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HomeMy WebLinkAbout18157-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall - Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18083 Date JUNE 6, 1989 THIS CERTIFIES that the building ACCESSORY Location of Property 1225 JACKSON LANDING MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block OS Lot 08 Subdivision JACKSONS LANDING Filed Map No. 5280 Lot No. 23 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 1989 pursuant to which Building Permit No. 18157-Z dated JUNE 1, 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 ACCESSORY GAZEBO AS APPLIED FOR The certificate is issued to WALLACE & GINNY MACOMBER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~~iL_ Building Inspector Rev. 1/81 loss: 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 G ~ $ ~ ~ 1 Z Dote 19...~y.. Permission is hereby granted 3 , at premises located at ....~rr.1...rz..J~./..... ......~G...~ .,I~lr...,.............................. County Tox Map No. 1000 Section Block ...D~...... lot No.....®..~......... pursuant to application doted ...........c.~'`~./~,.,~ 19.. and approved by the Bui lding cahnspector, Fee $....c~.:s' /8ulldin nspector Rev. 6/30/80 _ m~.~ ~;.:a P."~ i ""eai TOWN OF SOUTIIOLD `•a~ BUILDING DEPARTMENT ~ ~m~~~"`""°-°- TOWN HALL ~ N1AY2,g~ SOUTHOLD, NEW YORK 11971 LI 7 6 5 - 18 0 2 r®~Po OF SpEPr ~~oco APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE..~~~( NEW CONSTRUCTION ~ ...O~1LD O~,R~~PRE-E%ISTING BUILDING..//.... VACA~N~/T LAND..L... _ _ . Location of Property. ~~c1•~ .u/~'•G~~JU.~i9AJ0/l~~r ..~(~,8 G~~~_ _ _ -~~//17Y~~T~/C~l-_ _ HOUSE NO.~~ STREET y/ HAMLET O v n e r o r O v n e r s o f Pro e r t GUr5~l19C~` ~ /~3 ~®/I/~&',~ P Y--...---•-•--•- County Taa Ma`p/No. ('1000/Sectio/~n~ ~J~.. Block ©~6 Lot- ~Q Subdivision.. Y~~',~(~(~~5,",'~~Q/XJO:. - Filed Map :~°-2o~-.Lot. Permit No. ..........Date of Permit _.......Applicant Health Dept. Approval Undcrvriters Approval.............. Planning Board Approval Request for Temporary Certificate Final Certificate ....y........... Fee Submitted: $ ~'~5~_-- APPLICANT.. rev- 10/14/88 a 1$b~.; FORM NO. 6 TOWN OF SOUTAOLD BIIILDING DEPARTMENT ~ TOWN HALL - 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must b~ filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: 1. Final survey of prop~rty with accurate location of all buildings, property lines, streets, and unusuallnatural or topographic features. 2_ Final approval of Health Dept. of water supply and sewerage-disposal(S-9 form). - ~ 3. Approval of electric$1 installation from Board of Fire Underwriters. 4. Sworn statement fromplumber certifying [hat solder used in system contains less than 2/ 10 of I;C lead: 5. Commercial buildings;i industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. - 6. Suhmit Planning Boarcj Approval of completed site plan requirements. For existing buildings (Prior to April 9, 1957 non-conforming uses, or buildings and "pre-existing" landluses: 1. 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 abstr',act of title issued by a title company which shall show single and separiate 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 writing to the applicant. 3. Date of any housing code or safety inspection of. buildings or premises, or other pertinent informatiod 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 reasoj~s therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OF OCCUPANCY - 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 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.Q0 Residential $50.00 Commercial I APPLICATION ON BACK !i i rev,. 10/14/88 I 1 / 765-1802 BUILDING DEPT. 1 NSI~ECTION [ ]FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING FINAL REMARKS: 0 DATE S INSPECTOR ~ ~ W o b ai ~ to r-~I N F`r~J ice, f.~ 01 ~n LU 3 ~ ~ a `j r ?y\,+ ~ r~r ~ ~ Imo. W J lL N W N = `o Py Ka Q a. rv .r. U t/ 1 l -I 1'~ ~ c- Q J ~ Z d _ _ ~ 7 (7 al why .J~ ~ ~ = ~ W ~ W ~ ~ ~u r~ MJ ~1,~ A ~ ~ p ~ yam~... ~ J OC N 3 W"M © ~ ~ p. m J F p~ o J? N (70 OCLL m H s. AW Mil , a ~ LL O N .s-..*az-,.ems-__. ,,,,...~.,:r_=~:.~,w~-~c ~.:c::_._----•.~:-••as~¢•_y~y. ---------"1-"~''' i c c m~ i 4~~f~.,,~, pN - N ~ O U i ~ Nr N ~ OGD D j D m N l Xi 1 O! N 'p G ~ ~ O N ~ N ~X ~ r w o c- o o v3" n ~ ~ 1~ ~ ~ ~ °i ~ rn d ~ ~ ~ y u A U O LL~ ~,uu~~cL~i ~"`r"!j' O w Fr~N N ` fq 1` U 1 ~ ~ e .11a~ m` y r a a i.~ U ~ _ . v ..~rwxt.Fo~~ ~V dt... ~ ,o _ i. p ~ ~ ~vU1N7C19i?.'1+..~ .v~ O ij v l H ~ /J ~ v ~ X A N N N '.i.' ~ A~ f ~ ~ N W v!" T ..I i ~ X~~I L x ~X, ~ v ~i - ~ o i(1 ~ ~ q ~ ' ~ _ f ~ ~ rll ~ ~ ~ 1- f U 1 ~ ~ ~ " ( ij ~ o C I, _ . ~ U i a ~ b > ~ .v ~ a ~ N I! ~ G i ~~yy~~ in ^ Ylt W~ ' ~ Q k. ~XPW~~M~XdH~Ib'4%4MYW"'Y`?e'NY3YRYWYYkN}YgtipiMvW X.µ1N%J: MVIyfFinIWFYW P X.Mm~x t MW wSn rrm..weM1m~rt~i4*n`~tx..vFOn••~n.i.w,..F.~Xy:.. ~..e~~.....~. . ' ~ ' I - iUFFOIK COUNTY HE~ ARi - - ~ BRIQLE FAMILY il1ENT r'~ OWELLINO ONLY Tli BEWAgE DIEP08Al AND WAtEA 6lMry Y fACIIIhES f`0 8 W OTlD 6Y THIB bEPARIyTTEND A D N 1a o -t~--------~._ ^ 1 iv r is i sr , A) 1 _ w.9 LOT 17 .1tT 0 11 M_ 1.. Z vacn.r ( C~ VI ~I~Z.E-~Q 3 Q 0 Ff r Yl~ p o e,,, ~ J 1 1-OT 23 I Ohl v ~ / ~I U"rI+P ~ r y11 ~ru ,-v' ~U ~ o o Sow ~vf rf~i v 0 +9. .ICI a1 °~D Ja v' ' U ti o,° ' .n p. 1 N 3 5 Fl7 °ri'. S 68° 34.40"W /,~.r Quo _ ~yr 192 UV' ~ - ~ow'L LOT 2 2 AF2EA 22,425 SCJ F7 C~ ~y> N IvG// Y~ ' r~ O ~ACKSON~S ~ ~rJ~ LANDING CERTIFIED TO ~~`l~ LANG ISLAND MOH TG AGE CORP. ~f,, TERRA ABSTRACT ~ WA LL ACE rAACOMBER SURVEY OfA~`~(, `'o LOT 23 ~ ~ ,a d/ "nfnl/ of ~ncKSUN's l_ANIT~U^ B-I? a7 ~'isa~ FILED MAH 28, 1969 FILE NO 5280 AT MATTITUCK ' TOWN OF SOUTHOLD SUFFOLK COUNTY N. Y. V/~ygO~AN~ fG,P4 1000 113 05 - 08 ~.~c'bo SCALE I"= 40' ~ UEC 3U, 1986 ~ I ~ FEB 2, 198 7 'h' Pnper.d Nr Mcordono~ v.Nh fh. minimum 1 Mo A9 e! ~P N Y S L 1 C NO 4 966 8 nondard. kr Ihl• wmp a. ulubli.h.d by NE du 1.1. A. 1.5. and appror.d and adopr.d P SURVE YORS R ENGINEERS r p C, for wch uq hY Th. N.w YorG Srm. land (516) 765 - 5020 tiro Au°<I°ri°°. F'.O BGX 909 ]RELOCATION OF WELLS AND CESS E'OOL SHOWN MAIN ROAD /IE RfON 4RE FROM el SDl17HDLD, N Y 11971 ELD OBSERVATIONS ANO OA 11 OB IA INEO I`RVM O/HERS A6 - 7960 BOARD OF HE.ILTH 3 SETS OF/PL<1NS Y........... FORM N0.1 SURVEY V TOWN OFSOUTHOLD CHECK ...t~~~............ BUILDING DEPARTMENT SEPTIC FORM TOWN HALL SOUTHOLD,N.Y.11D71 NOTIFY TEL.:765.1802 CALL C•xamined ..r°//~ 19~~y~~• p MAIL T0 . Approved ..4°r 19G/. Permit No.~a ~ ~ ~ a Disapproved a/c MlAY 2 ~ 19~ ' ~~/Q//J SLOG. OEPT. . v ~~2,. I' ' ' TOWN OF SOUTHC7LD (B ing Inspector) APPLICATION FOR vU1LDING PERMIT ® Date 15~1.~ INSTRUCTIONS / a. Tltis 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 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 be drawn on the diagram which is part of this appB- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Buildin; 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 Buildin; 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 co[}~St~ryS~io[\ B~°t~uuildlHgs, additions ar alterations, or for removal or demolition, as herein described. T][e applicant agrees to`cotriply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorize"d inspector, 9n j3r~mis~5"and'in build}g for necessary inspectio ~:,~'X~:~.+~~(1R'~ ";,:n~ ~ t; ~ ~ ~ Signature ot'a licant or name-„i ~ ~ • • • 4 i; ~ A S:;R: ( PP ~ a ~orpora[ion). ~k1 '1' 4~~~'t M~~ tF9 a tf /~y/p/~ ,,/~j- _ "~f~ ~.°/~y~ - ;~~p +~41' '1R t)1fe(I N~ f~~,~z,e~tf.:rS" t a . • t3:3fl1U0'. ~'I~i?~b,J~`~t;;ttt'6f,;s' g(`~~j{~ lingl ¢dress$f'.[PFhcant) • ~ 3~4r3»!t)~ .r /?~°b77'?/a~,(J~.c~.~sJ' ""e ..r y, ~ ~ i State whether ap~~,~iv+~n,'}lesseg~,agerbr't~Ycfiitect, engineer, ga~tcral cbntractor, elgc4rkcmn, pluin'ber or builder. , n .*t $ ry , /~Jrrr~/~~~Jjy pyyyyy iy 9 (s., t Ak ,i 4~1 y~:. ....,,...0~„r.,f{fig tAt"t{,,~t ri(Wi/s .1 ,~yS'((,y, ~(t ~n y _ A 1J 5 a. w 'Nii A OIYt I'y~1 .jJ1:Y.Yl~~~~~. A`.~. g.p Hra S~ / Name of owner of~e~~1 •~1~~ ~/~cUmQ~2....,:,._....< ~l.M (as on the tax roll or ldtcst deed) # ~ ttrz"+ If applicant is a cor~[~j113~f ~y~~,y~a_ygj;ikeyd officer. (Name and title of corporate officer) Builder's License No . . Plumbei s License No . . Electrician's License No . . Ot![er Trade's License No . . 1, Location of land on which proposed work will be done. Vi9C./C•'s'OlJ,.>`- F{ouse Number Street. • • • " Hamlet County Tax ~ta'p N~o. 1000 Suction Block ®5 „ • , • „ • • „ Lot . , ~ ~ „ • _ • • , , , _ . • Subdivision ~/~'!~s~as. ~~'p~/~~ F.ilcd flap No. Lot . ~ . (Name) . State existing use and occupancy o,fp~remises amend intended use and occupancy of proposed construction: a. Existing use and occupancy ..1~~~.~"~...~'~.2.~:~ . b. Intended use and occupancy .'./~.FCG/l~T/GlL ~AZ_Fw30....••:••...•••.....••••••.••.....•...•.- 3. Iv'gturc of work (check which Applicable): New I3uildin ~ ' Repair Rcr~toval , g Addition .'Utcration . ' Demolition Other 1Vork6Fr~~ 4. Estimated Cost . ~ ~ ~ OCR (Description) Fee...~:~.............................. ' S. If dtvcllin~ (to be paid on fling this a~p~lication) number of dwellins units 1?,~F! , , , , , , , Number of dwelling units on each floor.!t`/fJ, If garage, number of cars f?~~i.. • , • . 6. If business, commercial or mixpd occupancy, specify afore and extent of each type of use /l/,/p, , , , , • . 7. Dimensions of axisting struCtutcs, if any: Pron[ , , ;t~,~/~ Haight , N'u~~nnber of Stories . ' ' ' ' • • •Rcar • • Depth . Dimensions of same structure kith alterations or additions: Front ~ ~ ~ ~ ~ ~ ~ • ~ ~ ' ' ' Depth r~;y3) ~'•tY?~.... • Height . Rcar . 8. Dimensions~of entire new construction: Front l4F.i• ~ • ~ • ' N' ' ' • • Number oC Stories , .~Gii^uFxV Rear . • . • . . Haight , , Depth . I~uihber of Stories . • • 9. Size of lot: Front ~4tkl~ ~r Gr~E~ Rcar . l0. Date of Purchasa .F'F~cl,L, /,7~Y'i~ . , . Dept . ' Name of Former Owner ~ • ~ ' ~ ' 1 1. done or° use district in which premises are situated .~~s'/~(T! ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' • • • ° oes ro osed construction vio • • . 13, Will lot be re°raded , , , ,late any zoning law, ordinance or regulation: . ,Q', • . • • ° . ~Vip c~cess (al be c ~ved from remises ~ ~ ~ ~ ~ ~ ~ • • !4. Name of Owner of prcm's s l~7ly!r_~.R cE /1!)AC~m;~gri , Address~~~(~VRCkVc p , ..Yes ~ ~ ~ ~ No ll ' ' y,~R:~e~rar! .Phone No.~l~:v~;~d~:5%S!d- ' Name of Architect N~,. , ,Address . • ' Name of Contractor t~ . ~ ..................Phone No...... . 15.Is this property located within „"Address ,.Phone No........'....:.,. * 300 Eeet of a tidal wetland? *YES....NO.... If yes, Southold Towri Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all~l, 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.;, i ' ~ cJ/,/Ql/~~ ~IJC{,'CS'~ AP~~OV~ED AS N01'ED FEE: ' . Y: NOTIFY BUI ~ ~ 7R5.9A(>,T 8 AM TO a pM N AT OCCUPANCY O~ FJI.LOWIpI,G,,,,g„ wR THE 1. FOUNDATION ~IONt3: USE'S FOR POURED CONCR~RE4UIRED , UNLAWFUL s. ROUGH . FRAMINa a ~'ldlMelN~g WITH®UT C~R?IFiCATE 9, IN$uLA„ON 4. FINAL - CON$TRUCnON MUST OF OCCUPANCY ALL E ~PLETEFORC.Q, ~o?~Nv CODER, A~ ' Ok$IpN t~I tapegTR~~ - I ~ - ST,1TL OF \EtV YORK, I~' LL ~ COUNTY O (i\amc of individual si~ S(S r ' ' C ' •,nin4. ' ' • • • • • • • • • • • being duty sworn, deposes and says that he is the applicant about named. 4 contract) ilc is fhc ~ • C i (Contractor, agent, corporate officer, etc.) ~ ~ ~ • ~ • " " " " said owner or owners, and is duly authorized to perform or have performed tha said work and to make and Gle this --Pplicgtion; that all statements contained in this application arc true to the best of his knowledge and belief; and that the ,vork will be performed in dre manner sot forth in Iha application filed therewith. rworn to before me this ~ ~ . ...day of . ~ M~•• ....,19".7. ~otary• Public, , , •~YIiNE County - ~ Y Puk;Fteb 5t¢tce arf N.. m i 0 ti 8'< ~ ...~~i~~~Y// IVra.~4ps`xtil'Rb21Cs~:'.~ y Oualtflet's ds. ECin~s Gountg • • • • • • • • t°oArtlPalilSlQYG Ex:;~tct,s~ j{rJ(„t~9D (Signature oCapplicant)