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Home My WebLink About17153-z FORM N0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ..Z 17018._,,,, Date June 23, 1988 THIS CERTIFIES that the building A c c e s s o r y Location of Property 945 West Mill Road Mattituck House No. Street Nam/et County Tax Map No. 1000 Section . ~ 06........Block 9...........Lot . , , , ,I.1........ . Subdivision ...............................Filed Dlap No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated June 2 , 1988 pursuant to which Building Permit No. 1 7,1,532, , , , , , , , , , , , , dated .June. 2.1 , : ] 988 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 . ....Ac.S@SSo?:y..bui,ldin.fi• Tlie certificate is issued to .....Stephen J. 6 Pamela S. Nostrom I o wn er, %r%sSd~c$~,$i#ti~ of the aforesaid building. Suffolk County Department of Health Approval , , , , N /A UNDERWRITERS CERTIFICATE NO............ N /A PLUMBERS CERTIFICATION DATED: N/A . ~ ~~t.!Q e~ . . Building Inspe or nav. 7/81 roans xo. s 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 o 01715 3 Z Date .....fa,~~/ 19 Permission is hereby granted to: ~ g ~c ' , .../....:d.~.~~ ~ to . . . . . . . . . . . . . . . . y...'../. . . . ^ . . . / . . . . . . . . . . . . at premises located of ......`1..5`.x.1 ~"t"•••••~~ County Tax Map No. 1000 Section Block Lot No..............~/.... ,3/~. d pursuant to application dated ..fin/y~ 19~, and approved by the Building Inspector. D~ Fee $.........~R+"• / B ng Inspector Rev. 6/30/80 i FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted to the Building In~ec- 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. ALTBRATION $25.00 1.Certlflcate 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 5.Uodated C.O. $ 50.00 Date New Construction,,,,,,OldorPre-existing Building Vacant Land u Location of Property . ~,W-?, , WQs~ ~ ~.4T,7~}~u?..... ,r.?.•.a.. ~l~s.~:.... . House No. Street I ` Hamlet Owner or Owners of Property ..?.~^'e'~ ~:....~~:f!'1'~I~ ~ Nq,~,R6?t'1 County Tax Map No. 1000 Section Block Lot ~ :S......... . Subdivision .................................Filed Map No. ..........Lot No. . Permit No.I .7. , . Date of Permit ~?~)......Applicant . Health Dept. Approval ........................Labor Dept. Approval . Underwriters Approval ........................Planning Board Approval Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ ~ ~ ~'.Q ~ Construction on above described building and per it meets all ap licable codes and regulations. Applicant...._~s~~4t? a~,.,e-,e-7a ~ 3 y 9a ~ ~/a~/~~ ~ P / 7/S3 Z tf C.U. 'z / 70 / t'7 3 !M , 765-1802 i~UllDING DEPT. rrVSPECTroN [ ] FO~JNDATION i5T [ ]ROUGH PlBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~INA! REMARKS: , ~ ~ ~ l/ ~ Y~l~!~1~'p ~ dd r Dom,. ~ _ ~ L,~~ DATE ~ ZZ BrB~ INSPECTOR U~~ " BOARD OF HEALTH _ 3 SETS OF PLANS FORM NO. 1 SURVEY . „ TOWN OFSOUTHOLD CHECK U 6UILDING DEPARTMENT SEPTIC FORM TOWN HALL ,.:;OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL BLDDF U P~r.n MAIL T0: Examined.......' r\pproved~r . 19~Pennit No..~71~3t~ Disapproved a/~~j . uil Inspector) APPLICATION FOR BUILDING PERMIT Date ~$.'..2~..........., 15641. INSTRUCTIONS a. This 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 of 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 inspe tions . da ~wV~ . (Signature of a licant, or name, if a corporation) ,~.~lS...w.~;~l till. R.~:I..~~o~~~~.G.. gg 4(Ma~lin~ address of applicant) State whether app see, agent, azchitect, engineer, general contractor, electrician, plumber or builder. IR!~.Mt«~.~..~..,...~ .~v'~p'; .y~me(~. s.~.... ~(b.s~ IoM Name of owl ey~e~, t . . r't.4~k'1~9";3~~+~~q „p~~„+~f1; ~,t;w (as on the tax roll or latest deed) If applicant s'Qrt,t~ ~ ~ authorized officer. (Name and title ~q cp rhte bfjr~cer)' `r~iESN44°:"'~6'!'°.l4,fi~~7~6~~'f~ Builder's License 1~ ° b=£t1 y1 3i'in±ta,~'? t~§ ~r;~It}.~I~~~~~,_.•~ iTHOUT CERTIFICATE Plumbei'S~~i~1~ sPP~~ '%1~43+~'tPv8L13ryit ' , . / M.'t Y.x.~ bh Electric,~f1~t~f~~~~i1T"~~rs'~~~ C\JU~AC~ Other Trade's License No . . 1. Location of land on which proposed work will be done. Srf!!'1.'? ......AS, , , , ,1: ! ~o ~~Q ' ~.~.M.~.c! ~a~1:......M.u~; ~ House Number Street Hamlet Coun[y Tax Map No. 1000 Section Q~ Block 1.......... Lot . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S. I.Q,Pa>~ 1 4 . h 4 b. Intended use and occupancy W..~.C~,SC~;.;~,~„,~„~',g~~,, . ~ p ( ;applicable): New Building , , , , , A ~ ~ , , . Alteration 3. Ret air of work check whiReinoval . Demolition ~ ~ ~ ~ ' g" ~ Description) 4. Estimated Cost.,:3,®",~~,,,,,,,,,,,,,,,,,,,,,,,,,,Fee..'. , . . Ie " `('to aid n(~~ng 'pplication) 5. IF dwelling, number of dwelling units , , , , , , , , . Number of dwelli'n' un't~on.eaG~. If garage, number of cars ~ . g ) ~ . . If business, commercial or m`ti'ued occupancy, specify nature and extent of each type of use , ;i , , , , , , , Hei~ltt g.... res, if any: Front Rear Depth . Di mensions of existin struct tuber of Stories . . . . Depth , ~+'ith alterations or additions: Front Rear . Hei ht ...Height , ..................Number of Stories . 8. Dimensions of entirasnew construction: Front , Rear....,.......... Depth g Ntjmber of Stories . . 9. Size of lot: Front Rear .......................Depth . p 10. Date of Purchase ' ....Name of Former Owner ' 1'I. 'Zone or use district in which 'remises are situated . g olate any zoning law, ordinance or regulation : . 13. Will lot bee draded tructton vi Will excess 51] be removed from premises: Yes No P p P 14. Name of Orchltect remises : : .Address ...................Phone No............... . .Address ...................Phone No... . Name of Contractor . . . . . . .Address . .Phone No.. , 15.Is this property located within 100 feet of a tidal wetland? *YES....NO~.. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to dee?d, a~nd~show street names and indicate whether interior or corner lot. ~''~~li'~ "u,,' G~~~'B"~~M~n/y'"v Spa S~ ~1)~~N~M Fw 7a~ s~6A4~ ' I I~ F~ K• - l3ss.eM~l~e~ . ~ ~ s ~ DA i ~EE• ~ 786.1$Q1 s /1M 7p x, rM 711E i ( ~p u,$ .2 'FDLLUIMQIG M~t~y~ ~r rr1/~ry~..,r/~.Vr_Ty~lw~ • . INSUk~MI' ' , r ~ ' .FINAL` L~!!N MIIbT b'F 7 = ) w'~eRi olZ ~ ~ BE COMpL „ FOR C.O. L CQNSIRUC71~M1 .MNALL MEET STATE OF~N&WY~RK, " ~ ~ 7 E REQUIR@MENT6 Of TiIE N.Y. COUNTY OF S:S G Rt{- ~0 -S `I7 S S TE CONSTRUCTION Et ENERGY p r g. CODES. NdT gE$PONSIEIE ImO11 5-F:e NtRtN.:~. ~...~°:sd`~'~.~ , bein dul ' ' ' ~ ~ ' ~ f g lD~ 0~$he applicant (Name of individual si Wing contract) above named. He is the ..................:G7.f!!N. E/Z.......,.,...............,. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed 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 Gled therewith. Sworn to before me this ........G.Z.( .............dayof...~. ,19.~~ Notary, Pu~bQlilc~,,.......... , . , , , County V't" r""' l ~ NotaryPubpo,laye~~jy~ ' (Signature of applicant) No. 4822888, Suffolk Coin Telm Expires December 81,15:...-