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Home My WebLink About14419-zFORM NO. 4 TOWq~ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23303 Date OCTOBER 24, 1994 THIS CERTIFIES that the building ADDITION Location of Propert~ 1865 WESTPHALIA ROAD MATTITUCK, NY House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 1 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 30, 1985 ~ursuant to which Building Permit No. 14419-Z dated NOVEMBER 4, 1985 was issued, and conforms to all ef the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EDWARD A. NOLAN, JR. & ELIZABETH NOLAN of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. 1/81 !~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 14419 Z Permission is hereby granted to: .... ~-~.~...~...Z~.~....~.....J.~ .... .... ~OL~ .... ~.~..~.~.~..Z~.v..~ ...................... ,o ........ .~.~.Tz~.~..~.~..../.~...~./..~. ....... ~c~....~.~..~.~./.~...~......~2 .................. ...... ~.~.....~...~ .F.~.~.;~.......~..~.~ ,.J..F..~ ...................... .~ ............................................. at premises located at ...,./~. '.~..(~.-~......~/~.:~/.~./~....~.. ................................................... County Tax Map No, 1000 Section .... ./...~...,/. ......... Block ......~.../. .......... Lot No....(~....~?.., .~.. ......... pursuant to application dated ........................................................ , 19 ......... and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ..... ......... ; ........ Old Or Pre-exSsting,Bui~ding ............... ~ ...... Location of Property ..... ~. ~ ~/~ , ' , House No. Street Hamlet Onwer Owners Property .... ~..~...~d..~....~./.~.,, ~ " ' or of .... .4'--.~/~.~,i~.)~,--~A /:..~. ~.~ County Tax Map No 1000, Section ..... ./..~../....Block ..... · . .. ./ ..... . Lot. ..... g.~.. ............ . Subdivision .................................... Filed Map ............ Lot ...................... Permit No ..... /~.4/..~..Date Of Permit.././'~'-./~.: ~..~..Applicant .... Health Dept. Approval ..... ~./~.'. ............ Underwriters roval...~d/~.,X ........ App ..... Planning Board Approval .... ~/~ .......... Request for: Temporary Certificate. Final Cer icate..f ........ Fee Submitted: ~ ~ ~ ' "' u F1ELD INS?ECTIWN ~ DATE 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGN FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE ,- FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING ['g~NAL REMARKS: . d.g,./. $ ,, I:! p ~'~"~I:~ ~FORM NO. 1 ""~; ;'" "~;' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ?9OUTHOLD, N.Y. 11971 TO S OLD ~ TEL.: 765-1803 Ex~ined ~..~ ...... , I~ ~~ 9... Disapproved a/c "; ................. '~ ....... ..................... ........ .... APPLICATION FOR BUILDING PERMIT 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary~ in.sp, gc~dons.~j ~ ,~ t .... .... " (Signature of applicant, or name, if a o p ' · y.o....~?0..,.~....a-~..../~,....~, r..,g, r..t..o,...~. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... } . .~..~...t~. ]~.~../.~.. ~....~..O..~..,..~: .............................. (as on the tax roi1 or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... 0~. ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. / ~.r,,_.r- .~..~-..~-r.~..~t,,, t~.d... .m.n..rr:=..,,~.,~. ................. House Number Street Hamlet County Tax Map No. 1000 Section ....... .~..~. I ...... Block ...~. .............. Lot .... ~. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... I....~/k}t.t~r... ~'.'.'.~.gxt.~..~-. ................................. b. intended use and occupancy ............... ,~...ta~.. ~....u~..~..~... D.~.--.~..~. ......................... 3. Nature of work (check which applicable): New Building ' Addition ,D. ,~'.~. K. Alteration Removal Demolition ' Other Work Repair ........................................................ (Description) 4. Estimated Cost ....... . o,o Fee ~:?.t~. '* (to be paid on filing this application) number of dwelling units .............. Number of dwelling units ion each floor 5. If dwelling, If garage, number of cars 6. If business, commercial or mixed occupancy, spe~il:y nature and extent of each type of usc ..................... · ' s of xisti g structures 'f any: Front ' 7. Dnnenslon e n ,1 .................................. 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 . . . ~'8 Rear .,{(~.., ..... Depth ./..o. Height ..../: P7 ........ Number of Stories ............................. ~ ........................... 9. Size of lot: Front ..... ~.a. ~.-~. ........... Rear ..... ~..~: ~ ........... Depth ... q,q ~.¥. .............. 10. Date of Purchase .q~. $'.~. ..................... Name of Former Owner .. i. 8.~.t, .sq.& .~q ................. 11. Zone or use district in which premises are situated .......................... ~ ........................... 12 Do s p po ed str cfi n vi late any oning law ord' gulation: ' · e fo S con IJ o o Z , lnance or re ..... j ........................... , 13. Will lot be regraded ............................ Will excess fill be removed,from premises: Yes 14. Name of Owner of premises .................... Address ................ i' · ' Phone No ................ Name of Architect ........................... Address ................ !... Phone No ................ Name of Contractor .......................... Address ................ i. · · Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fi'om property lines. Give street and block number or description according to deed, and showl street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ..... ............. (Name of individual signing contract) above named. .... being duly sworn, deposes and says that he is the applicant He is the ......................................................................................... (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best ofhi , kno wled .n l scand, that the work will be performed in the manner set forth in the application filed therewith. : Sworn to before me this 3 0 ..re. £;' · .................... day of .......... ,19. ' ' fl~tt'N If. I)£ W~ yedt NOTARY PUOLIC, Stateldl#w 14o, 4707878, Suff~k Ih)indigo ~ T(nm F. xlflres Match 30, l~...~d' ' ~{Si~n/~ture of applicant) Col.m~ o' lfus ~urvey mop not beodng Ihe Iond 5urveyo~l In[cc seol o~ embossed seal I, holJ no! be considered Io be o vo~id copy C, un,,.m., or codifications inc~ic0led hereon lholl run o~ly po,son Io~ Whom Ihe ~u~vey is pmpmed, ond on hi~ behol~ Io hde company, govommemol agency end lending insfiluli~n hereon, ond lo the o*slg~eel of Ihe landing insfiluli~n. Guamnt~el o~ cedi[~callonl am no! Imn~eroble la addJllenal ImlJfutJ~o& NOTIFY BUILDING 765;1802 9 AM TO~ P~ FO~ THE FOLLOWING INSPECTIONS'. ], FOUNdATiON - TWO REQUIRE~ FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBIN~ 3. INSULATION 4. FINiaL -' .COF¢STRUCTION MUS] BE CO~:~PLETE FOR C. ALL CONSTRUCTION SHALL MEEq TH~ REQUIREMENTS OF THE N.Y ~ATE CONSTRUCTION & ENERGh ~/~ODES. NOT RESPONSIBLE F~ DESIGN OR CONSTRUCT]ON EPROP' SURVEY FOR GERALD B. ARMSTRONG AT MATTITUCA' TOWN OF. 50UTHOLD SUFFOLK COUNTY, N.Y. SCALE; I"= 40' dUN~ ~7, 1977 R£FE~ENCE~