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Home My WebLink About20611-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~-RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20837 Date JULY 2~ 1992 THIS CERTIFIES that the building Location of Property 385 House No. County Tax Map No. subdivision ADDITION MARY'S ROAD MATTITUCK~ NY Street Hamlet 1000 Section Filed Map No. 140 Block 2 Lot 33 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5~ 1992 pursuant to which Building Permit No. 20611-Z dated MAY 5, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whic~ this certificate is issued is ROOF OVER EXISTING PATIO & SCREEN AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOHN A. & JEANNETTE WILCENMICI Rev. 1/81 FOU~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL. SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°_N? 20611Z Date ................................... , 19..~...~'. Permission is hereby granted to: ~ ~ ........ ~ ...... ~'~Z~ ................. .....~.~~.,...~...~.: ....... !.!..~..~.~ ..... ...... ........ ... ~- ~ .............. ~.~ ~t pr~mi~,~ ~at~ ~t ~...~ ......... ~.~ ...................... County Tax Map No. 1000 Section ...... /...~....~. ........ Block C) ~., Lot No ........ ~ ............. pursuant to application dated ........... ..~.....~.....~' .................. , 19,c~,?,,, and approved by the Building Inspector. Fee $....~....~...~...~ .... Rev. 6/30/80 Form No. 6 TO~N OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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, i957) 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. 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-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date -~w Construction .......... Old Or Pre-exiszting Building. [...~... ........ cation of Property .... i. ...... IIouse No. Street Hamlet lwer or Owners of Property. . .~...~,~.~ unty Tax Map No 1000, Section. /~O Block ..... (~..~. .... Lot...~..~..... bdivision ................... ............... Map ............ Lot .................... · - Filed rmit No ........ Date Of Permit... .. cant.. alth Dept. Approval ...... · .... Underwriters Approval ........... arming Board Approval .... .~../.~. ...... ~uest for: Temporary Certificate ........... Final Certicate...~ ..... Submitted: $...~..~., ... . APPLTCA\,~ ...................... TOWN OF $OUTtIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 June 30, 1992 Mr. & .rs. J. Wilcenski 385 Marys Road Mattituck, New York 11952 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. ~/_--~ An application for Certificate of Occupancy is not on file. /5/ No Underwriters Certificate on file. ~_~/ The check is~k~d/not on file.)$25.00 /5/ No Health Dept. Approval on file. /5/ No final inspection has'been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit Building Dept. No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) ?OUI__JDA'T!ON rOUNDATIO:! ~OUGH FRAME & -PLUMBING f2nd) E~SULATION FEE N. STATE ENERGY CODE FI;;AL ADDITIOMAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 \Ppro,'ed ....V.~}.~....~-. ,, 191% Permit No. ~.~..~)..~-. )isappro~ ed a/e ............................ · (Building h~spector) ' ' .~r .... APPLICATION FOR BUILD!NG PER'lIT BOARD OF' HEALTII 3 SETS OF PLANS ......... SURVEY ................... CIIEcK I':OTI P'!: CALL ................... HAEL TO: INSTRUCTIONS a. TI'ds application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ts 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 streets · areas, and giving a detailed description of layout of property must be drawn on tl~e diagram which is part of this appli- (ion. c. The work covered by ttfis application may not be C~mmeneed before iSSUance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit all be kept on the premises available for inspection throughout the work. e. No building shall be occuoied or used in whole or in part for any purpose whatever until a Certificate of Occupancy all have been granted by the Bui'Iding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the filding Zone Ordinance of the Town of Sou(hold, Suffolk County, New York, and other applicable Laws, Ordinances or :gulations. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~e applicant agrees to comply with ail applicable laws. ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessary ins~:tions.~_ (Sigr~atprc"of applicant, or na~le, if a corporat[o'n') .... · ,. (Mailing address of applicant) /O ~ · ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~cor orp is O.. H¢9.. - in owner rem es . · , . , ..... . (as on tlie tax ro or latest deed) applicant is a corporation, signature of duly authorized officer, (Name and t~tle of corporate officer) Builder's License No · Plumber's License No Electrician's License No ....................... Other Tradc's License No ...................... Location of la,rd on which proposed work ,viii be (tone.. ~:~"~'- ""% --'' '/ .............. '... i ........ ~; ' ................... :.r!. to llouse Number Street Hamlqt c bT ,Xl No 1000S lio }St. 0 ' o,n ,:,, . cc n .............. mo k ........ Subdi '" ' ' '; '~ ........... Filed Map No (Name) .............. Lot ................ glare ex/sting use ~nd occupancy of premises and intended use and occupancy of proposed construction: ~. Existing usc and occupancy . ~, , , ~ ~. Intended use and occupancy ..... ~ ~ ~w~'~,,'~ 'qv~ <~ . _ .......................... ~)e ~ · . Locate clearly and distinctly ~11 property lines, Give street and block terior or comer lot. 3. Nature of Work (check which: applicab .... ' ixcpoar .............. Remova g._,, . .... Addition ......... Alters[ion . .... ~cmo t on ...... 4. i ~ , .... Other Work ......... Est mated Cost ....... , ~.l~d!).~ .~..... (Dcscr:,~tio '. * fee If dwelling, muu bar of dwell n ' ' .............. 5. - u- '- (to be prod on filing th s application) Ifga,rag:,numberofcars ...~' ""all ..... :: iii i 7.u.~bar°rd'veIl g units on cach floor...: ...... . 6. If business. CO?martial or m .Xed occupant s cc" ........................... ' 7. D,menstonsotex,st,ngstnctu[rc r~,. ,:Y' ,P ffynatureandextcntofeacbt Dcofus " tleight ... ~, .......... Nqmber df Stories ........ ' ...... dear .............. Depih ............. Dimensions et same structure w' . . ' ............................. ,th alterations or addmons: Front ................ 8 Depth ................ i'" Height Rear ................. Dimensions of entire ................. ' Number of Stories .............. Size oflot: Fi'ont .... ' ............. 10' Date of Purchase ' '" .................................................... ........ · ....... Relr · I ' ',~ .... t Denth ............ ,';,line o£ Former Ow mr ' ' ' ' ..... I l. Zone~or use district 1 w rich "re ~i ,'-- , ~,. u ~u~ are SltJated.. . . 12. ~',ocs proposed construction vi61atc any zotfi, lax " ...... ' ........... · ed ! g v, ordmance or're-ulati . ' ............. V, dl lot be re~rad ~, .......... 13, ~n ..... - .... . .....l ...... ,,. ~ on ....... .~-~.. ....... ~ la excess fill be removed rom pre n scs Nc 14. _ ~.e m uwner of premtses .. 1. ~ ....... ~,uuress ... Name of Architect ......... , Name cfc ................. Address ... ~ ............... Phone No ............ ontractor ........ · ' ' ' k~,. Is chis property within ;~'%'" ............. Address .. · ........ Phone No ................ · If yes, SouChold ~uu feet of a tidal wet~.-,~'~''%L ............ PhoaeNo ......... , ..... ....... <... ' Town Trustees Permit may be requt PLOT DIAG P. AM buildings, whether x~stmg or proposed, and, indicate all set-back dimensions from ':umber or descrlptioh according to deed, and show street names and indicate whether 'ATE OF NEW V-lg~K r~r-~ /, . ,'<n o::... /ff s.s , .... (Name orindividual signing ?ntra~ .......... being duly sworn, deposes and says that Ilo is tile applicant ' ' [ (Contractor ................................................... , agent, corporate officer, etc.) ~aJd owner or owners, and is duly au:lhorJzed to perform or haw performed the said work ~nd to tn~e and file this licafion; that all statements contained in this application are true to the best of his knowledge and behef; and that the k will be perforated in the m~ller set Jforth in tile application filed therewith. ' ' ~m to before me