Loading...
HomeMy WebLinkAbout22221-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25511 Date: 02/02/98 THIS CERTIFIES that the building ADDITION Location of Property: 2105 EAST MILL ROAD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Seotion 100 Block 3 Lot 13 Subdivision · Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 6, 1994 pursuant to which Building Permit No. 22221-Z dated AUGUST 1, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SUSAN J. GAYDOSIK & ORS. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FORM NO.3 1OWN OF $OU'~HOLQ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] 22221 Z Date .......... ~...../. ................. .................................................. ,~~..../...~.~...., ........ ./.(/..-.~ ................................ CountiToxMopNo, 1000 Semion ...... ./....~..~... ...... B~ock ~ LotNo, .,,/.,..~.. pursuant ,o application dated ........... .%.J...~./..y......~.. ................ 19..~....r~... .... and approved bythe Building Inspector. Fee $.,..~...~....~ ....  // ..................... ~;~il'~l'~' i;;~;;~;g; ~ ............... Rev. 6/30/80 BLDG. DEPT, Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~NCY ~ ~ ...... ~ ......... muz 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, sureets, and unusual natural or uopographic 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, t957) 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-existing 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 $15.00 Date ................... New Construction ......... Old Or Pre-existing Building ................. Location of Froperty..Z. o re,cb .gJ House No. Street Hamlet Onwer or Owners of froperty .... ~., ...................................... county Tax ~p No 1000, Section...I.q9 ........ Block...3 ........... Lot..J.~ ................. Subdivision ..... Filed Map Lot .......... Permit No. ~.~..~..~. !...~....Date Of Permit. ~. J. ~.1~ .Applicant...~. ~.l..~p$~ !~ ...... Health Dept. Approval....... ................. . . Underwriters Approval ......................... Planning Board Approval ..................... ... Request for: Temporary Certificate ........... Final Certicate..../. ...... Fee Submitted: $..~.~. ~..O.O. .................... - 5 ......... · ':'' APPLICAIFf I - Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 30, 1998 Susan Gaydosik 2105 East Mill Rd. Mattituck, New York 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) No Underwriters Certificate on file. XX 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 9 22221-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. Town Halt, 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 August 23, 1994 Bob Kehls Home Improvement 28545 Main Road Orient, NY 11957 Re: Susan Gaydosik Inc. 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 xx 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 # 22221-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ~'SULATIOH FER'~. y. STATE E}IERGy .' CODE 'FI:ML ' ' '. ~DDITIO}IAL COM~IENTS: ROAD Copies o~: lhls survey map not 4¢afino tho h-nd surveyorOs inked seal or embo~:¢d ~eal ~h~ n~t ~ c~c"J~ ~J :o ~s ~ whd copy, ,,~ :.'n ~(~ run only fo lbo SURVEY FOR SUSAN JANET GAYDOSIK AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNT~ N,~ SCALE: 1"=40' AUGUSTI4,1960 NO~ 19,197G GUARANTEED TO: SECURITY TITLE AN* SUSAN dANETG~Y · SOUTHOLD SAVINGS N.Y.S. LIC. RIVERHEAD~ N.Y. TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. 11971 TO OLD TEL.: 765-1802 Exami led Z~. · ../. ....... BOARD OF HEALTH ......... 3 SETS OF PLANS SURVEY .................. CI1KCK ............. Disapproved a/c ..................................... ~ ing ~/'/A'PP'LICATION FOR BUILDING'PERMIT ' CALL · .... . HAIL TO: Date ................... 19... INSTRUCTIONS a. This application must be completely filled in byrtypewriter or in ink and submi, t~0d' 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 l~uildings on premises, relationship tb adjoining premises or public sti'eets or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli- catidn. ¢. The work covered by this application may not be commenced before issuance of Building Permit. ,.2. 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 ~y 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 apphcable Laws, Ordinances or Regulations, for the construction of.buildings, additions or alterations, or for removal or demolition, as herein describdd. 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 necessa~nspections. , _ ' ' ..... . (Signature of applicant, or namd, if a corporation) £d.. .77./. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, g~neral contracto~r, electrician, plumber or bu}lder. N~me of owner of premises ./~/Ch~.~..~./~..~.~.oq?...~..~. Z ~/~..~,Q~O ~ ...... TP , ' · / (as on the tax roll or latest ~A~ - ~/~ B.R n appdcant is a corporation signature of duly authorized officer. ~E..'~:~ , ~:.' ""' ' ~Name and title of co~[a~ ;~;[) ...... FOLLOWING INSPE~IONS: ' Builder's License No. / 3&~ 7 /~.&~ I. FOUNDATION - ~O REQUIRED ......................... FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Plumber's License No. 3. ~hSULATION : 4. F~NAL CONSTRUCTION MUST EJectricJan's License No ....................... ~E COMPLETE FOR C.O. ALL CONSTRU~ION' SHA~ Other Trade s Ltcense No ...................... THE REQUIREMENTS OF STATE CONSTRU~ON & I. Location ofland on which proposed work will be done .. CODES. N~ RES~B~ ,.,~ ~ .~,,~ ~ p~ , ~ · .: ....... ;;...; ..~1~...7~.// ............. C~.<.~. ' /X~YT/m CJ ........ ~ ............. · ltousc Num bet Street Hamlet County Tax Map No. 1000 Section ... :..[0.0 ........ Block .... ~ ..... · Lot ................... Subdivision ......................... '. Filed Map No. ... ........ "'' (Name) .............. Lot ............ 2; State existing use and occupancy of premises and iutended use and occupancy of proposed construction: a. Existing Use and occupancy . ' .... ~ ~,. ~ -~,~,, b Intended use and occupancy ~:.:, ,u · 3. Nature of work (check which applicable): New Building ......... Additi ' Repair .............. Re,oval ............ Demolition o.n ...... I · ~ ~ ~ (Description) 4. Estimated Cost .~. ~0~ . .o~ ' ~ ~' o. nawelling, number of dwelling umts . · .~ ..... Numberofdwel ngunitsofieacii"fl~"Z . lfgarage, number of cars ,~ C~~Am' ' ..~...~ ..... ..... · ...... .~v~ u~cupancy, sR~Ji~t~r~ ~Xtent of.each tyne of use . ~'ght ~b '. ; ............... Nu er of Stories .............. ~mensions of shme structure alterations or additions: Front e Rear . . . 8. ~lmenmons of entire new construction: Front ..... . R ~ ~ r .... · . .' ear.m~ .......... Depth ~ ........... ~eight ... ~ ........... Nether of Stories ...... . 10. Date of Purcha~ '~ .......... ~ ...... Depth ~5~ I I. ~one or use restrict m wlncl~ pr~mises are situated .. ~/~ ~ ..... ~.. ............... ;..r: ....... 12. ~ . . . ' .' ....... '.-~.' ..................... ,,,~ ~f?posed construction violate any zoning law, ordinance or regulation. ~ ............ 13. ~mmtoeregraded .. ;~ .. A[ ~ ..... ~ ............................ ' ' · ~* · ./ .... ~. ~..,..~.~.. ~m excess fill be removed from remi es' Nme of Architect ,' ,~h'~tess ~/./-~~hone No. ~.~.'.~7~. Nme ofContractor h .. . · ......... . .. .~. · · aress ................ . Phone No .. ~.. Address ~.~.t~6.~ ~[~hone No 1.5.' I~ thSs property within 300 feet of a C~dal wetland? ~v~ ? -. ~ ' ........... ' .... · If yes, Souchold Town Trustees Permit may be requSred. .' ~ ..... Locate clearly and distinctly all property Lines. Give street and block interior or corner lot. buildings, '~heth~r existing or proposed, and. indicate all set-back dimensions-from number or description according to deed, and show street names and indicate whe;th~r (Name of individual/~igning contract) ......... ~bovenamed; ' ; ,'~ ' ~ i. being duly sworn, depose9 and says that he is the applicant {e ls:th~ .. ...... ' '~'*:!' """" ' : (Contractor, agent',~'c~;iate or etc ) ' ' '5..s,..a}d_..owne,[ o.r ,o. wpe.rs, and is duly rF~tlmnzed to perform or h~~the said work and t plaUCatlon; ,,,at au statements contain~,~ ;, ,~,; .... ,.~,. . , o m~e and file this , . ~u ~ u~:a app:lcdtlon are true to tnt best of his knowled~n nn ' · turk will be erfomed .... o d behef, and P in the manner sqt forth in the application filed therewith. . - -. that the ,worn to before me this [ ...... . . NO. 4879506 , .ff . ~ ' - '~ ] .........