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Home My WebLink About27866-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 10/03/06 No: Z-31890 THIS CERTIFIES that the building ADDITION TO ACCESSORY Location of Property: 2765 ELIJAHS (HOUSE NO.) County Tax Map No. 473889 Section 108 LA (STREET) Block L- MATTITUCK (HAMLET) Lot 7.16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 13, 2001 pursuant to which Building Permit No. 27866-Z dated NOVEMBER 5, 2001 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 ACCESSORY SHED AS APPLIED FOR. The certificate is issued to STEVEN & VINCETTA SHEFTELL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~:- . r'!__ -.- H ,~l I' I j Od - 2 LOS i I I ~:~'jJ'S9\:J~r"J~,) ! --j 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: I. 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 2/1 0 of I % 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. 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. New Construction: Old or Pre-existing Building: E"?l.flth ') LrHJ..{' Street v ( check one) Location of Property: B 7~ c:; House No. /'1\ A-rttTt.lCv( fJl/ WI, Sl Hamlet Owner or Owners of Property: [VI R +- \'Y\ ~ .s-re-ve'N IOcr Block s+l-E\=="\t LL- tf Lot 7./(, Suffolk County Tlll' Map No.1 000, Section . Subdivision . Filed Map. Date ofPermit.~ Applicant: Lot: Permit No. (). fJ 8hb- 7 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~txJ Underwriters Approval: Final Certificate: ( check one) ~.7110ll ~O-6 ;1'61'0 %~ /k//d ~ 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. 27866 Z Date NOVEMBER 5, 2001 permission is hereby granted to: SUSAN SIMM RD 1 2765 ELIJAHS LANE MATTITUCK,NY 11952 for : RENEWAL OF PERMIT #17549 FOR CONSTRUCTION OF AN ADDITION TO AN ACCESSORY BUILDING AS APPLIED FOR at premises located at 2765 ELIJAHS LA MATTI TUCK County Tax Map No. 473889 Section 108 Block 0004 Lot No. 007.016 pursuant to application dated SEPTEMBER 13, 2001 and approved by the Building Inspector. Fee $ 75.00 k ~ Authorized Signature ORIGINAL Rev. 2/19/98 -;Pf~z 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [] ROUGH PL [ ] FOUNDAnON 2ND [] INSU ON [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: < DATE V INSPECTOR FORM NO.1 TOWN OF SOUTHOLD ocr I 7 1988 BUILDING DEPARTMENT TOWN HALL Iiif'T SOUTHOLD. N.Y. 11971 1OWNOF.SoUTHOLD TEL:\765.180:! Examined It? .~........, 19.19 f.-Ll Approved . /.~~!......., 19qPermit No. .~'y.f.? Disapproved alc ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS /' . Y:. . . . . . . . SURVEY ...... ..v.;... .. ..... .. CHECK ........ .-v... ..... ... .. SEPTIC FORM................ NOTIFY CALL MAIL ...11 rF.-: .~-:lJ? TO: . . .. . . . . . . .. . .. .. . .. .. . . . .. . . . . . . · · . . · .. .i1d;fj:~?!I... APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . ., 19 . . . 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, housinll code, and regulations, and to admit authorized inspectors o1\.premises 'and in building for necessary inspec' s. l~ ,:' r ,,- ~ . ant, 0; ~;ni~, ir' a' do~porat;on)' . . Rp' ! . . ~7.iD.~gi ~ftJ-/S. hff!JFI(I?'!!?~7.'-':<ff.II)J,'-;: } !1~~ (Mailing address of applicant) \~' :1;1~:1\~ '.'..~\~l;l t-L "du~"UI.; State whether applican&1l9'tlWltu,'18llWel<\~, architect, engineer, general contractor, electrician, plumber or builder. ... 9..~ U .~~~.Vo~.~. ':)~'~~~.'::'11,~~;l;',~;~. ..~.......... .... ... ... ..... .......... ...... .. .......... ... reo"" "'O,T:.ltlRI;>~ J' ., "'. :; , Name of owner of premisQ;).lIC). 3l!tt.~q~lrl.q.. f. ?::u .7 fI. . . . . . ~ :r:. '!! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nw JJAI4 >lOIT.J\lMl ?14O:> J jf (as on the tax roll or latest deed) . ..\''' JH'f ...0 ~1IlVQ~JIl ~,n . If apphcant IS ;Hljjfj,.otw~vlll.lwllOnzed officer. ~ , n \0'11. 1010' 1'1"" . ... . .. . (N~~rt~~~J=~1rt~~;)" -' . . . .. . Builder's License No. ... <!;/ihF. ... . ... .. ... .. Plumber's License No. ........................ Electrician's License No. ...................... Other Trade's License No. ..................... I. Location of land on which proposed work will be done. ................................................. /-. ..- ' . .J: J&f:.. . . . . . . . . . . Bi .Jf.lt1.S. . . .1'J.^!!=: . .. . .. . . . . . . . .'Xl. ftTT. /70-.c. .K.. . . .. . . . . . . . . . .. . . . . .. House Num ber Street Hamlet County Tax Map No. 1000 Section . /0. 't... .. .. .. ... Block .... p. 4.. .. .. .... Lot... 7-: / ~ .. . .. .. .. I -- (> / . S- Subdivision #.'.~.~1~. J-..fJ"!/:. . J:.5.7.fJTJ:::'? ./.JP;',. . . . . Filed Map No. to. b. . . . . . . . .. Lot.. /3. . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .., . R f.<:: i .T?t.AJJ;' r:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , " '- b. Intended use and occupancy . ~'i:J~r-!?,1.'?,y,. :~. .l~x lSll(V,I;,.. .'frp.f?fl.C G... .Sflt:;D............... , 3. Nature of work (~heck which applicable): New Building. . ... :'. . . . . Addition.. .~.. Alteration .......... Repair ............... Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . 1(, g:;v . ; , fDFJEPption) 4. Estimated Cost. . . !I t7J(.'. . . . . . . . . . . . . . . . . . . . . . . . . . . .. Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . . (to be paio on IihngJt!%~"lioiI1l, 5 f. .. \ N " I l(lfl':'l'f\"1JO~ "'j \}JOT 1 . I dwellmg. number of dwellIng umts . . . . . . . . . . . . . . . umber of dwellIng ll"lts 0'\'1 c,,~ I roOf :~.,.;. ;.'1 ......_. _ .. If garage, number of cars ...........................................'................. .... . . .... . . . 6. If.busin~ss, com~ercial or mixed o.ccupa.ncy, specify'natyre and extent of each t~e of use. . .. .:~'.. 'd,.; . . . . . . . . 7. DunenslOns of eXlstmg structures, If any. Front.. . ./..'J. . . . . .\. . . Rear . ./.3-. ; ., . . . .. Depth,.I:.......... . Height .1"-:.......... Number of Stories .....:. ./. ..... . . ... .,.......................'.......... .. Dimensions of same structure with alterations or additions: Front . ~.), . . . . . . . . . . .. Rear...;};}........... Depth . .1. (>. ~ . . .. . . . . . . .. . .. . Height . . . .J. (J, ~. . . . . . . . . . . . .. Num ber of Stories. . . . / .. .. .. .. . .. . . .. . 8. Dimensions of entire new construction: Front... ./~."... . .... Rear.. . It>. ~........ Depth. .7:.......... Height .. ../0./... .... Number of Stories..:...I................ ........................... ....... . . //C1 ' /6" c.' 'Ir< / 9. Size of lot: Front... .r,................. Rear...... (J.......... ..... Depth ..4 oJ.................... 10. Date of Purchase . /.-;. .'-.-: . ~'?:-: . . . . . . .. .. .. .. Name of Former Owner A(F.IY. . . . . . .. . . . ..... . . . . . . . . . II. Zone or use district in which premises are situated. . . .Re;;. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... 'i>":~ . . . . . . . C?" . . . . . . . . Will excess fill ~e removed from premises: . Yes r Jig 14. Name of Owner of premises 7./.l'IArrtlN. . . :>/.'71./1']. . Address~7.6.{ f.1.I.J.atf:? .1-1'1 /"1. Phone No. d-.r.8'::. .,J.~ '. '6. Name of Architect .... . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address ................... Phone No. .. . . . . . . . . . .. . . .. 15.Is this property located within 100 feet of a tidal wetland? *YES....NO.~ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ;~~~ AS NOTED DATE: 0 B.P. # / 7.s-~ '/ t: PEE~ BY'~ NOTIFY IL ING DE~ 765.1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUlREO FOR POURED CONCfIE1'E 2. ROUGH . FRAMING . JlWM8INQ 3. INSUlATION 4. FINAL . CONSTRUCTION MUST BE COMPUTE FOR e.O. ALL <X)n./1tIIClION IfW.I. MElT THE IIIfQIJIR.~.1lI Of! 1MI ..v. STAll COr.t...cnc. . .I8alJY CODES. NOr ~II nl I ,1IOIt DESIGN ()IItGOm'~..1OnI STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . . . . .. S.S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 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. Sworn to before me this .. .... ....... .1.7...... ..,."r.. .0.<+..... ..... ....19ft. ~ Notary Public, ...~. f(.I)?t/.~......... County ~ ,,' . . \ IlELENItDEVOE . ....... .................. NOTAllI' PU81u:. S1Ile of New YIlIi To No. 4707878. Suffolk c.:nlyJ" , .l<1li Expires March 30, 1 (Signature of applicant) . P,; , " 0, , 1 t-.S ,--. - ,.., ....- ~I,,/.' .... f ~..." ,.-' , I ,.:1' , 1 I-- I ! G ,~i. '0 " ::: (; # - - t- t- ;,.._ \I' ~.- ~ u. __A I.J.J ~_l___~ - ...J <I: - - - .- :::>fd o::I..L- 0;:->- ~ C:J:: - U '" >- --:l ~ ~ uz ~ ~ ~:::> ~ c.. en (y) ::::;)_ C,,;l ~i -~ 0::) . I ~ i ',- '" i _________ I ~ i" ~' t- I fl- . . ---,._-~-- ~ -.,.----- Q.:. ...I';: ~ -::t '" P '4;tf '. ... " M " w--...--....--.--..---...- Rc:oD 'D/ '" r t-.A/v \ C\I I ! , P '. /121l , ._..--- -- n ~. I ~" SIMM _ ~__n______ _____.~ <' ;/ ELi f 1/""," . N. I , I \ I ~ I ~ , ~ ! '0 I \ RES 1'Dt:fJCE 1 i I ~ 1 ,"" , 1 ~ ~ 1.1 I I A \ "-l 4: V\ i _-L I , -- .r 1 Q ~ , "- ~ I I ~ ~ /b~/