HomeMy WebLinkAbout25787-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26668
Date: 09/07/99
THIS CERTIFIES that the building ADDITION
Location of Property: 715 BAY AVE
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 143 Block 4
Subdivision
Filed Map No. __ Lot No. --
MATTITUCK
Lot 3
(HAMLET)
conforms substantially to the Application for Building permit heretofore
filed in this office dated APRIL 20f 1999 pursuant to which
Building Permit No. 25787-Z dated JUNE 11, 1999
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 ADDITI~ TO EXISTING ON~ FAMILY DWELLING AS APPLIED FOR "AS BUILT"
The certificate is issued to MARTIN J TARPE¥, JR.
(O~MER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
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. 25787 Z Date JUNE 11~ 1999
Permission is hereby granted to:
MARTIN J TARPEY
715 BAY AVE
MATTITUCK~NY 11952
for :
CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR "AS BUILT"
at premises located at
County Tax Map No. 473889 Section 143
pursuant to application dated APRIL
Building Inspector.
715 BAY AVE
Block
20 1999
MATTITUCK
0004 Lot No. 003
and approved by the
Fee $ 75.00
Aut hori~fed Sigrf~ture
ORIGINAL
Rev. 2/19/98
FORM NO, 6
TOWN OF SOUTHOLD
· . Building D~l)artmont
" Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in Wpewriter OR ink, and submitted ~ ~ to the Building Inspec
tar with the following; for new buildings or new use:
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusua
natural or topograpblc features.
2, Final approval of Health Dept. of water supply and sewerage disposal-iS-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters,
4. Commercial buildings, Industrial buildings, Multiple Residences and simi[ar bu~idlngs and Installs
fleas, a certificate of Code compliance from the Architect or Engineer responsible for the
5. Submit Planning Board approval of completed site plan requirements where applicable.
.For ex[sting 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, build{ngs and unusual natural c
topograpl~ic features.
2. Sworn statemcnt 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 inform~
tlon required to prepare a certilicate,
C, Fees:
.l. Certificate of occupancv $25;B0-- BUS[NESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Cepy of certificate ef occupancy $ 5,'00, eve~ 5 years
5. Upd~te~ c.g. ~"50.00 Date ...... ~. .~ .....
NawCOns[~uc~ion ~ Old or Pre-ax[sting Buildina Vacant Land
Location of Proper~/ ....... ~'.~.~.. ~*~Xg ~,~. ~.~.~ ~X ......
CoanW Tax Map ~o. l~O0 Section ...3.-A~ ...... Block . ...~ .......... kot .............
SuBdivision ................................. Filed Map ~o ........... Lot
Permit No ........... Date of Permit .......... Applicant ................................
,.
Health Dept. Approval ........................ Labor Dept. Approval ......................
Underwriters Approval ........................ Planning Board Approval ....................
Request for Temporary Certificate ..................... Final Certificate .,...~ ......... ?~,~'. · ..
Fee Submitted $.. ' ....................
Construction on above described building and perch;t, meets all appllcabie codes and regulations.
..... .................
Rev. lO.le.?a
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 21, 1999
Mr. & Mrs. Martin Tarpey
715 Bay Avenue
Mattituck, New York 11952
Please note, your Pre-existing Certificate of Occupancy can not
be issued until your 2 open Building Permits have been issued
Certificates of Occupancy.
To Whom This ~ay Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 25787-Z DECK
our office on this matter. Thank you for
Please contact
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
;~ - N'fOI',fuMEI,IT
GUA~AN'T',~r:-D TO.TM~ SECUI2.tTY TITLE AND_,_".'.
~JAD.,At,~TY COI,,~.ImA. t-,P(' AND 'TO TME NOETN '
VAN TUYL ~ 50N .
LICEnSeD LAMD'' ~U~V~YO~ .... ?
~lt-~D IlqS~PKCTION IB~PORT DATE CG~NTS
~Ot~NI)A~ IO1,] (iS'Y)
f~AX3[O~ (2~U)
2~SULAT3[ON PER N. ¥.
STATE ENERGY
CODE
FINAL
ADDITIONAL CO~S:
jgcq , ./
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
8OUTHOLD, N.Y. 11971
TEL.: 765-1802
Exa,nined ~ ~. ~...~....., 19 ~-~
Disapprove[{ a/c ....................................
BOARD OF IIEALTII -' .....
3 SETS OF PLANS ..L'....
SURVEY ..........
CHECK ..........
SEPTIC FORM .............
NOTIFY
...
MAI To:
APPLICA'I tON FOR BUILDING PERMIT'
· ~ INSTRUCTIONS :
a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 t'o adjoining pr'emises or public streel
or areas, and giving a detalied~description of layout of property must be drawn on the diagram which is part of this appl
cation.
¢. Tile work covered by this application may not be commenced before issuance of Building Permit.
dj Upon approval of this application, tile Building Inspector will issued a Building Permit to the applicant. Such perm
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 CertiBcate of Occupanc
shall41ave been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for tile issuance of a Building Permit pursuant to tl-
Building Zone Ordinance of tile Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for tile construction of buildings, additions or alterations, or for removal or demolition, as herein deseribe~
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t
admit authorized inspectors on premises and in building for necessary inspe~/~
'~' '' (Signature o[,a~ica" n~,~or~',~il; &'Corporation)
State whether applicant is owner, lessee, agent, architeot, sngineer, general contractor, electrician, 'plumber or builde
.................... (as on th~ tax
If applicant is a corporation, signature of duly authorized officer. ~ ~.l~lO ~'~AR~IENT"~I
(Name and title of corporate officer) ·
Builder's License No.. .
Plu,nber's Liceuse, No ........ USE 'IS' 'UNLAWFUL
Electrician's License No.
.... WITHOUT CERTIFICATE
~'l~ $ ~ TO 4 RM FOR THE
~ I#aI'C-CDONS:
t ~ - ~O REQUIRED
[ ~-~& ~MBING
4. FIlL. CONS?RUCTION MUST
~ ~ ~R C.O. ~ , '
A~ ~NSTRUC~ON SHALL MEET
~E REOUIREMENTS OF THE KY,
~ATE CON$TRU~ION & ENERGY
Other Trade's License No ......................
I. Location of land on which propo o ........... DE.SIGN. O.R..CONSTr .,,J.C..~ ~ .EJar ;,.,..o.
,
'House Number ' Street . {I;in'l;t' .......... ....... .....
County Tax Map No. 1000 Section ............... Bloc ............... Lot ...............
Subdivision ..................................... Filed Map No ............... Lot ..............
(Name)
State existing usc and occupancy of prenfiscs and intended use and occupancy of ~roposed construct~ofl:
a. Existing use and occupancy ...... ~. · .~ .... ; -'- ·; ..............
b. lntended use ann occupancy· · .. · .~. ... .............................
~.~ tcheck which applicable): New Building .......... Addition .......... Alteration
.,,qatar .............. Removal .............. Demolition .............. Other W'ork .............
.~'~.~:9 (Description~
Estimated Cost ............................ Fee ....................................
(to be paid on filing this application)
If dwelling, numbe'r of dwelling units ............ i.. Number of dwelling units on each floor .............
If garage, number o~ cars ......................................................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use ...................
Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............
Height ............... Number of Stories ......................................................
Dimensions'of same structure with alterations or additions: Front ................. Rear ...............
Depth ...................... Ite~ht ...................... Number of Stories ...................
'-.& Dimensionsofentirenewconstmction: Front ~ ~ ~v /3~ ~s Depth .
Height .. ~. ........ . Number of Stories ......................................................
9. Size of lot: Front ...................... Rear ...................... Depth
10. Date of Purchase ............................. Name of Fomer Owner ..........................
1 1. Zone or use district in which premises are situated ..................................................
12. ~ Does proposed construction violate any zoning law, ordinance or regulation: .............................
13. Will lot be regraded ............................ Will excess fill be removed from premises:
14. Name of Owner &premises .................... Address ................... Phone No .............
Nme of Architect ........................... Address ................... Phone No .............
N~e of Contractor .......................... Address .... : .............. Phone No .............
15. Ia this property located within 300 feet of a tidal wetland? *Yes ..... No .; ...
*If yes, Southold To~ Trustees Pe~it maybe required. ~ ~ ~
' ~ PLOT DIAG~M .
Locate clearly and distinctly MI bulldogs, whether existing or proposed,~ an&indicate all set-back d~ensions fr
prope~y lines. Give gtreet and block number or description according to deed, and show street names and indleate whet
integer or corner lot. ,: , ,-.' , ~, , ~
STATE O F NE~f~22 ~
above n~ed; ~ '-~
tlc is the 9 ~ ................................
(Contractor, agent, corporate officer, etc.)
of said owner or owne~, and is duly autho~zed to perform or have performed the said work aha to make and f
application; that all statements contained ~ this application are true to the be~t of his knowledge and belief; and t
work will be peffo~ed in the m~ner ~orth in the application filed therewith.
Sworn to before me this / / . ..
Notau Public, . .,.~ County
Qualified in So,elk Gom~ /~ t g ~ I (Signature of ap
,' ~mission Expires M~ ~. ,_ /~