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Home My WebLink About19317-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19287 Date AUGUST t0~ 1990 THIS CERTIFIES that the building. Location of Property 500 BLOSSOM BEND House No. County Tax Map No. 1000 Section 115 Subdivision ACCESSORY Street Block 6 Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 31.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27~ 1990 pursuant to which Building Permit No. 19317-Z dated AUGUST 9r 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 SHED (AS BUILT} AS APPLIED FOR. The certificate is issued to JOHN & JACQUELINE WAHI~RS (owners) of the aforesaid building. SUFFOLK COUNTY DEPkRT~ENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H-016992 - JULY 11, 1990 N/A Buildin~ Inspeckor Rev. 1/81 · 011~ NO. 0 TOWN O~: 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) ...... at premises located at..~....~...~.. ....... . .~.....~....~.....~..~ ................................. / .......................................................... ~.~.. ....... .~....~.../..:..~.~ ....................................................... County Tax Mop No. 1000 Section ..... ,//..~ ..... Block ......... ~.,~. ..... Lot No, pursuant to application doted ....~/.~..~,. ....................................... , 19.?...~..., and opproved by the Building Inspector. Rev. 6~30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY HATE.Jq~y.~ 1990 NEW CONSTRUCTION -.~ ..OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property 500 Blossom Blvd. Mattituck HOUSE NO. STREET HAMLET Owner or Owners of Property.. .~ohn F. Wahlers, Jr. and Jacqueline V. Wahlers County Tax Map No. ]000 Section ...1.1~. Block . 06 Lot p~fpp~.and p/o 027 Subdivision Mattituck Estates, .I.n.c¥iled Map .4.4.5.3..Lot..2.6. an.d p./O 27 mi No D of P mit ~ Per t ........... ate er .......... Applicant ................... Health Dept. Approval .................. Underwriters ova . Appr 1 ........... Planning Board Approval ................ Request Fee Submitted: for Temporary Certificate ....... Final Certificate ..... .X.X. ......... rev.~ 10/14/88 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~0'~ ~9 BUREAU OF ELECTRICITY ~ S5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT in the foltow~n8 h,catlon; ~ Basement ~ Ist FI. ~ 2nd FI. ~ }~'~ / )[ [ Section Bl~k ~sex~minedon ~i~I,Y (}~ ~ ].~)9[} ~ndfoundtobeD~compJia~ceu'ththerequ~renentsqfthlsBoard. FIXTURES RANGES OVENS Lot EXHAUST FANS FIXTURE SWITCHES OUTLETS DRYERS FURNACE MOTORS TIME CLOCKS ~AULTLOUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C OTHER APPARATUS: OF CC COND NO. OF HI-LEG A W G NO, OF NEUTRAJS OF HLtEG OF NEUTRAL P.OA~OX 208 Per_ This certificate must not De altere~ in ony moaner; return to the office of the Boord if incorrect. Inspectors may be identified by their credenficds. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED ~N ANY MANb~IER. WILLIAM H. PRICE, JR. Attorney at Law 828 FRONT STREET P.O. BOX 2065 GREENPORT, NY 11944 Phone (516) 477-1016 July 26, 1990 Building Department Town of Southold Main Road Southold, NY 11971 RE: WAHLERS 500 BLOSSOM BLVD., MATTITUCK, NY Gentlemen: Enclosed herewith please find: 1. Application for Building Permit for shed 2. Application for Certificate of Occupancy for shed 3. Copy of Underwriters Certificate 4. Copy of Survey 5. My check in the amount of $10.00 If you have any questions, please do not hesitate to contact me. Very truly yours, William H. Price, Jr. WHP:kk Enclosures TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... (Build(~ Inspector) APPLICATION FOR BUILDING PERMIT Received .......... ,19.., Date July 25 INSTRUCTIONS .~ ~ ~ a. This application must be completely filled m by typewriter or ,nmk ~and~st~b~itted ~o ~th¢;B~ldihg Inspector, wit~ sets of plans accurate plot plan to scale Fee according to schedule· ~'~. ~ ~. ~ , ....... ' ~. ~ ~.' ~ ' ~ 3[~ ~,l';: ~'~ . b. Plot plan showing Iocanon of lot and of buildings on premzses~'relatmnsh[p ~o.adJommg premises or public stre~ or areas, and gtvmg a detml¢d descnptton of layout of property must be dramn on~ the dm~ram whzcE ]s pa~ of tlus cation.~ , ~ ~·= c. The work covered b ~sapp~cationmafnotbecomm¢ncedbefo~eJssu~ceofBu~d~'permi~. ' d. Upon approv~ of t~s appBcafion, t~e B~]din~ inspector w~[ i~u6d ~a Bufld~gpe~K ~o ~k~=~pp~C~t. Such sha~ be kept on the premises av~able for ~spec~on ~rou~out the work ~ : ~ ~ ~ ~. ~ ~: e. ~o bu~d~ ~h~ll be~ occupied or used in whole or ~ p~ for ~hy purpos~whatever~until~ ~,ifi~ate of Occup~ shaB have be~n ~r~ed by~eB~il~g ~specton ~ ~ ~ APPLICATION IS H~R~B~AD~ to the Budding Dep~ment ~or~ ~e [ss~,q~of.a B~l~l~g Pe~t pursuit to ~ui]di~S Zone Ordnance of the Town of Southold, Suffol~ Co~ty,~Ne~Yo'rk -~;0~.~p~l]~6]e.~ws Ord~ces Regulations, for the construction of buEd~gs, additions or alteratio~,~r fe[[e~ or demolition, as here~ descdb~ The applicant agrees to comply with a~ app~cable laws, ordinances, b~d~g code, ~s~ ~;~E;~ation~, and admit authorized inspectom on premises ~d ~ buita~g for necessa~ inspect~i~[~ ~ ~ .... ........ (Signature of applicant, or name, if a corporation) ~O Box 2065~ ~.eenpo~[/ ~ (Mail~g address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ Attorney/Agent Nameofownerofpremises John F. Wahlers, Jr. & J.acqueline V. W.ahlers (as on thc tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... lectrlc,an s Ltcense No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................ 500 Blossom Blvd. M~tituck House Number Street Hamlet County Tax Map No. 1000 Section 115 Block 06 Lot 031. 001 & P/O 027 Subdivision .~93~ .~%~t..~q?: ......... Filed Map No.. 44~3 . Lotg~. A .~9. 2~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Private one-family dwelling b. Intended use and occupancy Private one-famil7 dwelling w/ ~et~c~ed s~e~. Nature of work (check which applicable): New Building X (s.h.o.d) Additio,t i Alteration Repair .............. Removal .............. Demolition ............ ~. Other Work ............... .~ ~i (Description) Estimated Cost . . ./ ........................... Fee .... ~ ......................... (to be paid on filing this application) If dwelling number of dwelling units Number of dwelling units !on each floor If garage number of cars ' ~ If business, commercial or mixed occupancy, specify nature and extent of each typei of use ........... Dimensions of existing structures, if any: Front ............... Rear ........ ~ ..... Depth ..... Height ............... Number of Stories ............................. ! .............. Dimensions of same structure with alterations or additions: Front ............. ! ....Rear ..... Depth ...................... Height ...................... Number of S~tories ......... Dimensions of en Height ....... Size of lot: From Date of Purchase Zone or use distr Does proposed c( Will lot be regrad Name of Owner Name of Archite Name of Contrm Locate clearly ar property lines. Give imterior or corner lot See tire new construction: Front ............... Rear ......... i Depth . ........ Number of Stories.. ¢ .... $~0. Au, aT¥~y..~g~:&qhecl ............. xoo Rear . 9q epth .25 . ............................. Name of Former Owner .. i .............. ct in which premises are situated A-Agr±¢ultural/Residential nstruction violate any zoning law ordinance or regulation: ' ~'d ............................ Will excess fill be removed ;from premises: f premises .................... Address ................ t ........................... Address ................. :or .......................... Address ................ PLOT DIAGRAM distinctly all buildings, whether existing or proposed, and, ind: eet and block number or description according to deed, and show urvey attached oCCuemc OR USE IS UNLAWFUL ¢[ITHOUT CERI'IFICATE CF OCCUPANCY STATE OF NEW YO ~K, 20UNTY OF .... ~[j.1FFp. ij~...· · S.S ............... · . .:.JR. (Name of individual signing contract) above named. Yes No ·. Phone No ................ ·. Phone No ................ ·. Phone No ................ DATE: ~ FEE: ~ NOTIFY 9UI 766..1802 FOLLOWIN¢ cate all set-back dimensions from street names and indicate whether DEPAm'M~J~'~L AM TO 4 PM ~I~R THE i INSPECTIONS: 1, FOUNDATION 'BNO REQUIRED FOR POLIRED CONCRETE 2, RoUGH i' FRAMING & PLUMBING 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 REsPONSISLE FOR DESIGN OiR cONSTRUCTION.ERRORS ....... being duly sworn, deposes and says that he is the applicant Attorney/Agent He is tlie (Contractor, agegt,.¢orporate officer, etc.) ~ af said owner or owners, and is duly authorized to perform or have;performed the s~id work and to make and file this ~pplication; that all statements contained in this application are true to the best of his]knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before ~ne this ........ d&~. ........ day of ......... oT.u.ly. ........ 19 9.0-- ~'~---, - ........... ............ oun,,