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Home My WebLink About14784-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~/RTM~NT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17690 Date JAN. 18~ 1989 THIS CERTIFIES that the building WOOD STOVE WITH CHIMNEY Location of Propert~ 935 BAY AVENUE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section I43 BLock 04 Lot 27 Subdivision GEO. H. RILEY Filed Map No. Lot No. 02 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1986 pursuant to which Building Permit No. 14784Z dated APRIL 25~ 1986 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 CONSTRUCT CHIMNEY WITH WOOD STOVE CONNECTION. The certificate is issued to HARRY AND BAR~ARA JACKSON (owner, of the aforesaid building. SUFFOLK COUNTY DEPART~4ENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building 'I~s~ctor FOEM NO. ~ TO~N O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1~?$4 z Da,e ...... ~..~..~ .............. ,9..?...&. Permission is hereb/granted to: .~.~..~....~.?.... ............. Y.....; ... ........................ at prem,,es ,ocoted at ...e..~..~.:~.-v ;~....~....~..~U~ ..................... County Tax Map No, 1000 Section .../..,.~....~... .......... Block ...... .,(~..*J.. ....... Lot No .......~..,.~. ............. pursuant to application dated ..... ~.. .................. , 19.~..~, and approved by the Building Inspector. Fee $ ........................ Building In.~pector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION o.f....OLD OR PRE-EXISTING BUILDING ...... VACANT LAND Location of Prope~ty...~.'.. ~.~.C, ........ ~.~,~..~ ROUSE ~O~ ...... / STREET HAMLET Owner or Owners of Property ..... ~. ..dr% ~.. ~ .~. ............ County Tax Hap No. 1000 Section .f~.~.. Block .Applicant ..~-Z~L~z~ ........ Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Fee Submitted: $ .................. Certificate rev. 10/14/88 FIELD IN S~'~CTION COMMENTS FOUNDATION ~~(lst), FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7GS-1802 BUILDING DEPT. REMARKS: INSPECTION FOUNDATION 1ST [ ]/~OUGH PLBG. FOUNDATION 2ND [,~/INSULATION FRAMING ~/] .FINAL / ~ DATE ,, , INSPECTOR #.3 Almond Porcelain E~m~el with stmc pipe painted wid~ Jotul High Temp Paint. //3 Majolica Bro~,~ Porcek~in Enamel. This high gloss surface, with its highlighted detailing gives the #3 a truly rich a~ elegant finish. #3 CLEARANCES TO COMBUSTIBLES REAR EXIT STRAIGHT TO WALL REAR EXIT WII'H ELI~OW TOP EXIT'* WITH ELSOW · Clearances can be reduced to 12" using UL Listed wall protection. See ~nstruotions of wall protection for details TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N,Y, 11971 TEL.: 765-1803 Examined ' D." 19 ~.(~ Received ........... ,19... Disapproved a/c ..................................... ,~/~-~b ~ ........ (Building Inspector) ~ t APPLICATION FOR BUILDING PERMIT Date...~ff4.../..~.../:~)(..., 19 ~/o 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. h. 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 g 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 Law% 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 ins?fictions. ...... '-.?-.. .................. (Signature dj affpl!cant, or name, if a,cpr, p2ratio~) .... ?. ...... AY: .... /.lqS.& ................... · O~ailing a~dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises..~. Ct~.L?~4~. · .~".; '. · · .~. · · ~. (~.~J..~. · .~. · .-~. · ~ · · .~~./~. ............. // (as on the tax roll or latest d~d) 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. ~..o..o4ti.t,$.{¢,....*...~.~.tqR? ff ~ ... 1. L o ca ti on of land on w hi ch propo se dw ork will be.d one. ?3.... '~.O. ~,~. ~..~.:. ,'../~(~{ '~~. -.. House Number Street Hamlet County Tax Map No. 1000 Section .. X~./.,~ .......... Block . .O/~t.,.00. ........ Lot..0.:4-..7....O...c?.o. ...... Subdivision.. .~,~.J.q'.~.(/.'?.<.../~...~.../~'~:'.~, .......... Filed Map No ............... Lot ............... (Name) L/ State existing use and occupancy of premises and intended use and occupancy of proposed construction: use and occupancy .......... ~.~. ~.--~. · '~/ .... x .................................... a. Existing occupancy .......... /~¢r~....o~...~ ............................... b. Intended use and 3. Nature of work (check which applicable): New Building .......... Addition..i ........ Alteration ...... ~' t,' · Repair .............. Removal ............ Demolition .......... - '... Other 4. Estimated Cost....,~2~..O~/.? .......................... Fee ....................................... (to be ~paid on filing this application) 5. If dwelling, number of dwelling units t Number of dwelling units on each floor If garage, number of cars ............................................ : ............................ 6. If business, commercial or mixed occupancy, specify nature and exten~ of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ............................ i ............................ Dimensions of same structure with alterations or additions: Front ........ ' Rear .................. Depth ...................... Height. ..................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ ....... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front .. ..................... Rear ...................... IDepth ...................... 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. Wffi lot be regraded ............................ Will excess fi/1 be removed from premises: Yes No 14. Name of Owner of premises ... ,,~J~o'~..~ ......... Address .................... Phone No ................ Name of Architect ........................... Address ............... i ....Phone No ................ Name of Contractor .......................... Address ............... i.. . Phone No ..... ,, .......... 15. Is this property located withinl.00 feet of a tidal wetland? *iYes ..... No ..ff.. · 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 YORIC, r S S COUNTY .... ' ...... .~~..qfi~.~.,~...d~.. ................. being duly (Name 61qr~vidual signing contract), . ~.. ~ above named. ' ' ' sworn, deposes and says that he is the applicant He is the ............................................................... ~ ........................ (Contractor, agent, corporate officer, etc.)' of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and file this application; that '~il statem~ents contained in this application are true to the best of hi~ 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 '.. , / ~ ... ~ ........ , 19 ~.(q. i ........................ day of. ~ ~ ~ ........ /' ....... /]',' ';/'~' ...... " .... i' ~ ....... ~4~r~~ //~ l,f~gr~'e 0~t applicant)