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18920-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19461 Date OCTOBER 18, 1990 THIS CERTIFIES that the building ALTERATION TO ACCESSORY Location of Property 2305 ELIJAH~S LANE MATTITUCK, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1990 pursuant to which Building Permit No. 18920-Z dated MARCH 29, 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 INSTALL BATHROOM PLUMBING IN A NON-HABITABLE ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to JAMES RELYEA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-143401 - JULY 31 1990 PLUMBERS CERTIFICATION DATED JULY 21,1990-PERFECTION PLUMBING & HEATING Building Inspector Rev. 1/81 roans xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL gqCOMPLETION OF THE WORK AUTHORIZED) ND 1$J~~ Z .....~~4X.1....!,~~..9 19..9.v Date 11 Permission is hereby granted to: ~~.c~ w J a.~,l,~-cia.. n 0.• ra ..y.?::~.p.~..Q...~4!:(....:n:? G~:x,..~r~!'"t:~'^:.ot...rl:::~...~..... .:....-""'J..~:~:`:'^'::~:.... ,V} 1 _ at premises located at ?3.w~Q.~........~.::~< ..~:x~.R-............~.CI~G............ U County Tax Map No. 1000 Section ....~.~..g.......... Block Lot No....7.:.~...~~t........ pursuant to application doted .~.~?:Cdh..._~..? 19..Q.Q, and approved by the Building Inspector. Fee $.c?5:.. ~ ~ . ~ GL---~ . Building Inspector Rev. 6/30/80 Form No. 6 ~ ~ TOWN OF SOUTHOLD •~~-°"""~'"°"~'"~s~ M~ BUILDING DEPARTMENT ~ V~4'~~ ' TOWN HALL 765-1802 p~'( i 81990 ' APPLICATION FOR CERTIFICATE OF OCCUPANCY pC.I?~C. A. TO ''~app]Fle~~ion~must be filled in by typewriter OR ink and submitted to the building "ector 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 foam}, 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains a less than 2/10 of 17> 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. ' B. 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, 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 , , 5,. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .fQ~?.~f~ Q New Construction........... Old Or Pre-existing Building n Location ef. Proper±y. ~-G.~~19~~...~ • /.~t~ ~ TNC~ K.......... House No~.} Street Hamlet Onwer or Owners of Property...V.~/~!~~~....~~L:y~.~ County Tax Map No 1000, Section.~~ ~ ......Block.. Q :~..........Lot..,~s./.,~ Subdivision/.QG1..Ls1~/~5...~:I.9.11~.~r.....~iJ.~:..Piled Map..~:~~.+f...jLot...~Q...Q..:........ Permit No. V. .F. ~~J...2.Date Of Permit..~.f e2 of .Applicant...1,1.R f~ .~.5../. 1.~.~-#~~. Llealth Dept. Approval ..........................Underwriters Approval...................... i'~ i Planning Board Approval Request for: Temporary Certificate........... Final Certicate....v...... Fee Submitted: $ CD ~ I R YG t . • • .APPLICANT ~ . ' TEL. 7G5-t 802 ©~o~~FF.OIk~ TOWN OF SOUTIIOLU ,,^a ~ ~ OFFICE OF BUILDING INSPECTOR o x` ~ a P.O. BOX 728 ~ ' ~ TOIVN EIALL O~OI ~ ~a0~ SOUT[IOLp, N.Y. 11971 June 15, 1990 James 6 Patricia Relyea 2305 ELIJAH'S LANE MATTITUCIC, N.Y. To Whom This'.May Cobcern, We are unable to complete your Certificate oL- Occupancy because of the following reasons. An application for Certificate of Occupancy is not on file. <ENCLOSED) No Underwriters Certificate on file. Tlic check is (d4is1yc#G'rl~ot on file. ) $25.00 % / No flcalth Dept. P:pproval on file. % / No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Bui]di.ng Permit 1 8 9 2 0 2 BuildincJ Dept. ' No Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after April 1,198~I ) TEL. 7G5-1802 ~oS~FFd~c ~o, To~rr or souT~oa.~ ,?l;::a 4' ,`c OFFICE OF BUILDI23G INSPECTOR ~ . P.O. BOX 728 ' o ~t~,, v' TOWN HALL "O/~0~ ~~0`r 50UTHULD, N.Y. 11971 C E R T I F I C A T I O N Date J ~2 ~~~y Building Permit No. /D ~~G~~_ Owner ~ Ifc%eaQ4 ( le se print) 4 P1ur,.b2r~C,~Frc~o~ ~m~iwq=/°"~~J (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. T (plumber's signature) Sworn to befor^_ me this d i day of - ~ I '~--~1 14~, ~ otary Public ~ Notary PUb11C , C.'OllRty N®TAi2Y PU6L(C, 5+«,e of New Yode / Na. G2-dfi3o565, ~i,fial< Count ~'@BYIYflI,$310n EXpRCg ~~~=3), ~ 990 _ 1 looo7ac THE NEW YORK BOARD OF FIRE UNDERWRITERS r'ACe ' BUREAU OF ELECTRICITY ° 83 JOHN STREET, NEW YORK, NEW YORK (0038 ;(ULY 31,iV911 6A07Sh9I7/9(1 N ih3h01 = Dote Application No. on Jile THIS CERTIFIES THAT only the ebrtried equipment a described 6ekFm and introduced 6y the appfleent named on the ebose epplioatton number in [he premises of IAftE3 RELY~A, ELI.JAN'ti LA, MATITTOf.K, N.'Y. in thefdlouiny loco ' nt ? lst Fl. ~ Ynd Fl. I'AR .Sertion Block Lot raves a:amined an and found to 6e in comp/ianre with the reyuirernenG of thu Buerd. FlXTURE RXTURES RANGES COOKING DECKS OVENS qSM WASN!!S EXHAUST FANS EFTAQES SWITCHES OUTLETS INCANDESCENT FIUDIIESCENT OTHER NAT. E. W. M1T. E. W. AMi. E.W. AMT. W. AMT. N. P. 15 20 1'7 13 2 3 r DRYERS FURNACE MOTORS IUTUEE AFFUANC! IRMERS S?lCIAIRK'?T TIME CIOCKS REII UNIT HEATERS MULTFOUTIRT gMMERS = AMT. K. W. Oll M. I. GAS N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. P. RrS?~R AMT. WAITS NO.OF 16T S SlRVICE gSCONNECT NO.OF S E R V I C E AMT. AAV. ME p ~ 11 3w 1 F SW ] 6 SW l / AW DCOND. OF CC COND. ~ NIiEG p~' HI'IEG ~ ~~AU Of ~ EN UTNAL 0T11ER AMARATUS: Ilf <fTRINf, FOR f,ARAGE AND 2nd PL. ROOM'i-1 ELEC. ROON HEATERS.3-. 75 K.W.,1-.5 K.W.,1-1 IC.W.,1-1.h K.W. PANELflOARpS:1-l4 (.1R. 100 ~ 6.E.C.I:-d I~ SMOKE DF.TEr,TOR:-t ~ RICHARD G. RELYFA P.O. HOR 372 - LAIIREI. , NY, 1 f 94A p~u MANAO~ 11 Per .This cerNficaN must not be altered in any manner; return to the office of the Board if incorrsd. Inspectors may be itMntified by tMirrc ntials. COPY FOR MHLa1NG DEPARTMlNT. TiNi COPY OF CERTIFICATE WST NOT 6E ALTERED IN Al1Y MANiER. r lELD II:SPECTIO.J ~I U.. ATE ~ i;OMMENT° -o m 1. H~ _ y~ FOUNDATION (1st) .,,,0 c FOUNDATION (2nd) _ z . y 2 O P,OUGH FRAME & ~ d PLUMBI G K 3. m IIJSULATIOP7 PER N. Y. p _ STATE ENERGY CODE x 4 . L ,.lst~~ y p/1 ©te,c-~i~-~" FI;dAL ~ ~ _ y~-1 O b z ADDITIONAL COMMENTS: ~ 4 cn b F-i ~ ~ ? ..fJ H H O .o z ro A • r - . d [7 'T1 H F'LU1t%713ERCERJIflCA71pN f~N LEAO CONTENT BEfORE ~.~`~'~sats",~~:~~! ~ia~7~ 8y8te11rplp~~~ CERT/F/CATEOFOCCUPANCY ~~~f~. ~~g~g~ ~;f, #s 1 ~~_~o~ oltYpaKor~L~ SOLDER USED IN YIG4TER ~:~"~'~'_~S'~_._._--__.. ~ SUPPLY SYSTEM CANNOT NczrlFV t4~c~.C7tt«; ~r~.:~x=Ft ~-Mf.~ar ,a1 PL,U1~BiNG EXCEf02/100F~76t~AD. ~ r~6-,~~z s~ ~a~n Y:~ r,;,, >Ur3 as+~ A~.~.p~unnal~aw/~S~e rc)LI_rpN~?„C, a r;~.,~"; & WATER LINES NEED t. ~~i~~a~arfo~! ~ ruvc~ s1~c~f.nF~~t~ TESTINiiBEFORECOVERINO a`n~ ~e~ci~erl cQr~c s4~r€ 3. INSUL.F~TEON A. F{Nf>L - CC)NSTRUCT1tJN MUST` k3fi CQMPl.ETE Ft7R C.C ALL CC7N5TRUCi1C)N SMALL RA1=ET ~ THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CQQES. NQT RESPC)NSIBLE PC)R DESIGN 8R CONSTRUCTION ERRCIR$ -~J ~ , ~O occup~~G~r o~ j use rs ~:~~~~u~ ,c~,s - ~I~LUPAlVCY o•4ro-£ ~ - - ' ~L c! iH ~/"~~G--_ t`T~d~-c=rte ~ ~~f ~ ~J~ l~s f ss u/~- ~ ' S Y5'` ~ '~.~8®x BUILDING DEPT. 1 NSPE~TIQN [ ]FOUNDATION i5T ( ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMAR S: DATE D INSPECTOR BOARD OF HEALTH 3 SETS OF PL.\NS FORM N0.1 SURVEY - TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC r•oart TOWN HALL $OUTHOLD. N.Y. 11~J71 NOTIFY 'o cc~~~ TEL.:7ti5-1802 cnLL "~-~f .-8 MAIL T0: / Examined ..~.R~ p~..a9.., 19 ~v .c~-1 y Approved . ~AhG!r..~:°(., 19~'`'. Permit No. ~ $ 9.3.°..~ • . Disapproved a/c ~ ~ U \.vJ\,'J , ~ wa ~ ~ ~ f'i (Building Inspector) 61-00~ OFl'"t, ryA. TOtNN OF 5l7UTFJfJLC7 APPLICATION FOR BUILDING; PERMIT Date .,5~.~~ f .~.rJ....., 15.". - INSTRUCTIONS <A a. Tltis application must be completely filled in by typewriter or In ink and submitted to the Building Inspector, with ~ sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan shoving 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 all applicable laws, ordinances, building code, hou~n~ ode, and regulations, and to admit authorized inspectors on premises and in building for necessa inspections. (Signature of applicant, oc~a corporatron) . ~,3~~.G~:t'rJ.ktkts...C..~€t!ti.~...~~l.~i.Z~4~- . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .....C~.te~110.~~ Name of owner of premises . ~.~?t.~!1.~: ~ l.~e: Y:'.~ ~ . (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 . . Plurnber'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 ~ • • • • • • • • • . Block ...G..!-fi Lot ..~~a , , Subdivision 4 lsf..lt/.'/.5 ..t-, A~~ ~5.~! >5., Filed A1ap No. . ~ a,(q' J; Lot . (Name) ~ - State cxistin~ use and occupancy of premises and intended use and occupancy of proposed construction: a a. Existing use and occupancy .....1.~~~4~..5:,57./.~~...C~-~!~~~y~. , ,S7,T'~~,~;~~ ; . b. Intended use and occupancy .•S'AI!?tT••••!*~~~ ~Lo.~y~iy~.......... - 3. Nature of work (check which appli'I Addition ; - • • • Alteration . ~ . Viable): New [3uilding , , Repair R[;moval Demolition ........:.Swimming pool........... . Tennis Court ..pp~~...... ~A~c~h ssory Building.. .....Fence .......Other jdork/~f-1a^?~LN~^t 4. Estimated Cost P. l d 0 0 . . flee , •~-e.,i -Yti'e.... • (to be paid on filing this application) 5, If dwelling, nutnber of dwelling units Number of dwelling units on each (loot . If garage,numbcrofcars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . 7. Dimensions of existing stntctures, if any: Front ..2 ?-,l.:C,+ Rear . ,2, ~-/::4;t Depth . ,%4~::'~, . . Height ~&'':.CS.. Numbei of Stories . . . . . Demth s~on~ ~sa~~ ~tructure~ ivtzhialtcrations or additions: Front , ,,~'s9 A? ~ , Rcar ....S'~^~.>:r . . p - Height , . ,S,'.rj,,tt;t. Number of Stories ...:z . 8. Dimensions o 1~ nstntction: Front . Rear Depth Height ~.'~Vumber of Stones . . 9. Size of lot: Front Rear Depth . 10. Date of Purchase ,,,,,,,,,,,,,,,,,,,,,,,,,„-Nameof Former Owner l 1. Zone or use district in which premises are situated . . . l2, Does proposed construction violate any zoning law, ordinance or regulation : 13. 1Vill lot be regraded { .................1Vill excess fill be removed from premises: • Yes , No . . 14. Name of Owner of premises , ~ .Address , ..........Phone No.............. , , . Nameof Architect ..............Address ...................Phone No................ . . Name of Contractor , ,Address ..Phone No.. , , . 15.Is this property located within 100 feet of a tidal wetland? *Y);5....NO,... *If yes, Southold Town'Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ?iuildings, whether existing or proposed, and, indicate al! 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 comer Iot. j ~ STATE OP NE1V YORK, 'S.S COUNTY OF . . (Aamc of individual si~n~ • ~ ~ ~ ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant ' • • . • ~ .ing contract) , above named. , He istttc (Contractor, agent, corporate officer, otc.) , oC said owner or owners, and is dully authorized to perform or have performed the said work and to make and file this application; that ail statements cont~incd in this application arc true to the best of his knowledge and belief; and that the work will be perforned in the manner set forth in the application tiled tltcrcwith. Swum to before me this ~ r Notary Public, , , , , ,/?~x; , , ~ K!~ County HELEN IC DE VOE . Na 4787878, SuffolkCounty~, (signature of applicant) iQPm EKPrtestM rcth 30'19 w