HomeMy WebLinkAbout21002-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26847
Date: 12/20/99
THIS CERTIFIES that the building ALTERATION
MATTITUCK
Location of Property: 10270 SOUND AVENUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map NO. 473889 Section 122 Block 2 Lot 12
subdivision Filed Map No. __ Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 6, 1992 pursuant to which
Building Permit No. 21002-Z dated OCTOBER 6, 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 INSTALL WINDOWS IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to WENDY DAVIS
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
Inspector
Rev. 1/81
FOaM NO. ~
TOWN OF SOUTHOLD
BUILDING DEFARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
N°-NY 21001~Z
Permission is hereby granted to: /
.... ../.~.~ .7.~ .... ! . . ~.
· , ....... ...~~..~,~.,..~ ....... z~- _
,o
at premises located at ~' ..... ~,,4::~,..::~,.~.,r/ .~, ....... , ,c~,, .~....~,/,,, ..........................................
County Tax Mop No. 1000 Section .... ~,,...~,,..~. Block ....... ~ ........ Lot No ....... ,/,,.~..,~ .......
pur~uont to ~ppU¢otion dot~:l ............................................ , 192~ end opproYed by the
Building Inspector.
Fee $.~.~..
Rev. 6/30/80
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Fax (516) 765-1823
Telephone (516) 765-1802
DEC. 1, 1999
MS. WENDY DAVIS
10270 SOUND AVE.
MATTITUCK, N.Y.
11952
TO Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21002-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
, '~ [~ [~ F~ ~1 f," TOWN OF SOUTHOL
Pt~-!~?~._.I,'!~ ]~ '" !~ ~:BUILDING DEPARTMENT
i: ~i ) ~: TOWN HALL
TOWN C~F SOU'FHOLO
This application must be~IT~Tn by typewriter OR ink and submitted to the build
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 for~
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contain
less than 2/10 of 1% lead.
5. Co~ercial building, industrial building, multiple residences and similar buil,
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
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 applic.
If a Certificate of Occupancy is denied, the Building Inspector shall state th
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 $25.0'
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Qccupancy on Pre-existing Buildinm - $100.00
3. Copy of Certificate of Occupancy - ~ .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Conm~ercial $15.00
D ' Ik: ......
New Construction ........... Old O[ Pre-existing Building..J.~¢~.~-~.~.~.
ocation of ................. ....'"'
House No. Street Hamlet
County Tax Map No i000, S~ction...~..~.~ ...... Block.-.~.-~. ......... Lot."%'''~'=~' ........
Subdivision. . · . . . Piled Map Lot ...........
Permit No....~.[.0~.."a. Date Of Permit..[O.~-~7-~. ?-.-..Applicant~''er(~'''~'c-'ff· ~' ~'''
Health Dept Approval Underwriters Approval ....
Planning Board Approval ....
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ..... : ...............
OUNDA~ZON (1st)
OUND~TIOU
:OUGH FRAME &
.FLUMBING
.'ZZSULATION PER N. Y.
STATE ENERGY
CODE
FI;IAL
ADD~T~ONA'L COMMENTS
765-1~02
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[/J/~RAMING
REMARKS:
[ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
[ ] ROUGH PLBG,
[ ] INSULATION
[~FINAL
DATE
Town Hall, 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
March 28, 1996
MS. Wendy Davis
Sound Avenue
Mattituck, NY
11952
Re: Building Permit #21002-Z & 17099-Z (alt's)
Premises: 10270 Sound Avenue, Mattituck
Suff. Co. Tax Map #1000-122-2-12
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.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined I.'fl~.. [/_~ .......... , 19 .~..2--
Disapproved a/c
(Building Inspector)
BOARD OF HEALTH .........
3 gETS OF PLANS ..........
SURVEY ...................
ClIECK ......................
SEPTIC FORH ..............
CALL . . ~ .......
MAIL TO:
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
s~ts of plans, accurate plot plan to scale. Fee according to schedule.
r b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
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 w6rk.
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 Depm'tment 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 cod% and regulations, and to
admit authorized inspectors on premises and in building for necessary jns~.n~/- -~. ~/
........ /../. ................
--' (Signature of applicant(, or flame, if a corporation)
......... .............
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ...~..~..~D...~..~/...~..~.~. ).~. ....................................................
(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...I..~.~'~...~..~....~..."~.. ......
Plumber's License No ........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done .................................................
............
}louse Number Street Hamlet
County Tax Map No. 1000 Section ... f~ .......... Block ... ~ ............ Lot./~. ..............
Subdivision ..................................... Filed Map No ............... Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy .~~ ....
b Intended use and occupancy '
10.
Il.
12.
14.
I5.
property lines. Give street and block m
interior or comer lot.
Nature of work (check which applicable): New Building .......... Addition ...... Alteration ..........
Repair ........ Remov~l .... ' .......... Demolition .......-
...... · · er Work ...........
, (Description)
Estimated Cost , Fee
(to be paid on filing this application)
If dwelling, number of dwelling ufiits ...... /.. Number of dwelling units on each floor .....
· If garage, number of cars ...... ! ..................................................................
If business, commercial or mixed Occupancy, specify nature and extent of each type of use ..................
lif .'~ 8.- '..~ "
Dimensions of existing structures, any: Front ........ Rear .............. Depth ..... ' .......
Height Number of Stories .I ' '
Dimensions of same structure with alterations or additions: Front ....%.k-;..F~..~,,. ..... Rear ............... ' '
Depth i Height Number of Stories" ''
Dimensions of entire new construction: Front Rear Depth ' '
Number of Stories ...........................................
Height .....................................................................
Size of lot: Front" Rear Depth
Date of Purchase Name of Former Owner
Zone or use district in h .....
w ich premJses are situated .....................................................
Does proposed construction viola!e any zoning law, ordinance or regulation: ... ~ ~ ......................
Will lot be regraded ........ .1'~. i.? ................ Will excess fill be removed from premises: Yes
Name of Owner of premises .~-~..~...~/x0. L.¥... Address . 1 9.g.~.~..~..~...~[. Phone No. ~7.~..~,'-~... ?
Name of Architect ' Address Phone No
Name of Contractor . .¥~ig~ ~.~.'[3..~D. ~ ...... Address .Z.~.t[.~4~'~.o~.... Phone No..7~...¢.G..q'. ~.
Is this property within 3010 feet of a tidal wetland? *Yes ........ No .........
· If yes, Southold Town Trustees Permit may be required.
... i PLOT DIAGRA/Vl
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
mber or description according to deed, and show street names and indicate whether
APP V_,, b AS NOTrD
FEE: BY'
'765-1802 9 AM ~ 4 PM ~ THE
FOLLOWING INSPECTIONS;
1. FOUNDATION ~O
FOR POURED CONCRETE
2, ROUGH - FRAMING ~ PLUMBING
3. tNSU~TION
4, ~tNAL CONSTRUCTION MUST
BE COMPLETE FOR
ALL CONSTRU~ON 8HA~ ME~
IHE REQUIREMEN~ OF
STATE CONSTRU~ON & ~ERGY
CODES. N~ R~ffiN~B~ FOR
DESIGN OR C~U~ON ~RO~
STAT~ OF N~--Ar~R~'~.~__,, [ I -.,q S ,
coumv OF,. m X ,
........ ...... . ........
(Name of individual signinl contract)
above named·
He is the .......................
·.... being duly sworn, deposes and says that he is the applicant
uthorized to perform or have performed the said work and to make and file this
of said owner or owners, and is duly
application; that all statements, contained, in this application are true to the best ofhis~ knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me thi~ . i --
......... :.. £ '
..... ~... d~y~..:)~ .... ,19... ~
/ //
~W Publ ~ Sm~ o~ ~ y~ ...... ~ ~./ .....-. · .~. {... ~.~ . T ...............
. ~ No, 4879505 : "' /' ~ ' ' - (Signature -~ ' "'
~alifled In SuffolkCou~ ~/ ~ g t ~ o~appncan~)