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Home My WebLink About20131-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24055 Date DECEMBER 1, 1995 THIS CERTIFIES that the buildin~ Location of Property 790 BAY AVENUE MATTITU~K NY House No. Street Hamlet County Tax Map No. 1000 Section 143 Block 3 Lot 14 Subdivision Filed Map No. Lot No. ADDITION & ALTERATION conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 4, 1991 ~ursuant to which Building Permit No. 20131-Z dated SEPTEMBER 9, 1991 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 AN ADDITION AND ~JuTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. JOSEPH (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N212945 NOVEMBER 13, 1991 PLUMBERS CERTIFICATION DATED NOVEMBER 12, 1991 MATTITUCK PLL~4B & HEAT Rev. 1/81 l~m~ NO. It 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) NE 20131 Z Permission is hereby granted~to: _ _ _ ,~ / , _ ............ .d~....~.~..~ ...................................... ,o.~~......~ ...... ~~...~.....~/.~..~.:..~....~ ............ .~/~.~.....~..~..~...~ ~..~.~.....~~....~.~..~..~ ........... at premises located at .........~..,~...~. ....... ~...~....~ ................................................................. County Tax Map No. 1000 Section ..... .~...,~.....'~.. ...... Block ........... .."~... ..... Lot No ..... .,(..../.... ........ pursuant to application dated ..... ~./.~... ....................................... , 19.~./.., and approved by the Building Inspector, Rev. 6/30/80 Form No. 6 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN ~LL 765-1802 FOR CERTIFICATE OF 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. 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 statemen~ from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Cormmercial 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 ~oard Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Ppre-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 yriting to the applicant. C.'.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 $25.0.0, 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 $15.00 Onwer or Owners of Property ............. ~~ ~ ................................. . ./..¢?.. .... County Tax Map No 1000~ Section.. .Blo . . Subdivision .................................... Filed Map ............ Lot ...................... Permit No .... Da e Of Permit... ~ .Applicant. .. ...... · .~ ............... Underwriters Approval ......................... Health Dept. Approval Planning Board Approval ..../\/z~ ............... Request for. Temporary Certificate ........... Final Certicate... Fee~c'~Submitted:'~f'>C/~-~$ ............................. . .~-~./~..~~ ..... . ............. APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~?~l~O'~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date ~{¥/]g]~ ~i ') ~ ~q'~' Application No. on file ~7~1)~J9~/<~j ~ ~ ~9~ THIS CERTIFIES THAT oR~y the elect~caJ equipment ~ ~scrlb~ beJow a~ ~ntroduc~ by the applicant ~med on the a~ve application number in the prem~es of in thefollowlng Iocatlon; ~ Basement ~ Ist FI. ~ 2nd ~. Section Bl~k Lot ~s examined on ~{(~ ~'{~"~1 ~ (~[( 0 ?~, ~ ~)~)~1 and found to be ln compllance ~.it. hthereqttire.~e~ts~fthlsBo~rd. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES ~LUORESC~NT OT~ER DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS; E R V I C NO. AWG OF CC. COND AW.G, OF HI-LEO NO OF NEUTRALS A. WG OF NEUTRAL GENERAL MANAGER!iii This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials, , COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERT!,~ICATE MUST NOT BE ALTERED IN ANY klANNER,o' TOWN OF SOUTHOLD OFFICE-O~BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 CERTIFICATION ~TEL 76 -1802 Date Building Permit NO. O~,ner.. '~+0~ (please print) (please print) I certify that the solder used contains less than 2/10 of 1% lead.. Sworn to before me this ~ ~1,..: Notary Public in the water supply systen County 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] IN~.~)N [/,,,,}-*FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROU/GH PLBG. / FOUNDATION 2ND [r-)z'INSU~TION FRAMING [ ] FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [/~I~UGH PLBG. FOUNDATION 2ND [ ] INSULATION [ - F~F~MING [~] FINAL DATE /'~ .- INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [~]~FO.~UNDATION 1ST []ROUGH PLBG. [,/~ FOUNDATION ZND []INSULATION [ ] FRAMING []FINAL REMARKS: ~ FOUNDATION --...(lst), _ FOUNDATION 2. (2nd~ ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: / ,/ Examined S£P - 11991 ......... , FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... BOARD OF HEALTIt f~ ..:.. CllECK .................... SEPTLC FORH .............. NOTI FY ~ CALL HAIL TO: APPLICATION FOR BUILDING PERMIT D~te " 19 -- INSTRUCTIONS a: Tlfis 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- zation. c. 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 shall be occnpied or used in whole or in part for any purpose whatever until a Certificate of Occupancy .halt 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, New York, and other applicable Laws, Ordinances or ~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with ail applicable laws, ordinances, buil~ling code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. AMERICAN EXTERIORS Box 657 MATTITUCK, NY 11952 (016) ,~08,'~6~5 (Signature oi' applicant, or name, if a corporation) ................... d.g.7. . . ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · Name of owner of premises...,.. ,, ~.Q~-I~. .... .~0~ ~. I1 Igl'..1~ [.k~ ~ [.~. .............................. :', ~ . ' . (as on the t,m( roll or latest deed) If applicant is a corporation, ~signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... 'S.~'..~ .~....B.~.~...l... Plumber's License No. '~. ....................... Electrician's License No ....................... IIouse Number Street County Tax Map No. 1000 Section ..... Other Trade's License No ...................... Location of land on which proposed work will be done. ~'~ ~.~ 'gVC ~- Hamlet ...... Block .4. .................. Lot /.. ¢ ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and Occupancy of premises and intended use and occupancy of proposed construction: a. E isting use and occupancy .......... .l'iTI .......... .................................. b. Intended use and occupancy ............ - .I 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Remqval ............ Demolition ,. ............ Other Work ................ ioo ....... ,, · ~. · ~i ' "' (Description) 4. Est/mated Cost .... -,Sj.b.~O...0. i ........................ Fee .... i (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 ' II' busine'ss ..... · ................................................................... · , commercial or mixed occupancy specify nature and extent of each type of use . Dimensions of existing structure~ if any: Front Rear Height Num b'er of Stories ............................. Depth ............... ............... wiih ........................................................ Dimensions of same structure alterations or additions: Front ................. Rear .................. Depth .................... !. Height ....... ~,.....: H ~.,~, ..... Number of Stories ........ 8. Dimensions of entire new construction. Front ~7.. 7'~ ."Z..?. Rear .............. Height .../0.~e ........ Number of'Storiesii..lil.. ' 9. Size of lot' Front ............ Depth ..... I0. Date of Purchase ......... Zone or use distric- ' ,'.',' ' "!'. ....... . .....' ....Na..~m~e o~f..Fo...rtF, ciO. ~oer .~/~t~ .~..~..~.~.~'~]~[j~J ........ l l. -- [ In WlllCn premises are simatea ..... ;Me; .~.l.O .~]9..'1~ (..~-.~.. ..... 12. Does proposed construction violate any zoning law, ordin~n-ce or regulation . 13. Will lot be regraded ......... ; ...... 2'fl .... Will exc~es~s fill ~ ~;£.m. °~ed fr-~°m premises: 14. Name of Owner of premises ~]j~'4:~ltf...~/)~V~e&6ddress Phone No. ffd Name of Architect I ' ·. · · ,- ........... . ................ Address ........ Phone No. Name of Contractor i ......................... .......... , ......... Address . Phone No .............. '.. 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Tgwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ~uildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block nun~ber or descriptioh according to deed, and show street names and indicate whether interior or coruer lot. APOROV,,ED AS NOI'ED 765~1802 9 AM FOLLOWING INSPECTIONS: 1. FOUNDATION ~O R~QUIR~D FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSU~TION 4, FINAL CONSTRU~ON MU~ BE COM~ FOR C.O. ALL CON8TRU~ON 8~ ME~ THE REQUIREME~ OF' ~E N.~ S~TE CONS~U~ON & ~ERGY CODES. N~ RES~NEIB~ DESIGN OR ~N~U~ON ERRORS ;TATE OF NEW YORK, S.~ :OUNTY OF ................. ............................... 1 .............. b lng duly swor depo d ys that h is the applicant ..... , .... e n, scs an sa e (Name of individual slgmn§ contract) bore nan]ed. is the ........................ ~ ................................................................. i (Contractor, agent, corporate officer, etc.) said owner or owners and is duly ~uthorized to perform or have performed the said Work and io make and file this phcatmn; that all statements contained m this application are true to the best of his knowledge and belief; and that the 'or~ will be perfo~ed in the m~ner s~t forth in the application filed therewith. ~om ~o before me this