HomeMy WebLinkAbout29786-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29866 Date: 11/25/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2255 WICKHAM AVE MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 114 Block 3 Lot 1
Subdivision Filed Map No_ Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 6, 2003 pursuant to which
Building Permit No. 29786-Z dated OCTOBER 7, 2003
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 "AS BUILT" STORAGE CONTAINER AS APPLIED FOR.
The certificate is issued to MONICA & MIKE LTD LIABILITY CO.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF BEAT TH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
D"'
Signature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29865 Date: 11/25/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2255 WICKHAM AVE MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 114 Block 3 Lot 1
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 6, 2003 pursuant to which
Building Permit No. 29786-Z dated OCTOBER 7, 2003
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 "AS BUILT" STORAGE CONTAINER AS APPLIED FOR.
The certificate is issued to MONICA & MIKE LTD LIABILITY CO.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ut
zed/Signature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29780 Date: 11/14/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2255 WICKHAM AVE MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 114 Block 3 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 6, 2003 pursuant to which
Building Permit No. 29786-Z dated OCTOBER 7, 2003
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 "AS BUILT" STORAGE CONTAINER AS APPLIED FOR.
The certificate is issued to MONICA & MIKE LTD LIABILITY CO.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
u oriz d Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD -5 TOO i-t
BUILDING DEPARTMENT CQ1V T p.l lvcI25
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 I%lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect 'yj 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 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 Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00
Date. Ck . -2w
New Construction: Old or Pre-existing Building: (check one) /15 _RU1LT
Location of Property: S S u ;okw�,A✓t° Alla*, c//G
House No. Street Hamlet
*Owner or Owners of Property: 1on,'ecL 9L Miie LKC
Suffolk County Tax Map No 1000, SectionBlock Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: / (check one)
451
Fee Submitted: $_ J � _ �� ��01
Pi� o a �l-7Sll �—
Applicant Signature
FORM NO. 3
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)
PERMIT NO. 29786 Z Date OCTOBER 7 , 2003
Permission is hereby granted to :
MARINA INC MATT-A-MAR
MAIN STREET
MATTITUCK,NY 11952
for
CONSTRUCTION OF THREE "AS BUILT" STORAGE CONTAINERS AS APPLIED FOR
at premises located at 2255 WICKHAM AVE MATTITUCK
County Tax Map No. 473889 Section 114 Block 0003 Lot No. 001
pursuant to application dated OCTOBER 6, 2003 and approved by the
Building Inspector to expire on APRIL 7, 2005 .
Fee $ 450 . 00
WC(rized gnat
ORIGINAL
Rev. 5/8/02
o��gUFFO[�COG
o� y�
Town Hall,53095 Main Road W T Fax(631)765-9502
P.O. Box 1179 j, Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 14 , 2003
Matt-A-Mar Marina LLC
PO Box 952
Cutchogue, New York 11935
Dear Mr. Raynor:
Before we can process the Pre-existing Certificate of Occupancy
we need a new check for '$10V.100 . (Enclosed is your now stale
dated check #775 . ) .
Also, to process the Certificate of Occupancy for the "as built"
storage containers we need an additional fee of $1tro.00 . Each
storage container gets a Certificate of Occupancy.
Building Permit 29786-Z .
If you have any questions, please call us at 765-1802 .
Sincerely,
Southold Town Building Dept .
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 ,�/ Survey
www. northfork-.net/Southold/ PERMIT NO. 2-617 d {f- Check
Septic Form
N.Y.S.D.E.C.
o Trustees� 20`3 Contact: jjes� p
Approved G' 6 ,20 / Mail ti{:AJ_ Z
Disapproved a/c SCLC 3
_ Phone: 7 z
Expiration 7 _, 20Q�7(,9J
APPROVED AS NOTEDt ding ector
DAZE: �+?�`� s.P. a alcl�Yb�
FEE:—L; ByICATION FOR BUILDING PERMIT
NOTIFY BUILDING P4RTMENT
765.1802 8 AM TO 4 PM FOR THE XDate 120
FOLLOWING INSPECTIONS: INSTRUCTIONS \
1. FOUNDATION - TWO REQUIRED
a.FPffl P F �CO�� pletely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of la� 1"oplan to sc tle.Pee according to schedule.
.Ilt FTTOI�i lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, Ad F TE L�
"Is
cf4en may not be commenced before issuance of Building Permit.
v Wg#e Building Inspector will issue a Building Permit to the applicant. Such a permit
C.
shall by erection throughout the work.
�WigWn9d in whole or in part for any purpose what so ever until the Building Inspector
issues a c o Fccupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
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 inspections. y�
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
0 w Y1,ey
(aine of owner of premises mU'h.i 0.L'-- W Milne, L,1- C
(As on the tax roll or latest deed)
applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
uilders License No.
umbers License No.
ectricians License No.
!her Trade's License No.
L9cahon of land on which proposed work will be done:
pa�fiS e a. 4w eLjT i`7'u l�zl�
ouse Number Street Hamlet
lCounty Tax Map No. 1000 Section Block Lot
Subdivision Filed Map No. Lot
(Name)
Mate existing use and occupancy of premises/and interi{led use and occupancy of proposed construction:
[\/ a. Existing use and occupancy /S69a�7 4 Ar d �70✓. n o�
b. Intended use and occupancy SGar»�
Nature of work(check which applicable): New Building ✓ Addition Alteration
Repair Removal Demolition Other Work
(Description)
Estimated Cost Fee
(To be paid on filing this application)
If dwelling, number of dwelling units Number of dwelling units on each floor
If garage; number of cars
1
i. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO_
13. Will lot be re-graded?YES_NO_Will excess fill be removed from premises? YES_NO
Names of Owner of remise. .,2,., 9=/t/L'�lLzAddress C� YL
p � �Qo°k' 9'S2 )�ioneNo.Gs'/- 7.341`d�0V
Name of Architect Address Phone No
Name of Contractor Address Phone No. /
5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO c/
IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO
* IF YES,D.E.C. PERMITS MAY BE REQUIRED.
Provide survey,to scale,with accurate foundation plan and distances to property lines.
1 . If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
TATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)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 this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Swom to before me thi
1 day o'f� 20_c�
oN tart'Public � Si Applicant
LYNDA M.BOHN
NOTARYN QUBD tate oil ewYOrk
ouaiified in Sutlolk County
Term Expires March S,20 Q 7
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