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20695-z
s FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24194 Date MARCH 7, 1996 THIS CERTIFIES that the building ADDITION Location of Property 5535 WESTPHALIA ROAD MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 12 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 4, 1996 pursuant to which Building Permit No. 20695-Z dated JUNE 8, 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 A DECK ADDITION TO A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEPHAN & SUSAN KELLNER (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Bui ding Inspector Rev. 1/81 FORM NO. 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) N°-N° 20695Z Date / Permission is hereby granted to: ~V...................... L5 44 at ...a>.......... 6....~.....¢~~~r::.~.. to i r 4 at pre is located at ........:27 .Jy/........ V ~!.:(..4flG Lt+rf 4V . County Tax Map No. 1000 Section 11,f......... Block ......1,? Lot No.....L7~`.......... pursuant to application dated 19..927,- and approved by the Building Inspector. Fee . .t..... /Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL" _ 6 1996 765-1802 eUi~s>t APPLICATION FOR CERTIFICATE OF OCCUPANCY TO AIN P"Ho! 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 19 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 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Cerrttiffiic'ate of Occupancy - Residential. $15.00, Commercial •$15.00 6i Date New Construction .2Olld Or Pre--ex}ss,,t~ing Building .....,...J............ Location of Property... ~J.......Jlp! L...... 5 [louse No. Street Hamlet Onwer or Owners of Property J(SP~~~....~~r...... ~ County Tax Map No 1000, Section..`/:? Block L2....... Lot.... Subdivision.......... .......................Filed Map............ Lot...................... Permit No.°2 d.~.~,1 Date Of Permit.G//"~ .....Applicant Health Dept. Approval ..........................Underwriters Appr.oval......................... Planning Board Approval _ Request for: Temporary Certificate........... Final Cer.ticate......... Fee Submitted: $........r~ Q 5t~81g`~ AFPLICA IT o~~gOFFO~,pCQ c~ Gym N y. Town Hall, 53095 Main Road ~p • Fax (516) 765-1823 P. 0. ox 11 Southold, New York 911971 Q~ Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 26, 1996 Mr. & Mrs. Stephan Kellner 5535 Westphalia Road Mattituck, NY 11952 Re: Building Permit #20695-Z (deck add.) Premises: 5535 Westphalia Road, Mattituck Suff. Co. Tax Map #1000-113-12-5 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. Print Key Output Page 1 5738SS1 V2R3M0 931217 SOUTHOLD 02/13/96 14:35:14 Display Device . . . . . . X5 User . . . . . . . . . . . CLAIRET NYSRPS ASSESSMENT INQUIRY DATE 2/13/96 473889 SOUTHOLD SCHOOL MATTITUCK SCHOOL ROLL SEC TAXABLE PRCLS 1 FAMILY RES TOTAL RES SITE 113.-12-5 TOTAL COM SITE 5535 WESTPHALIA RD ACCT NO 14 = OWNER & MAILING INFO ===!=MISC 1======== ASSESSMENT DATA KELLNER STEPHAN & SUSAN A !RS-SS ! **CURRENT** RES PERCENT 5535 WESTPHALIA ROAD ! 1 !LAND 700 **TAXABLE** MATTITUCK NY 11952 ! BANK !TOTAL 3,200 COUNTY 3,200 **PRIOR** TOWN 3,200 1 !LAND 700 SCHOOL 3,200 ! !TOTAL 3,200 ==DIMENSIONS =__l=====_= SALES INFORMATION ACRES .50 !BOOK 11380 SALE DATE 12/01/91 SALE PRICE 1 !PAGE 343 PR OWNER BROOKS SUSAN =======TOTAL EXEMPTIONS 0 TOTAL SPECIAL DISTRICTS 4 CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE !FD030 IPK071 !WW020 Iswoll F1=NEXT PARCEL F3=NEXT EXEMPT/SPEC F4=PREV EXEMPT/SPEC 75.10- 03-013 F6=G0 TO INVENTORY F9=G0 TO XREF F10=G0 TO MENU ~SOFF0j/( oho Gym N ae Town Hall, 53095 Main Road ro • .F Fax (516) 765-1823 P. 0. Box 91971 Telephone (516) 765-1802 Southold, New York 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 4, 1996 Mr. Stephan Kellner 5535 Westphalia Road Mattituck, NY 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 # 20695-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) a d R FOUNDATION (2nd) 4. 2. G ROUGH FRAME & o fv'i, -PLUMBING ti 3. 744 r a m m INSULATION PER N. Y. STATE ENERGY CODE I ' 4 n~~ y FI;JAL ZF' ADDITIONAL COMMENTS: • x ro p\ b S H `s) • O W 0 v _ H 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: cc DATE INSPECTOR i_F/;]( BOARD OF HE''A~~~L{{{TH w., f~~ FORM N0.1 ,;,;,,.S'.ETOF P.,NS TOWN OF SOUTHOLD ~4,41992 BUILDING DEPARTMENT _ TOWN HALL SEPTIC FORM T SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTI FY . CALL Examined ...nr.,,,,.,,,1992 MAIL TO Approved (pi , , , , , 195~~.-Permit No..©~<.: . Disapproved a/c ~ (Buil ng Inspector) APPLICATION FOR BUILDING : _RMIT Date 19 ' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 streets or 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 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 the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department 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 code, and regulations, and to "JI admit authorized inspectors on premises and in building for neces . 'sec tuns. - (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Q. L R~ 4 APR OVER CIS NOtED....... Name of owner of premises DATE' Y (as on the tax roll or N( IFY BUDEPART HNTM1AT If applicant is a corporation, signature of duly authorized officer. 766_1802 S AM TO 4 PM FOR THE FOLLOWING IN§PECTIONS: 1. FOUNDATION'"- (Name and title of corporate officer) OCCUPANCY OR FOR POURED CONT O EOUIRED USE IS UNLAWFUL 2. ROUGH - FRAMING & PLUMBING Builder's License No INSULATION WITHOUT CERTIFICATE 4, NA - CONSTRUCTION MUST Plumber's License No . OF OCCUPANCY BE COMPLETE FOR C.O. --AH -CONSTRUCT10N-SHALL` MEET Electricians License No. 7HP REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Other Trade's License No . Ci'rGES. NOT RESPONSIBLE FOR s~/I E '()R CONSTRUCTION ERRORS 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section 3........... Block 'L Lot... 3' Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy I . 3. Nature of work (check which applicable): New Building Addition Alteration Repair Remobal Demolition Other Work .~Q-..... . (Description) 4. Estimated Cost... / Fee...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor , . I garage, number of cars 6. If business, commercial or mixed, occupancy, specify nature and extent of each type of use 7. D Height imensions of existing structures, if any: Front Rear Depth , , . Depth Number ofStories with alterations or additions: Front Rear , . Dimensions of same structure wiHeight Number of Stories . 8. Dimensions of entire new construction: Front Rear Depth • . 9. Size of lot: Height Number of Stories . ]0. Date of Purchase . , ..1 ~ e~ 10. Zone or use district in which pre'.. Rear Depth g uses are siti,ated , , • Name ame . f Former owner proposed construction viola a any zoning law, ordinance or regulation: 1 12. Does 3. Will P lot be • • • • • • • • Will excess fill be removed from premises: Yes 6) Name of Owner of premises . . . . . Address Phone No............... . 14. Name of Architect . ; Address Phone No............... . Name ofContractor Address ne No............... . 15. 14 this property within 300 feet of a tidal wetland? *Yes........t *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 number or description according to deed, and show street names and indicate whether interior or corner lot. e ~I etJ«K ~~Ik I? T Atli I STATE OF NEW YORK, S.'S COUNTY OF (Name of individual s.... being duly sworn, deposes and says that he is the applicant contract above named. Heisthe (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of. . . J¢ 19.E Notary Public, County JOYCE M VNILKIN' S~~. Notary Publio, State of New Yorke' ' ' ' ' ' ' ' ' ' No. 49b2248, Suffolk Qo (Signature If applicant) Term Expires June 12,19 I IOO.Od EcJ~ P N~7°240 O\ a) o O E ~3\ 2~ ~O o_ o~ c' N° s 0 (p O. "\yN L " WN Ir9 m e l' Q L 0- OX/ P N s o ~ A 7 i ( T QA CA ~ P 1 n °A ~P P ~7 < O o d p. I , 4 m ~I O 1, O ~Op,O 00 \ SOW ~uV1o~k ~y~ Nate Coy rod 6' \ J NOTE 0=MONUMENT REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK HOWARD W. YOUNG ALD. PRO EN WO YOUNG LAND SURVEYOR , SS"NAL ENGINEER AND 12843 N.Y.S. LIC. NO. 45893 iAN ,AND ~SVRV~'YUR NY S Llr, NO. - SURVEY FOR . -,jOS~EPH BROOKS & SUSAN A.BROOKS GUARANTEED TO: AT MATTITUCK l HOME TITLE DIVISION OF CHICAGO _ _ • TITLE INSURANCE CO, TowN uF SOUTHOLD JOSEPH B SUSAN A. BROOKS - SUFFOLK CO., N. Y. °ATENOV.23,i9?I °'71-705 5CALE: 111_401 ~ ~ ~ ativ $xuyr Fws,, 4 a w ~'1 xs u N } r ny r. ~ I v s d+ ~ a,.t F ! , ~ a , e tt i nN`J ht rc~Y i Y Fav 2t 3Eh 1~ rr 5 ~ ~ ~Y I l ~r~ r 'r Y ~I Liay M t a r 3 ~'Y , C t s z y u a - 1"-Y a 7 c'~'~NfG ,~tpp Y td ~ b A n, r t6! 5 f.a«a- 'E i . r t y.. ! a a~ ` n R I'' ~ t r IR, k - `9 t 4 r i u4, T - r _ o T IF 19~ c~ G'__M -~~rsr' A-i r re• 11 G-R~~_ ,2_x8- C,Rr~~•F~.. . Y. rT