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Home My WebLink About21984-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCy No Z-22940 Date APRIL 13, 1994 THIS CERTIFIES that the building ACCESSORY Location of Propert~ 3100 DEEP HOLE DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 17 Lot .14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 28, 1994 pursuant to which Building Permit No. 21984-Z dated MARCH 31, 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is i~sued is ACCESSORY BTO~AGE SHED IN FRONT YARD "AS BUILT" 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 JAMES H. & FAY V. bH~ALL N/A N/A N/A FORM NO.$ TOWN OF SOUTHOLD TOWN HALL SOUTHOLD, N.Y. N_o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....... ~.~......3....I ....................... 21984 Z Permission Is hereby granted to; ~ r~o~ ~......q-:.,~.~.~:......~.././. ............................................ ~~ ~,~. .... ~/..~ ........ ~./......./~.....J~., ............... .... ~..4. .,.~, ....i,...!:..%...c.z.4. ...... ~.~...:.....l/.~.--.,~.. .~..z~.~ ...... .~......~:a~.~ y .......... ~.,,, ....... z~ ...... /~..~ .............................. ~ ,~' ; ......7...~ ........ ~-:..'. ....... ~/..4.~. .......... ~ ................................. '!:'>..i.. ...................................................................................................................... at premises located at .................. ~../.~ ......... ~ ....... ~......~7 ............................................ CountyTax Map No. 1000 Section...../.../....~... ........ Block ....... ../....~,, .......... Lot No. ....../y ............... pursuant to application dated ........................................................ ] 9 ..... and approved bythe Building Inspector, Fee ~.,...~.r.:.~ ....... Rev. 6130/80 FOUNDATION ( 1st) ....... -- FOUNDATION ( 2nd ) ROUGH FRANE 'PLUMBING 3. INSULATION PER N. Y. - STATE ENERGY CODE ~ .// / 'FINAL ., · . .//_ ADDITIONAL CO,~ : L~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18051 Examined ........ .J ....... 19. Disapproved a/c ..................................... ~-*-~ ~&ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BO,,;~RD OF HEALTH ~' 3 SETS OF PL.~,NS ......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. NO-T I FY ~ CALL ................... HAIL :: .... ... ' SI .'.. T~II~I OF 8OOTHOLD~ ........ a. Tins 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 tins 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 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, b.uilding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i~'~pections. / ~ ,~ ... N.., .................. -- ~(Signature of applicant, or name, if a corporation) (Mailing address of applicant) -- State whether applicant is~w~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~Y/~...~.~. ~. H.~..t~./~.4. F.~. ~....~.~..~..l~..~/. ?. (. .................................. ~(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 Location of land on which proposed work will be doneC-<fl~2~ ................ .~. .................... F- ! ~ · · · House Number Stre,~t Hamlet / County Tax Map No. 1000 Section ...llff. ........... Block .... /..7. ........... Lot.../..~. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: ·" ................. -: ": '~'.' ?:" ~C/' '~ ..................... b. Intended use and occupancy .;...' ............ I0. 11. 12. 13. 14. 15. property lines. Give street and block number or description according to deed, and show interior or corner lot. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... Repair .............. Rembval, .............. Demolition .............. Other Work ............... · ~.(~. ~ .4.~,.~,..Q(" ' (Description) ' Estimated Cost .................... Fee .................................... (to be paid on filing this application) If dwelling, number o f dwelling iunits ............... Number o f dwelling units on each floor .............. If garage number of cars:' If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions:pf, ex.i~ting structures if any' Front Rear Depth He,ght ~ ~ ~!., ~}~ ~ . Nun]'ber of~ories ........................................... ........... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .......... ~i~:~ ......... ,.. Height ....... Number of Stories Dimensions of en~ new constructmn: Front .............. Rear .......................... Height Number of Stories 'Fro~ff'; Rear Depth Size of lot Date of Purchase , Name of Former Owner ' Zone or use district in which premises are situated ..................................................... · ' ' ' 'or regu Does proposed construction vml.ate any zoning law, ordinance lation: .......................... .... -.. Will lot be regraded ~ Will excess fill be removed from premises: Yes No Name of Owner of premises ...i ................. 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, street names and indicate whether STATE OF NEW YORK-~ S S COUNTY OF .... .~'~.q'~.~../. 7Z~ ...... ~, . .. ~ ~ ...... being duly sworn, deposes ~d says that he is thb applicant (Name of ~n&wdual mgmog contract) above nam~ He is the -:~.. ~ ~ ~ , (Contractor, agent, corporate officer, etc.) of said owner or owne~, ~d is duly~ authorized to perform or have perfomed the said work and to m~e ~d file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner ~set forth ~ the application filed therewith. Sworn to before me this ~ ................. ~ay~I.~.~: ..... ~'.~ ....... , 19 [ ,~'[iN.t f (Signature of No. 472508~, Su~lk Term ~pir~May 31.19~ ..... AppRovED AS NOTED . NOTIFY BUILDING DEPARTMENT AT 78~-!802 O AM TO 4 PM FOR THE FOLLO~NG INSPECTIONS: 1.FOUNDATION - ~0 REQUIRED FOR POURED CONCRETE 2.ROUGH - FRAMING & PLUMBING 3.INSU~TION 4,FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ST/.~TE CONf;TRU(JTION & ENERGY ,~C .... "" ,.:S ON.,,BLE FOR DES~Gr~ Oi~ CONSTRUCTION ERRORS