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Home My WebLink About20903-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20979 Date AUGUST 27~ 1995 THIS CERTIFIES that the building Location of Property 1735 PARK A~E. House No. County Tax Map No. 1000 Section 123 Subdivision ADDITION MATTITUCK~ N.Y. Street Block 2 Lot 33 Filed Map No. Lot No. Hamlet conforms substantially to the ~2pplication for Building Permit heretofore filed in this office dated AUGUST 14, 1992 pursuant to which Building Permit No. 20903-Z dated AUGUST 18~ 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 WOODSTOVE IN ~R EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to HERBERT ROSENFELD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFIOATION DATED N/A Rev. 1/81 / B/d~n~ InspeCtor TOWN OF SOUTHOLD BUILDING DEPARTMENT TO%VN HALL SOUTHOLD, N. Y. BUILDING P£PdvIIT (THIS PERM. IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No-N.° E090~IZ Permission is hereby granted to: ..Z~... ,~**~ ...~ £~,<..~.. .......................... .... ../.~....~ ....... d~: ....................... ...z~.~~**.~. ......... ~.....././..~ ...~g ........ X~~ ......... a~......~.~.~. ......... ~~&_~...: ...................... =, p~i~, ~=*ed ~, ................. ~.~. ........ ~ ....... ~.. .................................................. ............................................................ ............... ................................... co~,~ ro~ ~o, ~o. ~0oo Se:*~o, ...~ ............ m~k ...... ~& ....... kot ,o ....... ~ ........... Building Inspector. ///B,qlding Insoector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~PLICATION FOR CERTIFICATE 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. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '¥re-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. 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 - $i00.00 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 .............. New Construction ........... / ~ ~()id Or Pre~xistiDg_ 7/'/~ ~/~c_~Building~ ........ iii i'~.~' ~ .~..~ ~ ' '~'~.~.--~ .~.~ .~C~ Location of Property .... /.~ .......... ~.~;.~..~v~,.~..: ........ House No. Street Ramlet Onwer Owners of Property ~.~-~-~. County Tax Map No i000, Section .... f.-rW ....... Block ............. Lot..P ............... Subdivision.................. ............ ... . . . Filed Map ........... . Lot ..................... . Permit No~C/~.~%.~...Date! Of Permit ................ Applicant. ~..~.i.~.i Health Dept. Approval ....................... ... Underwriters Approval ...................... . .. Planning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate....w~.. ..... qubmitted: $~.... A P lCA T FOUNDA'TTON FOUleD ATIO|~ 2. P. OUGH FRAHE. & -PLUMBING INSULATION PER N. STATE ENERGY CODE FI;~AL ~DDITIONA'L COMMENTS: Examined ....... , 19~U-... 19.~. Permit No ........... ^pproved.. //.o5'. ........ . Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ,~ _ . . /~oui ' = Inspector) " APPLICATION FOR BUILDING PERMIT BOAgD OF NEALTH 3 SETS OF PLANS SURVEY ClIEEK ............. CALL .: ............... MAIL TO: Date ................... 19..· INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink ;md submitted to the Building Inspector, with 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 street= or a~eas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. ¢. The work covered by this application may not be commenced before issuance of Building Permit. ~. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permil 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 ~e Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bailding Permit pursuant to the Building Zone Ordhmnce of the Town of Southold, Suffolk County, New York, and off,er applicable Laws, Ordinances o~ 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 ~nspections. -- g pucar~, or nan . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, piumber or builder. /./ g Name of owner of premises ................................................................... . ....... (as on the tax roil or latest deed) If applicant is a corporation, signature of duly auth?rized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electri~ian's License No ....................... Other Trade's License No ...................... Location ofland on which proposed work will be'done .................................................. · ............. ......................... 5 ................... }louse Number Street Hamlet County Tax Map No. 1000 Section /.~ 3 Block ..... .~ Lot..~. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy '~-5'/,P~'~V~" ~9 F .O, 6v'A/~:'>~- ~' ,~'~4~'//-.~. b. Intended use and occupancy .................................................................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..~.. ..... Repair .............. Removal .............. Demolition .............. Other WorK. .............. ~4-~.,,~ ~ ~ ~-.~ ~ ~ .,..~ ~ ~ ff../& ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units .... ./. ......... Number of dwelling units on each floor · If garage, number of cars ............ ~' .......................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ............... : ...... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories ............... ~.~ ....................... ;.~ ............. 9. Size of lot: Front ..... ./A°. . ~.' ......... Rear ..... gq .a. 1Q3": ......... Depth .,2p?. ~.~ ............ 10. Date of Purchase ...///'.(/'.~.( ......' .... . ......... Name of~ormer Owner . (~.U,4 t,~.~...~A'~d...gq'~..~..~'.-' .... I 1.Zone or use district in which premises are situated .................................................... 12. Does proposed constmction violate any zoning law, ordinance or regulation: .A/..o ........................ 13. Will lot be regraded ...... /~(q ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises #F//$..~.~.,~,¢///:~.2~? ....Address ...F~. &~ff. z. ~'~".~. ....... Phone No. g~/$:.".P./.~. ~/ ...... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone Ix~ ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No...c~. ..... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and, indicate all set-back din~ensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE ?. .OGCUPANCY .......... ,... ¢ 5... (Name of individual signing contract) ~bove named. APyRQVED AS NOTED DAT~-.~.- B.P. # ~ NOTIFY BUIL~tNG DEPARTMENT'AT 7654802 9 AM TO 4, PM FOR THE FOLLOWING INSPECTtONS: I. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2, ROUGH -FRAMtNG 8~ ~L.UMBtNG 3, IN~U[ AT[fIN 4-. FINAL CONSTRUCTION MUST 8E COMPLETE FOR C O ALL CONSTRUCTION SHALL MEET THE REQU!F, EMENTS OF THE STATE CO~'~STRUCTION & ENERGY .CODES, NO'I' RESPONSI~3LE FOR OES!GN OR CONSTRUCTION ERRORS being duly sworn, deposes and says that he is the applicant te is the ........................ <~. ~ .~...(~. .............................. : ...................... (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the bqst. of his knowledge and belief; and that the york wUl be performed in the manner set forth i'n the application filed therewith. iwom to before me this ............ ..... Term Expires Octo~r 31, 19 z ~-