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HomeMy WebLinkAbout20648-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20789 Date JUNE 12, 1992 THIS CERTIFIES that the building ADDITION Location of Property 50 PAT LANE & 175 MARK RD. House No. Street County Tax Map No. 1000 Section 114 Block 10 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 09 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 21, 1992 pursuant to which Building Permit No. 20648-Z dated MAY 22, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to MARK SABAT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/a N/a Bu~!~n~ Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N°_N.° 20648 Z Date ........................................ , Permission is hereby granted to:y _ ...... ...... ....................... ...~....~..:.~.,...~..~..~.~..I ............ _,_ .,, ~ ~ow..v ,. ,~...'.~~..~......~........~...~.~.....~.~ ~.~,.~.~.~..t~..~ .................. : .................... at premises located at ...~'Z~......~.~..~.....~......~........~..~9:~.../~....., ....... .~....~~ ....... County Tax Map No. 1000 Section ........ ./../,..~. ........ Block ....... (..~ ......... Lot No. (~ ~j pursuant to application dated ........... ~/~.~.......'~....~ ................ , 19.~.....'~., and approved by the Building Inspector. Fee $...,-~'~..:...~.. Rev. 6/30/80 Form No. 6 TOWN 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'l% 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. · 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 1992 Date ..... ~.~.~.~..17.,. ........... ew Construction ........... Old Or Pre-existing Building ................. ocation of Property .... 50 Pat Lane & 175 l~ark Rd. Mattituck, N Y llouse No. Street Hamlet ~wer or Owners of Property ~ S~BAT ,unty 1000, Soction ...... !!? ..... lock .... .......... 09 bdivision .................. .................. Filed Map ............ Lot .................... rmit NO. 20648Z .1~..y;..2.2:1992 JAI~ES GRAY SR. ............... Date Of'Permit ......... Applicant ........ alth Dept Approval · ' .................... Underwriters Approval arming Board Approval ........................ quest for: Temporary Certificate ........... Final Corticate ........... - : .25.00. · Submitted $ ....................... C O~o O g~ · ~OUNDA~ION (1st) ~OUNDATION (2nd} IOUGH FRAME & .PLUMBING :NSULATION FERN. STATE ENERGY CODE FI;IAL .I ADDITIONA'L COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ...'Y~..~...~..a,:..., 199.~.. · \pproved . .~.0~.U :~.9,..., 19'.1, Permit No..~ .O.~. q.~...~. Disapproved a/c ..................................... (BmTding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... ] SETS OF PL.'t.~IS .......... SURVEY ................... CIlECK .................... SEPTIC FORH .............. hO~ LFZ: CALL ................... HAIL TO: Date..~..'E./.~.. .......... 19 .f.2~. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. ¢. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available for inspection throughout the work. e. No building sliail be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building. Permit pursuant to the luilding Zone Ordinance of the Town of Southold, Suffolk County, N~w York, and other: applicable Laws, Ordinances or ~.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to dmit author/zed inspectors on premises and in building for necessary inspections. . . ,x. .......... -- // (Si=natu?'e of applicant, or name~ if a,corporation) (Mailing address of applicant) hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .f. t9 Y- ......... . ................... 4amp of owner of premises .,.,.,~. lqJ( ...................., .......... . ..... (as on tlie t.a~x roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No .......... · ............. Other Trade's License No ...................... · Location of land on whictl proposed work will be d'one ............ · ,- / . · ................... .................. llouse Number Street Hamlet County Tax Map No. 1000 Section ....... /./.~. ....... Block ..... ~..~ .......... Lot.....(~? ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construct/on: a. Existing use and occupancy....~..oy.~-..~.. .................... .................................... b. Intended use and occupancy ............. .try1 . f~. . 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... pai Re r .............. Rem val .............. Demolition .............. Other Work ............. · (Description) 4 Estimated Cost (to be paid on filing this application) 5 If dwelling number of dwelling Chits Number of dwell,rig unxts on each floor If garage number of cars i ................ 6 If business commercial or mixed occupancy specify nature ' 7 ..... and extent of each type~ of use · DJmenmons ofexmtJng structure~ if any: Front ............... ' ........... ' ~ ~Rear · "': .... ' Height Nu'nlbcr of Stories ................. Depth.. ............. Dimensi~ ............ with ........................................................ of same structure alterations or additions: Front ................. Rear .................. D pth . e .................... '.. Height ................... Number of Stories 8 Dime si of ti nstncti F "' · nons en renew co ~ on: ront ............ Rear .............. Depth .............. · H igl Numb fSt Ties ' e it ............... er o o 9 Si flor: Front ...... ' .................................... 10. Date of Purchase ......... ~ ...... ear ......... D pth Na of F O ' ' 11 Zo d '.' ......... ......... me Ormer wner ................ .... ch p ini situated ........ · ne or use mtnct ~n win re scs are ........... ' .... 12 D Dp cdc ti vi l~t i .......................................... · Des pr os onstruc on o e any zon ng law, ordinance or regulation: ............................. 13 Willl b grad d ... · ote re e ......... i ............. Will excess fill be removed from premises: es 14 Nm of Own ofp mi i ..... Y No · e er re scs ................... Address ............ Phone No Name of Architect ........ i · Add ....................... Nam of Cont ................. ress .................. Phone No 15 I chi 'it~i 300 ...... 'f ....... Address ................ Phone No .... ty rid 1 d? ............... · s s proper w n feet o a a wetian *Yes ........ No ......... · If yes, Southold Tbwn Trustees Permit may be required. .... 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 nhmber or descriptioh according to deed, and show street names and indicate whether interior or coruer lot. NOTIFY BUILDING OEPAt~I'MENT AT 765-1802 9 'AM TO I. ~OUNDATIO&~ . TWO ~E~UI~O ~OM POURED CONCrEtE 4. ~INAL CONSTRUCTION MUST 8E COMPLET~ FO~ ALL CONSTrucTIoN 8HALL ME~T THE ME~UIMEMENTS O~THE N.~ STATE CONsTrUCTION CODEs. N~ ~ES~oNsI~LE ~0~ DESIGN Offi CONST~OCTIO~ TATE OF NEW YORK, 'OU~y OF S Si ....................... day of ....................... 19... )tary Public ........... County (Signature of applicant) ......... ('~ ................... * ........... being duly sworn, deposes and says that he is the a cant ......... ppli amc of individual mgmng !contract) )ove named· is the ! . . ' (Contractor agent corporate officer etc ) ................... I said owner or owners, and is duly afithorized to perform or have performed the said work and to make and file this ,plication; that all statements contained ill this application are true to the ti, est of his knowledge and belief; and that the ~rk will be performed in the manner se~ forth in the ~pplication filed therewith2 yom to before me thi~ em'well .( DW"L~,[#4 ) 24,54 ( DWELLINe ) LOT I0 ~..~. ,4,~45°05' aO"E. CERTIFIED. TO.: SOUTHOLD .SAVINGS BANK SECURITY TITLE ~ GUARANTY CO. MARK P. SABAT 'YVONNE M. SABAT /0~^~AR,K ROAD SUFFO~ ~ o~ ~ ~ ~ - DAT~~~R~F, ~. ~-Rh- ~7 The ~wa~e disposal and wa~r ~upply f~ ~ ~ location have been in~cted byth~ ~pa~ 1,,.. 136,00 LOT 8 CP. !.RV EY OF -OT. 9 " MAP OF DEER PARK FILED JULY 25,1960 FILE NO. 5204 ,ooo MAR 4 1988 S.C. DFPT. OF ~. H[ALTH $~ ¥tl~£,S ~ LIC. NO. 49618 I OW Z Li~lNe I ENGINEERS ,P.C. EYORS IF- 5020 90.9 ' ROA':D, : $OU~HO'LD ~ N';Y. II. gTI AT MATTITUC'K TOWN OF SOUTHOLD SUFFOLK COUNTY, N;Y. - 114 /. I0 09 SCALE I"= 30" FEB. 27, 1987 JULY I0, t987 Feb. 5, 1988(f/n~l) THE LOCATION 'OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FI LED OBSERVATIONS AND O~ FROM DATA OBTAINED FROM OTHERS. -87 - 15B.~...