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Home My WebLink About22989-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCupANCY No Z-25300 Date OCTOBER 6, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 300 PACIFIC STREET MATTITU~K~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 4 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21, 1995 ~ursuant to which Building Permit No. 22989--Z dated SEPTEMBER 6~ 1995 was issued, and conforms to all of the requirements of the applicable previsions of 'the law. The occupancy for which this certificate is issued is ALT~KATION, FOUNDATION, AND D~CK ADDITION TO EXISTING The certificate is issued to ON~ FAMILY DWELLING AS APPLIED FOR. TI~(~"A%S G. & HELEN C. KOC~ ( owner s ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ~/A H-051938-SEPTEMBER 20~ 1996 SEPT. 24, 1997-TANDY PLUMBING & ~ATING Building Insp/r FO~M NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN H~LL SOUTHOLD, N.Y. N~ BUILDING PERMIT [fi'tiS PERMIT MUST BE KEPT ON THE PREMISES UNTil FULL 2 2 9 8 9 Z Dote .......... ~,' ....... ~ ................. CounfFTaxMoP No. 1000 Section .... ./...~..~... Block ............. ../.......~o....,~......~.. ............... pursuant to application dated ............. ~,j.., ,~..., ,/, ........... 19....~..· ......... and approved bythe Building Inspector, Fee Rev. 6/30/80 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN H~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application muet 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 linee, 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 etatement from plumber certifying that the solder used in system containe less than 2/10 of I% lead. 5. Co~nercial 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 c6mpleted site 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 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 i. 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-existinR BuildLnm - $i00.00 3. Copy of Certificate of Occupancy - ' 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date --.~--~-¢-,--/-~7 ............ New Construction ........... 01d Or Pre-existing Building .... ~ ......... Locatio~ o ~rop ~y .......................................... House No. Street Hamlet Onwer or Owners of Property ..,~,.,-.,~.. z.. , ......................... Oounty ~= ~p ~o 1000. Section.../.~./ ....... ~lock ...... ~ ......... net ..... 7.~ .............. Subdivision ................................ Filed .Map ............ Lot .................... Fermi .... ate .... ............ Health Dept. Approval .......................... Underwriters Approval'. ........................ Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $~O........... .................. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'~(~?'~ ~ BUREAU OF ELECTRICI~ 85 JOHN STREET, NEW YORK, NY 10038 ~y ~ e~tric~ ~u~ment ~ ~db~ be~w ~ int~uc~ by ~ ap~i~nt ~med ~n the a~e ap~ti~n number in the p~m~s ~f ~s examln~ on ~Tb]['~ ] ? t [ 9~ and fou~ to be i~ compliance with the Na~'o~al Elect~c~ Code. DRYERS MULTI.OUTLET DIMMERS SYSTEMS NO. OF FEET OTHER AI~ARATUS: S E R I C E I9t ~f. 11952 Per [ ;GENERAL MANAGER 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, TOWN OF SOUTHOI,D OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner -'~/~O~ ~ 5 (please print) Plumber ~.~/~ ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before~e this ~ day of ~~z~,r~f/- . t Notary Publ ip; ,TRR~~County N~a~f Ptfo~ S~t;~ of ~ Yo~ No. 3~47411~ O~cfifi~ In N~U /Sulfo~unt~ Commi~icn ~pirc~ ~/~=~ (plumber ' s ~ature) Notary Public 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 September 8, 1997 Christopher M. Leaden P.O. Box 652 Aquebogue,N.Y. 11931 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) ~/XX No Underwriters Certificate on file. 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 # 22989-Z (KOCH) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FIF~LD INSPECT ION RI'~PORT DATE COMMENTS FOtINI)A'I'ION (IST) ~ ~~11 ~ ~r~w~ ~1~-- ~ - · ROHCN FRAME & PLUMBING INSIN.ATION PER N. Y. STATE ENERGY CODE FINAl. ~ -7 ~7 -.I ' ~~ STURTEVANT MILLWORK CORP. L-~noe~en '" DATE PHONE 516-~ · ~' ~-~~ STURTEVANT MILLWORK CORP. 765-1802 BUILDING DEPT. NSPECTION 1ST [ ] ROUGHPLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL FIREF~A~CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~//ROUGH PLBG. FO.~JNE)ATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FO/UNDATION 1ST [ p,~ FOUNr~ATION 2ND [ ] FRAMING ROUGH PLBG. INSULATION FINAL [ ] FIREPLACE & CHIMNEY REMARKS~ ~,+,~-~.~ INSPECTOR 765-180::' BUILDING DEPT. INSPECTION [ c,~ FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: ~c~ [ ] ROUGH PLBG. ] INSULATION ] F;NAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [.]/I~ATION [ ] F~U~MING [L~I~FINAL [ I FIREPLACE & CHIMNEY REMARKS: ~ ~ ~ ~/~ DATE 7~~~____ I N S PECTOI 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [, ] ~.ATION [ ~],'"FI NAL [ ] FIREPLACE & CHIMNEY REMARKS: /~.~_ / DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO~"PLBG. [ ] FOUNDATION 2ND [ ,~,.,..U.LATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT'. TOWN HALL TEL.: 765-1802 Examined . .., 19 Approved.I .~~ .... 19 .~..~Permit No.~.~. fZ?. Disapproved a}c ................................ i ...... 3 SETS oF ~na~s ....... suavE¥ ................. CIlECK .................. SEPTIC FORH .. ........... CALL . .'~ . .. HAIL TO: INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter or in ink and submitted to tim Building Inspector, with 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 st?eel or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app[ cation. c. The work covered by tiffs application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will i~sued a Buildiug Permit to the applicant. Such permi shall be kept on the premises available for inspection througimut the work. e. No building shall be occu~oied or used in whole or in part for any purpose whatever until a Certificate of Occupanc' shall have been granted by the Building Inspector. APPLICATION IS ItEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applJcable 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 imM)eotions. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, ontract,~22,electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... .~..'ff.~../~.. ~ ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade s L~cense No ...................... Location of land on which proposed work will be done ................................................. soo .3%..' ........................... lIouse Number Street ttanrlet County Tax Map No. 1000Section ...' /Z7/7../ ........ Block ..... .O..~. , Lot....O/~. .......... ' Filed Map No ............... Lot ............... Subdivision ........ . ............................. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . b. Intended use and occupancy .... .~..~. fl.~..'*?~m,'~...'..~....~..ct.."Z"..~..~.~....C°..°/~. .................... ' 'J Alteration ' 3. Nature of work (check which applicable): New Building . ] ........ Addition Repair .............. Removal .............. Demolition .... : .Z. i . . Other Work ............... · .. (Descriptiou) 4. Estimated Cost Fee ..................................... (to be paid on filing this application) floor ................ 5. If dwelling, number of dwelling units ...... ( ........ Number of dwelling units on each / · If garage, number of cars ........................................................................ 6. If business, commercial or roi.xed occupancy, specify nature pnd extent of.each type of use ..................... 7. Dimensions of existing structures, if any: Front ...... ?.~ ...... Rear .... D..Sf' .... Depth ...~..7. tteight ...... 7.0. ....... Number of Stories ....... ~. ............................................... = .......... Rear ..oq~.' ........... Dimensions of shme ~tructure with alterations or additions: Front ..... .~ ~ Depth .... ] ~.. ~ ............ tteight ..... /.62 .' ............. Number of Stories ..... .-"-~. ............... 8. Dimensions of entire new construction: Front .............. : Rear ............... Depth ............... Height ............... Number of Stories ....................... , ................................ 9. Size of lot: Front ......... , ......... ~.. Rear ...................... D~epth ...................... 10,.X'Date of Purchase .................... ......... Name of Fenner Owner l~ ~.F--*~. ~ b///e'6/,~/''q' 1 l,..X'Zone or use district in which premises are situated ....... . .............................................. 1 2. Does proposed construction violate any zoning law, ordinance or regulation: ... //.o. ......................... 13. Will 16t be regraded ....... ' ..................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ........... , ........ Address ................... Phone No ............ :... Name of Architect ........................... Address ................... Phone No ................ Nmne of Contractor ~.' .h.r'/.s? ..,~..~.~. . .Z-?..o-.~?..~%.... Addressr:q .g?. ~.,~..~. ~.O..~.... 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. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ;TAT. E OF NEW ¥'O')RK. ~/ ~, ~ ~OUNTY OF .~ .~-~-~. ~. .... (Name of individual signing contract) bore named· :e is the ....................... q ...... x' . I (Contracto~, agent, cor'porate officer, etc.) . f said owner or owners, and is duly auX'~h~e_d l.o~form or l!ave performed tile said work and to make and file this oplication; that all statements contained in thiJ application are true tO the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this ....... ..... c~/,c.~...'...dayof...~..'.4~-t.,,.~../'....'.,,, -- ........ ..... . ......... ~ ~B~H ANN N~E ' ' (Signature of applicant) Nota~ Publi~, State of Ksw York No. 52-8125850, Suffolk Cou~ Term ~ires'~ O~o~r 31, 19~