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Home My WebLink About23006-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office Of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23860 Date SEPTEMBER 12~ 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property 1155 DEEP HOLE DRI%'E House No. Street County Tax Map No. 1000 Section 115 Block 13 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 10 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 23~ 1995 pursuant to which Building Permit No. 23006-Z dated SEPTEMBER 11, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to G. SCOTT & PATTI J. VERITY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 'N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A /~uil~ing Inspector Rev. 1/81 FORM NO.$ TOWN OF SOUTHOU) BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDI 23006 Z ~,e .............. . .~/...../.../. ................................ Permission is hereby granted to: ..-,,:,,,,-.~...../..:...~:~.....: ..................... .. Z...../.~...x,>./..,z.,..;',x....~~ ........... ../~-~....x.-..-:...... ~:.~.....~ ~ ~ ~ ;,... ~: ~./.?~/ :x.....~ ......... ~ .......... ./~.~ ............ ~3.,.;.~. .......... ./.-:.~ ........... ~.:..~..~..~ · x~:4 ........... ~>...~.//.....~ .......... ~: ....... ..~....~-.'.~ ........ x~.../...:......'~...~.....~.~- ........................ . ........................................... .,,:dZ..~.:.~..,:~.~ ......... ~..~..... ........................... CounlyTax Mop No. 1000 Section ,,...../../,~ ......... Block ........ /f~,J,., .......... ["ot No ....... ,,/....~.. .............. Building Inspector, Fee $ ....... ~',~ .............. ......... ...:....4_2..:_/: ........................ / ~/ Building Inspector Rev. 6180180 1995 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-I802 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 all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of xcater 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 "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 tile 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-existin~ Buildine - $100.00 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 ate ...... .................... New Construction .... ~ ..... Old Or Pre-existing Building ................. Locat{on of Property .... ~.1.~ ................. P~ .~93~ .P~ ............. g~.~ $~.q~ ..... House No. Street Hamlet Onwer or Owners of Property...G:..~Q.~.L..¥~.i.~y..&..l~.a..L.L.i..q....V.e.r..i.L2z' ........................ County Tax Map No 1000, Section..l~g.O ...... glock.13...OO ......... Lot..fl%O.0fl0 ........... Subdivision .................................... Filed Nap ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicunt ............................. Itealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approvul ........................ Request for: Temporary Certificate ........... F~nal Cert~ca .... Fee Submitted: $...~5...O.Q ................... ' { I ~ 0 ¢...¢- . ......................... . CO-~o~) APPLICANT William D. Moore WILLIAM D. MOORE Attorney at Lax* 315 Westphalia Road P.O. Box 23 Mattituek, New York 11952 Tel: (516) 298-5674 Fax: (516) 298-5664 Town of Southold Building Dept. Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, NY 11971 July 26, 1995 Re: 1155 Deep Hole Drive, Mattituck, NY Dear Ladies/Gentlemen: Enclosed please find an Application for Building Permit and Application for Certificate of Occupancy for the deck at the above referenced premises together with a survey of the premises which shows the deck. Also enclosed is our check in the sum of $100.00 for payment of your $75.00 fee for the building permit and $25.00 fee for the certificate of occupancy. us. If you have any questions, please do not hesitate to contact Thank you. WDM/mr Encls. .~ndersen' STURTEVANT MILLWORK CORP. coCOm.e home m quali~ me nome to Anders~n. 75 N. INDUSTRY COURT DEER PARK, N.Y. 11729 PHONE 516-667-6700 :ANDERSEN® PERMA-SIIIELD WINDOWS & PATIO DOORS FOR COMMERCIAL & INSTITUTIONAL USE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-~cms ES JOH, STREET. HEW YORK. ~EW YORK ,OO3e V.,e November 29, 1977 ~ppli*.,onNo. o./il* 940361 N THIS CERTIFIES THAT only the el~trical e~ulpment ~ described below and introduced by t~ applicant named oR t~ abm,e application ~umber in the premises of ~. Frank ~,. Zaleski. ~1035 Deep Hole Drive, ~tti/uck, ~.,~efo,o..~.g~.,t~o.~ ~ ,~.,.~., ~ ,~,rt. ~ ~.d ~. outside FIXTURE FIXTURES RANGES :OOKING DECKS OVENS DISH WASHERS EXHAUST FAN DRYERS DIMMERS OTHER APPARATUS: A, W,G, NOOF HI-LEG OF CC. fOND ~o C E 1-G.F.C.I. (Swimming Pool) This certificate covers compliance at the date of inspection only. Because of unusual environments i~ is advisable to have frequent test and/or repairs made by a qualified person. Ruland Electric Co. P.Oo Box 143 ,. Mattituck, L. Io 11952 Lic. #242-E This certlficote must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be .... identified by their cl'edenhpJs~.,' . 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNr~ATION 1ST [ ] ROUGH PLBG. [ ] FOUNn)ATION 2ND [ ] FRAMING [ ] INSULATION [ ] FIREPLACE & CHIMNEY REMARK~,~:. ~~"----~ / DATE ,'I' FORM TOWN OF SOUTHOLD ~ 2 ~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 119771 TEL.: 765-1802 '9/// .., 19~.). Permit No ^p.roved ..... -_.--.... Disapproved a/c ..................................... BOARD OF IlEAL'fit ........ 3 SETS OF PLANS SURVEY CHECK ......... ~ ......... SEPTIC FOR~I b'OT I FY; CALL HAIL, TO; APPLICATION FOR BUILDING PERMIT Date . ...J.u.l.y...2.5., .......19 .9.5. INSTRUCTIONS 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 sti'eet~ or areas, and giving a detailed descripti.on 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 applicatiou, the Building Inspector will issued a Building Permit to the applicant. Such permil 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 auy purpose whatever until a Certificate of Occupancy. shall have been granted by the Building Inspector. APPLICATION IS ttEREBY MADE to the Building Department for the issuance of a Bu!ld.ing Pe[mit pursuant to th~ Building Zone Ordinance of tile Town of Southold, 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 cod~, t~o~g,,coc~et and regulations, and tc - (Signature of applicant, or name, if a corporatiou) William D. Moore .P.: Q....B. 9.x..2.3. ,..M%a.~ i.t.u.~,..NY. J.,I.9....q ~ ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .G....S.c. 9.t.t' .V..e.r.i.t. it' .a.n.d...P.a.b.t.i...J....V..e.r.i.t.t,' .............................. (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 .......................... Plumber's License No ..... '.' ................... Electrician's License No ........................ Other Trade's License No ...................... Location of land on which proposed work will be done. ...................... p.e.e.p...Hg.%e., p.r.%v.e. .... ' .......... ?.u.c. ....................... llouse Number Street flamlet County Tax Mail No. 1000 Section .. fi:l ~..'.0. ......... Block .... ~, ~...O.Q ' Lot...0.1.q.. O0.0. ....... Subdivision ' Filed Map No ............... Lot ............... (Name) State existing use and occupancy of prem scs and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ODe..f. am±l.y..dwe.lliB!; .................. ~:.:,,.z. h,U.:.~...: ........... b. Intended use and occupancy ...... Qlle..f.a. mi 1.y..dwe.Llil3g..wi..t.h..d.e..c.k. 3. Nature of work (ci~eck which applicable): New Building .......... Addition ...X ....... Alteration ....... Repair .............. Removal .............. Demolition .... : ......... Other Work ............ ·., .- (Description 4. Estimated Cost ............. ; ........................ Fee ......... ;.~:;.: ..... (to be paid on filing this application) 5. IF dwelling, number of dwelliug units ..... k .......... Number o1' dwelling units on each floor.. 1 If garage, number of cars ...................................................... , ., 6. If business, commercial or mi.xed occupancy, specif'y ne/nrc and e×ten/of.each type or use .................. 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............ ileight ............... Number of Stories ..................................................... Dimensions of shine structure with alterations or additions: Front ................. Rear ............... Depth · lleight ........... ' ......... ... Number of Stories 8. l)imensions of entire new construction: Front .............. : Rear ............... Depth ............ Ileight ............... Number of Stories 9. Size of lot: Front ......... ............. Rear ...................... Depth ................... 10. Date of Purchase ....... 7..x .Sr-.9.~. ...... . ......... Name of Former Owner E¥~tiq]c. .8~. tl.o.tl~ll~rl.a..g.a..1.o.~.~ 1 I. Zone or use district in which premises are situated R-40 12. Does proposed construction violate any zoning law, ordinance or regulation: .... no. 13. Will lot be regraded . . . tm_; ..... ,,. .,.. Will ex~es[[ilI~be removed'from premises: Yes ...... ~. SCO~; %/~1¥~ ~_.. ~1o~ ~)eeo Hole I~. N 14. ~-~tune el uwner or premises Patt. i .fi:. '¥erigT · · i%aoress Mag. [i.L.uek ........ rnone o ............ Name el Architect ........................... Address ................... Phone No ............. Name el Contractor .......................... Address ................... Phone No ............. 15. Is this property within 300 £ee.t of a tidal wetland? *Yes ........ No.,.X ...... · If yes, Sour:hold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions properly lines. Give street and block number or description according to deed, and show street oames and indicate whet interior or corner lot. APPROVED AS NOTED DATE: NOT'~ ~UI~DiN~ D~P~RT~ENT AT ~65-1~2 FOLLOWING INSPE~ON5: 1. FOUNDATION - ~0 REOU~RED FOR ~RED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. F~AL - CO~STRUCTIO~ MUST BE COMP~E FOR C.O. ALL CONSTRUCTION SHALL MEET THE REOUtREMENTS OF THE N.Y. ~TATE CONSTRUCTION & ENERGY CODE~. NOT R~SPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR~ STATE OF NEW YORK, S.S COUIqTY OF .... ~.U.EE 0LK .... ........... .W,i.x ~. ~.gtr0..D,. ~QQ I:~ .......... ......... being duly sworn, deposes and says that he is the applic (Name of individual signing contract) above named. lie is tile .... .a.~.~.n..g ................................................................. . ........... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed Ihe said work arid to make and File application; that all statements contained in this application are true to the best of his knowledge and belief; and that work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~.~5.h~. ' .day of Jul~ 19 95 ........ ~':TD. RUIl(l:WV'~tJ (Signature of applic~ N~Pul/.~G~l~o{I, Im~Y~q~ William D. ~oore