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Home My WebLink About22186-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~uuwAN~Y No Z-23202 Date SEPTEMBER 8, 1994 THIS CERTIFIES that the building Location of Propert~ 1435 PARK AVENUE House No. County Tax Map No. 1000 Section 123 Subdivision Filed Map No. ADDITION MATTITUCK, N.Y. Street Hamlet Block 2 Lot 30 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated J~ITE 27, 1994 .pursuant to which Building Permit No. 22186-Z dated JULY 14, 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 OWE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 LARRY & CA-£n~RIWE M. LENTI N/A Building Inspe/or FORM NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAIl $OUTHOI.D, N.Y. ~o 221~8 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ~ , , / , ............. ............. ,..~,...~,.~ ~,~,,,,.,.,.,~.,~:,, to ~ · .......... ...d.,.~n~.,,~.~.~...,.~.. .......... .~..~.~.~ .......... ~z.....~,,~ ............... ...~ ....... ~.~.2.~...~. ............ .~.~......~~..(7 ....... ........ ~ ........... ~ff./~..,L~.¢~, ........................................................................... CountyTa× Map No. 1000 'Sectlon...../..,,'~,,.,,-~,.. ..... BIocl~ ......... ~ .......... LotNo. ,,'~.,.,,,,(~,. .................. pursuant to application dated ......... M.~....~.~...... ~-7 .......... 19...2...~-.., and approved bythe Building Inspector. ,.---~__~0 Fee $...-Z... ~.....?. ...... Rev. 6/30/80 BLDG. DEPT, TOWN OF SOUTHOLD Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOIYN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 lihee, 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 ~ess 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. B. 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 i. 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 Buildin~ - $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 New Construction.~.~,~... Old Or Pre-existing Building ................ House No. Street - ~ Ha~et O~wer or Owners of Property. ~ ''~ .~.Lg~ .......... County Tax Map No i000, Sectio Subdivision .................................... Filed Map .......... Lot ................... Health Dept. Approval ..... ~.~' ............... Underwriters Approval.. Planning Board Approval ...... ~.~ ........ ~Request for: Temporary Certificate~ .......... Final Certicate ......... Fee Submitted: ~. ......................... FOU?._; D A_.TI.~O,'{ __" ' . (._._1 s t_~) FOUI4DATIOI.! ' ' (2nd) 2.' ... - · -".'.-.:i...'~ -, ROUGH FRAHE &. INSULATION PER'N. Y. .STATE ENERG~ II .' CODE ADDITIONA'L COM~IENTS: 76S-1802 BUILDING DEPT. INSPECTION [ ] FRAMING~ ~FINAL ,J FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 Disapproved. a/c ...................... ' ~FSO~OLD _~ · ,' '('l~t~ii~in~ ~" .ICATION FOR BUILDING PERMIT INSTRUCTIONS Bb~RD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CI1ECK ...... ?..~ .......... SEPTIC FORH .............. CALL .. . ...; HAIL TO: · a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 s,&ts 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 sti'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 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 Southbld, -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 necessau4 inspections. . . --' ( 'g f app ~'(ant, or name, if a corporation) ~ to.s...~..~ £.. ~i~.~. ~.h. 04~.,. ~,.~.~... (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, en~neer, generai ·contractor, electrician, plumber or builder. .. ~.. ?.~...~..~....m~.. :.,.¢~,¢_..' .................................. . ........................... N~ne of owner of premises .h.g K~..~... :~.~. %&.?~!~. .... ~.~.T..t ...... ' ............ . ' (as on the tax roll or latest deed~]~{}~.~O .l~ [~OTE~' '"_' "~' If applicant isa corporation, signature of duly authorized officer, ' OA'ffi:-" -- -~a.a # .............................................. · (Name and title of corporate officer) 765-1802 9 AM 'iD 4 ~ FOR THE' Builder's License No... ~ !t/q/..-. H../. .......... Plumber's License No ...... ./~...'~-. .............. Electrician's License No .....~. ~ ............. Other T adc s Lmense No. ' FOLLOWING INSPEC~rlONS: I, FOUNDATION IV'fO REQUIRED FOR POURED CONCRETE ~. ROUGH ~,, FINAL ~[COMPL. F ~ ALL CONSTf~LtCTtO,N 1. Location of land on which proposed work will be done .......... STAT~ CONSTRUCrfTON & E~iE,I~GY ........ ¢;O~S.' ' ~qtW ' ~g~ON'.q.~t~£~ ' :g{,5~ '" .I.+3.~'.'. ....... p~.~ ....... ~&~'~~: 'o~~...::,~ ~a~ . ltouse Number Street Hamlet-- County Tax Map No. 1000 Section ~.~..I.~x~:~Block .................. 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 % i/x3 ~k~- ' 'q ' b. Intended use and occupancy '3. Nature of work (check which applicable): New Building .... Addition erat~on .......... Repair .............. Re~aoval .............. Demolition : Other Work .~. ~.00 ~ ~ ~ (Description) 4. Estimated Cost ....... ~.~ .... * .... · ....................... Fee . . ..'7- ........... ~ (to be paid on filing this application) 5. If dwelling number of dwelling units Number of dwelling units on each ' ............... floor If garage number of .................. 6 If business commercial or mixed occupancy '" ............................................. ' ' · · , , specify nature and extent of,each type of use · Dnnens~ons ot ex~stmg structures if any: Front Rear Height Nuinber of Stories ............... . · · .. ........... Depth ............... Dimensions of shine structure with alterations or additions: Front Rear Depth ' Height .................................... i ' Number of Stories ' ' 8. Dimensions of entire new construction: Front .............. : Rear ............ ~.,.~ ~12~:¢ ...... ight mb ~;il He ............... Nu er of Stories ......... ...... . .... , ....~.'..',:' . , ...... 9. Size of lot: Front .......... ......... [.. Rear ...................... ~ueprn .'::';.. ........ .~,.. .... 10. Date of Purchase .......... l .......... ', ........ Name of Former Owner ................... 11. Zone or use district in which p~emises are situated ................... ~..2'i .12. Does proposed construction vi~late any zoning law ordinal~ce or regulation' "i~ ........... } ....... 13. W~ll lot be regraded .. .t~.q9 ..... , ......... .~,,. ........ 14. ~ame ofOwnerofpremises .~?.,.?-.~..L...~.~?.; Address l~?~' ~,fi,~,~ .b~.. p- ": ~ .... , ............... hon Name of Architect ......... ; .... (43~ ...... Address ........... , ........ Phone No. . Name of Contractor ~a.6 ~[~ce. .... · .......... .................... Address .24.0.~, ~ g.~.~..¢t, v4~ .P4 Phone No..2r~8% 15.' I.s l:h:Ls property within i300 feet of a tidal wetland? ~Yes ........ No.. ;~,~.P..'.' ............. *If yes, Southoid 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'number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF S,.S 5 .... (Name of individual signing contract) being duly sworn, deposes and says that he is the applicant above named. Heis the..',........~.. %.~% .~1~.~ ......... . ............................................. , ........ (Contractor, agent, cor'porate officer, etc.) of said owner or owners, and is duly lautl~orized 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 4et forth in the application filed therewith. Sworn to before me this ....... .... ..... ' ...... ~. '~ ~ ~ ~ v . ~ . ,..~ , ~ . ¢ ... ................. . LINDAJ. COOPER ; . ff..'/ (S~gnature ofapphcant) . Notary Public, State of NeW York No. 4822563, Suffolk CoUnUg~ ~ Term Exalres Dee. emtmr 31. t~