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Home My WebLink About23964-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24922 Date MARCH 7, 1997 THIS CERTIFIES that the building ADDITION Location of Property 1455 PIKE STREET MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 140 Block 2 Lot 41 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 25, 1997 pursuant to which Building Permit No. 23964-Z dated MARCH 6, 1997 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to BERNICE TYLER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A x4 [ -,/-/,� /guild ng Inspector Rev. 1/B1 TOBM NO. f 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° 23964 Z Date ....MarchA..................................... 1997.. Permission is hereby granted to: Patricia A. Moore, Atty (Bernice Tyler) ................................................................................ 315 Westphalia Rd. ................................................................................ Mattituck, N.Y. 11952 ................................................................................ to ....CONSTRUCTADECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED F0) "AS BUILD"*. ............................................................................................. . s..... ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................ ................................................................................ at premises located at.....1 ......................455..PIRE STREET....... MATTIT[JCK,..N:Yr.................................. County Tax Map No. 1000 Section .......)AQ........... Block .......Z............. Lot No. ...4.1................. pursuant to application doted .....,FEBRUARY...25. �........................... 19..2 .., and approved by the . .. Building Inspector. Fee $.....75.00......... .. ....... ........ .•.......................... in Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted 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 11pre-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 Buildina - $100.00 3. Copy of Certificate of Occupancy - _ .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 /97 QS ,�JUIH_ Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . Old Or Pre-existing Building. C C- �/. . . . . . . Location of Property. .f . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . kJ�,/; C. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . .Block. . . .-. . . . . . . . . .Lot. . . . <./. . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . PermitNo. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .�!. . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . J1.c• S�Y� APPLICANT ass-isos BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO GH PLBG. [ ] FOUNDATION 2ND [ J SOLATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: O4- � 2 D. DATE 3/-s-/97 INSPECTOR 24 BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL. SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . . . . . . . . . . . . . . . Examined.. .J�O......... 19.T.? p [/ MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved..J.10........ 19 '/ permit .J.3..1.�./ . .................................... Disapproveda/c .................................. .................................... ...................................................... r n>�Inspector)uili .... APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . .. 19. . . . 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 mist 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 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 ary purpose whatever until a Certificate of occupancy shall have been granted by the Building Inspector. APPLICATION IS BMW MALE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tom of Southold, Suffolk Canty, 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 corporation) ................................................... (Mailing address of applicant) State whether a licant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............0 ?.. ........................................................................................... Nave of owner of premises aerhiGC . fu1�� ........ .......... ........................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nae and title of corporate officer) BuildersLicense No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. / L/S 5 P%k.. S-A-Z-e-r...............Nl�............................ House Number StreetHamlet LZ Z Canty Tax Map No. 1000 Section ... ...... Block ..c'?............ Lot ...... Subdivision ...................................... Filed Map No. ............... Int ............... (Name) 2. State existing use and occupancy of premises and ✓ intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ? ..!Gi�f7.. ................................... �n "./ b. Intended use and occupancy .....L �r�41.e rl 4.e.................................................. 45 7- 3. Mature of work (check which applicable): New Ikuilding .......... Addition .......... Alteration .......... Repair ............ RenovaI ............. Dahnlition ............ Other Work (Description) 4. Estimated Cost fee ............................. ................. (to be paid on filing this application) 5. If rkJelling, nnber of duelling units ............ Nnber of owelling units on each floor ................ If garage, nnber of cars ...................................... 6. If business, cemhercial or mixed occupancy, specify nature and extent of each type of use........... ........... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. lleiglht ......................... Nnber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Ike tlh Rear ............... P ......•............. lleigiht Nenber of Stories .................... ............... 8. Dinensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Nnber of Stories ..................... 9. Size of lot: From .................... Rear .................... Depth . ................ 10. Irate of Purchase ..................... &--ice of Former Owner ........................................ If. Zone or use district in whidh premises are situated ...................... ........................................ 12. Ikles proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be ronoved from premises: YES NO 14. Nares of Owmer of premises ........................... Address . Plane No. ........... ............. Nailhe of Architect .................................... Address .............................. Plane No. ............. Metre of Contractor ................................... Arklress ...............................Plane No. ............. 15. is this property within 300 feet of a tidal wetland? * YES .......... *IF YES, SOU art mm 7131SIFBS PElAfrr my BE RE(pdim. PIAT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block nrnber or description according to deed, and,slaw street names and indicate %Ahellher interior or corner lot. SIA'IL•- (V NiW Y(X?K, (XXINIY (IF .�v ......... SS Inc)'0/-,e ................beiol' duly :;-Urn, deposes and says that he is the applicant (Hare of individual signing contact) alxwe firmed, Ileis the ....... !1. ................................................. ........................... (Contractor, agent, corporate officer, etc.) of said owner or omr.rs, and' is duly authorized to perform or have performed the said work and to mnke and file this application; that all. staterents contained in this application are true to the best of his knowledge and belief; aril that the work will be performed in the urrnner set: forth in the application filed therewith. 9worr to befo<<r//eoonue this .dae f .....� ! ..19 Notary MAL .. ............. - ` CLAIRE L. GLEW �. .�. ..�. .............. Notary Public.State of New York (Sigu.-uture of Applicant) No.487950 5 Qualified in Suffolk County 9 Commission Expires December 9,19