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Home My WebLink About14493-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT - Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-]6557 Date January 4, 1988 THIS CERTIFIES that the building ADDITION TO EXISTING GARAGE Location of Property 15905 Main Road Matt]tuck, New York h~S~ ~/0~ ........................................................ Street Hamlet County Tax Map No. 1000 Section .. ! ! .5 ....... Block 0 0 I .Lot 0 05 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... 14493 z N o v e mb e r I 3, 1985 pursuant to which Building Permit No ................... '.., dated ...J.a.n.u.a..r .y..3. ,...1.9.8. 6. ........ was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITION TO EXISTING GARAGE FOR STORAGE AREA ROGER T. WINES The certificate is issued to ..................... [o~n.o.r,Xl~i~:~Xt~t~.~t,~ ..................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. N / A N/A PLUFiBERS CERTIFICATION DATED: Rev. 1/81 FO~ NO. ~ TOWN OF SOUTHOLD iiUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEWIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE. WORK AUTHORIZED) N9 14493 Z Permission is hereby granted to: ..... ................. ....... .~..o.,¢.....u..~.. ....... ..~....~L.~. ...~.~... ........ =~"...~/~""L-Z'.~"c-~'.r'~'"""/ , ~ ~1 ~o ......... .~.L~.. .~.~:......~.~F~.~.~.~`~....~..~.....`~.:~:[L~.~.....~. ~.(?"z:`~.~. .... . . . ..~. . .~. .cC. ...... ~. .'[. .~. ,:c.,,r-~. ~ . . . . /~..~.~.,e~, ....................................................................... at premises located at ........ L..~...L~....~....~"~.. ........ ~.~..[.I~.~.....~.~.....~ .......................................... .................................................................................................... I~../...-~-~.~,~.~.~.~ ~...~,:~... Counl7 Tax Map No. 1000 Section ...... I..L,~"~., ...... Block ...... ,~,.J. ........ Lot No...,,~,,,.,~.,..,~"~,,... pursuant to applicotion c~ted ..... J~,~..(~....~.. ......... 1....~ ............... , 19..~...~,--and approved by the Building Inspector. Fee $...(~ .~.........'~.... .... ,.~. ...... u ding nspec or Rev. 6/30/80 ~ APPLICATION FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Hall Southold, N.Y. 11971 765- 1802 FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted I~ 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 instaPa* 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 property showing all property lines, streets, buiMings 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 inforfna- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Ce~ificate of occupancy New Dwe].ling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $~0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.C. $ 50.00 Date .......................... NewtOns t, vuc t,~ on ...... Old or Pre-existing Building .... ~:.~ ..... Locat,on of Property /S.. ......... House No, Street Vacant Land ............. ............ Ham/et Owner or Qwners of Property ............................................................ County Tax Map No. 1000 Section ..... /'./.~. ...... Block .... ¢~X~../ ...... Lot .... .C~. ~.-Z ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ,/,~,~, ~,a. Date of Permit ./'//~,~,/~..Applicant..~.,,, ..... Health Dept. Approval ' .Labor Dept, Approval ............. Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev, 10,10-7e Co - TOWN. OF SOUTtIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tlALL SOUTHOLD, N.Y. 11971 December 29, 1987 TEL. 765-I 802 Roger T. Wines Box I10- Main Road Matt[tuck, N.Y. 11952 To Whom This May Co~cern, We are unable o complete your Certificate of Occupancy because ,of the following reasons. /~/ An application for Certificate of Occupancy J.s not on file. ENCLOSED /5/ ~1o Underwriters Certificate on file. /~/ The check is(~Xa~J~%d/not on file.) $10.00 /5/ No flealth Dept. Approval on file, /5/ No final inqpection has been made. ['].ease contact our office on Thank you for your cooperation. Building Permit # _~ _~ ~ ~ ~ Z this matter. Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND £ J iN/AULATION FRAMING ~/] FINAL REMARKS: DATE INSPECTOR~'~/~ ~~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL - o ~...l~..~.,~.~c_;~..~. .... ,.~,...~.~ .. I-~ ,~.~. ~ ~.~.~.(~ .~.~: ~d.. ~ ~ ~Z PLEASE TAKE NOTICE that your application dated .~ .... [~ ............ ,19 ~.~ for pemit to, C~ ~.~. ~Z. ~'~. ~ ~ .~,~. ~O.. ~~'& ...... ~t /~ ,o"- ~ ~ .... ~cation of Property ...... ~.. D.. ~ ...... S~ro~[ .... County Tax Map No. 1000 Section { ~ ~ Block O t . ~t ~(~ ~Y. .... - - Map No ....... Lot N~ Subdivision Filed .................. is returned herewith and disapproved on the following grounds ................................, ..~ -~ ~ ~ , .-. [ .......... . ~ .... ~ C.=.. ~.~ .C.v.~ ~. ~ 0~%.~ · Building Inspector RV 1/80 FORM NO. 3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated for permit to C,<27~k--).~.~...~..~.~...,~.~.TD.. t, ;.'~.~.c~.h4.../,O...~b~. · · .~.. · .d~. · ........ at Location of Property ...... '~'" ~" ' ,~treei ................ Hou,~ No.' { 1'5' Block ~ ~ Lot .0.~.~ ~'~'.. County Tax Map No, 1000 Section .............................. - Filed Map No _ -- T Lot No Subdivision .................................................... is returned herewith and disapproved on the following grounds ............. . .................. .... ~_~..-%. ~ .~, ~.~-.. ~.~....~.Q..~ .~.~.~ ~.~... · .~ ..... '~7'.T~..~..~...-.~.....~.~ .... .,~..<v~./,,-.~.c/k.W.i..o.~.~.,<.a,~ ....... ...~. k4 .C,.q-~.b-~-~- · . ·../,(. .................................................. / RV 1/80 , ~IELD INSPECTION DATE COMMENiS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING -- 3. INSULATION PER N. Y. STATE ENERGY ~ODE ' ' FINAL ---~: ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined · .<.~..~..~:.. ~./~:: 2..~l' .9~. ·''''-~ Approved .... l _;e it No.. t .C ¢' Received ........... ,19.. · (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 inspections. -~,.. ~,~..~-~.. ~ ~ ................... (Si ture 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. Name of owner of premises ....... <('~. · . (..~...%~'/.g~'/ ................ ' '~' '~ ''~ ........ (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 ...................... 1. Location of land on which proposed work will be done .................................................. .../~7.~..x: ............. ~.o_;~.....~..~d ............ ...~..a. (?.,i~...~.. ...................... House Number Street Hamlet County Tax Map No. 1000 Section ...... /,/..~.. ....... Block ...... .C?.O../. ...... Lot ..... .~..o..,5.~. ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .~'~O~. ~ .... C;N%~L~..O.~...~....~ .~_~ .~..~.~.(~/,~_~. .... property hnes. Give street and block number or description according to deed, and show interior or corner lot. 3. Nature of work (check which applicable). New Building .......... Addition ... ~ ...... ' Alteration .....1.~,~... Repair .............. Removal .............. Demolition ........ ~... [. Other Work ._~./~.Ct.)!,~. 4-EsUmated Cost ......... ~..., ........ ~ ............... Fee~ .... ,.~ ................... (to be p~id on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units ~on each floor If garage, number of ca~ ' 6. If business commercial or mixed occupancy spec~y nature ~nd extent of each t~pe~of use ........... ~.. ~ ..... 7. D~ensmns of exmting structures, if any: Front ....... /~..~... Rear .../~. ~. ~ ...... Depth ...2W..~ ....... Height . . [.,~(: b/( ...... Number of Stories ......... Z ................... ; .............. D~ensions of same structure with alterations or additions: Front ~ Rear ............... Depth ...................... HeiSt ...................... Number of Stories ..................... 8. D~ensions o~enti~e new construction: Front .............. Rear ......... ~ ......Depth ........ ...... Height .. . ~ ....... Number of Stories ............................ , ........................ 9. Size of lot: Front ...................... Re~ ...................... Depth, ................... ~. Date of Purchase ............................. Name of Fo~er Owner .~.,.. ~ ~ ~... d.q.~ ~:Cd-. Zone or use district in which premises are situated .......................... . .......................... Does proposed construction violate any zoning law, ordinance or regulation: ..... ~ .......................... Will lot be regraded Will excess fill b~ ' ' ............................ removed from premises: Yes No N~e of Owner of premises .................... Address ................... Phone No ................ N~e of Architect ~ Address ~ Phone No. N~e of Contractor ... ~ ................. Address ~ ~ ./dd ~ [~.?~d~ ~.C~hone No. ,~ ~.~ Z~ ~. PLOT DIAG~M Locate clearly ~d dist~ctly ~1 bufld~gs, whether existing or proposed, and. indicate M1 set-back d~ensions from street names and indicate whether STATE OF NEW YORK, oF ....... , ......... ..... :. ' being duly sworn, deposles and says that he is the applicant (Name of individual signing contract) above named.' He is the .............................................................. ~ ........................... (Contractor, agent, corporate officer, etc.) vf said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained, in this application are true to the best of his knowledge and belief; and that the ~ork will be performed iff the manner sit forth in the application filed therewith. 3worn to before me this 19 f.c ...................... day of ............... ,.. qotary Public, . .................... ' .....County i (Signature of appliqant)