HomeMy WebLinkAbout14989-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z15829 Date June 9, 1987
THIS CERTIFIES that tbe building sunroom addition to dwelling.
Location of Property 1185 Res ewood Dr ive Mattituck
House No, Street Hamlet
County Tax Map No. 1000 Section ...... 1.1.3., . .Block ....... 2. ....... Lot 4
Subdivision ..... .R.o.s.e..wp.o,d,..E.s.t,a,t. ?.s ....... Filed Map No...5..2.4.0. .Lot No.19
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... g..u. .rig. .2. , . .1.9.8. 6. ..... pursuant to which Bttilding Permit No.. 14989Z
dated ........ .J.u.n.'e...1.6.,...1.9.8.6. .... was issued, and conforms to all of the requirements
of tile applicable provisions of the law. The occupancy for which this certificate is issued is .........
Sunroom a~tdition to an existing dwelling.
BRUNO & CAROL SABAT
Tile certificate is issued to ...........................................................
of the aforesaid building.
SuffolkCountyDepartmentofHealthApproval .................. ~/~ ....................
N807513
UNDERWRITERSCERTIFICATE NO ..................................................
PLUMBERS CERTIFICATION DATED:
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)
14989 Z
Date ....... .~..J';:']..~. ................................. ,
Permission is hereby granted to:
...... ...... ........
..... ~x..../..~.'l..&.....~.~.~.,,v.....,~v~
.... . .H...,~.'~..c-[.~ .c/~.,,..~:..~......¢. !..~ ..~..~
........ .C:..q ~.;~../~ .~..¢.~.. .................. ,,m..~. ~,,. [-~.~. ~...~.~..~,.L~ ....................................
.:E~..c,..~....~~.c..~.....~ ................ ~.~ ...................
~, ~,~ ~,~ ..... l.t.~.~ ...... ~~o.o.~...~., .......................................
............................................................................................................. ~~.c.~.,..~
.~~..~~ ............ ~.z~ ............. ~...~...~.~ ....... ~ ........
co,.~ ~ ~p No. ~ooo s~t~o, .... L)..~ ........... B~k ..... ~.,~ .... Lo~ N,....~,q.~. .....
Building Inspector.
Building Inspector
Rev. 6/30/80
TOWN OF SOU*.O,D :1 JUN 8
Building Department
Town Hail : ~.~
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY ~
Instructions ~ ~
This application must be filled in typewriter OR ink. and submi~ed I ~ to the Building In,cc-
tor with the following; for new buildings or new use:
1. Final su~ey of property with accurate location of all buildings, prope~y lines, ~reets, and unu~al
natural or topographic feaNres.
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 Unde~riters.
4. Commercial buildings, Industrial buildings. Multiple Residences and similar buildings and in,alia-
tions, a certificate of Code compliance from ~e 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-exi~ing'
land uses:
1. Accurate ~ey of p~perty showing all property lines, streets, buildings and unu~al naNral 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 pe~inent informa-
tion required to prepsre a ce~ificate.
Fees:
1. Certificete of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..........................
NewC°nstruction ...... Old or Pre-existing Building .2g/ ......... Vacant Land .............
Location of Property . ././o?.~. ........... .' .... /.?o. ~57;..r.~.,. p.gc~,/'/~..~ ....... /.~.~ .~'~".7. ~,.~/..~ ......
House No. Street Hamlet
Owner or Owners of Property /~/?.~'~-.J .,J..~.~,./.... ,~.~'~./~.~l ..............................
County Tax Map No. 1000 Section . ./.'/...~t .......... Block .... ~.. ........ Lot...~.' ...........
Subdivision..~.°.{5 YY?..~..~;.~q ~ ............ Filed Map No..~/...~. 4)...Lot No../..cz'. .........
Permit No../.5~. ?.o~. ~.~.~Date of Permit ~.H~..~/.~...Applicant ...~..o.~..~.~/%<~.5/.~...~.~.-~ .........
Health Dept. Approval ~.~.'.-~..~. ............... Labor Dept. Approval ....~.f'./~:~. ..............
Underwriters Approval . .g~.. ................... Planning Board Approval .. ,/~. ?.~.-.c~. ............
Request for Temporary Certificate ..................... Final Certificate . ./~.'.
, .................
Fee Submitted ~;. ~.~.: .~...d.. ./ .........
Construction on above described building and.permit m.~-t-sAal. I-/applicable codes and regulations,
· ..............
Rev, 10-10-78 / /
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
Whom Th~s May Concern,
We are unable to complete your Certificate
of Occupancy because.of the following reasons.
/5/ An application for Certificate of Occupancy
is not on file. <',&~-~C~)
~/Z~ No Underwriters Certificate on file. /E/ The check is(outdated/not on file.)~L570o
No Health Dept. Approval on file.
/Z/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
--Building Permit # .'_~J-- ~ __ ~-F ~ Z
Building Dept.
***/~/ No Plumber Solder Certificate on file.
all permits involving plumbing being
issued after April 1,1984 )
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~LOO[3B[ BUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK, NEW YORK 10058
THIS CERTIFIES THAT
only the electrical equipment ~ ~scrlbed below and intr~uced by the applicant ~med on the obove application number in the premises of
Bruno saba~, 1185 Roeewo0d Dr., Matti~uck, N.Y.
~,asexa~ninedot~ Ap~l~ 27.1987 andfoundtobeincoopl'ancew'ththtrequlrements~ftb~sBoard,
FIXTURE FIXTUR~ RANGES C OVENS DISH WASHERS
6 7 7 6 1 F
DRYERS FURNACE MOTORS FUTURE A~LIANCE ~EDERS ISPECIAL REC'PT TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SERVI~ DI~ONNECT NO, OF $ E R V I C E
Pat ~ne ].ic.~300E
~attit~ck, N.Y., 11952 em~t ~N~e~
Per ~ ~ *
This certlfkote must not be ohered ~n ony monoer; return to the office of the ~oord ~f incorrect. Inspectors moy be identified by their credentla~s.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CSRTIPICATE MUST NOT BE ALTERED IN ANY MANNER.
2'65-1802
BUILDING DEPT.
INSPECTION
[/]/OUNDATION IST [ ] ROUGH PLBG.
[~]~ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
REMARKS:
DATE
INSPECTOR,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS: ,,,
FINAL
765-~802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION 2ND []INSULATION
FRAMING []FINAL
FIELD i~NS FE~ T ION DATE COMMENTS
FOUNDATION ~-
FOUNDATION (2nd)
FLUMBiNG
C,ODE
ADDITIONAL COMMENTS:
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date..~.~../~'.~.~... // ., 19 .~..
PLEASE TAKE NOTICE that your application dated ... ~ .... ~: ........ 19~..
for pe~it to ~E~. ~(~(~( ................................ at
Location ~f Property
House ~o.
Street Hamlet
County Tax Map No. 1000 Section ... ~(~ ...... Block .... ~. ..... Lot .~.~ .....
Subdivisiq~~.~, ~ Filed Map No.. ~Z.~ .... Lot No .... t ~ ..........
is returned herewith and disapproved on the following grounds ...............................
....... ~ ~c~..~.. ~ ~ V~. Q E..~~ ~ ...................
...... F~~..%.. ~K. ~/~ ~L.. ~.~ ..............
U
Rv ~/80
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved ................. 19 . . . Permit No..~..~.~.~. J
Disapproved a/c 7..~?. ~..~.. ~ ...................
Received ........... ,19...
'3 ('Bu{ld~ng Inspector) .... ~
APPLICATION FOR BUILDING PERMIT
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
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 described.
The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary in/~t~ti~ ~ .~
gnature of applicant, or name, if a corporation)
~. ~../~2~. ·/14 .~..F.F:'.T..~.~.~....~4r. (~. .........
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bulld___er.
.............. .~ ~. ~.~....~.~...~.r .~*.C..~..~ ~'~..)~C ........................................
Name of owner of premises ..... ~..}7.~O. c3.. ~..Q .~....~..°~YT.°. !...-~. ~...~. ?:.¢..~.~. ............................
(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 .... .~?.~..O..~....4J...~.. ......
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
..... l l%&. .............. ........ ......................
House Number Street Hamlet
County Tax Map No. 1000 Section ..... /. } .~.. ........ Block ~ Lot...~... .............
Subdivision...~.Q~ .~-~..°. O.~~. .~3~ .......... Filed M'a;'~ '~.~. i ~i... Lot .... I.(~. ........
(Nmne)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~O.e-~...~.i.~..r~.} ! .c~..~...t~..~!l~ .Q~ ....................................
b. Intended use and occupancy ...~.~..~).~. ~..~D..-7....~...~YD...P..C~Q...rYD. ..................................
3. Nature of work (check which applicable): New Building .......... Addition ..; ....... Alteration
Repair Removal Demolition ' Other Work
4. Estimated Cost . .~.. ] 9. ~ .Q .~. ......................... Fe ............................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling unit~ 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 structures, if any: Front .... 6fi..4~.+.. ...... Rear .. (0.4..~.b~: .... De th &~+
Height . ¢.~..-E. ff.: .......Number of Stories .... [.~ ...............................................
Dimensions of same structure with alterations or additions: Front ................ Rear ..................
Depth Height ............. Number of ~ '
............................... ~tones ......................
8. Dimensions of entire new construction: Front ............... Rear ........ ...... Depth ...............
Height ............... Number of Stories ................................................ . ........
9. Size of lot: Front ... '~ l g...q7..~,. .......... Rear ...l.t.~..~.4. ............ )epth .. l{o.q..~.4... ............
10 Date of Purchase Name of Former Owner ' .
11. Zone or use district in which premises are situated ........................ ... ...........................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...~.~ ..........................
13. Will lot be regraded .... .~.o. ................ .~... ,Will excess fill be removed from premises: Yes
14. amc o'f Owner of premises .~ rpro ?.~.~..~.I .~ .~%~'*ddress ~ot~r+opp¢. Or...i.~.~.u~g Phone No .......
amc of Architect Address [ aha NIh .........
amc of Contractor . .:~.o.~.4q.m.b..r~.~q~ .'~p.. ....... Address ~.~ ~.~.~.~..~ .o~.. Phone No..~.%~.~..8.1.~.~..
15~ this property located withinl,00 feet of a tidal wetland? * Yes ..... No ~ .... "
yes, Southold Town Trustees Permit may be required.
~. PLOT DIAGRAM
] ~e clearly and distinctly all buildings, whether existing or proposed, and. in~ [icate all set-back dimensions from
o ty lines. Give street and block number or description according to deed, and sho~ street names and indicate whether
l~ for cornerlot..
STAT ~ OF NEW YORK, ~ S
COUNTY,~F ....... ,,~ ........
.... ~. ~%c.~..~...'~. ....................... being duly sworn, deposes and says that he is the applicant
./(Name of individual signing contract) ' ,
able named. '
He is the ... .c..7'? .c--. ......
(Contractor, agent, corporate officer, etc.
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 applicatiot~ are true to the best ofhisiknowledge and belief; and that the
work will be performed in the manner set forth in the aPplicatiofi filed therewith.
Sworn to before me this
'li
Certification h~dtcated hsmnn ~lml run only to the
person Jot Wlldql [Jl~: SiffVi:t' ~S p:npared, and off his
behalf lo fi',e h' '~ csm~s:~uv, ~!'.v~ nmentaJ agency
.... ',.~ ~:'n, and to the
Educabm, ~ ,,
~ L.~::hflcation is
~ :'t:, ~ of this survey is
Copras of this sc"u.~ ~:lap not bearing the Land
', '~ ¢ I or embossed se~I shall not be
considered to be a vahd true copy,
i