HomeMy WebLinkAbout19456-zFORM NO. 4
TOW/q OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20065 Date JULY 11~ 1991
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 260 ELIJAH LANE MATTITUCK, N.Y.
House No. Street
County Tax Map No. 1000 Section 108 Block 3 Lot
H~let
5.6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 13, 1990 pursuant to which
Building Permit No. 19456-Z dated OCTOBER 12~ 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 ACCESSORY HORSE BARN & FENCE AS APPLIED FOR.
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
WILLIAM & EILEEN VILLANO
· // ~uilding Inspector
Rev. 1/81
· 0~3~[ NO. ~1
TOWN 01: $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, Ho Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NO_ 1945C 7.
Permission is hereby granted to:
~....'.~..~...~...~..../..~.~...
............
....... .~.~~.....,.~.~,
,o ..~~...~ ....... ~~:...~...../...~.....~ .........
_~.~ ........ ~ ........ ~~......~ ...................................................................
at premises I~ated at .....~ ......... ~~..~ .............................................
..................................................... ....................................................................
Co~ Tox M~p No. ~000 S~t~on ....~.~ ...... B~k ........... ~ ..... Lot No ......... .~.~..
pu~uant to application dat~ .......... ~.~ ............................. , J9 ...... an~ appr~ by the
Building Inspector.
Fee $..~...~
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTblENT
TOWN IL~LL
765-1802
APPLICATION FOR CERTIFICATE OF!occUPANC
TOWN OF SOUTNOLD [[
\. 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 instal, lation 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 C'~pliance 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-exzsting' 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 Inspecfior shall state the
reasons therefor in writing to the applicant.
.. Fees
1 Certificate of Occupancy - New dwelling $25 O0~A]~'
Alterations to dwelling $25.00, Swimming pool $~5'~
.uo, Accessory buildiug $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing BuildJng _ $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
ew Construction ......... Old Or Pre-existing Building
ocation of Property.. .......
House No. · .... Street ................
~wer or Owners of Property .... .~..~ .~. 4
~unty Tax Nap No i000, Section. . .Block. O~
............... · .. .l
alth Dept. Approval .... ' ......
...... ~ Underwriters Approval
anning Board Approval
quest for: Temporary Certificate ....... Fi
~ .... nal Certicate. .
Submitted: $ .....
TOWN OF $0UTHOLD
OFFICE OF BUILDING IN~'PECTOR
P.O. BOX 728
TOWN ttALL
SOUTItOL~), N.Y. 11971
Hay 2, 1191
TEL;365-1802
Bill & Eileen Villano
260 glijahs Lane
Hattituck, N.Y. 11952
To Whom This May Co,ncern,
We are unable to complete your Certificate
of Occupancy because ,of the following reasons.
/
/
/_~/ An application for Certificate of Occupancy
,is not on file. ' (ENCLOSED)
/
/~// NO Underwriters Certificate on file.
/~/ The check is(~Xnot on file.) $25.00
/5/ No IIealth Dept. Approval on file.
/5/ No final ins.pection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit tt I 9 4 5 6 Z
Buildinq Dept.
***/5/ biO Pluinber Sol. der CoKtificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
-FLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FI;;AL
ADDITIONA'L COMMENTS:
FORM NO, 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y,
NOTICE OF DISAPPROVAL
PLE^S~ T^K~ NOT~CE that your application dated
for pe~it to ~%.~ . ~. ~.~ .~,q . .~..~.. ~ ..... at
Location of Property .
Ho~o ~o. ~ ' ~/~;i ' '
County Tax Map No. 1000 Section ... } ~.~... Block ~.~ ........ Lot ~' ~ ....
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the follow/ng grounds .
~az.,.~~.5. ~..~..~.~ ~..~.
Building Inspector
RV 1/80
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765.1802
Examined · .¢ ........... 19 .~.~..
Approved./~/../.'~. ...... , 19 .~.-~Y. Permit No..ff..~/f, ff..~..~['~
Disapp?oved a/c .....................................
BOARD OF HEALTH ............
3 SETS OF PLANS ............
SURVEY .....................
CHECK
· ); fi .............
SEPTIC ............
NOTIFY~
MAIL TO:
INSTRUCTIONS
a. Tiffs application must be completely filled in by type~vriter or in ink and submitted to the Building Ihspector, with 3
sets 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 publ/c streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
¢. 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 applfcant. Such permit
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 any purpose whatever until a Certificate of Occupancy
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 the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
Tile applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of hpplicant, or name, if a corporanon)
'(Mailing address of applicant)
.
State whether applicant i lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done; '-
House Number Street. Hamlet ' '
County Tax Map No 1000 Section } ID"~ Block .C).~ 5f ¢
Lot '
Subdivision ..................................... Riled Map No ............... Lot ........
(Name) .......
2. State existing use and occupancy of premises and intended nsc and occupancy of proposed construction:
A. Existing use and occupancy...~...~.. ............... : ........ , ...........................
B. Intended use and occupancy.6,J.~a..[.~l..;(. ! .'~.'.~.rx..C.(~...'/~..~_~. ...................
Nature of work (check which applicable): New Building Addition Alteration '.
Repair. ........ ...~mo.Val ......... ; ..;. Demolition ............. Sw mining poo? ..............
Tennis Court .'.'.';~] .. ~ccessory Bulldxng .......... Fence . 4.,~'...Other Work;~t\
4. Estimated Cost .,.i~,~..I ........................ Fee ..................................... ' '
(to be paid on filing this application)
5. If dwelling, number of dwe ng ffnits ............... Number of dwdling units on each floor ................
If garage,, number of cars ..... I ..................................................................
6. If business, commercial or mixedloccupancy, specify nature and extent of each type of use .....................
?. D,mens'onsofexisting,=cture ,,ifany:Front. ............... . ...............
Height Number of Stones . · ·
Dimensions of same structure " ' or additions: Front Rear
with alterattons .................................
' Number of Stories
Depth ~ Height .............
' Depth
8. Dimensions of entire new construction: Front ............... Rear ...........................
Height Number of Stones
Size of lot: Front ~ Rear Depth
Date of Purchase ! Name of Former Owner ........
Zone or use district in which premises are mtuated ....................................................
Does proposed construction violets any zoning law, ordinance or regulation: ................................
Willlot be regraded ........ i ............ . . . .. . Will excess fill be removed from premises: . Yes .... No..
Name of Owner of premises ' Address Phone No ·
Name of Architect .l. Address. Phone No ................
Name of Contractor I ' Address Phone No
15.Is this property loea~ted within 300 feet of a tidal wetland? *YES .... NO ....
~If yes, Southold Tow4 Trustees Permit may be required.
, PLOT DIAGRAM
Locate clearly and distinctly alli buildings, whether existing or proposed, and. indicate all set-back dimensions from*
property lines, Give street and block inumber or description according to deed, and show street names and indicate whether,
interior or comer lot. I
10.
11.
12.
13.
14.
STATE OF NEW YORK, S.S
COUNTY OF ................
.......... ~"t ................... being du sworn, eposes and says that he is the a cant
(Name of individual s'~nmg contract)
above named.
late is the I '
· )
i (Contractor, agent, corporate officer, etc.
of said owner or owners, and is diily anthorized to pe,rform or have performed tbs said work and to make and file thi~
application: that all statements contained in this application are true to the best of his knowledge and belief; and that tho-
~vork will be performed in the man6er set forth in the application filed therewith.
S~vorn to before me this i
........................ day pf ...................... 19 ·
Notary Public ........... ~ ........... County
NOTARY PUBlIC, State 0L (Signature of applicant
now or formerly Edward SandbereJ
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT
a ~EAR¢sT W~'e~ "~m__U~. -* #SOURCE OF
NOTE: ~= MONOMENT ~ : STAKE
SUBDIVISION M~P FILED IN THE OF THE CLERK OF
SUFFOLK COUNTY ON 0CT. 7~1977 AS FILE NO. 6609.
MAIN ROAD 5~,~ so ~
SURVEY FOR
WILLIAM VlLLANO. & EILE,E,N VlLLANO
LOT NO.2"GREENBRIAR ACRES'
AT MATTITUCK
TOV/N OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
MAR. $~1988
SEPT. i7~ 1987
DATE' JUNE 25, 1987
SCALE: t"= 40~
NO, 87 ' 690
~4 LJ~AUTHORIZEO' ~,LTERATION OR AOOLTION TO THIS
r GUAR . '
E~~MPANY'
Jh].YOUNG YOUNG
RIVERHEAD, NEW YORK
ALDEN W, YOUNG; PROFESSIONAL ENGINEER
AND [/AND SURVEYOR NY.S, UCENSE NO. 12845
HOWARD W. YOUNG~ LAND SURVEYOR
N.Y.~,' LICENSE N0.45893