HomeMy WebLinkAbout18046-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218903 Date MARCH 19, 1990
THIS CERTIFIES that the building ADDITION
880 WEST MILL RD. &
Location of Property 1275 JACKSONS LANDING MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 009 Lot 013
Subdivision JACKSONS LANDING Filed Map No. 5280 Lot No. 16
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 5, 2989 pursuant to which
Building Permit No. 180462 dated APRIL I7, 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 GARAGE ADDITION TO AN ERISTING ONE FAMILY DWELLING.
The certificate is issued to STUART D. WECHSLER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N075944 JUNE 13, 1989
PLUMBERS CERTIFICATION DATED N/A
Bu~Inspector
Rev. 1/81
IOBH N0. !
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°- x.8046 Z Date 19.g.J.
Permission is hereby gwnted to~~: yy}} -.y. p
~ end........................
*~..`j.:...lJ,.`.1s:3 .
to 1~..~.rt:Sr.~..a~,:"~ ~c~:.....~tFiQ....~...-S
:S*.:~. ~.1.:9...0-!.'.1.....~~~......lP'.1.5?-,
at premises located at ...~.~.d... ~?.s~r:...7rr7.~....1.°-:ds.....1.r7,.~ ~~...~Git:tGS~tq..IS.4T.....'.:1.
....Y1~....~.~.~`...c..~.2¢~.L~a- .
County Tax Map No 1000 Section^.....). D..1P . Block Lot No...~.3...........
pursuant to application doted ...~;~C~+~,-!:. . 19. Q.~„ and approved by the
Building Inspector.
Fees~a(:~D......
.a.:.~.-~......
Bu ding Inspector
Rev, 6/30/80
9
Toux oP sourDOLD
DUILDIIJC DCPART:tC2iT
TOUti IIALL
SOUTIIOLD, tiEA YORK 11971
7G5 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPAtiCY f
DATE_.~.
KEN CO::STRUCTION
....<.~c.OLD OR PRE-E%IST;I~I71C IIUI-LfD-IIiCI~. _ ...j _ VA jCAtlT LAITD..7/~~.-/./y.,,..L
Location of Propcrty..6 0~l ~':'C?~~"t.~'~- .1~Q 1"_ ~SI~C~ -I~SGh `ut`"~ . ~"'1 ~ ~l'.+'^-l
UOUSE NO_ STP.EET Il~LET
Ovaer or Ovncrs of Propcrty.._~~.~_.._~.. ~ C~S :.Y
County Tax Hap No~_^~]000 Section IU~•_ IIlock Lot
Subdivision_...~Y?~~CSG~...~~~~~File(d Hap _.~~~_LoC_~7~.(~~._.
Pcrnit Ho. jJ.~l.~(_~Datc of Pcrmic 7{_~~ ~~._ApplicaaC
Health Dept. Approval UndcrvriCCrs Approval.._____.._..__
Planning Board Approval
Request for Temporary Certificate Final Certificate
Pcc Submitted: $
APPLICAfiT
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rw• !0/iL/88
FORM NO. 6
TOL7N OF SOUTIIOLD
BDILDINC DLPARTlIENT
TONN IIAL:
765 - 1II02 ,
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. This application must be filed in typcuritcr OR ink and submitted to the Building
Inspector with [hc following; for aev buildings or new use:
1. Final survey of property viCh accurate location of cell buildings, property lines,
stteeGS, aced unusual natural or topographic features. '
2. Final approval of Dcalth Dept_ of water supply aced sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Pire Underwriters.
4. Svora statement from plumber certifying [hat solder used in system contains less"
than 2/10 of IX Icad.
5. Commercial buildings, indusCrial 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 IIoard Approval of completed site plan requirements.
B. For existing buildings (Prior Co April 9, 1957 non-conforming uses, or buildings
and "pre-existins' laced uses:
1. Accurate survey of property shoving all property lines, streets, buildings aced
unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
If a Certificate of Occupancy is denied, the IIuilding Inspector shall slate the
reasons therefor in writing to the applicant.
3. Dace of any housing•code or safety inspection of buildings or premises, or othez
pertinent information required to prepare a certificate.
C. For Vaean[ 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 shoving single aced
separate ownership of the entire lot prior [o April 9, 1957 shall also accompany
the applicatioa_ If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing Co the applicant.
D. FEES:
I_ CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Duelling $25.00,
Alteration to Duelling $25.00, Svim<ning Pool, $25.00_ Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Occupancy on pre-existing duelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $]0.00
4. 9acant Land Certificate of Occupancy - $20.00
5. IIpdated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $15.00 Residential
Commercial
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STATE ENERGY
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ADDITIOIIAL COMMENTS: ~
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BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( ) ROUGH PLBG.
[ ]~DATION 2ND [ ]INSULATION
[ FRAMING [ j FINAL
REMARKS: K
. ~rL.
DATE /2 INSPECTOR ~ `
rss-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ 1 FRAMING C ]FINAL
REMARKS:
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DATE ~Z a ~ INSPECTOR
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BOAF.D OF HEALTH . ~j
3 SETS OF PLe1NS 05^.•..... .
.
FORM NO.t SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC Oi~Pf
' TOWN HALL ~ ~f
EOUTHOLD, N Y 11971 NO FY
TEL..7G51802 CALL
q MAIL T0:
Cxammed~. 191. ,,rr~
~Ypproved... 19~. Perini[ No $.~7~0~
DisapProveda/c
yt'ert" ~
.Q-S+
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date April 5, 1589
INSTRUCTIONS
a Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
sets of pians,accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adlomm; premises or public stree~
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl
cahOn.
c. The work covered by ttus application may not be commenced before issuance of Building Permit.
~ d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perm
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupant
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bwilding Permit pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Re,ulations, for the construction of buildings, additrons or aiterauons, or for removal or demolition, as herein descnbe~~
Tlie applicant agrees to comply with all applicable laws, ordinances, building code, housin, code, and regulations, and t.
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, it a corporation)
1$~ J2pVlcy, Point Road, Middle Island, NY. ,11953, - , , , , ,
(hlaihn; address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
General•Contxactor
.
Name of o••vner of premises _Mr. Stuart D. Wechsler .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
........James. hb.Cli~1 ..President....... .
(Name and title of corporate officer)
Buildec's License No. 12929-H
Plumber's Liccnse No
Electrician's Liccnse No 24G(rE
O[her Trade's License No . .
1, Location of land on which proposed work will be done. .
T
....~0 West Mill Road- 1275 Lacksan.Iancling Matuturlc
.
House Number Street Hamlet
County Te\ bfup No 1000 Sccuon ..1~ Block 9 Lot .13 .
Subdivision Jackson Laridwg Filed hiap No. 5280.... Lot lb/6. , . - . _ . • .
(Name)
State ceisting use and occupancy of pre ses a intended use .ind occupancy of proposed construction.
a. Existing use and occup~~r~.~~'.arid.Tiwmx' .
b. Intended use and occupancy GARAGE ADDLLION -
3. Nature of work (check which applicable)' New Building Addition .~ge ~'ilteration .
Repair Removal Demolition .Other 1Vork .
• (Dcscnpnon
4. Estimaicd Cost $30,DCO.CD. Fee ~ .
(to be paid on filing this apphcaiion)
5. If dwelling, number oC dwelling units ...°Re....... Number of dwelling units on each floor .
Ifgaracc.numbcrofcars
6. If business. commercial or mired occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any Front Rear .Depth ,
Hei,}it 29.`....... Number of Stones ....Za
Dimensions of same structure with alterations or additions' Front 2b` Real .
Depth ...97.'.4" . IIcight Number of Stones . 2.~................ .
Dimensions of entire ncvv construction. Front . 34`. , , , , , , , , , , Rear . , Depth ?3~ , , , .
Height ...............Number of Stones ?garage.& Iiyu~ s~??°e.. _
100' 110' ......2~ .
9, Size of loi• Front Rear De th
p
10. Date of Purchase ...Name of Former Owner . .
.
I I. Zone or use distract m which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation
13. Nltl lot be regraded nO Will excess till be removed from premises: Yes I
14. Name of Owner of premises Stuart D; Wechsler , , , , ,Address 26• Adelphu La: , , ,Phone No.7~ .
.
Name of Architect ~!m?o..?at~ Address 154 laurel Ave. , , .Phone No.261.~741+•
Renovations and Interiors 1565 stocky poarit RIJ: 9271-711 • • ' • ' • -
Name of Contractor .........................Address ...................Phone No............. .
15_Is this property located with in~00 feet of a tidal wetland? *YES....NO.X
*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 fro
property lines. Give street and block number or descnption according to decd, and show street names and indicate wheth
intenor or comer lot.
STATE OF \EN Y'ORIi, S.S
COUNTY OF .
• • - • • • • • • • • • • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the apghca
(Name of individual signing contract)
above named
Iieistlie
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authonzed to perform or }lave performed the said work and to make and file tl
application; that all statements contained m this application are true to the best of his knowledge and belief; and that tI
work will lie performed in the manner set forth in the apphcation Gicd therewith.
Sworn to before me this
~ q
\oiary Public, , . ,~!gx:C.aril. County (//~/J
NDiARY PU6EIB~StDate of~New Yak (Signature of apptican
Nn ^TD'RrA,SuHulkCaadvm,
Term Expves nnercfi 30, 1