HomeMy WebLinkAbout17739-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z20156 Date
AUGUST 21~ 199~
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 4328 R.O.W. OFF WESTPHALIA RD.
House No. Street
County Tax Map No. 1000 Section 113 Block 09
Subdivision Filed Map No.
MATTITUCK
Hamlet
Lot 11
Lot Noo
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JAN. 3, 1989 pursuant to which
Building Permit No. 17739Z dated JAN. 5~ 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 TENNIS COURT
The certificate is issued to ROBERT & MARY ANN SMITH
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. NO ELECTRIC AS OF THIS DATE
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
/ B~ilding Inspector
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No- ~17'f39 Z
Permission is hereby granted to:
o . .Il ~"
...~.~,,....,.....~..~ ...........
~o ..............................................................
.~ .......................... .:.: ...................
~.t premises located et ...~..~.~...~......i~...: .......... :'"*"/~'t"/~
.... ~.T~...~..~..~ .........................................................................................
County Tax Map No. 1000 Se/etlon ....... //.~ ......... Block ..... .(~..~. ......... Lot No......~.J.l .............
pursuant to application dated .... ..~.~.....~. ................ , 19.~.~.., and approved by the
Building Inspector.
Fee ).e~.. ....................
Building Inspector
Rev. 6/30/80
BUILDINC, DEPARTMENT
APPLICATION FOR CERTIFICATE OF OCCUPAN(
.uw~ OF sou'r~O~!
This application must be filled in by typewriter OP, ink and submitted to the building
inspector with the following: 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 tlealth 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 1% lead.
5. Co~ercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code C~pliance from archiuect or engineer
responsible for the building.
6.Submi~ Planning Board Approval of completed site plan requirements.
;. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
pre-existxng land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application aud a consent to inspect signed by the applicant.
If a Certificate of Occupaucy is deuied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
:. 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 BuildJng - $100.00
3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10,00
4.Updated Certificate of Occnpancy- $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Co~ercial $15.00
' .... ..........................
ion.,.~... Old Or Pre-exiot~ng Building .................~/ ~ /
· ...........
ltouse No. Street ~ Hamlet .....
nwer or Owners of Proper ~
,~,ty ~ ~=p ~o ~000, So=~ion. Z4~. .... O ? ~//
.... Block ................ Lot ......................
,bdivisio, ................................... Filed Ma~ .......
..........
......... ~ ..... Date Of Permit./..~.~yf/... Am~licant ~ [ '
'alth Dept Approval
' ' ....................... Underwriters Approval .........................
anni,g Board Approval ........................
quest for: Temporary Certificate ........... Final Certicate .....
".~/j~/¢/ , · ... ,.
co ~ / ~ "~;~,;~W'. .....................
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
.PLUMBING
INSULATION FERN.
STATE ENERGY
CODE
FI~AL
ADDITIONAL COMMENTS:
New York State Department of Environmental Conservation
Building 40--SUN~ Stony Brook, New York 11794
NO PERMIT NECESSARY - TIDAL WETLANDS ACT
Thomas C. Jorllng
Commissioner
Application No.
Loca t i on:
A review has bee[] made of your propo~_al t.o:
Based on the information you have submitted, the New York State
Department of Environmental Conservation has determined that the project
is listed in Part 661.5 of 6NYCRR (Tidal Wetlands Land Use Regulations)
as a use not requiring a permit or notification letter of approval.
Therefore, no permit is required under the Tidal Wetlands Act (Article 25
of the Environmental Conservation Law).
Please note that any additional work, or modification
as described, may require authorization by this Department.
tact this office if such are contemplated.
to the project
Please con-
Please be further advised that this letter does not
the responsibility of obtaining any necessary permits or
other agencies.
relieve you of
approvals from
Very truly yours,
Deputy Regional ~ermit Administrator
--. ..
FRANK A. KUJAWSKI, .Il{., President
ALBERT J. KRUPSKI, JR., Vice-President
JOHN rd. BREDEMEYER, III
JOHN L. BEDNOSKI, JR.
HENRY P. SMITH
TELEPHONE
(516) 765-1892
BOARI) OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
November
22, 1988
Eh-Consultants, Inc.
1329 North Sea Road
Southampton, N.Y. 11968
RE: Robert Smith, R.O.W. off Westphalia Ave., Mattituck, N.Y.
Dear Mr. Mackiewicz:
The following action was taken by the Board of Town Trustees
during their regular meeting held on November, 17, 1988 on the
above referenced property:
WHEREAS En-Consultants in behalf of Robert Smith applied to
the Town Trustees for a waiver to construct a pool and tennis
court on property located on R.O.W. off Westphalia Ave.,
Mattituck, N.Y. Property is identified on the Suffolk County Tax
Map as 1000-113-9-11
WHEREAS the Town Trustees have conducted an on site
inspection of the subject property, and
NOW THEREFORE BE IT
RESOLVED that the Southold Town Trustees approve the request
for WAIVER for Robert Smith to construct a pool and tennis court
on property located at above mentioned location.
Please be advised that this determination is not a
determination for any other agency or department which may have
jurisdiction in this matter.
Very truly yours,
President
Board of Town Trustees
FAK:Jas
cc: Bldg. Dept.
file
INSPECTORS
(516) 765-1802
VICTOR LESSARD, Principal
CURTIS HORTON, Senior
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, Assistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 17, 1991
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Robert G. & Mary Ann Smith
1035 Park Ave.
New York, N.Y. 10028
RE: Building Permit ~17739Z - TENNIS COURT @
505 Point Pleasant Road, Private Rd. ~21, Mattituck, N.Y.
Dear Mr. & Mrs. Smith:
I am in the process of attempting to resolve the conditions
at the Schlunpf site.
While investigating the files and site it was noted that
the Building Permit ~17739Z has expired and a Certificate of
Occupancy has not been issued.
Please contact this office to correct this apparent
oversight.
Thank you for your cooperation.
Sincerely,
SOUTHOLD TOWN BUILDING DEPT.
Vincent R. ieczore~,
Ordinance Inspector
VRW: gar
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
RI'MARKS:
DATE
./
~ V. ~asanen
t
FORM NO. 1
TOWN OF SOUTtIOLD
BUILDING DEPARTMENT
TOWN HALL
BOARD OF HEALTH~ ...........
3
SETS J~F PLANS¢'.. , .
SURVEY '% ......... .,. ''..
CHECK ~e. '~3.~.7 .................
SEPTIC FORM ................
SOUTIIOLD, N.Y. 11971 NOTIFY
· TEL.: 765-1802 CALL ."~ ~.c/.'7/¢ 2.~-,g'. .' ........
Disapproved a/c .....................................
...............................................
~~..~
(Buildin~ Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tlds 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 9f 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 tttis appli-
cation.
¢. 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 l?e 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 Dep~tment for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Couuty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, a,d. ditions 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 ~ building for necessary insfi~ctions.
, (Sionature'~;""'t" '~ o~' applicant, or name, if a corporanon)
· . (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer,...~ .. . contr_actor~,)electncmn, plumber or builder.
:~ '~'O' '~"¢:~'~'5'~' ;'' 'LL~'~'~,l~ '~ "~~/~~(as on ih%,,~'~ol! or- -~" ....
Name of owner of premises -- · · .
, , , .; ''...; la/e, stO;
If ap~ cant is ~corpora~,. §' gnae9re Df/d ,uly authorized officer,
(Name and' htle ~,~orporate or'ricer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No.
Location ofland on which proposcd work will be done. , --~..'.--'",..,,..
House Number Street Hmnlet
County Tax Map No. 1000 Section .. / ./.~. ........... Block ...d)..g ............ Lot..~A< .............
Subdivision ~; > ~A~9"~ ~t~ Filcd Map No, Lot
(Name)
2. State existing.se and occupancy of premises and intended use and occupancy of proposed constrnction:
a. Existiag use and occupancy r .. ~._ ........ . ............................ .......
b Intended use and occupancy .... J~.~) ~ ~~
3..~Natur. e of work (check which a~plicablel: New Building ..... ' ..... Additim .......... Alteration., .......
l~.epalr .............. Renl,oval .............. Demolition ........ 1. · Other
4. EstimatddCost.. ~' .''q:.~9 .............. Fee ..
rte be prod on fihng th:s apphcatmn)
5. If dwelling number of lweIling~units Nomber of dw Iling units on each floor
If garage number of cars
6 Ifbusine'ss ........................................................................
· , commercial or m~xed occupancy specify natnre and extest ofeacb type of
7 Dimensronsofexistin~stmcturCs if any: FrOnt use .....................
' , .............. Rear .............. Depth
Ileight Nu fiber of Stories ...............
Dimensions of same s~c~ w~ith alterations or addi.ti~ns: Front ................. Rear .........
Depth . :~...~ ~.~. ~.. lleig ~t .................... Number of Stories ..................
D~tllenslons of entire new const~ ctlon Frollt
8. ' ' ' ' ' ' ..~O.~.(.~... Rear ............... Depth .............
Ilmgbt~..~ ....... Number of Stories
9. Size of lot: FrOnt ...... ~ ........ Rear .............. Depth ........... j ......
10. Date of Pt ~chase i '',, ~,' ............
. . · ......................... mame oivonner Owner .............
I 1. Zone or use rhstrmt in which premises are situated .............................................. ' .....
12. ~,~ proposed constru?jon ~io~gte ?ny zoning law, ordinance or regulation: .~ ...................... ' .....
13. w,u ~ot be regraded .,.~ {~{~.<~5{~) .... Will excess fill be removed,from premises: Yes .....
14. N~neofOwnerofpremises g(o~~ .ddr~_~a~ ~ .....
Name of Architect .... l ..... . . Address .................. Phone No ................
15.Is this property loca~ted ~ithi'n 500' feet of a txdal wetland* ~....o ....
~If yes, 8outhold Tow~ Trustees Permit may be required.
... [ PLOT DIAGI~
Locate clearly ~d distinctly ~llbuildings, whether existing or proposed, ~d. indicate all set-back d~ensions from
property ~nes. Give street ~d block ~umber or description accord~g to deed, ~d show street nines and ~dicate whether
interior or comer lot.
OC(UPANC¥ OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF iOCCUPANC¥
APPROVED AS NOTED
DATE. ~ ~._~.~ Bp# ~"~
OTIFY SUILDING O/PARTMENT Al'
765.1802 9 A~ T~
FOLtOWING
1. FOUNDATION TWO REGUIRED
FOR POURED CONCRETE
2. ROUGH . FRAMING & PLUMBING
3. INSULATION
4. FINAL CONSTRUCTION MtJST
8E COMPLETE FOR C.O.
ALL CONSTRUCTION b;ffALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONS~UCTION & ENERGY
CODES. N~ RES~NSlBLE FOR
DESIGN OR cON~u~ION ERRORS
................. day of .~ ...... 19.
Notary Public
, ry , State of New Yolk
No. 4822563, Suffolk Counli(/~Th
Term Ex, olres December 31,
(S]onature of apphcant)