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HomeMy WebLinkAbout23817-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24856 Date JANUARY 16, 1997 THIS CERTIFIES that the building Location of Property 1065 MAI~T~NR LANE House No. County Tax Map No. 1000 Section 144 Subdivision ADDITION MATTITUCK, N.Y. Street Hamlet Block 3 Lot 1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 28, 1996 pursuant to which Building Permit No. 23817-Z dated NOVEMBER 20, 1996 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOSEPH & BARBARA MIECNIKOWSKI N/A N/a N/A ~' / JBui/ding Inspector Rev. 1/81 FOR,Bi NO, 0 TOWN OF SOUTHOtD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 23817 Z Permission is hereby granted to: . ~.~//..-c.......~ ............................................. ~o...~.~,~ ........ ..~ ....... ~...~...../~.~.~5.~ ....... ~ ........ ~ ............. ... ~~..... ~:~. ~..... ~ .;. ~..... ~..~...~ ~ ....... ~'.......~....~... ~, at premises Ioca~/at ........ /~./~.......i~./~o~.~.....~ ......................................... CounW Tox Mop No. ,000 Sect,on .... ../..~ ....... B,~.~.~ .......... Lot No ....... ~./.. ......... pursuant ,o application dated ............ ~....~..~.~ ............... . 19..~.~., and approved by the Building Inspector. Rev. 6/30/80 ' ' :' TOWN OF SOUTHOLD '.~ BUILDING DEPARTMENT 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: i. 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 '~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 dwellimg $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 Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date... 7."~VC'f.. o .~ .~Ae~ Z. .................... New Construction ........... Old Or Pre-existing Building...~. ocation of. roperty ..... P. ................ .......... ................ House Ho. Street F~let Onwer or Owners of Property..---..., .................................... .... .. .. · . County Tax Map No 1000, Section .... ?.'?~. ..... Block .... ~ .......... Lot....~ ................ Subdivision ....... Filed Map ............ Lot .................... Permit No .............. Date Of Permit ....... Applicant ......... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Carticate ....... Fee Submitted: $ ...... E.~,'.~..©. ............. ...~....~/J~_. ,- Town Hall, 53095 Main Road P. O, Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 8, 1997 Matthew Hallock 4365 Wells Rd. Peconic, N.Y. 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23817-Z (MIECNIKOWSKI) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I)A'I ir I IIAI. .~t~c, OF ~v ID:7270600 DUG 12'96 :50 No.O06 P.02 l.e,, SURVEY FOR THEODORE W. C. SWITSAVA(~E ELEANOR SWITSAVAGE MATTtTUOK TOWN OF $OUTHOLD *~,~.~,~'r[,~ C~ ~l y OU~A~TEED TI~ OIV~IO~ *'':' SUFF. ~., ,~. · ~galOAa TITLE INSURAN~ . - · ~ , dUFFOLK COUNTY FEOERA~ dUNE I, 1964 ....... /770¢ . '",':',~."~v 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INS~L*ATION [ ~]'~NAL DATE INSPECTOR FORH NO. I 'I'OI4N O17 ,qOUTIIOLD BUILD1NG DEPAR'I~IENT TOI4N IIALL .gOUTtloLD, N.Y. i 197 I 'FEI..' 765- 1802 BU^I{I) L}I' III';/H,I'II ............... 3 SETS OF PLANS ............... SURVEY ........................ SEPTIC PORN ................... M^ 1 I, 3'0: .................... ^PI'LICA'I'ION FOR BUILDING PERHIT I NSTRUCTI ONS n. 'lhls opUI icatlc~ ~mst be cc~l)letely filled ia by tyl~*rlter or in ink ml mbu[tt~ to tl}e Ikdldlug l,sl~etor wit 3 r~t~ off ptn~, ~e~rn~e plot pl~ to scale. F~ occo~llng to ~ch~k, le. b. }]oL pine ~t~ l~nt;~ of lot o~ oF l~llldtt~ r~ e. 'll}e ~rk c~r~ 1~ thla a~lJc~ti~a~ ~ ~t 1~ c~l I~[ore i~m~e of ~{ldlng Pemlt. e. ~ lxxJld[~ rJmll l~ (mo~pi~l or u~ in ~le or (k:~imr~:y r)ml. 1 h~e {~n grm~t~l I~ O~ ~lildll~g Insl~tor. l~{lding 7x~ O~li~m~e of LI~ ~ oe ~tl~Id, ~fffo]k O~ty, ~v York, a~ other a~l~cable ~a, O~lla~es or I~{~dal. i(m9, for tl~ c~stn<tJ~ of lmildi~, ~klitlc~s or alteratJ~m, or far m~al or (~lition, a~ hereiu ¢~scril~l. 'tlm alqfllcont n8~ to ca,fly wlth all nHflicnble ................. (818~mture of nl~licnnt, or mom, if a COrl~rol:i(m) (~ail {rig ~]rese o[ o~l {cant) ~ ac ~ of p~[~.. ~..~. ~C..~¢...//Z[~.~q~.~ ....................................... (as m tim ta~ mil or latest: d~) (Nc,me aad tit le a[ corporate officer) Builders License No ................... l'lu,ti}ers License No EleeLrlelans License No ...................... OU~r IT:~'s I3cen~ ~ ..................... .... ...................... ......................... ................... lk~se K~mr Strut I~fflet (~,mty Tax ~'l' ~)- I[]~ ~tJu, .... Z'~ ..... BI,ink .... ~ ......... lot...~.-- ........ $~lxIivisi<~ ...................................... Fil~ ~[up ~) ................ 1~ ................ (~) a. Exi~t~t~ u~ n~ (~OJl~atK~ ... ~.. ~ ...................................... /~ // b. hfler~l lm~ nt~ ~o~[~t~7 .................. ; .......................................................... j~Hur{~ of teoik (c. hedt ~,~lich aHflididtle): I,La~ Ikdhlin8 .......... ~kliLion .......... Mt~ertffjo~ .......... I~q~lir ............ I~l ...... ' ....... I~flition ............ Other I.L~L ..~ ........................ I~1. i.~l/e(I (~)n l: I , fe~ .............................................. : (lo 1~ Imid on fitin~ lhi~ ~pplicu~i~O l I; ~L~llinli. I~d~r o~ ~lll.g lil~iL~ ............ ~lti~r 01:~11 hl~ u.h'~ I~l ~h ~]t~r ................ IkHl~lr . ........................ j~.~l~r of ~lorja. ...................... lLqllh .................... Ihi~lLi' . ................... ~ld~r tlr ~l'ori~l ............... Ihil~ll ......................... ~.d~r of fil:ori~ ..................... ~11,' YES, ~IIIDII 'l~fl 11~l~1~8 I~I~IT ~ I~ IB(~III~I). APPROVED AS NOTED DAm 3717. _ PEE:' .y: NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COIvlPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N,Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS )k: J:; IIm ..... ~ ......... ~ ....................................................................... / tt:o.t ! n(:t~r, nl~,e, nl', ~'.orlzJrnle of fi(mr, el c.) ... la duly {tuLhorlz~l Lo [x. rfon, Dc llave x. rl'or,~.(l lite Bald ~)fk lil~J to I]ilke afxl fll{. thiJi IhaL tJl~ ~)rk ~ill I~ I~rJ:oIll~i itl l.h~ I1~1111~[ 80~ I:o~lll iii Jilo nJ)pl. Jcnl:Jon filed Ih~rc~iLit, No. 487g~05 Qualified in Suffolk Cou~ Commission Expires Decembe~ 8~ 19