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Home My WebLink About24117-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25204 Date AUGUST 19, 1997 THIS CERTIFIES that the buildin~ ADDITION Location of Property 4330 WESTPHALIA ROAD House No. Street County Tax Map No. 1000 Section 113 Block 9 Subdivision Filed Map No. MATTITUCK, N.Y. Hamlet Lot 15.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 28, 1997 .pursuan~ to which Building Permit No. 24117-Z dated MAY 12, 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 DECEADDITION "AS BUILT" ON P~EAR OF EXISTING ONE F/%MILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & CATHERINE DiVELLO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORI~ NO. 9 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2tllT Z Permission is hereby grant d to: ~..~.,:/~.....z~.,....,x,.......zz~./... .......... .......... r ~ at premises located at ....... · .~...~..~...~-. ................... County Tax Map No. 1000 Section .... ./.../...~L.. ........ Block ....~.. ...............Lot No../....~./..~ ............ pursuant to opplicotion dated ......... ~-~.~ ............ , ]02.'.~., and 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 of completed 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 all p~operty lines, streets, building and unusual natural or topographic features. 2. A properly completed applicatio~ 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 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 Occupancy on Pre-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - .25~ 4. Updated Certificate of Occupancy - 450.00 5. Temporary Certificate of Occupancy - Residential $i~.0Q, Commercial $15.00 Date ...... .'~. ~. ~r. ~ .. ........................... New Construction ........... Old Or Pre-existing Buil~ding..¥%~.. ............ Location of Property ~.C)., .. ~~..~...~...~...~..~..:.....~.~.~..]...~...~ House No, Street Hamlet Onwer or Owners of Property ........................... County Tax Map No 1000, Section.../.~.~ ....... Block .... ~.~ ....... Lot...~.'.5..-..~ .............. Subdivisio,,n~...~ .~..~.,.~. ~.~..~.' .~Q.~..~...Filed Map ............ Lot ...................... Permit No [~[~....~. ...... Date Of Permit...~.1..~...~.. ..... Applican[ .~.~..~....~.~ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ......... ,.~..... Fee Submitted: $ ......... APPLICANT Ir I rial. r~l co l-r1 1 m 2 Z Ix3, o~ T~ 0 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INSULATION REMARKS: ] FIREPLACE & CHIMNEY DATE ,NS," CTO,* 76S-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUG~LBG. [ ] FOUNDATION2ND [ ~JL, ATION [ ] FRAMING [//J FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR BLDG. DEPT. ~,~,WF~ Of SO;JTHOLD D[~ a/c ................ .FORM NO. ] TO'IN OF SOUTHOLD BUILDING DEPARTMENT TOI~N HALL SOUTHOLD, N.Y. { {97 { TEL: 765-1802' INSTRUCTIONS BOARD OF UEA~LTH ~ S~TS o~,5~Ns ;"~'~ .......... SURVEY ............. c.~cR .~-::/1~:::: ........ s~Pnc ~o~ ................... NOTIFY: MAlL TO: ......... a. This application mst be caupletely filled in by type~iter or in ink and anl~fitted to the Building Inspector ~ith 3 sets of plans, accurate plot plan to scale. Fee according to ~ehedele. b. Plot plan sho~ing locatim of lot and of buildings on praises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property mst be dra~ o~ the diagra~ ~hicb is part of this application. c. ~he sork covered by this application ~ay not be eemeneed before is~ca of Building Pemit. d. Upon ~w~eal of this applieatlou, the Building Inspector ~ill issue a Building Pemlt to the applic~t. Seth peri'it shall be kept ~ the praises available for iaspection thronghont the wrk. . e. No building ~all be occupied or ased in ~ole or in part for any pm-pone ~aatever antil a Certificate of Ocqulmncy shall have been granted by the Building Inspector. APPLICATIUiq IS k~a~f M~E to the Building Deport~nt for the issuance of a Building Pemit pJrSU~t to the lkfilding Zo~ Ordinance of the Tt~xa of Se~thold, Suffolk County, Ne~ York, and other applleable La~, Ordinane~s',or P~galatlons, for the construction of buildings, aflditi~s or alteratlous, or for re.oval or de~alition, as hereiu described. The applic~t agrees to comply wlth all applicable Iv, ordin~cas, tmilding code, housing code, and regulations, and to ad.it asthori~t inspectors on premises and in bull.ding for ~n~e~ in~ctions. ~.~...~.....~ ............. (Signature of applicant, or nane, if a corporation) {l~aillng addres~ of applicant) State wlether applicant is owner, lessee, agent, architect, engineer, ~eueral contractor, electrician, pltmnber or {milder. .. ~~ :~..~.~...~c...~~:..~t~e. :...~....%g~...~..%f.~ ............................................. Name of o~er of prmdsas {'~ ..-~..L ~;5-. (an on u~ t~ ~on or Iatest ~~ APP~OYED AS NOTED I' aFpllcant is a corporation, siRan~mce of duly anthori~ed ......................................................... i~IDEI~I~RITER$ CEII~I[ICA~r' ~ j (N~e and title of corporate officer) k'--"~ B~{LO{NG DE~M~-NT AT ~U~.. U~ ~ ............ '" " ' '"' "" OCCOPA~C~ O~ FO"',OU,~OCO,C,~S Pz~. ~i~ ~ .......................... USE IS B~{1AWFBL 3.z ROUGH-}NSULATioNF~MiNO & PLUMB{NG ~.~i.i~. U~ ~ ...................... WITHOUT CER~{F{CATE ~. ~,~Ac CONST~Ug,O, UUST ....... · ,~u BE COMPLETE FOR C O. ..................... · N SHA~ l. ~ti~ o~ 1~ ~ ~ ~ ~ ~1 ~~.~~ ~~~Tg'~'~E"N.~ , {~ , . b ' _ ' .~ ~Q~TflU~ION & ENERGY ... ~ ~ ................. ~~.. ~ ~r ~ OR CONSTRUCTION ERRORS ~ ~. ~ ~ ....~).~. ...... ~ .... ~ ...... ~ .... ~.~ ..... (~) 2. State ~sti~ ~ ~ ~ I0. II. 12. 13. 14. 15. I~tm-e o£ work (d~eck whidl al~lical)le): ~ llJilding ~ldition ....~... l ..... . ........ ............. A tarelton . l~i~ .......... ~; .~81 '.. 'i ..........I~litio, ............ Other ~ ..... ........ Est i.mt~l ~st ~ ...... I ...... f~ ................................. ~' ............ (Lo lm ~id ~m filing this a~licati~) If ~k~lti~, ~t~r of ~lli~ units ............ t~r of ~lling traits ~ ead~ ~r ................ l'f g~rage, t~m~r of cars ..... ................................. If I~inesa, ~rcial or mi~l ~, s~ci~ ~ture a~ ~tent of each ~ of u~ ...................... ..... , . , , ~q, h mn~l~8 of ~l~t~ng 8tm~es, if any: ~t..~ .......... ~ar ............... ~pth ................. ' I ~i~,~ ........ ~ ............ ~. ~ ~ s~o~i~ ....... t .............. Dinmnmi~s of ~ ~tn~t~e width alterati~s or ~itlon~: Fret ............... ~ar Oiu~n~i~ of entire ~ ~t~ti~: l~t .... ~ar . .. ~pth ............ Ia this p~rLy within ~ f~ of a till ~tl~l? * ~3 .......... ~ .~... from pt-opert¥ lines. Give street: and ~dmther interior or corner lot:. PI.OT DIAGRAM ~1 L~Ddingo, ~etlmr ~xlsting or proposed, and trglicate all set-lmc, k dinmnsions block ra~ber or descriptien according £o deed, mhd ~ street nmos und indicnte ........ (("/' .......... r .................. be g duly sworn, delx)ses taxi says that he ]s tim appl.~nt (~e of iidividml, signing c~tract)~ (C~tractor, ngent, ~orlx)rate o~flcer, etc.) o~ ~ald ~r or ~ra, and ia d~,Iy ~thori~ to [~rfonn or h~e l~rfo~ O~e ~id ~[k a~l to na~ an] ~[I.e thi~ ~ applicati(n~; Ihal: nLl state.ntB c~t~t~l in t:h[s a~d ~mtion are t~ to tl~ I~t: o~ his k~x~l~ge and I~l.~ef~ thac the ~)rk will Im ~rfon~l in I.h~ i~mner ~t fortl~ in ~e al~l. JcaCi(~ fil,~ tlmr~i~. ,tX,n)n! Lo before ,~. Ihis .... .... ..... ~ta~ h~tic ELIZABETH AN~ NEVILLE Notary Public, State of New York No. 52-8325850, Suffolk Com~u Term Expiros O~ber 31, 1~ (Sigrmture of ^ppticant)