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Home My WebLink About15148-zFORM NO o ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17365 Date SEPTEMBER 28, 1988 THIS CERTIFIES that the building ADDITION Location of Property 16105 MAIM ROAD MATTtTUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 01 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Buiiding Permit heretofore filed in this office dated JULY 28, 1986 pursuant to which Building Permit No. 15148-Z dated JULY 28~ 1986 was issued, and conforms to all of the requirements of tke applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to JOHN M. & JANET STEWART (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~kLTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 1~0~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJvlIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 15!4~ Z Permission is hereby granted to: ......,::~....s..~! .................................................... ~~~.~.._,;.,:.~..::~....~..~:,~..~.__ ............ ; .......... ; .................... at premises located at ...J...~..)..?..~. ........ ~,~....,.~ .......... ...~.~ ................... County Tax Map No. 1000 Section ......... J.~..~., .....Block ....... ..1~.....~ ....... Lot No ..... .~ ................ pursuant to application doted ....... ,~..,~...~ ................... , 19.~., ond opprov~ 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: I. 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 (prior 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling.$25.GO, Accessory i$|0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupanc¥ $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ................. NewC°ns tz"uc~;i°n .... Old or Pre-existing Building ............. Vacant Land ............. Location of Property ..o ./.G./.(~,,~.-~ '. ............ ~/).l..~J. -~0./¥~. .~..~./T-~ dC House No. Street Ham/er Owner or Owners of Property ....~.O/-~t,J..,~.rq.~)...~.~,/~/,~,,~. County Tax Map No. 1000 Section ........ ....... Block .... Lot Subdivision ................................. Filed Map No ........... Lot No ........... Permit No./...~-./?..~'.~... Date of Permit .......... Applicant .~.0/).~... ?'.~.....~'..~.40../J.~.~. ........ Health Dept. Approval · · Labor Dept Approval Underwriters Approval ... ..................... Planning Board Approval ............ Request for Temporary Cer]:Jficate ..................... Final Certificate ... ~ ......... Fee Submitted $...~.-?.. ~. (~. .............. Construction on above described building and permit meets all applicable codes and regulations. Applicant ....... . .; .................................. TOg~N OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. I3OX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 TO Whom This May Concern, TEL. 765-1802 We are unable to complete your Certificate of Occupancy becau.~e .of the following reasons. /_-// An ,~pplication for Certificate of Occupancy is not on file. '/_///No Underwriters Certificate on file. /_/ No Health Dept. Approval on file. .3 final inspection has been made. P]o,%,4o. contact: our office on this matter. Thank you for your cooperationS" Buildir~g Perrait tl I ~_~ _L '~ -~ z Suildinr~ [)opt. "**/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION (1st) FOUNDATION ( 2nd ) !IDATE ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Di~'. tO00,, ;';~,~.t ~;TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..... .:~.~.., 19 ~..~ Approved..' .'~.~. ,'~.~.., 19~.~. Permit Disapproved a/c ....................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF BOU'llqOLD Received ........... ,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 tl~is 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 ~ 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. (S~re 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 builder. .......... ............................................................................. Name of owner of premises .... . .-~./~/.~... ?....-~.,? .N.~... ,S' 7-~zO~q ~T (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... Oqm'o, vc-e~. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ......... .......... l .... £..b ............... ,,?.z77./. c._ZC ........................ House Number Street Hamlet County Tax Map No. 1000 Section .................. Block [ Lot i/5'- ..................................... Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . ~.~.-.~/.D~N ~ ...................... . ..... b. Intended use and occupancy ~'~3~7~/?~0_%__ LOiV'/n -/)c-..ed~ ................................ 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .. Alteration 4 .... [ ..... Repair .............. Removal .............. Demolition .......... ...~. Other Work .'7~..c~.a. .~ .... (Description) ~'"'2,~ '~'/,200 ' 4 Estimated Cost · J Fee ' tto be paid on fihng this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ........... :: ~... If garage, number of cars ........................................... ............................. 6. If business, commercial or mixed occupancy, specify nature and extant of eac.h type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear . lq ~'.~,'...P.f.~. Depth ............... Height ............... Number of Stories ........................... i ............................. Dimensions'of same structure with alterations or additions: Front... ..... .........' Rear . ................. Depth ...................... Height ...................... Number Of Stories ..................... Dimensions of entire new construction: Front .......... ' ..... Rear ....... : ........ Depth ............... Height ................ Number of Stories ......................................................... 9. Size of lot: Front ..... , ................ Rear ...................... i Depth ...................... 10. Date of Purchase .... 7/.~.o./.~. ( .................. NameofFormerOwner,.Vte~Tc~N~...~?.s..5.~.~..~. ..... 1 1 Zone or use district in which premises are situated ~ 12. Does proposed construction violate any zoning law, ordinance or regulatinn: ...!..~..0 ...................... 13. Will lot be regraded ...... .N. ? ................... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises .~tq....S..T~cD~.... Address ~4~. lc'p, ~0-.wr-. ~..r~cg2.. Phone No...~.q.~.;~. ?Q? ..... Name of Architect ........................... Address .............. ..... Phone No ................ Name of Contractor ...Zl..o/(~ .s.T~4.gO?. ?. ........ Address ~t~:~. :r~p... U.,*.~.~.m..c~. Phone No....~?.g.-?. ?'.o.~... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ~... · If yes, Southold Town Trustees Permit may_ be required. PLOT DIAGRAM i Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property l/ned. Give street and block number or description according to deed, and shbw street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) · above named. He is the ............................................................ i ............................. (Contractor, agent, corporate officer, etq.) of said owner or owners, and is duly authorized to perform or have performed thel 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 tha) the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...............'~/,ff..,, '~ ~ ~].t~'~.o& ~'. ..... day.of ...... ~ ......... , 19 .~.~. (Signature of applicant)