet County Tax Map No. 1000 Section 159 Block .3. Lot... 21 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .8.?1.~.1..e..~.8.~1. ~?..y..d:.l~..e.i.l.l. rl..~ ....................................... b. Intended use and occupancy utility she~ ' 3. Nature of work (check which applicable): New Building .......... Addition.. ~ ........ Alteration .......... ~ Other Work ~i1~ V,p Sb.~ Repair .............. Removal .............. Demolition ......... , ....... , (Description) 4. Estimated Cost ........ ~.~.0.Q ......................... Fee ........ i ............................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .. ' ..... Number of dwelling units on each floor.. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .-.--.'. ...... 0 7. Dimensions of existing structures, if any: Front ..... 30 ! 3.~ ..... Rear . 3.... ~ ............. Depth' Height ............... Number of Stories ....2 ................... l ............. Dflnensions of same structure with aiterationg or additions: Front ............ [ ..... Rear ................. Depth ...................... Height ...................... Number ofiStories ..................... 8. Dimensions of entire new construction: Front ...... I~ i. ....... Rear ..... 8..~. i .......Depth . .~.2..~ ......... Height .... .~ 1. ...... Number of Stories '1 . 0. Size ofiot: Front" ..... ' ........ ........................... Depth rS0' ............ ............. Rear ....................................... 10. Date of Purchase . ~.xI.~.F.. ~.9.8.~ ................. Name of Former Owner .]..l~o.y..8.~.~..k.ey.a . .~.ll~..~.d..e? .... 11 Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: ....I3.O. .......................... 13. Will lot be regraded ........... n.a .............. Will excess fill be removed from premises: .Y?s No Name of Architect Address ' Phone No Name of Contractor .......................... Address ............... ! .... Phone No ................ 15. Is this property located withinl.00 feet of a tidal wetland? * ~es ..... No ..~.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM 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 NEW ~~ COUNTY OF ..... ~ ~ ........ S.S ................................................. being duly sworn, depc (Name of individual signing contract) above named. scs and says that he is the applicant He is the ............................................................. ' ........................... (Contractor, agent, corporate officer, etc.)I of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of hil knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith, Sworn to before me this ................ ~. ...... day of....~...O-c~.. ............ 19 ...~. Notary Public, . ..... ~ff~....~'...~..~...~.d~..-.... County//~ )/~,~ // , ~.,,~10~...~_~~ . (SCfgnature of applicant) Term Expires l~fch 30,1~.~,~" HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT plot JULY 20 REVISED: APR 3, /984 SURVEY FOR ROY STAKEY ~6ART OF LOTS NO. 61 ~ GS , "AMENDED MAP OF MATTITUCK HEIGHTS" A'r MATTITUCK DATE= DEC. 5, 1983 TOVtN OF SOUTHOLD SCALE, / "-' $0' SUFFOLK COUNTY, NEW YORK NO, 85-/042 GUARANTEED TO: USLIFE TITL~N~ $URANC~ CO. OFN. Y. \ NOTE .' ·: MONUMENT 0 -' PIPE SUBDIVISION MAP FILED IN THE OFF/CE OF THE CLERK SUFFOLK COUNTY ON 'JULY ~,l, 1955 AS FILE NO, 1184. YOUNG YOUNG ALDEN W, YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR NY_S, UCENSE NO, 12845 ~I~WARD W. YOUNG, LAND SURVEYOR N I' S, LICENSE N0.4§895 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK