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HomeMy WebLinkAbout18601-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19453 Date OCTOBER 17, 1990 THIS CERTIFIES that the building ADDITION Location of Property 2120 WICKHAM AVENUE MATTITUCK, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 139 Block 3 Lot 33.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 24, 1989 pursuant to which Building Permit No. 18601-Z dated OCTOBER 26, 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 ADDITION TO EXISTING ACCESSORY SHED AS APPLIED FOR. The certificate is issued to EDWARD & JENNY SKIREL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ilding Inspector Rev. 1/81 Fosas xo. s 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) nJo .L ~ ~ ~ Z Date 19.~/.. Permission is hereby grantedyt'o: C ..6.t....~yY~~,~~r ~r A at premises located at .....~~..,1-c~~y..yC.~.....!!G:~..~.G....... ....................................................:.'.l.G1..G4........................................................................ County Tax Map No. 1000 Section ......f~~....... Block Lot No.....`~.-~~..:.,/..... pursuant to opplicatlon dated 19. and approved by the Building Inspector. Fee Bui ing I for Rev. 6/30/80 • , ^ ~ ' p ~.i~.r:.r.~~v.+~@ I.~J'~~~~S~~TT~f ~I ;'~I~ TOWN OF SOUTIIOLD /yr,. ~ C 199p BUILDING DEPART?LENT YY44II :J TOWN HALL BLDG, O!:'P7. SOUTIIOLD, NEW YORK 1 197 1 TOWN OF S{}, iriit~r ,_..~.,..,_a._. 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY ' / ~'~~;9d DATE. F.©.,:,,!.. NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING..~pACANT LAND..._.__. Location of Property..,°~'~~"d ~f1rll~.~L:c.:!!;,ti~f~~_.... /j/J,~yL~G•~~G,(~ HOUSE NO. STREET HAMLET `C Owner or Owners of Property.....!-~~~`~ _ , SI'~~/~`~Q. ~ . ~,(Jc'r ~.Q___ County Taa Map No. 1000 Section ~K~. . -J Lot. ,3 3 / • - Subdivision./....../,.,.,,,-,..,•- „ Filed MaP ---.....Lot...._..._. Permit No. (.~~~,(--.Date of Permit .~~;y-Applicant ~.~w~~~..~~~~~/ Health Dept. lspprcval Underwriters Approval Planning Board Approval Request for Temporary Certificate Final Certificate " Fee Submitted: $-~(~d 0.-...._.-.-. /o~~~ t APPLICANT..... " ' reV- 10/14/88 Q%t-~ y 0 q ~ eo ~ l yy53 L, ev J ~ FORM N0, 6 TOWN OF SOUTHOLD BIIILDING DEPARTMENT TOWN HALL 765 - 1802 tl APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must befiled in typewriter OR ink and submitted to the Building Inspector with the follo~ing; for new buildings 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 of Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electricaj. installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/10 of IZ lead., 5. Commercial buildings,l,industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board '!Approval of completed site plan requirements. B. For existing buildings (Frior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land yses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in vr~iting to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information 'required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, 1957 shall also accompany the application. If a!Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D, FEES: 1. CERTIFICATE OF OCC~TPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over S years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential ! $50.00 Commercial cev, 10/14/88 ~I I i~LJ Z::.°,: z .:J:: I~~h:_ it ~U:YMENTS v II m _ II c'OUIID_TIO;] ~ (1st) __•I - - ~ 1• ?OUtIDATIO;J I c (2nd) ti -a - y 2. I ~ d I 'OUGH FRAI•IE & PLUMBIiIG I y 3. ~ y~ m IISULATI027 PER N. Y. I ~ H STATE EIIERCY I ~ CODE I I . Ii y~, FZ;JAL I • I ~ ~ 0 °I ADDITIOPIAL COMMEIJTS: m s w • H a~ O • m / ~ e.~ m ^o r. _ ~ W ~ ~ ~ , ~ . ~ ~ 0 ~ Q ~7 \ m 2 ~ ~ ~ ~ ~ Q~\ F3 9.> ~i o ~ ~a o r~ ~a m ~ \1` ~ ~ ~ 9 ~i@ o Q U R BOARD OF HEALTH O 15 O 3 SETS OF PLANS FORM NO. 1 ~ ~ TOW'V OF SOUT • • • . 6 BUIL"D.ING DEPAR OR,1 , , , , , , , • _ • . ~ TOWN HALL BLDG. DEPT. SOUTHOLD, N.Y. 1797'1 NOTIFY TOWN OF SOUTHOLD TEL.: 7G5-1802 CALL • • . Examincd.~~~~„fd,,,,, 19 MAIL T0: 3~1 l Pa ~ Approved l~~a, ;ro......, 19~~Permit No. Disapproved a/c • , _ APPRDV D AS MOTED' DATE: G~ B.P. p - a d - FEE: ....~~f.. 6ti ' BY: - NOTIFY BUI G DEPARTME AT (Buildin^ nspec ) 765-1802 9 AM TO 4 PM FOR THEAPPLICATION FOR BUILDING PERMIT , ' FOLLOWING INSPECTIONS: 1. FUUNDATIUN TWO REQUIRED ~ Date . ®G~, - FOR POURED CONCRETE ~ • • • • • 19 2. ROUGH - FRAMING ~ PLUMBING INSTRUCTIONS 3. INSUI.ATIUN a ' 1' ~~tT~Q~ately filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets oL~ ~Ft~ ~n to scale. Fee according to schedule. or ~l ~ ~ gat and of buildings on premises, relationship to adjoining premises or public streets a €G(~on of layout of property must be drawn on the diagram which is part of this appli- cati t - lion may not be commenced before issuance of Building Permit. • • • ,the Building Inspector will issued a Building Permit to the applicant. Such permit shall~keot on the prerBtses available for inspection throughoutYlire Work. eNOFI6Vb~tlfr~N6alpbRp'T@ p~'used in whole or in part for any purpose whattvei until a Certificate of Occupancy sha117fi.5e7$QBt~rAt~'kq~1?)+itllt~lBp~ir~~tspector. ! hr LLOWN~IN~~ SpE~ ~IS~ ~~to the Building Department for the issuance of a Building Permit pursuant to the BuildinF~P own of Southold, Suffolk County, New York„ and other applicable Laws, Ordinances or Regu~atG~I ~~116flF~ir~c e~„pf;,~tuldings, additions or alterations, or for removal, or demolition, as herein described. The 3tp(~t~p~gyq~-j~es to comply wt a`1~ applicable laws, ordinances, building cotje, housing code, and regulations, and to admy~ apj~~nzed t~~t-~~r~~~and in building for nece~sary inspe do BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET ~ " • • g ' • ~ • ~ ~ ~ • p" ' • ' • " " ' • " ' ' P " " " ' THE REQUIREMENTS OF THE N.V. (Si nature of a licant, or name, if a cor oration STATE CONSTRUCTION A~ NERGY 9 D. ~ ~ 3 3 9 .~F ~ ~y 2r~ ~ e. CODES. NOT RESPONSIB~ FOR ' ~ ' ' ~ ~ IJESIGN OR CONSTRUCTION ERRORS (hfailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. < / ,~s Name of owner of premises ~d ~a J./1.~'~:'Q:/ (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 COt7TRACTOR'S MUST BE SUFFOLK COUNTY LICENSED ~ Builder's License No. , Plumber's Liccnsc No. , , , , , , , , , , , , , 1~~ d Y ~ 1 Electrician's License No. ~ ~ f e~ Otltcr Trade's License No . . 1. Lor~cation of land on which proposed worrk will be donnne. ~~J.i~.k ~!'4r!,/k~ , •2,G,~,,he,~ s / ~~`~f .4:'.~ O~© ..............'v,L~~/k~?'~. .!•'>"1>",'Q.............L./, ,oy/~v,G,!~t. G~'..... F House Number Street ~ / Hamlet County TaxAfapNo. IOOOSection 3 Block Lot., 3 Subdivision .Filed i\1ap No. . Lot . (Natnc) State existing use and occupancy of premiseGs and intended use and occurrpancy of proposed construction: a. Existing use and occupancy ~ . lG? ~:%,l , , , .Qrl,,~,/~c~n- b. Intended use and occupancy , , ,~'4!k`;t;` c C r J• f J 3. Na[ure of work (checl. which a lica ~a' P~ ble): New Building Additio~' ~t~ht{~" ly,,, Rcpatr Removal Demolition , , ~ O{ther 1Vd1k'..::' j 4. Estimated Cost (.®Q.. Fee ,/~02,~ ~ ~i.'~cscBFtlb.~i~on) . . ~ (to be paid on filing this application} 5. If dwelling, number oC dwelling units Number of dwelling units on each floor _ , . . ' Ii garage, number of cars . 6. IC business, commercial or mixed~'joccupancy, specify nature and extent of each type of use 7. Dimensions of existing structures!, if any: Front Rear Depth _ Hcigltt Numfjer of Stories . ' Dinunsions of same structure wttlt alterations or additions: Front Rear . Depth ...................Height . Number of Stori. . 8. Dimensions of entire new construction: Front . Rear D`eptt}t~''t,' Height .......:........Numl}erofStories. ~rs 9. Size of lot: Front ~':O Rear (r ~7.........~. Depth t. l,ab.`~.L, ' 0. Date of Purchase e~.`1~~1~. ~.I Name of Former Owner'~~=,~;~';6D~~P~:haR.;tf?Q~, , , , , 1. Zone or use district in which premises are situated ~ ' ' ~.:5'... 2. Does proposed construction violate any zoning law, ordinance or regulation: t~...:' . 3. 1Vi11 lot be regraded 1~O r Nill excess till a em 'v¢difiom Premises:' ' Yes No, 4. Name of Owner of,premises Kkr/Q `,/Address .N/.~~~t,'i~kt,~.=Plib'ne No. '.e'~.q8:~ ~:$"'Qi ~j. . Name of Architect ~-.!,.4t.!~i~, ;Q~, , , , , ,Address I'tibn"e`No: . Iv'ame of Contractor . .Address .......Phone No.~~// . . 5. Is this property located within 300 feet of a tidal wetland? *Yes No /r.Sh *If yes, Southold Town Trustees Permit may be reqyu~ired. ~ . PLOT DIAG1tAM Locate clearly and distinctly all tjuildings, whether existing or proposed, and.indic te.;,,,~~ Sggt-back dimensions from operty lines. Give street and block number or description according to deed, and show s~eR=1ia'rPies and indicate whether tterior or corner lot. ,y , ~skwda~ t n ~ A~d~~tr'mw ,~~Nag2 ~i~i ~ ~ ' sh d ,~Y I , ~ ~~~y,,ry - . , ~i`1 - I iii ~'~i~~~'~{ 'il is ~'f~a~p'All~~a ii sei i ;;s. • b~.~~lG~ ~ S co~~~~ ' ~ ~d~ ~ ~ ~d ~ ~ 7.`0 oet '~"o o I ~ Sly ~e. ~ ~ ~ ~ I "ATE OF KEtS' ~'ORI:, ~ . C;1TY O F tro?-~F, ~IK.~.. S'I~S . . . lft~~,`.~ being duly sworn, deposes and says that he is the applicant (tiamc of individual si~nina contract , ovd named. j' :isthc..:......C~ L?.k4 (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform o`r have performed the said work and to make and file this alication: that all statements contained in this application are true to the best of ltis knowledge and belief; and that the nk will be performed in the manner s~ct forth in the application filed therewith. •om to before me this ............a? .day of. 19 tart' Public, f~?~; ; , ; U~-... County t HELEN N. DE VDE • • • . IbiARYPUBLICrStateoiNev,YMM (Sig ature of applicant) Na W707878, SuRnp County Term Expires Msrch 3P,19~f ~ , j I