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HomeMy WebLinkAbout18324-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218499 Date OCT. 25, 1984 THIS CERTIFIES that the building ADDITION Location of Property 300 BAYER ROAD MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 139 Block 03 Lot 23 AMENDED Subdivision MATTITUCK HEIGHTS Filed Map No. 1184 Lot No. 64 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 25, 1989 pursuant to which Building Permit No. 183242 dated JULY 25 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 2ND STORY DORMER TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to GREG TYLER (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N096497 OCT. 11, 1989 PLUMBERS CERTIFICATION DATED PECONIC PLUMBING & HEATING OCT. 16 1989 uilding Inspector Rev. 1/81 n~osas xo. s TOWN OF SOUTHOLD BUILDING DEPARTMLNT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ° ~ c7 3 G 4 Z Date ~.,.c,c.X,t.~...c~.a~ 19..1 Permission is hereby granted to: 11 ...~?,~~:...;K:~f......~, ..~Q.X. y.:~.~ tom.........' .1~ ...............'.....~...an..... at premises located at ....~.Q?,?..........°~:w4.....l~:a.........~'~1... ~?.:Y County Tox Map No. 1000 Section .....I..~~..9........ B1ock ......Q...~....... Lot No..~..3 pursuant to application dated 19.~.g., and approved by the Building Inspector. Fee 5.~:. Building Inspector Rev. 6/30/80 rr/~/ 1~ S ' ~ FORM NO. 6 y' ~ ~ a P'o Q,o TOWN OF SOUTHOLD ~ D ~r Building Department Town Halt Southold, N.Y. 11971 * ~ 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPA CY BLDG. DEPT. TOWN OF SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted •e.~~ to the Building Inspec- torwith the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 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 topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of Occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $ 10.00 4. Vacant Land C.O. $ 20.00 f~ a0/rj~ S.Undated C.0. $ 50.00 Date 0 New0~'...... Old orPre-existing Building Vacant Land/' . Location of Property ~~4t'Q~ l~l~~~~l House No. ~ Street Hamlet J Owner or Owners of Property . „ . County Tax Map No. 1000 Section Block .....~..J...... Lot....42..3 Subdivision .................................Filed Map No. ..........Lot No. . Permit No. ~tl ~~y7 Date of Permit . ~~/~.~~Applicant ~ ~~.~'21py, enC Health Dept. Approval ........................Labor Dept. Approval Underwriters Approval ................Planning Board Approval Request for Temporary Certificate .....................Final Certificate . ~ . Fee Submitted $ c~-~.'~ . Construction on above described building and ermit meets all applicable codes and regulations. Applicant ..4'~Ce-F`t'~.. ~/!.`/.'/FC~~u...~%~'L...~~ , Rev. 70.10Ja JA.P{ ,30 SQ9 ~ Ca zi~~9y _ - ~-R-. ~ ~ ~ _ ~ , TNT I~1Ai Yt'C OF F U1RMtR1T'~~tS 1.uriif)t1 BAUe~Et.ECTlNCfI'Y ~ p ~on*t ETAtirT. NEMI roteK. wEw rOntt tOOSs n.a OcraINX.R la.:ly$f: ,yP~e.ebwnu.w.pt. !^~~°l.•s,,;!~~,i4tti3 rb t,,,: ; _ i TNW CERTIIlE THAT - awb. rM ~MebM~PNwywwt.~t iKarWi bait` rJ twtrwMa~ h tfr TtJ'Bt~ltt wnwrJ ow tko ~6ow op~Mwttow TKLIILi1M in dw pwdw N ~G?tr;', `i'Y'i,r;~, t4,gYL~R 4~ff~~), MA1"r'i"C(}!"K. nt.~. in tke foGotrlttR bTAwtlont ? Brrwt~nt ? 1Kt fl. ~ SnJ F!. Section Black Lot KrY eroTniTKaf aw SY,2>TI:14$M'i11. 2 i. `i.':'s ~TKJ fauwd W be in rompl7owce Truk the TvyoiroTrKaTKtA of tku BeoTd. - t){ttt~tt B~ OTMM AMT. K. W. AMT: t. W. AMT. K.W. AMT. K. W. AM}. Mr. _e. BRY~RS / ~ AIM'UMILt ~ MC/T vOClf{. ~ MIN lrklf~f KIMM AMi. K.W. ii e.. K?. AM1. TT0. AW.0. AMT: Aitl. AMT. AM~t. AMC M. 1. AMT. WATI6 - B~ BBIVIQ f # B V 1 C E - AMT. Aw. - Trrt T N 1w t 17w t ? iw » M w. a roTn. Tq. a TIFIla p• W Tq. a TIlYTaA1S flT11M1 AIrARAiYk ,fir ar~,tx>pi NI:~2iNi~ QN6Y~:i. tSMUt[>: 1Jb:'Y.'EY "L'Ok : -'.I. fi 6 S CbH't'itAC"u~+ T ir, . ~`i S t3U:4 ;d:( fit)(?TM(>LL> nta . ~ t 4r 1 O~1MIAl MMiI1M . i TEL. 765-i 802 oo~~FFO[KCpGy~ TOWN OF SOUTHOLD ' Z t OFFICE OF BUILDING INSPECTOR ~ z P.O. BOX 728 c°r~ ~ TOWN HALL `'p~o~ ~ SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date - ~ w/ Buildin/g~ Permit No. I oZ Owner C~,~-~ ~yf~~ lease print) Plumber/ ~C U?,~~C, / "~li~'d~Jl/~ n~`7C`~~y (please print) l I certify that'the solder used in the water supply system contains less than 2/10 of to lead. - ~~~y (p um er's si ature) Sworn to before me this day of a ~ I/i t 19~• Notary Publi Notary Public, ~~~(J1~ County BARBARA 57EpNOWSKI Natary public, 5taeo of Nava York No. 4Li~A7B°a Qualified in Suffolk CounEy COmmib^miarF Ettpira3 NA&reh ;3ED; 7 9.~ 5'0 ~ ~i - ~~Fr ~ TEL. 7GS-l8n? o~, ~c, To~rrr or sou~oy.~ /t~ i~~1;:~..27Iw:v~'Y S'..4 Ol~ 1'ICIi OI' BUILDING 1NST'ECTOR ,t. ~ ~ TOWNlIALL A'~~ ~ ~ O~ S01J7'l1oLD, N.Y. 1 1971 ~y~! ~1 ~ October 1 1 , 1989 _.t6" BOB KEHL HOME IMPROVEMENT INC. BOX 520 SOUTHOLD, N.Y. 11971 RE: GREG N. TYLER 'Po Plhom This May Concern, 47e arc unable to complete your Certificate of Occupancy because of the follo~•riny reasons. /d/ An application for Certificate oi' Occupancy is not cn fil.c. (ENCLOSED) ~C / Mo Undcr~arltcrs Certificate on file. / 't'he chccFc .i:; (~~X~)eX~>d/nut on file.) $25.00 !_1 No lteal.th Dept;. Approval on file. No final inspection has been made. Please.. contact: our office on this matter. ' Thank you for your cooperation. Iluildicc7 Pcrm.i.i-. ~t i 8 3 2 4 Z 13uildinq Dept_-. / Uo Plumber Solder Ccrtif-icate on file. ' ( al.l permits involvi.ny plumbing being i~sucd afL-er April 1,1984 ) i IcLD I;:S: c ..U;. ~~Uni"-, I~ C'vC4M~NT~ ~ ~ ~ ~ ~ 1. I I~ Do N9 OUt1DAT20"1 (1st) ~I c r ?OUNDATI011 ti d' (2nd) _ to z 0 ?OUGH FRAME PLUMBIN~ 3. ~G a ~ I1ISULATIOf1 PER N. Y. STATE ENERGY CODE 4. ~ y~C FI;1AL ADDITIOPIAL COMMENTS: ~ x m ' x ro ~ N a v~ y H O '-0 m c- • ~ H • p. _ t*7 ro H / V ~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T (l~ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~MING ( ]FINAL REMA S: DATE ~ ` ~ INSPECTOR; BOARD OF HEALTH 3 SETS OF PLANS FORMN0.1 SURVEY " TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT sEpTlc FORM TOWN HALL ~OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CnLL q Examined ~`S 19~yq, MAIL T0: Approved 19G J. Permit No.I r~.3°~.~~. Disapproved a/c ................................:~~~,o.c;. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date I5. . INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Bui]ding 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 premises or pubic stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl cation. 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 perm: 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 Occupant 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buIldings, additions 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 in building for necessary inspections. .,~qli, ~~e/GS F/o~,£ 1ih.~ifor//~.E,r~7s~ ~R1 (Signature of applicant, or name, if a corporation) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. „~iEiC ,p~°~ Name of owner of premises ' T y~~l?_ ...,,70' (as on the tax roll ar latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. /~'?,7,7.~-~ Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done . . ~9. <2...... Ci'>? y~i2 ~~:.............../'.i~~: ; yr, ck House Number Street Hamlet County Tax t`fap No. 1000 Suction .....~.3 Block Lot ~_„J , , , , , , Subdivision Filed ~fap No. ..If ~Y...... Lot .~'.-~~7...... (Name) Z. State uxtsting use and occupancy of premises and intended use and occupancy ofproposed construction: a. Existing use and occupancy ~lx.!~CC t b. Intended use and occupancy ...~~CJ'~D'C r - 3, Nature of work check whic ( ~ Re air , , , , h applicable): New Building Addition Alteration _ P removal Demolition , Other Work . • ~ ~ ~ ~ ~ • ' 4. Estimated Cost ~;T,~j.Qd Q , , , , , , • , , . (Description) - Fee (to be paid on filing this applica[ion) 5 If gara`lennumbcr of cadwelling units ....t7 , Number of dwelling units on cacti floor , , 6, If business, commercial or mixed occupancy, specify nature and extent of each type of use . , ~ ~ • ~ ~ • 7, Dimensions of existing stn Nures, if any: Front ~6 , , , , , , , , , , Rear , , ~d ' • • • • ~ ° • ' • Y ' ' ' ' ' ' Height umber of Stories . • Depth .:S.y, , , , , , , . Dimensions of same structure with alterations or additions: Front , r?G , , ~ • ~ • ~ ~ • • ~ ~ ' ' ' ' ' ' ' ' ' ' ' - Depth ~Y Ileight o~? k'.. Rear ~,2.` . $ Heml>isions of entire new co • • • • • • . Number of Stories x, , ~istruction: Front Rear . ~6~ .Depth . , ~1, 7•j ~.8 ~ ..umber of Stories . ,l ~ , . 9. Size of lot: Front Rear , ...............Depth ...%S'a:............. . 0. Date of Purchase 1 1. Zone or use district in which, ' ~ • ' ' ' ' ' ' • • • • Name of Former Owner . Premisesaresituated..,R~Zflpr~;~Ti~c•.,••„••• 12. Does ro osed construction P P ~ iolate any zoning law, ordinance or regulation: !t! ~ ~ • • • • ° ' o 3. Will lot be regraded i ...Will excess fill be removed from premises: Yes Name of Owner of remises , P , N.~. Ty~;c;~ Address . B1t y,,re, ;C.a /1t~+?`~9c4'Itone No. o'I.YP -9 03 tA! • Name of Architect ,Address . ° ' ° ' Y " " " Name of Contractor„~4~.:~~-;•Q~ •PhoneNo,..,, IS.Is this property located within 300•Addresslait7:'yR;~„ar4;~c'w?'.NF',,,phoneNo..~x3•:.YS2)~ feet of a tidal wetland? *YES....NO.~G:. *If yes, Southold Toiwn Trustees Permit may be required. PLOT DIAGRAM • Locate clearly and distinctly ;all buildings, whether existing or proposed, and indicate al! set-back dimensions fron property Lines. Give street and blo~k number or description according to deed, and show street names and indicate whethe ihterior or corner lot____~_ ~A' y\~ Z STa~Y ~wf k ~ ~6zC ~ _ _t-'~~ ~~aoL poi STATE OF NEW YORK, ~I COU Y OF . S.S • ' ~e`y'G' ' 'f ~ • ~ ~ ~ • • ~ • • • . • being duly sworn, deposes and says thai;he is the applicant (Name of individual sip ing contract) above named. ~'He;isthe .....................f.,.. Contractor agent, rporate office ,etc.) of said owner or owners, and is du~y authorize to perform or havel2ave P~ the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this i (~I.-/l' q Notary Public, , , ,~iy:ex~?r/ . i ,~/ce:.000b~- County • i• HELEN K. DE VOE 'i ~"-Y . ~NomA101878;BUNdkCNouob i tern, Expires Merch 30,19... (S ignarure of applicant) - - _ e~AYEle? ~COh1G - 'O - j NtaF?Yo~ F?~ ol?~_r t'y _ _ _ / ~s/ue/+-rte y/~,s~o F'7'o~r~z/ / C t-y L 59, R0 a°°~"T S"T-~ q 2p 3!i G` t'a ~ ~ ~ L7lG L. 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