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HomeMy WebLinkAbout20137-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspeotor Town Hall Southold, N.Y. C~RTIFICATE OF OCC~3PANCY No Z-23693 Date JUNE 12, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 845 ELIJAN'S LA. & 130 RAC~AEL'S RD. MATTITUCK, N.~. House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.4 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 5, 1991 ~ursuant to which Building Permit No. 20137-Z dated SEPTEMBER 12, 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 ALTERATION FOR RECREATION ROOM, BATHROOM & STORAGE ROOMS IN AN NON-HABITABLE CELLAR AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL SALLY A. GOODE N/A UNDERWRITERS CERTIFICATE NO. N-187043 - MAY 15, 1991 PLUMBERS CERTIFICATION DATED JUNE 3, 1995 - C~%LE KASRE ding Inspector Rev. 1/81 1~0nM' ~0. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 20137 Z Date Permission is hereby granted to: ....... ........ .............. ....................... ~c..~..~......~..~. .............. ~..~ ....... .~..~ ,,/~:~~...~.....~....~. ~.....7e~ at premises located at ..~...~.....~..~..~:~...~..~ ............................................................... Coun~ Tax Mop No. '000 ~¢tion .../.~.Z ........ B,~k ...... ~: ......... Lot No ..... Z'...~./. ...... pursuant to application dated ..... .~.../...~../~./.. ............................ ,19 ........ , and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOU~HOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by gypewriter 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 f~rm). 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 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. For existing buildings (prior to "pre-existing" land uses: 1. Accurate survey of prope' unusual natural or 2. 'A properly complete If a Certificate.;.,; reasons therefol ~ Fees 1. Certificate of Occ Alterations to dwe. Additions to acces~ 2. Certificate of Occu 3. Copy of Certificat~ April 9, 1957) non-~onforming uses, or buildings and 'g all property lines, streets, buildimg and zatures. ~n and a consent to.inspect signed by the applicant. ~ is denied, the Bpilding Inspector shall state the o to the applicant. ' i - New dwelling $25.00, Additions to dwelling $25.00, /25.00, Swimming pool $25.00, Accessory building $25.00, ~ilding $25.00. Businesses $50.00. on Pre-existing Building - $100.00 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 6/6/95 Date ......................................... ~ew Construction ........... Old Or Pre-existing Building ............... ~ EliJah's La Mattituck Location of Property ' House No. Street Hamlet )nw Owners of Property Sall~'.Goode ;ounty Tax Map No i000, Section. ~O8 ~ ~f ............. Block .............. Lot ................... ;ubdivision Elijah's La. Estates Filed ' 2 .................................... Map ............ Lot ...................... ................ Date Of Permit ........ Applicant ............................. lealth Dept. Approval .......................... Underwriters Approval ......................... ~lanning Board Approval ........................ eq~est for: Temporary Certificate ........... Final Certicate...~.. ...... ee Submitted: $ ...... ~..(?.~. ............. Inland Homes Inc. ' APPLICANT :~' TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 · SOUI'HOLD, N.Y. 11971 , · TOWN HALL C E RTI F I CAT ION TEL. 765-1802 "' ": Date 6/3/95 Building Permit'No. 20~57-Z Owner Sally Goode (Please print) Plumber Gale Kaske (please print) I certify that the solder used in the water supply contains less than 2/10 of 1% lead. system Sworn to before me this j/¢~c day of Notary Public, - ~---/(plumber' ~ signature) County Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY. BS JOHN STREET, NEW YORK, NEW YORK 10038 FIXTURE OUTLETS FIXTURES SWITCHES DRYERS E MOTORS RANGES OVENS OTHER APPARATUS: E R V I C A, WG OF NEUTRAL GENERAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credent~ak. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD ©? FiRE .~m=o~/.~-:~ Se;.tember 12, 1975 ~pt, t;~t,o,,.v,,.o,~/u~ 811437 ~ Z4~9 ~,,~na",' ' r, omes, Elijah Lane & Rachael lid., Ma~iZuck, L.2. ........... ~,~ .... SEptember 10, 1975 Appliance Feeder/s: 1-2#14, 2-3#8, 1-2#12 deorge Zimiinghaus 4 Park P1 , r Per ...... Town Ha{I, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 1, 1995 Ms. Sally Goode 845 Elijah's Lane Mattituck, NY 11952 **** SECOND NOTICE **** 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. (Enclosed) ** No Underwriters Certificate on file. xx The check is outdated. S25.00 No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20137-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY flAS BEEN ISSUED. ]'65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FOUND^TION .... ( 1~ t_~) FOUNDATIOU {2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FIef AL ADDITIONAL COMMENTS: FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 ~./~., ~Y TEL.: 705-1,302 xamh]cd .......... , 19 .... ~sapproved a/c ..................................... 8OAaD OF HE,\LTII . . . 3 SETS OF Pt..\NS SURVEY ......... ' ] ........ C · SEPTIC roR~l .............. CALL HAIL TO: ~ uild~Cg'~ Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. *Fids application must be completely filled in by typewriter or in ink and anbmitted to tile Building Inspector, with 3 ~ of plans, accurate plot plan to scale. Fee according to schedule. b., Hot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a deta/led description of layout of property must be drawn on the diagram which is part of this appI/- !I 1 ica -kept on the premises Such permit 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 11 have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building P~rrnit pursuant to the Iding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :ulations. for the construction of buqdings, additions or alterations, or for removal or demolition, as herein described. : applicant agree~, to comply with all applicab e laws, ordinances uildin,, co ' o · :it autliodzed inspectors on premises and in build',- r ........... ~ ~ de, henson= code, and regulations, and to a if a corporation) (Mailing address of applicant) :e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. ...... ~e of owner of premises ......................................................... , (as on tile ta?, roll or latest deed) ................. ;plicant is a corporation, signature of drily, authorized officer. ,' (Name and title of corporate, officer) nullder's~.icanse No..%~.~,t% ............... p , . lumber s Llcense No ........... : ............. Electrician's License No. Other Trade's License No...e. .................. ocation of land on which proposed work will be done .... _, ;r2 ......................... .... ~. ti. (~44~ ?.(~. · er ~' ' ....... ~; ;;; ............................................ ouse Numb r l-Iamlet .................... Lot... ., ........... .bdivision ..................................... Flied Map No, (Name) .............. Lot ............... ate existing use and OCCupancy of premises anil intended use and occupancy of proposed construction: ' .................... ,,.., '" · ; .... .:,;..;.--: .... in'ended seandoccu ancy ..... 3. Nature of work (check which a~I- . . ' Repair ..... ,, '~tJ~cab e) New gu dng · · Ad ',' · .. ~..~ . ~ ' ~ ...................... Fee ~ Irgarnge, number of ears . . .g (to be pnid on ~lim: this applicnhon) S. [fdwelling, numbero[dwelhn~ nits ............... Numberofdw~lHngulntsoneach floor 6.' II buSig~ss, commercial or mixed~ ............... ' ........ DilneHsiotls of existin~ stm.,u. ~ .~ ' ................ ' 7. j occnpancy, specify' ' ' ................... .... nature a~ld extent of each b'pe of use ......... ' ....... He,, t . . o ~, ,es, il any: Front .... . ...... Rear .............. Depth '' .......... Numl~er el Stohes ............... · .............. Dimensions of same structure wit:~ alterations or additions: Front ..................................... Dept~ ~. , S. unn~j n~j~ _,io_[ ~] . ' .................. Nnmber of Stories ....... 9. Siz~ ~ JrofStofies. . .. ~tear ............... Depth .......... . .... 0. Dar ........ · ...... . .... I. Zen.heri ~ ' .... '' ' · ' .... " ''' ~' · ' · :.' · · .j .... Name offer her Owner ...... ' ............. 4. N~e of Owner 0~~ I... J J~ j.' ..... ~.,WIll excess hll be removed from )remiscs: 'ye*~~'' ~;' Name of ArcMtec~ ........... '... · ...... ~mdress ................... N~e of C~ntractor ........... ' ............ Address ................... Phone No ........... ~ ' ' ' ' .............. Address ................... Phone No ...... ~. Is ~his property within 30 feet of a tidal wetland? *Yes ........ No... '''' , · If yes, Southold Toon Trustees Permit may be required ..... .... PLOT DIAG R~f Locate clearly ~d distinctly ~1 bfiild~gs, whether existing or proposed, and. indlcate ~1 set-back d~ensions from :ope~y lines. Give street ~d block nu~ ' tefior or comer lot. i ber or descfiptioh accord~g to deed, and show street nines and indicate whether APPRQ,VED AS NOTED 78B-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: ~. FOUNDATION ~ ~0 REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. iNSU~TION 4. FINAL CONSTRUCTION MU~T BE COMPLETE FOR C.O. ALL CONSTROCTION SHALL ME~ THE REQUIREME~ OF THE N,~ STATE CONSTRU~ON & ~ERGY CODES. N~ RES~N8IB~ FOR DESIGN OR CONSTRU~ON ERROR8 'rE oF NEW ¥..~3~P ,,J ~ ' , :] .......... being duly Sworn, deposes and says that lie is tile applicaat "-(Nalne of i~vit ual signing cofitract) : named. ~ i tile .......................... J' '~ (Contractor age/it corporate officer ................... , , , etc.) d OWner or owners, and is duly authSrized to pcrfornl or have performed tlre said Work and to make and file this at/on; that all statements contained iff this application am true to the best of his will be perforated in the manner set forth in the applicat/o, filed fl~erewith, knowledge and belief; anti that the to before me this . ,. ,. . ................. -i I