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Home My WebLink About13906-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ........ Z. 1.4..4.1.5 .... Date . May 19 198..6. THIS CERTIFIES that the building a d d i t i o n Location of Property 1375 Bray Ave. Mattituck /~s~ hid ....................... 's't/e~i ....................... il~rhie~ County Tax Map No. 1000 Section 1 2 6 .Block $ . .Lot 7 Subdivision .......... .X .................... Filed Map No .... .X .... Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated · gpri 1 18 198.5. . pursuant to which Building Permit No. 13906Z dated ..... M.a. ¥..2 .................. 19.8.5., 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 ......... Addition. The certificate is issued to ........ PAUL J. & SUSAN M. MAJESKI ............. ..................... of the aforesaid building. Suffolk County Department of Health Approval lq/A UNDERWRITERS CERTIFICATE NO. N ? 0 6 5 6 7 Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13906 Z Permission is hereby granted to: ....... ~,o..~....~.~....7.. ....................................... ...... / ~o ...... .C~.~.~.. .~. ,~.~..~ ~ ~. /p..~. ..z~. . z O.~... . ...~.~. .o.~ ..,.: ............................................... ................... . .~. ...,~..~...~.....~.~. ...... ~,~.~.~. ....................................................... ot premises located at ..../......;../....~...Z~.2 ....... ~'...t~..~.......~..~..~., ........................................... .......................................................... . ........................ ...~w.~..z~,~..,,...~.....~ ................. pursuant to application dated ...~..~./..~ ....... /...~... ................ , 19Z..,:~and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 features. 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 C.O. $5.00 ¢/~ / 5. Updated C.O. $15.00 Date .............. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ./.~./~'.... ~,~).(,/.. ~.Lz'.~.X~.~,~ ........ House No./ Street Hamlet Owner or Owners of Property . ./.~/J/....,J.. ,/~/t'..~.,..C~,/JJ~I~/.../~/,.. ,/~L//~,~',~,/~./. .......... County Tax Map No. 1000 Section .../¢~.~ ....... Block ..... ~;~. ........ Lot.. ~ ........... Subdivision ................................. Filed Map No ........... Lot No PermitNo. /~..~.G~_,-. Date of Permit .,.~--/c~/~.~..Appl,cant..~F~.y.. ~.-~'.~'fi~.~ .............. Health Dept. Approval ..................... ;..Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....... .~.. ............. Fee Submitted $ .....~.. · . . . . .'d O . .V/.~.. [~.~.. ...... Construction on above described building and permit~j~eets all applicable cod~es an~ regulations. . q007 .... ............. ............. Rev. ~0-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~(:J 85 JOHN STREET, NEW YORK, NEW YORK 10038 T.,S CERT,.,ES T.AT ~#~9o6~ N 70656 [ only the electrical equipment as described belotv and introduced by the applicartt nao~ed on the above appllcatlon number in the premises of in the foltowing Iocation; [~lBase,nent ~'~ Ist Fl. [] 2nd FI. Section Block Lot was examined on and found to be in compliance with the requiretnents of this Board. Au~3USt 22, 1985 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V I C NO. OFECCCOND.pR~ A' W. G. NO OF CC, COND. A,W,G NO. OFNEUTRAt A W G. OF HI-LEG OF NEUTRAL Paul ~'.& Susan~. J~aJeski 1315 ~ray Avenue ~a~tituck, BY 1&952 certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be credentials. 3F BUILDIN ALTERED IN ANY MANNER. 'IELD INSPED'TIOI~ COMMENTS ~OUNDATI. ON (2nd) OUGH FRAME PLUMBING INSULATION PER STATE ENERGY G,ODE FINAL ADDITIONAL COMMENTS: 76S.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [/~' FINAL DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTM ENTLv.(~ TOWN HALL · ,~OUTHOLD, N.Y. 11971 TEL,: 765-1803 ..... ..... pproved ·., ......... isapproved a~/~ '~..: ............... ~:~ '~' .... ~"/' · · :,3' · Received ........... ,19... APPLICATION FOR BUILDING PERMIT " INSTRUCTIONS a. 5~s ~p~cation mu~e~.ffv.eteiy hn~d in~ ,pewdter or in~h~h~ ~z o the Bufldzng Inspector, wzth3 ts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~ show~g location of lot and of build~gs on premises, relationship to adjoining premises or pubQc streets ~eas, and g[v~g a det~led description of layout of property must be drawn on the dia~am which is pa~ of this appli- cation. c. The work covered by t~s application may not be commenced before issu~ce of Bufld~g Permit. d. Upon approval of this application, the B~lding Inspector will issued a Build~g Pemit to the appUcant. Such pemit [MI be kept on the promises ava~able for inspection ~rougBout the work. e. No bugd~g shall be occupied or used in whole or in paK for any purpose whatever ~til a Ce~ificate of Occup~cy all have been granted by the Bulldog Inspector. ~PLICATION IS HEREBY MADE to the Build~g Dep~tment for the issu~ce of a B~lding Pemit p~rsuant to the dlding Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or egulations, for the construction of build~gs, additions or alterations, or for remov~ or demoliQon, as here~ described. he appUcant agrees to comply with all appQcable laws, ordnances, bufld~g code, housing code, and regffiations, ~d to mit autkofized ~spectors on premises and ~ bulldog for necessa~ ins~ '" ~i~nature~f i~lia~ij ;; ~;~ ~;;~;;~i;;/) .... . ~p.&~.t.T. ~f,.< .~;f ~.~. Z ..~.. ............ (Mailing add,ss of applicant) :ate whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ...................... .................... ane of owner of premises ............................................... (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ~..~./.~.'~. Plumber's License No.../?..d .... !:/.~..~,..?./.'¢~,. Electrician's License No. Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. /.~. 7..-? ............ .~. ---¢- w 1 ~ ~ ~ ' t'.-~ /'-,, ...... ...... C~..v.,..: j .......................... ~ .................. House Number ~/~ireet Hamlet County Tax Map No. 1000 Section ..... /. ?".. ?. ...... Block ...... ~.. ......... Lot...?. .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occnpancy ...... (9. ?.. ,~. .... ?.'..~..~.. (,.f/y.... .,t'. .-¢. .,'. ,' b. Intended use and occupancy .... ~..&:~.. ..................................... 3. Nature of work (check which applicable): New Building ' Addition Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... J' ' ~ (Description) 7 Estimated Cost ........ ,~e. · · I ......................... Fee ........................ . 4. (to be paid on filing this application) If dwelling, number of dwelling units ............... Number o f dwelling units on each floor ................ If garage, number of ears ..... ] ................................................................... If business, commercial or mixed occupancy, specify nature and extent of each typ3 of use Dimensions of existing structure~, if any: Front ..../ff. ~. .......Rear ....q..ff. ...... Depth. ~..,~.' ........ Heigh ..... 5~,~. ...... Number of Stories ....... ~/ ........................................ Dimensions of, s~ame structure wi~h alterations or additions; Front .... ~..ff.. ........ Rear .... ~. o~. .......... Depth i ..... ¥'~' ............ :.. Height ........ 13~. ~., ........ Number qf Stories ..... /. ..... ': .%.~ ~ ...... ' 8. ~Di,~:n+sionsofe~tirenewcox~n,.st~ru,,c~o,,n~:o+F~ro~n~t, ../.~'.,./Z..Q... Rear .. ]. ~.~.,~. /....Depth ... /...~-J... .. ......... · . ....... ....... i ...... ;; ......... 9. Size of. lot: Front ...... :[. S. ........... Rear....~[. 3... . Depth..~./. gO ..... 10. Date of Purchase ........... i .................. Name of ~'o'r~r'6~v~'e/. ..... /~. ~.~... ii... 11. Zone or use district in which prdmises are situated ................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .../~.0 ........................ 13. Will lot be regraded ........ ! ................ ,.~.J,Vill excess fill be removed from premises: a}r Yes No 14. Name of Owner of premises . .P(.~. a. ! .~.d'..o{.a.4. ~[.e~y .e~rc~c~ress .~. ~.a/?/pv, e (cf, .~...¢/~hone No ~ ~v,¢, Name of Architect .......... I ................. Address ................... P~one No Name 6f Contractor.../.(~.°Y.,.O~'..~.~..~.,~(.-¢. ~ ..... Address .r.~f~ ~..~t~. ~o'~e No.. ~ 2..~.?. 'qv'/. ... / / PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from prope~W lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. : '7 £' ¥ ' above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file ~is application; that fll statements cont~ed ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~n~r set forth ~ the application filed therewith. Sworn to before me this Notary PublicX~~ 9 ~ '-'% .... ~.9~tk. County .,th/_ ~0 (sou~-~ ~~) /A :,, / / / / /i OCCU CY OR USE l:, : WFUL i; 'i'iFICATE OF OC MICY - APRROVED ~ 'NOTED,- -,-' FOLLOWING INSPECTIONS: 1: FOUNDATION - TWO REQUIRED FOR' p~URED CONCRETE 2. ROUGJ~ - FRAMING & PLUMBING 3. INSULATION 4,- FINAL ~ COP'qTRUCTION MUST ALL CONSTRIJCTIOi~ SHALL MEET THE REOUIPEMENTS OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS,