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Home My WebLink About13812-z TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18166 Date JULY 5~ 1989 THIS CERTIFIES that the buildin~ ADDITION Location of Property 4855 NEW SUFFOLK AVENUE House No, Street County Tax Map No. 1000 Section 115 Block 4 Subdivision Filed Map No. MATTITUCK, N.Y. Hamlet Lot 10 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27~ 1985 pursuant to which Building Permit No. 13812-Z dated MARCH 28~ 1985 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 AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N-711898-OCTOBER PLUMBERS CERTIFICATION DATED EDWARD S. ADAMS 08~ 1985 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 CO~PLETIQN OF THE WORK AUTHORIZED) N9 13812 Z Permission is hereby granted~: ~ , at premises located at ............................................................ : ............................................................... County Tax Map No. 1000 Section ......... ~.!..~..'~.. ...... Block ........ ...~. ......... Lot No....1....~. .............. pursuant to application dated ............. ~~ ,,o~,,~, .............. , 19.~.....~'~, and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ........ TOWN.. .OF..SOUTHOLD Instructions This application must be filled in typewriter OR ink, and submitted ia ~11~111~ 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-existir~" 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 Date .... .-~'..~x~.. New Building ............. Old or Pre-existing Building ~/ Vacant Land Location of Property .~..~.~..~.. ~'./.~.~.'.'¢' ~'¢Jz~"~°/"~ .~..~.~' House No. Street Ham/et Owner or Owners of Property . ~.,~..~.~M,~.~ ~' County Tax Map No. 1000 Section ...... .~../..'~.... Block .. ~- Lot Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /.,~../.~.Z-.. Date of Permit ~.~App~l'ic~a~.... ~"~-,~..4;4~..~...~... ~..~..~..'~/'. ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .... ?/..~./. 4~..~'-· ........ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ . .~-~.~.~ Construction on above described building and permiJ;~neets all applicable codes end, regulations. Applicant ..... ~ ......... Rev. 10-10-78 VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD June 23, 1989 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Mr. Edward Adams 4055 New Suffolk Avenue Mattituck, New York 11952 RE: Building Permit 913812-Z 4055 New Suffolk Ave. Mattituak, N.Y. Suff. Co. T.M. 91000-115-4-10 Dear Mr. Adams: On January 17, 1989, we sent you a letter informing you that a Certificate of Occupancy for the above numbered building permit was never issued. We returned your check #1905 as it was outdated and requested you forward a new check in the amount of $25.00 so that the Certificate of Occupancy could be issued. According to the Code of the Town of Southold Chapter 100-284 it is unlawful to occupy or use a building without a Certificate of Occupancy. In order to avoid legal action, please forward your check in the amount of $25.00 immediately so that the Certificate of Occupancy can be issued and this violation can be resolved. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Vincent R. Wieczore~i~' Ordinance Inspector VRW:gar FIELD INS?ECTION COMMENTS FOUNDATION { 1st) FOUNDATION (2nd) ROUGH FRAME & FLUI~BING INSULATION PER N. STATE ENERGY ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~INSULATIoN FRAMING [ ] FINAL DATE ,. q INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 8.5 JOHN STREET, NEW YORK, NEW YORK 10038 Octe~e~ 08,, 19~5 34~612/~5 ~ THIS CERTIFIES THAT only the electrical equipolent ~ described bel~ and introduced by t~ applicant named on the abo~e application number in the prem~ses of ~c~ward Ad,ms, E/$ ~rral:ooka Avenue Co~. New S~ffolk Ave~ P~tituek~ N~ ~n the following Ioc.tion; ~ Basement ~ I st FI. ~ ~nd FI. Section Block Lot was exami~d on Octob~ 03~, 19~5 3 4 2 1 and found to be in compliance with the r~quirements of this Board. RANGES DISH WABHERS EXHAUST FANS DRYERS OTHER APPARATUS: AWG pER ,~ OF CC. COND v I C E NO OF HI-LEG j A W. G, r No OF NEUTRAl OF Hi-LEG AWG, OF NEUTRAL P.O. ~ox 3.43 [~attituck~ N~ 1195~ Li~42E GENEI~AL MANAGER . . Per ~ This certificate must not be altered in any manner; return to the office of the Board Jf nco~rect Inspector ..... ~ ~-.x-a ~ .~ . ~, sTNOT B~ ALTEREp IN ANY MANNER Examined.. ~)$Os&..& .1¢.~.., 19 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y, 11971 TEL.: 765-1802 Approved . .~J)0,&.e~...~.~.., 19 .~.S7 Permit No..)..~..~./.~...~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ................... 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 inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, etectric!a.n, plumber or builder. ......................... .~..~..~.~..~ ............................................................. Name of owner of premises ..... ~. ,~..'~'.'~ .~. · .... .~..~)~,r~,~' ..................... (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 Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...4.o ............ . .o: .c,.,t: .............. House Number Street Hamlet · ' /(.s". County Tax Map No. 1000 Section . Block *" .................. Lot .', Subdivision .............. . ....................... Filed Map No. //O~- ~'/~/~ Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ /. )..t"/.4/..~ ......~..r~d~./d. '.~..~(.~..~. ................. ' ............ b. Intended use and occupancy ....... .Z~..~fi.'.dy'..,~..,~../~ff....~..~?...,~....,~./.~..~....~.,.~./.~...~.~.../~. ~ .,~- .~.e'.J'.~. ..... 3. Nature of work (check which a~plicable): New Building ..... '.' ....Addition ....X'. ..... Alteration .......... Repair .............. Ren~oval .............. Demolition .............. Other Work ............... ~ i ' (Description) 4, Estimated Cost ..... ~,~f.~ ,.Od · .,[ .......................... Fee ...................................... I *'~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ......................................................................... 6. If business, commercial or m~x~d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... ' fSt ' Height ............... Number o ones ...................................................... Dimensions of same structure ~vith alterations or additions: Front ................. Rear .................. Depth ................... i' ' ' Height ...................... Number of Stories 8. Dimensions of entire new consfruction: Front ...... /..2r.~,-~..t'C Rear .../.,~..~"'..~..~. i 'I~e'p't~' ] i~'~. ' .~,~.' ] Height . .?.. ~ ....... Number of. Stones .............................. ,.. Size of lot: Front ........../q,/Oi"' ,./..~. O..~. f~. Rear ........./. ~. ~ .~..g?~?...-,-.-Depth"':":~.. ~. ~.. ~..~.~.. ~..::::::: ~,'~]' ~ ' '~'~" ' ' Date of Purchase ...... r. t.l.,.,~. ............... Name of Former Owner . Zone or use district in which p}emises are situated ..... /~/~.;'?-~.Z-~4' O,~..~.~'~q'. · ~,,,~2.~,4q. · ................ Does proposed construction violate any zoning law, ordinance or regulation: .............................. ... Will lot be regraded ......... .J~.'. ............. Will excess fill be removecl from premises: Yes Namel of Owner of premises . ~,mz~..~.,~...4~.~.,¢~. Address Zg4¢e,444"..-'.,P~.~..~..~f'.~.. Phone No. ~.q.e}e.:..~g~...~.. Name of Architect . ........ 1 .................. Address ................... Phone No ................ Name of Contractor ....... ~ Add Pho No , .: .................. ross ................... ne ................ 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an&indicate all set-back dimensions from property lines. Give street and blocl: number or description according to deed, and show street names and indicate whether interior or corner lot. O/Or't' · I STATE OF NEW YORK, ! :~' '~ ' ~' COUNTY OF ................. i t.~.3 .:,, ,, ~'. ~'~ ' L ............................ 1 ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) above named. ! He is the ..................... I .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dilly authorized to perform or have performed the said work and to make and file this appli.cation; that all statements con!ained in this application are true to the best of his 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 ........................ day ( ..... HH FN K, DE V0E ~- . NOT/~RY PUi~[ lO. Sla~o 0~ New York No 4707313, Suifd~Cmmt~ f .... 9:N ....... .('/..~'-7 . . County (Signature of applicant) NOTIFY q'.ru ~'~ :G ~EPAPT,MFNT AT If copper tubing is used Jar water distributing system; piping shall be o[ types K or L only PLUMBER CZRT[FfCATfON' ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED ZN WATER SUPPL Z SZST~'M CANNOT EXCEED 2/10 o2'1% LEAD. ,~, FLc')O~., ~LA W FOUND/t`, ! fOl'q GREENPORI, N.Y. 11944