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Home My WebLink About22016-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23843 Date SEPTEMBER 1, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property. 275 CARDINAL DRI~q~ MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 6 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 1994 ~ursuant to which Building Permit No. 22016-Z dated APRIL 14, 1994 was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is A SUN ROOM ADDITION TO AN EXISTING ONE FAMILY DWKLLING AS APPLIED FOR. The certificate is issued to MARY & HENRY P2%YNOR of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. 1/81 u~ding Inspector FORM NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ 22016 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: .~.~..~.~..:~..~ .......................... ...~.~,~.....~.4;~ ....... z).~:~ .................. ..~,:.~.:~<..~. ........... ~/.,.......,:~,,, .... to..,~..~.~ .......... d .......... ..?...~:....~ ......... .~.~...,..'~. ......... ~ .................. ...... ~.....~z~ ............ ~ .......... ~.,..~." ............ ~~ ....................... ...... /:Z...~ ........... .././.~:.2..~ ........ ...~.~..~.,. .......................................................................................... / at premises located at ................ ..~.'..Z..O~.. ........ ..~..~'~.'¢.......'~...~.:.......~....~'..: ................................................ ,'~///r~ :~,~:~_ ~,/,,~ ............................. ::~'i:~::'"'i~:'"::;,~ ....... ;>: .......... ::', ......... :'".¢.. ........... '::: z~ ... pursuant to application dated ...~..../~'....~. ...... : ......................... 19....__~...~...... and approved bythe Building Inspector, ~ee $...,~. ...... '~lnspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 1995 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. 1. Certificate of Occupancy - New dweiling $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~ Buildine - $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....~,. ..... Location of Property... :~-~)~ ..... ..(~...~.~.~.C~ .b.~',. .............. ~ ............. House No. Street Hamlet County Tax Map No 1000, Scction...tt .~ ..... ?lock ..... ~ .......... Lot ...I.~ ............. ..... ............ ...................... lleal[h Dept. Approval .......................... Underwriters Approual ......................... Planning Board Approval ........................ Bequest for: Temporary Certificate ........... Final Certicate. / Fee Submitted: $. ...~. / '" ......... 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 July 13, 1995 Mary R. Raynor 275 Cardinal Drive Mattituck, NY 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 # 22016-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. $. FOUNDATION (2nd) 2. ROUGH FRAME &. .PLUMBING INSULATION PER N. Y. STATE ENERGy CODE FI;;AL ADDITIONA'L COM:~ENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE ~/,~/~'~"'" I. SPECTO R J~_~ 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F~~MFOUNDATION 2ND [ ] INSULATION lNG [ ] FINAL DATE ~//~>- INSPECTG~--~~ BLOG, DEPT .'7... ~' ~".~.Pe Approved ..... .~.~./.~.~.~.., 19 rmit No.~..~..' .~..~.... Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ....'~-~ .... ~ SETS OF PLANS .......... ,,,,~S IJ RV EY ................... jctl~c}: .................... SEPTIC FORH .............. t;OTI~Y= CALL ................... HAIL TO: . /(/Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .......... ./. ....... 19 $ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sits 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 publ/c 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. 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 heroin 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. ,(~ (Signatme of aptSlicant, or name, if a~borporation) ~.~.~.-..c7.~ ~p/.~.~..'.~ .... ~n a..wT..,...r%..~<../y. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... 9..~.~ ~ O.K. ............................................................ Name of owner of premises ...~v)..~..~..k(....~,. (~..~.~.~3 .~].~. ............................................... (/ts 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 ................................................. ....;k.7.~. ............. .c. fi ~.d .~.L...)3. Fd.. ................ ..m..n...~..,..w...~ .~__~ .............. House Number Street Hamlet County Tax Map No. 1000 Section .,f/.~. ............. Block .~ ................ Lot./..~. .............. Subdivi}ion ~..~. i I.~./...T~...~..~ . .~-~.~. ~. ~. {~.~ ...... 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 ...... .~.~ 1.%. )..I. ~- .Z . . b. Intended use and occupancy ..... . .~...~..~. ( .~..~.}.xJ. ).'~./. .~...&-... ........................................ 3. Nature of work (check which apphcable): New Building .......... Addition .......... ,Alte~/tio_ll ..~ ..... Repair .............. Rem6val .............. Demolition ............. Other*;'; ........ i .... ~[~I ~ ~escription) 4. Estimated Cost ..... /..0).5.9.9 .................... Fee ............... i (to be paid on filing,,tht~application) 5. If dwelling, number of dwellingiunits .............. Number of dwelling units on each floot~ .' .............. If garage number of cars 6. If business, commercial or mixed occupancy, specify naCre and extent of each.type of use .......... 7. Dimensions of existing structures if anv' Front ~?.' Rear /C6' n~,,h ' Height ............... Nuniber of Stories ...... I .................................... ?'~". / ......... Dimensions of same structure with alterations or additions: Front ... ~.~.' 2~ ....... Rear .. dO..q ..... Depth ...... ~. .......... ~ Height ..... Number of Stories.. 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height .............. Nu~rri, ber of Stories ......................... - .......... 10. Date of Purchase ...... ].c~ ..~.~. i ....... . ......... N//me of Former Owner .~.l~ ~ad .D'~O.~ F=. ............. 11. Zone or use district in which pr~mises are situated ..... ~570.~.E ~t.T~.ff/.._~ ...................... , ......... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation: ..... lk/c.~. ........... . .~ ...... 13. Will lot be regraded ........ /~l.~. ................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premmes b~t3 .~.~[ .~J~ ~[o. ~(~ .... Address ~./) .DF. ~ ~A~0..(~.. Phone No ..... Name of Architect ... ........ ] ................. Address ..... i ........ .' .~.'. i Phone Nol Name of Contractor ~.'T .tSN. '.c-.~ .~...F. L, ~ X ~ ......Address k'e f~]TJT'..I .'t'~.'.. 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 ailI 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. 15. STATE OF NE.E/YORK, ............. ~. · '~' .V .... .~..'..~.~./~ 0-~ .. being duly sworn, deposes and says that he is the applicant (Name or individual signi 1~ c'o'n~;a'c'ti ........ above named. ~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 tlie work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this da ...................... Y f .................. ,19 Notary Public, . ¥1lROglg,ti ?; ~~'(% . '. County