HomeMy WebLinkAbout18617-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT _
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23731 Date JUNE 23, 1995
THIS CERTIFIES that the building ACCESSORY
Location of Property 250 SALTAZRE WAY MATTITUCR NY
House No. Street Hamlet
County Tax Map No. 1000 Section 100 Block 1 Lot 39
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 25, 1989 pursuant to which
Building Permit No. 18617-Z dated OCTOBER 31, 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 AN ACCESSORY SHED AS APPLIED FOR.
The certificate ie issued to WILLIAM J. & MAUREEN H. SANOR
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
rosai 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)
N O 6~ 7 Z Date ...?..Q.,/s~~ 19.~!
Permission is hereby granted to:
. ~ ~oa~
~'s~z-
to ....~?'~1. r~
R ..................~~`®....~.../....P................~.............................................................
of remises located at ..........................~;4~~~~~?.............'..~~
~Y~~~+~lr.............................................................................
County Tox Map No. 1000 Section ........~Q.t~...... Block ............../..'.....99Lot No.......:,~.~~............
pursuant to application dated ........E°'.,l..F`3. 19~l...., and approved by the
Building Inspector.
po/
Fee $....~1..~~r.
Buildi g Inspector
Rev. 6/30/80
_ Iorm flo. G
'[ota~ or sou~ruot.D {,€;~r .d
BUi1,DING l)fP/1R'CPILNT ~ i~r
~G 'ro1~N IInLL ~ JUN 2 11995 r
7~s-tuoz
APPLICA'r10N I"Olt CGR"CIITICn'fli 01' OCCUPANCY ~ ~Ctt~(;~
~1• This applicativ? must be filled i-n by typewriter OR inlc and submitted to the building
inspector with the Coliowing: Cor new building or new use:
1• Pina]. survey of. property eu1.Ch accurate location of all buildings, property lines,
streets, and unu:;ual na Cu ral or topographic Cea CU res.
Z• final Apptoval from Ilealth llept. of waCCr supply and sewerage-disposal (S-9 Corm .
3. Approval of electricvl installation from Board of Dire Underwriters. )
4. Sworn sCatement Crornplumber cer Cifying that- Che solder used in system con Cairs
less than 2/10 of 17 lead.
5. Commercial buildin „ industrial building, multiple residences and similar buildings
trod instal lations,~e certificate of Code Compliance from architect or engineer
responsible for the building,
6. Submit Planning board Approval of completed site plan requirements.
6. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'pre-existing" land uses:
' ~ 1. Accurate survey of property showing al]. property lines, streets, building and
unusual natural or topographic Eeatur.es.
2. A properly completed application and a consent Co inspect signed by the applicant.
IC a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C• Pees
1. Certificate of Occupancy - New dwelling $75 pp, Additions to dwelling $25.00,
AlCer.ati.ons Co dweJ-ling $25.00, Swimming pool. $25,00, Accessory building $25.00,
Additions to accessory building $75.00. Businesses $50.00.
2. Certificate of Occupancy on Yre-existing Cuildine - X100.00 '
3. Copy of Certificate of Occupancy - $20 00
2t• llpdaCed Certificate of Occupancy - 550.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ll a C e ....D~~6~ Ot ~ 9
flew ConstrucCion........... Old Or Fre-exisCinr
~•5 ~ S,~L b Building.
Location of Property..... .....T/9J,~f G(/~t • •/~/J..
liouse No. ~ 1. l C~~
/q~~ / SCreet Ilainlet
Onwer or Owners of Fr-opert ...:;','.`~/fP.~ ~
County 'l'ax t~ta r No Y7 5 ~ P 9 OO ~
I 1000, Section....(., ,,.•..Blvclc......../.,
.....Lot.....
Subdivision......
..............................filed Mop............Lot..........
'ennit No ................Date Of Permit.......,
••••....Applic;tot........
health Dept. Approval......
....................Underwriters Approval...
'lanning hoard Approval........
tequesf Cor: Temporary Certificate........
Final Ccrticatc......--'
'ce submitted; 5.. a S ~
R~c~4q~a~
37.3/ . .
_~®~,~cuFFQ~(,g~~®~~~
Town Hall, 53095 Main Road ~ ~ Fax (516) 765-1823 ~
P. O. Box 1179 w ~ Telephone (516) 765-1802
Southold, New York 11971 ~,py ® ®'t°
~ol
F~
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 12, 1995
Mr. William Sanok
250 Saltaire Way
Mattituck, NY 11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 18617-Z
Please contact our office on this matter. Thank you for
cooperation..
SOUTHOLD TOWN BUILDING DEPT.
icLO Z::.S: Z ..v;: I~UA:.. II ~v:YMENT~
m
_ I ~ ~v
=OUNDATIO`J (1st) -
I
?OUNDATIO~J (2nd)
`off
'OUCH FRAME & I (1,
O`
PLUMBING
3. y~`
H
m
11SULATIOPI PER N. Y.
STATE EPIERGY I
CODE
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7ss-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] 1 CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE A CHIMNEY ~ ~
REMARKS:
DATE ~O ~ INSPECTOR
t~?~
~ ~~/7
765-1802
BUILDING DEPT.
1 NSPECTION
[ ] FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING FINAL
[ ] FIREPLACE & C IMNEY
REMARKS:
;F~ r
DATE ~INSPECTO
BOAKD OF HEALTH
3 SETS OF PLANS
FORM NO. i SURVEY ,
TOWN OF SOUTHOLD CHECK - - • .
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLO, N.Y. 11971 NOCALL ~ ~a~~:.7$,S Q.. .
TEL.: 765-1802
MAIL T0:
Examined ...~Q,,~~'
l....., 19 n
Approved ~!~/~~1......, 19~Permit Nof~G~ 7.~ U ~ ~ U
Disapproved a/c ~i Z
Bt.DG.DEPT. `
'fbWN OF S IITHOtD
~ ~.4.-~-........
ilding Inspector)
APPLIC ION 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 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildnngs 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 $uilding 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 of applicant, or name, if a corporation)
S/~CTi7l./~.~. ~,4, I~ArTjTvC/~ /v Y
(Mailidg address of applicant) / / ~ S"~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ~t ~ L / ~ ~ Nd
(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 MUS~ tlE SU~FyjLK COUNTY LICENSED
Builder's License No. , . .....z!~.~ .
Plumber'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 treet Hamlet q
County Tax M<ap No. 1000 Section pB Block r............ Lot .
Subdivision ..5~?,~i,~v~r~E . ~..5'T/~, l~~S, , , , , Filed Map No. , Lot
(Name) .
Z, State existing use and occupancy ofp~premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy /..~~y.. /~D Gs~
b. Intended use and occupancy ...~Q~ L
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