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Home My WebLink About19518-zFORM NO.' 4 TOWN OF SOUTHOLD BUILDING DEPART~igNT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21067 Date OCTOBER 7~ 1992 THIS CERTIFIES that the building Location of Property 460 PADDOCK WAY House No. County Tax Map No. 1000 Section 107 Subdivision ALTERATION MATTITUCK, N.Y. Street Hamlet Block 4 Lot 2,11 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER '6, 1990 pursuant to which Building Permit No. 19518-Z dated NOVEMBER 16, 1990 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 TO THE INTERIOR OF AN EXISTING AGRICULTURBJ5 STRUCTURE AS APPLIED FOR. The certificate is issued to ALLEN & CHARLOTTE DICKERSON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~ILTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED M/A Rev. 1/81 IPOR~ NO. ~B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N, Y. BUILDING PERJ~IT (THIS PEI;b~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~- 19518 Z County Tax Map No. 1000 Section .... /....O,,..7, ......... Block .....,,(~..,.,~,, ....... Lot No.....,~,,,,.;..,/,~ ........ pursuant to application dated ...~..~~.....~. ................ , 19..~.~.., and approved by the Building Inspector. Fee $ ...~:).'~...:....'~. '~' ~e'~B~ding Inspector Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 : APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 ail 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 f{om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% lead. $. Commercial building, industrial building, multiple residences an~ 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. ' B. 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 an~ '~ 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. 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. Cer.tificate 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. T~mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 'ew ConJtruction .... .~....: Old Or Pre-existi~g Building ...... Hamlet ' awer or Owners of Property.. .~ · . ~un:y Tax Map No lO00, Section...l.~.7 ...... Block ..... .~..4. ...... Lot ......... : .... ~ ~' %w\OuC · V% ~ .... Lot ...................... App i " 'alth Dept. royal ......................... Underwriters Approval ...... ~ ............... arming Board Approval ........................ quest fo~: Temporary Certificate ........... Final Certicate .... .~. ..... FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: >_ o i.__ ¥ N-' lx ~ 00 < N t co o ~r'r' II ~0~ FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOU THQIJ3,,. ~,.L'¢. 1.tg7 TEL,: 765-1802 Examined Disapproved a]c ..................... . ~..g.,,,~..~.. (Building Inspector) APPLICATION FOR BUILDINGPERMIT INSTRUCTIONS BOARD OF HEALTH ...... 3 SETS OF PLANS .... SURVey ,. oo CA~.L . ..~Y.~:.~.q~. ......... MAIL TO: Date . ~rq/'. ......... · . a. Tiffs application must be completely filled in by typewriter or in ink find submitted to the Building I~pcCtnr, with sets of plnne, aCCUrat~ plot plan to scale. Dee according to scheduIe. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of liqyout of property must be drawn on the diagram which is par~ of this appl cation. o. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of tliis application, the Building Inspector will issued a Building Permit to the applicant. Such perm: shall 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 a.ny purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for i:emoval or demolition, as herein described The applicant agrees to compl · admit authorized inspectors ~ State whdther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. tax roll o(fi~est;d e )-:: -; ' -- - If applicant is a corporation, signature of duly authorized officer. all applicabqe laws, ordinances, building m"ute, housing code, and re~,u ' · ''·.. i .....~V~. ~,, ,~U~.~.L~----- (Signature ot &pplicant, or n~'n~e, if'a'c'o~-t;o'r:;tic~n75 · (Mailing addres oe 7 T .......... BE COMPLETE FOFg ALL CONSTHUCTION SHALL M~ET ~HE REQUIHEMENTS OF THE S~TE CONSTRUCTION & ENF'RGY COOES. NOT' RESPONSIBLE FOR I. Location of land on,high proposed work ,.~ili be 4one; DESIGNORCONSTRUCTION ERRORS Ilouse Number [r~"~ t,' .....r ................ · ........... Hamlet · · /.,o. ' oan,yTa.,,,,ap . .,OOOS c,,on ..... ..... : B,oc ..... 0..4:.?? ...... ..... _ (N:une) .............. Lot ... J ~ :. ~tZte existing use and occupancy of premises and intended u~ .... ,~ ~ - ......... ~ /~ ..... ,'~ ~c,CUpanc;y of proposed construction: A. Ex±sting use and occupancy ........... /~.~ )r! ~ ..~ '-~(A¢,'", [ B. Intended use and occupancy ............... ~..~'.q~c[C_O~.7~/'/l{ 3. Nature of work (check which applicable): New Building .......... A · .~.~'. ..... Repair .............. R~moval ............ ;. Dcmqli~.ion , .. 4. Estimated Cost ......... ~q: ...................... Fee.. ~ lication~ f dwellm~, number of dwelhng ~mts ................. Number of dw ...... ~ara,e. number of cars ..... ,~q ~ ~C.~f~..~4~ ................................. 6. If business, commercial or mixed odcupancy, specify natu're and extent of each type of use · ~ ............ 7. Dimensions of e5isti~g stmCture~, if any: Front.., ...~9 ....... Rear ...... ~.... ~... Depth .... $~.... Hemht ...... ~ .... Number of Stories , ~ .......... ' Dimensions of same structure with alteration~ or additiops: Front . ...~ ........ Rearj..~ ....... Depth ....... ~ .......... ~.. }Icier ....... ~ .......... ~. N~'mber of Stories .... ¢~Q ..... ~.... 8. Dimensions of entire new constdmtion: Front .... ~[.& ....... Rear .. fT. .......... Depth ~ ........ Height ...... ~ ....... ~umber of Stories ........ ~ .... : .... -.. a~.. ~ .... ~ ......... ' ........... 12. Does proposed construction violate any zoning law, ordinande or regulation{ ..... ~q ......... Nme of Architect ~' Address ~. Phone No N~e of Contractor ......... ' .~.. ' . .. Address ........ 7~ ......... Phone No..,0~) .......... · If yes, Southold Towh Trustees Permit may be required. PLOT DIAG~M Locat~ cle~ly ~d dist~ctly MI~ bulldogs, whether existing or proposed, ~d. indicatc ~l set-back prop~y Hnes. Give street ~d block,number or descHption accord~g to deed, ~d show streci n~es and ~dica~e STATE OF NEIV YORK, COUNTY OF ................. above named. sworn, deposes and says that he is the applies:: H-e is the ..................... ...................... : ............................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe,rform or bare performed tim said work and to make and file th~ application: that all statelnents coniained in this application are true to the best of his knowledge and belief;and that work will be performed in the manner set forth in the application filed therewith. Sworn to before me this tary Publ.c .......... ff~;'l;I, II .... County : ROY H. N~taty Public, State o~ New eo~nmis~o~ ~xpf~., ~ t~,~- (Signature of applicant L .f %00~ 98'9~ = '/3'1. 9'ON '8'0 6'6E /.'~ = 98'9g = .,. ' G 'ON ~.'~. '1 q H£d3