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Home My WebLink About22921-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24095 Date DECEMBER 22, 1995 THIS CERTIFIES that the building ADDITION Location of Property 145 WAVE~RRT LANE House No. Street County Tax Map No. 1000 Section 100 Block 1 Subdivision Filed Map No. MATTITUCK, N.Y. Hamlet Lot 12 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 19, 1995 pursuant to which Building Permit No. 22921-Z dated AUGUST 1, 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 ENTRYWAY ADDITION ON REAR OF EXISTING ON~ FAMILY DWELLING AB APPLIED FOR. The certificate is issued to of the aforesaid building. NANCY ARNZEN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-372459 - DEC. 8, 1995 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 uzlding Inspector FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAU. $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .................. ~.,/../. ............................... 22921 Z Permission Is hereby granted to: ~:~ ... ~.~~,.... ~~ ~ .... £~:~..~ ............................................... to~..~......~.~......~ ........ ~~,~..:.....,~.,~.,~:~ ...... :~ ~ ....~.,~. ~ .,,~,..~~ ....... .~.....~.,'~ ............... ~...~~ .......... ~.~ ................................................................................................. at premises located at .......... ./..~...~..........~/...~..(/..~...~..,~-~../...'~......~.~.. .......................................... Counly Tax Map No. 1000 Section....~...~?..~,, .......... Block ...... ,,,~,.,,/. ............ Lot No ...... .."~....~., ............... pursuant to application dated ................... .~./,/~..~,. ......................... 19.,.,~, and approved bythe Building Inspector, ~ee S.....~:~ ....... Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPAIITFiENT TOW!~ HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submi:ned 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 tha~ 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 orooerly completed application and a consent to inspect signed by the applicant. If'a ~ertificate 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 Buildinm - $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, Commercial $15.00 Date ...%~%Q~ .............................. ~RX~L~X~3~.-...--..-. ~ Dr_____Pre-existi~,Bu~j~_._..__. --- ................. Location of Property. ~ ............ i~Yg. QFg~..~~'~' ........ ~B~%~¢g ................... ~ouse No. Street Ramlet Onwer or Owners of Property Nancy Arnzen ...................... County Tax Map No t000, SectionSalta~re ea t.B~ock ............... Lot.~.l$. Subdivision .................................... Filed Map ............ Lot ...................... Permi~ No....4.~.-~... ~.~.~7.Date. Of Permit.~/~/~. ...... .. Applicant...........,---..Ji~ Brockbank Cg~s~. ........ ..' ~ea~[h Dept. Approval.~gg~.~¢ .............. DnderwrSters Approval ......................... __annzng Board Approval ........................ yes = . ~=~ ~^~-~,,~ Final Certicate ........... Submitted: $~...,O-.~t/ ..... ~....' ....L.~...~ 3 I ' ' ' ............. t~ee~51 THE NEW YORK BOARD OF FIR~-UNDERWRITERS [~AC~, 1 EUREAU OF E'ECT.,C,~9 85 JOHN STREET, NEW YORK, NE~.YORK 10038 -- DEC~R ~8,1995 1~3595/95 N 372~59 Date ~pplica~ion No. on file THIS CERTIFIES THAT o~y the e~ trtcal ~ulpme~t ~ ~scrlbed below a~ int~uc~ by t~ applicant ~d o~ ~he a~ve appl~atio~ ~umber in the prem~es of N~ ~IZON, ~45 WA~CR~ST, ~TITUCK~ ~s examined on and found to be in compliance with the NaEonal Elect~c~ Code. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES 2 3 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: E R I C NO, OF CC, COND, PER ~' A. WG OF HI,LEG NO, OF NEUTRALS OF NEUTRAL T.H. CH~SHIR~ ~ SON P.O.BOX 243 CALVERTON, NY, 11933 LIC. #3856~ GENERAL MANAGER Per 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. ~,s co.v o?cE.T~.C^~ ~ u.s~3~o3 ~5^.~.E~ .. ^.v 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [[]] :ORAUNM~NA~ION 2ND [[ ]~ATION [ ]FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ].~FOUNDATION 1ST [ .] RO/UGH/PLBG, [ ] F/JDUNDATION 2ND [//]' INSULATION [~/]' FRAMING [ ] FINAL []FIREPLACE&CHIMNEY REMARKS: /,~'/'~ DATE 65.1802 DING DEPT. ECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ].~I~DATION 2ND [ ]INSULATION [ ~ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. [. ~ATION 1ST [,p,~ FOUNDATION 2ND INSPECTION [ ] ROUGH PLBG. [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTION REPORT DATE FOUNDAIION (2ND) C OMM E N'I S ...~_.~ .... ROUGII FRAME PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ]ii~! Brockbanl{ Construction P.O. Box 252 Mattituck, NY 11952 298-4768 OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE, OF OCCUPANCY UNDERWRITERS CERTIFICATE REQUIRED Mattituck, NY 11952 JUL 9 t995 298-4768 P.O. Box 252 Mattituck, NY 11952 298-4768 P.O. Box 252 Mattituck, NY 11952 '298-4768 \5 ~IOT ~ · = MONUMENT SUBDIVISION flAp FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUN'I'Y ON AUG. 3, 1966 AS MAP NO. 4682. t.o~ ~5 / ,/ \' / SCALE: I "= 40' JULY-15, 1975 SEPT 23,1~)75 SURVEY FOR ABRAHAM PALLAS 8~ PAMELA' J, PALLAS LOT 15 "SALTAIRE ESTATES" '~" MATTITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. eUARANTEED TO, SECURITY TITLE ~ GUARANTY CO. SOUTHOLD SAVINGS BANK YOUNG 8, 'YOUNG LAND SURVEYOR, N.Y.$. L%'~. NO. IZ 845. RIVERHEAD, N,Y. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1803 Examined ...... 5/~. ...... 197.5''~ Disapproved, a/c ..................................... 3 SETS OF PLAdS .'~ . '~suRvg~ ............ SgeTtC ro~m .............. CALL t ...... HAlL TO: . ~.B~Ic~ Iuspector) .. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locatiou of lot and of buildings on premises, relationship to adjoining premises or public sfi-eets 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 Building Permit. d. Upon approval of this application, the Building Inspector will igsued a Building Pe~it to the applicant. Such permit shall be kept on the premises available for inspection throoghm~t the work. e. No building shall be occupied or used in whole or in part for ar y purpose whateveLuntil a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS ttEREBY MADE to the Building Dep~tment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Soutb01d, Suffolk County, New York, m~d other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolifion, as herein described. The applicaut agrees to comply with all appl~g:ab~M~l~'~l~h'fi~es, ~uilding code, housing code, and regulations, and to ad nit at t ~orized inspectors on premises and hi buildi~g~for necessaw i~ll~~~ . ' ~ . '.. ,;~ (:,,2.~'¢~ ;¢'~,'atureofappllcant, orname, lfacorporation) ~ (Marling address of apphcant) State whether applicant is owner, lessee, agent, ard~t~ct, eng~'~~cont lectrician, phunber or builder. Name / (as on the tax roll or la[est deed) If applicant is a corporation, signa[ure o[ duly aufimrized officer; (Name and title of corporate officer) . ~ ....... :. ....- - Builder's [ic~,se No.. ~.,. ~./7/~'..... OUL I g Igg5 Phlmber's License No ..... ' .................... Etech c ~ s License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done .................................................. ........ '.'. ..,:.V. . .:. ... ......... m. . lIouse Number Street lfamlet County Tax Map No. 1000 Section~/jT~tt//.~..'Tq--, ..... Block ' Lot . . . /.X.~: .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E ,s,ng ,se ,nd ocenpa.cy . . .'-. . . / ' b. ,ntended ,,se and occ, paney . . . '.O.--. .K. . e . ............................ ) 3. Nature of work (check which applichble: New Building .......... on.., Alteration .... ; ..... Repair .............. Renloval ............. Demolition ..... : ........ Other Work ............... ] (Description) (to be paid on filing this application) 5. elhng, nu lb f dwelhn unit Nu er of dwelling units on each floor. . 6. If business, co~nmercial or mixed occupancy, specify natnre and extent of,eac t type of use ..................... 7. Dimensions et existing structures' if any: Front ............... Rear .......... De t . . . . lie It ............... Number ofStories . . . ' Dimensions of shine structure ?t ~ alterations or additions: Front '-.-~..~'?..~. ~ . Rear ............ ..... e ..... >.,. ......... ;.. um ecofStores .t~.A.(.~.~ . II igl Numb f'St i ......... : ....... ~ ............ l.~eptn ........... 10. Date of Pure :asa . . C.C:~./~.."" 'Pal .............. 11. Zone or use dmtuct 11 wluc: premises are s rusted.. ' 12. Does proposed constrnction violate any zoning law, ordinance or regulation .~.'7. "~-- ......... i .... 13. Will lot be regraded ' !' ~ i ........ .... ........................... Will excess fill be removed i'rom pr raises Yes No 14. Nmne of Owner of pre nises ' , ........... , ........ a~oress ................ Phone No .......... t.s this property within )00 feet of a tidal wetla~j~ *If yes, Southold T. own Trustees Permit may be required. No.z~...... .". i PLOT DIAGRAM Locate clearly and distinctly all?buildings, whetlmr existing or proposed, and, indicate all set-back dimensions ~rom property lines. Give street and block gumber or description according to deed, and show street na~nes and indicate wi ether interior or corner lot. STATE OF NEW YORK, APPROVED AS NOTED DATE: ~B,P.# Fm NOTIFY BUILDIN6 DEPARTMENT AT 7aB,1802 g AM TO 4 PM FOR THE FOLLOWIN6 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE .' ~. ROUGH - FRAMIN6 & PLUMBING 3. INSU~TION 4. FINAL ~ CONSTRUCTION MUST BE COMPLETE FOR c.O. ALL CONSTRUCTION SHALL MEET THE R~QUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NO~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS coum-y OF ..................SiS / ........................................ ' ......... being dnly sworn, deposes and says timt he is the applicant (Name ofindividnal signin contract) ' above named. Ileis the .. .................. , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly mthorized to perform or have performed the said work and to make and file this application; that all statements contai: ed in this application are irne tO tim best of his knowledge and belief; and that the work will be performed iii the manner :t forth in the application filed therewith. Sworn to before me this ~ HELENE D. HORNE Notary Public, State of New York No. 4~5130~ Oualtfied !n ~ffo!~ Courlty d~,,~ ( lgnature ofapphcant)