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Home My WebLink About20212-zFORM NO. 4 ToWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20293 Date OCTOBER 21, 1991 THIS CERTIFIES that the buildin~ Location of Property 450 SALTAIRE WAY House No. County Tax Map No. 1000 Section 100 Subdivision ADDITION MATTITUCK, N.Y. Street Hamlet Block 1 Lot 37 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 16, 1991 pursuant to which Building Permit No. 20212-Z dated OCTOBER 18~ 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 REPLACE & E~GE EXISTING DECK ADDITION TO ONE FAMILY The certificate is issued to DWELLING AS APPLIED FOR. WILLIAM P. ENGLIS~ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ·//uilding Inspector /O~,M NO. I TO~VN 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°- 20212 Z pursuant to application dated ....~.~..?//.x~. ................................. , Building Inspector. Permission is hereby granted to: . ~. ,,~ ~ .......... .......... ........ '~z"~;'""~' .... ~'"'i - // ...... /.....,,.~..,. ................... ._.,.?~, ............. .: ...... ~ , , ,~ , ~o .~,~...~~...~...~~....~....~.~.......~ ~......~.......~.~....~,~&,...'~...~....,~....< ...... ~ ~,,~,~.~ ......... ~ .............. ~~~.....~~i .... 7 .................. c~ ,~ ~p ~o. ~ooo s,~,o~ ....... Z~..~ ..... ~k ......... ~ ......... tot uo ....... ~.~ ..... 19.~/and appr~ by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN 1tALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted inspector with the following: 1. for new building or new use: Final survey of property with accurate location of all buildings, prc 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 i% 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. 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 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 ~.. Date..../.~.~.~.~..~. .... Xew Construction ........ Old Or Pre-existing Building ................ Location of Property...~J~. ......... ~?.~ ..... 7~.~...~. ........ ~.~.~. House No. Street Hamlet Onwer Owners of Property~/~ ~'. County Tax Map No 1000, Section.~.~ ....... Block .... ~. .......... Lot..~[~ ................ Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval ......... App ............... Underwriters roval .......... Planning Board Approval ................ Request for: Temporary Certificate ........... Final Certicate ........ Fee Submitted: $,. ....... ~ :-.., ,-~_. ............ · ........ CO-~ c~ 0~,~ ~,~ APPLICANT NOTE=I = MONUMENT SUBDIVISION PLAN FILEO IN THE ' OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AUG.:5~ 1966 AS MAP NO.4s~Z SURVEY FOR TIMBERLAND ASSOCIATES, INC. LOT 54 "SALTAIRE ESTATES" MATTITUCK TOWN OF SOU,THOLO SUFF. CO., N.Y. SCALE ~ 1"=40t SEPT. 29, 1967 MAR. 22, 1968, SEPT. 4 ~ 1968 dUNE 19, 1969 GUARANTEED TO~ THENORTH FORK BANK ~ TRUST CO. GUARANTEED TITLE DIVISION OF A~C.~AN TJ~J~.F,,,INSURANCE CO. PROFESSI'O/~ ENG~ER AND RIVE RHEAD~ N.Y. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ./.~/./.~. ........ , 19'~./. Approv&d.. ~./ff...~. ....... 19 ¢~. Permit No. '~' ' '~../.?J Disapproved a/c ..................................... INSTRUCTIONS BOARD OF HEALTtl ......... 3 gETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL ................... HAIL TO: Date ......... : ........ ,19... 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. 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 occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy .hall liave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding 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. D~e applicant 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. .... .................. - ' (Signature of applicant, or n~me, if a corporation) · ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner ofpremises~//./~ff,4t ./'~- ~'/ ff/~.~,z~,~/~/~ ~, ~_z~./k/~/~/~..~ ' (as on the tax roll or latest deed) If 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 which proposed work will be done ~./5'- ~ ~/ ~..~/.L~./2/,,~5~- ~-~"~;5 Y-J7 /-~r'~r:.,~%' · -'/4)q. .............. ............... ................. llouse Number Street Hamlet County Tax Map No. 1000 Section /~ ~ Block ~ Lot ,. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~../~. , , , ... b. Intended use and occu ..-~...~d ~ /j./4{ d~_/ ~ .' - ,: pancy ...,',,c~.'".-..'-7w:..../...'-7..'."r-:'-~ .............. , . ., 3. Nature of work (check which applicable): New Building .......... Addition /~"'~ A/teration ...'..' ..... Repair .............. Rerqoval .............. Demolition ....... . ....... Other Work ............... 5 If dwelling number of dwelling! units (to be paid on filing this application) · ' ............... Number of dwelling units on each floor If garage number of cars ' ................ 6 ' Ifbusine'ss ' ................................................................... · , commercial or mixed occupancy specify nature and extent of each type of use 7 Dimensions of existing structures If any: FrOnt ................ Rear .............. Depth ............... _H.eight Number of Stories ..... . Dunens~ons of same structure w~th alterations or additions Front ................................ Depth i ............... Height Rear ................. 8 ................................. Number of Stories · Dimensions of entire new construction: Front ....................... Height Number of Stories ............... Rear ............... Depth ............... 9 Size ofl;~: ............. ' ...................................................... · Front ........... l .......... Rear 10 DateofPurchase / ....................... Depth .. ..................... · ' ............................ Name of Former Owner 1 1. Zone or use district in which prqmises are situated ............................. 12. D°es pr°p°sed c°nstruction viol?re any zoning law, ordinance or regulation: .................. i ............... 13. Will lot be regraded ' ' · ....... Will excess fill be removed from premises: Yes No 14. Nmne of Owner of premises ...i ................. Address ................... Phone No ............... Name of Architect .......... i ............... Address ' ~ ' ' · .................. Phone No ............... Name of Contractor ......... : ................. Address ................... Phone No ......... · ....... 15; Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold ~own Trustees Permit may be required. ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fron property lines. Give street and block number or descriptioh according to deed, and show street names and indicate whethe interior or comer lot. --- NOTIFY BUIL.DI 765-1802 9 Al FOr. LOWING IN I. FOUNDATi FOR POURE£ 2 ROUGH- 3. INSULATION 4, FINAL rrlE~ ALL ED AS NOTED i DEPARTMENT AT ~ 4 PM FOR ~HE '~OREQUIRED ~7 ~ ~ ~1~' iNSTRUCTION MUST FOR C.O. THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS TATE OF NEW YORK, 'OUNTY OF .... ' .... , · ..a~. '~ ................ being duly sworn, deposes and says that he is the npplicant' (Name of individual signing! contract) hove named. e is the ......... · i (Co 'cto ................................................. ntra r, agent, corporate officer, etc.) ' said owner or owners, and is duly a~thorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that4he ork will be performed in the manner salt forth in the application filed therewith· ,/om to before me this Notary Pub/lo, State of New York ' · ............... No, 4951384 ! (Signature of applicant) Qualified In Suffolk Coon Commiss,on EXpires Malt 22, ~t~