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HomeMy WebLinkAbout14530-zFORM NO. 4 TOWN OF $OUTHOLD BUILDtNG DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, Z-15288 Date February 19, 1987 THIS CERTIFIES that the building Aeeesssory One Car garage 1590 West Mill Road Mattituck, l~e~ York Location of Property ~$~s~ 106 10 002. 1 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 December 9, 1986 14530 Z ..................... , ... pursuant to which Building Permit No ...................... dated February 7, 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 ......... ACCCESSORY ONE CAR GARAGE The certificate is issued to HOWARD E. & PATRICIA M. WOLBERT ..................... ?o¥.'o;, x xx .................. of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO .................. N/A N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FOK~ NO. 0 TC~'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 3:? 14530 Z Permission is herebt granted to: .....~..~..~.~.~.~.:.~.:..~. ......... x~~ ~o ....... ~.~.~~...~~.=.~...,..~..~.~....~~ ..... County Tax Map No. 1000 Section .,,.~..,,~,,..6 ....... Block ...... ~..¢:~. ........ Lot No....~...~.~'~.'....J... ~,,~o,,t ,o ,~I,co,,on ~ot~d .~...~ ......... ~. ........................ , l~ .~....., ond o~rov~ ~ the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCI Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land CoO. $5.00 ~.. ~//.~ F2 5.Updated C.O. $15.00 Date ......... .~ .............. NewConst. rucbion ...... Old or Pre-existing Building ............ Vacant Land ............ House No. Street f Ham/et Owner or Owners of Property . ./.,~'~'~/,~. ~Z~: ~'7,~...~.~..~.. ,~ ./~.~,//~J..X~.0..~...~.~.-~.,~ County Tax Map No. 1000 Section ...... Block ..... ~.~. ....... Lot... ., ........ Subdivision --'-'- ~ ................................. Filed Map No. .Lot No. ~ Permit No//~,-~,~,~', Date of Permit ~./?/~.~. Applicant ~,'~,/~'/~,~ ~ Health Dept Approval ~ Labor Dept Approval ~ ' Underwriters Approval ~ ........................ Planning Board Approval ....~... ............... Request for Temporary Certificate ..... ...'-~...'. ......... Final Certificate .... .~.~. ............. Fee Submitted $ .... ~.~..O.O. ................... Construction on above described bu ilding and permit meets all applicable codes and regulations. Applicant...//~/~~... ~~ ................... Rev. 10-10-78 MILL R~AD TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 January 16, 1987 TEL. 765-1802 Mr. Howard Wolbert To Whom This May Concern, We are tmable to complete your Certificate of Occupancy because of the following ~easons. ( XX)An application for Certificate of Occupancy is not on file. ( )No Underwriters Certificate on file. ( XX)The check is (~8~not on. file.) $5.00 ( )No Health Department Approval on file. ( )No final inspection has been made. .Please contact our office on this matter. Thank you for your cooperation. Building Permit # I 4 5 3 O Z ( )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April 1, 1984) NOTE: As of January I, ~987 there has been an increase for Certificate of Occupancy. ~ou are being billed under the old rate.I If payment is not received by February 16, 1987, the fee will be $]0.00 for your Certificate of Occupancy for the accessory one car garage applied for under Building Permit #14530Z. FIELD INSPECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL COMMENTS ADDITIONAL COMMENTS: Examined....~../.. 7. ..... Approved ....~.~..7 ..... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 .,1 ~. Permit No..] .q.~7~..O.. 7 Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS i~aceJ, ved ........... ~'ID... Date.../Z/~ ......... 19~. a. Tiffs 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 tiffs appli~a~i6n 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.__ ~ (Signature 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. ......... .... ..................................................... Nmn; of owner of premises /-/~)~.~.. ~EFt..~/Q(~..~.ff//2.')(~/~(~..~).~. ~.~gj~/r_jT' ........................ (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 ....... (~e17~. .............. Plumber's License No ....... .~')./.~. ............. Electrician's License No .... YO./~.. .............. Other Trade's License No .... .t~../.~. ............. Location of land on which proposed work will be done .................................................. . .t .qo ........ d.d. ........... ....... ............. House Number Street Hamlet · County. Tax Map No. 1000 Section .... /{9.~. ......... Block ..... j.~.. ' Lot .... .~.~. ]. ........... Subdivision .................................... : Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occu. pancy of proposed construction: a. Existing use and occupancy ....... Intended use and occupancy .../.(~.~....~a .~t~,~.~. ............................................... b. '3. Nature of work (check which applicable): New Building I,'" ' Addition .i. Alteration Repair .............. Removal .............. Demolition ....... Other Work ............... ! (Description) 4. Estimated Cost ...... .~.~./, ~tg~).*. 0.0 .... Fee..~ ...... .......................... "~ ~ (to be p~aid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unitl on each floor ................ If garage number of cars ' 6. If business, commercial or mixed occupancy, specify na.ture and extent of each tynp of use · . ~ I I I I ....... £ ' '/ ..... : 7. Dimensmns ofexistin~ strnctures ffany: Front..~.~./}~. ....... Rear . .~t~ .].{~) .... Depth .~..//.~ . Height . ~.c~{ g.//./.IQ./.. Number of Stories ...... tgz)ef~9/J~,~ ........ i ................ Dimensions of same strncture with alterations or additions: Front .... -~ ....... .... Rear .. :w .. ............. De th -- ~ Hei t ------ ' p ...................... gh ......... . ............. Number of Stones ...................... 8. D~mens~ons of entire new construction Front ~5t Rear r~I De~th [ Height .... /.O ......... Number of Stories ...... D/2~. ................. ............. ~ ............. 9. Size of lot: Front .. j. O0.". ...... Rear . /[-k'lt De~th ~-q~,~ ~(~ / 10. Date of Purchase ..... /'~,,~t..~q~ .1.~.' i ...... i i~a~; ;fFo'r~e'r'Owner ~0/,OO~rE~..Z.°/,~'D I 1. Zone or use district in which premises are situated....-'~. .................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .,QO ......................... 13. Will lot be regraded .... /O~ ..... ,...,~ .. ...... ~.... Will execs fill be remove~ [, from premises: Yes 14. Name of Owner of premises/-/0/,t.l~/lzG/. ~/h~qT2G/6L ./,dJ~l~a"~ . ~D~ ct~..[~ ?2C~l?hone No. ~:~7~.q./. .... Name of Architect .. tr)D~ ................... Address .... ~ , Phone No ................ Name of Contractor . .,,~'~/~ ................... Address ..... Phone No ............... PLOT DIAGRAM .stinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from : and block number or description according to deed, and.sho~ street names and indicate whether Locate clearly and~ property lines. Give st~ 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) i above named, j H~ is the ................................... ; ......................... i ........................... (Contractor, agent, corporate officer, etc.)I 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 hif knowledge and belief; and that the ~ork will be performed in the manner set forth in the gpplication filed therewith. Sworn to before me this .............. ~..~. ...... day of ...... ~. · .~. · ......... , 19 .ff~. ~/otaryP blic C unty ~'~ ............................ : ........ :t' ~'}} .... (S~g~t,u,r.~,9~pl>l~cant) L Door OP£N /H~.