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Home My WebLink About23292-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OC:~UWARCY NO Z-24210 Date MARCH 15, 1996 THIS CERTIFIES that the buildin~ Location of Property 1465 T~SA DRIVE MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 16 Lot 13 Subdivision Filed Map No. Lot No. ACCESSORY conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1996 pursuant to which Building Permit No. 23292-Z dated MARCH 12, 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 SHED IN 'r~ REAR YARD AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JAMES & BARBARA BROCKBANK N/A N/A N/A Rev. 1/81 /~ B ilding Inspector FeRM Ne.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAM. $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 23292 Z Permission is hereby granted to: ...~.~....~~<.....~ ............................. / Y..,~.~....:~4 ......... ~ ~ ~....~ ............ ~ ................. ~ ~(~ ........... ~ ........... ~ ............. ~ ..... ..................... ................................................................................................. ............................................................ ~c~.....~.....: ........................................................ / ~ ~tp,~m~~t .............. ~.~ ....... ~a ....... ~ ............................................................. ........................................................... ~~ .................................................................... Coun~Tax Map No. 1000 Section ....... /~ ........ Block ......... (~ ........ Lot No. /~ ~ ~Z 19 pursuant to application dated ................ ~ ....................................... ~..., and approv~ by the Building Inspector. Fee $ ......................... Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Ppre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly complsted application and a consent to inspect signed by the appiicant. 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 Buildinm - $i00.00 3. Co~y of Certificate of Occupancy - $20200 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 Date ......... ~..~, Ke. ,'7.. ~.~ ............... construe.on. ........... or Pre-ex i sti uil d ............. .." __ ~oc~t~o= of Fropert~../: .... .~ ....................... S. ........ '..//< ........ House No. Street Hamlet Onwer or Owners of Property ................................................. o.. .. ... · . · ... '//~ / f- /..S.. County Tax Map No 1000, Section...~.% ........ Block .... ~. .......... Lot ................... Subdivision ......... Filed Map .......... Lot .................. Permit No Date Of Permit Applicant ...... Health Dept. Approval ....... ../~...z~...~....~.~... . .Underwriters Approval. ~ ................. Planning Board Approval ........................ Request for. Tsmpor y Certificate ........... Final Certicate..' . ...... Fee Submitted: $..¢.~.'.~ ...................... / ./ 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ]~] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: d~ ~ DATE 3//.;/'?~ INSPECTOR , THE NEW YORK BOARD OF FIRE UNDERWRITERS 8058912 BUREAU OF ELECTRICITy [~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Oate MARCH O7,1996 Application No. onfiie 11226896/96 H (~49000 THIS CERTIFIES THAT only th~ electrical equipment as described below and introduced by the applicant named on tl~e above application number in the premises of JAMt]S E.BROCKBANK, 1465 THERESA DRIVZ, MATTITUCK, N.Y. inthefollowin#h,cation; [] B~semen, [] Istrl. [] 2nd F/. G~I/0~3T Section115 Biack15 Lot 34, ~s examined on ~A~C]'t 034 ~ 1996 and found to be in compliance with the Nallonal Electrical Code. FIXTURE ~ [ I FIXTURES I RANGES ICOOKING DECKS I OVENS I DISH WASHERS EXHAUST FANS 5 [ 10 5 4 1 DRYERS IFURNACE MOTORS IFUTURE APPLIANCE FEEDERS iPECIALREC'RF TIMECLOCKS I BELL '~ MULTI-OUTLETcv¢,i=~¢ DIMMERS Afl4T K,W. OIL H.p. GAS H,p. A~T NO, A, W.G. AM'[, A~p, A/~T, AMPS. TRANS. HI ~T'I H" N~: ~"~T ~T' II SERVI~ DI~ONNECT ~. OF S E R V I C PANBLBO~S~ 1-"le CIR. 125 G.F.C.I:~.i . 1465 THERESA DR. MATTITUCK, NY, 11952 O~IBRAtMANAGI~R This certificate must not be altered in any manner; return to the office of the Board if incorrect~ Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUS~iNOT BE AI':TERED IN ~NV MANNER FOIIH HO. 'I'()T,/N ()F SOII']'IIOI,I) JlUJI.DJ NG I)EP^IUII'IEHT TOT,IH I1^1,1. .~OilTIlOl,l). Fi .¥ TEl.: 765- IlO^Ell OF III~,AI,'I'II ............... 3 SIt, TS OF PI.AHS ............... SIII1¥1t.¥ ........................ CIIECK ......................... SEP'I'I (I FORFi ................... HO'I' 1 IrY: C^I.I ................... )IA] I. TO: .................... APPI.ICATION F'OIt BIIILI)INO PERHIT l H.qTRIICT IONS Dute ................ ,19 .... a. 'flda alqfllcathm I,~lst Im cotl)letely filled in by t:yln~trlter or i,I ink a,~l mdx,,itt~l Lo Lite Ikilhli.g hml~etor 3 ~ta of plmm, ac~a~rate plet ph~. to scale. F~ according I'o 8ch~h~le. b. Plot plan ~i~ l~t{~; of lot a,d of I~dhli~. ~ pr~sise~, ~latiotmhip to ~ljoinlng pr.niaes or i~d}lic ~t. reel', or areas, m~l ilivlt~ a ~tai{~ ,kscriptlu~ of la~t of pt~rty ,,~mC Im dr~ ~ the diagr~ Ihit~ ;qq)l lcfii I~m. d. IIl~, nlq~nl of thio fllq)licel:J(nt, tim Ik,ilding hmlmetor ~ill i~ a Ih,ihling l~nnlt Io the applicant. ~tch I~nnit ~,,,tl Im kept ~, tim p~.l~s available For hml~ct{~ th~x~lx~t the ~)rk. e. ~) I~tihli.l{ fdmll I~ (~,1)[~1 or u~d in ~mle or iu imrt for m~y iXJrlXme ~mtever until fl ~rdficnte of {~qm~:y ~mli {mv~ Imea grnat~l by II~ Ih~Hdh~l{ bmlmClor. API~.I(~'I'I~ ]9 I~I{Y )~ to tim Ik~Hd}ng I~I~i.~C for the i.mm~ of ~ ~ihli~ Petmlt D,r~ant to the Ih{ldh~ ~ O~lhm~m~ of tim 'l~m of ~ll~hl. ~fffl)lk (~mty. ~v York, nmi other a~licobl~ I~, O~lhm~. or ~lat{~.. for tl~ ~mtt~mti~ o~ I~dldi~s, ~kllc{~m or alteraci~m, or fl~r ro~al or ~1 ilion. t~gtd at knm.. t,~l. t~, ',.~knlt m~tlmr lv~l, hml~etor8 ~ pr~uise., m~l ]~~~~{ nl .. r ' (~illng mklres* oE a~ticaat) .qtnte .hetlmr apl)lieaet: ia Cnn)er, lessee, ogenL..rdlilect, ellgi,~r, ge~mrnl co[il.factor, electrician. I)lu~imr o[ Ix~ilder. (aa Ix~ the I.a~ roll or latent de~l) If nl~llcn.t ia o corl~rotl<n~. Bl~mt'us~ of ~hly mfll~)ri~l officer. title of corporale off{cer) l'Jts~l~ers l,|ce,a~ ~ ............. ~ ..... F.{ectrh:imm License No .... ~ ............ Oiler 'l'rf~'s l.icen.e ~)..[ .................. .~ // -~ --_~ ~ / l ....... ............. ..................................... / ~l~liv{sl<n~ ...................................... Iril~l ~q~ ~) ................ l~t ............... (~) 2. St'~t~ existing u~ a~ ~C~l~a~y of I.'~i~ n,~ iete~v~l use .~{ ~c~{~sey o~ ~l~ c~mtmctlon: b. Intel~l u~ n~l ~l~y ............................................................... ........... ]~,~ ......... ~,,,~,.l~,, ........... (,],~,. ~.~),~ ~~.~ ................ I~. I.~l.h.~led {~t ..~ .... ~ ........ If (~HIh~ll. Ix~l~c of (i~ll hl~ ,~lll~ . Ii.1~ ()~ (t~lllnll .nlt~ (~ e~lc.h fl(~)~ ................ If It~iPlte) I~1~' (if (:m'~ ..... ] ................................. . : ......... ~,,,* ...._~ ..... ,~,,I, .... ~ ...... lil~l; ...................... , II~1~ ()~ ~l()rl~ll ........... li~l)lh .................... IlliCit .................... ~1~ (ii ~l()~le~] ............... II. IIl.~n~)l(~m o~ e~Ll[~ i~ [~xmt~l~l.l(~ I~'~L ................ I~ar ............... ltl)Ih .............. ~. tilde ()~ I()~: I~I~1: .......... ~ ......... li~r .................... lIpIh .................... II. ~ (ir u~ (ll~lrlcl I, ~l~l~ !)r~,l~ e[~ ~it~l~l ............................................... 15. I, Ihl8 pmlmrl.y wllllifl ~) feet o~ a ti(Iai ~l:lm~l~ YIL~ ......... ~ I)l,ll'l' II I~(II1~tl Iz~:el~ (:learly [.~1 dloihcily ~11 I.~II(IIiT,. tJ)elher e,l,l:h~ ()~ l)r()lX)~(i(l~ m,I Ii~llc,l:h ell Bel'-I)~:~ ~, I)rol~rl'y I1~. Illve ~l~ mil I)1~ ~.i~l~r ()~ (iocrll)ll(.i ~m(:()rdl~ ti) (lee(I) m~l ~c~ oireo~ IJleHler lelerior or i:on~r ]et.I lilTtll'; lily I'I'.1l I:(Xll41¥ Ill~ ................. ~ .... i . (Itllllll (If iixlivi(hml NOTIFY' BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ROUGH - FRAMING & PLUMBING INSULATION FINAL - CONSTRUCTION MUST BE cOMpLETE FOR C.O, .L CONSTRUCTION SHALL MEET IE REQUIREMENTS OF THE N.Y. S .CONSTRUCTION & ENERGY C)DES. NOT RESPONSIBLE FOR IlGN OR CONSTRUCTION ERRORS · .l~!i,ft (hily i~)~'~l~ ilelx)tm~l iilxl iiilyll Ilmt lie Ill Ihe iqq)l l,lle,t~ (:orlx)llite effl(:el;) eL(:,,) ~mmission Expires Deoem )er 8, 19 ~ ~