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HomeMy WebLinkAbout24355-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26233 Date: 01/26/99 THIS CERTIFIES that the building ACCESSORY Location of Property: 3965 MILL LA (HOUSE NO.) (STREET) (FJ~4LET) County Tax Map No. 473889 Section 107 Block 4 Lot 2.8 MATTITUCK Subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 12~ ~997 pursuant to which Building Permit Ho. 24355-Z dated SEPTEMBER 16~ 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 AGRICULTURAL STORAGE BUILDING FOR ONE FAMILY DWELLING AS APPLIED FOR CONFORMING TO THE REQUIRED PRINCIPLE SETBACKS. The certifioate is issued to ART~JR & LAURETTA J BAUER (O~R) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N476618 01/12/99 N/A //Bu 'ding f. speotor Rev. 1/81 FO~,M NO. J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT N? (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 24355 Z ~,e ........ ..~Z.~... ............... , ,9~.Y - / Permission is hereby gr~ ~ _ ........_._.._....~.,../~~ .............. .,3...2.~...~...../ff. z//.....~.~..'~ .................... . ...,zfZ/.~,,.../..,.....:.~.,.....~..~/.z~.. ,_ . ot premises loc,ted ot ~....~..~.. ~ ~ .g~./....../...~,'~... :/:~.,,~.,L..~.~ , ~,~ ~, ~o~ ~o. ,ooo ~,,,o~ .... z~:...~ ,,~, ............ l........ ,o, ,o ....... ~,.~.. pursuon, ,o opplicction doted ................ ~../.~., 19.Y..~;;7., ond opproved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Th~~ust be filled in by typewriter OR ink and submitted to the building '4ax~p~c~uL wmuL, ~Le '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 Approvalof completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ~pre-existing" laud uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application sad 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. 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw~mm4ng pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existlnR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - · 4. Updated Certificate of Occupancy -.$50.O0 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date bl. - -----. .................... - - - ~w Construction....~ ...... Old Or Pre-existing Building ................. ~,=,tion of ~roperty..'~ ......... ~. ........ .n~ ............ ~.~.~ ........ ~ ....... ~ .... House No. Street Hamlet --r or o~ers of ~repe=y.~.}~.~X. t. ~a~.¢~a...~. ~ ~S.a .......................... ~ty ~= ~p ~o 1000, sant~on...\..°.~ ...... ~loc~....q ........... ~ot..~..~ ............... . .%9..o..~.E prr Fil ~bdivision .................. ed ............ Lot .................... ~rmit No. . ,~ ......... t Of ~alth Dept Approval Underwriters Approval tanning Board Approval . .. aquest for: Temporary Certificate ........... Final Oerticate....~. ...... ..,. .~ ........ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1045096 BUREAU OF ELECTRICITY ~- 40 FULTON STREET, NEW YORK, NY 10038 Date JANU.rd{Y 12,1999 Application No. on file t6813298/98 N 47661E THIS CERTIFIES THAT only the electrical equipment as describe,d below attd introduced by the applicant named on the above application number is in the premise~ of IfR. i~{S. BAUER, 3965 HILL ka/~E, ~[~.TTITUCK, .NY in the following location; [] Basement [] 1st Fl. [] 2nd Fl. OUT Section Block Lot was examined on ,.JA/qUARY (~6 , 1!379 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS FLUORESCENT OTHER DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO, OF FEET SERVICE DISCONNECT S E R OTHER APPARATUS: Bb~_N - 1 G.F,C.I:-I OF CC. COND NO. OF HI-LEG NO. OF NEUTRALS DOUBLE-POLE ELECTRIC PO BOX 147 PA~'.HOuUE NY, 11772-~147 GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return t6 the office of the Board if incorrect. Inspectors may be identified by their credentials, CO~'Y FOF: ~U/LOtNG OEPARTMENT. THIS COPY OF cERTIFlCAT~ ~tJsT NOT BE ALT~'RED tN ANY MANN'ER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL B0.&AD OF HEALTH../.. · .. SURVEY . . SEPTIC FOKH SOUTHOLD, N.Y. 11971 .~.../..~. TEL.: 765-1802 Examined ..... ........... Permit N D[sapproved a/c ........... ......... ~ ............. ICATION FOR BUILDING PERMIT INSTRUCTIONS CALL .................. HAIL TO: Date .................. , 19... a. Tiffs application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationsiffp to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on thc diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by .the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein despribed. The applicant agrees to comply with all applicable laws, ordinances, build'~, ~g code, and regulations, and to admit authorized. ~nspectors on premises and in building for necessary inspe~~ . (Signature of ~pplicant, or name, if a corporation) (Mailing address of applicant) I\C~- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or %uilder. Ouo .~.. , Name of owner of premises B [~l.~..~..~ .].. ~.~U.~ ~. L~e~.. ~.: ........................ (as on the tax roll or latest deed) . ................... ................ 1. Location of land on which proposed work will be done .................................................. .s~.~s. .......... ~.~.~.x .... .u..~.o..~ ..... ' ...... ~..~.~.u.~ .... N..5 .... ).1..%.s.~ ....... House Nu]nber Street Hamlet County TaxMapNo. 1000 Section ...[..~....~. ........ Block .,~. ............... Lot Subdivision .~.O(~.~.. ?.L~'...~9~...fSi'. .......... yiled Map No ............... Lot...~ ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of ~rOpG~ a. Ex~stm=' ' ~ use and occupan~. ~.'l o.q [~. ~m ,.I.q...~ ~ I I -',x ..... ,.~-~,~' ~'~ b. Intended use and occup~~..'~.~',.-~--~'.~-~.-~--,',~--~'~,~., ....... . 3. Nature of work (check which applicable): New Building.........){ .......... Addition · Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... ~ '~- , ,3' " (Description) 4. Estimated Cost ...... c~O.~. ....................... Fee ...................................... (to be paid on filing this application) 5. If dwelIing, numbe~ of dwelling units .... ~. .......... Number of dwelling units on each floor ................ If garage number of cars ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ' 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ......... ~' t .......... 8. Dimensions of entire new construction: Front .. ~ .~ .......... Rear .. )~ .......... Depth .~.~. ........... Height . .I .~'. ~k". ....... Number of Stories .. .......[ . , ......................... ~. ....' ........... 9. Sizeoflot: Front .~,~.~.~1.,.~.~ .......... Rear .. (~.3.O · . .......... Depth .~..q~:~.t. ............ 10. Date of Purchase .3.~q~* ............ ....... Name of Former Owner ~.[.~qO.. ~oa, t~.{'~,~', .......... 1 I. Zone or use district in which premises are situated .~.~..e~.. ............................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...1:,/..~ ..................... ...... 13. Will lot be regraded . ~ ....................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises -~*.~.~.~ ~ ......... Address ................... Phone No ................ Name of Architect " Address ... Phone No. Name of Contractor x' Address ... Phone No. 15. Is this property within 300 feet of a tidal wetland? *Yes ........ N .o~. ....... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whethe~ inter/or or coruer lot. ' ~ t ( UNDERWRITERS CERTIFICATE/ \ I QUI F.D/ AS NOTED  1. ~OUNDATION - ~O REQUIR ~ [ O/ ~O~ POURED CONCR~E ~OUGH - FRAMING & PLUM~Ir ~ ' ~'7 ~. :' :' ~' :.'~ . "~ ALL CONSTRUCTION SH~LL, ME ~ '~. ~ , ~:~:-::':'~ ; ' T~E ~OUIREMENTS OF THE ~ ~ [ I C~FR~tg~ OR CONSTRU~tON ERRO OF J .....n ~. ~..~.~ ~''~ ~ ....... being duly sworn, deposes ~a says that he is the applican (Name of individual signing contract) above named. .............. ............................................................ (Contractor,'agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file thi ~pplication; that ail statements contained ~ this application are true to the best of his ~owledge and belief; and that th, work will be perfomed in the m~ner set fotth in the application filed therewith. ........... ~ ..... ~ .... v of ............ IJ~ .... 19... ....... ..... .....