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Home My WebLink About15433-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Z-15172 O[ Occupancy Dat V. ?.'. . THIS CERTIFIES that tile building Accessory building . 280 Riley Avenue Mattituck, New York Location of Property/;$~ ~ ~o~ ........................................................ $ Street Hamlet County Tax Map No. I000 Section ... 1.4..3 ...... Block .... 0.5. ......... Lot ..... 7.: .1 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated O.c,t..ober. ,21 19 .86p hi hBuildingPermitN 15433Z ...... ' ......... , . . ursuanttow c o ...................... October dated ................. : ........... 19. , was issue and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued i~ ......... Accessory building as applied for. The certificate is issued to ... FRANK L. McGOWAN .................................(owner, le~ ~Y~k Y ................... of the aforesaid building. Suffolk County Department of Hea/th Approval , N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector ~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 15433 Z Permission is hereby granted to: .~.~.~ ....... ~....~..,.....~..~ ......... o~.do~ ~.. l.o..~.Ao ..... ....... .............. ot premises located at ..~...~...0. .. .*. ................................... County Tax Mop No. 1000 Section .... ./,...~,...~. ......... Block ..... ,(:~,.~,~ ....... Lot No....,?,;..! ............ pursuant to application dated ..... .~...~..~...~.....~..I.. ................ , 19..~...~.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bdilding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ 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. 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- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property...~..~.~',..~./..Z~.x. ,,~. ~¢.4~..,." .,~.. ,~/...;~. ~.j..~r~../ .................... House No. Street Hamlet, Owner or Owners of Property .......................................... County Tax Map No. 1000 Section .Z ~..-~.. ........ Block ·..-~..'-. ......... Lot.. '~"~ .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~'T~ Construction on above described building an~rmit.~ts all applicable codes and regulations. App icant ............ Rev. 10-10-78 ~OUNDATION ( 1st ) 'OUNDATION (2nd) {OUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye INAL ADDITIONAL COMMENTS'. I'GS-X80Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL FORM NO. 1 TOWN OF SOLITHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971.,. TEL.: 765-1802 E×amined 19 Approved .O.~-~..~q'. .~..o~., 19 g.~. Permit No..J.~.~ .~.~-..~... Received ........... ,19... l~isapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT Date /..~. - /~ 19.~.d' INSTRUCTIONS a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accnrate 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 appl[- cation. c. The work covered by this application may not be commenced before issuance of Beilding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permil 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 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 descnbv, d. 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 insp~.e.qtions~,. ,,,.,..,~...__~a,,,~,~,,,_~'~ .'~:...~. · (Signature of applicant, or name, if a corporation) ... .,id, ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.._ Name of owner of premises ...~e~.d~....~.'..,~.f..~.~.~r/.~..~?...~. kg'..~. ......... ............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done. ........ ..... · House r; i '" Number Hamle~/ County Tax Map No. I000 Section .... ./.~.'~. .......... Block . ..,~. .............. Lot...fi../ .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing usc and occupancy .................................... ~'.~ ~3:~.,q~.~t,~ ...................... b. Intended use and occupancy . ~ .e ~. ~. · · ~/~ ,t~,t.l,r~..~v,~,~ ~,~;',~%t~o ............. s3 Nature of work (check which app icable): New Building ...... Repair .............. Removal . Estimated Cos ........ If dwelling, number of dwelling uDits ............ Demolition .............. Other Work ............... (Description) (to be paid on filing this a.pplication) .......... Number o}' dwelling units on each floor ................ If garage number of cars If husmess, co n nercml or mixed bccupancy, specify natnre and extent of each type of use ..................... ..... if any: Front Rear Depth Dnnenmons of existing structures, ............................................ Height ............... Nu nbbr of Stories ........................................................ Dhnensionsof same structure with alterations or additio s: Front ........ ear ................. Depth ...................... . Height ........... ........... ~umber~f Stories ........... Height ....... ~ ..... Nu, mbler of Stories ..................................................... 11 Zone or nsc district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................ 13. Will lot be regraded .. ~ .... i .................. Will excess fill be removed from premises: Yes ~.~ N fO fp ' Addi' 14. amc o wner o remises .... i ................ ess ................... Phone No ................ Name o£ Architect ........... i ................ Address ................... Phone No ................ Name of Contractor ' Address : Phone No 15. Is this property located wlithin 300 feet of a tidal wetland? *Yes ..... No .~... *If yes, Southold Town Trus't~es Permit may be required. ' PLO'I' DIAGRAM Locate clearly and distinctly all .buildings, whether existing or proposed, and. indicate all set-back dimensions from )roperty lines. Give street and block npmber or description according to deed, and show street names and indicate whether nterior or corner lot. , ? :OU~Y OF .~F~xZ~ .. , ~ , K ............ ~. d.~. ~,~ ........... > bang day ~orn. aCpo~, ~d ~y, that h~ i~ th~ ~pp~i~t (Name of individual signihg contract) ,bore named, I¢ is the ....................................................................................... (Contractor agent corporate officer etc ) .~f said owner or owners, and is dul~ authorized to perform or have performed the saki work aBd to make and file this .pplication; that all statements conta'ined in this application are true to the best of his knowledge and belief; and tha.t the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this i ......... ........ day ........ 19 '" ' '. ~'otary Public, · .... ~! ......... Coun y ALVE~A KELLY - ........................................ Oaall~ ~. ~v~r ~ ~ (Signature of applicant)