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HomeMy WebLinkAbout21329-zFORM NO. 4 TOWN OF SOUTROLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF No Z-24211 Date MARCH 15~ 1996 THIS CERTIFIES that the building ADDITION Location of Property 1465 ',-~RESA DRIVE MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 15 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6~ 1993 pursuant to which Building Permit No. 21329-Z dated APRIL 9, 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 S GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES & BARBARA BRO(~KBANK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING - MARCH 4, 1996 N/A Rev. 1/81 /L~ing Inspector FO~I~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NH? 2132S Z Dote ............................... , ~9. Permission is hereby granted to: .... ...~.~....~.:~.: ...... u.~...:...~.. ,o ..~....~....~.....~~..~...~.~...~.~.~ ~. ........ v I,, ~- ~LL~ ~u~~~ ~~, ~.__~ ," ' ............ at premises located at .....}...~'.~...~.........~..~..~..~.L~L ....... :.~.~ ....... County Tox Map No. 1000 Section ........ .~,1..~'~.. ....... Block ........ L.~.. ....... Lot No ...... ~..~ .............. pursuant to application dated ...................................... , 19..~,~., and approved by the Building Inspector. Fee ~..../ ................... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FORCERTIFICATE 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. Conm~ercial 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 Vpre-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 Buildin~ - $100.00 3. Co~y 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 p roper ry../.. ~.~..~. ............ ~.~.~..~.. ~ .C~.....~..~.. i i House No. Street , Hamlet Onwer or Owners of ~roperty ........ Y.~..~. ..................................................... County Tax Map No 1000, Section .... ././..~. ..... Biock ..... ..... ----/..~.. .... Lot .. / ~ .............. Subdivision . Filed Map Lot Permit No .... ate Of Permit ................ cant ................... Health Dept. Approval.~...~..~. ? ........ Underwriters Approvai.ffZ.C ............... Planning Board Approval.~..~.V~.~.~... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $...~...~.'..~.?. .......... ,...,....~~~/_ ...~~ ...... .............. FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS WE ARE rN THE PROCESS OF ISSUING A CERTIFICATE OF COMPLIANCE FOR THE ELECTRICAL iNSTALLATION AS COVERED IN AN APPLICATION N~TED ~ELOW. 765-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,~NAL ,, INSPEG?I'OR Town Hail, 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 September 27, 1995 Mr. James Brockbank 1465 Theresa Drive Mattituck, NY 11952 Re: Building Permit #21329-Z Premises: 1465 Theresa Drive, Mattituck Suff. Co. Tax Map #1000-115-15-13 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher Senior Building Inspector APR - 6 t993 ^pproved ©CU... S. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19h. ., 19~..~, Permit No..~../.~.~..~ BOARD OF HEALTH ...~.a.~. 3 SETS OF FLANS ......... SURVEY .................. ClIECK .................... SEFTIC FORH .............. FrKIL TO; / Disapproved a/c .............................. .~ _ ./~ :. APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS ~ 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 sti-eets or areas, and giving a detailed description of layout of property must he drawn on the diagram which is part of this appli- cation. c. The work covered by tkis 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 Southbld, 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 describ6d. The applicant agrees to comply with all applicable laws, ordinances, building code, housing c_oc}~,-and regulations, and to admit authorized inspectors on premises and in building for necessqrgInspections.~,¢~ //(Signa!ure of applicant, or name, if a.~corporation) ~-~ State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. ' or owner o f premises ~'~ ~' ~0c¢~/40~t'~4 x~ g~q f~ I~r~ P¢ ~.~1 ' .......... Name ............................................... ~,~. (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...(~ .k&3.~.XX.~ ......... Plumber s License No ......................... Electrician's License No. Other Trade's License No ...................... Location of land on which proposed work will be done...~..~.~, .k.~<.~k ................................ House Number Street Hamlet Couhty Tax Map No. 1'000 Section [~r.Xh~:~. 75~... Block .............. ' Lot.. ~.~. SubdivJsion~~%~ ~ ~ ~...'. Filed Map No ............... Lot ............... (Name) ' %~L ~ ~h~ T~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... } 12 ~~.5~ ............. b. Intended use and occupancy ~ ........... . ...... ;r · '"'; -'"- ............ p~li ) ilding ' Additi Alt · ,3 :' I~ature of work (check which a cable: New Bu · ~ ........ on ....... eration .......... Repair RemOval Demolition · Other Work E C .~.>~).~ .~) (D ipti ) 4. stimated ost.. .i: ........ ~.. escr on ~ ~ ~ ,~tc'~ A ~/e~ (to be paid on fihng this application) 5 ~!~ng nu,mber~of dwelli~ng ~nit's' ~ Number of dwelling units on each floor · ~ numoer olcars I ' 6 ~If bumness ' '<-" ..................................................... ; ............. · , commercial or mixed occupancy, specify nature and extent of, ~Q~ l~ent~' ~--~' ~'~ 7. D~menmons ofexistingstructure~ if any: Front ~.O ?.T Rear each t e of use ........ . . ~ ..... Height Number of Stories '( ' ' ' '*"~ ........... ~ ............. Dimensions of s~me structure wi~h alterations or additions: Front Rear Depth ' i Height .................................... · Number of Stories ' 8. Dimensions of entire new construction: Front .............. : Rear ............... Depth ............ Height ............... Number of Stories ............ - ' ' 9. Size of lot: Front J ' ~o~ ' ......... ' ....~. .......................... D ' . I . · ...... IJepth .................... 10. ,,ate of Purchase .~.~..~ ..... ~ ................. Name of Former Owner'-~..~.,~ -~'~l~.~ 11. ~one or use district in which pre ises are situated .~,._\~-'~i' t~th0~ {"~tht~--f ~-,r~r~' ;--~(.k,',j,.~'~,~' '~: ....... 12. Iai ................ -...,,,.,~,-,,,,,,o ~,,,,,,~ ...... ~ ,, .1 ........ Does proposed construction viol~te any zoning law ordinance or re,relation' .~,i~ ...... ' ' 13. Will lot be regraded .'~.~ . ~ ..... , ...................... ........ r .................. Will ex.cess fill be removed from premises: ("'Y~s ~ No 14. Name of Owner of premises . .~tW-,\.~....; ........ Address .k.u,.~.5...~.khu~,,,.~..~ll~¢.~hone No.. ~.°~.'3.~"~.... Name of Architect ~ A~ - .......... . ............... duress ................... Phone No ......... Name of Contractor (DC~/.~2g--~ . Addres~\'-k%q~k',tx*.~,lxo~,X~'~,~ ,. t~o,a t'~;.;;:'~,'' · . , .......... - ............ ~-..,:'.'. one mo. 15.' I,s this property w~th~n 3,00 feet of a tidal wetland? *v~ ~ ,).k~O.. · ~ If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate 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 corner lot. COUNT.Y-O . . ............ 'k~-'O"' "'~;.~.k/k'-/. i ........ ..'.. ays that he ,s the applicant (Name of individu~ si~in,'g contract) ...... being duly sworn, depose~ ~d s above named. Heis the .~ ...... Contractor, agent, corporate officer, etc. of ~aid owner or owners, ~d is duly iauthofized to perfom or have performed the said work and to m~e and file this application; that all statements contained ~ this'application are true to the best of his knowledge and belief; and that the work will be perfomed in the manner ~et forth ~ the application filed therewith· . Sworn to before me this /"') [ ........ ....'., , y a0 mtl. .... , , ,, . ...... ._ - "':" ',:'": ' r NOTARY PUBLIC, ~-' , , , ' t g ature ozappuc~t) ·