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Home My WebLink About13794-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy Z-I5579 April 2, 1987 No .................. Date ................................. ADDITION TO EXISTING ONE FAMILY DWELLING THIS CERTIFIES that the building ................................................ Location of Property 10470 Main Road Mattituck, New York House No. Street Hamlet County Tax Map No. 1000 Section 143 .Block 3 .Lot 33.3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 26, 1985 13794Z ....................... pursuant to which Building Permit No ...................... dated Ma r c h 26, I 985 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 TO EXISTING ONE FAMILY DWELLING The certificate is issued to JODY PUMILLO ..................... /o¥.'o; ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N778954 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FO~ NO. o 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_. 13794 Z Permission is hereby granted to: ..... .T_I~....I...~...&.. ..& ................................ ' .M... , Icl~-- /et premises Jlocoted et ~..O...%L.?....O,J., ....'~.~.....~..o ....... ,,...~,.~ ......................... County Tax Map No. 1000 Section ..... !.~..,~ ......Block .....,,,~,,, ............ Lot No .......,~, .~..;.~ .... pursuant to application dated ...... ..~.0~..~. ......................... , 19 ........ , and approved by 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 OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m Iammmm 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZOperty 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 bu ildings. 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 $.25.00 -- SUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.vaoant ,and o.o. $20.00 .d. 5.Updated C.O. $ 50.00 Date.. ] .................. NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. No.' ..... Owner or Owners of Property ...~.~. ~'.~.'.~.~ .............................. ..l 5 ....... ......... ' Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. '. ?.. S ?.. l. Date of Permit .':'..:. :....Applicant . ~ . ~.( ...... .~.. .... Underwriters Approval ...................... Planning Board Approval ................... Request for Temporary Certificate Final Certificate ~ Fee Submitted$... 2~'~° Construction on above described building and permit meets all appKb~)e codes Ap,~ regulations. App cant ..... . ............. Rev. 10-10-78 ~ ~ ::)~,~'~THE'' NEW YORK BOARD OF FIRE UNDERWR{TERS 1001381,!',,/'/:~ " ~, : BUREAU OF ELECTRICITY . ~-xm ., ~ :; ',. 'tL ,~ ; r 85 JOHN STREET, NEW YORK, NEW YORK 10038 O.}e [NQvember 13, 1986 , ~ppl~,..,~o. No,,,.ft~ 391375/86 ~ 77895~ ' Joay Pum&ll¢~i~ ~in Roa~, behind Coacg Stoppe Resturant Mattiguck,N.Y n thefollowh g I,cat on;' ~ ~ Ist Ft. ~ 2nd Fl. Section Block Lot ~msexami.edon',,NOV~Or 3r 1986 FIXTURE :1 ~r , ~ FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FAI~S R V I ; C ~This certificate must not be hltir&d in any manner~ return to the~ office of the Board if incorrect. Inspectors may be identified by their credentials, FIELD INSPECTION FOUNDATION (1st) FOUNDATION (~nd) ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY QOVE FINAL ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ...~(3J~.~. a .{a., 19 $.~ Approved . . .~.~-~/}..~..[{., 19[. ¥'. Permit No..]..~."~ .c~ .c/?7., Disapproved a/c ..................................... ~.Dg. DEPT, TOWN OF SOUTHOLD Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely tilled 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 iF~ectil~ns. < . . . ................. ~,q~gnatt~ of applicant, or name, if a corporation) .... ................... (Mailing address of applicant) State whether applicant t~..own%., lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 .... c~'51J~- Other Trade's License No ...................... · ...... ....... 1. Locati~d on which proposed work will be done. . .------~ ~ . .w..; .......... ~/t ............ : ............................................................. House Number Street Hamlet County Tax map ~o. 1000 Section ...~.. !~. ~.... mock ... ~ ............ Lot..~ r.~ ........ 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 occupancy .... ./~. '.~.'.~.~~ ..................... : ........................... b. Intended use and occupancy ............................... ~ ............................ 3, Nature of work (check which a cable: New Building ..... ' ..... Addition.; .... Alteration Repair .............. Removal .............. Demolition ........ 1"' Other Work ............... ~ (Description) 4. Estimated Cost ........... Fee . . '~ (to beipaid on filing this application) / , 5. If dwelling, number of dwelling units .............. Number of dwelling unffs on each floor .... /. ........... If garage, number of cars ........................................... ! ............................ If business, commercial or mixed occupancy, specify nature and extent of each tv~e of use ............ , ..... Dimensions of Height ...... ]. Number of Stories .... f. ..... Dimension~pf ~ta~e strtmtiu,re vtilh alterations or additions. Froni' ' ~.'/.. "] ...... I~}~'' '14'~(¢J ........... Dnnenslons of entire new construction: Fr;~t' ]i]~ ........ Rear .... ~.~. ....... Depth ~..~.': .~. Height ...... /(~ .....~. Number of Stories ..... / j. ........... Date of Purchase ............................. Name of Former Owner : Zone or use district in which premises are situated Does proposed construction wolat~ any zoning law, ordinance or regulation: .... ' ................. I ..... Will lot be regraded ........ L..x../~..(~v;r> · .., ,. ...... Will excess'fill be remov{d from premises: ' 'Yes Name of Owner of premises ...o~.. ~../~...L~. ~... Address ............... i ....Phone No..:¢c/3..'~.q 51;~ ..... Name of Architect ........................... Address .................... Phone No ................ Name of Contractor .......................... Address ............... i ....Phone No ................ PLOT DIAGRAM : Locate clearly and distinctly ail buildings, whether existing or proposed, and. i~dicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~1 1. 12. 13. 14. STATE OF NEW Y[O~.~ .. COUNTY OF. ~,% .~ .~?...U..~... S.S , p. .tta ' · .... /~. ~[.[~/~. ..................... being duly sworn, depdses and (Name of individual signing contract) above named. He is the .................................................................................. ~ ........ (Contractor, agent, corporate officer, etc.i of said owner or owners, and is duly authorized to perform or have performed the sgid work and to make and file this application; that all statements contained in this application are true to the best of hi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ l.~, .............. dayof .... ,~.~ ......... ,19 .~'" Notary Public, ' ...... ~' ' ommisSloll Exp~re~ March 30, says that he is thC applicant (Signature of applicant;). r-- ,J. l~ Itel COCK Ioo ? '1 r '~ ~,P~.~OYED AS NOTED . ATE: ~]~/ D ~A~AGE755-18~ 9 AM TO 4 PM FOR THE ~... ~.~.,r.~ [ ~,~ ~,.,~ ' ...... N. ~