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Home My WebLink About14649-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . Z15069 Date . Novem.b.e.r 7, .1986 THIS CERTIFIES that the building . Addition Location of Property ....... 5.6, .5..O.l.d...M.a.i..n. ~.R. oad Mattituck . House No. Street Ham/et County Tax Map No. I000 Section 122 ..... Block 07 . .Lot .2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated ....... March 3 ,19 8.6. pursuant to which Building Permit No..%z~6.4.9. g dated ...M.a.r,c.~..1.4. ................ 19..8.6, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which ttfis certificate is issued is ......... ....... A~ditipJ% .'cO..axi~.t.:i, Dg. p.n.e...f.a.m.i..ly..d.w. 9.1!.i.n.~: ........................ The certificate is issued to STANLEY J. & JANICE M. FLIS. S of the aforesaid building. Suffolk County Department of Health Approval . . N/A UNDERWRITERS CERTIFICATE NO ................. p.e.n.4i.n. 9., A6./.s..6 .............. Rev. 1/81 FORM NO. 1[ TO~H OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14649 Z County Tax Map No. 1000 Section ....... ./..,~....~...,,. Block ...... .~....~'. ....... Lot No.....~... ............... pursuant to application doted ..... .~.~.~. ....... ~ ................. , ]9.~..~, and approv~ by the Building inspector. Building Inspector Rev. 6/30/80 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Receipt ~II~'O. .) 'u U Southold, New York 11971 .......................... ~ Fee for Fee for ~] Yard Sa~e [] [] Fee for Fee for r_u~tificate [] H.I.C. [] Bui ding Permit L_~ of Occupancy [] Misc. ........... '~',]'ild lng Inspector 1. Accurate survey of paCoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to u se, 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date ...A.uj~:. 2.0.,..1..9.8.6 ......... New Building ............. Old or Pre-existing Building .. ~ ........ Vacant Land ............. Location of Property ...5.~ ,~..0.],<:]. ~p~L.q · ~,~],. ..................... ~ p,t:,~ ~. I; [AC.]~ .............. House No. Street Ham/et Owner or Owners of Property ~.t.~,~. ~.e~v..,,T ,. ~ .J~p~.qe. ['1,...~'~,;[,s.s. .......................... County Tax Map No. 1000 Section .. ;[.2.~ ......... Block ...Q? .......... Lot..~ ............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 1,~.4.9. .... Date of Permit ..~/~.4/.8.(~ .Applicant . .J~P;i.qC. ~',[.J,~ ~ .................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~( ................. Fee Submitted $ ~ ,00 ........................ Construction on above described building and permit me, ets all applicable codes and regulations. Rev. 10-10-78 FIELD ~INSi~ECTION 1. FOUNDATION ~ls~! FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [.]~IDATION 2ND [ ]INSULATION ["?'~'~'F~MING f~L REMARKS= 765-~802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL 7&S-1802 BUILDING DEPT. INSPECTION ~(~] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING REMARKS: FINAL DATE INSPECTOR ,, 765-1802 BUILDING DEPT. INSPECTION [~yFOUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [ ] INSULATION ~/~/~i FRAMING [ ] FINAL DATE INSPECTOR, THE NEw YORK I~OARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~, 8~ ~8OHN STREET. NEW YORK. N~ 10~38 Appllca~ion No. on fil~ THI~ C~I~IE~ THaT DRYERS FURNACE MOTORS SERVICE DISCONNECT S E R OTHER AI~ARATUS: C P.O. BOX This certificate mint ~t ~ aher~ in any manner; return to tM office 0 t~ ~ard if incorre~. Ins~ors may ~ i~nt~i~ ~ F~ B~ DEPART~T. THIS C~ ~ CERTIFI~TE ~T ~ BE ALTERED IN ~ ~ER. PROPERTY OF: STANLEY & JANICE FLISS JR, 565 OLD MAIN RD. MATTITUCK N.Y. 11952 MAIN ~'I-t~T~ R a,~ D 1~1,51 TAX HAP 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180~ E,aminedl, ^pproved.. . . .q..., me=it No. t¢.¢ Y. ?. Disapproved a/c ..................................... ' ' (Building Inspector) APPLICATION FOR BUILDING PERMIT T° O ,S°m°m I Received ........... ,19... 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 all applicable laws, ordinances, build/)ng code, hou~ing~gC~e, and regulations, and to admit authorized inspectors on premises and in building for necessary insp96tions// / //.~Y, . ..... ............... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... O. wner..and. B.uilde.n ........................................................................ Name of owner of premises . .S..t .ap.l.e.y..J....&...J.a. qi. 9.e..M.: . .F.l.i.s.s...J.r... .................................. (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 ..... 7 5 ................... Plumber's License No... 2 3 6.6.T ................ Electrician's License No...1.~. ~. ~. ~ ........... Other Trade's License No. ~¢~.. ~.c) $.S ~. l ....... .1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section . .1.2, ,2 ............. Block . .0.7. .............. Lot....2 ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Home a. Existing use and occupancy ..................................................................... b. Intended use and occupancy Extension to ex~st,zng ho~e~' , ~, 3. Nature of work ',(check which apphcable): New Building Addition. X.. Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... "~ ~ ,. ~/~t~ (Description) 4. Estimated Cost ....... '$'%~i .0.0.Q. 9.0 ................... Fee ...................................... .... ~ ~' (to be paid on filing this application) r. 5...o,lf dwetlmg~..nh'mbe~ of divelling units...0.qe ......... Number of dwelling units on each floor .... If garage, number of cars ... ! .................................................................... 6. If business, commercial or miked occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structffres, if any' Front 20 ' . . Rear ~[.9.'. Depth . ,3.4 ' Height .1. 9. I .6 ? .........Number o f Stories .. 1. ~..S.t.q r..5_ 9.s. .......................................... Dimensions of same structure with alterations or additions: Front . 3.q [ ............ Rear .... 3.5 [ .......... Depth..54! ............. i ... Height ...1.~ '. 6!' .............. Number of Stories .... %~. &t. qr Se~. ...... '-&'Dimensions of entire new con{truction Front. 1.6' .... ' :::: .D.e.p~.h · Rear . .1.6 ........ 3 2 ' · ' ............ ~ " ................ · Depth g.6.8. ~. ................. 9. Size of lot: Front ...2.0.Q...; ............ Rear .... 11119.' ' ' 10. Dat~'ofPurchase .. M.ay.. ~51,..$9.8.5. ............ Name of Former Owner I~lg~c.y..~l~.r. qCk;[ .............. 11. Zone or use district in which premises are situated ..... B..1 .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: . .N..o ............................. 13. Will lot be regraded . ,N.q... i .................... Will excess fill be removed from premises: Yes X No 14. Name of Owner of premises .Si~.a..n.l.e.Y...F.i..1.s.s...J.r. Address5.6...5..O.l.d...~p.l.n...R.d... Phone No. ..... Name of Architect ........ i .................. Address ................... Phone No ............... .* Name of Contractor .S.t.a.n..1.ey..~T:..F. 1.1..s.s..J.r. ,.. Address .~O~u.e. ............. Phone No .... Same...- ..... 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 YORK, COUNTY OF ................ S.S ............................ ' ..................... 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, etc.) of said owner or owners, and is duly 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 manner set forth in the application filed therewith. Sworu to before me this 80t~lC_l~.. '.~.~,~l Iff (Signature of applicant) oor o1,~ 'Solid T