HomeMy WebLinkAbout19561-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19559 Date DECEMBER 5~ 1990
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 1450 WICKHAM AVENUE
House No. Street
County Tax Map No. 1000 Section 139 Block ~
Subdivision Filed Map No.
MATTITUCK, NEW YOR_K
Hamlet
Lot 47
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 3, 1990
Building Permit No. 19561-Z
pursuant to which
dated DECEMBER 4, 1990
was issued, and conforms to all of the requirements of %he applicable
provisions of the law. The occupancy for which this certificate is
issued is EXISTING ACCESSORY STORAGE STRUCTURE AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid buildinq.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
PETER & CYNTHIA WADELTON
Bualdlng Inspector
Rev. 1/81
i~O~3J[ NO. ~
TOWN O~ $OUTHOLD
BUILDING D£PARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PER, MIT
(THIS PERMIT MUST BE KEPT ON THE PREM]SES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No- 19561 Z
Permission is hereby granted to:
...~...~..~...~.~:~.....~,,.~.....~., .~
,.....%.~..~. ..... ~,~' ' .-..'..~ ............................................
.....~.~.~ .... ..~..:~... .... ,..~..~..~.~ ........
.,~.~.~.~,~..~.~.~ ....................... , ..... ~...~ ......... ~ ................ ~ ............... ?.~ ..... ..;. ..........
~,,r,~,,,,,~,,~ ~, ...L~.~ ..... .~.~~.~~...:. ........ ~.~.~ ........
County Tax Map No. 1000 Section .... J....~.~. ........ Block ...... ..~.....~.., ...... Lot No ...... ..~..7.. ...........
pursuant to application doted ~.'i.'."~,~g.~.....~.. · ..... ~ .......... , lO..?...~,., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
December 2, 1990
BLDG.
TOWN OF so._uq?~ot
Southold Town Building Dept.
Main Road
Southold, New York 11971
RE: Application for Certificate of Occupancy
Premises: 1450 (fmly 1370) Wickham Ave.
Mattituck, New York
SCTM# lO00-139.00-03.00-Lot 047.000
Sirs/Madam:
In connection with my client's application for a Certificate
of Occupancy for a shed on the above premises, I have enclosed the
following:
1. Application for Building Permit
2. Application for Certificate of Occupancy
3. Consent to Inspection
4. Survey dated 6/26/80 showin~ shed
5. $50.00 fee for building permit and C.O. (ck #4664)
I have also enclosed check #4665 in the amount of $50.00 to
obtain an amended Certificate of Occupancy. Please amend Certificate of
Occupancy No. Z 1016(cop¥ attached) to include ~the detached ga_r_age ....
Please advise me if there is anything further you need to obtain
the above.
Don~d M. McGayhey
DM~: sgm
encs.
TOWN O~$OUT~OLO, --
APPI.,IOATIO~ ['OF, CERTTFIOATI;: OF 0CCUPAHC'Y
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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.
]. 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
11/19/90
Date ................................. .. .. ... .
~ew Construction ........... Old Or Pre-existing Building .......... . ....- .
,ocation of Property..%~9 (~y,1370)Wickham Ave.~ Mattituck, New York House No. Street Hamlet
Peter B Wadelton and Cynthia L Wadelton
,nwer or Owners of Property ...... ' . ' '
;ounty Tax Map No 1000, Section.~.'PP. ...... Block..PP;9? ......... Lot.9~:999 ..............
,ubdivision ...................... Filed Map Lot
'ermit No Date Of Permit Applicant
'ealth Dept Approval Underwriters Approval
lanning Board Approval ........................
equest for: Temporary Certificate ........... Final Certicate .... ~ ......
APPLICANT
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-19560
Date DECEMBER 5, 1990
THIS CERTIFIES that the building.
Location of Property 1450 WICKHAMAVE.
House No.
County Tax Map No. 1000 Section 139
Subdivision
ONE FAMILY DWELLING
Street
Block 3
Filed Map No.
MATTITUCK, NEW YORK
Hamlet
Lot 47
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 18, 1960 pursuant to which
Building Permit No. i180-Z dated SEPTEMBER 23~ 1960
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 ONE FAMILY DWELLING WITH DETACHED GARAGE *
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
PETER B. & CYNTHIA L. WADELTON
*THIS CO UPDATES CO Z-1016 DATED MARCH 15, i961.
Bui lng Inspector
Rev. 1/81
Form No. 6 , i~: ~ ~ ~ ~
APPLICATION FOR CERTIFICATE OF OCCUEANCY
TOkrN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN RALL
765-1802
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.
J · 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 .... ....................... .. .. .
~ew Construction Old Or Pre existing Building -
,ocation of Property 1.4..5.0 (f.,.l.ly !3..793 Wickham Ave., Mattituck .New .Y.o,r.~ House No. Street Hamlet
Inwer or Owners of Property..P.e.t.e.r.B. Wadelton and Cynthia L. Wa.d.e.lto. n.
~ounty Tax Map No 1000, Section..1.3.9...0.0. .... Block..0.3..0.0 Lot 047.000
,ubdivision .................................. - . Filed Map ............ Lot ..................... .
'ermit No Date Of Permit Applicant
[ealth Dept. Approval ...................... .... Underwriters Approval...~ .....................
lanning Board Approval ................. .... ...
equest for: Temporary Certificate ........ ... Final Certicate .... ~ ......
APPLICANT
FOUNDATION ( 1 st)
FOUNDATION (2nd)
ROUGH FRAME &
.PLUMBING
INSULATION FERN.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF soUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHQL.~.. L~L,¥. Ltq7 'L
TEL.: 765.1802
Approve ..... 19~P. Pc~it No..I.~.1.
Disapproved ale .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
CIIECK ....................
SEPTIC FORH ..............
CALL ...................
MAIL TO:
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to thc Building I~p~_ctor, wi. ti
sets of pl~nn, :u:curata plot plan to scale. ~ according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strc:
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is parr of th.is apl:
cation.
c. The ~vork covered by th/s application may not be commenced before issuance of Building Permit.
si. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perrr
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 m3y purpose whatever until a Certificate of Occupant
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pu.'xuant to t.~
Building Zone Ordinance of the Town of Southold. Suffolk County. New York, and other applicable Laws. Ordinances r
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describm
The applicant agrees to comply with all applicab"le laws, ordinances, building code, housin~ code, and regulations, and t
admit authohzed, i.nspectoz~ on premises and in building for necessary inspectionS. ,' / / ,,f /
. . (Signatur~'of applicant, or name, if a corporanon)
(Mailin~ address of applicant)
State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Owner
Peter B Wadelton' and Cvnthia/Wadelton
Name of owner of premises '
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
· ~ame =nd title of co';rate
Builder's License No ...........................
Plmnber's License No .........................
Electric an s L cease No .......................
Other Trade's License No
1. Location of land on which proposed work will be done;
1450 (fmly 1370) Wickham Avenue., Mattituck, New York
House Number' Street .............................
Hmnlet
County Tax Map No. 1000 Section 1.39 . .. ' Block 03.)0 .. Lo~ 047. 000 ,'
Subdivision ..................................... Filed Map No. . ....... Lot ..
(Name)
2. St;ut existing .se and occupancy of premises and intended use and occupancy of proposed construction:
A Existing use and occupancy .........
Accessory Structure (Existing)
B Intended use and occupancy ......
3. Nature of work (check which a cable: New Building .......... Addition ......... ,'alteration ....... ~..
Repair' Rbmfval Demolition Swinuaing pool.
Tennis Court ......... IAecessory Building ~i Other
i ......... Fence ....... Work; .........
4. E~timated Cost ........... · ~ ......................... Fee ....$.~, 9P ...........................
,i (La hc paid on filing this a~plication)
S If dwelling number ofdwcliing;units Number of dwelling units on each floor
If garage number of cars '
6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ....................
7. Dimensions of exm~,~ ..F[ont . . , ............ Rear .......... Depth ........
Dimensions of same stmctur~ w.~th affl~tmns or additions: Front ..... ~ ..... Rear ..........
Depth .......... ~ ~.. ~ }Ief~t .......... Number of Stories .....
8. Dimensions of criterion Uon.,Front Rear ..............
............. ~umber oP StoNes
........... , .... Rear .5~.A3 ...............
10. DateofPurchase .~/yp~4...i222[f2 ........ Name of Fo~er Owner V
1 I. Zone or use district in which pr~mises are situated
12. Does proposed construction vioiate any zoning law ordinance
, or regulation: ............................ · .-
13. WHllot berenraded . . i '
14. N~e of O,v~cr Of pre~ey~?E::; ......... .J' ....AddreeeWill excess~ickhamfill be removedAve, from pr~:298_.
....... . ........... Phone No ..............
N~e of Architect ......... ; .......... ~ ...... Address ~~. ........ Phone No ...............
N~e of Contractor ........ ~ .... · ..... Address ................... Phone No .... '; .... ~ ....
· If yes, Southold Tow~ Trustees Permit may be required.
PLOT DIAG~M
Locate cle~ly ~d dist~ctly al bulldogs, whether existing or proposed, ~d. indicatc MI set-back
prope~y Hnes. Giw street ~d blocknumber or descgption accord~g to ~cd, ~d show street n~es and ~dieate w:::::.
mt~nor or comer lot.
SEE ATTACHED S~VEY
APPRO, VED AS' NOTED
FEE: ,,
N~IFY BUILDING DEPARTMENT AT
766-1802 9 AB TO 4I'PM FOR THE,
FOLLOWING:INSPECTIONS:
1, FOUNOATION TWO
FO~ POURED CONCRETE
2. ~OUGH - FRAMINGi & PLUMBING
3. INSULATIO~
4, FINAL CONSTR:UCTION MUST
BE COMPLET~ FOR ~; O
ALL CONSTRUCTION ~SNALL MEET
THE R~QUI~EM~NTS~OF THE N,Y,
STATE CONST~UCTIO & ENERGY
CODES, NOT ~fSP(~NSIBL~ FOR
DESIGN O~ CONSTRU( :TION
STATE OF NEW YORK,
COUNTY OF ............ . .. ..
. (Nameofindividualsig
above named.
S.S
liug contract}
being duly sworn, deposes and says that he is the applies:
He is tile.'
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dully authorized to pc;form or have performed tile said work and to make and file th
application: that all statements con!ained in this application are true to the best of his knowledge and belief; and that
work will be perl'ormed in tile manner set forth in tile application filed therewith.
Sworn to before me this
........................ day oT ...................... 19
Notary Public County
(Signature of applican