The URL can be used to link to this page

Home My WebLink About22805-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23694 Date JUNE 12, 1995 THIS CERTIFIES that the building ADDITION Location of Propert~ 845 ELIJAH'S LA. & 130 RACHAEL'S RD. MATTITUCK, NY House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 2, 1995 ..pursuant to which Building Permit No. 22805-Z dated J~q~E 7, 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 BUILT" The certificate is issued to SALLY A. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A ! Jldfng Inspe6tor Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENi' TOI/~N HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22805 Z Date. Juu.e....7..: ....................................... 19...9..5. ..... Permission Is hereby granted to: INLt~N-D HOMES, INC. A/c Sally A. ~ode 315 NESTI~IA ROAD NATTITUCK, NEI~ YORK 11952 to CONSTRUCT A DECK AUDITION TO EXISTING ON~ FAMILY DWELLING "AS BUILT" AS APPLIED FOR. at premises located at......8../t,.S,..~.l..~J.f..h.~..s...~.a..:...&.....I.3.0...Ra.c.)a. e.l.Ls...gR,a.d.....~,~.~.~'i'[~''~''~'' .......... Count/Tax Mop No. 1000 Section .......... 1,~.8. .......... Block ...... ..6. ................. Lot No...?,....6. .................... June 2, pursuant to application dated .......................................................... 19.. ~.5. .......... and approved by the Building Inspector. Fee $ ...... 7.5..:?0. ........ Budding In-'sl~ector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT .TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by ~ypewriter 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 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. Submit Planning Board Approval of completed site plan requirements. '6. For existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and Ppre-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 t9 accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 6/ /95 Date ...... ~ .................................. Rew Construction ........... 01d Or Pre-existing Building..~. .............. Cutchouge Location of Prope~ty..~j~'.~..~..8~.~ ....................................................... House No. Street Hamlet Dot Good ' )nwer or Owaers of Property .................................................................. ]ounty Tax Map No 1000, Section ..... SP~ ..... Block..'.~ ............ Lot...~:5 ................ ;ubdivision Elijah's Lane Estates 2 .................................... Filed Map ............ Lot ...................... Of mit .... Inland Homes 'ermit No ................ Date Per ................ appzmcanu ............................. [ealth Dept. Approval .......................... Underwriters Approval ......................... 'lanning Board Approval ........................ .equest for: Temporary Certificate ........... Final Certicate..~.. ....... ee Submitted: $ ........................... ~. Inland Homes Inc. APPLICANT 765-180~' BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGHPLBG, [ ] FOUNDATION2ND [ ] I~ISULATION [ ] FRAMING ['1~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE INSPECTOR FOUNDATION (2nd) ROUGH FRAME & ........ 'P~LU ~ N G ' INSU L~TTON- ..~TATE ~NEI~ G.Y CODE FINAL o KD])Z l'l'OE ALT~ C 0 MM E N T S: BOARD OF HEALTH ,, ,:,~, FORM NO. 1 SURVEY ......... TOWN 0F SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. ..... ..... TOWN HALL · ' NOTIFY ,,. ~OUTHOLD, N.Y. 11971 Xl d [)isapprovcd a/c .. . ~ ~ild~nspecto0~ APPLICATION FOR BUILDING PERMIT, , INSTRUCTIONS , Date ....' ......... , Y, a. Tiffs application must be completely filled in by typewriter Or in ink and submitted to the Building Inspector, with 3 .~cts of plans, accurate plot i)lan to scale. Fee according to schedule. TM '~ ' .... : '~ ' '" ' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed,,d?scription,of, layou, t of property must be drawn on the diagram which is part of this appli- cation .., ..... ', ;:'.'1!' '..:.:,'l,., ....... . ..j...,h ' . '~ ' ', '-' '! ~..,.!h ,1,'..'! c. Tile work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of tills application, the Building Inspector will issued a Building Permit to the applicant. Such permit qmll bc kept on the premises available for inspection throu¢lout tile work. e. No building shall be occupied or used in whole or in part .for any purpose whatever.until .a Certificate of Occupancy ,4mil have been granted by tile Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Ihfilding Zone Ordin,ane,e.~of~.tho Town of Southold Suffolk County, New York, and other appllcablo Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. l'he applicant agrees to cdmply with all applicable laws, ordinances, building code, housing code, and regulations, and to , . . . .... .hrns' nc. ,dmit authorized inspectors on premises and in building for necessary inspe, cct. .m~.d ,. , (Signature of applicant, or name, if a corporation) : ,, , . (Mailing address of applicant) State whether applicant is:.o, wner, lessee~ agent, architect, engineer, general contractor, electrician, plumber or builder. Genera~ Cbnt~a'c~tdr ..... '~ ' Dot ~:~'~ ~'~ -:' '" ~" ~ : ' '~'-~ (as on the tax roll or latest deed) Ir applicant is a corporation, signatnre of duly authorized officer. (Name and title o£ corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK ~OUNTY LICENSED Builder's License No .......................... Plmnbcr's License No ;! ' Electrician's License No ~ ' "' '~ "'" Off T ado' Li No ~ ' N/W corner 'f Elijah'$ Lane of land on which proposed ·work will be done~ .o ', · I. Locatiou ........................ ~ ....... ,..~0,~ .......... and Rachael' s Eo ,aG~uul~cnouge ~ . ~ , [louse Number .. ~, ,,v 1~ ,l'h,, h~.i; '.,¢! ~Street ;q,, ,, , ,".,dvl ..... , . . ~ ,,,,., · Hamlet, ..... ' ,[!i~08"d: h,,'it m';"' ' ' ...... "' "~ ....... ",,". ' ." "7~ Zf-'. , ':'"" ".' County Tax Map No. 1000 Section .................. 'Block .................. t~ot ....... ;...,... ...... ~ 2 Subdivision..Eli,~.ah ! ¢. T,axt¢. istai;aa ........... Filed Map NO ......... , ......Lot .......... ¢ .... (Natne) ' .... 2. Slate existing use and occupancy of premises and intended use and occupancy of proposed constructionl a. Existing use and occupancy ............................. ..~.{,¢~[0.3.~ $.'r/~ ........... b. Intended use and occupancy . Aa Bu±lt . .E~.i.?.t.i.n.g. 3. Nature of work (check whic[x applicable): New Building ..... ' ..... Addition~.X.~.~.:[.:q-.g. ,~lteration ......... Repair .............. R~moval ..... , · .', ·;. · :' Demolition .............. Other Work....' ........... , ,~ . :: , ,. I ., . , ' (,.escnRhon) 4. Est,mated Cost..5..~.:(~.l ... . · ': ...:..'./.:).::. Fee ...................... . ................ , .~ ~ ~. .. , ~, :: ... ~ (to be onfilin ~ cation 5 If dwelling number of dwelf!ng units ' Number of dwelling units on each floor I f garage, nmn bet o f cars..i: '. ........... 6. If business, commercml or mixed occupancy, s ' pecffy nature and extent of each type of use .............. 7 Dimensions of existing structures if any: Fron~ee ~u~'®;y Rear Depth lleight Number of Stories ' . Dimensions'of santo structur8 with alterations or additions: Front899 ?.3: .a.p_. Rear Depth ' Height Number of Stories ' 8 Dimensions of entire new coi~structinn: Front P, ear Depth I~ 'ght ~.~ ~ Nmnber of Stones ................. i .... Depth ~ 'i ........... 9. Size of lot: Front ........ i .............. Rear..'l~O! ................ I O. Date of Purchase ....... i .................. '... Name of Fenner Owner ..: .................. 1 I. Zo ~e or use d~stnct nl wluch premises are situated .......................... , ........... 12 Does proposed .... ordinance or regulation: · co mtructton ¥~olato any zomng law 13. Will lot be regrad~d ...... I. Will fill be r red fro Yes · · · · ·.... · · ·......... eXCeSS cmo m premises I I Name of Owner of premises i.D.q~ Good. ~ Address Phone No Name of Architect i ' Address Phone No Name of Contractor ~ Address ' Phone No ' 15, Is this property located within 300 feet of a tidal wetland~ ~Yes'. .... ,: No ..... · If yes, Southold Town ~rustees Permit may be required. ........ , . ' ~" i' I~'' .... . .PLOT DIAGRAM ..... . . . . .~ Locate clearly m~d distinctly lall buildings, whether existing or proposed, and, indicate all'set-back dimez~sions fron property lines. Give street and blo;ck number or description according to deed, and show street nmnes and indicate whethe hltcrior or cornerlot. ' ' ' ":. ' .... :'"' ' ' , ' 'I '' I '~ ii: ' , . : ' . , . , Survey. and~,Blan$ ,1 , FEE': m' '--: NOTIFY BUILDING DEPAB~I/MENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING. 3. INSULATION 4. J:INAL - CONSTRUCTION MUST EE cOMPI..Ert; FOR,C,O .... , ALL 'CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STAYS' :CONSTRUCTION, & ENERGY CODES· NOT RESPONSIBLE FOR DESIGN OR CON,S, TRU, ,CT~,ON ERROR$ STATE OF NEW YORK, S.S ~ 'OUNTY OF ................ Robert E. Hiltz ~ ................................................. being duly sworn, deposes and says that he is the applicant (Name of Individual si ~)ning contract) Contractor (Contractor, agent, corporate office_r,, ,etc,,) · · of said owner or owners, and is duly authorized to perform or have p'erformed the smd work and to make and file this :,~plication; that all statements contained tn this application are true to the best of his knowledge and belief; and that the work will be perfon, ned in tho rammer set fort ~ In the apphcahon filed therewah Sworn to before ine this .' ~ ' '. '.':".' ' )',otary Public, ...... ' .... ' Gun '~_~..., ' " ..v., . , ' ~ ~ ute el appncam/ OCCUPANCY OR USE. IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY · -' MONUM6N2' SU~D/V/MON MAP FILED IN ~'H~ OF THE'CLERK OF SUFFOLK COUNT)~ ON AI~D/OI~ FBOz'~ DATA R=VSSlONS YOUNG & YOUNG JULY 21~1975 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK AUG. 7, 1975 ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: INLAND HOMES, INC. LOT 2 "ELIJAH'S L~ANE EST/~,.~'''' ' ''':~''' " ~OA~T,~p ~o:~ ~ 'X ~ TOW. o~ SOUTHOLD ~ ~ ~,"/ . ,",~", l.z ~1 SUFFOLK CO., N.Y. ~' '~"'"::" '~'''' "' ' '