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Home My WebLink About21481-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22458 Date JULY 20, 1993 THIS CERTIFIES that the buildin~ ADDITION Location of Property 3390 COX'S NECK LANE MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 8 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 3~ 1993 pursuant to which Building Permit No. 21481-Z dated JUNE 14~ 1993 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 ~ISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A MARTHA JANOWICZ Building Inspector Rew. 1/81 FODM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N-° 21481 Z BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] Counh~lax Map No~ 1000 Section .......... L,~...~..... Block .......... ~ ............ Let Ne ....... ~. .................. pursuant to application dated.,..~/ .................................... 19..~'.~... ........ and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ ....~'rOV'LM ---,--,~.O~' SOU!~IOL, ~·. ~,-~,, j 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, er buildings and "pre-existing" land uses: i. 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 Inspect'or 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .., ........... ~ New Construction ....... '.~ Old~O~ Pre-e~xisting,BFild~ng. ~ .~ .......... Location of Property .................................... ~ .................... House No. Street Hamlet O nwer or 0 w ners of Pro ert . ..~'~ ~ ~.~/[C . County Tax Map No I000, 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: ................. ? .................... A P IC T FOUNDATION 1st) FOUNDATION 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~"~INAL REMARKS: ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 11750~3 SUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 o.t. NOV~HSER ~1,1994 Ap. llc.,io. No. onfile 85617494/94 N 332~65 THIS CERTIFIES THAT only the electrical equiprrlet~t as described below and introduced by the applicant named on the above application nurnber in the premises of MARTHA JANOWICZ, 3390 COX NECK ROAD ~ MATTITUCK ~ N.Y. in the following h,catlon~ [] Basemen~ [] Ist FI. [] 2nd FL Section Block Lot u~s examined on OCTOBER 27,199~ and found to be i~ complitt~ce With the Naiional Elec£t~cal Code. fiXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES 6 11 4 6 DRYERS FURNACE MOTORS FUTURE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C NO, OF CC COND, A W G, NO OF HI-LEG OF CC. COND OF HI-LEG OTHER APPARATUS: MOTORS: 1-F H.P. SMOK~ DETECTOR:-]. Q.C. ELECTRIC INC, P.O. BOX 518 [~UR~L, NY, 11948~: LIC.#3823~ GENERAL MANAGER Per ~ ................... This certificate must not be altered in any manner; return to the office of the Board if incbrrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIfiCATE MUST,NOT BE ALTERED IN ANY MANNER. , APJ~ROVED AS NOTED NOTIF~ iBUILOING DEPA,J~,T"~t~NT AT FOLLOWING INSPECTIONS: : ' ,FOR ~OURED CONC,R~TE,, 2. ROU6H - FRAMING ~ PLUMBING 3. N~U~T~ON 4. FINAL '~ CONSTRUCTION MUST ALL ~0NSTRUCTION' SHALL THE REouIREMENTS OF ,THE ~ONSTRUCTION ~ ENERGY ~RRORS 12' ia/ 12o · 80.0' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL..: 765-1803 (B u ildin~..L, rfp e c t or) APPLICATION FOR BUILDINGPERMIT BOARD OF HEALTH ........ 3 SETS OF PLANS ........ SURVEY ................. CIIEC~ SEPTIC FORH HAIL TO: Date ................... 19... INSTRUCTIONS : a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 tiers 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 shsll be occupied or used in whole or in part for any purpose whatever until a Certifieate 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections· (Signatur or (Mailing address of applicant) State whether applicant is owner, lessee,"agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner of premises ....~......~.~./~.0 go J .~.'~ - . ...... (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..~.c~..~.~... ' ........ P1 tuber s L~cense No ............... . .......... Electrician's License No. Other Trade's License No ................... 1. Locat,on of land on which proposed work will be done .......... ..... ' ....................... x ......... ;/' 'Z" "~/''-''~''.. ltouse Number . Street County Tax Map No. lO00Section ...l'!.~.~'. .... . ...... Block ......... ~. ' Lot ...... a ............ 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 ........ · 3. ~Natur. e of work (check which!applicable): New Building ..~ .... ' . · Additi6 . . t~epmr '. ....... Re',,, , . · . n. .. Alterati .. ' '' · . · ;...ovm .............. Demolition...'.; ........ Oth,erWork..~ ~' ,2- ~ ....... ip'' t~..~.~..: i ' - . (Descr tion) 4. Estimated Cost ...... : .................... Fee .. ~ '., (to be paid on filing this application) ':~g mb ' ' $. If dwelling, number ofdwelh units ............... Nu er of dwelling units on each floor ..... · lfgarage, numberofcars .,.!. . . ' · ..... ' .... 6. If business, conunerc;-~ ,,~-,;,,~,~ [ ........... .; '" ' ...... " ................................. 7. D ...... pancy, specuy nature and extent of,each type of use .............. unenmons ol emstmg structqres, if any: Front ........ .... : ·. Rear De ight Nd ................ pth ....... He ............... tuber of Stories ............. ' . ........ with .................. ............. · .... Dimensions of shine structure alterations or additions: Front ...... Depth ' Rear ' Height ........................ 8 ................... ~ .............. ' ........ : Number of Stories ' · Dimensions of entire new construction: Front ............ · ' Rear Depth ight .~,N~/n b .He · · '. ..... '. · er of Stories ............... / ...... Size of iut: Front. ~-O, ' " /5, 5' &"~ ' ' .......... 4']5L'~. ......... ~'"~ ..... ~ ...... Rear... .... ~..~,,~,.~ .... Depth .... Date of Purchase .......... , ......... . ......... Name of Former Owner ..................... one or use district ~n which premises are situated .................. ; ....................... · D°es pr°p°sed construction violate any zoning law, ordinal~ce or regulation: .......... . .......... Will lot be regraded ....... ;! .................... Will excess fill be removed from premises: Name of Owner of premises . .: ......... ; .... Address .. Phone No ....... . Name of Architect ..... : ' ~ ' ' ' ................. · ...... ,.. .... ................. Address .............. Phone No ...... Name of Contractor ...... i ...... ' .... ' ..... : .... ' ' ' · ........... Address.. .................. Phone No ............. 15. I.s this property withini300 feet of a tidal wetland? *Yes ........ No ......... ~'' · If yes,'Southold iTown Trustees' Permit may be required~ i. PLOT DIAGRAM Locate clearly and distinctly Mi buildings, ~heih~r existing or proposed, and. indicate all set-back dimensiohs from property lines. Give street and bloclq number or description according to deed, and show 10. 11. .12. 13. 14. interior or corner lot. street names and indicate whether STATE OF NEVeW'r'm t' OF. L · :.. (Name of individual signing contract) ...... ~bove named. e ~s the .., .................. , ~a ~s auly auth~perfom or have perfo~ed the said work and to m~e and file this pplication; that all statements contaified N this application are true to the best of his knowledge and belief; and that the /ork will be perfomed in the manner s~t forth i~the application filed therewith. ' worn to before me this ; ~ , ....... . ' . ~ ~ ' being duly sworn, depose9 and says that he is the applicant