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Home My WebLink About26429-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27013 Date: 04/03/00 THIS CERTIFIES that the building ADDITION Location of Property: 955 CONKLIN RD MATTITUCK (HOUSE NO.} (STREET) (HAPrLET) County Tax Map No. 473889 Section 139 Block 3 Lot 30.1 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 29, 2000 pursuant to which Building Permit No. 26429-Z dated APRIL 3, 2000 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 DECK ADDITION "AS BUILT" TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BEULAH RICKETTS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A ~'/Au~orized Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 26429 Z Date APRIL 3~ 2000 Permission is hereby granted to: BEULAH RICKETTS PO BOX 592 MATTITUCK,NY 11952 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING "AS BUILT" AS APPLIED FOR. at premises located at 955 CONKLIN RD MATTITUCK County Tax Map No. 473889 Section 139 Block 0003 Lot No. 030.001 pursuant to application dated MARCH 29~ 2000 and approved by the Building Inspector. Fee $ 75.00 Rev. 2/19/98 ORIGINAL 765-1802 ~ ' :' APPLICATION FOR CERTIFICATE OF OCC ANCY This application must be filled in by typewriter OR ink d submitted'tg,~ bu ldi~ inspector with the following: for new building or new us~_~ 1. Final survey of ~property with accurate location of all buildings, property linea streets, and, unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) 3. Approval of electrical installation from Board of Fire Underwriters. 4, Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar build~ and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plaB requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings Vpre-existing" land ns~s: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applican If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw~ming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinm - $100,00 3. Copy of Certificate of Occupancy - ~ .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.OO Date.. ~P~. ..28~.~OpO ..................... New Construct~.~. Old Or Pre-existing Building .................. Location of Property.. 7~.~.r~,~p..P~.:~..F~.~%~qc.k.L..l~. ..................................... House No. Street Hamlet Onwer or Owners of Proper ...... ~..~ ..... '-~ ............... County Tax Map No 1000, Section...l~gq ....... Block.~ ............. Lot.30.1 ............ Subdivision .................................... Filed Map ............ Lot ................. Permit No ...... ... ...... Date Of Permit................Applicant ........................ Health Dept. Approval .......................... Underwriters Approval .................... Planning Board Approval ........................ / ) Request for: Temporary Certificate ........... Final C~a~ ........... /~/~ / 25.00 ... Fee Submitted: $ .......................... . ///' /,/ ~ '; . ...... · ....... GARY FLANNER OLSEN Main Rd, PO Box 706 Cutcho8ue, NY ] 935 GARY F[ANNER OLSEN ATTORNEY AT LAW ASSOCIATE: DAVID ~(/ORTHINGTON OldEN ATTORNEY AT LAW RO. BOX 706 · MAIN ROAD · CUTCHOGUE, LONG ISLAND, NEW YORK 11935 PHONE 631-734-7666 FAX 631-734-7712 March 28, 2000 Re: Ricketts to Mattola Our File # 6960 To whom it may concern: Enclosed herewith please find the following: 1. Application for Certificate of Occupancy for deck as built. 2. Check in the sum of 25.00. 3. Building Permit for deck as built. 4. Check in the sum of $75.00. 5. Sketch of deck. Please contact Carll Austin of Lewis Realt~'%~t 298-4600 // the inspection. Very t r~y/urs, ~AR~ FLANNER OLSEN GFO: lmk Enclosures Southold Town Building Main Rd. - Town Hall Southold, NY 11971 Dept. for F~Or'l : Lewis Realty Group [no (HATT) PHONE HO. : 5i6 298 4877 HAR. S0 2000 0i:04Pr'1 P1 s~s~ ~,n~s . / P.O. Box 1097 CUTCHOGU~, N~W YORK 11935 (516) 298-5272 (516) 734-71~2 ~ J'llpl]llt~ hereloy lo furnish material and labor -- complete in accordance wllh gpeeil~3atioos below, ~or the sum of: .?~-.G,~,... ~.~r.~ ....................................................................... Examined ' ~ 19 BOARD OF HEALTIt 3 SETS OF PLANS 'FORM NO. 1 SURVEY ......... TOWN OF $OUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY gOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL · , ...... MAIL TO: 19 Permit No ^pproveu ................ , · ·. Disapl~roved a/c ................................... ;. ~',, ~' ;" ~ '~ ' '~ ~'~,~i (Buildinglnspector) ,. t; ,, APPLICATION FOR BUILDING PERMIT 9 Date. ~ , ~ , :, ': ~,,.~i-~ INSTRUCTIONS a, TMs application m~st be completely H~ed ~ b~ ~pewfiter or in ~k and submitted to the Budding Inspecto~, wRh 3 sets 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 adjo~infi premises or pub~c streets or ~eas~ and giv~g a det~led description of layout of property must be drawn on the diagram which is par of ~s app~- cation. c. The work covered by t~s application may not be commenced before issu~ce of Bulldog Permit, d. Upon approval of this application, the Building ~spector w~l issued a BuHd~g Pe~it to the appfic~t. Such pe~lt sh~l kept on the premises ava~able for ~spection throu~out the work· e~eNo bu~d~g shall be occupied or used in whole or in p~t for any purpose~tever unt~ ~ Certificate of Occup~cy shall have been granted by the Building Inspector.. ff / . . ~PLICATIO~ iS HEREBY MADE to the Bulldog Dep~tment for the ~sua~e of a B~ld~ng Pe~t pumu?t ~o Budding Zone Ordinance of the Town of Southold, ~uffolk County, New ~ ~,~d other apphc~ble Laws, Ordm~ces or Regulat?.ns, for the construction ?f buHd~gs, addibons or ~Jterations~ or~ ~emoLal o~ demolihon, as here~ dese~bed. The .apphcan~ agr?s ~o comply wtt~ all apvficable ~aws, ord~nances,.buH~] ~zeode~ousmg code~ and regulations, and admR authorized mspectom on premises and ~ building for necessa~ ,ns~ ~/~__ ~ary~ her O~aen as attorney ~or Beulah' (Mailing address of applic~t) State whether applicant is_owner~ lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. I Name of owner of premises ................................................. (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. (Name and title of co.orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician s License ~.¢o .... ,,,,,. · ·, .... + Other Trade's License No ................. ,, ·,, Location of land on which proposed work will be done~ .................................... rmers Rd Mat]:~{:~?~:,k~ lq~ ¥o.~¥ ' 7.2,5 Fa ................. , ............... ' .... ~'''''''''''" House Number Street Hamlet : Tax M p No 1000 Sectio 1.3.9 . Block ~1 ..... Lot ,30~1, ,, , County a . n .............. .: ............ : Subdivision .................................. ,.. Filed Map No .... , .......... Lot .,., (Name) .. State existing use and occupancy of premises and intended use and occupancy of proposed construction: deck as built ; a. Existing use and occupancy . ·., ......... ~ ................... ' ................. ' .... deck as built b. Intended use and occupancy ................... ' ............... ' ................. " ' ' ' Altdation {Nature of work (check whicll applleabie)~ New Building~ Addition ,,' 3, Demolition Other Work,,,. ~,,,, ·,,, Repair '. ....... , ..... Removal ,,,,., .............. ,,,, .... (Deseriplion) ~ i ~' Fee 4. Estimated Cost ...... ,,.,,,,., ........ ',,''",""''"; ""''" ...... "'"'"'''""""''"' " (to be paid on filing this application) If dwelling, number of dwelling untts,,.,,, ·,.,,,,,, Number of dwelling units n each floor,.,,,,,,, ..... ,, If garage, nmnber of cars ,,.,,,~,,,.,,.,,,,,",",''"''""'~'"'''"'~'''"''''"''"""''""' 6~ If bnsiness commercial or miked qccupancy, specify nature and extent of each type of use ,,,,,,,,,,,, ~,, ~,,,,, ofexisting structures iifany; Front Rear .... ,.,,.. Depth ..,,,,,,,,,,,,, 7 Di .mensions , .... ,'" .......... ' Height ,,., ....... ,.,.NumberofStories ............ ,.,,~, .... ,,,,,,,,,""'"''"'"'"''''"" ' Rear Dimensions'of same structure witll alterations or additions: Front ....... , ~ ·,,,,. ·, ..... , Depth ,.,., ......... , ..... ' I Height ............. ,.,,,,, ~. Number of Stories ,,,, ,., ,..,,,,,, ,,,, ,, · '.8, Dimensions of entire new construation; Front .......... ....~. Rear,, .... ~,,..,'"Depth ,,,,,,,,, ,,.. Nun~b~r of Stories ........ , , , ......, ,,, ,, ." ,' , ' ' ? ' ' ' ' ' ' '" '"'" Height .......... ' ' ' ' ' Depth i Rear '" .... ''" ''" 9, Size oflot; Front ...,..,,,.,,.,.,,,, ....... ,"~""""'""' "'"' !.., .... : Name of Former Owner .,,,,,.,,,..,,,,,,,,,,,, '", 10. Date of Purchase ,,.,,,,,,,,. ,,,,,',,' ' Il Zone or use district in which premises are situated,,,,,,,,,,,,, .... ,,,,,,,,,,~,,,",'"' .... "'"~ ''" · · : ·· ?!.at.'. 12. Does proposed construction violate any zoning law, ordinance or reg ion. ,,, ~: "' Yes No ' - .......... { Will excess du ue remover from pre ' win ioroeregraueo ,, ~, ! , . *)' ! t',' ~' '' ' ' 13, . 14, Name of Owner of premises .,,.~,,, ............. Address ,,.,,,,,,,,,.,,,,,,PhoneN°' ,,,,,,~,,,,,,?, hit ct : Address ,,,,,.,,,,.,,,,,,,,PhoneNo. ,~,,,,,,,,,,.~. NameofArc e ,, ......... ,,,,,,,,.,,,'"' ; Address ' Phone No, ,. Name of Contractor ,,.,,.,,,,~.,,,,,,,, .... ,, '" .... "'"""'" ,15, IS ghis~property located within 300 feet of a tidal wetland? *yes ,,,'~, No ,~,,, ~If yes~ $outhold Town True :eec Permit maybe re~uired, ~ , , , ~ ',: PLOT DIAGRAM ,; : . ' Locate clearly and 'distinctly all property lines, Give street and block n {nte~or pr ~orner lot ' ' ,~ ,! sge, annexed drawing .uildings, whether existing' or proposed, and, indicate all set-back dimensions from ~mber or description ao¢ording to deed, and, shov~ street names and indicate whether STATE OF NEW YORK, $.S couNTY OF,. $BFI~O 'N( ........ ..... ,qa.r,y..E%a..n~.qr. 93,s,e.a, .... ~ ...... (Name of individual signing contract' above named, being duly aworn, deposes and 'says that he is the applicant He is tho ·,..A. tt;otr, n.e.y ............................... , ............... , ........... ' ..... v, ,, , ? .... ; (Contractor, agent, corporate officer, ete.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application that all statements contained in this application are true to the best of his knowledge and belief; and that the work w 11 be performed in the manner set forth in the application filed therewith. Sworn to before ,ne this i " / / -~ ~ i March ~ 2000 / / ' Z~ - ...davol, . . .,i.,, . / / ~ ,,/ LORRAINE KLOPFER ' //'/2/~'/ Nota Publi.,b~ateofNewYoa~ //'//// //' . .......... ,, Oualal~d }d.~uffolk Coul~ty / ~ ' ~' / (Signature of applicant) Commission E~p;Ires N°v. aO,.~g 0 0 ~