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Home My WebLink About20369-zFOt~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20670 Date APRIL 23, 1992 THIS CERTIFIES that the buitdin~ ADDITION Location of Property 945 WEST MILL ROAD MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 9 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 6, 1992 pursuant to which Building Permit No. 20369-Z dated JANUARY 7~ 1992 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 DECKADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A. STEPHEN J. & PAMELA NOSTROM Rev. 1/81 / /~uil~ing Inspector I~OB~ NO. 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 THE WORK: AUTHORIZED) NO- 20569 Z County Tax Map No. 1000 Section ....... /..~..~. ..... Block ........ .~... ........ Lot No ......../..~.. ............ 19..?.~.., pursuant to application dated ........... ..~./~c. .................................. , and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 BUILDING DEPARTMENT TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY · X. 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 i% 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 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-ex/sting 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 ........ · ,ew Construct~on..~C. ....... Old Or Pre-existing Building ................. Location of Property.~g~.'-..~..,f~.i!t.B~ ........ .~-.~i~jX }louse No. Street Hamlet ~nwer or O~ners of Proper~y... ~.. . :ounW Tax Map No 1000, . .......... ;ubflivision .... ~1 ............... Filed · · .~ ........ e/~ ............ ........... Nap ~ermit No ................ Date Of Permi~ ......... Applicant [ealch Dept. Approval .... ........ Under~ri~ers Approval 'lanoina Soard Approval .................. eq,es~ for: T'eaporary Certificate ........... Final Ccr~ica~e ........... ee Submitted: $ ..... ~,~ .................. q ...... , .................. FOUNDA TIO~'~ (lst) FOU:;D ATIO~'~ 2. (2nd) EOUGH FRAHE & ·PLUMBING ,3. I~SULATION PER N. Y. STATE E~;ERGY CODE Fi;;AL ID~?E il ADDITIO~AL COMMENTS Stephen J. Nostrom 945 West Mill Rd. Mattituck, N.Y. 11952 November 6, 1991 Mr. Gary Fish Building Dept Southold Town Dear Mr. Fish: As per our phone conversation a "building permit" has been filled out accordingly for a of this date please be advised that obtained from your dept and will be "deck" errected at above location. I'm departing the country this and any and all information will provided your office in a timely Thanking you in advance for your Sincerely, -S'tephen, J't t~o'strom P.S. Said "deck" was a replacement in the past hurricane. date and will be returning by 11-27-91 be fourth-coming upon my return and manner. assistance in this manner. "deck" for one that had been destroyed FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BOARD OF HEALTIt ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. Disapprove .............. Wr ' ~6~-1802 9 AM ~O 4 PM FOR TH~ ~uimi~znspector) F¢DLLOW~NG '~, FOUNDKr~ON ~,NO REQUIR~??~CA-'~N ~O~ BUIEDING PERMIT FO~ ¢OURED CONCRET~ 2 ~OUGH - FRAMING 8~ PLUMBING o. NS JLAHO~ INSTRUCTIONS ¢./,) TEL.: 765-1802 CALL Exanlincd . 19... .~ , Approved :... ., 19 Pcrmi . . ......... 7. Date " 19 · ,~lu,.,~qM~'~'O~r~t~st be corn J Lely filled ,n by typewriter or in ink and s .... .., , ~l,~,,,~[O~g;~J¢~Tk"~hh ~qUd?,kk ~[~ ..... ubmltted to the Budding Inspector, w~th 3 b', Plot~' h~'2!ff'6~g? 16~tib~ = ' t and of build~ s ....... , *--~ ¢0. ~N~/Hl'rr~ ~ ~'~J g on premises, relationship to adjolmng premises or public streets r ar~sh~¢a'gt7~ ~lD~t~[{~' ~fcn~llgn of layout of property must be drawn on the diaoram which's of th' '- The wom'~t.a, D~ may not be commenced before issuance of Building Permit. d ~p~n approval of ~b~ ~pplication, the Building Inspector wil issued a BuHdin* Pemit to the appHcant. Such pemit .a~l be ~epI oh~fhe premises ava~B~ inspection throughout the work. e. ~.~ildi~shag-B~Vo~ed_o~_used in whole or in part for any purpose whatever until a Ce~ificate of Occup~cy ~egulatio~}~ff~}t~E~g~l~ of buQd~gs, additions or alterations, or for removal or demolition, as here~ deschbed. 7he ap~li~e~F~p~%~plicable laws, ordinances, buQding code, housing code, and regulations, and to .... .................... . SE COMP[ET~ FO~ AfL CO~gTRUCTION SRAIJ., ME~ (Si=nature of applicant, or name, if a corporation) .(~ailing address of applicant) ~Eg GN OR ~ONSTRUCTION ERRORS ~late wnctter apphcan/ is owner, l~ssec, agent, architect, engineer, general contractor, electrician, plumber or builder. X'ame of owner of premises e~ . a (as on the t~ roll or latest deed) applicant is a corporation, signature of duly authorized officer. .................... ................... (Name and title of corporate officer) Builder's License No ...... ./L~. :~/.z~-. .............. Plumber's License No ...... ?..'~..~. ............. Electrician's License No ..... ~. ,/..2~. ............ Other Trade's License No ...... .&)/.J}.. ........... Location of land on which proposed work will be done...~...~q~, ......... coo llouse Number Street Hamlqt o0 q ' il ' Cotmty Tax Map No. I000 Section ............ Block ................ Lot ............ Subdivision ..................................... Filed Map No. · · Lot (Name) ................. State exisdng use and occupancy of premises and intended use anti occupancy of proposed construction: a. Existing use and occupancy ....... ~.~ j&~. ~.~. ~.~ ................... . ........................... b. lntended use and occupancy .... ~d...O>....~... D.~¢/~ .. '''. . '.. "' 3. Nature of work (check which applicable): New Building .......... Addition /----""~- Alteration Repair ... ~ ....... Removal ..... ~ ...... Demolition .. ~ ........ Other Work ~ ............. g® .ao.o. Description Estimated Cost. v,. . .~?... .~.~ · · ......... Fee ............... If dwelling, number of dwelling uuits (to be paid on filing this application) 5. "'?'~'~' "Numberofdwellingunitsoneachfloor.. /'{./.4 6.' Ifgarage, numberofcars ... ~/.,~ .... . , ....... ........ .... ~ ............................ 7. Dimensions of existing structures, ifany. Front. '.':...toM..&. Rear ...~../.,4 ....... De th ...~,Z.~.. If business, commercial or mixed occupancy, specify nature and exte of each type of use .... .?r'../.,~-.., ........... l-leight ... A'.//rh. ...... Nmnber ofSiories../:'./.~, i'i" . .P ' ...... Dimensions of same structure, with alterations or additions: Front .... /?/..,~. D.epth .. /?//..']7 ! ~ ~../.,,:q: ,o.: ...... ............ Ie,g t .... . ........... Number of StoriesRear · · . 8. I mnstons of .en,,tire new construction Front .b'J h.- ,, j, .................. 2 " ' ......... .~../.~ moht ... ~ ./I.'Y: ...... Number of Stor/es . f,4.//.,L .... ~ear .../f.z'/?- ....... Depth .. 9. alze of lot: Front /h'. Z'/~ ~ .... "" ' :.'~ '-~ ............... ........ DateofP rchase ii.a. 2gi'i ........... ' ' .......... ii ........ 10. ear.. · ........... Depth ../~/..~. .................. ~ame of Former Owner .... .t9~ ..~. ........ ; ........ I I. Zone or use district in which premises are sift ated }'o? dA 12. D e · . ' ...................................... . ' o s proposed Construction violate any zoning law, ordinance or regulati'on. ' ' ' ' ..... 13. Will lot be regraded ..... ~.../~L ~...Q ............ ' .... 14. Name of Owner of premises ' '/.,').~ ............. ',gill excess fill be removed from premises: Yes .................... Address k, / ~ Phone No.. --': Name of Architect ..... q/tar Name of Contractor . . ' ' ~G~/,jt~. .............. Address ..... ./p/..Zt;. ......... Phone No... -- t 5. Is th±s pronert:,, [.4',-:~'..'..' '.,1,',,' '~ ...... . ....... Address ..... ./?/..~. ........ · l:f -[- ~ *,%,--~; ouu reel: or a l:±dal wetland? ~v',,~' ......... Phone No....~.''' ... ...... yum, ~oul:no±a Town Trustees Perra±t: ma be '?° ........ No...L--~'~.... y toque_red. ... 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 coruer lot. rATE OF NEW YORIG,~ -'~ OU,Nrrv OF ~.~.~. O(_ S.S ~ee¢'~ g* '4-'~9 ~ ........ ~'~p. ke~o t3-, Ioo~,[ca~t~, ~1~ '(M~)~~k)gfi~¢i~d~'~}~i~k,~i~j; ...... ,... being duly sworn, deposes and says that he is the, applicant (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work ~nd to make and file this plicalion; that all statements contained in this application are true to the best of his knowledge and belief; and that the ,rk will be pcrfommd in the m~ner set forth in the application filed therewith. om to beforeme tbis ~ , ~ ............ .... , ta~Pub c, ~~.~~ ' .~kg ...... ~~-;}, ~,v. · ........ ~.., . ......... ~0, ~$~8~,,8u~18 ~ (Signature of applican t) 1'4NDING