HomeMy WebLinkAbout25589-zFORM NO. 4
TOWN OF 80UTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26450
Date: 08/13/99
THIS CERTIFIES that the building ADDITION
Location of Property: 4465 WICKHAMAVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 107 Block 4 Lot 9.2
subdivision Filed Map No. ~ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 16, 1999 pursuant to which
Building Permit No. 25589-Z dated MARCH 9, 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 20' X 25' DECK ADDITION WITH COVERED SCREENED AREA TO EXISTING ONE
F~TLY DWELLING AS APPLIED FOR.
The certificate is issued to JAMES & ELLEN STEVENSON
(OWNER)
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. 25589 Z Date MARCH 9~ 1999
Permission is hereby granted to:
JAMES & ELLEN STEVENSON
4465 WICKHAM AVE.
MATTITUCK~NY 11952
for :
CONSTRUCTION OF A 20' X 25' DECK ADDITION WITH COVERED SCREENED
AREA AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 107
pursuant to application dated FEBRUARY
Building Inspector.
4465 WICKHAM AVE
MATTITUCK
Block 0004 Lot No. 009.002
16 1999 and approved by the
Fee $ 75.00
Authorized 'S ~ gn~atu~r'
ORIGINAL
Rev. 2/19/98
mo
APPLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
This application must be filled in by typewriter OR ink and submitted to the buildin
inspector with the following: for new building or new use:
1. Final survey of .property with accurate location of ali buildings, property lines
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 buildi
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a
Upre-existing" land uses:
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.
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
A.Iterations to dwelling $25.00, Swimming 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 $15.00
Date ............................
!
New Construction...?. ...... Old Or Pre-existing Building .................
Location of Property ...........................
House No. Street Hamlet
Onwer or Owners of Property .......... ~ ................................
County Tax Map No 1000, Section.../h.~. ...... Block ...... ?] ........ Lot...7.'. J.~iq. ..........
Subdivision .................................... Filed Map ............ Lot ................. .
Permit No..~R~.~...Date Of Permit ................ Applicant ..........................
Health Dept. Approval ........................ .. Underwriters Approval .................. .. .
Planning Board Approval ........................ /
/
Request for: Temporary Cartificate ....... Final Certicate ...........
Fee Submitted:
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
~ay 4, 1999
Robert Bohn Contracting,
P.O. Box 55
Peconic, NY 11958
IBc.
RE: James & Ellen Stevenson,
1000-107-4-9.2
4465 Wickham Ave.,
Mattituck.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX 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 # 25589-Z
Please contact our office on this matter. Thank you for
cooperation.
$OUTHOLD TOWN BUILDING DEPT.
~OUNDATION (2ND)
Il'
FINAL
ADDITIONAL COI,~ENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ]ROUGH PLBG.
[ ] /F~IUNDATION 2NO [ .] INSULATION
[~] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
FEB I 6 tq99
_TOWN QF $OUTNOM)
I) i sapi)awed u/c ...................................
(Ikdl<{t~ lns~cor/
APPI, tCATIOH FOR BUILI)I~IO
ll, ISTRUGTIOH8
'(Stature og ~li~t, or ~ ti ·
~,~si} ~,si~ 9~1, ~ ......... ...................
~. ~ ~ ~ ~ .... ....~ .... ~.~ .... ~ . ~ . .
F
I, ~ or u~ district lo ~ld~ ~a am s t~ .......................... . ....................................
~ {~ tl~e .......... l ' ' ...................................
(C~tmcto~r~rnta o~lcer, eec,)
................. lx!{,{t dul,y 5'wi)rt,~ delx)~e taxi says ll,ol~ he J8 tho ai~pl,l<uml:
APPROVED AS NOTED
FEE: BY: ~'~"~""~"'
T65-1802 9 AM TO 4 lam FOR THE
FOLLOWING INSPECTIONS:
1 FOUNDATION o 'WVO REQUIRED
FOR POURED CONCRETE
2- ROUGH o FRAMgiG & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
USE ~S UN~¢FUL
OF OOOU?A~O¥