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HomeMy WebLinkAbout22026-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23012 Date MAY 24, 1994 THIS CERTIFIES that the building ACCESSORY Location of Property 2400 PARK AVENUE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 8 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 13, 1994 pursuant to which Building Permit No. 22026-Z dated MAY 2, 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 ACCESSORY STORAGE BUILDING (SHED) AS APPLIED FOR The certificate is issued to ANTHONY & MARY HOPE LO CASTRO (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) fyq Date 19/. IV® 22026 Z a Permission Is hereby granted to: J / ~?i.J /~~9uca~G:.J~j%.I/i7frr.?y . J........... I Sri r?t ~~..©......CiJ~/..R'~°•..'...........:..~. 5171 . •rsfaj.........d........rs...~~~~L„i,.. tes...../... / . ~C................................................................................. ? d............,.......... . . (r9s'; at premises located at ............................r}.. County Tax Map No. 1000 Section `-23.......... Block .......4;?. Lot No. /'Z j pursuant to application dated 19..T.~.., and approved by the Building Inspector. Fee . Bui in Inspector Rev. 6/30/80 a i---- Form No. 6 ppff ~5 TOWN OF SOUTHOLD gyp` BUILDING DEPARTMENT A7% 1210 TOWN HALL 765-1802 _ To 6 -OLD 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 ok.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 19 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. 21A 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, y building $25.00, Additions to accessory building $25.00. Businesses $ 6V 3 rtificate of Occupancy on Pre-existing Building - $100.00 . Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential /$15.00, Commercial $15.00 Date New Construction......... . Old Or Pre-existing Building. Location of Property ...Q4o o ~ K. 57. House No. Street Hamlet Onwer or Owners of Property..6~~~ ~~~~2c1 O c ' ACS .GS~ County Tax Map No 1000, Section..!:.......Block ..............Lot................ Subdivision ....................................Filed Map............ Lot...................... Permit No ................Date Of Permit Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate......... Fee Submitted: . „ , n i~$~7 APP IC T M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION FRAMING NAL REMARKS: ,l DATE 1NSPECTO 2Z M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST { ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL i REMARKS: 1 I DATE -INSPECTOR lV47 15LD :i'N 11D E Ii (i4LNT 9-1 v SU m O a ~ H e OUNDATION (1st) • c ti OUNDATION (2nd) o OUCH FRAME & I d -PLUMBING ti H 7 [T7 F7 NSULATION PER N. Y. ."3 STATE ENERGY II CODE m '1 r I J FINAL I (~r 0 ADDITIONAL COMMENTS: s • d • x v H • y H v` O H Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN 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 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. 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 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 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 Date .....qnAv'! 4 New Construction....... Old Or P existi g Building.Y~TS.?,, ~CCc~SSc?cy S~C~ Location of Property...... House No. I Strieett p~ Hamlet Onwer or Owners of Property. .i 1V !^d`. C:~.?. ~ Y:.?' County Tax Map No 1000, Section ...1O~ Block ...S........... Lot.... Subdivision ....................................Filed Map............ Lot...................... Permit No ................Date Of Permit Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certica e. X . \ Fee Submitted: $ . ...APPLICANT....... 1 - ~'P BOARD OF HEALTH . U L5 / FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY t~ 3 BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM t SOUTHOLD, N.Y. 11971 TOWy~MOLl TEL.: 765-1802 NDTIFY; O CALL Examined ...J~.^.Z 19~ MAIL TO: . . Approved /Z...... , 19 p/~ermit No... . Disapproved a/c (Buii>sp7777ector) APPLICATION FOR BUILDING PERMIT Date 19 n INSTRUCTIONS 1 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. 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 Law , rdinances or Regulations, for the construction of buildings, additions or alterations, or or r oval o e lition, as described. The applicant agrees to comply with all applicable laws, ordinances, build g c d~d; h in cc e 9 hit, and to admit authorized inspectors on premises and in building for necess ry i ti s. ( rgn ture of applicant, or name, f a rporation) ..ta\O,I, \ , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 4 }Ao C rQ oC~Y~ Name of owner of premises N. . (as on the tax roll or latestleed) APPROVED _AS NOTED If applicant is a corporation, signature of duly authorized officer. DATE: .5 'lY B.P. # -72-0 2- FEE: BY 1 NOTIFY BUILDING DEPARTMENT (Name and title of corporate officer) 765-9802 9 AM TO 4 PM FOR THJ Builder's License No. FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED Plumber's License No. FOR POURED CONCRETE 2,ROUGH -FRAMING Qs€'3_OMBING 3. WULA ION Electrician's License No . 43 INAL. - CON.STPo; lCT;ON, ?n€JST NF CON111P ..EIT FOR C O. Other Trade's License No . . AU, CONI':I o RtesITION SHAT-L MEET THE r7EOr !E-tEOtPNTIS ru- FHF NY. 1. Location of land on which proposed work will be done. c;+ RUC.", LOW • 4?3 . : !M = fit 6-y- • Q 1 "~........~..l ,i•. {:(:r!>r - House Number Street Hamlet County Tax Map No. 1000 Section a 3 Block !:a Lot. . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: c ` a. Existing use and occupancy d^Q ` , 11 Y~ b. Intended use and occupancy C.\\S~f ...r ,A 3. Nature of work .check which applicable): New g . Buildin Ali~ .rt Addition to atiow... . . . 1 Repair . Removal Demolition Other Work . S,1 46e96ription) 4. Estimated Cost Y Fee . . number of (to be paid on filing this 9ppliction) 5. If dwelling, dwell' If garage, number of cars •.ng,,,units Number of dwelling units on each floor . 6. If business, commercials m . , . • . • • • #xed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ; . . . . Rear Depth Height ...............Dumber of Stories . . • • . • . _ , , Dimensions of same structure with alterations or additions: Front Rear y Depth Height , , Number of Stories . 8. Dimensions of entire new construction: Front Rear Depth h. . Height Number of Stories . . . • . . . 9. Size of lots Front IaC7 Rear ~ Depth (c(a0~: ' 10. Date of Purchase .....1~.~ l ame of Former Owner , . Zone or use district in which i 12. Does proposed construction premises are situated Se ~r~Kti N • • • • • • • • • • , , . I3. Will lot be regraded violate any zoning law, ordinance or regulation: . „ ~ 0. . . . Will excess fill be removed from premises: Yes N< I4. Name of Owner of premises , k Su-'* F.9....... Address a~~ "io ~ ~ Phone No. . Name of Architect Address ....1 81? .lPhone No.. • • • • • • • • . Name of Contractor Address . . Phone No. 4 5.1..,Js this property within 300 feet of a tidal wetland? *Ye (..+^>':„*If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM ocate 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 comer lot. F+ .5 L i STATE OF N W COUNTY s.s W~ Jam. • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contrac ) above named.( He is the !~E? V (Contrvor, 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 the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................dayolf.......... Notary Public . County 4oi=6 .(Signat r \ f-D i I i l ~ j j i i J 1 i I kD 'D 1 3° j F12._4 t ' q - ~ •L f' , T211"~