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Home My WebLink About16894-zFORM NO. 4 TOWN OF SOUTHOLD BUILD{NG DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N Y. Certificate Of Occupancy THIS CERTIFIES that the building A c.e.e s s o r.y. .................... L°catl°n°fPr°pertYHDuse1322'5·''S'°u'n'd'No Ave. & 70 Westphalia Ave. Mattituck Street Hamlet County Tax Map No 1000 Section . I ./41 .. .Block ~ ...... Lot 27 Subdivision .......... Filed Map No ...... Lot No ....... conforms substantially to the Application for Btuldlng Permit heretofore filed in this office dated · A p.r. i .~ 8, . .198.8. pursuant to winch Building Pemllt No .1. 6. 894 Z. ......... dated .Apr. z 1.. I 5 ,.. ! 9.88 .... was issued, and conforms to all of the requirements of the apphcable provisions of the law The occupancy for winch this certificate is ~ssued is .... Accessory build~n~ as applied for. The certificate is issued to . CEURCIt OF TltE REDEEMER ....... [owner, ~ 16KI~i]{ ~'X X ......... of the aforesaid bmldlng Suffolk County Department of Health Approval ~ /A. ..................... UNDERWRITERS CERTIFICATE NO ........... ~/.A .................... PLUMBERS CERTIFICATION BATED: N/A Budding Inspector Rev 1181 FORM NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_l 6894 Z Permission ~s hereby granted to: ..;.~.~...... _'~.:a .~..~..~:~, ............ ~ ~-- ...~..~~...,.~.:~., ~..~..~. ...... -~, ~ County Tax Map No 1000 Sect,o,g_~..l ~.[ .... Block ..... .0...~. .........Lot No ..~-.-."l ...... pursuant to application dated ..~.~... '.~ .......... , 19.~1, and approved by the Bu~Idlng Inspector. Rev 6/30/80 / BLDG DE, T · TOWN OF SOUTHOLD A FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewmer OR ink, and submitted ma'---'-- to the Building Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Fma[ approval of Health Dept of water supply and sewerage dmposel-(S-9 form or equal} 3. Approval of electrical Installation from Board of F~re Undervvmters. 4. Commercml buildings, Industrml buddmgs, Multiple Residences and similar buildtngs and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5 Submit Plannmg Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957}, Non-conforming uses, or buddings and "pre-existing" land uses' 1. Accurate survey of p~operty showing all property hnes, streets, buildings and unusual natural or topographic features 2.Sworn statement of owner or prewous owner as to use, occapancy and condition of buddmgs. 3. Date of any houmng code or safety mspect~on of buddmgs or premises, or other pertment mforma- tmon required to prepare a certificate. C. Fees: Additions 825 00 POOLS $25.00 ALTERATION $25.00 1. Cert~f~cate of occupancy New Dwelling $25.00, Accessory ~$10.00 Buszness $50 O0 2. Certificate of occupancy on pre-exist~ng dwelling $ 50.00 3 Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.updated C.O. $ 50.00 Date .... 0~¥,7o.~9~ ......... NewConstructIon XZX~. Old or Pre-existing Bulldmg ........ Vacant Land ............. Location of Property 13225 Sound Ave. & 70 Westphalia Ave Mattituck House No. Street Ham/et Church of the 'Redeemer Owner or Owners of Property ........................................................... County Tax Map No. 1000 Section 141 Block 4 Lot 27 Subdlws~on .............................. Fded Map No ....... Lot No ............. Permit No. I6894Z Date of Permit .... Applicant ... Father. J~m~. :P,. ~;d~T;¥.. Health Dept. Approval .................. Labor Dept. Approval ...................... Underwmters Approval .................... Plannmg Board Approval ...................... Request for Temporary Certificate ................ Fmal Certificate ....................... FeeSubmmtted ~,0..0.0.. ~ I'{'O~ Construction on above described bulldmg and permit meets alljq3phcable codes and regulatmns. Rev 10-10 78 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING r~AL REMARKS: ~//~ ~~-~r~ ~ DATE INSPECTOR DUNDATION (1st) DUNDATION ( 2nd ) )UGH FRAME & PLUMBING !SULATION FER N. Y. STATE ENERGY CODE FINA/ ADDITIONAL COMMENTS' Approved~ Dmapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOUTHOLD, NY 11971 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK SEPTIC FORM ............. NOTIFY TEL.. 765-1802 CALL ................ . ~ MAIL TO: ,..~. 19'~~. ..... (Budding Inspector) BLDG O~f--J ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Ttus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc streL or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this app cataon c. The work covered by tins application may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Bmldmg Penmt to the apphcant Such peru shall be kept on the premises available for inspection throughout the work e No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmlding Penmt pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of buddings, additions or alterations, or for removal or demohtmn, as hereto describe The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and admit authorized Inspectors on premises and m building for necessary inspections, , .~ ~ .~, 42:~z ~., J~-- ~ -dJ~ ~-- ~- ..... (S~gnatufffof applicant, or name, if a corporation) The Church of the Redeemer P..e.v. Ji~e~ Ej~tjr.d~ ......... ---- ~_~_ _/~,~ ~_ (Mading address of apphcant) Sound Ave. & Westphalia Ave., Mattit State whether apphcant ~~ii~,~.' glneer, general contractor, electrlclan, plumber or bullde Name ofownerofpremis~fl~J~l~ ~ y-t~ ~ ........ ~. ~ ,, $~l~n the tax roil or latest deed) If applicant ~s a corporatt~l~~~er '' (Name and., ~'7..m~ ~ Plumber's License ~ ~ ~ Electr c an s License N-~ --.' . Other Trade's License No 1 &oc~tlon of land on ~vhmh proposed work w~ll be done House Number Street County Tax Map No 1000 Section ~0 of Sound Avenue & Westphalza Ave Mattituck Ha~nlet 141 Block 4 Lot. 2 Subdivmlon Filed Map No Lot ........ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a Exmt~ng use and occupancy Episcopal Church b Intended use and occupancy Storage Shed 4 5. Nature of work (check which applicable) New Budding . Shed .. Addition ,. Alteratzon Rep:ur .... RemoYal ....... Demohtxon ........ O.ther Work ..... Estimated Cost . .L60.99 ....... If dwelling, number of dwelling units ....... If garage, number of cars ............ (Descnp.tlon) (to be prod on fihng this apphcat~on) Number of dwelhng umts on each floor ........... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............. 7. D~'nenmons of ex~stmg structures, if any. Front .27 ... Rear ..... Depth 53 ..... Height Number of Stones .1 ..... Dm~enslons of~ame s~ructure with alterations or additmns Front ....... Rear Depth .............. Height .............. Number of Stones ............... 8 Dimensions of entire new construction Front 4F.t.. . . Rear .......... Depth .77y. Hmght .. . .8 S~ch.e.s, Number of Stones .......................... 9. Size of lot Front .70~.t ...... Rear ............ Depth 1.5.0fi 10 Date of Purchase ............ Name of Former Owner ........... 11 Zone or use d~stnct m which premmes are mtuated ................. 12. Does proposed construction violate any zoning law, ordinance or regulation' . ............. 13 Will lot be regraded .............. Will excess fill be removed from premises Yes No 14 Name of Owner of premises ........ Address ........... Phone No ........ Name of Architect ............. Address .......... Phone No .... Name of Contractor ................ Address ............ Phone No ............. 15, Is this property located withzn 300 feet of a tidal wetland? *Yes ..... No . .x.x.. *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all bufldmgs, whether existing or proposed, and indicate ~ set-back dnnensions from property hnes Give street and block number or descnphon according to deed, and show street names and indicate whether interior or corner lot COLOR , , TRIM ~ ,~., ,/ 't STATE OF NEW~31~'~2~-~aa_--v ~ ~"'J --:- -?'~" f (Name of md~v~duaI s~gnmg contract) above na~ed He is the .................... (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 tlus apphcation, that ail statements contained m th~s application are true to the best of his knowledge and belief, and that the work wdl he performed in the manner set forth m the application filed therewith. Sworn to before me this ........... f. .... day of .. Notary Public ...... ~. ~¢-~.. fi(/-. ~.~/{ /~' .~f .~-~.... County ......... (Signature of applicant) h,~j~e K. ;,E v~:... Yet Term Expres M~Cn