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Home My WebLink About24070-zFOR~4 NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Rall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25017 Date MAY 6, 1997 THIS CERTIFIES that the building ACQESSORY Location of Property 725 MARRATOOKA LANE MATTITUCK, N.Y. House NO. Street Hamlet County Tax Map No. 1000 Section 115 Block 4 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 1997 pursuant to which Building Permit No. 24070-Z dated APRIL 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 SHED "AS BUILT" AS APPLIED FOR. The certificate is issued to EUGENE M. MIBKA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Bui~dz~r Rev. 1/81 I~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N.o 24070 Z Permission is hereby granted to: - .~.~ ....... ~....~.z.~ ........ ..£~.~....z./.~ ........................................ ..~~......~....z./.~.~ ~.~.,~ ........ ~ ........ ~.~**.......**~./~......~.~..~ ....... ~.~Z./.~......L~. ................ ..... ~ ........... .,~..../***(~ ..~_..~..., ................................................................................ County Tox Map No. I000 Section ...../../..~ ......... Block ..... ~...~... Lot No ....... .~....~. ........ pursuant ,o oppJication dated ..... ,~...~....~..~... .......~/....~.. ......., J g....~/~).Zand approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 ~f c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 1. Accurate survey of property showing ail 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-existin~ Buildin~ - $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 ....... ....................... New Construction ........... 01d Or Pre-existing Building ..... ..~. ......... Location of Property... ]k~ ............. ~r0~. k~ .............M~rr~f.¢~f .......... House No. Street Hamlet Onwer or Owners o Proper ...................................... County T~ ~p ~o 1000, Sa~tion .... /If. ...... Block ..... q .......... ~ot ..... .~ ............... Subdivision Filed Map Lot ...... Permit No.~ 7~. ...... Date Of Permit.~.~ ~.7 ..... Applicant .... Health Dept. Approval .......................... Underwriters Approval ................. ........ Planning Board Approval ..... Request for: Temporary Certificate ........... Final Certicate .... ~.. .... ~. S :zg~fI ..... APPLICA~NT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN/SULATION [ ] FRAMING [ /~ FIN,~L [ ] FIREPLACE&CHIMNEY REMARKS: , INSPECTOR FORH NO. I TOIiN OF SOUTI1OLD BUll,DING DEPARTHENT 'roan IIALL $ODTIIOLD, N.Y. ] ]97 TEl.: 765-1802 BO~RI) OF IIEAI,TII .... 3 SETS OF PLANS .......... CIIE~,K' r ' ~ SEPTIC FOP, H .......... ...... '... NOTIFY: HAll, ' TO: ....... ............. APPLICATION FOR BUILDING PERI'lIT INSTRUCTIONS '1 a. ~lds application trust be completely filled in by tyr~rlter or in ink a~l ~l~itt~ to the ~dldi~ Ins~ctor 3 ~t$ of pl~s, ~ate plot pl~ to ~ale. F~ acco~isg to sd~kfle., ~ :~ : , , , b. Plot pl~ ~i~ l<ati~'of lot a~ of ~;ildlngs ~ ~mi~s, rel~ti~ship to ~jolnlng p~isea or ~blie struts or areas, a~ givi~ a ~tail~ ~scrlpti~ of l~t of ~r~ ~mt ~ dram ~ the dia~ ~ic~ is ~rt of this a~lleati~. , : ,, e. ~ ~rk ~1 I~ thiff a~licati~ ~ ~t 1~ c~k~l ~[ore isle of ~ilding PeriL. d. ll~ a~al of this a~hcat~, tl~ Mxld~ Ins~ctor will i~ a Adldi~ Pemit to the ~licat~ ~mlt ~mll ~ kept ~ tim ~i~s ~llable for ins~cti~ thm~t the x~rk. . , ,, e. ~ Ixdldi~ ~all 1~ ~i~ or u~ in ~le or in ~rt for ~ ~ ~mL~er ~til a ~rtificate of ~ Mmtl b~ l~n fir~t~ I~ tim ~ildln8 Ins~tor. ,~ ~;~ IS lm~ ~ to tl~ ~dlding ~r~nt for ~,~ issue 0f a ~ildi'~ Pe~it ~o ehe ~{ldi~ 7~ O~i~e of ~ T~ of ~tl~ld, ~fffolk ~mt~, ~ York, .a~ other al~llcable ~, ~i~es or ~lati~a, for t~ ~stn~ti~ o~ ~fildi~s, ~iti~s or alterati~s, or for ~al or d~llrion, ~ril~. ;~lm a~li~t agr~s to ~ly with all. a~licable l~s, ordi~es, I~ildi~ c~, t~si~ c~e, ~lati~s, a~ to ~it ~tl~i~ in~tors ~ ~i~s aM zn h~ for ~c~sa~n~/ (Si~r[ of a~hcant,'or ~m, if a core,ratio) ~.h~L.~~,~..~x~k ....... ' (~qili:~ ~klress of ~llem~t) State ~mtlmr o~lle~t io ~r, le~o~nt, archit~t, engi~r, ~ral e~t~aetor, el~f~na~p~l~& or I~dlder. ...: .................................... ~ ..................................... ~,~.~.. (an ~ tlm ~ ~ll or latent d~) NOTIFY BUILDING DEPART%lENT:~~ :76~.1802 9 ~M TO'4 PM FOR THE If n~l. leant i~ a co~rati~, si~bJ~ of ~1l7 mR~ri~l officer. 'FOLLOWING iNSPECTIONS: , ;. FOUNDATION - TWO REQUIRED ......................................................... FOR POURED CONCRETE (~ aM title of co,rate officer) 2. ROUGH - FRAMING & PLUMBING 3. INSU~TtON 4. FiNAl- - CONSTRUCTION MUST ~sil~rs Lic~ ~ .......................... BE COMPLETE FOR c.O. AiL coNSTRUCTION ~H~ MEET Pl~rs Lic~ ~ .......................... THE REQUIREMENTS. El~trici~a Licen~ ~ ...................... STATE~ CONSTRUCTIO8 & ENERGY -" CODES.' NOT RESPONSIBLE FO~ OOmr ~'s Lic~ ~ ..................... ' DESIGN OR C0NSTRU~ION ERRORS I. I~atlm of lam m ~dd~ ~ ~ will I~ ~k~ ..................................... , ........ ,... ~ ........... ...... 3~ ................... ~x~~..:~n .............. : .... : .~-~.~ ..................... '~m~ 'r~ ,~ ~. '~ ~tJon ..:.;.~. Bilk .... ~ ........ : ....... l.t..,.,,.~. ......... ~Mivlsi~ .............. , ........................ Fi l~l ~qp ~ ............. ; .. l~t ,. .......... g ... (~) State existi~ u~ aM ~a~ of pr~i~s ~1 inte~ u~ mxl ~ of ~ c~strueti~: a. Exlsti~ u~ a~ ~t~ .................................................. ,,. ,,,~,~ =, ~ ~ ...................... S~ ~..~ ~fi ........ .~: ~ ~ .~.: .... 3. N~ture of t~o[k (cJ~ck ~,ld, al~lic.hle); Nc"~ lkdhlin8 .......... ~klitio. .......... AIt'erat'ion ......... 'If lami~ma., t~amnrclal or mi~d:, m:~aqmt~y, Slmctf~ ,tal.ure m~l extent of each ty~ of uae ...................... 2~ or u~ dt~uciec i~ ddd~ ?r~.taea are ~L~L~[ .............................................................. i~ o1~ Ardli~ecL¢ .? ......... t .................... /vMre88 .......................... Hm~e I~ .... ~ · ~e of. Cz~trac. lor. - .......... ~ ......... ;- . ....... ~klres~ ........................... [SIo~m ~) ............. 1~ lido p~q~rly uJtl,in ~) ~t of a thlal ~tlai~l'l * YI~ .......... ~ .......... · l[~ YES, [~IIII[]D '1~ 'll~l~II~ 1~1~['1' E~Y IU~ h- - ? I'1.0'1" I)TAGItAH ~ diatl~lYlall Indldh~ ~el mr,exia tng or p(91~)~., m~l ,t~licate all aet~l~k dh~naiona l~:al:e clearly m~ . i ~ether JnLerior or corer loE. Ik.~ ill (.Im ............ ' ..... ' ............. ' .................. , ....... '.'. .......... (C~:)ltLractor, ~qgel~C~, (:orlx)r4Ue of I'ic:er, etA:.) ' : ;qq~lic;~cio.; Iht)l: t~]l sLate~,~t. (:o~ai,~d itl IhJa .iq)l ~ci~t'on me I r~m LO the lint;t: of hi~ kLx~l~ll~e lllgl I~l ierj ;.~1 (SII;nd .me o1: ApI}l,J'c;lid.)