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Home My WebLink About23014-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OOJumANCY No Z-23932 Date OCTOBER 5r 1995 THIS CERTIFIES that the building. ADDITION 900 BAYER ROAD & Location of Propert~ 1060 CONKLIN ROAD ~4ATTITUCK NY House NO. Street Hamlet County Tax Map No. 1000 Section 107 Block 9 Lot 28 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8r 1995 pursuant to which Building Permit No. 23014-Z dated SEPTEMBER 14r 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 A REAR LANDIN~ AN STAIRS ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED EMILY R. MAT~I~. (owner) N/A Rev. 1/81 FORM 140.3 TOWN OF $OUTHOU) BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. Ne 23014 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ......................[ ~.~;... ~;ii;~ ,..~: .............................. ...................... .......... ~~...,...~:~., ........ z~.~ ...... . ,o..~.,.~ ....... A, ........ ~ ....... ~.~.~'......,~...........~.r~,i~., ........ ~ ....... ~,...,.~?.¢ ....... ~.~:..~ ........ ~¥y. ........ ~./..~ ......... .,...~z.....~~.,,.,,,J,/~..~:..~.. ................................ .<..... .......................... ~ ........... Couniy Tax Map No. 1000 Section..../.~...~.. .......... Block....,,~.,.~'.. .............. Lot No. .. .~.....?.. ............... pursuant to QpplicQtion dat~ ...... ~z ........ ~ ....................... 19,,..~.., and Qpprov~ by ~e Building I~p~tor. Fee ~.....2~.~ ..... Rev. 6/30/80 '['OWl~ OF SOUTIK)I.D BUILDLNG OEPARTIIEHT TOWN HALL 765-!802 BLDG, DEPT. ,,~ TOWN OF SOUTHOL,~. APPLiCA'FION FOR CERTIFICATE OF OCCUPAHC~ '~ ',- This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: got 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 water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation [rom Board of Fire Underwriters. S~orn statement from plumber certifying that the solder used in system contains lass than 2/tO of i% lead. 5. Commercial building, industrial building, m, lrip]e residencas and similar buildings and installations, a certificate.of Code Compliance from architect or engineer. responsible for the building. 6. submit Pla.ning Board Approval of completed si~e 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 naturml or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificmte of Occupa,cy 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 ~o dwelling $25.00, Swimmin~ pool $25.00, Accessory building $25.00. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on ?re-existin£ ~uildin~ - $[00.00 3. Copy of Certificate of Occupancy - $20.00 &. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ................. uo~o,, o~ r~o~ .... ~'P ............. ._~.___, ......... ..._..._ ~ ........ ~ouse No. ~ Street tlmnie t ~.,~ o~ ~,~, o~ ~.~y.. ,~ i/~..~,...~.~ ~.~.c~, ...... ................. ,~ .............. ;isalLh Dept, Approval ......................... Umferwriters Approval ......................... Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 22, 1995 Ms. Emily Mather 900 Bayer Road Mattituck, NY 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is not on file. $25.00 Mo Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23014-Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. 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 22, 1995 Ms. Emily Mather 900 Bayer Road 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. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23014-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FRAME TNSIH. AT~ON PER N. STATE ENERGY ~DDE FI. NAT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R/OUGH PLBG. / [[ ]]~OR~UNM~ION 2ND [[/~ F~ATION [ ] FIREPLACE & CHIMNEY DATE FORMNO, 1 "'3 sETS OF PLANS TOWN OF SOUTHOLD ~- SURVEY BUILDING DEPARTMENT,. '- CIIgCK ................ TOWN HALL SEPTIC FORI'i SOUTHOLD, N.Y, 11971 TEL,: 765-180:3 Examined .............. , 19 Disapproved a/c .............................. :. CALL ........... .~. , . HAIL TO: APPLICATION FOR BUILDING PERMIT Date ................... 15 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and subnfitted to the Building Inspector, v, sefs of plans, accurate plot plan to scale. Fee according to schedule. , b. Pict plan showh~g locatinn of lot and of buildings on premises, relationship to adjoining premises or public si or areas, and giving a detailed description of layout of property must be drawn on fire diagram which is part of this ~ cation. ¢. The work covered by fids application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Such p~ shall be kept on the premises available for inspection throughout tlie work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate'of Occup shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant t. Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinane Regulations, for the construction of buildings, additions or alterations, or for removal or demofition, as herein descr The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, a~ admit authorized inspectors on premises and in building for necessary inspections. (Signatu, re of applicant, or name, if a corporation) .?o.o.. --(Mailing address of applicant) ..... State whether applicant is owner, lessee, agent, architect, engineer, generai contracto~f,~r[ja~ ~l'~er or but ............. O~gF~ . . . .......................................... ~^r~:. ~,h¢/?~,.#. ................................... NO.TIF¥ t~t.I-ILDR'~.G ,OEPAR'FMENT.AT. (as on the tax roll or l~tlq~I~9 AM TO 4 PM FOR THE If applicant is a corporation, signature of duly authorized officer. ........ :~;'.;; ;,;~',;ti; ;,~ ~;"; ;i' .OBC. UPANCY OR , ,, ~, e~lS UNLAWFUL ~.ilde,'s ~ice=e No ............ WITHOUT' CERTIFICATE Plumber's License No ........... OF' OCCUPANCY Electrician's License No ....................... FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUIRE[~ FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. tNSULATION --~. FINAL - CONSTRUCTION MUST '~L~C~LETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIHEMENTS OF THE N.Y.' S~ATE CONSTRUCTION & ENERGY CODES· NOT RESPONSiSLE FOR DESIGN OR CONSTRUCTION ERRORS Ct} er Trade s License No ...................... · ' , . _~"~ ~_ .? _ .~.f~.- l~.~/-'.~ ' '~"'~'c-.d~ ?..o.d..' ........... · ....... .......... House Number Street~ tlamlet 5~ , , - =.z icc Cot nty Tax Map No. I000 Section .~',':7/.".~. ........ B E .................. Lot .............. Subdivislon Filed Map No ............... Lot ...... : ..... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: g ' '* ' a. Existing use and occupancy . . . ~.~ ......... ~a}2. ~..'i ............... b. Intended use and occupanc, y /~ 3. Nature of wot~f~heck which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. V.. Removal .............. Demolition .... ; ......... Other Work · <~t'0") "~-C~'-:. i'. ............... ' (Description) 4. Estimated Cost ...... 19.. ,.-)=. · ·.. · - Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Nurhber of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mi.xed occupancy, specify nature and extent of.each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions ofshme structure with alterations or additions: Front ................. Rear .................. Depth ....................... Height ................... :.. Number of Stories ........... 2 .......... 8. Dimensions of entire new cpnstruction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ......... , ............ Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will Iht 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 ............. ~.. Name of Contractor ........ .., ................. Address ................... Pho~ No ............. Is this property within 200 feet of a tidal wetland? *Yes ...... ,.. No,/Z~ ...... ':'' · 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. 15. ~TATE OF NEW YOR. K-, . :ou y ..... ' ...',.~O.~lq... ~O / - .C~. ........... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) bore named. Ie is the ................................ ~ ~g ................................... ' .............. (Co ent, cor'porate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to m~e and rite this t>plication; that all statements contained ~ ti]is application are true to the best of his knowledge and beEef; and that the ,ork will be performed in the m~ner set forth in the application filed therewith. worn to before me this /~ /) . . ............' ' . .. ota~ Public, . .... /~ .... ~~. t o nty No. 4725089. Term E~ires 1,5, u,~oU~t osl° ~ "T' rtl 'T --I