HomeMy WebLinkAbout25653-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26992
Date: 03/20/00
THIS CERTIFIES that the building ADDITIONS & ALTERATIONS
Location of Property: 272 PARK AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 123 Block 7 Lot 6
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 3, 1999 pursuant to which
Building Permit No. 25653-Z dated MARCH 26, 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 ALTER GARAGE IN EXISTING ONE FAMILY DWELLING TO A FAMILY ROOM.
The certificate is issued to MELVYN MORRIS & MARY EISENSTEIN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N-512260 01/10/00
N/A
Authored 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. 25653 Z Date MARCH 26~ 1999
Permission is hereby granted to:
MELVYN MORRIS
272 PARK AVENUE
MATTITUCK~NY 11952
for :
CONSTRUCTION OF ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR.
at premises located at 272 PARK AVE MATTITUCK
County Tax Map No. 473889 Section 123 Block 0007 Lot No. 006
pursuant to application dated MARCH 3 1999 and approved by the
Building Inspector.
Fee $ 235.00
Aut ho-ri z~d Signature
ORIGINAL
Rev. 2/19/98
BUILDING I)EPARTMENT
TOWN ItALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
At~....~.~apgO~<f~tS~Sn must be filled in by typewriter OR ink and submitted to the buildin
inspector'O'{lq{-~]H~6' following: for new building 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 from Health Dept. of water supply and sewerage disposal(S-9 form)
3. Approval o~ 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. Co,~erciaI building, industrSa] building, multiple resSdences and s~milar bu5ldJ
and installations, a certificate of Code Compliance from arcbStect or engSneer
~esponSible 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
"pre-existing" land uses:
1~ Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A p~operly 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
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Qccupancy 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 $i5.00, Commercial $15.O0
Date .~..~.~.9.-~.. /~ ~.~.~.~ .....
. ~.
New Construction ........... Old Or Pre-existing Building .................
Location of Property...~.?.P~. ...... .~./~../~.~....~, ~.~: ......... ~..~..~ ~ ~ .... Z/~'~ .....
House No. Street Hamlet
Onwer or Owners of Property .~. ~/. ~9~r~. l ~../~q. ~7' .el ~ .~. ~..~.~ .~. ..............- ....
· 973 f~g
County Tax Map mo 1000, S~ction.~g.~ ......... Block.0~..q~'..O? ....... Lot.. ~.~..~. .........
Subdivision .................................... Filed Map ............ Lo t ..................
.. ~ ~¢· ../~?? ..
Ap p 1 ic an t .~..~.~. ~. ~/~.
·
Health Dept. Approval .......................... Underwriters Approval.. ~..o~.. ..........
Planning Board Approval ........................
Request for: Temporary Certificate ...........
F~e Submitted: $ .................. .. ..
zc. 5p Y0
Final Certicate...~.. ......
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Fax (516) 765-182~
Telephone (516) 765-1802
March 14, 2000
Melvyn Morris and Mary Eisenstein
272 Park Avenue
Mattituck, NY 11952
'~.i~N0~E-~ partial Certificate of Occupancy can not be issued.
"~'y~ur Certificate of Occupancy can be issued the entire
scope of the Building Permit must be completed and inspected.
Also, the amended plans you submitted must be stamped by your
architect. ~e(~ ~e~C~ ~ ~
TO Whom This May 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.
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 # 25653-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FiRE UNDERWRITERS ,a Ez
1001093 BUREAU OF ELECTRIC, IT¥ 'i. /' ·
Date :A~UARY IO,2000 Application No. on file 187~3399299 N 512260
THIS G~RTI~IfiS THAT ~ ~,,,,~ **~ ' ~ ¢
o~ly the elect~cal equipment as described below a~d i~troduced by the applicant ~a~ o~ ,t~ above appHca~, ~umber is i~ the premises
MEL MORRIS, 272 PARK AVENUE, MATTITUCK, NY
in the following location; [] Basemeni [] 1st FI. [] 2nd Fl.
was examined on JANUARY 05,2000
FIXTURE
OUTLETS
DRYERS I FURNACE MOTORS ] FUTURE APPLIANCE FEEDERS
^MT. EW. O,t ,.,. ~S ,.,. ^MT. NO. ^.~.~.
AMT. AMP. TYPS , ~ 2W 1,3W 3~3W 3,4W NO. OFCCCOND.
PADDLE FAN-1
ADDITIION-1
SMOKE DETBCTORt-1
OUT Section Block
be in compliance with th~ National Electrical Code.
and found
to
RANGES I COOKINGDECKSl OVENS I DISH WASHERS
MULTI-OUTLET
SYSTEMS
NO. OF FEET
Lot
EXHAUST FANS
AMT. H.P*'
DIMMERS
AMT. WATTS
E
NO. Or NEUTRALS A W G
OF NEUTRAL
DOROSKI BLEC. INC.
425 MONSELL LANE
CUTCHOGU~, NY, 11935
LIC.#294~
GENERAL MANAG,ER
11 /'~
This certificate must not be altered In any manner; return to the office of the Board if incor~ect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIEI~ATE MI~T ~NO:F'BE,~LTERED N,ANY~ANNER '
I)ATE CO~IBNT~
UNDATION (IST)
UNDATION ( 2ND )
,UGH FRAPlE &
PLIIHBING
ADDITIOHAL CO~O~IqTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ,] F/OUNDATION2ND/ [ ] INSULATION
[ ~ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATI~ ~~/~? INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] INSULATION
[ ] FIREPLACE & CHIMNEY
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ } FOUNDATION 2ND
[ ] ROUGH PLBG.
[ ,~J~N~LATION
[ ] FRAMING
[ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
· FORI~ 1~Oo I
TOgH 0¥ SOU~OLD
BUZI~IHG
TO1~
80UTHoLD, N,¥. 11971
' a'~i~: 765-1802
~ined ................. , 19 ....
~P~PL~CATIO~I FOR BU~LDI~IG PERI{IT
BOARD OF It~TB ...............
3 SETS 01~ PLANS ...............
~SU~V~ ........................
~EPTIC ~0~ ...................
XHSTRUCTIOHS
a. ~nis applicaci~ must ~'~e~ly fill~ ~ by ~i~r or tn i~ ~ ~tC~ ~ ~ ~1~ ~cor ~
3 ~ta of pl~, ~ plot p~ ~ ~a!e. ~ ~i~ ~ ~e.
b. Plo~ plm ~ lxac~ of lo~ ~ of ~l~!T m ~ ~btt~ip .~ ~o~ ~ or ~lic
s~ta or ~, ~ ~ a ~ ~i~ of ~ of p~ ~C ~ ~ ~ ~ ~ ~i~ is ~ of
~is a~li~ci~.
d. U~ ~ of ~is a~i~ci~, ~ ~la~ ~c~r ~11 i~ a ~ld~ ~C W ~ ~li~t.
~t ~1 ~.~t ~ ~ ~ ~l~le ~r i~tt~ ~t ~
~ ~1 ~e ~ ~ ~ ~ ~ld~ ~.
~ ~ ~ ~ ~ ~ ~ldi~ ~-t ~ ~ i~ Of a ~ldi~ ~t ~m,t to ~
~ldi~ %~ ~m~ of ~ ~ of ~ld. ~lk ~. ~ Yo~. ~ o~r ~li~le ~. ~i~s' or
~ati~. ~r ~ ~ti~ of ~6~. ~;t~s or ~te~ti~. or ~ ~ or ~liti~. ~ ~in
~. ~ ~limt ~s ~ ~y ~ ~1 ~li~le 1~ o~~os, ~1~-~ ~. ~i~ ~. ~
.....
~ili~ ~ of ~lim:)
..... ...................................................................................................
· ..........................
If a~li~t is a m~atim, siam of ~ m~ri~
(l~me and title of co~p0ra~e officer)
Builders License No ..........................
OCher Trade's License I~o.
House l~ber Stt~eet Na~let
- ' ~iled Uap .lb ................ Iot ...............
Subdiviaio~ .....................................
2, State existing use .nd ~_o~ of premises and inte~ ~-~d me
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