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Home My WebLink About19191-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, CERTIFICATE OF OCCUPANCY No Zt9220 Date JUAY 16, 1990 THIS CERTIFIES that the building. Location of Property 10120 SOUND AVE. House No. County Tax Map No. 1000 Section 122 DECK ADDITION MATTITUCK Street Block 002 Lot 009 Hamlet Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 1990 pursuant to which Building Permit No. i9191Z dated JULY 16, I990 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 DECK ADDITION TO AN EXISTING MOBILE NOME (DECK HAS BEEN THERE AWHILE). The certificate is issued to of the aforesaid building. MILLICENT TUTHILL (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ' ' ~/ /ldlng 'Tn~pector Rev. 1/81 FOB, M NO, ii TOWN 01: SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEP, MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 'j ~ '191 Z Permission is hereby granted to: ..~ .~....:~. ................. ~. ............................. ,o. . · , · .. . ................ · .~ ...... ~....~~......~.~......~.....~,z~. ......... ~t~re'mise, located at ./..~.../...~..... ,O~.~..~...~ .............................................................. County Tox Map No. 1000 Section ..../...~.....~.. ........ Block ........~.. ............ Lot No....~... ................. pursuant to application dated ...... ~..~T... ................................... , 19...~....~, and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 BUILDING DEPARTMENT TOWN HALL 765-1802 ! APPLICATION FOR CERTIFICATE OF OCt 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: I. 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 state'cut from plumber certifying that the solder used in system ~ less than 2/10 of 1% lead. ,- 5. Commercial building, indus, trial building, multiple residences and similar buildings and nstallatlons, a certificate of Code Compliance from'architect or enginemr i 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: I. Accurate survey of property showing ali 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. C. Fees I. 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 . .~. Temporary Certificate of Occupancy - Residential $~.00,~Commercial $15.00 · ~l ~ ~ Date ...... .~..~v.~.~...~ ................... ~ew Construction~.~/..~..~..~. O1d Or ~ ............ ~ \ ~=-=~u~ng muz±~ing ................ Location of Property...~.O.~.~..~.....~.~.~..~.~..~~..~ ................ House No.~ % Street ~ Ham_let Onwer or Owners of Property .... ~.:~...~....~.,~.~.~ County Tax Map No 1000, Section. ,.% ........ Block. F~_ · ............... .................. Subdt~ision .................................... Filed Map ............ Lot ..................... Permit No ................ Date Of Permit ................ Applicant ............................. ~ealth Dept Approval Underwriters Approval ,' Planning Board Approval Fee Su· zgO · · . TOWN OF SOUTHOLD i3UILDING DEPARTMENT TOWN HALL .~/~ , $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .......... , 19 .~.. Approved.. '..~. ........ Disapproved a/c >) ........................ j?~ ...... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ........ ~ ............ CHECK CALL ...... MAIL TO: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter orin ink and submitted to the Building lhspector, with 3 sets of plans, accurate plot plan t<~cale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of l~yout of property must be drawn on the diagram which is par~ of fids 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 applicant. 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 issua e~of ii Building Permit pursuant to the Building Zone Ordinance of the Town of S0'uthold, Suffolk County, New York//and ot~er applicable Laxvs, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for/~emovaJ/6r demolition, as herein described. The applicant agrees to compl~q~l~¢~j¢~, laws, ordinances, buildi%~ code,/)a~using co~, a~}d regulations, and to admitauth~rizedinspect~rs~np}em~sesandinbui~in~f~[inecessaryins~~..~W~//.~/-~./~. tale whether a ficant,is ~ er 1 7 ...... ' " ' ' ' PP D0~"'~, :' 'es~M~t' [~V~t~ct~ engineer, general contractor, electncmn, plumber or builder. ................... . ............. X c ~' ' ~,' ~ ' .................. F~r¢' ~.L.,~,t" ",'-*' .............. -~ ............ V ~ (:1~1 ~C ,: ', ' "~ ~(hs on the tax roll or latest deed) lC applicant Js a corporatiB~]a~reVgf dql9 a,uthoriz~(,~ificer. (Name and title of co,orate officer) Builder's License No .................... Plumber's License No ......................... El CmClan s License No ....................... Other Tradc's License No ...................... Location of land on whicthproposed work will be,done; . ' - pN ' County Tax Ma o. 1000 Section ......... Block ....... ~; ......... Lot ......... / Subdivision ..................................... ~il~d Map No ............... Lot ........... (Name) .... State e .' ' · x~stmg use and occupancy of premises and intended usc and occupancy of proposed construction; A. Ex~st~ng use and occupancy ............ ' B. Intended use and occupancy ...................................... ..~,~t~g 9*2]~:~Jb~¢. ' ' ' ' · . .Swzmmln ool ....... Rep~lr .............. R~moval ~ .............. Dcmoht~on ............ g p ..... T6nnis Court ......... Acclessory Building .......... Febce ....... Other Work ............ 4. E~:timated Cost .................................................................. · · I (to be paid on filing this application) 5 Ifld · · N · we hng. nmnbet of dwelhng uni[S, ............... umber of dwelling units on each floor ............. ... If!gara~:e number of cars 6. Ifibusiness, commercial or mixed oci~upancy, specify nature and extent of each type of use ................... 7. Dimensions of existing structures, iff any: Front ............... Rear ............. Depth H6ight ............... Numberiof Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ' Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ........ . ....... Depth ............. Height Number! of Stories 9 Si?,e of lot: Fro'nfl..,. ! .,..~'. ·. ,," ....: ~ .. Rear Depth ' fP h , i N fF O 0. D¢te o urc ese ............. 1 ............... amc o orrner wner ............................. I Zone or use district in whic ~ premises are situated ..................... 2. Does proposed Construction violate any zoning law, ordinance or regulation: ................................ 21. W~II lot be regraded .......... , Will ex fill b d fr mi Y No · ~ ................ cess e remove om pre scs: e~.... .. 4 Nme of Owner of premises 4 . .' .... Address Phone No Name, of Architect ............ 4 .............. Address ................... Phone No ................. Name of Contractor ~ ' Address Phone No ' 15.I~s this property loc~te~ within 300 feet of .a tidal wetland? ~YES .... NO .... · I.f yes, Southold Town Tirustees Permit may be required. i PLOT DIAGRAM Lo~ate clearly and distinctly.nil bt ~roperty lines. Give street and block nterior or comer lot. ildings, whether existing or proposed, and, indicate all set-back dimensions from abet or description accordhag to deed, and show street names and indicate whether , 4FPJOV DA /iOTED/ ' FEE: ~BY: ~ NOTIFY ~ DBI~__~I~T ~T FOLLOWING INSPECTIONS: 1. FOUNDATION . 1%1tO REQUIRED FOR POURED CONCflETE 2, ROUGH - ~R3 & PLUMBIN¢] 3, INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE R;OU~RE~ENT$ OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBM~ FOR DE$I~3r~ OR CONSTRUCtiON ERRORS ?~ATE OF NE%V YO, RI~ a \\~ .~ .... .... 2 ..... · .~/.~..~. ,"'~X..~h -~x,12~x. . .~.~ h'~ ..... being duly s,vom, deposes ~d says that he is the applicant · , (Name of individual signiu~ contracO~ (Contractor, agent, corporate officer, etc.) said owner or owners, ~d is duly :~uthorized to perform or have performed the said work and to m~e and file this ~vphcat on; that all state~nents contaiuCd in this application are ~rue to the best of his knowledge and belief; and that the ~ork ?il be perforated ia the m~ner s~t forth in the application filed therewith. ~wom to before me this .... 0h xx ...... ;. .......... ....... cou., ~pies of this su~ ~ ~ ~aring the Isnd suw~'s Inked seam or em~ J~I ~t ~ conside~ ~ ~ a vamid copy. Guarantees or ce~cat~ I~t~ hereon shah run ~ly to the person for w~m the ~ is prepared, a~ on h(~ beh~]f to the rifle company, ~mmemal agenw and len. ding institution ~isted hereon, end to the assignees of the lending institution. Guarant~ or certffmcations are not Va nsferab]e to additional i~ns ~ su ~uent ow~rs. ~AoPl' NIOIF SURVEY FOR MILL~CENT B. TUTHILL · T MATTITUCK TOWN OF SOUTHO£D SUFFOLK COUNTY, N.Y. SCALE: I': 40' APRIL IS, 1974 FEB. 4~ 1975 ,~PRIL REFERENCE, OUARANTEED TO= CHIC4GO rlrL£ INSURANCE COmPaNY M/LLI¢ENT B, TUTIt/LL LAND SURVEYOR N,Y$, LIC. NO. RIVERNEADt N.Y,