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Home My WebLink About14950-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16242 Date October 2, 1987 DECK ADDITION THIS CERTIFIES that the building ................................................ 4250 Breakwater Road Mattituck New York Location of Property ,. .......................................... ' .................... . Mouse No. Street Ham/et 106 09 0l County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 27, 1986 pursuant to which Building Permit No. 14950 Z dated ... J. ,u .n.c.. 7. .,..1.9. 8..6 ........... was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which ttfis certificate is issued is ......... DECK ADDITION TO EXISTING CABIN AS APPLIED FOR GUSSIE CANNONE & MC GURK The certificate is issued to ..................... [o'~n~),'~0~:'~ ...................... of the aforesaid building. Suffolk County Department of Health Approval I~ / A N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 TOWN O~ $OUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER.MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is herebt gronted to: .... ......... ...~..o....x....~..~.q. ............................................... ..... ot premises located at ....~..~...'~,.'~.....~~ ................ ~~.~ ................ County Tax Map No. 1000 Section ..... (..0..,.~.. ......... Block ....... .~..~. ....... Lot No ...... ..~..J. ............ pursuant to opplication doted ...... ~.....~.....'~....~ .................... , 19.~..(,~, and opproved by the Building Inspector. Budd,ng Inspector Rev. 6/30/60 FORM NO. 6 TOWN OF SOUTHOLD Building Department · Town Hall '~ Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in wpewriter OR ink, and submitted m _~,,.-~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final ~rvey 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 p~operty 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 buildings or premises, or other pertinent informa* tion required to prepare a certificate. ' C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre~existing dwelling $15.00 3. Copv of certificate of occupancy $1.00 4.Vacant Land C,O. $5.00~,, 5,Updated C.O. $15.00 Date ,. .~.-~. ......... NewtOns t~ct±on ...... Old or Pre~e×isting Building .............. Vacant Land ............ Location of Property . .~..~ ?..~ ........ .~./~.~_..~. House No. Street Harriet Owner or Owners0f Property J do ...... /r'..d/o ~ .~ ....... ~ .................... Countv Tax Map No. 1000 Section .. ~. (~..~ ....... Block ... ~ .~. ....... Lot ..... O...~' ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./~. h.~,~.'.Z: Date of Permit ~,/-2//~¢.Appl,cant..A,.~¢~.~'./.~.~/,'~T. ~',~.Af4.-~..~, . 4¥.~/..~'.~ Health Dept Approval /~.. ~.* Labor Dept Approval Underwriters Approval .... ~., ./~; .............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ........ .~., .~. O .. Construction on above described building and permit meets all applicable codes and regulations. Applicant ....... , ........ Rev. 10-10-78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11/)71 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /Z/ An application for Certificate of Occupancy is not on file. /5/-- No Underwriters Certificate on file. /--~ The cheek is(outdated/not on file.)~ ~~~ - ,,-- /5/ No Health Dept~ ApprOval on file. /5/ NO final inspection has'been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # _~/ Z ! ~.O Z Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 7GS-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING R.ARKS: ~'~ [ ] FINAL FIELD INSFECTION FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL COMi~ENTS ADDITIONAL COMMENTS I - . I~IA'r¢ITUCK. LONG ISL~NI~ CINV"ISI GNO'"I '~DnJ,.I,,LJ.VH FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined...~.'~ ..... , 19.~.~. Approved · .~, .,I,~r~, .~, ., 19~. Permit No. l .L(?.~..~Q..~,. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT L,.,,.,~w~,~ o~ SOU~HOLO Received ........... ,19... Date...o~./'~. ?. ......... , 19a~. ~' 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 shah 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 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 inspep'gions. (Sigfiature of applicant, or name, if a corporation) ·; , (Mailing address of applicant) State whether is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ................. :-. ........ .' ...... . .,6...o./. e. ............................................. ,c2 , Name of owner of premises . .-~.. ..... ] ....... k._, ~.~ ................. ,. ~. ~(~ ~.., .............. (as on the tax roll or latest deed) If applicant~ a_corporation, signature of. duly authorized officer. (Name and title of co,orate oftice~)/ Builder's License No ......... (.~.. ............. Plumber's License No ...... .~../~. ............... Electrician's License No.../~.A~: ................ Other Trade's License No..../d~.4:~ ............... ~,~ ~O 1. Location of land on which proposed work will,be done.~ ~ ~.~..~f~ .' ...... . .......... ..... House Number Street Hamlet County Tax Map No. 1000 Section ~ ~ Block ~ Lot.. Subdivision .~¢~.~.'~.,.. ,~.~.~g~ ....... 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.. Z .~.{~y. ff.~.CX.~[. ;; ....... ~ .................... ;' ~;7 O~lflEC~QeQ USe aha occupancy ............................. ;' r · ~" ' ....~ ................. ~ . .~ (Description) 4. [stimatea Cost ........... :../.2, P... ' o o Fee ....................... ~~' "~ ii '~' (to be paid on filing this application) 5. If dwelling, number of dwelling tlnits ............... Number of dwelling units on each floor ................ Ii'garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmcture~, if any: Front ............... Rear .............. Depth ............... Height .............. Number of Stories ........................................................ Dimensions of same structure wffh alterations or additions: Front ................. Rear .................. Depth. ................... ~.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new consm.~ction: Front ............... Rear ............... Depth ............... Height Number of Stories 9 Size of lot: Front .' Rear Depth 10 Date of Purchase i Name of Former Owner 11. Zone or use district in which prgmises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... 1 ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...! ................. Address ................... PhoneNo ................ Name of Architect .......... ................. Address ................... Phone No ................ Name Of Contractor ' Address Phone No pLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or dorner lot. STATE OF NEW YORK, f S.S COUNTY OF .... ;., .......... (Name of individual signing contract) above named. : (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dialy authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application filed therewith. Sworn to before me this ~. ?. .......... day f ..... ~ .......... , 19 Notary Public ..... ~---,¢-mw...~.'...~..~.~.~. .d~-~o . County ......... HREN I(.DEvOE ·