HomeMy WebLinkAbout22151-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23352 Date
NOVEMBER 17, 1994
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 1525 REEVE ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 100 Block 3 Lot 10.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J~NE 13, 1994 .pursuant to which
Building Permit No. 22151-Z dated JUNE 24, 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 GARAGE ADDITION WITH ROOF DECK & LOWER DECK TO EXISTING OWE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
MICHAEL & CHRISTINA LEVENTEEIS
UNDERWRITERS CERTIFICATE NO. N-323238 - AUGUST 10, 1994
PLUMBERS CERTIFICATION DATED
Rev. 1/81
Building- In~pe~r
FOBM NO.$
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLO, N.Y.
BUILDING PERMIT
No
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
22:~51 Z
Permission Is hereby granted to:~;~ / ~
............ ~...: ........ 4..%~,.,./...~.~ ........
............ ./..~ ........ ~.~.~.~ ....... ~.,...
............. ~.~.~..~¢....~
~..~.,~.... ..... ~ ~..c.../.~ ........ ~........4..~.~..e..~...../..~ ~../...c,. .........
~..E~.~ ~./.....~.....~.....~.~i~__ ,, ~.~..;...z~ ....................
....... ~..~..~.z/.~.~ ........ ~......~?..Z.~...~,~.., .............................
~','~'Z, iZ~',~'7"}'~"~ ........ ~'~;'.'.;.'.'~'"'""~; .........................................
.............................................. ~.~,..,.7....ca.,.~..~.cx~ ........... zZ...-....~, ...............................
CounlyTax Map No. 1000 Section ....... ,/,,.4~.,,~.. ..... Block .......~.... ................ Lot No. '/~?./....~. .......
pursuantto appllcationdated '~J/c~/b/-~, ...~..~...'..., 19., ,~....~......, and approved bythe
Building Inspector,
Fe~ ,...~/~..~...
Rev. 6130/80
TOUN OF SOUTHOLD
BUILDING DEPARTHENT
TOUN BALL
SOUTBOLD, NEW ¥OBK
765 - 1802
11971 ,',
APPLICATION FOR CgRTIFICATE OF OCCUPANCY
'/-/--.,'.
RE~ CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
Loc~tlon of Property... -
UOUSE NO. STREET UAHLET ......
Sonncy T=~ .a. No. ~000 See~io. .i~R. Blo~ ~oC /~' /
Subdivision ....................... Filed Hap ........ Loc ..........
- - pplicanc ......
Health Dept. Approval ........... ' ....... Underwriters Approval .....
PIann~nE Board Approval ...............
Request for Temporary Cert,,ificate ....... Final
Fee Subm£Cted: $ .....
Certificate ................
rev' 10/14/~8 _ ~
¢o~. 33S 9..--
FOI~
TO~N OF SOUTIIOLD
BUILDING DEPARTHBNT
TOWR l IALt'.,
765- 1802
3.
4.
$.
6.
APFLICATIO~ FOR RERTIFICATM OF OCCUPANCY INSTRUCTIONS
This application must ~e filed in typewriter OR ink and submitted to the Building
Inspector with the foil!owing; for new buildings or new use:
I. Final survey of property with accurate location of all buildings, property lines,
streets, and unusua~ natural or topographic features.
2. Final approval of Hdalth Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electridal installation from Board of Fire Underwriters.
6. Sworn statement from plumber certifying that solder used in system contains less'
than 2/10 of Ig lead.
5. Commercial buildingS, industrial buildings, multiple residences and similar.'
buildings and installations, a certificate of code compliance from the Architect
or Engineer responsible for the b~ilding.
6. Submit Flanning Board Approval of comp~leted site plan requirements.
For existing buildings !(Prlor to April 9, 1957~ non-conforming uses, or buildings
amd "pre-existing" land uses:
I. Accurate survey of ~roperty showing all property lines, streets, buildings and
unusual natural or Topographic features.
2. A properly eomplete~ application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
sho~ single and separate ownership of the entire lot prior to April ~, ]957.
If a Certificate of[Occupancy xs denxed, the Buzldxng Inspector shall state the
reasons therefor in iwriting to the applicant.
3. Date of any housingicode or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
For Vacant Land Certificate of Occupancy:
I. An application for ~aaant laud Certificate of Occupancy shall be submitted,
and a certified abs~ract of title issued by a title company showing single and
separate ownership df,the entire 10t prior to April 9, 1957 shall also accompany
the application. IJ a Certificate of Occupancy ia denied, the Building Inspector
shall state the realons therefor in writing to the applicant.
FEES:
I. CERTIFICATE OF CCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to ~'.elliug $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
Certificate of Occupancy on pre-existing dwelling - $100.00.
Copy of Certzfmqate of Occupancy - $5.00 - over 5 years - $]0.00
Vacant Land Certificate of Occupancy - $20.00
Updated Certifi¢
Temporary Certi~
~0/~4/$8
ate of Occupancy - $50.00
[cate of Occupancy -$15.0,0
Residential
Commercial
Town Hall, 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
November 2, 1994
American Exteriors
P.O. Box 667
Mattituck, NY 11952
Re: Mr. & Mrs. Leventeris
Prem: 1365 Reeve Road, Mattituck
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 # 22151-Z
Please contact our office on this matter. Thank you for
cooperation.
$OUTHOLD TOWN BUILDING DEPT.
~M-i~2
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [.] INACTION./
FRAMING [//]'FINAL
DATE
INSPECT~/
765-t802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ~'~NAL
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH~PLBG.
FOUNDATION 2ND [ ] INSULATION
[~RAMING [ ] FINAL
7G5-~,~2
BUILDING DEPT.
INSPECTION
[ DATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
FINAL
REMARKS,
FOUIIDATI'ON ..... '
-- _ _ __ .2.t~
FOUI~DATIOI,! (2nd)
~OUGH FRAME
. ..;. ,'.,,,. · BING
I~SuLATIoN PER'~. Y.
STATE ENERGY
CODE
FI~ML
ADDITIONA'L COM~E~.;TS:
~A
/
/
.b
Approved .,
FORM 1'40. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180:~
Disapproved a/c .....................................
/? ( ilding,nspector) /
/~JzgCATION FOR BUILDING PERMIT
INSTRUCTIONS
SURVEY .
SEPTIC FORH ..............
CALL ........
HAIL TO:
Date ' 19
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. Up.on 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 paxt for any purpose whatever until a Certificate of Occupancy
stroll 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
B't. ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of bufldings~ 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 f~or necessary inspectSons. __ '
-- (Signature of applicant, or' -n&ne, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
N me of owner ofpremises...[ ..*.. .........
If applicant is a corporation, signature of duly authorized officer, a~,~B.R #,
.............................................. NOTIFY BUILDING OEPARTgf~NT AT
(Name and title of corporate officer) 7654802 9 AM TO 4 PM FOR THE
~'~.~ FOLLOW'NG INSPECTIONS:
· Builder's License No... .'T.. H~.. _. ..... }. f:OUNDAT~ON TWO REQUIRED
FOR POURED CONCRETE
Plumber's License No ......................... 2. ROUGH o FRAMING' & PLUMBING
3, INSULATION
Electrician's License No. 4. F~NAL r. ~,, ~ -
...................... · ~0 *STLUC liON MUST
8E COMPLEI'E FOF; (LOT
Other Trade's License No ................... ... ALL CONSTRUCTION SHALL MEET
-- THE REQUIREMENTS OF THE N.Y.
1. Location of land on which proposed work will be done. STATE CONSTRUCTION & ENERGY
County Tax Map No. I000 Section: ..... J.0. 0 ......... Block .... %3 ............ Lot..].~. ¢O~ ...........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. 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 . :../~f~~..
3. Nature of work (check which ~Pplicable): New Building ......... Addition
Repair .............. Removal .............. Demolition ' ' ' · ·
(to be paid o~~ri~oj) ....
5. lfdwellino, number ofdweliin~ units ............... Number ofdwelling units on
6. If business, commercial · ' ................................... ; ...............................
or m~xled occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear ............. De ...........
'gl Numbe of st ries .............
e~ ~t ............... r o pth ....
i i f s stru ' e With It ti dditi ......... i' 'l~n' ........ ' ........
~) mens CBS o amc ctur a era ons or a OhS: Front 2 r ..............
pth ................ .
8 D~ .................. Height ...................... Number of Stories .........
· i f nti tic Fr .............
mens ons o e re new construe n: ont .............. Rear ..
Height ....... N tnb of St ri .............. Depth ........
9 Si fl ...... u er o es ...... .................
ze o ct: ront ........ , ............ ear ................
10 Dar of P h .... Depth
· e UFO ese .... ' '
11 Z ................. ' ......... Name of Former Owner ........
· one or Use district in which premises are situated .............. ' ....................
· ocs proposed Construction v ate any zonin aw, or nance or regulation ...................
13, Will lot bere~raded : ' ' '~
Will fill b d ......
14 fO ~ f-p ............................ excess e remove o r m es: Yes N
· Name o wner o remises ~ .... Add · o
N cfA hit · ': .............. reds ............. Phone No.. .
amc rc ecl ......... Add ...... ' ........ ''"
fC · · · ................ reds ............... Phone No ...........
Name o ontractor ................. .. Add .... ' ....
· i'300 ....... reds ................... Phone No .......
ty
15. Is this proper within feet of a tidal wetland? *Yes ........ No .........
· If yes, Southold ITown Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly ali 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. '
STA;FEOFNEWJgO'RK, - / S
COUNTY OF. · ,~~,.
(Name of individual signir~g contract) ..... being duly sworn, deposes and says that he is the applicant
above named·
He is the i .', ........ :
',,~ . ~racto~t, corporate officer, etc.) ........................... .
~f smd owner or OWners, and ~s dulylaut~~ or have performed the'said work and to make and file this
~pplication; that all Statements contaifled in this application are true to the best of his 'knowledge and belief; and that the
,york will be performed in the manner ~et forth in the applicati6n filed therewith·
;Worn to before me this
....... .... day of.
~'otary Public .................. i .~ C2~nty ','' ~.~
~m"~ ;"~?;~m~"~ork (Signature of applicant)
~o. 5~-8t2S850, S ,ur'folk CouBl~y/
'la,' 'n ,~ ~,~ 'es 0 :~ ,b~r "~1.