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Home My WebLink About17003-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19687 Date JANUARY 29, 1991 THIS CERTIFIES that the buildin~ Location of Property 3300 REEVE House No. County Tax Map No. 1000 Section i00 Subdivision ADDITION MATTITUCK~ N.Y. Street Hamlet Block 1 Lot 3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 29, 1988 pursuant to which Building Permit No. 17003-Z dated MAY 17~ 1988 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N-137076 - JUNE 21~ PLUMBERS CERTIFICATION DATED BRIAN E. & DIANNE F. KELLER 1990 JAN. 28~ 1991 - BRIAN KELLER Rev. 1/81 ' / B~in~/Inspe~tOr FOEM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK A. UTHORIZED) 017003 Z Permission is hereby granted to: .~.~...-b~......~~ ...... ...~..~..,..~..~~.....C~..: ................... .~~...~..,~.,.....u..'l.~c.~ ..... ~ ~o ..... .0,,,....~....'~.,.........~..... ' ...l~t:'~. '"' ~~..~.~ ~4,~-...'~ .. , ............. at premises located at .,..~.~/,,~Z~...~.~....~ ....... ~..~ ......................... pursuant to app ication dated .... ~0~,,~-'~(.......~..~. ................... , 19.~..~., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. 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. 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... ~ .V .~.~. n~ ...................... New Construction ........... Old Or Pre-existing Building ...... ~ ....... Location of Property ..... ~.?.~.~ .... ~.~ .................. House No. Street Hamlet Onwer or Owners of Property..~/~f~..~...;f-..~.~4~.-F'~.~....~.:..~..~/~.~ ........... County Tax Map No 1000, Section..../.~.~ ...... Block ....... ~ ........ Lot ....... ..~. ............ Subdivision Filed Map Lot Permit No..~.~.~.~.~.~Date Of Permit.~.~.~..J~ ...... Applicant...~..~-~ ................ Health Dept. Approval .....( .~.~- ................ Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ......... Final Certicate. ~ Fee Submitted: $ ....... w.' .................... ~ ~ 115 ......................... 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. Owne r_ ~/~/ ('please print) Plumber (please print) I certify that the solder used in the water contains less than 2/10 of 1% lead. supply system S~to before me this ~' ~day / Notary Public, ,~/~ County (plumber's signature) Notary Public~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1061290 BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~IUNE 2~1990 69~7~90/90 H 1~7D76 ~t~ ~ppl~ation No. on fil~ THIS CE~IFIES THAT BRIAN~ REEVES AVENUE, MATI[[I)CK, N.'~. ~. exami~ on and found to be in ~mpliance ~itfl the requi~ments of this ~rd. FIXTUR[ RXTURES ~0 6 DRYERS FUI~IAC. E MOTORS SERVICE DISCONNECT S CO~ING DECKS OVENS D~SH WASHERS kMT. K.W. ~T. K.W. AMT. K.W. ~T, K.W. ~IRING FOR AObITION ONI.Y-1 {~.F,C. I:-I TED CHESHIRE JR. P.O, BOX 255A 9280 SOUND AVE. HA'lTl'TUCK, NY, 1~95~ E R V i EXHAUST FANS DIMMERS C O~'~wI:[[~ NO. OF I~EU?RAI, S Per ~/~~dentials. ~1~ COPY FOR BUILDING ~T~. ~S C~ ~ ~TIFI~TE ~T ~ BE ALTE~D IH ~Y ~ER. ~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ! IALL SOUTltOL~), N.Y. 11971 Hay 16, 1990 TEL. 765-1802 Brian & Dianne Keller 134A Reeve Ave. Mattituck, N.Y. 11952 TO Whom This May Cogcern, ~ We are unable to complete your Certificate of Occupancy becanse.of the following reasons. /--//An_ application for Certificate of Occupancy is not on file. .(ENCLOSED) /_~ NO Underwriters Certificate on file. /_~ The check is(o~g~gg~/not on file.) $25.00 /~/ No lIealth Dept. Approval on file. /~/ No final ins.pection has been made. Please contact our office on this Thank you for your cooperation. Building Permit tt I 7 0 0 3 Z matter. Buildin~t Dept. ~*/_ o Plumber $olt[er Certificate on file. all permits involving plumbing being issued after April 1,1984 ) FOUNDATION ( FOUMDATION 2. (2nd ROUGH FRAME/ .PLUMBI INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: j?~o~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ]~/~ROUGH PLBG. FOUNDATION ZND [~NSULATION []FRAMING []FINAL REMARKS: ~~-~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND []INSULATION [/,2~RAMING []FINAL REMARKS: , DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [-~/FOUNDATION 1ST [ ] ROUGH PLBG. [ ~FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ ,~ ,~ .... DATE [/ f OCCUPANCY OR USE iS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NOTIFY B(.JiLDING OEFflRTMENT AT 765-1802 9 ~)~9 TO 4 m~ FOR THE 1. FOUNDATION ~,VO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REOUIR~ENT~ OF THE N.Y. STATE CON~¢iON & ENERGY CODES. ~ RES~SIB~ FOR DESIGN OR C~MC~ON ~ROR8 If copper tubing is used for water distributing system; piping shatl be of types K or L onl3L UNDERWRITERS CERIIFICATE REQUIRED ,b ~_~:.,:~ _: ._.__,_ : oo. c:J~' ' ' (~ , ~ o~,,. om o~ ....... :'lc ..... /.i', '-- 100,17 ..... -- ' ,. ' ':' TEe wate~ t~is r~i~c~ will c0.l~ to ~~[, LOTS LOCATION: ~"-'"~,,,~.'--~'-T' |-'T'L.JC,..',Z.-.. · -~-OW~-.l OF ~.O~.,~T~,40~-C:, SURVEYED: GUARANTEED TO: ~ ~c_~J ~-ry "]' ~ -~ t-_ ~L ~ C~j ~ ~j -~,-~ CO. .~,~[ BOARD OF HEALTH · ' ,. '; ', 'FORM NO. 1 SURVEY ~1 J~ ~'~,,~,~1 "~i ...... PR~2 g [-,~,:, :~ TOWN OF SOUTHOLD CHECK ...... J~[_ ................ ~,_:, BUILDING DEPARTMENT SEPTIC F~RM ........ : BLDG. DE~ 'T. TOWN HALL ~0~[~ ~ T~I~J~Z,~['-~ ........ SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined .... ~J.~., 19~.~ Approved .... ' '~ ~.~ ~. ~.., 19~. Pe~it No. ~ .~0.~.~. ~ 0¢4 Disapproved a/c .................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date.. ~.7~.~5.~..., 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 7sets 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 necessary inspection~ //./ ~'~.e_~ (Signature of applicant, or name, if a corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~ .z~..,v-< .~ .............................. Name of owner of premises . . .~'~,-~. ~.. ~ . . ~.o.~...~_ .............................................. (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~ ....~J..~,<~.. ~--.. ,ia;.4.. ,~,~.~.o....¥~=~.. ..... ~ ............ i.. · 33.o. .............. .................. ........... ....... House Number Street Hamlet County Tax Map No. 1000 Section ..... /.0.0. ' .. Block / 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 ............ t~. ............................................. b. Intended use and occupancy .............................................................. 3. Nature of work (check which applicable): New Building .... ' Addition ..... Alteration .......... Repair ............ Removal .............. Demolition .......... i.. · Other Work ............... ~ i (Description) 4. Estimated Cost ..... ~ Fee " (to beipaid on filing this application) 5. If dwelling, number of dwelling units .... ./ .......... Number of dwellihg units on each floor....~ ............ If garage, number of cars ........................................... i ............................ 6. If business, commerciai or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ...~'. o. ...... Rear ...4'". i ....... Depth. ~f-~/.. f ....... Height ../,~. .......... Number of Stories... ~. ..................... i..., .................. i ..... Dimensions'of same structure with_alterations or additions: Front . x~,,~,,~z. ~--~. j ..... Rear . Depth ...................... Height ...................... Number of Stories ...................... ---8.. Dimensions of entire new construction: Front...~,~ ..... . ..... Rear ... d/.. ,' ....... Depth ............... Height .... ,/~ ......... Number of Stories ....... e' ................... i ............................ 9. Size of lot: Front .. ~,/~ ............... Rear ../~..~ ................ iDepth .,?.o. ,~....~.. ~.o.~,. ....... 10. Date of Purchase ............................. Name of Former Owner .. ............................ 11. Zone or use district in which premises are situated ......................... 1... 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded ............................ Will excess fill be remove!d from premises: Yes N~- 14. Name of Owner of premises . Address ... ............................... ! .... Phone No ................ Name of Architect ........................... Address ............... . ....Phone No ................ Name of Contractor .......................... Address .... :. .. I Pi No ........... lone .............. 15. Is this property located within 300 feet of a tidal wetland.* *Y~s ..... No ..... · If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and~ inHicate ail set-back dimensions from property ilnes. Give street and block number or description according to deed, and sho~ v street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, depo'ses and says that (Name of individual signing contract) above named. he is the applicant He is the ............................................................. I ............................ (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 this application; that all statements contained in this application are true to the best of hi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before mc.this ..................................... 19 ..~? Notary Public, .... Iltflf#K,t~E VOE County ~o~ ..... ~l~,$~l~te..~}~ Yl~k (Signature of applicant) . No. 4707878, Suffolk Ceunty.~ q lefmExplresM~rch30, t9 f~,, I