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Home My WebLink About22684-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY ' No Z-23667 Date MAY 25, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 3525 COUNTY ROAD #48 MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 2 Lot 21.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1995 pursuant to which Building Permit No. 22684-Z dated APRIL 18, 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 AN ACCESSORY BUILDING AS APPLIED FOR. The-certificate is issued to NORTH FORK CHURCH OF CHRIST, INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. P~UMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMEFfl $OUTHOLD, N,Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ................................... 22684 Z ~'~ Permission Is hereby granted to: ,../. ~.. ~,.~...~¢.. ...... 2: ....................... ...~~. ?~....~..../..~-~ ...... ../../...?.~../.. ....... to...~~......~ ........ ~ .......... ~ .......... ~~~..~ .... ~~:~ ........ ~.',~ .......... ~ ........ ~~....~.: / ...................................................................... ~~/. . .~. . . . . . . .~. . . .//~ ...................................... Counh,'Tax Map No. 1000 Section,,.,..~..~../.. ......... Block ........ ..O.....~.. ......... Lot No....~...~: ..,~..,. ....... dot /~/~-¢"~ ~ ~ 19.-..~.....~..., and approved byihe pursuant to application ed .......................................................... Building inspector, Fee $....'./.~. ........ ; ...... Rev. 6/30/80 Form NO. 6 TOWN OF' SOUTIIOLD BUILDING I)EP/~gTHENT TOi./N IIALL 765-1802 APPLICATION FOg CERTIFICATI; OF OCCUPANCY A. Tt zs application must be filled in hy typewriter OR ink and submitted to tile building inspector with tile following: for new building or new use: 1. Filial survey of property with accurate location of all boildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Ilehlth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 6. Sworn statement fromgplumber certifying that the solder used ill system contaivs less than 2/10 of 1% lead· 5. Commercial building, industrial building, multiple residences and installations,~a certificate of Code Corn ~' ~ ,and s~mzlar buildings responsible for the building, pzlance from architect or engineer 6. Submit Planning Board Approval of completed site plan requirements. B; F~r 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 dwelliug $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~ - $[00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00' New Construction ........... Old Or Pre-existin~ Building ........... ~'..~ Location of Property .... 'II, 3525 County Road #4~ Mattituc~, m.z. Itouse No, Street Hamlet Onwer or Owners ,.,f Property... NORT~ .F.ORK' CR~IRCM OF CHRIST County Tax Map No 1000, Section ..... 141' 2 21.4 ......... Block ................ Lot ................. oubdzviszon .................................. Filed Map ............ Lot ...................... Permit No 22684Z ~ APRIL 18,1995 SAMUEL W. LARKIN$ .............. oate Of Permit ................ Applicant ............................. !lealth Dept Approval · '' ' Underwriters Approval 'lanning Bo rd a Approval .................... ~equest for: Temporary Certificate ........... Final Certicate ........... ce Submi.t ted: $ 25.00 Town Hall, 53095 Main Road P. O. Box 1179 Southoid, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 24, 1995 Samuel W. Larkins 190 Ackerley Street Riverhead, NY 11901 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 # 22684-z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FIELD INSPECTION REPORT U~DATE II ~NTS FO~ATION '(IST) , I FOU~ATION (2~) II ROUGH FRAHE & PLUMBING STATE ~m~RC~ ,, ,, co~ II Il ADDITIONAL COMMENTS: ~hill Available in 12'x10', 12'x17', 12'x24', 12'x31', 14'x21' & 14'x31': oor ~ Side door for greater acce truss system ~ Over 8 ft. oVEn The ~ .-;~._~.. ~,TALL ., · ~,~ V~nyl Sheridan ~ ~/ Available in ?O'xS' & 10'x14' BLDG DEPT, · ToWN OF TEL.: 765-1802 Disapproved. a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BU!LDI?JO DEPARTMENT. TOWN HALL 8OUTHOLD, N.Y. 1197~1 · ( ' '~/Impector) ' · !'" '~' ' APPLICATION FOR BUILDING PERMIT BOARD'OF HEALTH ...... sETs OF PLAN~ ......... --~suRv£¥ ................. "¢'C IEC ....... 307.-.72 iK ..... HAIL TO: INSTRUCTIONS Date , J~¢ CC,h: .,?, 7. o ....... ~19. ~. 5 a. This application must be completely filled in by typewriter or in ink an'd submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. ~ b. Plot pta: showing location of lot and of 6ulidings on premises, relationship to adjoining premises or public or areas, and giving a detailed descriptinh of layout of property muir be drawn on the'diagram which is part of this app[ c~tion. ' · ' c. ' The work covered y this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the. Building Inspector '~ill igsued a Building Permit to the applicant. Such perm: shall he kept on the premises avaUable 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 Occupanc' shall have been granted ~,y the Building Inspector. . .. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southbld, .Suffolk County, New York, and other applicable Laws, Ordinances o 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 code, and regulations, and t~ admit authorized inspectors on premises and in building for necessary inspections. (SfgnaturF of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant ~s owner, lessee, 'agent, architect, engineer, generaJ contractor, electrician, plumber or builder. ' ........... ,z :"; ~., '- ..................... ... . Name of owner of premises . .Nort.h..F. Otk .q b U?.c. I1 .o..~( .C.h.~. i st ' ' (as on the tax roll or latest deed)s~m~ NOTED If applicant is a corporation, signature of duly authorized officer.' ' ; ( e and titl~ of corporate officer) B ilder's License ............... OCCUPANCY OR , . · .USE I.S. UNLAWFUL lumber s L~cense No. . ........ Electrician's License No. WITHOUT CERTIFICATE, ........... '0F"0CCUPANCY Other Trade's License No. ",THE IREOJIREMENTSI ' OF THE N;Y. 1. Location of land on which proposed work will be 'done.. 3 ~ 2,5..C o u n.t.y.. 80 B.d.S.TZl~'g' ".-.C.~I~.,~..I.1~.~.,~. ~iI~)[~, &N. ~N E RGY ' D.ESIGN OR CONSIROCTION ERRORS Hous Number : Street Handet Cou~ty Tax Map No. 1000 Section... '..... ...... Block ..¢~...,; ..... '. Lot .............. SubdJv sion ............ · ......................... '. Filed Map No. ; (Name) Lot Stat~ ex/sting Use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing ~se and occupancy Re.i/i§ i dr.S. · se'r.v.i.¢@$.', .... . / '.'%,..' .;. .', ; : ;¢.~q ~a~ .................. b. Intended use-'and occupancy .S.1;q.r.a~e. shed and Fanc.e · .'4 :? NOTIFY BUILOING DEPARTMI:NT AT ' 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING &~ PLUMBING S. INSULATION 4. FINAL - CONSTRU. CTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET .3, Repair .............. Re,oval ............ 4..Estimated Cost .. $.5.00,00..{ ' Fence 196.00 Nature ofwork (check which, applicable) New Building .,.' ,X....., Addition .... ,..... Alterati{Sn ..... ; .... Demolition .... : .......... Other ,W,m-k.... ........... (Description) $35 O0 Fee ', .... · (to be paid on filing this application) 5 If d b fd Iii its'. .... N mb fd Iii h , `,veiling, hum er o we ng un ......... , u er o ',va ng units OI1 eac r .... ............ If garage number of cars,' ' 6. If busin,ess, commercial or mi.x~d occupancy, specify nature and extent of,each type of use ................... ~ pth ' 7. Dimens,ons of existing structur s, if any: Front ....... ; ....... Rear ......... De Height Nurcber of Storie~ ' Dimensions of shine structure With alterations or additions: Front : ................. Rear, ............. Depth ' ' ~4 ' ~ ., ....... . .h, , Number of Stories ' ' D~menmons ofenhre new construction: Front ' I' Depth Height ' Number of Stories " 9. Size of lot: Front I . . ..' ......... : .................... Depth ......... ,, ............ 10. Date of Purchase .,,gpr,i.1, ~',' '1'~93~ ." Rear,,. ' 11, Zone or use district in which pr}raises are situated ..............................................., , ...... 12, Does proposed construction violate any zoning law, ordinance or regulation: NO ...... 13. Will 16t be regraded ...... NO ~ ................... Will excess fill be rem6ved from premises: Yes No× 14, Name of Owner of premises ..., ........ ; ........ Address . , , ..................... Phone No ................ Nirne of Architect ' ' Address Phone No Name'of Contractor i Address , Phone No ' 15.' I.s.this property within 300 feet of a tidal 'wetland? *Yes.....,,, No,.~...... *If yes,'Southold Town Trustees Permit may. be required. i' P .L. OT DJAGRAM Locate clearly and distinctly alii buildings, Whether existin~ or Proposed, and, indicate~all set-back dLmensions from property l~nes. Give street and block humber or descrlptim{ according to deed, and show street names and indicate whether interior or corner lot. PARKING 1540 sq, lt. PR~OVID£O ~ H,C. STALLS ~10' '~0' STA~'=-=OF NEW YOR':'r~, ' ' "' ' '"":'' COU~.Y OF .... ~, ~, '.,; ,',: (Name of individual signin'~ contract) 3bore named. Rooert O. H~,ti 1 tull O ltlINE~ IA ~ I~ A IV ROh~T,D. HAM~. t~.0. BOX 2oi ~C~ N ~ ~, ·, .., being duly ssvorn, depose~ and says that he is the applicant % is the . [ (Contractor, agent, cor'porate officer, etc,) )f said owner or owners, and is duly '~uthorized to perform or have performed the said work and to make and file this tpplicatioin; that all statements contaitled in this'application are t'rue to the best of his knowledge and belief; and that the .york will' be perforrhed in the manner slat forth in the application filed therewith, ;worn to before me this .' .. '.5 . .q:Y . da .... ,~ I~ ~..~ ~*_~. ~ ' ' ' (Signature of applicant) .