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Home My WebLink About14320-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15146 Date D e c .e.m.b.e. r .30.: Tennis Court in rear yard . THIS CERTIFIES that the building ................................................. 1630 Theresa Drive. Mattituck, New York Location of Property/~s~ ~o~ ........................................................ Street Hamle~ J 15 Block 14 Lot 3 ' County Tax Map No. 1000 Section ........................................... Subdivision M/o Deephole Creek EsCs .42.5..6 6 ............................... Filed Map No ..... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated October 1. 19 8.~bursuant to which Building Permit No 14320z dated ....October I, 19 85 ............................ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ii ......... Tennis Court in.r.ear .yar. d, NICHOLAS & EILEEN METHVEN The certificate is issued to .......................................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO N./..A . Rev. 1/81 FO]g~ NO. ~ 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) N~ $4320 Z Permission is hereby granted to: ..... u..~/.~.~...~..E,/.~.~ ........ ~.,..~... ...... ../.~.~....~.~. ....... ~.~l..,...~ ................... .......... ~.~.~:i..t'..~.~. ...... ~:.~ ........................ ,o ............. ..c....o...,...~.~ ........ ~..,...,.;~ ....... ..c.?..~L....;'..,.......~.~.....~..~.,:..2... .......................... County Tax Mop No. 1000 Section ..... /./..~... ......... Block ........ ./.~.. ....... Lot No.....~.. ................. pursuent to application dat~cl ......................................................... ]~ ....... and appro¥~l by t~e Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: 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 iprior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sbrvey of p~operty showing all property lines,, st[eets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner a~ 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 occ_upancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 5. Updated C.O. $15.00 Date ............. New C on s t r uc t i on ..... Old or Pre-ex isting Bu ildirlg ........... Vacant Land ......, ..... House No. Street Hamlet Owner or Owners of Prope~y. ............... .... ....... County Tax Map No. 1000 Section .............. Block ............ ot ............... Subdivisio~¢.?~.. .... led Map No ..... Lot No .............. Permit No. ~.~. Date of Permit ,( .~/ ..... Applicant . ~.~...~~.~ ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riter~ Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Fina~ Certificate ....................... Fee Submitted $ ~, O O - ' Construction on ' ' ' g p ' al~cable codes~nd regulations. above desembed buddm and erm t meets Rw. 10-10.78 :~£N3NNOS qYNOIZIGG¥ XDH3NR 'X 'N H~ DNISN~q~ puE) NOI~VGN~O, 7GS-'~802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE /d//~//~ INSPECTOR/~<~ ~:::~ 'FQRNI NO. 1 TOWN OF $OUTHOLD BUR. DING DEPAFITMENT TOWN HAL/ ~OUTHOLD, N.Y, 11971 TEL.: 765-180~ Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ....... 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 tide issuance of a Building Permit pursuant to the Building Zone Ordinance of t~e 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 coml~ty with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspecti~n_s. /~ · .... (Signature of applicant, or name, if a corporation) .../~ 7.~....7:.~.~¢.~...D.~ .~ ~.~. ......... (Mailing~addc~.e~ss~/~.~of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ .0..~'..,?..*:: .~. ......................................................................... Name of owner of premises ../f..V. ?..~i .,~..~....~..,. F.....~/..&..~./..L/... .......?~......,A'~ (,f'...~.~.,'%f... ........ (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done.', ................................................. .. 1.¢..3.~ .............. :T,.q..¢..~...~.,s.,o: .... ~..~ ~.e--. ........ k'.x.~..-Dm.....T-..U..~..c.; ........... House Number Street Hamlet ": - County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision j~..~...~.,D... }4'9.[~....~..~fl..~..~...~..~¢~SFiled Map No..'f[.~..~..('ff. ...... Lot..(-,~ ............ (Name) State existing use and occupancy of prem~ises and intended use and occupancy of proposed' construction: . a. Existing use and occupancy .... i. ;. :.~ I.:; :-,~.., . e~ .... .~hc, .~.5[~ ,r . . .u~'-~..~g,.~: ,~t ....... b. Intended use and occupancy .... .t.~r...~ .~. ,\. S .... ~,6.U .fi'...~, .............. ;-...:. ,'. ,., ............... 3. Nature of work (check which applicpble): New Building .......... Addition .......... Alteration Repair ~;,)~ ~ RemovalI De~nolition · Other ' (Description) 4 Estiinated .Cost ',,,~ · :"~', . ' ~ ~ - ' ,, ' : *' (to be paid on filing this application) 5. If dwelling, number of dwelhn ums ............ Number of dwelling units on each floor ............... number of cars If garage, ..................................................................... 6. If business, commercial or mixed oclcupancy, specify nature and extent of each type of use ................... 7. Dhnensions of e ~st~ng structures, l any. Front...~. O ......... .~. o. Depth Height ,..[..~ ......... Numberl of Stories . .O.-.v.%.~g-~ ..................................... Dimensions of same structure with Mteratlons or additions: Front ................. Rear ................ Depth ...................... Height ...................... Number of Stories ........ ~ ........ 8. Dimensions of entire new construction: Front..[..c~r~.. ......... Rear ............... Depth ........ . ... Height ............... Nun?Der' of Stories ........................................................ 9. Size of lot: Front ... [.O..-.o ..... i ........ Rear ..... 111~./.5/7..~. s.~. ~..~... Depth . ...-~...O...4....~..~... 10. Date of Purchase .... .'~.¢%~-.74~.' ............. Name of Former Owner . .'vi.../'q..~<t,V..tTt.e?.~ ............. 11. Zone or use district iu which premises are situated ................... ' .................................. 12. Does proposed constructi, on violate|any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded . .~e~ ...... I ................ Will excess fill be removed from premises: Yes No Name of Architect ............ k'/2 ............ Address ....... /.~ ......... Phone No ..... · · ... · .. Name of Contractor ........... 1~'. ............ Address ...... ~ ......... Phone No .............. ~l ' PLOT DIAGRAM Locate clearly and distinctly all buhdings, whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and block nur~ber or description according to deed, and show street names and indicate whether inter~or or comer lo~. i ~TATE OF NEW YORK, S.S 'OUNTY OF being duly sworn deposes and says that he is the applicant (Name of individual signingi contract) ibove named· is the ~ (Contractor, agent, corporate officer, etc.) ' said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and filg'this- pplicatmn; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner s~t forth in the application filed therewith. ]wom to before me this .................... . ... day of..i ............... 19. qotary Public,.' (Signature of applicant)