HomeMy WebLinkAbout13709-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. z16581 Date .5.a.n.u..a.r.y. 15, 1988
THIS CERTIFIES that the building . . .A .1.t.e.r..a.~.t.q n. ................................
Location of Property 15400 Main Road Mattituck
h ~ ~ fo ~'d ....................... 's't le~ i ............................
Hamlet
County Tax Map No. 1000 Section ... 1. ! 4. ...... Block , . .0.9. .......... Lot . .0.0. l .............
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· .............Feb' 11, ....... 1985 pursuant to which Building Permit No. l.3.7. Qg.Z .... -
dated ?.e.b. :. .2.6. ,...1.9.8.5. ............ 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 .........
Replace windows and doors tn an existing commercial building
The certificate is issued to LINDA L. & NICHOLg,S J. g. LBO
..................... ?o~;.'o;, ~i~&~k¥itio't~ ......................
of the aforesaid building.
Suffolk County Department of Health Approval ......... ~ ./.A. .............................
UNDERWRITERS CERTIFICATE NO ................. N/A
PLUMBERS CERTIFICATION DATED: N/A
Rev. 1/81
FOB~ NO. ~
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)
13709' Z Dote ............ ;..........;..;.;.........-:'~... ...... , ~.~q--
Permission is hereby granted t.o.'..~..
...... ~.../.,~. ~..,~...~.~ .....................
.................... ..........................................
County Tax Map No. 1000 Section .../.../.../-~... ......... Block ..~..../~... ........... Lot No..,~,~.. ,/. ...........
,..uo., ,o opp,,.,,o. ~o,.d .... .~_.¢.~.........../...
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 m~ 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 featu res.
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 property 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 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: Additions $25.00
1. Certificate of OCCUpancy New Dwelling $25.00, Accessory ,$]0.00 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.O. $ 50.00 Date ..........................
NewC°nstructi°n ...... Old or Pre~existing Building ............ Vacant Land .............
Location of Property v~.~-....~..~.... Z~../.'~.../.. ,~.~. ............ <//~..~.~..,).~..H~ ...........
House No, Street Ham/et
Owner or Owners of Property . ~...//?~/~/ ,/-~..~./~,/C,~F~/~-$...~.~../~.~.,.~. ~
f.
County Tax Map No. 1000 Section ............. Block ............ Lot ..............
Sub ~wmon .......................... Filed Map No ........... Lot No ..............
r ' ' ' .................. ' ' 'cate .......................
Fee Submitted $ ....... /.~; ,~. .................
LINDA L. ALBO AGENCY, INC.
514 Rte. 25A
Rocky Point, New York 11778
744-4500
LINDA L. ALBO
LIc. Real Estate Broker
December 28, 1987
'Town of Southold
'fo~ Hall
P.O. Box 1179
Southold, New York 11971
Att; Mr. Victor Lessard
Re: 15400 Main Road, Mattituck, N.Y.
Dear Mr. Lessardo:
As per your request, enclosed please find Application for Certificate of
Occupancy Form and a check in the amount of Ten ($10.00) Dollars both with
reference to the above.
If I can be of any further assistance to you~ please do not hesitate to
to contact me.
rim ,~LIN~~~
Eno. Licensed Broker
P D
Southold, N.Y. 11971
(516) 765-1938
June 11, 1987
Mrs. Linda~L~_~l~o
~-~ain Road
Mattituck, NY 11952
RE:
Site Plan for Linda L. Albo
located at Mattituck
Dear Mrs. Albo:
The above mentioned site plan has been received and reviewed
the Planner and Planning Board.
It is requested that the surveys be revised to include
the following information:
1o The wooded area as opposed to that area which is
not wooded. This should be clearly delineated on the
plan.
2. Street trees in front of the parking if there are
none existing there now.
3. The Board feels that the grade in the south/east
corner of the parking is too severe, (10% proposed).
The Board would like to have less of a grade and requests
that the revised plans indicate something more gradual.
4. The Board would like, in writing, an indication as
to what types of erosion and sediment control will be
used during the constructionof the parking area since
the property to the South is owned by the Nature Conservancy.
5. An elevation of the entire structure including the
proposed addition is also requested.
Upon receipt of the above (6 copies of the revised site plan)
we will again review this~matter.
Mrs. Linda L. Albo
Page 2 6/11/87
In order to conduct a coordinated review on your proposal,
it is requested that you contact the Building Department
since approvals from other Town Departments may be required,
ie. Town Trustees, Board of Appeals.
If you have any questions, please don't hesitate to
contact our office.
V, ery truly yours,
BENNETT ORLOWSKI, JR. , CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Diane M.
Schultze,
Secretary
cc:
Building Department
Board of Appeals
Town Trustees
COMMENTS
FIELD INSPECTI.O~I .........
FOUNDATION
(1st)
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C,ODE
4.
FINAL
(2nd)
ADDITIONAL, COMMENTS:
LINDA L. ALBO AGENCY, INC.
514 Rte. 25A
Rocky Point, New York 11778
744-4500
LINDA L. ALBO
L~c Real Estate Broker
August 7, 1990
Southold Town Building Department
P.O. Box 1179
Southold, New York 11971
Re: Permit # 13709 - 15400 Main Rd., Mattituck
Dear Lynn,
As per our conversation of today, please send me a copy
of the C.O. on the above referenced.
I have enclosed Check # 0276 in the amount of Ten ($10.00)
Dollars and a stamped self addressed envelope for your convenience.
LLA:rjm
enc.
Thanking you for your cooperation in this matter, I remain;
Your ru~"?
Licensed Broker
' FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
Date .... ~ ...... 19 .~dC'""--
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 c,¢o~te, h~ousing 9o'~te, ar~ regulations, and to
admit authorized inspectors on premises and in building for necess~.~ C_~_~,~
~/(Signature of alYlSlicant, or name, if a corporation)
(Mailing address of'a0plicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Name of owner of premises .Z//~/~.~.~.. ~. (~..~.~.f..'....~..~./..~.~. .... ~.c~:rb~z~. ~ ......
(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 ...... /~../~f-~. .........
Electrician's License No ..... ~ .......
Other Tratle's License No .... .~../~..~...~...~....
Location of land on which proposed work will, be done. ~..~.~... ~...~..o~.. ........ -- ~ ....................
I.
..... .;. ........... .............. ..............
House Number Street Hamlet
County Tax Map No. 1000 Section ..... /.'/..¢ ....... Block .... ¢ ............ Lot.../ ..............
Sl~odivision ..................................... 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.·'il,,/,-,- ~,, ~>..~.. ,L'?~Z~_~ .... ~~..~..... ............................
b. Intended use and occupancy . ...~.~.~--r .'.'. ~ .............................................
3. Nature oft,~,~.(check which a~plicable):. New Building ..... ' ..... Addition .......... Alteration . ./-:-~.'. ......
Repair .............. Removal .............. Demolition .............. Other Work ...............
4. Estimated Cost .... .~.4.~ ........................ Fe~... ~ .7... ' (Descripti°~l
~' (to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If gar?ge, number of cars .... ! ................................................ . ................
6. If business, commercial or mixed occupancy, specify qature~ and extent of each type, of .use'~. i~. ~ ....
7, D~menslons of ex]stmg structures, if any, Front, .~,6, gE ........ Rear ,~. ~,, ~, .... Depth/~,',4',~j7,
Height ............... Number of Stories .... ~ ...........................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
D pth ' Hight Number of St ties
8. Dimensions of entire new cons~rnction: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
Size of lot: Front .~,~o~.'. .~...~.~. ....... Rear ...................... Depth ......................
Date of Purchase .... ,.-~. fq~.~-: ............... Name of Former Owner .~~: .................
Zone or use district in which premises are situated ......................... ~. ~ ...... ! ...................
Does proposed construction violate andy, zoning law, ordinance or regulation: .../~..~..' .......................
Will lot be regraded . ....i' ' ' ~..b'.~. ............Will excess fill be removed from premises: Yes
N f P ' Ph
ame of Owner o remises . .: .................. Address ................... one No ................
Name of Architect ......... I .................. Address ................... Phone No ................
Name of Contractor ........ ! .................. Address ................... Phone No ................
10.
11.
12.
13.
14.
PLOT DIAGRAM
Locate clearly and distinctly al~l buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
inter/or or corner lot. ~
STATE OF NEW YORK, i S.S
COUNTY OF .................
,,- ~I, PPROVED AS
DATE: ....... B.P.I.#/..
~FEE: BY:
NOTIFY BUILDING D~
765-1802 9 AM TO 4 PM FOR Tlql~
FOLLOWING INSPECTIONS:
g'/. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
R. ROUGH - FRAMING & PLUMIJlNG
O. INSULATION
4. FINAL - CON'STRUCTION MU~T
BE COMPI ETE FOR C. O,
ALL CONSTRUCTION SHALL
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOI~
DESIGN OR CONSTRUCTION E~O~,~.
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual ' ' '
signing contract)
above named.
He is the ..........................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; 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 i
· County
(Signature of applicant)