The URL can be used to link to this page

Home My WebLink About19929-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19951 Date JUNE 6, 1991 THIS CERTIFIES that the buildin~ Location of Propert~ 280 WICK~AM AVENUE House No. County Tax Map No. 1000 Section 140 Subdivision ACCESSORY Street Block 3 Filed Map No. MATTITUCK, N.Y. Hamlet Lot Lot No. conforms subs'tantially to the Application for Building Permit heretofore filed in this office dated_JUNE 5, 1991 _pursuant to which Building Permit No. i9929-Z dated JUNE 6, i991 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 GAZEBO IN REAR YARD AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A . DOROTHY SULLIVAN Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ' ............... ~..-~...~....? ............ V~ ..... :'~'"'":"T? ............ ?~ ............... ~' ........ :";~'"'"W ................... ie I t ~ /_~c[/~ . at prems s oca ed at ..................................... ~..~ .......... ~..~..~... .................. County Tox Map No. 1000 Section ..... .]...~....O.. ........ Block ....... .(~....~ ..... Lot No ...... )...~. ............. pursuant to application dated ..... ...~.....~... ....................., 19.c~.1..., and approved by the Building Inspector. Fee $.~: ................... Rev. 6/30/80 Form No. 6 TOWN OF SOUTflOLD 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 fellQwing: 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archiuect or engineer responsible for the building. 6. Submi~ 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. i. Fees 1. Certificate of Occupancy - New dwelling $25.00~2Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool ~ 5.00, 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 June ¥. 1991 Date .................................. ew Construction ........... Old Or Pre-existing Boiiding ................. ocation of Property 280 WICKHAM AVE. MATTITUCK, ~.; ....... House No. Street Hamlet · ~wer or Owners of Property SULLIVAN DOROTHY A. ~unty Tax Map No 1000 Section ~40 3 |4 , ............. Block ................ Lot ....... ~bdivision ................................. Filed Map ............ Lot ...................... - 19929-Z JUNE 6, ~99! DOROTHY SULLIVAN :rmit mo ................ Date Of Permit ......... App'licant ............. :alth Dept. Approval. . ................. Underwriters Approval anning Board Approw~l ........................ quest for: Temporary Certificate ........... Final Certicate ........... e Submitted: $ ..... 25.00 ....... DOHOTH¥ SULliVAN COt. I ¢Sl ........ ..................... FOU~___~DATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ Examined....~. :14~d~...~.~.., 19q J. Approved .... .~ .~'?~-..[~.., 19 ~ [. Permit No.l..~.cl ~.~..~. Disapproved a/c .............................. ~,. -- ~,~ (Building Inspector) NOTIFY CALL ..................... MAIL TO: APPLICATION FOR BUILDING PERMIT 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 9f 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 tttis 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 throu*ohout 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 I§ 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 6on~traction of buildings, additions or alterations, or for ~emoval or demolition, as herein described. The api~lica,nt agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit autl~di-ized~insp?tors on premises and in building for_ necessary inspections. (Signature o£ applicant, or name, if a corporanon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (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 ....... 7~..'. · . Plumber's License No. Electrician's License No. .. Other Trade's License I~o'. ,. ................... 1. Location of land on which proposed work will be done ................ ' .................... ' ............ ......... ............................ Hohs~ Nu~b~F :.~ Street Hamlet Couifty ~'ax .M~ N}o. 1000 Section ............ Block ............ Lot ................ Sdbdivisi0r{,-:l ii'ii Filed Map No. Lot ............... - _ , - ~.rame~ 2. State ex]'stihg t~se and occupancy of premises and intended use and occupancy of proposed construction: a Exist ng use and occupancy · . ............ .......... ........................ b. Intended use and occupancy ................... i.! ...... i ...... ...' .~. ..~.. :~...a~.b.O. · ...... 3. Nature of work (check which applicable): New Building . ~...' ..... Addition .......... Alteration .......... Repair .............. Rejnloval .............. Demolition ............ Other Work ............... .~.~ (Description) 4. Estimate'd Cost ..... ' ......................... Fee ... rte be paid on fihng tins apphcatmn) 5. If dwelling, number of dwelling! units ............... Number of dwelling units on each floor ............... If garage number of cars 6. If business, commercial or mix6d occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures,, if any: Front ............... Rear .............. Depth. ............ Height Number of Stories ' Dimensions of same structure With alterations or additions: Front ................. Rear ............... D pth [ Hight N berofSt i ' e ..................... e .................. um or es Dimensions of entire new constrUction: Front ............... Rear ............... Depth ........ Nunaber of Stories ..... Height ................ ................................................. Size of lot: Front ...................... Rear ...................... Depth ..................... Date of Purchase ; Name of Former Owner Zone or use district in which promises are situated ' Does proposed construction violate any zoning law ordinance or regulation: Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises ................... Address ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Contractor Address Phone No ' 15.Is this property loc~ ted within 300 feet of a tidal wetland? *YES .... NO .... *If yes, Southold To%;~ Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from street names and indicate whether 10. I1. 12. 13. 14, property hnes. Give s{reet and block ~number or description according to deed, and show interior or corner lot. ~ APPROVED AS )TED NOTIFY BUILDING OE(~RTMENT AT 7C5 !~92 q A~TO aj PM FOR THE FOR POURED CONCRETE 2t ROUGH ~ FRAMING & PLUMBING 3. 4. FINAL CONSTRUCTION MUST STATE OF NEW YO[..., BE COMPLET~ FOR C.O COUNTY OF Suffolk . $.S ~ ALl CONSISUCIION ~HAU[ M~EI ........ ~' · ·, .................. being duly swom,~se¢~ m~ ~icant . (Name of individual signihg contract) COOES. N~ above named. ~ D~$1GN OR CONSTRUCTION ERRORS ~He is the ~qmeo~e~ ; . (Contractor, agent, corporate officer, etc.) ~ - f smd. .°wner or owners, ~d Js duly~., authorized, to perform or have performed, the said work and ~b.m~e and file this apphcat~on; that all statements continued m this application are true to the best or,knowledge and belief; and that the Work will be performed in the m~ner~set forth in the application flied therewith. Sworn to before me this S ' Nota~ Public .... ~.4~12 '~ ...... ~'' ......... (Signature of appli" '~ ~1.~ m,