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Home My WebLink About23897-zFOP~I I',10. TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24864 Date JANUARY 28, 1997 THIS CERTIFIES that the building Location of Property 2255 GRP/~D AVE. House NO. County Tax Map No. 1000 Section 107 ADDITIONS MATTITUCK, N.Y. Street Hamlet Block 8 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 15, 1997 pursuant to which Building Permit No. 23897-Z dated JANUARY 22, 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 DECK ADDITION WITH SHOWER ATTACHED "AS BUILT" AB APPLIED FOR The certificate is issued to ALLAN DIOKERSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A //i l~ng Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERJvUT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 23897 Z Permission is hereby granted to: ~..~....~:~?~.~.~. ........... ..~.~ ...... /~.~<...~.~... .~...~ ........ ~ ...... ~.....~~.....~ ...... ~~ ...... ,, . ., ~ ~2 . ~ ....... ~~ ............ ~ ........... ~ ................. ~ ............................................ ~,~,,m,,,,~,.~ ~, ....... ~.~.~ ........ ~~ ......... ~ ............................................... Co~ ro~ ~,p so. ~oo0 s~o~ ....~ ........ ~k ..... ~ ........ ~ot ~o..~ .............. Building Inspector. Rev. 6/30/80 Form No. 6 TO~N OF SOUTIIOLD BUILDING DEPARTHENT TO~H BALL 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 mew building or new use: 1. Final survey of property with accurate location of ail 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 l, 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 BuildinR - $100.00 3, Copy of Certificate of Occupancy - 920.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary ~ertiftcate of Occupancy - Residential $15.00, Commercial $15.00 Date ..~a~uar.g.15,.~997 .................... New Construction ........... Old Or Pre-existing Building. ~ ~.~ .... .. constructedl~o~~ Location of Property...~$~ ............. ~.~./%~ .............. ~Qk .............. House No. Street Hamlet Onwer or Owners of Propert~i .... A~D.~.. ~iGk~Q~./~%d.Ch~lott~ ~ick~aom ............ County Tax Map No I000, section...%Q7 ........ Block .... ~ ........... Lot .... ~ ................ Subdivision .................................. ~.Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Nsalth Dept. Approval.' ......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: . Temporary Certificate ........... Final Certicate..~ ....... .................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined ..... /-~. ~. ..... ,19 ~. 7 ^pproved ....... Disapproved a/e ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF REALTH ......... 3 SETS OF PLA~S .......... SURVEY ................... CHECK ................ SEPTIC FORH .............. CALL ................... HAIL TO: Date .~.a.n..u.a;rx.. J,. ~3 ...... ,19.9..7 INSTRUCTIONS a. This application must be completely filled in by typewriter 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, relationship to adjoining premises or publ~c streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- catior~. 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 wilt issued a Building Permit to the applicant. Such permit shall ~e kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pst 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 bufldings~ additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinance ,~, ,building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessar~Bectio~s· _/~ (Signature of applicant, or name, if a corporation) 460 Paddock ~latt£.f. uck,. New. Zo.<k. 11.9.52 ................ (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... Ow~.e.< .......................................................... ~ ......... Name of owner ofprem ses ~L.l.~r.t.C..I}$g.k.e. rson and Charlotte Dickerson.~pp~0~[[}.~$~0.s.[~.~ .- .......... (;; 'o;';;e'ia';;;l; 'o; i;t;;t' If applicant is a corporation, signature of duly authorized officer. . earn' NO~'IF'Y BUILDING O~PARTMENT AT (Name and title of corporate officer) .Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... ' 765-1502 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 4. FINAL - CONS'IRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Location of land on which proposed work will be done. CODES. NOT RESPONSIBLE FOR ................. ' .... DESIGN 'OR 'CONSTRUCq'ION ·ERRORS 2255 Grand Avenue Mattituck House Number Street Hamlet County Tax Map No. 1000 Section .. .... ~07 .......... Block ..... 8....j ......... Lot ..... ~ ............. Subdivision ..................................... Filed MhpNb ........ ~. ..... Lot ............... (Name) State existing use and _o?up_ancy of p~re__m_is~e_s_and intended use and occupancy of proposed construction; a. Existing use and occupancy Deck as .c.o.n.~r.u. cte.d. ~ au}door b Deck a.s..cp.n.~l:r.u, ctect., q~..~. ~o ef · Intended use and occupancy ......... ,<., or- 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...... Repair .............. Remoyal .............. Demolition Other Work D~.~}~ .... 4 Estimated Cost · (Description) Fee ' . (to be paid on filing this application) 5. If dwelling, number of dwelling ulnits .......... Number of dwelling units on each floor ....... · If garage, number of cars ...... i ............................ ' ....... 6. If business, commercial or mixed :occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories Dimensions of same structure with alterations or additions: ' Front " Rear pth . . ~., e ~'~ ' · ~. ..... . ne~gn['.., .D · [ lt'~'e',~ ............... Number of Stories ....................... -,unisons o~ em.,;rc ncw cenat."ac, tic, r,: Front .............. Rear ............... Depth .... Height ............... Numb'er of Stories ................ " ....... gi ....... · .'I,~Q ............................ 9. ze oflot: Front ..... 100 .............. Rear ................. De . .23.6 ................ J- J./J- .4/55 pth . . 10. Date of Purchase . . ... i ........ . ......... Name of Former Owner W..i.l,l~.a.m. j:l.., g~l~9~. ~. ti,iffy. ~g,... ~Zoneoruse · ' · · ,. · I 1. district in xvluch premises are situated lgr$9 (~es&deut~ Lorn .Dens£ty) Mason 12. ~Joes proposed Construction violate any zoning law, ordinance or regulation: ... 31.o .......................... 13. Will lot be regraded .. Nn. x~. }. ^ ................ Will excess fill be removed from premises: xYm~ .No 14. NmueofOwnerofpremises a~J.a~ ~,. m-c~erson .460 Paddock Way C ar erie.Disks,;son. AddreSsMaee±eue ,' 'N'~ .1.19'52- Phone No. Name of Architect ........... ~ ............... Address ................... Phone No ................ Name of Contractor ...................... ; :'. :. Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No...¥... · If yes, Southold To~n Trustees Permit may be required. '' I PLOT DIAGRAM Locate clearly and distinctly all boildings, whether existing or proposed, and. indicate all set-back dimensions~ from property lines. Give street and block nu'mber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTy OF..~U~'FID. IaI5 ....... S.S ALLAN C. DICKERSON ' .......................................... being duly sworn, deposes and says that lie is the applicant (Name of individual signing Contract) above nam.ed. He is the ..... O.~qner .............. (Contractor, agent, corporate officer, etc.) :o~:~xo*~aexx~:4~el<s¥ and is duly ai(thorized to perform or have performed the'said work and to make and file this application; that all statements contained in this application are true to the best of his 'knowledge and belief; and that the work will be performed in the manner setiforth in the application filed therewith. Sworn to before me this · 15th ................. day of. ,J. anuar~. · ·., 19 97 - D~...UN k'llan C. Dickorso~l ;' ' ?~,~, Y-~,~,~ ,,e-¥0~( (Signature of applicant) Notary Public Comn'lls$1on Exp~ Oct. 31, 1996