HomeMy WebLinkAbout23155-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26627
Date: 08/12/99
THIS CERTIFIES that the building ALTERATION
Location of Property: 2545 COX NECK RD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 113 Block 7 Lot 9
Subdivision Filed Map No. __ Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 20, 1995 pursuant to which
Building Permit No. 23155-Z dated DECEMBER 4, 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 AN EXISTING GARAGE TO A KITCHEN ON AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to MARY C HINDERLITER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H 061777 10/15/98
PLUMBERS CERTIFICATION DATED 04/25/99
WILLIAM H. HINDERLITER
ui~ing I~spector
Rev. 1/81
FORM
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD,
N~
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK A.,U,,~,.H~RIZED)
°ate ......... ........................
23155 Z
Counly Tax Map No. lO00 Section ....... ./...../..~.,.. Block .......... ~ ..........LotNo...~.., .....................
pursuant to application dated ......................... ~/~..~...~.., 19..~..~and approved bythe
Building Inspector,
Fee $.....,~.,..~,..,,%..
Rev. 6/30/80
Building Inspe/q,t~Sr
II
[~[,IJHB l NG
[NSHI.ATTO~'i PF~R N. Y.
STATF, ENI~I~,CY
COI)I': fi,
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i,, ' - 7 1999
APPLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
mo
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 ail 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.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Ppre-existing" land uses:
1. Accurate survey of property showing ail 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-existinR Buildinm - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .~er;J.._.~£1~.£~£ ................ · .. · · ·
New Construction ........... Old Or Pre-existing Building....~ ............
Location of Propert,..P ..............
~ouse No. - Street
Hamle~
County Tax Map No 1000, Section ..... /.(b ..... Block ...... .Q.7 ...... Lot ...... .~.~. ............
Subdivision .................................... Filed Map ............ Lot .............
Permit No ...... Date Of Permit ...... cant ................
Health Dept. Approval ...................... Underwriters roval.. .1.~.' .............
Planning Board Approval ..................... . ..
Request for: Temporary Certificate ........... Final Certicate...~ ......
Fee S.ubmit t ed: $... ~.~.~ ,~? ....................
APPLICANT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INS/ULATION
[ ] FRAMING [ h,~ FINAL
[ ] FIREPLACE&CHIMNEY
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
CERTIFICATION
Building Permit No.
Owner: l~p~a print) '
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers Signature)
Sworn to before me this
~,~"~ day of
Notary Public, iQ
{~I)NA[D S. PARSES
~ ~StJC, Sta~ of ~w
I~ 4602964, ~uf~ot~ ~u~
~m ~ February
County
" " THE NEW YORK BOARD OF FIRE UNDERWRITERS P~GE 1
BUREAU OF ELECTRICITY
~-- 40 FULTON ETREET, NEW YORK, NY 10038
Date OCTOBER 15,1998
Ap#fleatlo, No. o, Jfle 11764096/96 H 061777
THIS CERTIFIE~ THAT
only the el~ct~al ~qutpment as desk,bed below and tnWoduced by the applicant named on the above appl~afion number ~s in the prem~es of
~I~/CAT~ HI~ERLITER, 2475 COX ~CK RO~, ~TTITUCK, ~
tn th~ followlng locano,; ~ Basement ~ ls, FI. ~ 2nd FI.
was examined on OCTOBER ~6, ~998 Secaon Block
and found to b~ tn compl~nce with th~ Na~onal Electrical Code.
OUTLETS RECE~ACLE~ 8WI~CHES ~ ~,
16 16 10 ' ' ' kM~. ~.W. H.P.
OTHER &PPARMUS:
PADDLE FAN-!
TRASH COMPACTOR- 1
G.P.C.I,-2
WILLIAH/CATHYHINDERLITER
P. O. BOX 184
MATTITUCK, NY, 11952
GENERAL MANAGER
11
this certificate must not be altered In clp~y manrter; return to the office of the Board If Incorrect. Inspectors may be Identified by their credentials.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
March 30, 1999
Mary C. Ltndsay
Box 184
Mattituck, N.Y.
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
XX
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.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 23155-Z *
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
*NOTE: BEFORE CO CAN BE ISSUED, SWIMMING POOL TO BE ENCLOSED
TO CODE AND REINSPECTED.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF sOUTHOLD
March 30, 1999
Mary C. Lindsay
Box 184
Mattituck, N.Y.
11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX
XX
XX
XX
An application for Certificate of Occupancy is
not on file. (Enclosed)
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).
BUILDING PERMIT # 23155-Z *
Please contact our office on this matter.
cooperation.
*NOTE: BEFORE CO CAN BE
TO CODE AND REINSPECTED.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
ISSUED, SWIMMING POOL TO BE ENCLOSED
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] I~LATION
FRAMING ['~NAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[
[ ~.*2~/"INSULATI ON
[ ] FRAMING [ ] FINAL
[]FIREPLACE&CHIMNEY
REMARKS: ~~-~
DATE
765-1802
BUILDING DEPT.
INSPECTION
I~FO,.,,,.~','.o. '.~T I ~"O'.'O"
[ ] FIREPLACE & CHIMNEY
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
[ ] ROUGH PLBG.
[ ~SU LATION
[ ] FINAL
FIREPLACE & CHIMNEY
REMARKS:.
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P'd- ?/-.
~s~llu~lotlns / n~s~N Ul Pell~eno
'ON
'~d /u'e~N
~lO~J. Vd
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(lomluoa ~u!u;~[s ienp~^tpm Jo/OmeN)
luua!Iddu oql s.t oq ;~q; s.~,s puu gosodap 'mo~s Xlnp gu.toq ......;~.L-TZ'? ~ '~(7','2'/~-~'" 0 ~'b'f/.ZZ ......
.~ :-~,'~" :.qo ,kJ_NflO:
~ ~ ..... ';-~[~;,T"f~¥, ~ SOUTHOLD N Y 11971
~ 'rt~:..,:: -', .. ~ TEL.. 765-1802 .
Exam_ned ..... 19 ,
Disapproved. a/c .............. , .................... ,
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT:
TOWN HALL
//, (Building Inspector)
Ap c^? oN Fo. BUiLDiNG'
INSTRUCTIONS
Date .... /./'/~? .......... 19 9'g~'...
a. Tiffs application must be corn )let¢ly filled in by typewriter or in ink and submitted to the Building luspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
; b. Plot plan showing location et4 lot and of buildings on premises, relationsliip to adjoining premises or public s6'eets
o~r areas, and giving a detailed descrit~tioh of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by tkis application may not be commenced before issuance of Building Permit. .
d. Upon approval of this applica!ion, the Building Insp6ctor will issued a Building Permit to tho applicant. Such permit
shall be kept on the premises availabld 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 Occupancy
shai1 have been granted by the Buildin~ Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pemdt pursuant to the
Building Zone Ordinance of the Tow~ o.f Southold, Suffolk County, New York, and other appli.cable Laws, O. rdinm~ces or
Regulations, for the construction of buddings, additions or alterations, or for removal or demohtion, as hereto describbd.
The applicant agrees to comply withi all applicable laws, ordinances, building code, housing code, and regulations, and to
admit autliofized inspectors on premises and in buildMg for necessary inspectious.
(Signatur~of applicant, or name if a corporation)
State whether applicant is owner, leOsee, 'agent, architect, engineer, generai 'contractor, electrician
' l~ary Hinderliter
Name of owner of premises I '
(as on the tax roll or latest deed)
If applicant ~s a corporatmn, signatureiof duly authorized officer.
; (Name and title of corporale officer)
Builder's License No ..... ' '
Plu nber s L~cense No ......... i ....... ..........
Electrician's License No ....... i ......... . .......
Other Trade's License No '
work will be done.
(Mailing address of applicant)
plumber or builder.
~a.t,~ituck '
House
Nmnber [ Street Hamlet
Subdivisidn ....I ' Filed Map No Lot
(Nalme)
Stat4 existing use and occupancy o~ premises and intended use and occupancy of proposed constructioni
a. Existing Use and occupancy .~lA'lg.l.e..f. gIIki..3,7..cl.w..o. 1. ~.[.n.g ..........
,' same make garage into kitchen
b Intended use and occupancy
1. Location of land. . on which proposei
..... 2.0,7.5. Co.x..lxte. Ck..lq;o d ...............