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Home My WebLink About23207-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCuumANCY No Z-24141 Date JANUAR~ 29~ 1996 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 1585 BREAKWA'£~ ROAD MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 8 Lot 20.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 26~ 1995 pursuant to which Building Permit No. 23207-Z dated JANUARY 2~ 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 AN "AS BUILT" DECK ADDITIONASAPPLIED FOR. The certificate is issued to SHAWN & DAWN WILLIAMS (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ $OUTHOLD, N.Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE ~RK AUTHORIZED] 23207 Z Date ............... Z/.¢~... ................................ 19,,,,,,~,-,~-, Permission Is hereby granted to: ..../.~....,¢.~:~.~.~. ~.~ ...... ,~..~. ................... ,,/~,~,~.~ ....... ~..~....../,/~..~.~ ................ ,,,r......~ ......... .A.. ........... .~ .......... ~.~..;~ .......... ~ ...... ,~;.~,~7.. .............. ~: .......... ,....z~_../,~:~.~. ......... ....~...:~.: ........................................................................................................................ atprem,seslooat~dat ......... ,/~./.~ ....... (~.~¢~ ........ .../....Of.... .......................................... .4 ' County Tax Map No. 1000 Section....~....O,...~,. .......... Block.....~ .............. LotNo. pursuant to application dated ........... ..~..."~./.~....~.. .................. , .......... 19......~....~'....., and approved by the Building Inspeotor. Fees ...... Z,,o~,,',,~,... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING D EP ~HTM_ENT TOWN PLA~ L L 765-i802 .~PPLICATION FOR CERTIFICATE OF OCCUPAiqCY A. 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 proper~y 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 insta!laeion from Board of Firs Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, ~_ndustriat building, multiple residences and sJ-~ilar buildings { and installations, a certificate of Code Compliance from architect or engineer responsible for the building. , 6. Submit Planning Board Approval of comp!aced sica plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: i. Accurate survey of property showing ail property lines, streets, building and unusual natural or %opographic 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. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool S25.00~ Accessory building $25.00, Additions to accesaory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-~xistinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Cer=ificate of Occupancy - Residential $15.00, Commercial S15.00 New Construction ........... Old Or Pre-existing Building ................. Location of Property.l~.~.?.. :'[~-~.~.~......~..... ~ .-~. ~ ~..-~...~-~.. ~.....~? .~ '. ..... House No. Street Hamlet ooo, .... .... ......... ............... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Pe-~-ait ................ Applicant ............................. Health De~ Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Cerzicate..~. ........ Fee Submitted: $ ............................. .................... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~'*~INAL DATE FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, ~1971 TEL.~ 76B-1802 Examined .......... 1.9 Disapproved a/c ..................................... ~' 3 SETS OF PLANS SEPTIC POIttl ............ CALL .. IAIL TO~ ( ''g t ) APPLICATION FOR BUILDING PERMIT Date ................. , 19. INSTRUCTIONS a. Tiffs application must be completely filled itl by typewriter or in ink attd subnrltted to the Building Inspector, witl sets of plaus, accurate plot plau to scale. Feeaccording to schedule. b. Plot plau showfng location of lot attd of btdldh~gs on premises, relationship to adJoiuing premises or public sire or areas, al~d giving a detailed descriptiou of layout of property must be drawn on the diagram wltich is part of this ap cation. c'. The work covered by thio application lnay not be conuneuced before tssuance of ,Building Permit. d. Upon approval of this application, the Building Inspector will issued a Buildh~g l'ennlt to the applicant. Such pert shall be kept on the premlses available for inspection throughout the work.. e. No building ~hall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupat shall bare beeu granted by the Building luspector. APPLICATION IS tlEREBY MADE to [tie Bulldh~g Departntent for the issuance of a Building Permtt pursuant to Buildiug Zoue Ordinance of the Town of Southold, Suffolk Couuty, New York, mid oilier applicable Laws, Ordi,mtce~ Regulations, for the construction of buildings, additlous or alterations, or for removal or demolition, as herein descrlb The applicaut agrees to comply with all applicable laws, ordluances, building code, housing code, and regulations, attd admit authorized tuspectors on premises aud itt butldlug for necessary inspectinus. - · (Siguature of applicant, or ,same, if a corporation) (Mailing address of applicant) State wbelher applicant is owuer, lessee, ageut, architect, engi.eer, general coutraclor, electrician, phunber or buil~ ............................. ...................................... APPROYEII),AS,NOTED ...... (as on the (ax roll or las ur: ~=~r~a~UI/DING OEPAR/~ENT AT If applicant is a corporatiou, sig~ature of duty authorized officer. 765-1802 9 AM TO 4 PM FOR THE (Name aud title of corporate officer) Builder's Llceuse No ....... .~..l~. .............. Plumber's Lieeuse No ....... t~.~ ~) ............. Elcctriciau's Ltceuse No ...... ~.! ~ ........... Other Trade's License No ..... ('~..It~' ............ FOLLOWING INSPECTIONS: 1. FOUNDATION - T~VO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Locatiou of land ou which proposed work will be done ............................................... .... .... .......... llouse Humber St reet : tlamlet Couuiy Tax Map No. 1000 Section ................ Block .......... ~ ,, ~ ~.. Lot .... ' ........ Subdivision ..................................... Filed Map No ......... ~ ..... Lot .... (NaJne) State existing use and occupaucy of prenlises and intellded use and occupancy of proposed cous[ructJoil: Existing use and occupancy ~., .'~~C , · .... ~ ~1 ......... 8. Dimensions of entire new construction: Front ............... Rear .............. llelgbt .... · ........... Nnmber of Stories . .. ~ .............................. 9. Size of lot: Front ...................... Rear ...................... Depth lO, Date of Pnrehase .................... · ......... Name of Former Owner ....... t 1. Zone or use district in width premises are situated ............................... 12, Does proposed construction Violate any zoning law, ordinance or regnlation: .......... 13. Will lot be regraded ......................... .... Will excess fill be removed from premises: Natnre of work (check which applicable): New Bnilding .......... Addition .......... Alteration Repair ............ Removal .............. Demolition .............. Other Work ............... · . ,. (Description) · Estimated Cost ..... , .............................. Fee ...................................... (to be paid on filing tills application) ;, If dwelling, nnmber of dwelling nnits ............... Nnmber oF dwelling nnits on each floor ................ · Il'garage, number of cars ,, ................................. , .................................... 6. If business, commerclal or mixed occnpancy, specify nature and extent of each type of use ............ ~ ....... 7. Dimensions of existing stmctnrea, ii' any: Front ...... .~..~, / ....Rear .............. Depth .,/.~. ......... Iletgltt ............... Number of Stories ........................................................ Dimensions of same stnmtnre with alterations or additions: Front ................. Rear .................. Depth ...................... Ilelght ...................... Nnmber of Stories ...................... Depth ............... Yes Nc I,I. Name of Owner of premises .................... Address ................. Phone No Name of Architect ........................... Address ................. Phone No ..... ~, ......... Name of Contractor .......................... Address ..... , .......... . Phone No ............... 15. Ia tbia property within 300 feet of a tidal wet]and? *Yea ..... ~., No,., ...... iii yee, Soutllold Town Trtmtees Permit may he reqnired. PLOT DIAGRAM Locate deafly and distinctly all bnildings, whether existing or proposed, and, indicate all set-back dimensions Iron property lines. Give street and block number or description according to deed, and show street names and Indicate wbethe interior or corner lot. ;TATE O~ NEW ¥CtRK ~ ,, ........ ~ ~. ~'... ~k~k~ ............. b~ing dnly sworn, deposes and says that he is th, (Name of indlvidnal signing contract) bore named. is the ............................................................................. (Contractor, agenl, corporate officer, etc.) said owner o~ owners, and h drily authorized to perform or have performed the said work and to mako pplicalion; flint all statement~ contained In this application are trne to the best or his knowledge and ~ork will be per[ormed in the mann~ ~et ~orth in tho application filed therewith. ~wom to before me this / ) ........ ~gga ........ , ........ Te~m E~i~May 31, 19~ STANLEY ROAD R= 18.50' L= 34.54* q:) '"';* HEALTH DEPARTMENT-DATA F~ APPRO~U- TO CONSTRUCT NOTE: ~: ST~KE ARE A · 40~O,~.~ RE: LOT HO.~ M~NOR SU~OIV~S~ON FOR ANTHONY HELEN SURVEY FOR SHAWN P. WILLIAMS DAWN I. WILLIAMS AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE: SC ALE NO, JAN. 22:1991 JUNE ~ 986 1" = 86- 703 CO. URANCE ]YOUNGYOUNG RIVERHEAD, NEW YORK ALDEN W, YOUNG., PROFESSIONAL ENGINEER ANO LAND SURVEYOR N.Y.S, UCENSE NO, 12845' HOWARD W, YOUNG,, LAND SURVEYOR · N,~S. LICENSE N0.4§893