HomeMy WebLinkAbout18466-z FFo4
Town of Southold 7/25/2020
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P.O.Box 1179
53095 Main Rd
�4% app y�`�4 Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 20751 Date: 5/21/1992
THIS CERTIFIES that the building DECK
Location of Property: 1835 Naugles Road,Mattituck
SCTM#: 473889 Sec/Block/Lot: 99.4-20
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/23/1989 pursuant to which Building Permit No. 18466 dated 9/11/1989
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 existing accessM garage as applied for.
Corrected 7/25/2020 for address only.
4
The certificate is issued to Weisent,Francis&Marguerite
r
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
VV th riz gnature
FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20751 Date MAY 21, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 1925 NAUGLES DRIVE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 99 Block 4 Lot 20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Buildinq Permit heretofore
filed in this office dated AUGUST 23, 1989 pursuant to which
Building Permit No. 18466-Z dated SEPTEMBER 11, 1989
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 EXISTING ACCESSORY GARAGE AS uvpr.rFn FOR.
The certificate is issued to FRANCIS F. WEISENT
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERT1~'ICATION DATID N/A
( j~ ~i~l~
-~~-?y~%/ Building Inspector
Rev. 1/81
° !'OEM 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°- 18466 Z Date .9~1..'
Permission is hereby granted to: ,
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ct premises located of ..........1 ~:.~Z....:5 ......sly.~.r.(t/..`1.................................
...........................................................................q....................................................................................
County Tax Map No. 7000 Section L~.../........ Block Lot No.........C~.. tJ
~r
pursuant to application dated .........Ci.. yl.~.~ 19.~~ and approved by the
Building Inspector. /
Fee S~.
.!l~r.
uildi Inspector `V~~/ "
Rev. 6/30/80
~ Form No. 6
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i"CG~~.-( TOWN OF SOUTIIOLD ~ +n,5 j'~ '
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BUILDING DEPARTMENT ' t. ~
TOWN HALL
1 7es-lso2 ~9AY 2 01~~,
APPLICATION FOR CERTIFICATE OP OCCUPANCY
A. This application must be filled in by typewriter OP, 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 Copographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-4 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 12 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, 1457) 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
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 Euilding - $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 ..0.~. G ~..a' .
'ew Construction........... Old Or Pre-existing Building...?
.ocation of Property.. l q .~.5... NGU_b~,IPS, _ Dri tr2. _ „
I[ouse No. StrceC Hamlet
nwer or Owners of Property.. F,Yat~c15, ~,,WQJ.SC'.V1Z,~ .
ounCy Tax Map No 1000, Section.... .~......Block.......~.......Lot.....~.~............
ubdivision..c./...//../!.~- ..........................11.Filed Map............Lot......................
armit No...~9.~.Y'~Y.....Date Of Permit..~...1.`.. g~..Applicant
~alth Dept. Approval ..........................Underwriters Approval.........................
fanning Board Approval
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:quest for: Temporary Certificate........... Final Certicate..
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`e Submitted: $
~or_~o~~l APPLICAPI'P
l f~~` ~ T65-1802
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BUILDING DEPT.
.INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ULATION
[ ]FRAMING [ FINAL
REMARKS: v~t~
DATE ~ ~ D' INSPECTOR ..G~j
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STATE E!lERCY
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BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY • .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
~OUTHOLID, NAY.L1i971 NOTIFY ~ ~d~-•~",~~`
TEL.: 765-1802 CALL • • .
c M T0:
Examined . % . 19 .p,~~/ 6 M ~
Approved ....g/~ I9 Permit No..~4.~6 ~ ~ ~ ~ ~ l~l L~'
AUG 2 3 198.9
Disapproved a/~
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(Bu' Inspector)
APPLICATIO FOR BUILDING PERMIT
Date 19
INSTRUCTIONS
a. This 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 showing location of lot and of buildings on premises, relationship to adjoining premises or public street
nor 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 permi
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied o; used in whole or-in pazt for any purpose whatever until a Certificate of Occupant
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Regulations, For the construction of buIldings, additions or alterations, or for removal or demolition, as herein described
The applicant agrees to ecmply .,itl. aii applicable laws, ordinances, buuding code, housing code, and regulations, and t.
admit authorized inspectors on premises and in building for necessary mspec ion .
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder
.........~.~~~Z ..................,.I.l................................:..................
Name of owner of premises ~.B'Yt/G.~S....~!f/.e(dv~.~ .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR`S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No . .
F-
Plumber's License No. '
Electrician's License No. ~ .
Other Trade's License No. ~ r' '
1. Location of land on which proposed work will be done. ~S. /v?~~/~ ~
House Number yStrgeet Hanilet
County Tax Map No. 1000 Section J../ • • Block Lot ....o'i e~....~..... .
Subdivision . ~iled Map No. Lot , .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy/~of~proposed consyyt/~r~~/uction:
a. Existing use and occupancy ~ .
b. Intended use and occupancy ~I r~S~` .........~OlN/.~1/............. .
3. Nature of work (check which applicable): New Building .........o. Addit3bn Alteratign
Repair Removal I2e~ y~t
ot~ ~~~tt r Rork ..,UG3.G~C.... .
7 6X~S~/ ~f/'~ ~ (DescripSion)
4. Estimated Cost ,S O o' ° n Fee .
` (to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
If garage, number ofcazs ...Z.~LjfC
6. If business, commercial or mixed occupancy, specify nature and extent of each ty e of use . .
7. Dimensions of existing structures, if any: Front ....Z ~ .......Rear Depth ~ .
Height ...............NumberofStories............:...........................................
Dimensions q(saim~.structure with alterations or additions: Front Rear .
Depth ........5..`............Height ......................Number of Stories .
8. Dimensions of enure new construction: Front Rear Depth .
Height ...............Number of Stories........................................................
9. Size of lot: Front Rear....................... Depth .
]0. Date of Purchase .............................Name of Former Owner .
1 I . Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation : .
13. Will lot be regraded Will excess fillb~j removed from premises: Yes No
14. Name of Owner of premises ../.`/~;,rJe . G+rIP/J.'?~Address /.~.~SN/.~'.f.~"~~. Phone No, ,~,9~~3!S~.. .
Name of Architect ...........................Address ...................Phone No............... .
Name of Contractor ..........................Address ...................Phone No............... ,
15. Is this property located within 300 feet of a tidal wetland? *Yes No ,
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly 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.
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STATE OF NEWYORK, z k Q A-w S k t,
COLNTY OF S.S
being duly sworn, deposes and says that lte is the applicant
(Name of individual signing contract)
above named. ~ ~
He is the
(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 file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this ~
...............4?.3......day of`~..... 19~.~ ~.~iL'O~
Nota Public, Count /p/~~~
w' .;Q ..4+1JO~
~1ttiRY~t~C,K~d~tkrr,(ak (Signature of applicant)
Term
Exprei
Mir5ch~30k,1~9....1~