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Home My WebLink About18833-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19049 Date MAY 16~ 1990 THIS CERTIFIES that the building. ADDITION Location of Property 4170 CAMP MINEOLA ROAD MATTITUCKr N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 05 Lot 21.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Februar~ 22f 1990 pursuant to which Building Permit No. 18833-Z dated MARCH 2r 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 2ND STORY DECK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED RAYMOND VILLANUEVA & WIFE N/A Buzld~ng Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~_ 18833 Z Permission is hereby granted to: o..X. ol ~, . ~- ,',~L~-?.._~....~ ...................................................... ~ ~ ~~~. ................ ~ L...~.~.~. ..... . ,~ .~~....~..~.~....~. ~.~....~.~.~....~ ............. .................. ot pre. i,. ~*t~ .t ..~...Z~~~....~,. ........ ~.~.~ ........ Count,/ Tox Map No. 1000 Section .... .J...~......~ ......... Block ...... ..~....~.. ....... Lot No....,,~,~....1~... ....... pursuant ,o opplicoflo, doted ......~..~~......'~.....:~.. .......... , 19..~...°., ond approved by the Building Inspector. Building Inspector Rev. 6/30/80 Ao Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 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. SubmlL Flaunting Board Approval of completed site plan requirements. 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. Fees 1o 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 - $I0.00 4. Updated C~tificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ....... Old Or Pre-existing Building ................. House No. Street Hamlet County Tax Map No 1000, Section./.~..5 ...... Block ................ Lot ................. ............ Filed Map ............ Lot .... .~./...~...~~ Permit No ......... Health Dept. Approval.~..~..%f~..~--./.{.~... ........Underwriters Approval..... ......... .. ....... .. Planning Board Approval . . Request for: Temporary Certificate .... Fee Submitted: $...~.~.. 0-0 · ....... Final Certicate ......~.... .... q ................. TOWN OF SOUTHOLD OFI:qCE OF BUILDING INSPECTOr< P.O. BOX 728 TOWN HALL SOUTItOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. An application for Certificate of Occupancy is net on file. C~ No Underwriters Certificate on file. ?he check is(~/not on file.) $~<~ /Z/ No Health Dept. Approval on file. No final ins.pection has been made. Please contact our office Thank you for your cooperation. Bui]dJ. ng Permit tt / ~ ~ 3 3 Z Building Dept. ***/~/ on this matter. No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUI~DAT! 0:~ (1st) ?OU~DATIO:; ( 2nd } 2. EOUGH FRAME & .PLUMBING iNSULATION PER N. Y. STATE CODE FI;JAL ADDITIONA'L COMMEI;TS: 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST ~ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION []FRAMING []FINAL REMARKS: DATE INSPECTOR FOR~ NO. 1 TOWN OF $OUTHOLD BUILDING OEPART~IENT TOWN HALL ,,~OUTHOLD. N,Y, 11971 TEL.: 765-1802 ~,n~..,..~ ~.~..~ .... (Building Ins0ector} 'APPLICATION FOB BUILDING PER,lIT BOARD OF HEALTH ..-~.---- - SURVEY .Av~rt ........... c~Ec~ i...~ X.I~-, ....... SEPTIC FO RI'! ................ NOT I I~Y; q CALL . . . HAIL TO: TOWN Date ..:,d.:/.z.. -. IlqSTRUCTIONS a. Tlds application must be completely filled tn by typewriter or in ink and submitted to the Bulldin~ l~ector, ~vith sets of plans, ~ccurate plot plan to scale. ~ec according to schedule. b. Plot plan showing ~ocation of lot ~nd Of buildings on premises, relationship to adjoining premi~e~ ~t ~uhHc streets or ~rc~s, and giv~g · dct~led description of 1:yout of property must bc dr=wa on thc diagram wh~c~ ~ p~ of :~s :pp~- czfion. ~. ~c work covered by t~s ~ppHcation m~y not be ~ommenc~d befor~ i~u=nce of Building ~. Upon =pprovnl of this ~pp[[c~tion, the Building Inspector wHI issued a Building Pc~it to the ~pp~ ~c~ ~h:ll be k~pt cn t~e premises :v~Hable for inspection throu~out the work. ~. Mo build~g shall be occupied or ~ed in whole or in pnrt for ~Dy purpose whatever until a Cc~f Occup~cy ~h=ll ~ve been gr~n~cd by t~c Build~g Inspector. APPLICATIOM IS HEREBY MADE ~o the Bulldog Dep~m~nt for the i~uancc of a B~Iding Pe~it ~unnt to the Building Zone O~dinanc~ of the Town of Southold, Suffolk County, Me~v York, ~d other appHcable ~. O~d~ce~ or Rcgulat~oms. for thc const~tion of bulldogs, addRlon~ or al~ations, or for ~emov~l of demolition, ~ he~ d~bed. ~hc npplicanl agree~ ~o comply with all applic~e laws, o~ln~nc~, bulldog code, housm~ cod~, and r~ons, and to :dmit authoHzcd ~spccto~ on premises and ~ bulldog for necc~s~ in~pection~ (Signature of apphcant, or name, ;tale wh~ther applicant is owner, lessee, agent. ~chitect, ~ngin=er, general contractor, electrician, pinm~r or builder. ~oro,~,~orp~i~ ~: ~/(~0.'~. ~ v.~. ............................. (as on thc tax roll or latest deed) fapplicant is a corporation, si~aturc of duly authorizfid officer· ~ (Name'and title of co~mte officer) Plumber's License No ' Elcctrician's License No Other Trade's License No Location of land on which proposad work will be done; ., ·. ' - · . . .... ~o .......... ~.~ .c. Hous~ Number Stree[ ' ~ Hamlet Counw Tax M~p No. I000 S~ction .............. .. Block ............... Lot ......... .,- Subdivifion ...... ~ilcd Map No. Lot . (Name) ... State ~xi~ting u~ and occupancy of premi~ex ~nd intended uxe a.d occupancy of proposed a. Existing use and occupancy . ~ .... ~..~.~:z~../~.Q ~. , ................. b. ~,,~d~ ~,~..d o:c~v~,~ · .¢.~" ~' ...... ~ .... ~" Altcrati~n Nature of work (check which applicable): New Building .....'7~7... . ... Additian ..................... Repair ............. R~moval .............. Demolition .............. SuL-araing pool...,,t. --- ' r ~'L ......... ..... :... .......... ....... .... Tennis Coure ~timatedCast...~(~.6.~. ..................... Fee .............................. ... . . . . (to be paid on filing this app~ation) If dwelling, number o~ dwelling units .......... I~ garage, number of cars .......... . ~ .. ~ . Humber o f dwelling units on each floor .......... ........................................ ; .. If business, commercial or mixed occupant, specify nature and extent of each type of use .................... Dimensions of existing xt~ctutcx, [f any: FLoat.., ........... Rca~ ........... Depth .... Height .... Number of Stories Dimensions of same structure with attentions or additions: Front Rear - Depth . .. ......... :i ~ J. ~.~. ~ (r ~tei~t ................. '. Number of Stories ............ Dimensionsofentivcnewconn~&lon Front .. ~. '~ .. Rear .............. Dg~t~ Height ...............Numfi6r~of Stories ............ ...L: .... ;..... .................... S~zc at lot: Fr~ ;, - . Re .......... De~th ......, ......... Datoof~urcl~e.............:.:.......... · . ..... ~ameofFonuerOwner ........... , ....... : ......... Zone ~r usa d~tfict in which pf6~[~a are situated ........... . . Docs p~'opoxed ca~t~ction violate any zoning taw, ~rdinance or regulation: .......... · .................... W~I N lot be reg~ded ..... Will exc~ fill be removed from premise~: Yes .... of premises ........ ' ....Addre= Phone No .. N~e of Owner ....................................... . ................ Addm= ............ ;. Phone No N~e of Architect ................... N~e o[Contmctor ................. .~ ........ Addr~ ................... Phone No ..... ~,; .... ' · · · · If yea, Southold Town T~uacee$ Perait may be required. P~T DIAG~M Locate cle~l~ =d dis~ctty MI buEdM~, whether existing or proposed, ~d, indi~te ~l set-back d~ensions from ;ope~y Enes. Give street ~d block number or deacfiption accord~g to deed, ~d show steer n~ ~d ~z: whether .tenor or comer lot. ;TATE OF N~W XOR~I~ :OUNTYi OF .q~~'~ t · (Name of individual signing contract) bore named. ., (Contractor, agent, corporate officer, etc.) said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this Pplicafion: that all statmnenxs contained in this application are true to the best of his knowledge and belief; and that the 'ork w~l be pert'onned in the m~ner set forth in the apptioafion filed therewith. ' Qualified m Suffolk ~un~ No, 52-4643246 ~/ ~ (Signature of applic~t) Commission Expir~ ~ 30, 19 .[ ,i 'I OCCUPANCY OR US~IS UNLAWFUL WIZti,~UT CERTIFICATE OF OCCUPANCY - APPROVED AS NOTED . ~. ,~: v. ~.~.,.. ~NOT,. BUILDING DEPARTMENT AT 765-1~2 9 ~ TO 4 N FOR ~E ~1. FOUNDA~ - ~O RE~IRED R~ - ~ A '4, ~NAL - ~N~RUCTION MUST BE~E FOR C.O. ~ CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR ~NS~UCTION ERRORS