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HomeMy WebLinkAbout18191-z F FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Offiee of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18114 Date NNE 13, 1989 THIS CERTIFIES that the building ADDITION Location of Property 585 DAISY ROAD MATTITUCK NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 8 Lot 41 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 5, 1489 pursuant to which ~ Building Permit No. 18191-Z dated JUNE 8, 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 CHIMNEY & WOOD STOVE ADDITION AS APPLIED FOR The certificate is issued to GREGORY COUTURE (owner) 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 gosat 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 ° 8 ~ g Z Date !~a 19 Permission is hereby granted to: ./L~c. ~...~Cle_.~...... ...~v.:.~.....~37 ........~.d .5...:~.1`~ .:......................sy at premises I«ated at . pp ....................................`So.. S.............................................................................................................. ......................:......~1~~~-'~...~.:~.:.....~1..~..... ~~p~~............................................................ County Tox Map No. 1000 Section .....l~.la.~• pp,, BI«k ........a........... Lggot No...........~,~........ pursuant to application dated .........~.'~^~'........`.5 19...~/., and approved by the Building Inspector, U Fee 5.....:30.:..... ...:..~'kC~lf.............................. 3 ~ ilding Inspector Rev. 6/30/80 TOWN OP SOUTHOLD u~~ ~,~'ryflg fI BUILDING DEPART2fENT JU 7c) TOWN HALL BLDG. Dr•;P7.~ ` T01~`JfV OF SOUi'F~Olrf~ SOUTIIOLD, NEW YORK 11971 ~ w 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE. , : y~~'~^; S-} I ~j S j NEW CONSTRUCTION ...l.~,OLD OR PRE-E%ISTING BUILDING......VACANT LAND..._._.. Location of Property..S-~.' P~-SiSt,~ '/`~~.J(~ ^~c~.~,a c.1L HOUSE NO. STREET HAMLET - ' Owner or Owners of Property...~:'r::'e~~',Q~--~~:.~-4~ l V~ ~ f County Taa Map No- 1000 Section Block Lot Subdivision Filed Map ........Lot........_. Permit No. ..........Date of Permit ........,.Applicant Health Dept. Approval Underwriters Approval.._........... Planning Board Approval Request for Temporary Certificate Final Certificate Fee Submitted: s~s~;~fJ---.---,---- APPLICANT....... ~'..~-t~~-t.l.~u'c~SG.._...... Q'ec,. 3~5~ 9~ . Co ~.~s??y rev- 10/14/88 I I L, tr I . FORM NO. 6 . ~ TOWN OF SOUTHOLD BIIILDING DEPARTMENT TOWN DALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must belfiled in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual pa[ural or topographic features. 2. Final approval of Heath Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from Rlumber certifying that solder used in system contains less than 2/10 of IE lead.!, 5. Commercial buildings,lindustrial buildings, multiple residences and similar. ' buildings and installations, a certificate of cede compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Boardl~Approval of completed site plan requirements. , B. 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, buildings and unusual natural or to~Sographic 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 O~cupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing wide or safety inspection of buildings or premises, or other pertinent information'irequired 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 oflthe 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. I D. FEES: I 1. CERTIFICATE OF OCL~UPANCY - 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 - $25.00 Residential $50.00 Commercial i II rev: 10/14/S8 I I ~ ~LI B0.1RD OF HE,ILTH u FORMN0.1 3 SETS OF PLANS SURVGY .~~5 TOWN OF SOUTHOLD CHECK ~,Sa34;, , , , ~ BUILDING DEPARTMENT SEPTIC FORCI BLDG. DG P7. ..a TOLVN HALL TOWN OFSOU7hl[;I_t7 SOUTHOLD.N.Y.11D71 NOTIFY _ Q ~ TEL.:7G5~1802 CALL L•xamined .~jt-r~JX:•„gl,...., 19~ PIAIL T0 : \pproved . 0 19c1 Permit No..~~~1/~~. , . Disapproved a/c a(I~i{}•Idino Inspector) APPLICATION FOR BUILDING PERMIT Date . 15C?`j 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 lot 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 appli- :ation. 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 throu,ltout 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 Pezmit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Rc_ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Tite applicant acrees to comoly with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspect s. c (Signature o"a~plicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...emu:: ~ ~-.r . Vame of owner of premises ~,r ?S4 F.`~. , ~ a,J u• r 2 (as on the tax roll or latest deed) 'Capplicant is a corporation, signature of duly authorized officer. . ~ • . (Name and title of corporate officer) Builder's License No . . Plumber's Liccnsc No . . Electrician's License No . . Other Trade's License No. S. ~ ~ .5.......... . Location of land on which proposed work will be done. 5, `~~},1,7ni5~ : i.. `K ~I.~ IlouseNumbcr Street. Hamlet County Tax Map No. 1000 Saction Block , , . , , , ~ , Lot ....`:(.1 , Subdivision .S~4ns ~.C.. F.ilcd Dtap No. ~(N~mc) Lot............... State existing use and occupancy ofpremises and intended use and occupancy of proposed construction: a. Exisung use and occupancy >~4'::"::: 1: 1. occupancy b. Intended use and ~ L.`:. i^.':.:.._ 3. A'aturc of work (check which~pplicable): New Uuildin Repair Removal g • Addition A~tcratto~[ . • • • • • Demolition Other R'otk , . 4. Estimated Cost , f•~• • • • ~•~pQ•,. • • • • • (Description) Fee .y. ~ a 5. If dwelling (to be paid on Cling this application) number of dwcllin • • • • . . S units . Number of dwelling units on each floor. . Jf garage, num bee of cars ~ • • • • ~ • • • ~ • " " 6. If business, commercial or mixed occupancy, specify nature and extent of cacti type of use . • • . • • . • • • 7. Dimensions of existing structures, if any: Front . ' • • • . • • • • • Height . Nuritber of Stories . • • •Rcar Depth • • • • . • . . Dimensions of same structure ~Qith altcratio • • ~ • ~ • " " " " " " • • • • • • • • • ~ ~ • Depth . ns or additions: Front , ...Rcar . • . IIcight . . Number oCStorics . ' 8. Dimensions of entire new construction: Front • • ~ • • • • ~ • ' ' ' • • • • • • • . • ~ • Height Number of 2car Depth . 9. Size of lot; Front Stories • • • ~ ~ • • 10. Date ofPurchasc Rcar.........., Depth 1 1. Zone or use district in whidt premises arc situ ' ' 'Name of Former Owner • • ~ • • • • ' ' 1 Does proposed construction vio ated ~ • • • ~ ~ • ~ • • • ~ ~ • • ~ • • • latcanyzonin law, l3. Will lot be regraded g ordinance or regulation: 14. Name of Owner of premises . ,I,• , • • • • • • • • • ' ' ' • • • • 1Vill excess (ill be removed from premises: • • • • •Ycs - • • • No Name of Architect • • • • . • • Address ...................Phone No.. Name of Contractor . .................Address ...................Phony. No............... . 15.Is this property locaXed within •'.Address.. .Phone No. 300 feet of a tidal wetland? *YES..,.NO....~• *If yes, Southold Town~'iTrustees Permit may be required. I PLOT DIAGRAh1 Locate clearly and distinctly all (,buildings, whether existing or proposed, and. indicate all setback dimensions from property lines. Give street and block rjumber or description according to deed, and show street names and indicate whether interior or comer lot. V~~v"'~ V~-Q_y Gl/~ -2 G~$ ~ S t C~1 `e. cY ~ ~OJ S'Q, , S ~ N fl I 1~ FIu r , r_IC. W .'T ~ c`3 'r 1 C ~ •e.r ~i Q, 1-e.c- 1~ 1 v r . • - I ' I vm ~ ~ ~ ~a,~ b ~~y s o--- - ~ - . 's ` - _ . T,1TL OF XL~V YORK OUNTYOF S.SI ' ~ o I' ' ' ' ' ' ' • • • • • • • • . • being duly sworn, deposes and says that he is the applicant • •(\amc of individual si~nin^ contract) ~ovc named. :isthc . said owner or owners, and is del (Contractor, agent, corporate officer, etc.) • • • • ~ ~ • • ~ " • • • - olication: that all statements containedtlin rthis application arc ttruc toctherb st of h sakno[vl[,•dgc and belief; and thla[ tlhe rk wtll be performed in the manner set (forth in the application Gled therewith. om to baforc me thin ~.~.~/~.~.....day of/~....'~i. 19~d• :ar; Public, .~:^;..~.[,<1,eilif~~-.., • • County • ~7 ~~~1D C/7~.,, p NOTARY PUB[Il;, State of New Y4 ~ Na4~078785aolkCounty~ i''"''~'''~''''•••••••••••• ~ Terrn Ez 'yes Meech 3O, i9,.~Y (Signature of applicant)