HomeMy WebLinkAbout21174-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
, Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22180
Date MARCH 8, 1993
THIS CERTIFIES that the building ACCESSORY STORAGE SHED
Location of Property 1100 COUNTY ROAD #48~ MATTITUCK~ NY
House No. Street Hamlet
County Tax Map No. 1000 Section 122 Block 1 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to .the Application for Building Permit heretofore
filed in this office dated DECEMBER 28, 1992 pursuant to which
Building Permit No. 2t174-Z dated JANUARY 5~ 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 ACCESSORY STORAGE SHED AS APpLT~ FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
PAUL & MAUREEN GRIPPA
MIA
Building Inspector
Rev. 1/81
Ii, On'M* bTO. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THF. WORK AUTHORIZED)
N-°N.o ~117JZ
Permission is hereby grar~ed to:
.../z~..d~'.~..':,~(~.~ ......................
,o ....... ......
~ .................................... :j.~:~-~...::~:~ ::~:~: ........................................................
,~ prem~,, ~,~ed ~,..//X ..... ~ ...... ~ ...........................................................................
.............................................. ~~~; ...............................................................................
County Tox Mop No. 1000 Section ...... .~,.,~',,.,,2ZT.,~ .... Block ........ ~ .......... Lot No .......... .~ ........
~../,.~..~..................................,/ 19.~).~.., and approved by the
pursuant to application dated .........
Building Inspector.
Fee $....~.....
Rev. 6130180
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 ~ypewriter 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~i0 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.
Bo
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-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 Building - $100.00
3. Copy of Certificate of Occupancy - ~5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .....~.g~..~.~.~.~J...~..~.l./.?.~.~.~. ..........
New Construction....w~.. ..... Old Or Pre-existing Building.~ ........
Location of Pro~e~ //~0 ~0~/ ~/~/Z~;~f/~
House No. Street Hamlet
Onwer or Owaers of
County Tax Map No 1000, Section..~.~..~. ...... BlocR...../...........Lot ................. .. ...
Subdivision ........ ~ ........................... Fi~ Map ............ Lot .........
Permit No.. ~.~<~. [.~. ...... Date Of Permit.. %.~..~. 7~' '~'App ica .... ........... .......... ' ....... /.~.] ....
Health Dept Approval ..... Underwriters Approval . .
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ . .~.~.'['~ ...................
_ . ..............
~OUNDA~!ON (1st)
¢OUNDATIOf.! f2nd)
rOUGH FRA~,IE &
.FLUMBING
~;SULATIO~! FERN. Y.
STATE E~;ERGY
CODE
FI:;AL
ADDITIO~;A'L COMME~;TS:
ISTRICT
000
ECTION
22.00
LOCK
1.00
DT
~2.000
Standard N,Y.B.T.U, Form 8010 Executor's Deed--Individual or Corporation.
CONSULTYOUR LAWYER BEFORE SIGNING THIS INSTRUMENT--THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDF~R~, ~de the 18th day of November
BETWEEN
· nineteen hundred and ninety-two
JAY P. WICKHAM, residing at 101 Fox Hill Drive, Baiting Hollow, New York 11933
as executor of the last will and testament of
EDWARD P. GILLES , late o[
Suffolk County, deceased, who died on the lOth day of February, 1992,
party of the first part, and
PAUL GRIPPA and MAUREEN M. GRIPPA, his wife, both residing at
572 Seaford Avenue, Massapequa, New York 11758
party of the second part,
WITNESSETH, that the party of the first part, by virtue of the power and authority given in and by said last
will and testament, and in consideration o[ ---THREE HUNDRED THOUSAND A~D 00/100 ...........
............................ ($300,000.00) ............................... dollars,
lawful money o£ the United States, paid by the party of the
second part, does hereby grant and release unto the party of the second part, the heirs or successors and
assigns of the party of the second part forever,
ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate,
lying and being ~x~h~ at Mattituck, Town of Southold, County of Suffolk
and State of New York, bounded and described as
BEGINNING at a monument on the Northeast corner of the premises
herein described, said point being 842 feet (more or less) Westerly
from the corner formed by the intersection of the Westerly side
of Lipco Road with the Southerly side of Middle Road (C.R. 48);
said point also being the corner formed by the intersection
of the Westerly side of "Old Neck Road or Shirley Road" with
the Southerly side of Middle Road (C.R. 48);
RUNNING THENCE South 30 degrees 37 minutes 50 seconds East along
the Westerly side of "Old Neck Road or Shirley Road"~ 135.70
feet to land now or formerly of Alderman;
THENCE along said land now or formerly of Alderman, South 69
degrees 19 minutes 30 seconds West, 91.00 feet to land now or
formerly of Boehm;
THENCE along said land now or formerly of Boehm and land now
or formerly of Chang, South 75 degrees 23 minutes 40 seconds
West, 199.90 feet to land now or formerly of Shen;
THENCE along said land now or formerly of Shen, South 80 degrees
17 minutes 30 seconds West, 100.08 feet to land now or formerly
of Avent;
THENCE along said land now or formerly of Avent and land now
or formerly of Demchuk, South 78 degrees 00 minutes 30 seconds
West, 174.92 feet:
THENCE continuing along land now or formerly of Demchuk, South
13 degrees 00 minutes 20 seconds East, 68.55 feet to land now
or formerly of Meyer;
THENCE along said land now or formerly of Meyer and land now
or formerly of Reeve and Doughty, South 76 degrees 18 minutes
50 seconds West, 165.00 feet;
FORM NO. 1
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
APPLICATION FOR BUILDING PERMIT
.... L' ,{,,', 'fHOLD
INSTRUCTIONS
BOARD OF HEALTH .........
3 SETS OF PLANS
:/
SEPTIC FORH ..............
NO?I PY;
HA I L
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
stlts of plans, accurate plot plan to scale. Fee according to schedule. , .
b. Plot plan showing location of lot and of buildings on premises, relation'ship 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.
e. 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 Buitding 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and it~ building for necessary, inspections.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
,
State whether applicant is owner, lessee, agent,.architect, engineer, general contractor, electrician, plumber or builder.
¥ (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly auth~orized officer.
(Name and title of corporate officer) ,
Builder's License No .... ~..r~. ?~...~. ...........
Plumber's License No ...... ~/../~. ..............
Electrician's License No. / / ' -
Other Trade's License No.
Locatio.n of land on which proposed work will be'done ..................................................
.././oo c%,,,,% ,-lo¢ .............. ,d ..... .... .......
.............. . ................................. ,4/v
House Number Street Hamlet
County Tax Map No. 1000 Section .... /.~ ."~. ......... Block ..... ~ ........ Lot ....... ~.. .........
Subdivision ..................................... Filed Mhp No. '
(Name) .............. Lot .........
State existing use and occupancy of premises and in tended use and occupancy of proposed construction:
a. Existing use and occupancy ~z / t/~Tre x//ez'i~"--foz,~r-// ,~e'~l~/~ce,-
b. Intended use and occupancy..0-, f~. ~?..~' ,..~ .~t~,~,..¢5~. ,~:::~.~.
3. Nature of work (check which a~plicable). New Build --
· L -' ,,,~ .......... Addition .......... Alteration
Repaxr .............. RemovaI .............. Demolition . .. Other Work..~./'/.~].'a~..~j'
4 Estimated Cost ~ '
5. If dwelling, number of dwelling'units (to be paid on filing this application)
............... Number of dwelling units on each floor ...........
· If garage, number of cars
6 If business commercial '""~ ...............................................
or mzxed occupancy specify nature and extent of each type of use .....................
7 Dimensions of existing structurgs if any: Front ..............
Height Nun} "ber of Stories ............... Rear .............. Depth ...............
DimensiOn; ............ ' .......................................................
of same structure with alterations or additions: Front
Depth ! Height ................. Rear ..................
8 .................... I ........................ Number of Stories ~ .
· Dimensions of entire new construction: Front ' " Rear .............. ' .......
Height Number of Stories .............................. Depth ...........
9. Size of lot: Front /,~?'.'~/~.'~.' .~5. epth ......,_.,
........... ~ ........... Rear
10. Date of Purchase /. ................... D~ ;·. .......
11. · .............. Name of Former Owner ~_~t~oor(J C~llle, ......
Zone or use district in which pre:mises are situated ............. . .......... '...
12 Does proposed construction viol&te any zoning law ordinance or regulation ~.~.'¢ ..........................
Will lot be regraded ......... i ................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ... !.
, · ............... Address ................... Phone No ..........
Name of Architect ......... ~ ........... Address ............ Phone No .... ' .....
Name of Contractor , ' ...................
......... i ................ Address ......... . .......... Phone No ................
15. Is this property within 300 feet of a tidal wetland? *Yes.' ....... No .....
· If yes, Southold Town Trustees Permit may be required. ''''
"-. i 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 rmmber or description according to deed, and show street names and indicate whether
interior or comer lot.
irATE OF NEW YORK.. . '
JOUNTy OF.....~q¥'.5~ .k)q-. ...... S.SI
AP, PR.O ED AS NOTED
DATE://~/~-~ B.P. #
FEE: ~ DEPA"T~
BY: ,
765-1802 9 AM ~ 4 PM FOR THE
FOLLOWING INSPECTIONS:
I. FOUNDATION TWO REQUIRED
FOR POURED. CONCRETE
2. ROUGH- FRAMING R PLUMBING
3. INSU~TION
4. FINAL CONSTRUCTION MUST
8E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE R~UIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES, N~ RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
(Name of individual signing ,contract) ..... being duly sworn, deposes and says that he is the applicant
hove named.
~ (Contractor agent corporate officer etc ) ...........................
f said owner or owners, and is duly atithorized to perform or have performed the said work and to make and file this
~plication; that all statements containeO in this application are true to the best of his knowledge and belief; and that the
ork will be performed in the m~ner se~ forth in the application filed therewith.
worn to before me this
'A'N lo'~e~ '01lard ~VI0~ N0. 4125089,.Suff~ ~ (Signature of applicant)
.