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Home My WebLink About18079-z ( ' FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22481 Date 3LJLY 29, 1993 THIS CERTIFIES that the building ADDITION Location of Property 220 PINE STREET MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 1 Lot 28 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 27, 1989 pursuant to which Building Permit No. 18079-Z dated APRIL 27, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to GERARD & KAREN DIFFLEY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A i in Inspector Rev. 1/81 rosx xo. s TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. 6UILDING PERMIT (TH1S PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 8 0 7 9 Z Date a.? 19..8..1 Permission ~s hereby granted to:' I a. ~.....~'1. ....-C.' ...~~~'...~~,,//..~~,e..c.~...4.r~.-~a~1=!,n...~':a....4~-1..~.~?~:-~-~.... 4:'1:'.x. at premises located at . 220...~.d~t~R .....................••r•7~•,~.Gk . County Tox Map No 1000 Sectio?? ~~.n...... ^B~lock Lot No. . pursuont to application doted ....1~g~. 19.~.~., and approved by the Bui ldingclny~spector. Fee S.• ~ . r4 ~!a-t Building Inspector Rev 6!30/80 Form No. 6 ~ ~ ~ V ~ ~ ~ ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 BLDG DE?T TOWN OFSOUTHOLO AppLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the followLng: for new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board 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, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the ~ reasons therefor in writing to the applicant. C. Fees 1.~ Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...~::~...7 /S 5'3 New Construction........... Old Or Pre-existing Building..' Location of Property....'.7"?0 ..................Pi"e Sfr.eet...,..,....._r?Icuf~f: h+<~..._... House No. Street Hamlet , Onwer or Owners of Property.....C.Te:a-:.t a. _,t tls.~„ "~i:~7e~ IMF/,uo cr,~o oas cco County Tax 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 Certicate........... _ ~ Fee Submitted: 4 ^V'/Y Q,~, y 3 C O ^iZ ~ ~t~J AP~CANT 1dLD 1u~: C~.~..-Ut,l I~Un:n I LVMC`(f,NT~ i 'O R H - _ y OUJJDAT20*J (1st) ~ c . ~ OUNDATIOtJ ( 2nd ) m ~ z 0 ROUGH FRAME & i PLUMBING u~ ! 3. ~ t m ; ra r ItJSULATION PER N. Y. - '3 STATE EPJERGY CODE `a lk 4 . 5°~~ \ ~ ~ m . H FZ;dAL 7 ~ F ~ ADDITIOPJAL COMMEPJTS: x 4 f ' x v H S a H H O - c m ; a r H v m H N _ 1 . ~i - iI ~ ~ ~ ~ ~ to i - i 1 1I I r, I~ s`--~xa R. a i c i ~ 'I L i Zx p -i Ct I q ~t APPROVED AS NOTED DATE ~ BP q ! 8O ~ - - 1 ~ FEE BY ~ NOTIFY BUILDING OERARTMENT AT 765-iB02 9 AM TO ~ PM1F FOR THE FOLLOWING iNSPECTIUNS 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH -FRAMING & PLUMBING 3. INSULATION OCCUPANCY OR a BE COMPLETE FOR C O.ION MUST [LSE !S !!NlAWFUL Au CONSTRUCTION SHALL MEET WITHOUT CERtiFICATE THE REnUtREMENTS Of THE N Y. OF tlCCUPANCY CODES. NOI[ RESPONSIBLE EFOR DESKiN OR CONSTRUCTION ERRORS ~.°7 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH ~PLBG. [ ]FOUNDATION 2ND [ ] INLI'F ON [ ]FRAMING [ INAL REMARKS: D DATE ~ ~ i INSPECTOR j ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: r / / DATE ~ INSPECTOR D (2 fid ~ ~ ~ ~`2, ~ BOARD OF HE.~LTH L5 h7 ~ f '~3 SETS OF PL.1NS • - ~~~~pppp FORMN0.1 SURVCY - ~,7 qv~ TOWN OF SOUTHOLD CfIECK . . . BUILDING DEPARTMENT SEPTIC FORPt BLDG DcPT TOWN HALL TOWN OFSO ~ SOUTHOLD, N Y. 11071 NOTICY - TEL.. 7651802 CALL ' PfAIL T0: - Exammcd . s- .1, , , 19 APproved...?:~..., 19$9. Penrii[ No. ! g o?`t Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 15 INSTRUCTIONS a Tliis application must be completely filled m by typewriter or in ink and submitted to the Budding Inspector, with 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 premtses or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this app[tcatian, the Building Inspector will issued a Buildug Permit to the appL•cant. Such peiic shall be kept an the premises available for inspection throu;ttout the work, e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan~ 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 ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appItcable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe Tlie applicant agrees to comply with all applicable laws, ordinances, budding code, houstn~ code, and re;ulations, and admit authorized inspector on premtses and in building for necessary i pee ores ((Si ature of applicant, or name, iF a corporauon) J o~C~~ ?~.i e. 51• c1~,t ~ ~.f • (Mailing address of applicant) State whether appltcantt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buiIde ......V.t:1t v1 ~N^.... Name of owner of premtses ~S e r .w ct. E....:~.: t<'~. v::... ~ r ~{.~~.`1 . (as on the tax roll or latest deed) 1 IC applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's Ltcensc No . Plumber's License No . . Electrician's Ltccnse No . Oilier Trade's Ltcensc No . . I, Location oFiand on which proposed work troll be done . 2zv ...~lin fl. S-I r4 ILt ti'~~~.~Lt c.-iL................... Efouse Number Street Hamlet County T.ix Aiep No 1000 Section ~ • • • • • - • • • • • Block C•1, , , , , , - • • • • - Lot . Subdieisian Filed t`fap No. Lot . (Nemc) State c~isting use and occupancy of premises and intended use end occupancy of proposed construction a.Etiisunguseandoccupancy Siv~cl~¢ f"2~.llc_ cb-s~~~l~~~ b. Intended use and occupancy • - • • •~•`~`t•~•~6~1 u•~ ~ e i J 3. Nature of work (check t~hich applicable) New 13uddmg Addition • • - • • ,.~alteranon . , Repair Removal Demolition .Other Hork q'..... . • • • • • - (Desenpnw 4. Eshmatcd Cost ~6 b Fee~.~~ . (to be paid on filing this application) 5. If dwelling, nutnbcr of dwelling untts Number of dwelling units on each floor . . Ifgara,c.numbcrofcars 6. If business, commercial or mteed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any front Rear Depth . Hci~ltt NuntberofStoncs.................................. Dimensions of same structure with alterations or additions Front Rear Depth Iletgh[ ......................Number of Stones . g. Dimensions of entire ne~v construction. Front Rear . , Depth . Hcigltt Number of Stones . 9. Size oflo[. Front Rear............ Depth 10. Date of Purchase ...........Name of Former Owner . 1 I. Zone or use dislrtct m which premises are situated . 12. Does proposed construction violate any xontng la~v, ordinance or cegulatton. • . 13. Hdl lot be regraded ...........Hill excess till be removed from premises: Yes l4 Name of Owner of premises • Address ..Phone No . Name of ,architect ...........Address ..................Phone No............. . Name of Contractor ..........................Address ...................Phone No . IS.Zs this property located within 300 feet of a tidal weCland? *YE:S....NO.... *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 dtmerstons fn property fines. Give street and block number or descnption according to decd, and show street names and indicate when intenor or comer lot. ~L' STATE OF NE1V Y•ORI;, S.S COU^.TY OF . . bemgdulysworn,dcposcsandsaysthathetstheappticc (Name of individual signing contract) above named. . ;le is the (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly autltonzed to perform or have performed the said work and to make and file t: tPplicatton, [hat ail statements contmncd m this appltcatton arc true to the best of fits knowledge and belief; and that t ~~ork will be performed m the manner sc[ fot[li m the application Glcd thercwrth. >wotn to before me this q .day~o/f ./~".u-Q . ~J..~.9..... 19 .otary Public, jS ..tJ..,e P~•-.-..... County HELEN X DE U6E • ~ • G.t ifDTARY4U8LiC,SCateofldewYoik ($ignaturls of apphca: Na A767RiR, Suffolk Coate i Teern Expires klatch 3Q 1