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HomeMy WebLinkAbout16941-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18243 Date AUGUST 4, 1989 THIS CERTIFIES that the building Location of Property 200 LEGION AVE. House No. County Tax Map No. 1000 Section 142 Subdivision ADDITION MATTITUCK, N.Y. Street Hamlet Block 2 Lot 23 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 18, 1988 pursuant to which Building Permit No. 16941-Z dated MAY 6, 1988 was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is HANDICAPPED RAMP & TOtT~T ROOM AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ADVENT LUTHERAN CHURCH N-062156 - MARCH 10~ 1989 JUNE 26, 1989 -JOHN E. WALTERS PLBq4BING / Building Inspector FOruM NO. t 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) Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Permit Health Planning Board Approval NEW CONSTRUCTION ....... OLD OR PRE-EXISTING HUILDING-'~- ~--VACANT LAND ........ Location of Property ........ - .... HOUSE NO. STREET HAMLET Subdivi=ion ~ Filed Map ~ Lot ~ Dept. Approval .......... ' ' ' - .... Underwriters Approval ........ ADVENT~LUTHERAN CHURCH 1100 Bayer Road Mattttuek, N.Y. 11952 rev. 10/14/88 FOP~ NO. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN P. ALL 765- 1802 10/]4/88 APPLICATION FOR ~ERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with the foll~wlng; for new buildings or new use: ]. Final survey of property with accurate location of all buildings, property lines, streets, and unusual~natural or topographic features. 2. Final approval of Health Dept. of water supply and Sewerage-dlsposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from iplumber certifying that solder used in system contains less than 2/10 of 1% lead.[ 5. Co~ercial buildlngs,i industrial buildings, multiple residences and similar. buildings and installiations, a certificate of code compliance from the Architect or Engineer responsibile for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (~rior to April 9, 1957~ non-conforming uses, or buildings and "pre-existing" land Uses: ]. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A Sroperly completed ~ppllcation, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show ~ing~e.and separate o~nershlp of the entire lot prior to April 9 1952. · ert~flcate of Occupancy zs denxed, the lu~ldlng Inspector shall'state the reasons therefor in writing to the applicant. 3. Date of any housing c6de or safety inspection of buildings or premises, or other pertinent informationlrequired to prepare a certificate. For Vacant Land Certificate of Occupancy: ~. An application for va6ant land Certificate of Occupancy shall be submitted, and a certified ' abstract of title issued by a title Company showing single and separate ownership ofithe entire lot prior to April 9, ]957 shall also accompany the application. If ~ Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ]- CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration tq Dwelling $25.00, Swimming Pool, $25,00. Accessory building $25.00 Addition CO ~c~esMory buildings, $25.00 - Ruslnesses $50.00. 2.! Certificate of Occupancy on pre-existing dwelling - $]00.00. 3. Copy of Certifica~e of Occupancy - $5,00 - Over 5 years - $~0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial TOWN OF SOUTtIOLB OFFICE OF BUILDING INSPECTOR ILO. BOX I 179 TOWN ltALL SOUTIIOLD, N.Y. 11971 1989 TEL. 765-1802 RICHARD HENARD, 665 WAVECREST LA. MATTITUCK, N.Y. 11952 RE: ADVENT LUTHERAN CHURCH To Whom This May Concern, We are unable co complete your Certificate of Occupancy because.of the following reasons. /--/_ An application for Certificate of Occupancy is /lot on fi].e. ~3~u~] /--/ bio Underwriters Certificate on file. /.._ The check i:;(~/not on file.) /'~/ No llealth Dept. Approval on file. /-~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Dept. ***/~Ho Plumber Selder Certificate on file. ( all perm}tu involving plumbing being issued after April 1,1984 ) 1125065 THE NEW YORK BOARD OF FIRE UNDERWRITERS BURIEAU OF ELECTRICITY 8S JOHN STRBBT. NEW YORK, NEW YORK 10038 NARCH 10,1989 ~/~lo.~o.o.~l~ 60114389/89 N 062156 PA6E 1 THIS CERTIFIES THAT DVENT LUTHERAN CHURCH, LE610N AVE, tPOLEI~LILS, MATTtTUCK, N.Y. [] ;.t ri. [] ~.~ r~. OUT .~t~. m~k · ndfound go b~ in core.lance ~th the ~ui~ment~ o~ th~ ~. in t~a~,~o~mK ~o]~, [] t~l~.mni mexaminedon ESRUARY 27,1989 22 I 22 IXHAUST FANS SIBVICI I s E R V I C EXIT-t' BATTERY PACk~I FEEDERS:Z-3 ! 6 BASEHENT TO IST FLOOR PANELBOARDSII-8 CIR. 60 SMOKE DETECTORI*[ LAKE ELECTRIC 17 FOREST TRAIL RIDSE, NY~ ,J~1961 LIC.tlB45 E be a~ered in return to IBm office of the Boord if Inspectors TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. I~1 (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this 19~ Notary Public, County Notary Public JANET V STEW ,, ~xp,~s Nov. ~o, OUNDATION { 1st) DUNDATION (2nd) DUGH FRAME &/ -PLUMBING ~SULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 765-1S02 BUILDING DEPT. INSPECTION / [~/FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS:~ DATE INSPECTOR 76S-'1802 BUILDING DEPT. INSPECTION [ ] F/~UNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL INSPECTOR ~/~ ~/ 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~]~MING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~~OUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [~NSU~TION [ ] FRAMING FINAL DATE WFf/~ INSPECTOR ~~~ ADVENT LUTHERAN CHURCH Leg~n Avenue Mattituck, N Y DETAIL OF ROOF GIRDER SUPPORI. IN NORTH ' WALL Addition to plans reqO'ested, by Town of Southold, Building Department: 1/2/89 ,/ ............. TEL.: 765-1803 Examined ?~ .... 19 ..~.~ Disapproved a/c ..................................... .............................. ~...........tl~..,(Building2ctor)~ ~ . APPLICATION FOR BUILDING PERMIT 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL -~-i~ - -~z~ ~P'- · - · MAIL TO: 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 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 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 necess~.~e~ons~3z/~~ ~M x)F)A (~ , .... ~q~'~tSi~nature of applicant, ok name, if a corporation) ,.. (Mailing address of applicant) /L/~/ //~5~/Z- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ./~.~.. ~. ~.' .A).W... P.Q'.~..~.'(.~i/r~ ~ ./~/... C~.'~ ~ .C..~. ......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done] ................................................. .... ~. O..o.. ............. L.e-7~/..o..,v....~ v.~ ................ /fi(. ,¢:.' /777. ~. r~c~ ............... House Number Street Halnlet County Tax Map No. 1000 Section . ./~.& .......... Block...a~ ............ Lot...~..~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................ b. Intended use and occupancy (~.'~.?.../~..C..fi(....6q../~.~.~...&C/.O//~7'00-u .~7...~...,e~a /z~r~Tt 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ......... Alieration ........... Repair .............. RemoVal .............. Demolition .............. Other Work ............... I ~, [(Descrip~timt) 4. Estimated Cost 0..00. ......... : ........................ Fee ...................................... i ' (to be paid on filing this application) 5. If dwelling, number o f dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ...... i .................................................................. 6. If business, commercml or mlxedloccupancy, specify n~t~ure and extent of each ty.,pe of use .............. ,~ ...... 7. D mensions of~xisting structures!, if any Front.. ,..~.~ ......... Rear ,?~ .q. ... Denth .~ ~. ~. · ~' rNe m. eb~ to.' ' ................... ~H{"~lghtsio ' 'u u r,o, fS nes /. .... .~ .~,,~/ ,~,,/ ....... ~a men ns oI samer srruct e w~m tolerations or aaa~tlons: vront . ~.,,-~ .. Rear O~."/. . Depth ...~.. fi'~ ............ ., Height .,,~,(P ................. Number of Stories../. ................... Di ti tnt ' Depth mensions ofen re new cons etlon Front .......... . ..... Rear .............................. Height ........ ii ~.'371 Number of Stories ..................... ] .... ; .... 9. Size of lot: Front .... ,. .......... Rear..'7..,~· ................. Depth ...,.~'.O ............. 10. Date of Purchase / ~.q ~ Name of Former Owner 1 I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... . 13. Will lot be regraded ....... . ................. ,.. ,~, ,.W~l[0~cess fill be removed from Cremises: Yes No 14. Nme of Owner of premises /}.12. ~lff'NT~...O.~.~.'.~-/,4t~ .c~'d~r~ss . .t,~'.~.4o.~?..,qv~.,.~.~.~l~on}'~X/o..~A~?.": .~'.a.~.z... Nme of Architect .......... · ................ Address ........ Phone No. Name of Contractor ' Address Phone No 15. Is this property located Within 300 feet of a tidal wetland? *Yes ..... No .~... · If yes, Southold Town Tru4tees Permit may be required. PLO~f DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give'street and block 1 ~mber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW_YORK. . o S co0 rY oF. (Name of individual sigm above named. He is the.. J~. ~-~..~D3. · .'i( ........ ......... ~ ..... being duly sworn, deposes and says that he is the applicant ag contract) (Contractor, agent, corporate officer, etc.) of said owner or owners/and is dui authorized to perform or'have performed the said work and to make and file this application; that ail statements conta ned in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannerl set forth in the application filed therewith· Sworn to before me this. ......... day of HELEN lC DE VOE #OTARY PUBLIC, State of N . ldo. 4707878, Suffolk Ce term Expiros March 36' T .t IB' I 'T LoBBy Il oopl~r tubing II ued iystem; piping sh~ll I~ of WPes ~ F L~,::::~*_. P L PLUMBER CERTIFIC,47'/OIV ON I..E.4D CONTEIVT' BEFORE CERI'IFIC.,4~'E OF OCCUP,4NCY SOl. DER USED IN W,4TER SUPPLy SYSTEM CANNO~' EXCEED 2/10 of 1%/.EAD. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NOT~F',, eOEOWG 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS. I. EOUNDATION . TWO REQUIRED FOR ~URFD CONCREr~ 2, ROUGH. FRAMING & PLUMSING 3. INSULATION 4. FINAL . CONSTRUCTION MUST SE COMPLETE FOR CO ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE NY STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ~OTE. h ~o~-~,=-n..-~ ~ p~wme~ __i / 'rr i TY P. +1 E' L ~ ",,/AU- 1o t4 Il'Z" ~AD--T WALTER M. SCHLEGEL; P.'E, ' Con~ltlnN Enllfllsr 466 WASHINGTON ST~ET 2W NEW YpRK, N,Y. t~13 AS S lOC I,AT E: :' '"I:NTEIlt,OR ,DESIGN & PLAINNING ,, , DATE DRAWING NO. a,-e¢l! ~0.