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Home My WebLink About23021-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCuPANC~ No Z-24387 Date MAX 29~ 1996 THIS CERTIFIES that the building ALTEP~TION Location of Property 4605 WI~a~AM AVENUE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 4 Lot 9.7 Subdivision Piled Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 11~ 1995 pursuant to which Building Permit No. 23021-z dated SEPTEMBER 22~ 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 ALTER AND CONVERT AN EXISTIN~GA~AGE TO AMASSAGE '£~RAPy The certificate is issued to DANETTE & ~ISTOPHER KELLY of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N385293 PLUMBERS CERTIFICATION DATED (owner) MA~ 7f 1996 N/A Rev. 1/81 FORM NO.;~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N? 23021 'Z BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL COMPLEllON OF THE 'v~Z)RK AUTHORIZED) at premises located at ......... ~..~ ....... ~./'.~'~....~.,~...,. ..................................... oou~,Tax~ap~o. ,ooo sec,on.re...7.. ............ ,~,oc,~...m....~,~.... ........... ,o~o .......... ~:,,,~ ...... pursuant to application datec~ ....... ~.,~..~....,.~.Z.~ ................... 19.,,,2~ and approved by the Building Inspector. ~ee ,...2~ ........ Rev. 6/30/80 Yo--m No. 6 OF SOUTHOLE BUZLDING DEPART}~h~ TOW~N ~L 765-!802 .... ±u:==OE CEI~TZ~XCATE OF Tkis applicauion musu be filled in by =ype%~i~er OR ink and suhmi~ued ~a =he hui!d!ng inspeczor wizh ~he following: for new bui!~ing or new use: Finn! su.--vey of proper=y w!uh accuraue iocazlon of all buildings, properuy limes, ssree~s~ and unusual na=urai or uopographi= features. __ma± Approval from Healzh Depz. of wooer supply and sawerage-d!sposa!<~-9 fo--m). Aoo~ova_ of e!ec~.~c=~ *~.s=a!ia~ion from Board of ~ire Under%~iuers. 4. Sworn suauemenn from plumber certlfy~-ug %has nhe solder used Ln sysg~ conuains less ~h~n Z/lO of 1% Lead. 5. Co~eraia! bui!d~g~ ~dusuria! build,g, mu!zipia resiaences and s~i!ar buildings and insua!lauions, a cerutflcaua of Code Compliance from zrchlzac[ or engineer responsible for Lhe building. 6. Submi= Planning Board Approv~ of ccmplauad sine plan raquir~e~us. For exzsting buildings (prior co April 9, 1957) non-conforming uses, or buildings and '!pre-exlsti~g" !and uses: i. Accurase su~ey Of propari? sho%~--ng ail proper~7 lines, s~reess, building and unusual nauurai or zopograpk!c faazuras. 2. A properly oompleuad applicauion and a consen~ to Lnspec~ si=~aed by 5he appiicanu. if a Caruifiaaue of Occupancy is denied, ~he Bui!d!n~ inspeczor shall suaua uhe reasons 5here~or ~ ~iulng ~o zhe app!ican~. Fees !. Carz!flca:e of Occupamc? - New dwai!in~ 525.00, kddinions uo dwelling ._=._a._ons~'~-o~ -~ %0 dwe!ihmg S~.00,~: Swimming poo~' ~.00,~- Accessory buLlcin~' $25.00 kddinions zc gcaasso~ ~ ~ ~ ~ S25.00. ' ou__a_n= 3us~nesses ICG.00. 2. Ceruificaza of Occupancy on Pre-~xlsc~ But!din~ - S100.00 3. Copy of Carzt~aate of Occupancy - .25c !. Updated. r~a_~-~=~.___~a_~= of Occuoancv. . - iS0.00 5. ~=~.mporzr7 ~a--'=~cz.-== of Ocaupanay - Residenuia! S15.00, Co~erclai S!5.00 ~ons~_uc,~o ............. Old Or Pre-~isu!nE BuiidtnE ........... ~ House No. S ~ree: ]oun~y ~x Map No ~ - ~ .aques5 for: Temporary Carz!_=icaua ........... Final Cern!cate ........... 3[ qo .............. ............ Form TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL 765-[802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: [or new building or new use: i. Pinal 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-? form). 3. Approval of electrical installation from Board of Fire Underwriters. 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 installltions, 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: i. Accurate survey of property showing ail property lines~ streets, building and unusual natural or topographic features. 2. A properly completed application ~nd a consent to inspect signed by the applicant, If a Certificate of Occupaecy is denied, the BuiLding Inspector shaii state the reasons therefor in writing to the applicant. C. Fees [. 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-existinz Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00., Commercial $15.00 Ds e ......... .................. New Construction ........... Old Or Pre-existing Building "~-,~ ......... Location of Proper ry...~.~r ..... ~.l(~.~.. ,~..m ....... ~C.. ~¢..~1~ ..... ~[.. ~ouse No. Street Hamlet '5 ~ubdivision .................................... F:iled iqnp ............ Lot ...................... ?ermit No ................ Date Of Permit ................ App[icau: ............................. 'x,lie~tLh Dept, Approval .......................... Urlderwritcrs Approvol ......................... ~'lanning Board 1\2orovli ........................ '~,equest for: Temporary Certificate ........... FL,;l! Certicate.. ~ ..... ,,b i ted:'- .................. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~;_~.,~'~.,' i !~~:'~¢:'~z~ BUREAU OF ELECTRICITY ~- 85 ,JONN STREET, NEW YORK, NV 1003~ THIS CE~IFIE5 THAT o~y t~ ~ ~u~ment ~ ~cri~ ~ a~ int~ by t~ ep~icant ~med on t~ a~e appllcat~ ~ tuber in the p~m~es of Lot DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DIMMERS SYSTEMS NO, OF F~$T S E R V I C NO, (DF HI.LEG BOX 422 CUTCHC~UE~ NY~ 11935 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. COPY F'OR BU~I-DING DEPARTf4ENTo THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY F1AI~IFIERo 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 May 8, 1996 Ms. Dannette Kelly 4605 Wlckham 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) / / xx 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 plu~ubing being issued after April 1, 1984). BUILDING PERMIT ~ 23021-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. U ' I ROII(;II FRAHF, & I INSIILATTON PER N. T. STATE ENERGY I[ FINAL 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNr~ATION 1ST [ ] R.~IGH PLBG. [ ] FOUNI~ATION 2ND [.~] INSULATION ] FRAMING [ ]FINAL ] FIREPLACE & CHIMNEY _ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ [ ] FOUNC,ATION 2ND [ [ ~]'***~RAMI NG [ [ ] FIREPLACE & CHIMNEY REMARKS: ] ROUGH PLBG. ] INSULATION ] FINAL FORM NO. 1 TOWN OF $OUTHOLD BUILDING D£PARTMENT~ TOWN HALL SOUTHOLD, N.Y. 1197] TEL.: 765-1802 Approved ....... .Q./4'a~.[~ .... 19 Or"/.Wermit No?7. ?..O~,1 Disapproved a/c ' B'0ARD 'o~' }{EALTH ...... 3 SETS OF PLANS ...... SURVEY ............... CHECK ................ SEPTIC FORH .......... NOTIPY: CALL ............... HAIL TO: ~ng Inspector) a. Tkis application must be completely fllled in by typewriter or in ink and submitted to the Building Inspector, w 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 or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this a cation, c. The work covered by tttis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, tile Building Inspector will issued a Building Permit to tile applicant· Such pc 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 Occup shall have been granted by the Building Inspector. APPLICATION IS ttEREBY MADE to the Building Departmant 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, Ordinanc~ ~egulations, for tile construction of buildings, additions or alterations, or for removal or demolltlon, as herein descri .The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, an , admit authorized inspect0rs on premises and in building for necessary inspect~ --' (Signature of applicant, or name, il~ corporation) ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or bull Name of owner or premises ,...Qa.~..~v-. y.~..~ . .t[/>?~..v-' ....... M... ,v"~-4)..o ..'7' ..........1, l .............. : (as o'n 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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Locatiouoflandonwhichproposedworkwillbedone....~... '.g-~..~-- (,~(C-J,//~Ok.~/F~ ltouse Number Street Hamlet County TaxMapNo. 1000 Section . !~.~[. .......... Block ...q ' Lot .... .~..~.."-~.. ..... Subdivision ........ . ............................. Filed Map No ............... Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construct[on: a. Existing use and occupancy .... ~ ......................... ~ ............................. b. Intended use and occupancy . ............................. . .................................. · 3. Nature of work ~check which applicable): New Building .......... Addition Alteration .......... Repair .............. Removal .............. Demolition .... ; ......... Other W'ork ............... 4. Estimated Cost O00 Fee .................................... (to be paid on filing this application) 5. If dwelliug, number of dwelling units .... [ .......... Number or dwelling units on each floor ................ · It' garage, number of cars ....... [ ................................................................ 6. If business, commercial or roi.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 of shme structure with alterations or additions: Front ................. Rear .................. Depth ' . ................. Iteight ........... · ........ ,.. Number of Stories ........... 2 .......... 8. Dimensions of entire new cpnstruction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ....................... 9. Size of lot' Front . Rear De th 10. Date of Pure ~ase ..... .~..".gl:) ......... · ......... Name of Former Owner . ~[~.rl ..... ~ .'~'..']. 11. Zone or use district in which premises are situated.. J~St(~t~':~\ ............ .. ~.,:.... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ i ~. .............. 13. Will 10t be regraded .... .~.'. .................... Will excess fill be removed from t:ms'~J~§~~ No 14. Name of Owner of premises ............... ~ .... Address ................... P h o~ ~'~q:~. "~ q-.'J~.~ff~. :"~. ...... ' Name of Architect ........................... Address ................... Phone No ................. Name of Contractor .......................... Address ................... Phone No ................ Is 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 uumber or description according to deed, and show street names and indicate whether interior or corner lot. 15. APPROVED AS NOTED DATE: ~B.P.# ,~'~D''7./ ~ NOTIFY BUILDING DEPARTMENT AT. 765-1802 9 AM TO 4 e~ FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRET~ 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S.S :0 UD.F['Y-' ,~ z~, ~_~V~-_ OF .... ~ ........ .... -'~.~.7.[..1~.: .~¢..'~r. ..... .~..~-'~ .('-:('T..~. .... · ......... being duly sworn deposes and says that he is the applicant (Name of individual signing contract) ~bove named· {e is the ..... ...................................................................... . ............ (Contractor, agent, corporate officer, etc.) .f said owner or owners, ~d is duly authorized to perfom or have perfommd the said work and to make and file this pplication; that all statements contained ~ this application are tree to the best of his knowledge and belief; and that the :ork will be perfo~ed in the m~ner set forth ~ the application filed therewith. worn to before me this ....... //&. ' . .day of. ~c.~.~.~.~ .., ]9 .~ ~ota~ Public, . ....... ~ ............ County . , . ........... -- uNo coo . N~a~ Public, State of Term ~ires ~em~r 3~, ' i. ,;%