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HomeMy WebLinkAbout18723-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z 19306 Date AUGUST 20, 1990 THIS CERTIFIES that the building ADDITION Location of Property 875 PIKE STREET MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 140 Block 2 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 2, 1990 pursuant to which Building Permit No. 18723 Z dated JANUARY 9, 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 DECK ADDITION TO A ONE FAMILY DWELLING. The certificate is issued to JOHN KEOGH _ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED N/A ~Ci? 42. ..¢i.~~ QA. Building Inspector Rev. 1/81 Fosas xo. a 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 a 8 7 2 3 Z Date ~~~....,....1 19.9 D Permission is hereby granted to: ~ Q 7s:.....~..~-~:...... l- ....b1.~.... N.:`~........~~.s.s'.~ ct premises lacated ot ...~.~~......~~.....55,~! ...............p.r..)..~................... ......................................................................tt.//........................................................................................ Cvunty Tox Map No. 1000 Sect^ion~...... rl~..., Block .......Q..~--.... GLot No.....~~....1 pursuant to application dated ...1,.,~l.R~w!^:t.!^.arL........!~,7,.........., 19...1., and approved by the Building Inspector. Fee $..4~~'../. ...g ~p~a . ..t.. uildin I tvr Rev. 6/30/80 Form No. 6 ~ ~ e~ TOWN OF SOUTHOLD " BUILDING DEPARTMENT ~4 TOWN HALL AUG 2 OI99O a 765-1802 BLDG. DEPT. TOW[U OF 50UTHOLD - APPLICATION FOR CERTIFICATE OF OCCUPA .1. 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 Che solder used in system contains less than 2/10 of 1Z 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 regr..iraments. 9. 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 o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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 huilding 525.00. 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. L'puat.:d Certificate of Uccupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..AUGUST:.16,.19.0 :;~•v Canstruction..Y~X~~$?C Old Or Pre-existing Building :.cation of Property...875....... PIKE, STREET MATTITUCK r _ House No. SCreet Has~rlet 'lower or Owners of Property ...............JOH1V,I~EOGH _ ~ _ County Tax Map No 1000, Section....~40......Block.....?..........Lot......24 Subdivision ....................................Filed Map............Lot.............:........ - Permit No.. 187232 1 9 90 .Applicant.... JOHN KEOGH ......Date Of Permit."........ (;ealth Dept. Approval........... .IQ/............Underwriters Approval.......NLb1 " Planning Board Approval..........N/.~........... Request for: Temporary Certificate........... Final Certicate..KXXXX~.. ?ee Submitted: 25.00,,,~,,,,~,~~~., Cod 1~3a~ _ APPLICANT Qw N03i~ - 1, , __~.oGl~v ~~`~t_vc~u ~ "tS r~t~i~ ~i. 4ti~cr~t~C~LIJ,~I. t[a11i f } _ a ' ~ c~~1~ Y~it~~{iStL~ 1~P2(;1~~ I. f F ii ~ ~ I Ii` ~ ~ I.J ~i ~ ~ ~ ~ f r ~ 1- I ~ yti ~ `~L i ~ ~ ~ 1 I ~ i ~ ~ ~'6r ; { I ! p'; ~ ._s'~._ i I i ~i~~~ i' ~ - ~ i ~ ~ i F y; ~ r„ s . _ . ~y r' , ;'lELD I::S: ~ ~~Un.E I~ ;;G:fMENTC ill ~ . i . ^w ~ _ eJ. H '-3 w ?OUtJDATIO"J ~ (1st) ..r~, ?OUtJDATIOtJ (2nd) I z 0 oa J ~OUGH FRAME & V( PLUMBING N H 3. ~ n I2JSULATIOPI PER N. Y. ~ STATE EPJERGY CODE . ~ . 4, ~ FIJIAL ~ !I~ C.o, o~ ADDITIOtIAL COMMENTS: x..,yl I .O c*~ • x 'a ' J H s ~.0 . H H O m • r ~ s o ~ m -o a BOARD OF HEALTH 3 SETS OF PLANS FORM N0.1 SURVEY . TOWN OF SOUTHOLD CHECK . . BUILDING DEPARTMENT SEPTIC FORPf 70WN HALL $OUTHOLD, N.Y. 11~J71 NoTIC•Y c TEL.:7G5~1II02 CALL q hfAIL T0: Examined . 4s~:µ^°,rt^.~•...., 198.1 . APProved 19~~. Permit No. I.S.Z a.~.~ . Disapproved a/c . (Building Inspector) - APPLICATIOPJ FOR BUILDING PERMIT Date ~.,..a'~.~.U...., 19... INSTRUCTIONS n a. Tltis application must be completety 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 showing location of tot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must by 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature oi' applicant, or name, if a corporauon) • (Nfailing address of applicant) State whether applicant is owner, lessee; agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ~ ~ 4=.~. ~ ~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. 44 ^g y1a (Name and title of corporate officer) Builder's License No.'..... ~ , Plumber's Liccrise`Nb. , r~; Electrician's License No. ' Otltcr Trade's License No . . 1. Location of land on which proposed work will be done; House Number Stjre~et. ~ Hamlet County Tax \tap No. 1000 Section I • d • • • • . Block , , . ~ a-: , , , , , , Lot ....a. J...... , Subdivision Filed ~1ap No. Lot . State existing use and occupancy of premises and intended use and occupancy of proposed construction: h __n~ , a. Existing use and occupancy A!V ~ , ~7.^~. m; ~,~„f ..I'`),~~~',/~ s-,l . b.Intende t' `r ~~~Ck ~`7J~,~/©tJ d use and occupancy /w•t , , , , 3. atu e o w 1"I N r f ork (check which app tFable): New Building Addition Alteration . Repair Removal • • Demolition ..............Swimming pooL........., . Tennis Court Accessory Building..........Fertce ......,Other Work.. 4. Estimated Cost . , ~.~a.4~..... ~ Fee~~II. o~~Q (to be paid on filing this application) 5, IC dwelling, nurnber of dwelling un'ts . . Number of dwelling units on each Cloor . If garage.numbcrofcars 7. Dimens ons of existi'als~ructures°jlccupancy, specify nature and extent of each type of use . g f any: Front . ,Rear , Depth . . ' Height ...............NumbcrofStarics.........................,............................. Dimensions of same structure with', alterations or additions: Front Rear , , . . Depth . : Height Number of Stories 8. Dimensions of entire new constnuction: Front : Rear Depth • , , • . Height Number of Stories . 9. Size of lot: Front , Rear Depth , 10. Date of Purchase ~ ..............'..Name of Former Owner , . 11. "L'one or use district in which premises arc situated . . . . i:?. Does proposed construction violate any zoning law, ordinance or regulation : , 13. 'IVill lot be regraded • , , ' . .................Will excess fill be removed from premises: Yes , ; AIo , . 14. Name of Owner of premises . , . ~ ..............Address ...................Phone No.. , . Name of Architect , , , , , . .Address ...................Phone No. ~9.~ :.?~.a-la 3... . Name of Contractor . ,Address ..Phone No.. . IS.Zs this property located within 100 feet of a tidal wetland? *YtiS...r°NO.... *If yes, Southold Town'Trustees Permit may be required. ~ PLOT DIAGRAM Locate eleazly 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. j I C~~ . ~ ~ ~ APPROVED AS NOTED DATE: r 9 t3.F~ w ..L.g.2.-~~ FEE:- 1e~~ k3Y, .l'~s~ N071FY BUILDING OF.PARTMEtd'F ;:r 765-1802 ID AM TO n EN? fClr+ TSJI:' FOLt.OWING INSPEf,;'TIO(vS 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE OCCUPANCY OR 3. NSULATIONAMING & PLUMBING USA IS UNLAWFUL 4. FINAL - CONSTRUCTION MUST SE COMPLETE FOR C.O. WITHOUT CERTIFICATE ALL CONSTRUCTION SMALL MEET 0~ OCCUPANCY tHE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY STATE OI' NE\V YORE, CODES. NOT RESPONSIBLE FOR COUNTY OF . . S.S DESIGN OR CONSTRUCTION ERRORS • • • • • • • ~•°•W • ° ~ N• • • • • • • • • • . , being duly sworn, deposes and says that 1te is the applicant • (Name of individual signing contract) about named. Hcisthe...Q W ~ , . (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 statcrnents contgincd in this application arc tnrc totth+c best of his knowledge and belief; and that the work will be performed in the manner set forth in the application Glcd ilicrcwith. Sworn to before me this ' ........................day of 19 . . Notary Public . County ~ . ~ . ~ ignarure of applicant)