HomeMy WebLinkAbout18282-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28062 Date: 11/14/01
THIS CERTIFIES that the building ADDITION
Location of Property: 850 LUPTON POINT ROAD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473689 Section 115 Block 11 Lot 16
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 5, 1989 pursuant to which
Building Permit No. 18282-Z dated JULY 7, 1989
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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to LAWRENCE P & MARILYN E HIGGINS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Aut ze Signat e
Rev. 1/81
1087[ N0.
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 _ Z D~te ..........~````~`(.......7 19...1
° 18282
Permission is hereby granted
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9-y,. ~,~R~,..~~......a-~-,...~ ...~k,~.............
.`~.I~``~..,.....~,,~...~~,~.......
at premises located at ...6.r~4?....`.~.K.,~7~d.Y.1....U:.".:....~ G~,:li..~.~..P.~...
V
County Tax Map No. 1000 Section ........~~.5. Block ........1.~.......... Lot No.......~..~..........
i qq
pursuant to application doted 19.1., and approved by the
Building Inspector.
Fee t..
Bui ding Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT D g Q ~ D
TOWN HALL
765-1802 ',f.' -
APPLICATION FOR CERTIFICATE OF OCCUPANCY 9LDG ~FPT
A. This application must be filled in by typewriter OR ink and submitte 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 17 .lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Complianne 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 Buildine - $100.00
3. Copy of Certificate of Occupancy - ~ .25~p
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00,/ Commercial $15.00
Date ~~y~/!Z~/~J.~ .
New Construction......G..... Old Or P'r/e~-exxisting Bu lding... ~S/~ ///I",~ -lam
Location of Property.. tyv~~...~. ~f'.+.:.. ~7..~~ (!/!T~, .l.l ,/.!!~C
House No.~/ fS/treet 'I amlet
Onwer or Owners of Property Q. ~C. ~~e:~.. ~..T..~~~~yN..~ .~~J~.~~5..........
County Tax Map No 1000, Section...~..6':Tl~~Block..~{~ .Y:.~~..Lot...~
Subdivision. ..(Q; ~/..{i~led Map............Lot......................
Permit No.. V~ Z.Date Of Permit.. ~[~f~./......Applicant...........
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary C,ertificate........... Final Certicat
Fee Submitte~_ ~
....APPLICANT
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?OUIIDATION (2nd) _ _ m R~
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PLUMBING ~o
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INSULATIOf1 PER N. Y. I y
STATE Ef]ERGY I ,
CODE
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ADDITIONAL COMhfEt1TS: m
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B0.1RD OF HEALTH ,
FORM N0.1 3 SETS OF PL,1V5
SURVEY
TOWN OFSOUTHOLD CHECK '
BUILDING DEPARTMENT SEPTIC FOR:1...••
T06VNHALL
• ~OUTHOLD. N. Y. 1171 N p t~
pp TEL.: 7G5~1302 CALL ~ G 0: , ~ 3,~• ,
Ecamincd 19 d•q •
Gq MAIL(~TO:
.\pprovcd ~yyQ.;y: 7• . 19d .I. Pc D (5
/ rmit No: 1....... n.
Disapproved a/c , -"1 !I
.AL •5•
r4
1'OWNLOF SOtnHOLD
(Building Inspcctor)••~•~~~~
APPLICATION FOR BUILDING PERMIT
' Date J~(~ ~ ,l P'f
• I!
. INSTRUCTIONS
' a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, v:
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
ar areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this
ration.
e. 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 p:
shall be kept on the premises available for inspection throu_Itout the work:
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate oC Occup:
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY 11fADE to the Buildin; Department for the issuance of a Building Permit pu•;;:anI tc
3uiIding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. O:d::ty,c:
Regulations, for the construction of buildings. additions or alterations, or for removal or demolition, as hcrei.•t dc;::
~ ite applicant agrees [o comply with all applicable laws, ordinances, building code, housin, code, and re^ulat:o.^s, an:
cdmit authorized inspectors on premises and in building Ior necessarv insp~ iyo~
(Signature of I ant, or name, if a corpo:a:tonj~
. ~O.l30V MArr~r_vtK./.N.~.11Sf.Z _
(I~failing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p1umL•er o: built
,6w N 2Z .
\ame of owner of premises ./.l!gt';~~.uNt _ ..1 = . e_ hl ~AR.h,~,....'. ~ . • ~I ~ ~'.i NS
(as on the tai roll or latest deed) ~ ~ ~ ~ ~ ~
;C appliant is a corporation, signature of duly authorized officer.
(Name and title of corporate ofticcr) '
Builder's License No. , , ;
,~t;i~C ,12- ~ '
Plum bet's License No. , , . , , , •
Electrician's License No . .
Other Trade's Liccn;e No. , , , , , , , , , , , '
.
Location of land on which proposed work will be done. .0, ;ZG, !~y~'(j,,, I'1~ ~q rr t.t. ~7~ .
FlouseNumbcr Strcct.
Hamlet
County Tai A1ap No. 1000 Section ~ . I OO0 S Block I l s ~ 1 ~ ppII
Lot.IJQ..
Subdivision File 11a
p No.
(N:uttc) Lot
State c~isting use and occupancy of premises~aLnd intended use and occupancy of proposed construction:
a. Existing use and occupancy 1.~'' e:. - .~.~t~' ~ q^-e L
b. Intended use and oceu^aney
t
3. N'aturc of work (check which a ,
Repair PPlicable): New lluilding '
• Rcmoti•al Addition .Utc:atton
Demolition Other 14ork
4• Estimated Cost„~~~O D.•. •'NC'<c~{ Si/o '~~i•
• Fee.
5. If du•cllin„ number oCdwcllin; units ito be paid on filing chi; a
If garaec. num bcr of cars • " ' ' ' ' ' • • • PPh-attc
• Nttmbcr o(dwellin6 units on each floor.. , •
6. IC business, cotnmeretal or mixed occupancy, specil' • . • . ~ • ~ ~ ~ • ~ • • ' ' ' ' ' ' ' ' • ~ ~ ~ •
7, Dimensions of existing structures, if any: Front , • Y nature and extent of each t • • ~ • ~ ~ ~ ~
Heicltt Ypc of use .
Dintcnsions • ~ ~ • • • ' • • Nunt bcr of Stories , • • " " " • • • Rcar Depth , .
of same structure with alteratio
p h ns or additions: Front
' 8. nsi~ f entire new con Ilci:ttt Rear • • . •
Hci^1tt struction: Front , • • • • • Number of Stories . ~ ~ ~
.Num bcr o ' • • Rear , .
9. Sizcotlot:•Front,'.~•- fStorics..,, '••••••••••...Depth„ ~
10. Date oCPurchasc Rear...~.....:.•..........................
ll. Zone or use district in ~vtticlt••••~~•••"-"""• Depth
•..NamcofFormcrOwncr
1'', Does proposed construction vprcmises arc situated ,
tolatc an • • .
13. 1l'ill lot be re;raded , 5 z°ntnS law, ordinance or re;ulation: , • " •
14. Name of Owner of premises , , , , • • • ' ' ' • • • • «'ill excess fill be removed from premises:
Nam= of Architect • ~ ~ ' ' ' ' ' • • • • • Address . Yes
N'amcofContractor..,•••• ••Address.•••~.~~•~~••'•"•.PltoncNo........,~
IS.Is this ro •.................PhoneNo....,
P perry located vitltin•••"Address. Phone No..,,,~~~
*If yes, Southold Tovn Trustees PcOp itemay be, requiredetland? x
YES....tt0,~,.
• - PLOT DlAGRADf
Locate clearly and distinctly all building ,
ProFertY lines. Giti•e street and bloc!; number or description~actcordin^ to decd~~
P P and. indicate all set-back di:.cr::ion;
interior or corner lat. ~ a and show scree[ names and '
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T.; T e of xc1;~ ~-oRl;, ~
OUXT1' OF I~,S.S
• . • . •~~~..r-te. of individual si;nino contract) • ~ • ~ • • • ' • • being duly sworn, deposes and says that he is the a
ove named,
PPlicar
= is tltc
_
(Contractor, abcnt, corporate officer, etc.) •
said owner or o[vncrs, and is duly autltorizcd to crform • • • • • • • . • • • -
~lieation; that alt statements contained in this application arc true to the best of his knon9edec and belief; and
rk wdl be periormcd in the manner set forth in tlu application filed hcrovithd the said work and to make and file dti
om to bciore me this that the
da~~o/f. j~ / ~
a:; Public, .
County
NEIEN K tIE YOE '
NOTE • ~ . ,
irana Expires Mreh 30, IA_..~„/ • .
~ ` (Si;na[ure of applicant)
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OCCUPANCY OR rj^ ?~Ul C~' ~ w nETE
~v USA IS UNLAWFUL 2 `'~1GH FKaMitic, aLUMeING
WIThCUT CERTIFICATE ' INSULATION
4 FIPiAI_ - CONSTRUCTION MUST
OF ~C{i1JPA1f/Nf BE COMPLETE FOR C.Q.
/M~YY~~ ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
" ~ STATE CONSTRUCTION 8 ENERGY
CODES. NO? RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS