The URL can be used to link to this page

Home My WebLink About22439-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23755 Date JULY 7, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 1945 ELIJAH'B LANE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 26, 1994 ~ursuant to which Building Permit No. 22439-Z dated NOVEMBER2, 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 ALTERATION TO AN EXISTING BAS]~4ENT (CELLAR) TO INCLUDE A BATHROCMAND STORAGE AREANON-HABITANLE AB APPLIED FOR. The certificate is issued to JOHN & BARBARA MC DERMOTT of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL INSPECTION SERV. 5725 PLUMBERS CERTIFICATION DATED J~3NE 15, 1995 SEPTEMBER 15, 1994 JOSEPH HARDY /~ilding Inspector Rev. 1/81 FORM TOWN Of $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. ~ ~24~9 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ...~ ...... ~.5.~.~,~ .................................. ........ ;~ .............. .7..Z.....~~....~ ........... 'c. . 75'"'3 ...~.....,.~....~...~.../., ...... /./ ..................... t o~,O,~,~ ........ ~ ....... .,~.~~~~.. ...:.~.. ........... ./M........C..../..~.~.~ ................... .,~.... ....... ...,?..~~ ........ ~ .......... Ooun,,,Tax,,,,,:,,:,~o. ,000 Seot, o,~.../.~_5 ........... B,oo,~...."O"~ ............ Lot,,,o.....7..'..../.../.. ............ ,:,,.,r$,.,an,',o a,:,,:,,,oa,,on da,ed .......... ~.~.': ........ ~.~. .................. ,~, ...... .?./c,,d c,,:,,:,roved bythe Building Inspector, Eee ,.....7..e~..'..~:... Rev. 6/30J80 , L:I',i - 7 1995 " TOP;N 07 $()U i'~YR.D ~ ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 &ox //76 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 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 "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-existin~ Buildina - $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 ........ ~.~ ~Z~ ........................ New Construction ........... Old Or Pre-existing Building ..... .~. ......... Location of Property../.~.~. ~ .... g-~.~[ .~..~..... ~ .... )~/~"~-'I.T~.~.~.... fL).3/. ............. House No. Street Hamlet Onwer or Owners of Property ..... .~.~.~..~..~...~..~..~...~..~.....~...~...~...~.. ...................... County Tax Map No 1000, Sectiou.../.~.~. ...... Block .... .~. .......... Lot...~.~ .............. 'Subdivision .................................... Filed Map ...... Lot .................. No **. . . . ~'./J..~. .... Applicant ............................. Permit ................ D~ Of Permit. /~ ~ ¢ llealth Dept. Approval ........... Underwriters Approval.. ~' Planning Board Approw~l ........................ / kequest for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ......... ~O,,O :Z'P;3'755 .................................... TOWN OF SOUT~OLD OFFICE OF BUILDIHG ~NSPECTOR P.O. I30~i 528 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date June 1~ 1995 Building Permit NO o ~q~ % Owner John Mc Dermott Plum~er (please print) Joseph. Hardy (please print) I certify that ..h- solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this NotaY' Public, JOHN J. MALONEY NOTARY PUBLIC, State of New York eemmlmlon Expires Febma~/28, 19Y--~'' (516) 286-6642 ELECTRICAL INSPECTION SERVICE, INC. 375 DUNTON AVENUE EAST PATCHOGUE, NEW YORK 11772 5725 Date 9-15-94 APPLICATION No. ON FILE ADDRESS: 1~_5 Elizal%_ ~._ VILLAGE: Mattit~_ __ TOWN:_ ISSUED TO: ~'O~ t~. ~e~.m.~ INTRODUCED BY ~ ~ Electric_ LIC. NO. 4302--]~ wa~ examined on 9-14-94 and found to he in compliance with the National Eleclrical Code. ~ BASE. 1st. 2nd 3rd Attic pool LOCATION ~ DET. GARAGE HOT TUB This certificate must not be altered in any manner, Inspectors may be identified by their credentials, SOLDER USED IN WATER ON LEAD CONTEAC SEFORE C '76E.1802 0 AM TO 4 PU FOR THE CERTIFICATE OF OCCUPANCY 'lJ FOUNDATION - :'TWO REQUIRED . vu, POURED CONCRETE - 2. ROUGH - F~MIN6 & PLUMBING ~ FINAL ~ CONSTR~CTION ~~TION SHALL MEET STAT ..... ~. CONSTrucTioN CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR8 "'/ ~TATE ENERGy CODE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH "LBG. £ ] FOUNDATION ZN"[ ] I~fULATION [ ] FRAMING Ir/]' FINAL REMARKS: /~'~ff F,~ DATE 5';~o,~ / /' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..... //.~.~.. .., 19 Approved ..... , 19~.~. Permit No ..... ~ .~..~. Disapproved a/c ...................................... BOARD OF HEALTH ......... ---'3 SETS OF PLANS .......... SURVEY ................... -a-~"C H E C K .................... SEPTIC FORH .............. $ CALL ................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ?... 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 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 cover6d by this application may not be commenced before issuance of Building l%rmi/~. d. Upon approval 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 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 or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.F2~,_~/~~ State whether applicant is ~.wneCessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~..//t/~/..~.. ~..t~..~..../t~.......~..~...~..~...~... ........................... (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 ........ : ................ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ............................ Sti~et Hamlet / House Number County Tax Map No. 1000 Section ........ [.Q.~. .... Block ...... .~. .......... Lot... '.7.: ./. / .......... Snbdivision .................. .fiJ./.~.. ............. Filed Map No.. Y/.J/~ Lot ./t/i~. (Name) 2. State existing use and occupancy of premises and intended use and occupan~cy of proposed construction: b.a' lntended use and occupancyEXisting use .and occupancy ........ ~.~ ..... ~:.,.~.~i~i.., i:~;~:.: :.~ .... . ......... . . .,~.~,.....~..... .................. ..:~ ~.. ;'.. ;-~ ::..:. ;:,~-.~.I ......... Nature o'fwork ' ' 3. (check which apphcable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition ............ Other Work ............... ! ' (Description) 4 Estimated Cost ~/.~ 0QO: . i (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ............... · If garage, number of cars .... 2 .................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7Dimensions of existing structurgs if any' Front Rear i Depth Height ........... r~un)oer of Stories ................................................ ' Dimensions of same structure with alterations or additions: Front ....... ~ ......... Rear ................. Depth .................... ... Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............. Height ............... NunJber of Stories ...................................................... 9 Size of lot: Front ' Rear Depth 10 of P i fF · Date urchase ........... i .................. Name o ormer Owner ........................... 11. Zone or use district in which premises are situated ........... ........................ 12 Do d ti 1 di I rio ' · es propose construc on rio ate'any zoning law, or nance or regu a n: .., ............................. 13. Will lot beregraded.........i....................Willexcessfillberemovedfrompremises: Yes No 14 Name of Owner of premises ' Address Phone No Name of Architect .......... I ................. Address ................... Phone No ................ Name of Contractor ......... ~ ................. Address ................... Phone No ................ 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! buildings, whether existing .or proposed, and~ indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether' interior or corner lot. [~T'~ ,Z,-~ ~ 15. STATE OF NFxW-YOI~'I~ [//- "S COUNTY.OF. · ~ .~.~ .: · .1~-~. · P5~..~. J~.C .~.. a ~ .......... being '-' (Name of ihdividual signi¢g contract) above named· duly sworn, deposes and says that he is the applicant He is the .............................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized 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 manneriset forth in the application filed therewith. Sworn to before mf,-xtbis ........... dayof ...... 197.~' · Notary Public, ~~(./~.~. 7..~ County Notafylaubllo, State of NeWyork / . ,//.'~.: :':..5~,~%...¥...-..-..7.... ' No. 4879505 i /~/! ' ''' ~/ ' .... ~f ' ' ' " ~ 't~,..'_'_::.:'' '~'' *- ..... ta]gnature OI apphcant) Qualified in Suffolk CoW~/ ~/c-F' //// ~E,L-~ (~]gnatu '