HomeMy WebLinkAbout18900-z
i m+~ FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20359 Date NOVEMBER 19, 1991
THIS CERTIFIES that the building ADDITION
Location of Property 2645 ELIJAHS LANE MATTITUCK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 108 Block 4 Lot 7.I5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 19, 1990 pursuant to which
Building Permit No. 18900-Z dated MARCH 21 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 INGROUND POOL & DECK ADDITION WITH FENCE ENCLOSIIRE TO
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to WILLIAM A. & JEAN SCHMITZ
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. H-025326 - NOVEMBER 1, 1991
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
F
FOBDf NO.
TOWN OF 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)
N 0 8 ~ Z Date U~lr~., 19.~~.
Permission is hereby gran ed to• /
o~I'~,~ ~s ~ .
. . .
~
of premises located of ..~Y.... ............~~~1..6:~.....................................................
......................................................................................................1L.~L.......................................................
County Tox Map No. 1000 Section ......l~Cl......... Block .....,T............ Lot No..../..t..~~./.
pursuant to application doted / 19..~~.,.~., and approved by the
Building Inspector.
Fee $..~.v'.. d
• .L~/.:fe~........
uilding for
Rev. 6/30/80
rt °°1~ 4~4,..p f
~°y`;ti .
s*~ r z'; A)~, Form No. 6 ~,k~~'~~~~r'°y.,~F":,~~ J~
A~ t~` -
' ~ "7 ~ TOWN OF SOUTHOLD r e
~ti5~t~ ~ BUILDINO DEPARTMENT y"~ ~
a~ ~ ~ ~ ~ ° TOWN HALL ~ flay
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i,~,~,1,'~~ t i,:s, r F? 765-1802 ~ ,Tt
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APPLICATION FOR CERTIFICATE OF OCCUPAt~Y ~
u°`°"
This application must be filled in by typewriter OF, 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 Pire 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.
:1. 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.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
A1Cerations 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 $15.00
Date ...I.~J. ~1.9~
::ew Construction...... Old Or Pre-exis,/ting Building ...:...........yy.//,,,.
iocation of Property..7~. yS .......~~I~!~?t~t s...~-i~' I::/~. ~~4~'C.........
House No. Street Hamlet
Onwer or Owners of Property.~ILLt}ar~,,;r, ~~;'~IJ~Uu....,,~;.t(yxt.r.~
1 ,t~ i ~
t.ounty Tax Map No 1000, Section.../, ~~~.......Block...../...........Lot.. .
r ~
~ ~ p
Subdivision.. 57....../Filed Ma (...Lot .
i'crmit No./.~.9p~.Z.,Date Of Permit.:?~Zj.(.9a.....Applicant~~~'l~w:~:l':y:~:".~E'~/"::4z:.
!!ealt!t Dept. Approval........~':` ...............Underwriters Approval....
!'canning Board Approval..... ~a
Request for: Temporary Certificate........... Final Certicate..
~o
!'ee Submitted:
c~.~. ya 9 ~o ~ .
eo ~ao~s 4 . APPLICANT
4- _
THE NEW YORK BOARD OF .FIRE. UNDERWRITERS ~Ai=r; s
x(i2M317 OUREAU OF ELECTRICITY
83 JOHN STREET, NEW YORK, NEW YORK 10038
= NOYAMBER 01,1.997 750,"x9791/91 N 1iJ53'26
.Dote Apyplicotlon No. on ffile
~ THIS CERTIFIES THAT E'~RNIT NO. 7.8900% ~ RR
only the electricol puipment as deurihed below and introdtACad by the applicant netned on [he shoos application number in the premises of
a
s NT1d,TA~1 ~ J}AN SCNMITZ, 2645 E1,ldAM`S 7,11., 1,II,CO-23, .~},Al'I'T'7`UC.K, N. Y.
in thefollawing ktcation; ? Basement ? let Fl. ? Ynd FI. ?U6L/(1119' ,Section l Ot3 BlockKl /,ot , l 4
ocTaBw,R za, t997.
woe examined on and found to he in cmnpfiance with the reyuPrententa of thu Board.
A%TURE RXTURES RAh%iR5 COOKING DECKS OVENS DISN WASMlRS EXNAUST FANS
OUTLETS ACIES SWITCNES INCANDESCENT-FLUMESCENi OTNEN AMT. K. W. AMT. K. W. AMi. K.W. AMT. K. W. AMT. N. P.
1
DRYERS FURNACE MOTORS lUTURE AMYtANCE NEDERE SHOAL REC'K TIM! CI.OCK3 pLL UNI7 NEAiE115 MULTI.OUTIET DIMMERS
AMT. N. W. Oll N. P. GAS N. P. AMT. NO. A. W. 4. AMT. AMP. AMT. AMTS. TRANS. AMT. N. I SYSTEMS AMT. WAT1$
NO.OF NET
SEIVtC! DISCONNKT NO.Oi S E R V 1 C E
AMT. AMA. TYPE Et%Ih. IA tW lA9W TA3W JA KW ffN aCOND. OP CC COND. NO. OF NIiFG ~~N'~G NO. OF NEUTRALS OP NFUiGNAI
3
OTHER AMMATUS:
~ *(5WTAfPtTNC+ Yt>01,) This ct:T~tificaYF-
_ cover4 comgl.iance at LhF date of
_ inspectien only. Because of unusual
environments it .a advi.aahle r.n
have frequent test an3lnr' repairs
made by a qualified person.
WILLIAH SC11HI'I7.
$645 E1,iJAl4'S I.A.
_ HATTI'PUCK, NY, l 1952 TEYERiu MANA~
Per
This certificate must not be altered in any manner; return to the office of the Board if incorreN. Ins ors may be ideMifisd by their croden als.
' COPY FOR BUILDING DEPARTMENT. THIS COPY OF CER7IFICATE'MUST MOT BE ALTEREDIN ANY MAlNER.
INSPECTORS
Victor Lessard O gQFFO~k
Principal Building Inspector ~'p
Curtis Horton Gyp SCOTT L. HARRIS, Supervisor
Senior Building Inspector H x Southold Town Hall
Thomas Fisher P.O. Box 1179, 53095 Main Road
Building Inspector ~ • ~
~L Southold, New York 11971
Building nspectar ~ Fax (516) 765-1823
Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Irupectrn OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
October 10, 1991
William & Jean Schmitz
2645 Elijahs Lane
Mattituck, N.Y. 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)
XX No Underwriters Certificate on file.
XX The check is ( on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 18900-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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®.9 6 ~Y"; ' ,FEE: BY: ; ~
I ' I ! i 765,P8(12B~9LAM TO ~PPMTFOR THE
' ~ F®LLOWiNG 1(VSP~CTION$: t
' ! ~ ! i ~fou'S Y.~ FOUN®ATtON . - 71N0 REQUIREDI
' FOR PQURED ('ONCRETE ~ ~ I
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I ~ THE REQUIREMEPITS' OF THE N.Y.
12~ ys S' I ; i I ~ ~ STATE CONSTRUCTION ENEAGY '
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/ 7-u~ . w ~ l 19.52- ~ CO~JES. NOT RESPONSIBLE FOR
.
I i I ~ I j ~ DEfiI~N OR C.ONSTRUCT}Ok ERRORS
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BOARD OF HEALTH
3 SETS OF/PLANS
FORM NO. t SURVEY Y• .
TOWN OF 50UTHOLD CHECK lf.~`1-1~1. • .
BUILDING DEPARTMENT SEPTIC Foart
TOWN HALL
$OUTHOLD, N.Y. 11971 NOTIFY
TEL.:7G5-1B02 CALL
rJ MAIL q
Examined . ~ l9~~.. ~I: ~ .~.p . p .a(eya~i .
APProved ~y~ • • • • 19~~ Permit No. ~~J900.~ «•La,.
Disapproved a/c ~ U 1~~~~, 4~~ ~...133dgtts~~t--~
~ 9 ~ ~1~~~'~~~
( ding Inspector) u. ~~-Le i
C~IG~., ti.'.Y~.
APPLICATION FOR BUILDING PEflAA1T TO'+7~M ~St ~q'x`=s1S'~`stt?°""" •",t
Date , 15~-
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with n
sets of ptans,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 public 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.
c. 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 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.
The applicant agrees to comply with ail applicable laws, ordinances, building code, housinti code, and regulations, and to
admit authorized inspectors on premises and in building for necessary ins ec ions.
(Signature of applicant, or ame, if a corporation)
26!l.S.~~/~i.~1t's./.eE:. J?lt?%%liueK~. N..f.1/.P~?..
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder.
CAN. Z(Z .
Name of owner of premises ...~ll::~: t~4tf2 .,lt ..~:.-:~EkN, SCtIC`.'! ~.Z .
(as on the 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. ...........``.~51.. .
Electrician's License No. ......~er~ . .
Other Trade's License No . .
I. Location of land on which proposed work will,bc done;
2~ y:s ~t-i~~4N,s,. ~~~v~.....:.. ../.'N!?~iii "~ucl~C
Flouse Number / QQS/~treet. Hamlet J
County Tax Map No. 1000 Section 1 ~ 0„ • • • : • . • • . Block ~ Lot ...,(e , ,
Subdivision ~h~ ~~5. ~~¢NC, ,~s. „ • • „ Filed filap No. (,3 ^ J', ~ Lot ...I.?:........ .
(Name)
2. State existing use and occupancy oC pre/m~is,.e,~s and intended use and occupancy of proposed construction:
a. Existing use and occupancy "Itt rf ~ .
b. Intended use and ..•r~o«CS••• O°.L
occupancy
•n Addition Altclation .
3. Nature of wort. (check which applicable): New I3uildt S
Repair .,r Rpmo;val . Demolition ..Swimming pool.. .
Tennis Court Accessory Building..........Fence .k!:~..•Other Work............
Q.' Estimated Cost ...,f1..~•~ Fee
(to be paid on filing this application]
' Number of dwelling units on each floor •
5. 'If dwelling, number of dwelling units .
If garage. number of cars ' .
6. ICbusiness:'commercial or mixed occupancy, specify nature and extent of each tyF~e of use ~ ,
7, Dimensions of existing strucfure~, if any: Front ~2 Rear ....J'~.-?..fa. • • . Depth ....'~p; , , , . .
Height Number of Stories .
yy .
Dimensions fQQSame structure with alterations or additions: Front .JF.a.r•tp.`.`........ Rear ...~$..~R........ .
Depth IIcight Nuitlbcr of Stories f.
8. Dimensions of entire new constniction: Front Rear ....2':~........ Depth , •
Height Number of Stories . •
i'
9• Size of to o t . l«i ~ Rear ~5~.~ - Depth . .
10. Date of Purchase , f 97 ~me of Power Owner .
11. Zohe"or use district in which premises are situated ' t3/.~~N.l.~~~ . .
12. Does proposed construction violate any zoning law, ordinance or regulation: ~ • • • • • • • • • • • • • •
13. Will lot be regraded ,d/.4? .................Will excess fill be removed from premises: Yes , No .
14. Name of Owner of premises ~~l~t:~: t'1'•..f'Cf/~: o i Z:
Address Z.raY.~~lf~iN.~`.~•,Z.I~'• • • • Phone No. '4~.`l~`~:.5~/. ,7.... , .
Name of Architect ........Address , ....Phone No................ .
Name'of Contractor ....Address ..Phone No.....
~ . .
IS.Is this property located within 100 feet of a tidal wetland? *YES._..NO.L~r"
*If yes, Southold Towri Trustees PLOT DIAGRAM a required.,-
Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block'',number or description according to deed, and show street names and indicate whether
interior or corner lot.
i
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STATE OF NE1V YORf~, S.S
COUNTY OF
. , , , , • - - . , . • . . being duly sworn, deposes and says that he is the applicant
(d~"amc oC individual signing contract)
above named.
Hcistltc
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Gle this
application; that all statements con~[ained in this application arc true to the best of his knowledge and belief; and that the
work will be pcrfornted in the manger set forth in the application fled therewith.
Sworn to before me tghis ;
..,day ofd..... ~°.t :'':~-f~-:....., 19 ~1~:
Notary Public, !"~'~,v; :./,~J¢; County
NELENKDEVOE (Signature of applicant;
RY PUBLIC, State ofi New YorM
~erm~ExPfDres March
30, lounB_~/
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