HomeMy WebLinkAbout24425-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25384 Date NOVEMBER 25, 1997
THIS CERTIFIES that the building ACCESSORY
Location of Property 3435 ELIJAHS LANE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 108 Block 4 Lot 7.20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 30, 1997 pursuant to which
Building Permit No. 24425-Z dated OCTOBER 23, 1997
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 ACCESSORY STORAGE SHED IN REAR YARD AS APPLIED FOR.
The certificate is issued to KWANG WOON OH & JENNIFER Y. PARK OH
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ui ing inspector
Rev. 1/81
FORM NO.S
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)
Date......OCTOBER.......23.......................... 19...97..
24425 z
Permission is hereby granted to;
KWANG WOON OH
.............................................................................I............
3435 ELIJAH' S LANE
............... ..................................................................
MATTITUCK,NY 11952
...... ...............................
to......CPNSTRUCT AN ACCESSORY STORAGE SHED IN THE REQUIRED REAR YARD OF
............ . . .. . . .. . . ..... . . . SHED . .. . ..... .................... .......... ..........
A SINGLE FAMILY DWELLING AS APPLIED FOR
...............................................................................................................................................................
,. ......I.......... .................... .............................................................. ........................ .......................
... ................................................................. . .........................................................................................
............................................................................................................................................................. ....
3435 ELIJAHS LA MATTITUCK
at premises located at.................... . ............................................................. ......................
....... . ................................................................................................................................... ................
County Tax Map No. .... 473889.._. Section .,,,108........_.. Block ......0004....... Lot No. ..0.0.7...02.0
pursuant to application dated .....MAY..................30....................... 19.......97..., and approved by the
Building Inspector,
Fee$.........35.00...
.................... cr......................
Buildin Insp
Rev. 4/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application 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 1% 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 completed site plan requirements.
B. 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-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .251�,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00,f Commercial $15.00
�� �► •
Date . . . . . . . �
� � . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . .✓ . . . . Old(/Or Pre-ex�ting Buil ng. . . . . . . . . . . . .
Location of Property. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House No. r' Street Hamlet
JCL
Onwer or Owners of Property. . . . ./a-4:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . l(2r'. . . . .Block. . . . . . . . .. . . . . .Lot. 7.-. . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . .Filed Map. . . . . . . .Lot. . . . . . . . . . . . . . . . . . . .
Permit No.C2 . (0.S . . . . .Date Of Permit. . . l.0J.� l Applicant. . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . .
Fee Submitted: $. . . .6)3. . ._ . . . . . . . . . . . . . . . .
J.kAA
. . . . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ;71NAL
S ON
l 1 FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: 1 D
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DATE /0kr/q -71NSPECTOR
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__._. __M�!._... ... BOARD OF Ill-'A :fll . . . . . . . . . . . . . . .
1.01(1-1 NO. 1 '1 SI�.T: OF PLANS . . . . . . . . . . . . . . .
TOWN 01: S0111,110111) SIIRVI:Y
tllILDIN( h�PARfrIT CIII?CK . . . . . . . . . . . • . . .. .. . • • . .
10 1FORM '. . . . . .E.. 0ON IInII
SMY1,1101.1), N.Y . 11971
1'ICI.: 705- I1I07.
"OT II'Y:
. . . . . . . . . . . . ... . . . .
I:x:rnitx(I.ld ✓�/.�, 19.... MAIL TO: . . . . . . . . . . . . . . . . . . . .
Alglruved./G/ ��� . 19.... I'errrti t �U'�It CJS/ � . .....................................
Itis:rlglrcrvecl n/c: ............................ ................................. .. .
tildinl; Inslrc•1(rr)
AI'I'I :n'1'I ON FOR lilt 11.1)1 NC PICI1111'I'
11nte. . . . . . . . . . . . . . . . 19. . .
I NS'I'RIICT I ONS
n. lltin .1171)1icnticm rntrnt Ire cutplelely filled in Iry IylxR•rrilrr or in inl( n(xl strlrnit:Ceti to Lhc 14rildinr 1nn11rclor will,
!—,(,I of plsntn, nct-ornte plot: plan Io Henle. Ier n(xordinl; tonchedtde.
Ir. 1'lol: plant slKtwio :►
f; Icxt.icrt of loll snxl of lxtiltlinl;n mprr+ninen, rel ►I it►nnl►ip to :xljoininl; pronir:en or 1ltdr) is
:I rrrin or areas, snxl givinn n (Ictniled drncripticm of Inyoot of property n'rnt lie dr-noi olt the dinl;rrm wlticls irr 1x11-1: (,f
11ir: nppl ical.i(m-
c. 'Ihc ix►rk ctnrerrcl by titin nl>I►licntion r•rty 1-x11. lx-. ccnurrxrr) I►rforr isrntrnxr of Ik►ildinl; I'ern►il:.
d. 11111x, npprovnl of this nlgrl.ic.1titm, Ute. mfildiol; Iosllect.crr rriU iss(te n Ibtildiol; 1'etmit to the rr1r111irnnC. Sm-11x snit r:h:d l I►e I(epl: car the premiseg r►vnilnhle. for inslxIctitx/ OW0111;hout the work.
e_
No Wilding shall. lx- cxctq►ietl or cared in whole or in 11.11-1 for rnry lxsrpone wirrt"er t11►til n Cerl:ifirnte of
kculunx,y shall have Item prnnted by Ilse Iblildinl; htslx•clor.
AP'(9.ICn'1'IOT1 1S III.W..ItY MCI to lite Ruildinp, Ikk1r►rltrhnt for the insuatxe of n Ibtildinl; 1'ennit lxrcrn►nnt to 1111-
brild; ig 7,cxx: Ordimiiwe of the '1'(nst of riotiooitl, Suffolk (Rxtnty, Ncno York, nrxl outer ilyplicnble Lnws, Ordiontxrs of-
4,1"111:11 i oos,
rIcl;ulatioos, for 1.11" ccrosl.rtKm;ticof tit,ildiols, :xkliI:icros or nitttrstl:ions, or for remx,vn1, or dt•rrtnlitiort, nn herein
lescrilx•d. 'Ihe applicnnt :q;reen 1_o c(r'gtly wills nll stlq►lir.nhle Epos, ordinances, Imildinl; c(xle, I)a►sin1; ctxlc, :110
ml;ulal icmn, mxl to :xll.tit snrlhorized inspectors (m prtnmises rnxl in 11,rildinl1 for r►ec;esanry innl►ecti(xts.
... ..... ..... ......................... .. ......... .. . .
(Sipnalure of nlgd icnnt-, or t►rrne, i F n cot x)rat ion)
................................................. ..
(ht i I inl; :xldrrns of timi icnnt)
`;Erle t>lrcthcr nlgtlicmtl: is (hotter, lesree, nlrnt, .1tchilrcl:, cnt;itxer, rrtx±rnl conlrncl,or, electticirnt, pludxtr or Ixtildrt
. .......... ........... ...... ..........ellIPP F-10 AS ®T
PC,-
Mutt, of anter of. irrrnirrs .....���...... q ........... ...................
(stn ext I.he I.ax Poll or Inlent deed)
If :►Igtlicntsl: is n corlxirntirn►, rilrt7llure of atoy rntlhorizrcl officrr_ .-CITIg-Y BUILDING DEPW5WNI AT
FOR rFI
.... . .... ......... .................. G < G / _..L G /�."',_1LOWING INSPECTIONS:
4•
(N:rtr :11x1 title of (xrrlx)rnte officer) Ru;)a.iNDATION TWOREQ1.iIRE- l
€'JR POURED CONCRETE
n1- c R;Y GH — FRAMING fit• PLS MD,',,�
Ikri Idrrn Licrnse No. �id9111., T11)i
4 _ CONSTRUCTION kA ;S1"
ltrtix>rs License No. �w cD0*PtETt0bR C.O.
IClrcl.ric inns License Net. ..................... �? ap° re c ` ") ':;: r. CONSTRUCTION SHALL MEET
REQUIREMENTS OF .AWE MY.
Othrr 'I'1-:xle s l.icen:,e 1-k►. .................... "??E CONSTRUCTION & ENERGY"
I.
lox-al.ism of Isnxl cm wltirlt prolxmcd work will be dom.. . ... ........ ..... ..... k ,-P F.f,�r••NC)''• RESfVINSIB E- Fort
t«4PGN 0R:gMSTR4JCT R
Ikxtr:e Mrdx•rlrecC �,( 14-rnleC
Ctxmty 'I:nx Mrp No. 1(1(10 Beccles: ..I.�CG......... Ill(WIC. ......./........ Lot ....
5ctlxlivisicns .................................. .... F;Ird Kip No. ....... ........ lot ...............
7. `;Elle rxisl.iry; use ntxl (x-ct►prnxy of pmtti s'. :nixx, inl rrxlcd I,!-(. :nxl (x cnlxnx y of prolx►sed co ortruct iot►:
a- I:xi1-a inl; nr:(> rnxl (x:cullnxy �G(.�G .. ........ ..............•. ..................................
h. Inlrtxk(I ux nrxl cx't'vn
llxy ...... . �7 . ... ..b(!G�!4 .... ..... .. ...
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JVY ItNNIb1 11-
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WOW mi blaililm.1c)
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/4klltiun .. . . ... ... AlIukti jun . . . .. .
14au,li Ilusrrval Ik.uul 11 lun /
Z7 SY�C� Ute, (lo Ix: lulld ou 1'jliol; 111iU all)f)I it:Iit l()1 l) "
►• If Ihx:l l ioii, sxral,c:r of 'i,el1 ioi; unil ,a . . . .. ... .. .. of (hh:I I illi; Unita /M1 each f l(x)r . .. . . . .. .
11' amillge, latith:r of (:a1*11
li. II` Ix,U ilx:Ua, lx>,aur:rcial or uli xr:d (x:Cll lilt w: -
y. fit uillnit. bawl exftaU: of el)cla lylx: of u:;t.. . .... .
. ... . . . .. . . . . .
IliuxuaitMaa of exlUtinl1 UtrimAtsiea, if allay. I total .. ..... . .. .....
_
it. at Idralx:i of Sl o) i(::;
1►inr:la;i(M4l of t;irl� t)t!nlc:tl)r'e will) illiel't)l.iolin or iwhlil iun:): I"r'oul: .... . . . . ...
Ika)111 ......._......... .... 1 .. ... ... . .. ... .
-" 1'Aulx:r of :ilurlea
11• Il alalia li;I/x IL lrl
costive Ix1J ctla1al llw:
i; 1 ism s: "'I(all' . . ... ... . .. . .. .. 14:ar
Ik il;llL IJiuilel of N(gas t u . .... .
(J• :ilzt of lot:. hl(Mlt .r:':.......
14aIi ..... .. .. .. .. .. ... . . Ik:I,I h . ......
u,. Il;)1 e of �llicha:�: ...... . .. ...
.................... muse of horlll:f (killer
. ........ ........ ... . .
1. Y4xx: or title diUfrict: In wl,lch !)raoiztea ate si(twled . .. ... ...
. .. ...... .. .. . . ... .. . . .. . .. . .
2, Ikx:U plolx)tled lxx►Utrlx:tloxt ""'late :lily ?iMlillit j;aJ, (,1'tj111i11w:L'
I'I, illll lot be relicagled .................... Wiil t:xt:eaa fill Ix ruurvt:d I'1lr)► pianitiea: YES
of Archife(a:
Milieu of l)1Jtx!r of prunlrx:U la)
......... ................. n(1(j1l:Ha . ..... .. .. .. ......... .. .. .... . 111()1x:
I*').
N:ur: .. . .... .. .
A(III ac:atl ... Moak.. Us.
NiuK: of Owlicisclor
.............................. ..... nchlr l:t):i ..... ... ............. .I11o1 x: I4).
'). la IhfU proix:rty within Yx) feet (►f is tidal li►:clUtxl? A YIS:i
AIL. YI?S, U.;(XIl1Cl11) '1[1lJN '11U1;;111aS 11-14111-1- HAY IIU:I�IIIIU?Il. �1
t l.o•f DIAGRAH
Iix:ate clearly and dlal-il�aly till ImildingU, %Alether exiUtf(td of pn)posul, Mail ilxlirate all Uet•-halac dill,(:naiol)s
I'IIru luolx:rIY I i)x:U. Give atreat ulxl hl(x:lc Irulx:r or dent:ripl jtwl accolding to deed, alxl fi!►(xJ UI reel: nirtr a mall Itiii llu
►dualu:r illlerior or corlw-w lot
y C(�D l��
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cJ '• . . .1wily; (Italy
:ai(,lu, (1(;lx,:;t;t; na,(1 tinytt lhul. Iw: la Ihu ui,i,li('nul
(Il:nl: of II 'via ' ! s;lhnloh /ruull7l. ) U
idx,vc tljral:d,
. . . . . . . ... . . . . . . . . . .. . ... . . . . . . . . . . . . . . . .. . . ...
04)ill IItc ,', n oill'
!i . all lx)(ill(: all I ic(:1 , el(:.) . . . . ..
of zail14I txJlxr ur /xJ,x:I n, nlxl !a duly iaullx)il�t:d fu lM:tfolw ui Inw(: lx:ili)Iur. the t,a►Id ►il)rk utxl ll, u�du: :Uwl ail(: Ilsja
ni,l,ljenl fou; Ihnl. nil ul.nl/+srnl:U coillaillthl its 'hit, ;y)plll:)llfill, Ltlx: to tilt hrs:l: ui` Ilia lualMall it) liil 711x1 Il Iil!! nail
Il,nl Ill,: ►nnk will Ix: (xerfolur'if ill the Uruww:r all fail 111 jai Iht: ilpial icnl ion I iled Ihe,(wiilh.
1r<nn ll, Ix:lu11: uI: ihia
^. .. . .. .thly of .. 7..
tk)t illy 11x1,1 it .....
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44, \. ... . ..v C�C
ERT I.SCOTT i J. R, ;il;n;Rine of nhi,ll(;anl)
Not WIG.Stats of IYIIIW
GuaIdled M Suffolk Cou
No.01SC472
limn I:ICpirea May 31.
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SURVEY FOR
GRACE PARK
LOT NO. 17, "ELUAHS LANE ESTATES
AT MATT/TUCK DATE JULY 24, 1978
TOWN OF SOUTHOLD SCALE: 1 �r = 50
SUFFOLK COUNTY, NEW YORK 1 NO. 78-432
*UNAUTHORIZED ALTERATION OR ADDITION TO THIS OVARANTEED TO
SURVEY IS A VIOLATION OF SECTION 7209 OF THE ,•/+
NEW YORK STATE EDUCATION LAW. CHI C/AVO T/T
K COPIES OF THIS SURVEY NOT BEARING THE LAND R/VERHEAD V/ �gIV , 0
R
SURVEYOS INKED SEAL OR EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE COPY.
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED,
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- 1 G1
*NEAREST WATER MAIN MI.± *SOURSE OF WATER, PRIVATE--'PUBLIC MENTAL AGENCYAND LENDING INSTITUTION LISTED / It
*SUFF.CO.TAX MAP DIST. SECTION BLOCK LOT HEREON,AND TO THE ASSIGNEES OF THE LENDING -•� s
)E THERE ARE NO DWELLING�WITHIN 100 FEET OF THIS PROPERTY INSTITUTION.GUARANTEES ARE.NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT !
>F THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS. �r 0 4 89'
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINESTO STRUCTURES FyJ
FOR A SPECIFIC
OF HEALTH SERVICES, PURPOSEING ANDA E NOT TO BEE SEVTO ESTABLISH SUR��rO.
APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES.
ADDRESS: ,
rEL.�
YOUNG
Q YOUNG RIIVERHEAD, NEW,YORK E
SUBDIVISION MAP FILED/N THE OFF/CE OF THE CLERK
OFSUFFOLK COUNTY ON FEB. /4,/974 ASF/LENO.$06J ALDEN W.YOUNG,PRO FE SSIONAL ENGINEER
MONUMENT AND LAND SURVEYOR N.Y.S.LICENSE NO.12845
� :
O + STAKE HOWARD W.YOUNG,LAND SURVEYOR
*THE LOCATION OF WELL(W),SEPTIC TANKN T)8 CESSPOOLS(CP)SHOWN HEREON 41 N.Y.S.LICENSE NO.45893
ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS.