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Home My WebLink About22700-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23983 Date OCTOBER 24, 1995 THIS CERTIFIES that the buildin~ Location of Property 780 LEGION AVENUE House No. County Tax Map No. 1000 Section 142 subdivision ACCESSORY MATTITUCK, N.Y. Street Hamlet Block 2 Lot 13.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 3, 1995 pursuant to which Building Permit No. 22700-Z dated APRIL 25, 1995 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 RECONSTRUCT 22'x28'6" OF EXISTING GARAGE DAMAGED BY FIRE AS APPLIED FOR. The certificate is issued to JOHN K. & LORRAINE VAN RYSWYK of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A //Buiiding Inspector Rev. 1/81 FORM NO.$ TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ 2270O Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ......... ....... ?~..... ~..~.~ ...~ ,o . . . . ~. . ~ ~. ~ ~ ...... ~ ~ ~ . . . . . ~ . . . ~ ~ ........ ~ ~ ~ , , . . . , , , , . . . . . , . . . , . . . , , . . , .... ~ ...... ~.....~...~.~ .................................................................................................. ............................................ ~~.~..~...~........~.~.....w~..~ ............................ County Tax Map No. 1000 Sectlon.....//../~...~".. ......... Block...-/, .~,. ............ Lot No. ....~....~..;.~. ........... pursuanttoappllcationdated..~.. ./...f?..'.~..........'3..... ..................... 19...~..~..~....., and approved bythe Building Inspector. ~ee~...~.,~ ...... Rev. 6/30/80 '[Ot-~N OF $OUTUOLD BUILD f. NG DEFARTHEMT TOWH HALL 765-~.802 APPLiCAtION FOR CERTIFICATE OF OCCUPAflCY TOWN OF S This application must be filled in by typewriter OR ink and submitted to the bui!ding inspector uith the following: for new build~ng or oe~4 use: Final survey of property ~4itb accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2 Final A~proval from Health Dept. of wnter supply and sewerage-disposal(S-9 form). ] Approval of electrical installation from Board of Fire Underwriters. &. S~orn statement from plumber certifying that the solder used in system contains less than 2/IO of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installs'lions, a certificate.of Code Compliance from architect or engineer responsible for the building. 6. Submit Fianning 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: [. Accurate survey of property shm¢ing ail 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 sl~all state the reasons therefor in ~riting to the applicant. t. Certificate of Occupancy - Neu d~ellin8 $25.00, Additions to dwelling S25.00, Alterations to dwelling $25.00, Suimming pool ~25.00, Accessory building $25.00. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on ?re-existin~ guildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 &. Updated Certificate o~ Occupancy - $50.00 5. /emporary Certificate of Occupancy - Residential $15.O0, Commercial $~5.00 ....... ..... ........... Ne~ Construction....~..'.~ .... Old Or ~re-existing Building ................. ~ouse No. / Street ~ubdiuision .................................... Fi led I'i~tl ........... Lot ................... 2ermit ~o..~Y'~..?,~.~7~,Date O~ Permit ............ Applic;m¢~C~~~~- ;ienith Dept. Approvni ...................... Under~¢riters Approval .................. 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 October 16, 1995 Mr. John Van Ryswyk 780 Legion Avenue Mattituck, NY 11952 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 # 22700-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. INSULATION PER N. Y. STATE ENERG~ CODE FINAL II II II II ADDITIONAL COt4t-fENTS: ~ ' ' ' - 7'~- d "- / ~/v---- FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-180:3 Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. MAIL TO: (Building Inspector) APPL CATION FOR BUILD NG INSTRUCTIONS Date ............... ~ .., 19... 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 public streets or'areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part 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 pumuant 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 buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing co~[e~and regulations, and to admit authorized inspectors on premises and in building for neces?a~i~ec~s7)~~,, ,,,--~ ~,, ~-~<//~/~ / ........ :... :.. --- / fflignature of applicant, or ~am~e, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................................. 1 Name of owner of premises . &~ ~.. it,..~..~ ~ 6 ~a l ~ ..... ~.4 K.. 'fi'Z :5~' y' ~ ~ ......................... (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.T~. ~. ~.~. 7.~...(~.. ...... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...7. f/.o. ..................... . ............... .fif . Ffl r tzc.; .................... House Number Street Hamlet County Tax Map No. 1000 Section ... ~. ~7(...'~. ........ Block .... ~ ........... Lot....{..~. ¢1 .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...oZJ../~....~-~tM.,.~..~... j~>..cOl~..c..L.?.~..~-.. ..... '! '~ ......................... b. Intended use and occupancy ..... .~..£:q/~..~.~.v¢.o .... ~.'.~.~.q .c p!ep-...A.fl .~d~..~. ~.~. ?.~.~.....~ .... 9. , 10. 3. Nature of work (cheek which a~plicable): New Building .......... Addition .......... Alteration ....... ;.. Repair .............. RemOval ............... Demolition ..... O~ller Work ............... ~' t~ ' · .~'~.~oc-"l' ~-~ C~q'g'l::h~lE' (Description) 4. Estimated Cost ....~... ?..0..-~. ........................ Fee .~.?: f.-~.. ............................ I (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............. Number of dwelling units on each floor ...... If garage number of cars I 6. If business, commercial or mixe~ occupancy, specify nature, andextent of each type of use ................. 7. Dimensions of existing structurqs, if any: Front ..... '.e-7..~?,..'~.. Rear .............. Depth. ~.. ~...~ ....... Height Number of Stories Dimensions of same structure With alterations or additions: Front Rear ............ Depth ................... i.. Height ....... Number of Stories Dimensions of entire new construction: Front .... ~ ........ Rear ............... Depth .. ~2r-..c~..~. ..... Height ... ~lll~,~.a,.~l~Number of Stories . . Si e of lot Re r . ~ , . a ..... Depth .... i .. i Date of Purchase ........... ' ......... . ......... Name of Former Owner ....... ~l~.~. .~ .......... 1 1. ~on~ o. ,,s~ &strict m wlach p~ .m, ,es a..e ~ltt~te ..... . .... : ....................... .. .... . ......... 12. Does proposed construction violate any zoning law, ordinance or regular'ion:~ ....... ~.d'. .................. 13. Will lot be regraded ......... ~1 ................... Will excess fill be removed from premises: Yes No 14. 15. Name of Owner of premises ~ ................ Address ................... Phone No ................ Name of Architect .......... I ................. Address ................... Phone No ................ Name of Contractor ........ ~' ................. Address ....... ~'. .......... Phone No ................ Is this property within ~00 feet of a tidal wetland? *Yes ........ No ........ ~If yes, Southold ~own Trustees Permit may be required. ' ~ · I ' PLOT DIAGRAM - Locate clearly and distinctly alii buildings, whether existing or proposed, and, indicate'all set-back dimensions frmh property lines. Give street and block pumber or description according to deed, and show street names and indicate whether interior or corner lot. / .... ~.N... ~,..VA 6L. l~ ¢'.~. 1~. J.[ ............... being duly sworn, deposes and says that he is the applicant . (Name of individualsigni~g contract) above named. He is the ........... '~' "~'~' %'~''' i .......................................................... ' ........ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized 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 manneriset forth in the application filed therewith. Sworn to before me this : ....... · ~....'~......,-,~, .... day of.i .... ~...'.., 19 N°tsrY Public' Siete °f INow Y°rk / 7 ~igna~ure o f applicant) No. ~952246o Suffol~Court, W~r~ / Term Expires June 12, · ; tad' PENNY LUMBER NORTH ROAD - 80X 1440 MATTITUCK, NY 11962 PENNY LUMBER NORTH ROAD - 80X 1440 MATTITUCK, NY 11 I)52 by-