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Home My WebLink About23868-zFORM NO. 4 TOWN OF 8OUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPAN~Y No Z-24841 Date JANUARY 10, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 4175 NEW SUFFOLK AVE. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 4 Lot 34.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 12, 1996 pursuant to which Building Permit No. 23868-Z dated DECEMBER 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 ACCESSORY STORAGE SHED IN REAR YARD AH APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED EDWARD & BONNIE ADAMS N/A Rev. 1/81 I~OB~ NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 23868 Z Da,e ........................... ~ ................. . ,, Permission is hereby granted to~_ . ..~.~.,...Z~ · ~.~,~ ~. ~zz ,~ ............. ~, ,rem,,. ~.,.d., ........................ Z..~: ............ ~~ .... .................................................................... ~~.............................~-~ _ . ............... pursuant '0 ap~lica ion cloted .................~...~..~....., ,9.~..~_--~and approved by the Building Inspector. Fee $ ..... Rev. 6/30/80 Form No. 6 TOWN OF SOUTNOLD 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 Upre-existing" land uses: i. 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 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 Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - ~ .~5~.~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ................. Location of Property ............................................. House No. Street Hamlet Onwer or Owners of Proporgy .............................................................. .. .. County T~ Map No 1000, Section. ~ .Block .... Lot .... Subdivision............... ............... ... . .. Filed Map ............ Lot ...................... Health Dept. Approval ......... .~2l~ .............. Underwriters Approval ..... ~/~. ................ Planning Board Approval ......... .~/.~. ........... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $. ~.~.~ .......... 5 n / X LICANT Al)l) tT I {)riAl, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INS~ULATION [~NAL [] FIREPLACE & CHIMNEY ....... DATE INSPECTOR FORH NO. I 'rOl~/N OF SOOTIIOLO BOIl,DING DEPARTHENT TO~4N [I^LL SOUTOOI,D, N.Y. I ]97 } TEL: 765-1§02 Permit ............. ^~.ICAT1ON FOR BUll. DING PEBNIT INSTRUCTIONS BOARO Oma IIF, AI.TII ............... 3 SETS OF PLANS ............... SUEVEY CIIECK ......................... SEPTIC FORN ................... NOTIFY: CAI.I ................... NAIl, TO: .................... Date ................ ,19 .... a. 'lhis application ,mint be c~pletely [illed in by typc~n-lter or in ink a~l ~bnlct~l to U~e lkdldltq lnSl~C~Or xoit{ 3 ~ts o[ plans, ae~trate plot iR~ to scale. F~ accouli~g to sd~tle. b. Plot plm~ ~i~ l~atf~ of lot aM of lmildi~s ~ pr~ni~s, relatioDship to ~.ioJnlng pr~ni~s or str~ts or areas, ~ 8ivi~ a (~tail~ ~seripti~ of l~t of ~r~ ,~mt tm dr~m ~ tl~ dia~ ~Hd~ is ~rt of this al~licati~. c. 'lhe ~rk c~ {~ this a~licati~ v~ ~t 1~ c~l I~fore ism~e of ~dldi~ Peunit. d. U~ a~al of this a~licati~, the ~ildlng Ins~ctor v{ill is~ a ~i]ding Pemit to the a~)]icant. ~nnit ~all ~ kept ~ tl~ p~i~s ~ailable for ius~cti~ ti~r~lt the e. ~ [~dldi~ ~mll I~ ~pi~l or u~l in ~le or lo Imrt for a~ ~ ~mt~r uotll a (~rti[icnte of ~,~y ~,atl l~e I~n gr~t~l by tl~ ~ildi~g Ins~tor. Al~li~'rl~ ]~ IE~I~ ~E to tl~ ~Hldi~ l~r~nt for the ism,a~e of a hdldlng Pemit ~lrmmn~ to the I~ildi~ 7~ O~i~e o[ ~ ~ of ~timld, &fffolk C~nty, ~v York, aid other a~)llcable l~s, O~im~s or ~gulati~s, for t~ ~mtn~ti~ of {~ildi~s, ~kliti~9 or alterati~s, or for ~al or (~mlltiou, as Imreio ~ril~. 'llm applier ngr~s to co~ly with all a~lieable l~s, or(li~es, I~ildi~ ~e, I~si~g c~le, re. latins, m~l to ~.it ~tl~rlz~ ins~ctors ~ ~ises a~l in l~i]diog For t~cessa~ in~ti~s. ~ (91~t~re of a[~)licant, or ~, if a cor~rati~O ~ (~ili~ ~{ress o~ S~a~e ~ther ~lie~n~ {s ~r, les~, ~n~, nrddt~t, eDg}~r, ge~r~l c~r~e~or, elee~rlci~u, pl~i~r or I~d]der. '.: ........................... ~ ~.~ ............. = ............................ ~ .......... A~R0Y~{W0{fB ~ ~ N~{~ BUILDFNG DEP~NT AT If al~ticant is a corl~rati~, ui~tu~ o[ dpl~~~ ~ .~ ~ A~-: ~ ~,~:~ 765-1802 9 AM ~ 4 PM FOR THE ..........................<~ ~,~ da~ o~ ~o~ ,m~)~ .................. '-?'"~:~ ~ ~ ~:,~:~:~ ~ ~'3: ~ ,, ~A ?. 1. FOUNDAT{ON - ~OREQUIRED FOR POURED CONCRETE ~'~)' '~"~ ~ 2. ROUGH * FRAMING & PLUMBING ~ ~ D~ ~, ~ ~ BE COMPL~E ~ C.O. t't~,t~rs L,ce.~ ~ ........ ~ ' "~' ~'F'~"f~'~ ~>~i ALL CONSTRUCTION SHALL I~se ~d~r Strut l~nle~ ............. ~~ ~ I ~llvlai~ Fil~l ~p ~).. .~ .... I~C ............... (~) 2. State existi~ u~ a~ ~o~ of p~i~s aid inte~l~l use aiKf ~Ol[~[~y Of ~ ~. ,~;~,~ ,,~ ~ ~ ....... ~ ~.~.~Z~Aff.~.~ ........................... ; .................... V/ i~x:me clearly aim di~l'i~t'ly nl~l IxHldi~a, d~ether exlal:ing or pro[xmed, taxi f~xlica'te all 6et-track dl,enaiofm L 190, ~ I (N;,~,] of il~livldual ,igl~i~8 (:OlJJfaR[) i ((~ Itl .I r~ ei&ent;~ (:?rlxlrlJl'e oil:leer, cie.) of ,aid (~r or mlK~r~ m~l i9 duly [~Jtlior]~4~l ~o ixirfonH or h,ve I~rr'oT,ed Ihe ,aid ~)rk alii Lo ,td~e m~l file ~tlq~l i(:m:io[H Ilml: ,11 9tat8~nL~ elint:ahead in IhJ~ nFpllmIcJon nre I'~]~ to Ihe Ixml: of hi, [~l(~lse taxi I~1 iefj /~-- ~ ...... ....... ,,,,, N~A~ PUBLIC, State Cf N.Y¢ (all,itoh,re of Al,Id i(:a~,l ) No. 4725089, Suffolk COu~ Term Exp res May 31 i9~