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Home My WebLink About22747-zFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall $outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23753 Date JULY 5, 1995 THIS CERTIFIES that the buildin~ Location of Propert~ 540 CONKLIN House No. County Tax Map NO. 1000 Section 139 Subdivision ACCESSORY MATTITUCK NY Street Block 4 Lot Filed Map No. Lot No. Hamlet 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 19, 1995 pursuant to whTch Building Permit No. 22747-Z dated MAY 10, 1995 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is AN ACCESSORY SHED AS APPLIED FOR. The certificate is issued to KENNETH KMETZ & WENDY of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FO~M NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N_0 22747 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) CountyTax Map No. 1000 Section ...../..,,.'-'~.,..?. ........ Block ,....,~... ................. Lot No....~.-~... ..................... pursuant to application dated ............ . ,~'.,/-.~.. ............................... 19... ,~...~and approved bythe ~/Buildl~k~sp~ctor ' Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOIl 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 water 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 I% 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 the 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-existing Buildin~ - $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.,.Coinmercial $15.00 j Date ...... ~./~ ~/~ .~. ........................ New Construction ........... Old Or Pre-existing Building ................. ~ Location of Property ...... ~.~ ............... ~..~...~. ~..~. ~.../~.~.~.~.. ............... Nouse No.7 ~ Street Hamlet Onwer or Owners of Pro eft ~.~/~/~. ........ ---~J'~--'~'''''~'' .... ~ 9 ~' .... y ............... County Tax Map No 1000, Section ..... ~.~..~ .... Blnck ........... Lot .~- Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. llealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approw~l ........................ Request for: Temporary Certificate ........... Fieal Certicat~e ........... Fee Submitt~: $..~ ........................ ~ ~SA APPLICANT Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (5,16) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 27, 1995 Mr. Kenneth Kmetz 540 Grand 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) 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 plumbing being issued after April 1, 1984). BUILDING PERMIT # 22747-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. FIELD INSPECTION REPORT DATE COMME~S FOUNDATION (IST) FOUNDATION (2ND) ! i ................................... ROUGH FRAME & I~I$11LATION PER lq. STATE ENERGY CODE ~DmO~AL CO~S= ~" ,i TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT ' APR I 9 t!~" TOWN HALL , 8OUTHOLD, N.Y. 11971 ........................ ~ TEL.: 765-1802 Disapproved . . . ..F~ u ild~,.dn sp e c t or) APPLICATION FOR BUILDING' PERMIT ' INSTRUCTIONS Bb,\RD OF HEALTH ........ 3 SETS OF PLANS ........ SURVEY ................. CIIECK Date . . z///.q ........... 19 P~' a. Tiffs 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 publ/c sfi'eet or areas, and giving a detailed description 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 Buliding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the work· e. No buliding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc3 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department'for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances oz Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describbd· The appI/cant agrees to comply with ail applicable laws, ordinances, bufl~.~mg code, housing code, and regulations, and tc admit authorized inspectors on premises and in building for necessity. ~t.~__~ . · (Mailing address of applicant) State wh~ther applicant is owner, lessee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder· .................. ('~ ;;' t'h'e' t'a'x' ;o'il' ;;i1&t' ~;id') ......................... If applicant is a corporation, signature of duly authoriied officer. (Name and title of corporate officer) Bui~der'sLi~e,se No .... .~.~..~..~4. ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... . ............. }',', ..... . ....... 2 ................ · .................. i...' .... ........ '.: ............ · House Number Street Hamlet County Tax Map No. 1000 Section .. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... c~-~ ~" ~. ~ ".' b. Intended use and occupancy interior or corner lot. · 3. Nature of work (check which aPPlicable): New Building . . Addition ....... Alteration .... ; ..... Repair .............. Remolval .............. Demolition ..... ; Other Work ~-O73 ~ .... ,, (Description) 4. Estimated Cost .. ~ ' '~"%' .................................. Fee ..... " (to be paid on filing this application) If dwelling number of dwelling units Number of dwelling units on each floor 5. If garage n'umberofcars i ............... ' " .............. 6 ' If busine'ss ...................................... ' ....................... · , commercial or mixedioccupancy specify nature and ' 7 ..... ' ~ . , extent of.each type of use · Dlmenslons of existing structures) if any: Front Rear ..................... Height Number of Stories .... : ............. ' ........... Depth ............... Dimensi;~; ............ ''" ' .......................................... of shine structure witlh alterations or additions: Front ................. Rear ................... Depth ~ ................. i H ..... ,.. Number of Stories ' ' .... '. eight .......... . .. 8. Dimensions of entire new construction: Front .. · .; Rear .. }'O ~.~l'. .. Depth eT- eight 7. N b ,H ........... . m er of Stories ................................. 9. Size of lot Front l.Ok-.~ ' Rear / t'/'t~ q'S' ' .. . >4& '.:A ............ 10. Date of Purchase .~.¢, . .. x, .... '.;. ~L' '.' ' ~' ............... 1 I. Zone or use d:stnct in which premises are situated . ' .... ~.~' ~1,.~ :/' ' ': ....... 12. reposed construc zola e any zoning law ordinance or regulation' ... .Q?. .... ' ........... 13. wmmtberegraded tY.Q; ' . . , ....... ' ................... · · · .~.~. .....~ · ~ ......... wm excess n. oe removed from premises: Yes .(Nh 14. Name of Owner of premises . .tg. P.~ALI~. · ¢~.%~.% Address .5'. q'.oL$~.rq5/%e .... Phone No ...... Name of Architect ........... I' ............... Address ................... Phone No ................. Name of Contractor .......... ...... Address .... ~.~. Phone No ................ 1.5. I.s thqs property w±th±n 300 feel: of a tidal wetland? ¢¢Yes.. No ......... ~If yes, Southold Tqwn Trustees ?efta±l; may be roqu±red. ·; 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 namber or desex/priori according to deed, and show street names and indicate whether FGLLOW~NG INSPECTIONS: FOR POURED CONCRETE ' Z ROUGH - FRAMING. & PLUMGfNG 3, tIVSUL.ATIOI~ , 4, FINAL CONSTRUCT{ON MUST BE COMPLETE FOR C.O. ALL CO~$7'~UCTIO~I SHAI, L MEET TNE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODEs. NOT RESPONSIBLE FOR DESCGN OR.CONSTRUcTIoN ERRORS FATE OF. NEgL YORK_./ .... · .... i ....... · ......... being duly sworn, deposes and says that he is the applicant ~ (Name of individual signing icontract) ' )eve,named. is the ' IJlz4~ ; ' (Contractor agent .................................. 'potato officer otc ) ' said owner or owners, and is duly aatfiorized to perform or have performed the said work and to make and file this plication; that all statements contained in this'application are true to the best of his knowledge and belief; and that the rk will be performed m the manner sel~ forth in.the application filed therewith. ' /om to before me thi~m.~ · NotawPuble, State of New York.., ~ '-- - - ~ ' D ./ NO 4879505 , i r- . . · · ffokC un , · Commies on ~-xp,ree ueeemg~.r, u, ~ =---- ' , , . , ' (Signature of applicant)