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HomeMy WebLinkAbout20076-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~{ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20554 Date FEBRUARY 27~ 1992 THIS CERTIFIES that the buildinG ALTERATION Location of Property i945 ELIJAHS LANE MATTtTUCK~ NY House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5, 1991 pursuant to which Building Permit No. 20076-Z dated AUGUST 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 isENCLOSE PORCH ADDITION TO AN EXISTING ONE-F~MIL¥ DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOHN MCDERMOTT & WIFE N/A N 221909 JANUARY 27~ 1992 N/A Rev. 1/81 ~ORlt~ NO. O 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 20076 Z Permission is hereby granted to: .../.~ ../..~.~../~.../'~. .................. ...... ~~..,..~ .~..~......~~:: ........ ~ .................................................................... ~,~-,~ o, ...~~~.... ~~....~. .............................................. County Tax Map No. 1000 Section ........ .~...~....~...... Block ....... ~ ....... Lot No ....... ..~.<../.../.. .... pursuant to application dated ...... ~5~..~.~.?.../.. .......................... , 19 ......... and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC] l[II FEB 2 6 1992 TOWN O' ~,'~ '" 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. 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. 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 - $i00.00 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 .... ....................... .... New Construction ........... Old Or Pre-ex~stin uilding ........ L, ......... .. Location of Property .............. ~. ......... .~..z.~ ...... House No. Street Hamlet Onwer or Owners of Property ...... ~..~...¢.. Z..."?7~..'~.~.'~ .... · ././.~.+.~..~/. ,-~.e..'~-~. ................ County Tax Map No 1000, Section .... /.~. ~.'. .... Block ...... ~. ........ Lot ..... Z%li ............ Subdivision .................................... Filed Map .........., . Lot ................ . .. ... Permit No. a ~. ~..~.. ~.~.~ate O f Permit....~. l¢./.~. / ..... Applicant...~.~.~ .~..~..~. (~.~ .~t?..~ .-~. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval .................. Request for: Temporary Certificate .......... . Final Certicate ....... . .. . Fee Submitted: $ ~.~ ....................... .............. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Buikling Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 JOHN MC DEP~OTT 1945 ELIJAItS LANE MATTITUCK, NY 11952 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOL] J~NUARY 17, 1992 . To Whom This May Concern: We are unable to complete your Certif because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XXX No Underwriters Certificate on file. XXX The check is ~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 ~. 20076-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS ,¥,A~',Jll,<'I~'V .~7. I")~, JOHN STREET, NEW YORK..F~.Tp~ ]ep~s, ,~ ~'~ i COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY IdANNER. 1. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: NOTIFY 765-/802 9 'AM FOLLOWINt 1. FOUNDATIOA{ 2. ROOGH 3. JNSUL.ATION ! 4, FINAL -, CON BE COl ALL CONSTRUi THE STATE CC, DF~.S. NOT 765-1802 BUILDING DEPT. INSPECTION / [~FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION 2ND ~ ~ INSULATION FRAMING ~ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [~~DATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~ J FOU~)ATION 2ND [ ] INSULATION ~ t,~'FI~MING ~ J FINAL DATE ~//3 ~/~/INSPECTOR ~ 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~NAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~SULATION [ ] FRAMING [ ] FINAL REMARKS: TITLE T '%. REVISIONS YOUNG & YOUNG JUNE//,1974~ 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK dl// Y 1974 ALDEN W. YOUNG HOWARD W. YOUNg SURVEY FOR: INLAND HOklES, /NC. ~ ~ LO7 NO. 8, "ELIdAH'S LANE ES~ MATTITUCK oo,,e :',~ONO, L~ I , s~o~ co., ~,~: J"r'~ ~ ~. ,-... -mmm, TOWNHALL IIIHI ~ - ~1 , ~ ~i 8OUTHOLD, N.Y. 11971 lU U~: ............ ~J ~,:) TEL: 765-1802 ~ppro ..... , 19~r Permit No. Disapproved a/c BOARD OF HEAL'I'll ......... '1 SETS OF PLANS .......... SURVEY ................... CIIECg ................. SEPTIC FORH ........... ~' r"& J... "~:f-~ 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 :t~ 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 c'~)mmenced 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 ~all 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 uilding 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. he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to Jmit authorized inspectors on premises and. in building for necessary inspection~.~ . /~ (Signature o~ applicant, or name, if a corporation) · .... ................. (Mailing address of applicant) tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. lame of owner of premises ....... (as on the t.a¢ roll or latest deed) :' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~ Builder's License No. Plumber s L No ........... Other Trade's License No ~;/ ,Location of land on which proposed work will be done ..................... County Tax Map No. 1000 Section...~'/.0..~/Block .....~..9. ........ Lot ..... ~..-77../.l. Subdivision ............ (Name) Filed Map No. · · ' Lot State existing use and occupancy of premisT, l and i,ntended use and occupancy of proposed conslructio~n%l' l 32 (Description) 4. Estimated Cost-... · .... Fee ... , ..... · ~ i (to be prod on fi}!~lt~[sa I ation) 5. If dwelling, number of dwelling units . ~ ...... Number of dwelling units on each floor · If garage, number of cars ..... ! .....i[ .t .... [ "' .......... 6. I..f. bus~n.ess, co.mm, erc~al or mlxe4 occupancy, specifK..nature and extent of each tv,e ,~e t,~,, (~LC--.~Ogrf_ia ' ' ' 7. la~mensto~ns of cresting stmcture~ if any. Front '~lt.~ l#t~ D -'l,~r"J.ff~,~ .... ~. ..... x'il,'~/ffl~,it ...... ~ensmns~fsame structure w~th alterations or additions: Front ~'1 1 ~' ~.~. ~;'~ '[P" ....... Dimo--: ..... ~' g ' ~ '~ ............ Number of Stones ..~ . 8 ....... n~lons~I entire new construction. Front .~ ~ ~ ' ~'' _' ' '~-Y2.~X ....... Height .~ x~ ~ ~'~ '. ~, ~ ....... ar...~,~ ...... ~ept~ ..~... lO. DateofPurchase ~ .......... ~ear..:/~:U ..... Z ..... Depth ..~ ................ Zone or use district in which pre$ises are situated .............. 12. Does proposed constructiCn violable any zonin, la~ .... ~: .... ' '.' [. ' ' ' a'[~ ......................... Will lot be reor de~ ~/~ ~ ~ --, ,~umance or regmauon: ...~ . 13... ~ . . ~[~ .... a.'p/ .... t~ · · Will excess fill~ re~0v~d, from premmes: Yes 14. m~e oI Owner of premises . ~h[...[~~Address .. ~.. ~'1~ . Phone No ................ Nme of Architect ...... ~ ............ Address ~ .... Phone No. ~... N~e of Contractor ..~. "" ' ' ..... ~ .... ............ Address. [~l'~ . Pho NO ........ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ ' ~ ....... · If yes, Southold Tdwn Trustees Permit may be required. No ......... PLOT DIAG~ Locate clearly and distinctly ~1 ~uild~gs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from prope~y Hnes. Give street ~d block n~er~ d~sgfiptio' accord~ to deed a · · ~ntenor or comer lot. * g , nd show street n~es and ~nd~cate whether ,TATE ~F NETWORK ibe -1 :ou y oF.. s.s ........... ~ B..~ .~.e~0.~ ........ ,.. ing duly sworn, deposes and says that he is the applicant >ore named(Name of individual signing ~ontract) e is the ....................... ~ .................................. .~ ............................ ~ (Contractor, agent, corporate officer, etc.) said owner or owners, ~d is duly a~tborized to perfom or have perforated the said work and to m~e and file this ~plication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the ork will be perfomed in the m~ner set~ forth in tlte ~pplication filed therewith. yom to before me tiffs >ta~ Public .......... County + :/12s30. s.,¥~ e~u,,~ i (Signatu~ of applicant) ~mm, Expffos~O, 1~O i Nature ofw (check which applicable): New Building .......... Addition .......... Alteration Repau' .., ,~N ........ RemOval .............. Demolition .............. Other Work .(O..t~..