HomeMy WebLinkAbout19287-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23332 Date NOVEMBER 7, 1994
THIS CERTIFIES that the building. ADDITION
Location of Property 2475 COX NECK ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 113 Block 7 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 25, 1990 ~ursuant to which
Building Permit No. 19287-Z dated AUGUST 1, 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 FIMEPLACE & CHIMNEY ADDITION TO EXISTING ONE FAMILY DWELLING
AS A~PLIED FOE
The certificate is issued to
MARY CATHERINE HINDERLITER
(owner}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
TOWN OF
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~'28'/ Z Dote ....~..~.~.~ ........ ~ ...........
! 9..~...~.
Permission is hereby granted to: , _ ~, '~
....~- ~....~..~...~. ....... : ......................................... -~
~.~~.....u.:.~..:......u..~...~.~
........ .......... .........
at p ' o~ d a ....... .~ ......................... ~ .......... ~.)~. ...............
cou,,ty Tax Mop No. ~ooo Section ..... .~.!.~ .......... B,o~k .....~ ........... Lot No....~ .............
pur~uont tO oppli¢otton dot~-~l .................... .~ .............. , 19..~..~..~ ~nd appro¥~d blt
Building Inspector,
Building Inspector
Rev. 6/30/80
............. , Form No. 6
BLDG. DEPT.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 iines,
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
a~d 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
'¥re-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.
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 Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0
ste .... ............
New Construction ........... Old Or Pre-existing Building .................
Location of Property .................... .~. ~(...~Q....~..~...&..~ ........ ~/'.~.~..~..c~ ........
House No. Street Hamlet
Onwer or Owners of Property...~.d~....~.~ ~ .w~.~..w_~ .... ~.. ~..~..{~.~.
County Tax Map No i000, Section .............. Block ................ Lot ......................
Subdivision .................................... Filed Map ............ Lot ......................
Permit No..l~.~.~.?.~.....Date Of Permit ................ Applicant .............................
Health Dept, Approval .......................... Underwriters Approval .........................
Planning Board Approw~l ........................
~equest for: Temporary Certificate ........... Final Certicate...' ........
~ee Sabmitted: $ .............................
FOUNDATION (1st]
COM~gNT~
FOUNDATION (2nd)
ROUGH FRAME &
,PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
DATE
INSPECTOR
Town Hall, 53095 Main Road
P. O, Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone {516) 765-1502
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 3, 1994
Ms. Mary Hinderliter
P.O. Box 184
Mattituck, NY 11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx 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.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 19287-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
INSPECTORS
(516) 765-1802
VICTOR LESSARD, Principal
CURTIS HORTON, Senior
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, Assistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
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 SOUTHOLD
February 27, 1992
Mary Lindsay Hinderliter
Box 184
Mattituck, N.Y. 11952
Re: Building Permit ~ 19287-Z
Premises: 2475 Cox Neck Road, Mattituck, N.Y.
Suff. Co. Tax Map ~1000- 113-07-09
Dear Mrs. Hinderliter:
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-281 and 100-284 a building permit is needed for any
construction of additions, accessory structures or new
dwellings, and it is unlawful to occupy or use said structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTffOLD TOWN BUILDING DEPT.
GJF:gar
Gary J. Fish,
Building Inspector
FORM NO. 1
TOWN OF gOUTHOLD
"" BUILDING DEPARTMENT
TOWN HALL
d~ $OUTItOLD, N.Y. 11971
~ TEL.: 765-1802
Examine . 19
(Building Inspector)
APPLICATION FOR BUILDING PERIMIT
BOARD OF HEALTIt ............
3 SETS OF PLANS ............
SURVEY
SEPTIC FORH
NOTIFY:
HAIL
INSTRUCTIONS
Date ..... 2~ ....
a. Tlds application must be Completely filled in by typewriter or in ink and submitted to thc Building, fitSPector, with
sets o£ plans, accurate plot plan to scM& Fee according to schedule.
b. Plot plan showing location of lot and of bufld~gs on premises, reJafionship to =djoinlng prcm~ or pubEc
or areas, and giv~g a det~led description of layout of property must be drawn on the diagram which ~ of t~s appH-
ca,on.
~ c. The work covered by tMs applicatlon may not be commenced before issuance of Bu~ding Peril - '
~ d. Upon approval of this application, the Building InspeCtor will issued a Building Pc~it to the appfi~L Such pe~it
sh~ll be kept on the premises available for inspection throu~out the work.
e. No buildMg shall be occupied or used in whole or i~ part for soy purpose whatever until a CeRifi~ of Occup~cy
shall have been g~ted by ~e Bulldog Inspector.
APPLICA~ON IS HEREBY MADE to the Bulldog Dep~ment for the issuance of a B~Iding Pe~it ~uant to the
Buildlng Zone Ordnance of the Town of Southold, Suffolk County, New Yo~k, ~d other applicable ~. Ord~ces or
ReguJati~s, for the const~ction of bufld~gs, additions or alterations, or for ~emoval or demolition. = ~ described.
The applicant agrees to Comply with all applica~e laws. ordinances, bu~dMg code, housin~ code, and ~aons, and to
admit authorized ~pecto~ on premises and ~ buildMg for necessa~ i~pections. .
· (Swn ...........
: · ~o~
· ../y ,
- 3~ ~ t~v~e~s o t appl~t)
S ' ' ~; '
· ~ ..... ,u~[, caomeer, genera-Contractor, electr:cian, plumber or buildeL
...... .
Name o[ owncr o~premjses ...... . .-. .,., . .., ~.
(as on thc t=x roll o~ latest deed)
J~applican[ is ~ co~oradop, Sj~h~ture ~[ duJy ~uthodzed o~Qcer.
( amc. and bric ~F orate offi~
Plumber's Licen;~ No
........... t ~c~x~ ~ 7
Loeatlon of land on wlfich proposed work will be done;
~&H ......
a u'h~ber Street. .... Hamlet .............
7T .
OUn axMap No. 1000 Section ........... Block .................. Lot
SubdNision .. .................... Eilcd Map No. '..
~ late ex'' ' {Name) .............. Lot ......... '
· l~tl~g u~e a~d occupancy o intended tl~e and oceu~aneu
S f premises and
a ' ~ ~' _ __, of proposed construcfiom
Xl~tlng USC a~d OCCUD3Heu ~. '
.................................
'-' ......
b. Intended use and occupancy ............ e ·
1. Nature of Work (check which ap:)licable): New Building .......... Addition .......... Allcrat,on . ..,e~.e~,~.....'.
R_cpaJr..... ............ g~motr, l .............. Demolition . .. ............ Swi=rain?, pool ............
· xenn:.s uourr~ .......... ?ccessory l~uilding .......... F~.nc
~4. ~', , r.,e.~ c_e ....... Other t4ork..~, d~'~_~
Estimated Cost ./.,~... ..... [ .................... .
7
(to be paid on filing this application)
$. If dwelling, number of dxvclling t~nits .......... l .... Number of dwelling units on each floor .................
If garage, numbcr of cars ..... ~ ...............
6. lC business, commercial or mixedi occupancy, specify ,att,re and extent of each .type of t,se.:: .~/~ :::::::.
? Dimensions of existingstmcturei if any: Front
· , .., ............ Rear ............. .. Depth .
Hci,_'ht NumSer of Stories
D,mene,ons of same structure wiih alterations or additions: Front Rear
.................... :. tie
· ' t;,I ........... 2 .......... Nu,nhcrofSto,es..r;i,.t;,.;2222222 22222'
8. Dimensions o entire new cons clio,: Front .............. Rear ............... .
H .iN. 6 f Sto~ri
e[ght .............. u,n er o cs , .
si 7.a.o:'"Z": ...... i'ii: .............. :i? bZ:2: .......
9. ze of lot: Front ........ R ].<la..1 '
........ e .......... Depth ....... .
IO. Da,eof Purchase ........
· -. 7 ' ' i ................ Name cf Former O~vncr ............................
t 1. zone or use dmtrict in w~ich premises are situated .... ; ................................................
12. ,D.,.o, es, propos~d:co,structlon violate any zoning law, ordinance or regulation· . .......................
t3. Will lot heP;graded .;...t~,ol ....... : '
.. . ~..~ · · z ..... · .......... Will excess fill be removed from premises: Yes ....
14. Eame.ox Owner of premises ..¢fi--~¢... ~.~ .~6rdross..C, ac .t0~.~.. ,d-~. rhone No. ~ff~..~,g'.~. ....
~ame of Architect ......... i ~
· ~ ................ Address ................... Phone No .................
Name of Contractor ......... 4 ....... ~ ........ Address ................. Phone...No ..... ,%.. ;,.j.,~...
· IS.Is Chis property located within tO0 feet ~f'a tidal wetland? ~YES .... NO~..
· If yes, Southold TownlTrustees Permit may be required.
. ! PLOT DIAGILAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fror.'a
property Lines. Give street and block dumber or description according to deed, and show street names and indicate whether
interior or cotuer lot.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT iCERTIFICATE
OF OCCUPANCY
STATE OF NEW, YOm k' '
COUNTY OF ~o.-~.~.~[!~ SLS
......... ~.~O. * .............
(Name of mthv~dual mgni~{g contract)
above na~ed. [ '.
APPROVED AS NOTED
FEE"' BY: ....
NOTIFY 8tJtlLDING OEPARTMENT '~
765-1802 9 AiVi 'FO 4 PM FOR THE
FOLLOW NG INSPf{C1 tONS.
1. gOUNDATtON FVVO REQUIRED
FOR POURED CONCRL.:'TE
2. ROUGH · FRAMING & PLUMSING
3. INSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
being dnty swotu, deposes and says that he is thc applicant
He is the ~)co ~ W0---" ! '
.1~ (Contractor , agent , corporate officer . etc . ) .................. · '
of sgid owner or owners, and is duly lauthorized to pe.rform or have performed theJ;id wo~ and to m=~a
app[ica~:on; that all statements contai,?d in thi~ npplicatio, are true to the best~fi(kn0~ge and be~:~
?tn will be perforator in the me,er ~et forth in the applies, on filed therew t~ ~~'~'~=
..... ~ ~ ~, ~r i ~,, ~ ' ~ NOTARY PUBLIC, State 0f N~w~0rk
; ~ ~ N0. 4824320, Suffolk C~y'
gotary Public, ...... /./., .............. County
Commission Expires 3/30Z~7~ .-- .-..-'
(Signature of applicant)