HomeMy WebLinkAbout23056-zFO~M
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
IOWN ~
SOUTHOLD, N.Y.
N? 23055 Z
BUILDING PERMIT
(fi-IlS PERMIT MUST BE KEPT ON THE PREMISES UN1]L FULL
COMPLE~ON OF THE WORK AUTHORIZED)
Permission is hereby granted to:
.. .P.....~,..a¢.../.¢..o ...............................................
..... .P....~....~. ...~..&.....~..:..~.,.../../...~.¢. ..............
,o ~. ~. ,r~ ~. . . . ~ x //¢~. ./. .~ ~. ~ . . .~.~,. ./. ~. ~xx. .,,. ~. ~.. .~. ~. .~ ? ,~,. ,~
~,....~.~'.~.....~,~f_, ..~.~~..~~ .........
, .............................
............ ..........................................................
ooun~To×MapNo. ~000 s~o,,on ........ /~.¢..... B,ook...~ ................. Lo, ~o. ../.../. ......................
purs-uar~t ,o appllcatlor~ dated ............... ~.~..../. ............. 19...~.~ arid approved by the
Building Inspector..
~eo,.....~.~...~
Rev. 6~30~80
No Z-24626
FORM NO. 4
TOWN OF SOUTHOL~
BUILDING DEPARTMENT
Office cf the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OC(Jum~/t'C"/'
Date SEPTEMBER 11, 1996
THIS CERTIFIES that the building.
Location of Property 550 BAY A~ENUE
House NO.
County Tax Map NO. 1000 Section 144
Subdivision
~DDITION & AL'£B~ATION
~TTITUCE~ N.Y.
Street Hamlet
Block 5 Lot 11
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 21t 1995 pursuant to which
Building Permit No. 23056-z dated OCTOBER 12! 1995
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
iBsued is ~LTERATION & BREEZEWAY & GARAGE ADDITION TO EXISTING ONE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JOAN TEC~ET
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N-393633 - AUGUST 9~ 1996
AUGUST 8~ 1996-MATTITUCK PLUMBING & ~EAT.
Rev. 1/81
Form No. 6
TO~H~ o~ SO~THOL~
BUILDING DEPARTMEnt
765-1802
~PLICATIO~ FOR C~TIF!CATE OF OCC~
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for mew building or new use:
i. 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 i~stallation from Board of Fire U~derwritera.
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.
B. For ~xisting buildings (prior to April 9, 1957)' ~on-conforming uses, or buildings and
~'pre-existing" land uses:
I. Accurate survey of property showing all property lines, streets, building and
unusual ua~urai 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 I~spector 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 dw~llimg $25.00,1 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~ - $i00.00
3. Copy of Certificate of Occupancy - $20200
4. Updated Certificate of Occupancy - $50.00
;Temporary Certificate of Occupamcy - Residential $15.00, Commercial $15.00
ate .............
New Construction ........... Old Or Pre-existin~ Building .................
Location of Property .......................................
House No. Street H~r,1 et
Onwer or Owners of Property..~--f~..~. ............
//
county iooo. get,iOn .... ./.%.%. .... ...... ...... .ot ......................
Subdivision ..................... . . . .. ........o.Filed Map ............ Lot ......................
Permit No. ~j..(..~...~...~.Date Of Permit ................ Applicant~.?.~/.~..~(4.'~'J...~Cz~..~../-~...../?---/~.?-<----~-~
A royal .... ~,~ ...... Unde~riters Approval,~.-.~ ~ .' .............
Health Dept. pp .............
for: Te ' :' .. ~cate..~¥
Town 'H::~il, 530~5 Main ¢{oad
P, O, BOx 11'79
SnuthoM, New Yock ! t971
F~x (516) 7 ,S-18.~.t
Telephone (516) 765-I
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD,
I certif'y that the solder used in the water supply system
contains less than 2/!0 of 1% lead.
( Plumbers
Sworn to before me this
day of ' ,qUa,U57'- ,, 19 q&,
Notary Public, .5 ~-D~.,~ County
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
August 15, 1995
Environment East Inc.
P.O. Box 190
Peconlc, N.Y. 11958
RE: JOAN TECHECT
BUILDING PERMIT # 23056-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
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)
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).
Environment East, Inc
3075 Indian Neck Lane
P.O. Box 190
Peconic, New York 11958-0190
516-734-7474
FOIl NDAT [ ON ,
COHHENTS
&
INSULATION I'ER N. Y.
STATE ENERC, Y
CODE
ADDITIONAL COMHEN'iL'S:
Environment East, In.
3075 Indian Neck Lane
P.O. Box 190
Peconic, New York 11958-0190
516-734-7474
Albert J. Krupski, President
John Holzapfel, Vice President
William G. Albertson
Martin H. Garrell
Peter Wenczel
September 29, 1995
Environment East Inc.
Peter R. Stoutenburgh
P.O. Box 190
Peconic NY 11958
Re: JOAN TECHET
SCTM #144-5-11
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SEP 2 9 1995
OwN Or SOIJTHq~g
Dear Mr. Stoutenburgh,
The following action was taken by the Board of Trustees at their
regular meeting of September 28, 1995:
RESOLVED that the Southold Town Board of Trustees approve the
request for a Waiver to construct a 12.8' X 27' addition with a
breezeway attached to a 24' X 32' garage, and patio addition as
per survey. Located: Salt Lake Lane, Mattituck.
If you have any questions, please call our office.
Town Hail
53095 Main Road
P,O. Box 1179
Southold, New York 11971
Telephone (516) 765 - 1892
Fax (516) 765-1823
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK / djh
cc. Bldg. Dept.
CAC
765-1802
BUILDING DEPT.
INSPECTION
[ I FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FO~,INDATION 2ND [ ] INSULATION
[ ~'~ FRAMING
[ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: _
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [~NSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
~ ~ ' ~t ~ //
765-1802
BUILDING DEPT.
INSPECTION
[ ~FOUNDATION xST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
DATE~INSPECTOR~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ]ROUGH PLBG.
[ ~UNDATION 2ND
[ ~] FRAMIHG
[ ] INSULATION
[ ] FINAL
[
REMARKS:
] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT,
IINSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
] FRAMING
[ ] ROUGH PLBG.
[ ] INSULATION
[ ~I~L
[ ] FIREPLACE & CHIMNEY
REMARKS: ~//'//~
DATE
INSPECTOR
765-t802
BUILDING DEPT.
[ ] FOUNI:)ATION 1ST [ ]
PLBG.
[ ] FOUNI)ATION :)ND DN
FRAMING
[ ] FINAL
/
DAT INSPE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNI~,ATION 1ST [ ] ROUGH PLBG.
[ ] F~JNI~ATION 2ND [ ] INSULATION
[ ~ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
INSPECTO ~R~~ /~
765-~.802
BUILDING DEPT.
INSPECTIO N
[ ] FOUNDATION 1ST [ ~']/ROU~H PLBG.
[ ] FOUNDATION 2ND [,,,~INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
765-Z802
BUILDING DEPT.
IINSPEGTION
FOUNr)ATION 1ST [/~ ROUGH PLBG.
FOUNDATION 2ND [,~/1NSULATION
FRAMING [ ] FINAL
DATE /~,~//~ INSPECT~
· ,SE~ 2 I 1995
Exanlined
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,/ SOUTHOLD, N.Y. 11971
,,/'/. TEL.; 765-1BO:;a
7.?'/ .
BOARD OF HEAL]r}{
'~/ 3 SETS OF
-/ SURV£Y
CHECK
SEPTIC FORH
CALL . . .
HAIL TO:
Disapproved a/c .... . ............... ~ ..........
,LICATION FOR BUILDING PERMIT
INSTRUCTIONS
a..This application must be completely filled in by typewriter or in ink and submitted to the 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 stree
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 issued a Building Permit to the applicant. Such perm
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 Occupan¢
shall have been granted by the Buildiug Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tl
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances,
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe,
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and ~
admit authorized inspectors on premises and in building for necessary inspections.
/~.~h~/t~..~ ...................................
-- .~.,(SJ, gnatum of applicant, or name ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
....... l ..........................................................................
r~ -~'e~ cl;~- ..... . ....
Name of owner of premises ....................................................................
(as on the tax roll or latest deed
ir ap~oW', ~m~'ure ofduiy autl[orized officer.
t ~ (~eand title ofcorporai~ ;~h~;/>'~t~2 ~¢--~, ,~"r~cc'l-~ ~,..~h"~ 'c~i,,, --
Builder's Liccnse No ......................
Plumber's License No .........................
Electric, ian's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ........................
' Itouse Number Street Hamlet
Coun,ty Tax Map No. 1000 Section .. l.q...q .......... Block ...~7 ............. Lot .... Ll ............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)~
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy. 1 .?...C.C.C.~.,.5 .M,..~. W.~.'~ ()..~J~...W. 5.."~....~.~.4. ~..'~..~ ......
3. Nature of work (check which applicable): New Building .......... Addition ~ .4d',.lteratio .n---'~. · ·
Repair .............. Removal .............. Demolition .............. Other Work ...............
~.:~ (Desqription)
4. Estimated Cost.. .O___.J[~).~- Fee
(to be paid on filing this application)
5. If dwelling, number o £ dwelling un/ts ... ~ ........... Number o f dwelling units on each fioor.. ~ .............
. If garage, number of c~s ....... ~ ..............................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use
I ·
Height .... [¢. ........ Number of Stories . . j ................... } .................................
D~ensions of same structure with alterations or additions: Front ...~ .......... Rear . .. ~..~ ......
Depth ...... ~ ......... lte~lt ...t~ ...... Number of Stones . .t .... . . .
8. Dmmnsions of entire new constmctmn: Front ....... ~ ...... Rear ... ~3 .......... Depth ~ ............
}te~ght ............... Number of Stories .... ~ ...................................................
9. Size of lot: Front . .l~. ~.;I. ~ ............. Rear . . [.~[-.~ ~ ............ Depth .~.~.' ................
10. Date of Purchase .................... . ......... Name of Foyer Owner .............................
I 1. Zone or use district in which premises are situated...~q~.,.~.~ X~.~[ ..................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..M9 ...........................
13. W~I lot be regraded .... k99 ...................... Will excess,fill.be removed frm premises: Yes No
14. N~e of Owner of premises~¢~.~ ........... Address~ ~h?~ ¢5~hone No~J
Nme of ~chitect ........................... Address ................... Phone No .....
Nme of Contractor ~.~ ¢,~.~'.T~T. t*~.. Address~.Rq ~g~ ~. Phone No.~?~
Is this property wtthtn 300 feet of a tidal ~e~land? ~Yes..~.. blo
~I~ yes, 5outhold Town Trustees Permit may be required.
PLOT DIAG~
Locate clearly and distinctly ~1 build~gs, whether existing or proposed, and. indicate gl set-back d~ensions from
property ~nes. Give street ~d block number or description accord~g to deed, and show street nines and indicate whether
interior or corner lot.
15.
STATE OF NEWyORK~ , / SS
c~Y OF..aC~ .-q-~cd~_ .' (, ,
'.. i .'. ............
(Name of individual signino cohO:act)
above named.
being duly sworn, deposes and says that he is the applicant
tte is the .....-.~-~. -
)
af said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file this
application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
work w~l be performed in the manner set forth in the application filed therewith.
Sworn to Before me this
.........