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Home My WebLink About27214-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28009 Date: 10/10/01 THIS CERTIFIES that the building ACCESSORY Location of Property: 165 SELAH LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 9 Lot 4.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 23, 2001 pursuant to which Building Permit No. 27214-Z dated APRIL 3, 2001 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 SHED AS APPLIED FOR The certificate is issued to MICHAEL & LISA FANDREY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A "Z' .1 /'�' //ho zed Si nature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27214 Z Date APRIL 3 , 2001 Permission is hereby granted to : MICHAEL & LISA FANDREY 165 SELAH LANE MATTITUCK,NY 11952 for CONSTRUCTION OF ACCESSORY SHED IN REQUIRED REAR YARD AS APPLIED FOR. at premises located at 165 SELAH LA MATTITUCK County Tax Map No. 473889 Section 106 Block 0009 Lot No. 004 . 004 pursuant to application dated MARCH 23 , 2001 and approved by the Building Inspector. Fee $ 35 . 00 Authori ty Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD .•�+�""""""!�i BUILDING DEPARTMENT p �i TOWN HALL ►i 765-1802 t, APPLICATION FOR.CERTIFICATE OF OCCUPAN Y 13tOG.O�P'T• ttt �Of s OOTNOID A. This, application must be filled in by typewriter OR ink and submttfed 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 Health 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from 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, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. 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 Building - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . �. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . Olid Or Pre-existing Building.. .. . . . .\( . . . . Location of Property. jkr -�. . . :-�u.A�;I . .�!{�\`:1r. . . . . 1 �; �(:1 .1V�:1?. .. . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Propertys'�'`\�`-1': `�. :fs�s . . . �.A 9� . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. 1.9. �. . . . . . .Block. . . . .: . . . . . . . . . .Lot A . .� . . . . . . . . . . . . . . Subdivision. . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . ..Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.�-. l-7.q Jq -Z-: .Date Of Permit. :.?3..9?. . .Applicant.f.1.\Sl�'�k�. . .�'Q Health Dept. Approval. . . . 7:'. . :Q.. . . . . . .. . . . . . . .Underwriters Approval. . .. .\\.,>-4. . . . • • • • • • • • • • Planning Board Approval. . .'�. •`1-Ji�. . . . . 0 . . .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate".` • • • . . . . . i Fee Submitted: $. .?:�., 0.1U. . . . . . . . . . . . . . . . . . ' . . . . Aft) . . .L . . bo 2�$ APPLICANT o��SUFFO(�-coG y� czN Town Hall,53095 Main Road W Fax(631)765-1823 P.O.Box 1179 1i �� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD October 2 , 2001 Michael & Lisa Fandrey 165 Selah Lane Mattituck, NY 11952 RE : Your shed permit . To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file . xx The check is (not on file . ) $25. 00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 27214-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSUL N [ ) FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: O - L DATED � � INSPECTO /(�, S� lr FIELD INSPECTION REPORT DATE COMMENTS u FOUNDATION ( IST) I II Ij � FOUNDATION (2ND)------------ I �� -- ---------------------------------------- 0 is's � II — ROUGH FRAME & PLUMBING II I�it if it II II INSULATION PER N. Y. STATE ENERGY CODE u it it II II t� of p y II j FINAL _ADDITIONAL COMMENTS: -06 W o � r� ro H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST: BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD, NY 11971 - — - 3 sets of Building Plans F, - ; r Survey Checker 4f35 Septic Form N.Y.S.D.E.C. 4 Trustees sss3 Examined yy 120 Approved l''� ,206 ( PERMIT NO. e2 7 I Disapproved a/c — E ikldng Inspector APPLICATION FOR BUILDING PERMIT Date I2q/ , 20b\ 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 sale.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 application. 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 issue a Building Permit to the applicant. Such a 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. (Signa of applican name,if a corporation) k,. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Caw a`.CL Name of owner of premises L/1-S M; c--L, rA,,pQ f VA (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location pf land on which proposed work will be done: '� ' y` House Number Street Hamlet- County Tax Map No. 1000 Section 0 Block 9 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 b. Intended use and occupancyw C-- 3. 3. Nature of work(check which applicable): New Building� Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost, 15 to •a Fee (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 business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures,if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front V Rear Depth V0 Height I I ' Number of Stories I 9. Size of lot: Front Rear Depth 10. Date of Purchase -1-Gk 5 Name of Former Owner r!)-C4 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law,ordinance or regulation: N'0- 13. vt>13. Will lot be re graded Will excess fill be removed from premises: YES NO 14. Names of Owner of premises L n*ddress 165 Phone No. Z 1% S"Ir Name of Architect S . Address Phone No Name of Contractor S JP,,-JA Address Phone No. 15. Is this property within 300 feet of a tidal wetland? *YESNO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MA E REQUIRED 16. Provide survey, indicate scope of project, to scale,with distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) Wri\` 'c '�ko oyt!$ being duly sworn,deposes and says that(s)he is the applicant (Name of indivi ual signing contract)above named, J (S)He is the Ack a V&:J (Contract ,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 filed therewith. Sworn to before me this � r JW day of .Vh&-.N, 2QAI V ` l Notary Public Signature oT ApKi7lant LYNDA M.BOHN NOTARY PUBLIC,State of?AM** No.01 B06020932 Qualified in Suffolk County Term Expires March 8,20�5 -- -t - FF ... 1. -.. _ .. •. - ^ , f S' , r K 'A:' - _ •'fir zZ?.�. I ...r �1ti_ + - ..atm._:.. �l :,.:�' :A. s-`^�. �.:,. '• _ - - y._ -�. . i •T t+ - s 5. r _x ie > M1a �' _ • !G z T ^r - Ry Ail r _.✓ -. .. - .. ....... ,_ ,. _- ..tic.. .. �o -.- - _ _ ��'{ � �xle- v 't _ MR 50 Q .� • - -Y 1_ .ter � -. .. -- ... , ;r c, SUFFOLK CO. TAX MAP..-UESIGNAT"..,, DIST. SECT -- a .. . .r, rpt ti �_ -N�3P .:+ ! _ •• _ HLOCK P��: OWNERS ADDRESS- !"1i�'FTI'TWGbG:._b►i: i9��2 t i �► -i c.. 295 FEracE - 4OEM 8 TEST HOLE STAMP' . POC%' O ; WELL— ,r POOL GQtX - �. , -- ve,ars inhea PA r�rtaunc%beuFs:c-,' t • ... ....,. 'fl. - .W we copy. C-VAMMIRIG POOL,=-TC-LOC41 D - _ • - r� ad hcreaa t!v. AANIMHONY W,L eWA[%t�l' f S _. 1 F t :�__4 r ,�. z-.I< —.•� _. t. '_��- t . �_ �x•� i +►'►C �.�/+ny��s �T�_� Co. '�;I O 1, __. „ 'r. _ .>... • _ rr - `. Lj-Lt 7`,) J .y�'F—U'.—� ^� T� AT�/'+<�-i-. J 1 / - -- - ---- --- 1; RODERICK VAN TUYL. P.�. _ LICENSED LAND SURVEYORS33�g6 Fp P GREENPORT NEW YORK F pEw Y o 7:.!S;'t-it POST N81329 L P4 UT CERT" 2-x%4 S,f s toltn G PPI OVED AS NOTED DATE- B.P. ao &,I 22LY-2--- FEE B NOTI FY B WING DEPART ENT AT 765-1802 AM TO 4 PM FOR THE I FOL OWING INSPECTION& F)UND ION - TWO REQUIRED F,)R POU ED CONCRETE J Y?PAR4TENT AT A 2. R)UGH. FRAMING & PLUMBING 3. IP SULATI N 4. F iNAL CONSTRUCTION MUST ,ti a13 E COIV ETE FOR C.O. ✓ ALL CON$ RUCTION SHALL MEET -THE REQOI EMENTS OF THE N.Y. bTA-E lu SIRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS r . f .1 I r r 4� F i , k i t f C g g � Q 4 fl r ? i Posr I I � t 1 i t i t i C II 6 I s F o j l i D (}� " Z� fO C LN 3/ l � P �wooc