HomeMy WebLinkAbout20697-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-22615
Date SEPTEMBER 24, 1993
THIS CERTIFIES that the building. ACCESSORY
Location of Property 2740 EAST MILL ROAD MATTITUCK~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 100 Block 5 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 4~ 1992 pursuant to which
Building Permit No. 20697-Z dated ~ JUNE 8t 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 ACCESSORY HORSE SHELTER & FENCED IN AREA AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
GEORGE & JUDITH FLAIG
i~g Inspector
Rev. 1/81
FOBI~ NO. ft
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~°. 20697Z
Permission is hereby granted to: ,
..... /.~?~._~~..~ .........
....................................... ./...~.~ .......... ~..~. .~..~:. ...................................................
Cou.~ T~x ~ No. ~000 S~.o..../~ ............ ~ ..... ~ ........ ~o~ No ....... ~ ...........
Buildin9 Inspector.
Fee
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTtlOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION 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.
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.
Submit Planning Board Approval of completed site plan requirements.
,6.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
qpre-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 - Ne.w.~&w~lling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25].'~, 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
7
Date ......................................
New Construction...~.<~.~ ..... Old Or Pre-existing Building .................
Location of Property .......... ·
House No. Street Hamlet
0nwer or Owners of prentke,
County Tax Map No 1000, Section.' ...... Block ..... ~.. Lot /. ..........
Subdivision. · .~. · .~. -/../. · .... .~../i ·~ ................ Filed . Map ............... Lot /. .................
Permit No..~..O...~...~...~..Date Of Permit.~.~]~...~.~...~....Applicant..~'J/~;.~..~./~
~{enlth Dept. Approval ......................... · Underwriters Approval ........................ .
Planning Board Approval ...................... ..
Request for: Temporary Certificate ..... Final Certicate.
?Ce Submitted: $
....... '... . ...........
' APPLICANT
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building. Irapector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 14, 1993
SCOTT L. ItARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
George J. Flaig
31 Watson Avenue
West Babylon, N.Y. 11704
TO Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xxx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is (outdated/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 ~ 20697Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
.PLUMBING
I~;SULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONA~L COMMENTS
g-Ill
/411
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1g0:a
Examined .... ~./: ...... , 19 .~.]-7.
Approved .-. V~. ...... 19¢2~. Permit No.
Disapproved a/c ...... ...............................
APPLICATION FOR BUILDING PERMIT
BOARD OF HEAL/It
cIl C ........
t'O', ~ ,P¥=.~
CALL % ..................
HAlL TO:
· ~ 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 publ/c 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.
¢. The work covered by this application may not be commenced before issuance of Bui/ding 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 wdrk.
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.
A,PPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buil ' * '
· .. o . dina Permit pursuant to the
Buil&n= 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 ,appl/cant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
~dmit authorized inspectors on premises and in building for necessary inspections· ~, ~ x
t ~ app icant, or name, ii a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder·
Nameofownerofpremises ...:
(as on the tax roll or latest dee~J)~.'
If applicant is a corporation, signature of duly authorized officer ~N~O~ri~dU~Lr~DiNG
~ ' PARTMENT~
· (Name and title of corporate officer) 0CC JPAI C¥ 0R
Builder's License No...Q.t-~ .~..~-.~. .............~g~ ~g ~[g~]~[
IT O[ T CErTiFICATE
Plumber's [~cc~sc Ho .........................
0F 0CCUPA CY
Electrician's License No .......................
765~1802 9 AM TO 4 PM FOR THE
FOLLOWING iNSPECTIONS:
1. FOUNDATION - lrlNO REQUIRED
FOR POURED CONCRETE
2. ROUGH ~ FRAMING & PLUMBING
3. INSULATION
4, FINAL : CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STAT~ CONSTRUCTION & ENERGY
Other~Trade's License No ......................
C~7~S. NOT ~ESPONSI~LE FOR
· Location, onand on which proposed ,ork w il / d. E .5
House Number Street Hamlet
Cmmty Tax Map No. 1000 Section . ~0 · ...... Block ~ Lot
Subdivision ~ ( '
................................... F led Map No ............... Lot .. .
(Name)
State existing use and occupancy of premlses and intended use anH occupancy of proposed construction:
a. Existing use and occupancy . -~/~ - ,- ~/ ' ~
~ · ............. ..1,~ · .A ~zt~t~x~... ~ l~f.~ .............
"" ' .........
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work 2~.q'~.~.~'
....... "'~'4'-O g~ .,~ [ (Description).
4. nsnmatea ~ost .'~..
, (to be paid on filing this application)
5. If dwelling, number of dwellingiunits ............... Number of dwelling units on
If garage number of cars each floor ................
6 ' If busine'ss .........................................................................
· , commercial or mixed occupancy specify nature and extent of each type of use
7 Dimensions of existing structures if any: Fight Rear .....................
Height Numl~er of Stories ............................. Depth ...............
Dimensions of same structure wlth alterations or additions: Front ................. Rear ..................
Depth .................... i.. Height ...................... Number of Stories .............. ? .......
8. Dimensions of entire new construction. Front
tie~ght N ..................... Depth
-- · ~ Rear .............................
......... mq ber of Stories i '
9 Size oflo~: Fr(~nt .... ' ..................................................
10' Date of Purchase ........... i .......... Rear ...................... Depth ......................
' Name of Former Owner
11' Zone or ............................. · ............................
· use district in which premises are situated ......................................................
12. D · , ~ .
ocs proposed constru~n violate any zoning law, ordinance or regulation .......
13. Will lot be regraded ... i ...... : ....................
' ~ ....... ' ' '. S~S~' L ..... 1- .... : ...... wm excess fill be removed from vremises' ----vt; ~-'~f^~
14. ,,m.e m~awner o~prem~ses .°7.:-¢.~f/~. {F~..q(a- aaa,-,~?4~o/~-,x,.z,~/,~,, ,.,,.
M .... ,v , _t..~ . , ........... ~.,.~-oo ................... Fnone No'.~.
......................... Address ............ Phone N
Name of Contractor· ' '
........ i .............. Address ..... ., ........ ' .....Phone No ..............
15. Is this property within 300 feet ~'f'a tidal wetland? Yes ........ No ......... ''
· If yes, Southold ~own Trustees Permit may be required.
PLOT DIAGRAM'
Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate ail set-back dimensions from
property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
interior or corner lot.
TATE OF NEW Yc~l~
'oum'¥ OF ...... s.S
........................ ' .... :.l.n ................ being duly sworn, deposes and says that he is the applicant
(Name of individual signin~ contract)
bore named· ,
e is the ...: .................... , ..... ~,~-.~ .............................
J (Contractor agent corporate officer ) ...........................
I , , , etc.
· said owner or owners, and is duly a'uthorized to perform or have performed the said work and to make and file this
~plication; that all statements contmnad in this application are trne to the best of his knowledge and belief; and that the
vrk will be performed in tim manner s4t forth in the application filed therewith.
vorn to before me this
HEALTH DEPARTMENT- DATA FOR APPROV~L TO CONSTRUCT
TEL
NOTE. /~ :STAKE ·: MONUMENT
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK
OF SUFFOLK COUNTY ON JUNE ~1,1990AS FILENO. 8963.
SURVEY FOR
GEORGE J. FLAIG 8~ JUDITH A. FLAIG
LOT NO.I, "WOLF PIT POND ESTATES"
AT MATTITU CK
TO'WN OF SOUTHOLD
SUFFOLK COUNTY, NEV/ YORK
CERTIFIED
GEORGE
JUDITH
CHICAGC
YOUNG s YOUNG
ALDEN WYOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N Y.S LICENSE NO 128~
~ ~, o~,
/o o su Y for
~z~ ~ GEORGE J. FLAIG ~ JUDITH A. FLAIG
.... FEB 3~ 1992
~ 0~ ~- / LOT NO. I, WOLF PIT POND ESTATES OCT 17, [991
AT MATTITOCK 'D~T[. OCT. 8, 1991
~N ~ SOUTHOLD SC~L[- I"= I00~
SUFFOLK COUNTY, NEW ~RK ~0 9~- 0~54
su~v[~ ~ · v~o~ ~ S[CT~O~ ~ZO~ ~ ~ GEORGE J F~TM , '~ ~
NEW YO*K STAT[ E~CATION LAW .JUDITH A.~I'~ rO~
NOTE: ~ =STAKE I = MONUMENT ALDEN WYOUNG, PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK
OF SUFFOLK COUNTY ON JUNE ~l, ~90AS FILENO. 8963. ANDLANO SURVEYORNY. S UC/NS/ NO 12845
HOWARO W. YOUNG~ LAND SURVEYOR
~ ~ ~(~),~mC T*~(S~)m C[~S(~) ~M ~ N Y S LICENSE NO 4589)
SRANDIS & SONS INC.
8%~ #
115~:)#~
LOCATION MAP
SCALE, I" = 600'
, SCEN lC & '~
CONC. PAD
NATURAL
VE. GETATION
PAD
S.[8 40 II
NATURAL
557,69'
VEGETATION
200'
~.°~' A\ ~c,.
5,007--~
PROPERTY
ROAD
LINE
TYPICAL PLOT FLAN TYPICAL WELL DE