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17493-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18255 Date AUGUST 7~ 1989 THIS CERTIFIES that the building Location of Propert~ 435 WESTSfIEW DRIVE House No. County Tax Map No. 1000 Section 139 ADD TO ACCESSORY MATTITUCK Street Hamlet Block 01 Lot 023 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 29, 1988 pursuant to which Building Permit No. 17493Z dated OCT. 4~ 1988 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 DECK AROUND AN EXISTING ACCESSORY SWIMMING POOL. The certificate is issued to PAMELA J. SELLARS (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/a Building Inspector FOBBf[ NO. ~B 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) N9 017493 Z Permission is hereby granted to: ..L~.~......~....-~.~ ................... .... ."P~.....~.'z~ ............................................... ~.~~ ~ ,.~., /.~ .~ ~ ?. ........ .................. at premises located at ..~..~.~......~..j~l~,.~......I...~...~,..,. ............ .r...~..~.~.F~. .................. County Tax Map No. 1000 Section ...l..~.~..~. ......... Block ....... ..~....! ........ Lot No ..... ..~.....'~.....~. ...... pursuant to application dated ....... ..~,,~...~ ....~.........~..(~ ............. , 19..~.~..,, and approved by the Building Inspector~/.~- Fee $.,, .~.. ,~, ,.',,,~,,. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTDOLD, NEW YORK 765 - 1802 II971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING gUILDING ...... VACANT LAND ........ HOUSE NO. STREET HAMLET o~n~ or O~ners o~ ~ropert~...~:.~..--T..' ~C--~CA~ ~ou~t, Ta* ,~, ,o. ,000 Section ~.~. E~oe~ .O.t... Lot ..0..~:~.. Subdivision ....................... /:..:.?.,: Permit No. ..Date of Permit Filed Map ........ Lot .......... ...~ ...... Appli~ot ~.~l¢~.."[. ~.e~..~ lth D pt Appr 1 '~-- Ilea e . ova .................. Underwriters Approval .............. Planning' Board Approval ................ Request for Temporary Certificate ....... Final Certificate Fee Submitted: APPLICAN rev. 10/14/88 APPLICATION FOR CERTIFICATE OF OCCUP/~C¥ IN~TRDCTIONS 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 prope{ty 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-dlsposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/10 of I1 lead.I 5. Commercial buildings, ~xndustrxal buildings, multiple residences and similar buildings and install~tlons, a certificate of code compliance from the 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, I957] non-conforming uses, or buildings and "pre-existing" land ~ses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or toRographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstr6'ct 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 Oclcupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing co!de or safety inspection of buildings or premises, or other pertinent information :required to prepare a certificate. C. For Vacant Land Certifica~te 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 of ~he entire lbt prior to April 9, 1957 shall also accompany the application. If a, Certificate of Occupancy is denied, the Building Inspector shall state the reason~ therefor in writing to the applicant. FEES: 1. CERTIFICATE OF OCCUPANCY - 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 - $I00.00. 3. Copy of Certiflcat~ of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certxf$cate of Occupancy - $20.00 ~. Updated Certificate of Occupancy - $50.00 6. Temporary Certzfxcate of Occupancy - $25.00 Residential $50.00 Commercial FORM NO. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765 - 1802 rev. 10/{4/88 FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: OF £OUTLIOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL SOUTIIOLD, N,¥, 119?I TEL. 7(;5-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. /_-// An application for Certificate of Occupancy is not on file. ~/~ /--/ No Underwriters Certificate on file. /.n_~ 'Phc: ,check _ /~/ No Health DoOr, Approval on file. /-~/ No final inspection has been made. Please contact our office on this Thank you for your cooperation. matter. Dui lei (ncj Dept.. **~/--/_ ['lo Plumber uolder certlf~cate'~ " ' on file. ( all permits involvJ, ng plumbing being issued after AprJ.! 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND L ] INSULATION [ ~I~AL ~/. DATE FORM NO. 1 TOWN OF SOUTHOLD BUll,DING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. GSa....~-A4~...q.., 19 .~..~ Approved .~...e~..O-fl~...~.., 19 .~.~. Permit No./.~. .~. ?..~.~.. Disapproved a{c ..................................... ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH .,../. 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL MAlL TO:O,~, ~.')~' TOWN OF $OUTHOLO a. This application must be completely filled in by typewriter or in ink and submifted 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 this appli- 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 permit 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 Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 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. (Signature of applicant, or name, if a corporauon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ /~.[ ~h.~' 7.~, .c~'~.. ~...~.¢ ...................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) Builder's License No?.©. : Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section /:~.. g ........ Block ~./.... ................. Lot...C~..~ ............ Subdivision ................ tkl'ai~1 ................ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises an~d intended use and occ}tpancy of/propose,d construction: · g use and occupancy ...... ~ ................. .,.~ b Intended use and aemmancv ~.f.~./¥~'.-.~.-e,,-l~...~t~TT...'M~..4'7 ~. ~I~::~"~1~ ~ 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ........ Alteration Repair ..............Removal .............. Demolition .............. Other Work ............... i (Description) .-. t :..072.. ' Fee 4. Estimate'd Cost ............................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............. If garage number of cars 6. If bumness, commercialr..~, ...... or raix~ed occupancy, specify nature and extent of each type of use ....... 7. Dimenmo4 ~Jng:strUotm'es ffany: Front ..... Rear Depth . . Hmgh · .[ I ]1~..?;, ..... Number.of Stones Dunenmonl ~4 ~Tame_s~[gt~$-re,,W,i~;h altFratmns or additions: Front ................. Rear ........... Depth ...t ~1. ,k~q~,.tll~.~..~.~. H6iglit ........ Number of Stories ' ' ' ' 8. D~menmon~ ~.~t~entire new constructj{lg, Front . . Rear .. . De th ......... nmgnt .. i...' ..... )..... Nufat~errof Stlones . . 9. S~zeof or. ,r.o~- ...... ..................., Rear .... Depth ....... . ........ 10 Date of Purchase Name of Former Owner 1 1. Zone or use district in which premises are situated ..................................... 12. Does proposed construction vi01ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ i'. ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises ~ Address Phone No ' Name of Architect ......... ! ............ ; ..... Address ................... Phone No ................ Name of Contractor ........ , .................. Address ................... Phone No ............. '... 15.Is this property located within 300 feet of a tidal wetland? *YES.~.NO .... · If yes, SouthQld Town Trustees .Permit may be required. _ ~ - ~ ~ Locate clearly and distinctly al,1 buildings, whether existing~ or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whettier interior or corner lot. ~ STATE OF NEW~OR/~j--- , t ..- i S S · '¥ '~' "~": .................... ; .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty authorized to perform or have performed the said work and to make and file this application; that all statements conthined in this application am 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 . (:lmlllfled I~u~m,,..~, c'~'/ // (Signature of applicant)