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HomeMy WebLinkAbout24637-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25524 Date: 02/05/98 THIS CERTIFIES that the building ADDITION Location of Property: 11875 MAIN RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 141 Block 4 Filed Map No. __ Lot No. __ Subdivision MATTITUCK Lot 38 (HAMLET) conforms substantially to the Applioation for Building Permit heretofore filed in this office dated NOVEMBER 28, 1997 pursuant to which Building Permit No. 24637-Z dated FEBRUARY 5, 1998 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 TO EXISTING ONE FAMILY DWELLING AS BUILT. The certificate is issued to DONALD F & MAUREEN SACKER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Suildin~-~nsp~ctor~ Rev. 1/81 TOWN OF SOUTHOU) BUILDING DEPARTMENT TOWN HA~L $OUTHOLD, N.Y. 24637 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED) Permission is hereby granted to: ........ .q p...N. ~,.L.p... iff'.... ~....u..F,...S.~;~;f~ ................................ ..... ,..?. p... ~t.~hX.,...a..~.,7, ...................... ................................... ........ ~li~.T. ,T. :~..T.~J ~:. ~:., .i~ .Y... ,t.,t .%5 2, ..................................... to ...,. ~,Q hI,~,T.I~IJ,~;.T.,.~...DJ~(~.,~..,~ D,I~,~,T.~.QN,..~$.. ~B~L.~ E,~...E O.B.,.~ S... B, UZ,L ~ ............................... at premises Iooated at .............. ~ ~.~.7...5.,..,. ~.~,Z...N,...tip. ............................................... ~.~.T..T..~..T,.U...c..~ ........ CountyTax,Map No, ,..,..4,.7..~...B...B.~. ..... Section ..,.z,.4..:1: ............. Block ....,.0...0. ,0...4. ........ Lot No. ,9,7..8. ............... pursuant to application dated.,,,.N,.O.v, E,~ .B,E, R......2.,8, ..................... .., 19 ...... ?..7. ..... and approved by the Building Inspector, Fee $ ........ 7...5..:..0..©, ..... Rev; 6/30/80 F?rm No. 6 TOWN OF SOUTHOLD I ~!~!~OW~L~UT~LO':" ~~~' - ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY ..... =ppzzcat~on must be filled in by typewriter OR ink and submitted to the building inspector with the 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 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 i% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-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 applicant. 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, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building....~??.......~D ~_i~ ~ ~/~ House No. Street Ha~et Onwer or O~ers o~ Proper~y ........................................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval Request for: Temporary Certificate ........... Final Certicate ........... ,, , , . 7, , , , ?', , .............. 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ IFOUNDATION 2ND [ ]FRAMING [ ] ROUGH PLBG. [ ] INSULATION [~FINAL [ ] FIREPLACE & CHIMNEY ,INSPECTOR ,NOV 2 8~ ], BLDG. DEPT. M~WN OF SOUTHOLD FORH HO. ! TOf4N OF SOUTHOLD BUILDII~G DEPARTHENT TOI4N HALL SOUTIIOLO, N.Y. 1197 I TEL: 765-1802 Disapproved a/c .................................. BOARD OF HEALTH ...... ~ ........ 3 SETS OF PLAHS ............... SURVEY ........................ CHECK ......................... SEPTIC FOEH ................... NOTIFY: CALL ....... HAIl, TO: .................... APPLICATION FOR BUILOING PEI~IT INSTRUCTIONS a. 'HAs application rmat be conpletely filled in hy typc~vriter or in ink and m~l~[tted to the ~dlding Tns~ctor wire 3 ~s of pl~s, ac~raCe plot plan to ~ale. F~ ~cording to b. Plot plan ~i~ l~a~i~ of lot ~ of ~dldi~s struts or areas, a~ glvi~ a ~tailed ~ription of laya~t of ~o~r~ ~s~ ~ dr~ on the dia~ ~fich is lmrt of thi~ applicati~. c. 'H~e ~ c~r~ ~ fids a~licati~ ~y ~t ~ ~am~l before isle of ~dldi~ Pemlt. d. Ui~ a~)~al of fl~ia a~llcati~a, the ~ildi~ Ins~ctor will {s~ a MJiding Pemlt to t{~ applicant. ~ch ~mit ~mll ~ ~pt ~ tim ~s avail~le for in~tla~ th~t Ole x~rk. e. ~ ~ildi~ ~mll ~ ~ied or ~ in ~le or in ~rt for mW ~ ~mt~er mtil a ~rtiflcate of ffH.ICATIffi IS [E~BY ~ to t}~ Mildi~ ~r~nt for the is~nee of a ~dldi~ ~mlt ~rs~ant to the ]~fildiog 7~ O~i~a~e of t~ T~ of ~ltl~ld, ~ffolk ~nty, ~ York, aM other al~licable I~s, ~di~m~es or ~lati~s, for Om mmt~tlm of Imildings, ~it~s or alterations, or for r~al or ~lition, as Imrein (bseri[~. ~m appliem~t ~s to co~ly with all a~licable l~s, ordinates, Imildi~ c~e, h~sing c~e, a~ ~flati~s, a~ to ~it ~t~ri~ in--tots ~ ~i~s ~ in ~ikding for ~ces~ i~ti~s. (Si~ture of a~llcant, or ~, if a co.ration) (~il State ~etlmr applicant is °~er, les~e, agent, architect, engineer, general contractor, electrician, plmi~r or ~ilder. ...... ................... ...... ......................................................... N~ (~ a~ title of co,rate officer) ~ ~ AM ~ 4 ~ ~R THE I ~ ' ~0 R~UIRED ~dl~rs I,icen~ ~ .......................... ~D~ Pl~rs Licen~ ~ .......................... 3. IN~ 4. FINAl.. CONSvRUCTION MUST E]~t~ci~s ~]ce~ ~ ...................... BE COMPL~E FOR C,O, OU~=,~'s ~Jcen~ ~ ..................... ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N.Y, . [~ati~ of 1~ ~ ~i~ p~. .... ~rk ~ill ~ <~ ....................... ~ATE- ..... ~T~OCTI~Nn ' '~_ ...... ~ERGY ~ ~ . ~.' . ~ o,s,,~ FO, .................. ......... ........... .... ~~,~. ,~ ~, ...Z~ ....... ~,~ ..~.~.'. ........ ~ ..~< ......... ~ivlsi~ ...................................... Filed ~p (~) 2. State exlst~ ~ ~ <~<y of ~a aM in~ ~ aM <cu~ of pro~ c~st~ctlon: ~. ~t~ ,~ ~ <~ ......... ~/.e~ ..... 7)~C;~ .... ~ .... ~<&~ .................... ]. I~;~ture of ~o~k (cl~x:k ~l]ch sppilicable): Ne~ II~ihling .......... ~ition .......... AlLerd~io~ ......... If garage, tl~tmr of cars ..... [ ................................. 6. If lami~mas, ~mrcial or mi ~a~y, a~ei~ ~t.ure a~l extent of each ~y~ of u~ ......... ;;~ .......... Ihi~ C .............. [ ~dmr of 8~oriea Dm~na~s' ' of sam atn~t~are ,~,th'l alteraticma ~r ~itlona: Front ............... ~ar ............... ~pth .................... l~i~c ............... : .... ~/mr of Stories ............... 8. Dinenai~m of entire ~ ~mt~l:i~: lk~t ................ l~ar ............... ~pth .............. 9. Si~ of lot: l~t ........... i ......... ~ar .................... ~pth .................... I0. I~at:e of lMrd~s~ .............. ~,. ......~ o~ Fonmr C~mr ........................................ I1. ~ or u~ diatrlct in ~id~ p~mi~a are slt~tM .............................................................. 12. hms prol~l c~mt~t~ v~olpte any ~t~ I~, ordh~me or regulati~: ........................ ~me of Arddt~t ............. ~ ....................... ~lress .............................. Hmm ~ ............... ~ PI,OT I)IAGRAH ~d~tlmr interior or co~r 1o~. of said ~mr or (~rs, taxi is duly ~Lhoriz~ to l~rfonn or have i~rfnra~ I.he ~icl ~ck taxi to hake a[~ file Lhis S[~}I JcatJotl; tinlt si[ akatomnEs C(~lk~Jl~ ill Lh[B aHfl. ication sre thaL Lhe ~)rk will J~ ~rfotl~I itl I.Jl~ II, letter ti fo~tlx in Lite apgl (Sigiml:ure of Applicant) KEY MAP SCALE 1"=600' LOT LINE MODIFICATION SITUATED AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S,C, TAX No. 1000-141-04-38 1000-141-04-59 SCALE 1"=50' JULY 15, 1997 Joseph A. Ingegno Land Surveyor