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Home My WebLink About22364-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26146 Date: 12/08/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 11155 MAIN ROAD/ROUTE 25 MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 142 Block 2 Lot 22 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 15, 1994 pursuant to which Building Permit No. 22364-Z dated OCTOBER 5, 1994 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 ACCESSORY STORAGE SHED IN REAR YARD OF A BUSINESS AS APPLIED FOR. The certificate is issued to RAYMOND M. of the aforesaid building. & LAUREL FEERICK (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FORM NO.~. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 22364 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~o,~ ........... ~.~....~ ................. ~.~.¢... Permission Is hereby granted tg;. ...... .F..~.¥.,~.~.~..~ ...... ~.:....~.~.~.~/< ......... . .F..,..~..,..~..~7:......~...9....o.. ............................. ..~~........~ ........ Z?~......,~¢'~.~..~......~.~..~.~... ,,_ ,,)~ , u _ ., .~..,,~ ..... ,~..~..~.,.~,.~,,~. ....... ~.~......~£?.,'.,.:,,.~ ................................... CountyTox~ap,,,o. ~000 Sect,o,',...Z...7...~ ........ B,oc~ ...... ~ .............. Lot,,,o.,~.~ ............... Building Inspector, B Rev, 6/30/80 BLDG. DEPT. ~QF SOU'I HOLD TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR 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 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 Vpre-existing" land uses: 1. Accurate survey of property show/rig 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. · 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming p~ building $25.00, Additions to accessory building $25.00. ~usinesses?_50_.??. 2. Certificate of Occupancy on Pre-existin~,~.~.~w.i!d.i-~ 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. T~po~ry Certificate of Occupancy '- Residential $15.00,.Co~ercial $15.00 ......... ...................... ~ Const~c~lon ........... Old Or Pre-~ist~ng Buildimg ............ ~a~ion of Property...~J ~ House No. Street Ha~! et ~wer or O~ers of Property ..................................................... .... ,~unCy T~ No 1000, Section ........ Block ............ Lot ............. ;ibdivision Filed Map Lot ... ......... '~t'~it No ................ Date Of Permit ................ Applicant .................... '~alth Dept. Approval .......................... Underwriters Approval ......................... Lanning Board Approval . · / V ,quest for: Temporary Certificate ........ i'[ Final~C~erticate_~r_)____~nl,~ ........... ~DATYO.~ ~ 4~_~ 1st) ULATIO,'! PER'~. Y. ~TATE ENERG~ CODE ADD%T]~ONA'L CO!4~IE)IT$: I SCALE - ~ ~'~" "~'-D HELGA ' ' ' .... GUA~,N ~ EED ~ THE ~O~E. TITLE VAN '"' '" 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INFLATION [ ] FRAMING [~ FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR FORM NO, 1 TOWN OF SOUTHOLD BUILDING/DEPARTMENT` TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c .... o ................ ~. ............. ' ~;~PLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH .......... g SETS OF PLANS .......... SURVEY ................... CIIECK ..................... SEPTIC FOR~I .............. ¢ CALL ........... MAIL TO: 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 location of lot and of buildings on premises, relationship to adjoining premises or public streets 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 approva! of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depairtment 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 or Regulations, for the construction of buildicgs, additions or alterations, ffr'fjor removal or demolition, as herein/described. The applicant agrees to 6omply with all applicable laws, ordinances, b}~il~d~ng code, hou~n~ cpdq, jand regulat~ns, and to admit authorized h~spectors on premises and in building for necessary inactions. -- , ' ' ' i~~~O/;a}i~n') .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ........ : .............. r · Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................... ...... ...... ................................ House Num bet Street Ha~hlet County Tax Map No. 1000 Section .... 1 .!2 :.o.O ..... Block ..... :..rap. ...... Lot .... ..... 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 ..................................................................... b. Intended use and occupancy 3. Nature of work (check which a?licable): New Building .......... Addi ion .......... AlteraB'~n .,.~ .< ~, .... Repair .............. Rem?vel .............. Demolition . ~ ........ Othe, r Work .. 4. Estimated Cost ........ ] ,:.'77~..'. ...... Fee . [ (t g thi ~pli ) , , o be paid on illin s a cation 5. If dwelling, number of dwelling units .......... ; .... Number of dwelling units on each floor ................ · If garage, number of cars .... ' ............... '~ .... ...' .... ~ ....................... '~,'. '~ ............. 6. If business, commercial .... or mixed occupancy specify nature, and extent of each type of use .... ,[~'~.tx' 7. Dlmensmns of exls, J:leg structures, ~f any: Front . ·..~.q. .... Rear .... Depth . . . ~. .... Height ....... ~. ...... Nun~ber of Stories ............................ ~ ........................ ' Dmaensmns of same structure w~th alterations or add,hens: Front ....... Rear .............. Depth .............. Height . Number of Stories ....... ,. 8. D~menslons ofent~re new construction Front O Rear /~' D~nth Height .. .D:.. Number of Stories . . . 9. Slzeoflot Front ,'~.~. Rear '~" . nonth 10. Date of Purchase ....... ~/t.,,/~.~. ......, ......... Name of Fm-mer Owner . .~,,C(~tOM~..~..].t4gCl%t~ ...... · 11. Zone or use district in which pr~mises are situated ......... ~ ........................................... 12 Does proposed construction violate'any zoning law ordinance or regulation: ' -- 13. Will lot be regraded ............. 14. Name of Owner of premises . f~.y...~.~.Ct.~!.. .... Will excess fill be removed from premises: Yes .. Address ~c~.*.%Z~.r. ,/'t~q~/j,~wff, Phone No...'7.. Name of Architect ...... Ii..!... ~!.,I.., .... i i.. Address ........... 7. ...... '.. Phone No ................ Name of Contractor ..... .~.~34J',.,~Q. [ .1~.5 ..... Address .'7~..~'J.~.~ I~0 ').~[ ~.'~.,~one No...Ot. oq~{, 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all l buildings, whether existing*or proposed, and. indicate all set-back di~nensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S;.S COUNTY~F ................. ....... .~.0,.x/.~..~. ~.~. P.'~L..~..C- ..... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............ .~..~..L/")~...~. ~! ......... of said owner or owners, and is duly lauthorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith· Sworn to before me this 19 ~./t~ ~otary Public, . ......... ~~¢-~,..~ ...... County No~.r~482 ~ 6~, $ ~f~;C~u~,/~ / /' ~/~ (Signa~re o f appli~i~ti Term Expire~ December 31, 1fl 7T