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HomeMy WebLinkAbout17219-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217888 Date MARCH 27, 1989 THIS CERTIFIES that the building ALTERATION Location of Property 2615 MILL ROAD MATTITUCK _ House No. Street Hamlet County Tax Map No. 1000 Section 100 Block 03 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 6, 1988 pursuant to which Building Permit No. 172192 dated JULY 15, 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy far which this certificate is issued is STRUCTURAL REPAIRS TO EXISTING OPEN PORCH ON EXISTING ONE FAMILY DWELLING. The certificate is issued to HENRY W. DRUM (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPAOVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A i1 i~~ector g I P Rev. 1/81 nosas 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 017 219 Z Date 19~ff Permission is hereby granted o: ~~y...: ~.:s~,~ e .........~.,~.~s::.,~r~.....~~' s~ . ct premises located of ...sT~...~r~..~.v.`~..... County Tax Map No. 1000 Section ........~.~~...~J..... Block Lot No.......~~ pursuant to application doted 19~~ and approved by the Building Inspector. Fee O ....1.... Bull 1 actor Rev. 6/30/80 ~ ~d'-~"~ TOWN OF SOUTHOLD h~~l~ ~ ~ ~~g9 ~ BUILDING DEPARTMENT TOWN HALL TOWN OFSOUTHOtD SOIITHOLD, NEW YORK 11471 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE.~S/ '~1 NEW CONSTRIICTION .......OLD'OR PRE-E%ISTING BUILDING. ..VACANT LAND........ Lccatioa cf Property.... / L1 G° ,f~.. HOUSE NO. STREET HAMLET Owner or Owners of Property..L.~~.~~:,C..~!..~~~..Y.~ County Tax Map No. 1000 Section /Block Lot .C~.... Subdivision Filed Map ........Lot........._ Permit No. ~ [`:~~.g z...Date of Permit /~~~...Applicant/:Fti.~~. j,~, 2~°`~ Health Dept. Approval ....y Underwriters Approval....h1.~'~':..... planning Board Approval JY.~': Request for Temporary Certificate Final Certificate Fee Submitted: APPLICANT/!.K...... a6~s ~y~~ 3 ~ ~ yU c.v. z, c a ~ ~ ~f~~ -3~2 ~~~y rev. 10/14/88 F1cLD ICS:'EC;IOtJ ~~UAiE ~ COz`1MENTS ~ v t. ~ H H cOUNDAT 0 (1st) ~ FOUNDATTOtJ ( 2nd ) _ - C 2. 2 O ROUGH FRAME & PLUMBING ti H 3. ~ ~ j IIJSULATTOCI PER N. Y. y STATE ENERGY CODE x r ~ H m 4. FT;JAL o z ADDITIONAL COMMENTS: x ~r H e y H O z . - x ~ o co -c H o~~~FOU~~O VICTOR LESSARD ~ L Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ~ ~i P.O. Box 1179 (516) 765-1802 • ~ Southold, New York 11971 FAX (516) 765-1823 ~Ol ~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 7, 1989 Mr. Henry Drum 2615 Mill Road Mattituck, New York 11952 RE: Building Permit #15565-Z #17219-Z Tax Map #100-3-17 Dear Mr. Drum: ' During a review of our files, it was noted that a Certificate of Occupancy Ilas not been issued. According to the Code of the Town of Southold Artiele XXVITI 100-281 and 100-284 a building permit is needed for construction and alterations to an existing dwelling. It is unlawful to occupy a dwelling until a Certificate of Occupancy has been issued. Your final inspections have been made. Please fill out the enclosed application for Certificate of Occupancy and return to this office with a cheek for $50.00 ($25.00 for each CO). Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Vincent R. Wieczorek ordinance Inspector VRW:gar encl. BOARD OF HEr1LTH 3 SETS OF PL.1NS FOftM NO. 1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT sEPTic FOarl TOWN HALL _ SOUTHOLD, N.Y. 11971 NOTIFY - TEL.:7G5-1802 GALL Examined./~.........,19td~! MAIL T0: zC,IS Y`~1t~ ~j• Approved . ~ ls~........ „ IJp.~Penni[ No. f~~,~ Disapproved a/c ~ ~~~_-~-~~~~..~I~~ ~y~ , i JUL - .61988 (B ildi ~ nspector) ~ ~ 701"JF :,OUI' ()t.U.~vp.~ APPLICATION FOR BUILDING PERMIT Date 1~. INSTRUCTIONS a. Tltis 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 Re;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to cc)trtply>with;all;applicab~e laws, ordinances, building code, housing code, regulations, and to admit authorized inspectors on premises'arid in building for necessary i spe ns. 1~., °z9 ~ ~ ~ °w ~~x, (ignature of a licant, or name, if a corporatron) .t;A ~t z"#ttrb ~ 4.~ a ~i, • (Mailing address of applicant) - State whether applig~n~t~~sA,o.'n F,.I,~sslee,°~o~rit, architect, engineer, general contractor, electrician, plumber or builder. ~:~z4t~<. .,.c .,p~ ~ ~ ~ ~afr~„ . . Name of owner of premises , , . ,,/T:~ `v..~.~~ ~-U 4-e~/.. (as on the tax roll or latest deed) 1C applicant is a corpoi5'tion, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ..~.~.....~.~.~w~~ ~ I ~J~~~jc/~ 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 ~ Str~et\ Hamlet 1 County Tax Map No. i 000 Section ~d. U, Block ~ , , , , , , , , , Lo[ . Subdivision Filed tap No. Lot . (Name) 'i' State existing use and occupancy of p//remises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~'~.5... ~ ~LJ..~'.~ b. Intended use and occupancy i 3. Nature of w rk check which (;applicable :New IIuildin ' • ~ ( ~ ~ Addition rUtcration Re atr P ESl tr'..~ Removal Demolition Other 1Vork . ,1, • , • • , • • • , . , , (Description) 4. Estimated Cost SC! ~Q~ Fee . 5. If dwelling, number of dwellin (to be paid on filing this application) 'g units Number of dwelling units on each floor . If garage, number of cars • • • • • . 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use . , , , , , 7. Dimensions of existing structures, if any: Front . .Rear • • • • ' • ~ • ' Height Number of Stories . • Depth . Dimensions of same structure with alterations or additions: Front ~ • ~ • • ~ ' • ' ' ' ' ' Depth . . Itcight . Rear 8. Dimensions of entire new constnrction: Front ' ' ' ' ' ' ' ' ' • • • t....... Nu Nurnber of Stories . Height ~ Rear Depth Sti+~ 1nber of Stories . 9. Sizaoflot: Front Rear................................................... 10. Date of Purchase I Depth . • ,Name of Former Owner 1 1. .Zone or use district in w}ticlt • • • • • • • • • • • • . poemisesaresttuated,,,,,,,,,,,,, 12. Does ro osed construction vt p p late any zoning law, ordinance or regulation: • ill lot be regraded ° • • • • • • • • • • • • Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . I, , , , , , , , , , . • • , , , ,Address . Name of Architect "•••••••••••••••.PhoneNo,,,,,,,,,,,,,,,, Name of Contractor . ..................Address ...................Phone No............... . If es Southold Towl "Address .......PhoneNo. IS*ls this ro ert located with in~00 feet of a tidal wetland? *YLrS....NO.... Y P Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly aI) buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloclq' number or description according to deed, and show street names and indicate whether interior or corner lot. I OCCUPANCY O USE IS UNLAI~FUL ~THOUT CER ii~FICATE aPP~o ~oasMO~ OF OCCUPANCY oATE: ~.P« FEE•. NT AT N0T1 SUI 1NG DE ' ~ ~ 786-1802 8 AM TO A PM FGR THE FOLLOWING INSPEC7t~ p~IREO 1. FOUNDATION ' FOR POURED CONCRETE 2. ROUIiH - FRAMING d PLUMBING ' I' 3.INSULATiON Q. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.0• ALL CONSTRUCTION SHALL MEET THE RE4UIREMENIS OF THE N.Y. STATE CONSTRUCTTON & ENERGY CODES. NOT RESPONSIBLE FOR DESIIzN OR CONSTRUCTION ERRORS I STATE OF NE1V YORI`, COUNTY OF .,('~S//Sj '~(y~~~, • `t • • • •`r"~`•"~-....~._bcing duly sworn, deposes and says that he is the applicant (Name of ividual srgniitg contract) above named. ~ fie is the ~I (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 fife this application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manner'sct forth in the application filed therewith. Sworn to before me this ~i ...day of.j• • E9~.fr. ~R~K&?~!L.. ~ . Q~..... County ~-/~C~~~- NOTARYPU9LIC Smte~NewYark • < ..':V.. . . 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