HomeMy WebLinkAbout14055-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32003 Date: 11/16/06
THIS CERTIFIES that the building ACCESSORY SHED
Location of Property: 5430
(HOUSE NO.)
County Tax Map No. 473889 Section 113
WESTPHALIA AVE.
(STREET)
Block l!.--
MATTITUCK
(HAMLET)
Lot 19
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 14, 1985 pursuant to which
Building Permit No. 14055-Z
dated
JUNE 18, 1985
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 ACCESSORY STORAGE SHED IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to CLAIRE P. & WILLIAM H. SPARKE, JR.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3011744
10/23/06
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
1'0_ NO. I
TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD, N. Y.
BUILDING PERMIT
<THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 14055 Z
,":-.( t..IA\.I- I '<j -
Date '" '\.........................................' 19..f.::lii
Permission is hereby granted to: .
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to..~....Ckn.....P....~.CA.~_~.....~1.....frd..9f~rl..
.................................................................................................................. ...................1........................
at premises located at ..~.~.~.~.....~~~...~..,............. ~........
................................................................................................................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section .........l.l.~...... Black ........J.L....... Lot No. .....l.~............
pursuant to application dated .......~..~....\.i.................., 19.~.~ and approved by the
BuildIng Inspector. \
Fee $..d:$.:..~..
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Building Inspector
Rev. 6/30/80
.....~ . k,
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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eel 2. 6 is
APPLICATION FOR CERTIFICATE OF OCCUPANCY \
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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 2/10 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:
I. 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
I. 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.
Old or Pre-existing Building: V
/tJh1 / ~tPtfJ6'
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New Construction:
Location of Property:
5' AI'?c>
House No.
w;55-i-P#i4J- 4 J4. ~v~
Strect I
( check one)
n A-J-..-i-I-+-v'C: K
Hamlet
Owner or Owners of Property: WI to L 'J4 Iff' H, ~ (>11 fl. k IE -;f/2" 4-
Suffolk County Tllji' Map No"lOOO, Section II :3
.
Subdivision .J... d 1. L ,;: W" tfJ /)
Permit No. IJfOYJ- Z- DateofPermi!.
Health Dep!. Approval:
Planning Board Approval:
Request for: Te~rary Certificate
Fee Submitted: ~2.r ~
.. Block
c:t.J4I(<;:;' P.5fl1R.k'~
1/ Lot I cr
17/ Lot: A '-I 4-:z.J'
WIt.I-.I4K ./I. S/~Al-(G ,...../a.
..
Filed Map.
Applicant:
Underwriters Approval:
Final Certificate: /" (check one)
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Nov 1306 01:38p
William H. Sparke Jr
631 2987277
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BY "tHIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
, I
BUREAU OF ELECTRICITY : 1[1 ~ ~};;.jE.J.JLt. '
40 FULTON STREET ..;, NEW YORK, NY 10038!' ',' , !
I : I. NOV" 2D06 ,'.
C~RTIFIES THAT ..
upon premises own~i"CIC?S6~~~
Upon the application of
'NILLIAM SPARKE
,'0 BOX 437
~"ATTITUCK, NY 11952
WILLIAM SPARKE
PO BOX 437
MATTITUCK. NY 11952
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A visual inspe,:tic.' of the premises electrical systelT, limited to electrical devices and wiring to the extent detailed
herein, was (;o)nl'ucted in accordance with the requirements of the apr,licable code andlor standard
promulgated by th.! State of New York, Department of State Code Enforcemer,t and Administration, or ather
authority haVing jurisdction, and found to be in complianCe therewith on the 2:Jrd
~ OTY B!l!! . BIIin& ~ Tvoe
MisceDaneous
out door storage shed
with anic space
as buiJt-!998
Wiring and Devices
Oullet
F iKture
Outlet
Receptacle
Switch
Receptacle
5430WESTPHALIA MATTITUCK, NY 11952
3011744
Application Number:
Certificate Number:
3011744
Section:
Block:
Lot:
Builaing Permit:
I3DC:
nsll
Described as a occupancy. wherei, the premise~ electrical syster.: consisting of
electrical devices and wiring, described below, located inion the premises at:
storage shed, Outside,
Day of
Octot-.",'L006.
3 Ii
3 0
3 C
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3 0
I 0
Fixture
Incandescen.t
Genera! P"'pose
General Purpose
General Purpose
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$0.00
$0.00
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$15.00
Invoice T.tal
An as built inspection, of t.'" delineated electrical iDsta1lation, detennined tbat an .bvious liazard is not present and llie insl.:at,on is believed t.
be in comfonnance with the applicable mercnce standard for the estimacCd. period ofc.onsuuction of1be premises wiring S)'.ttnl.
seal
TRT~ IS YOUR RF.r:F.TPT
I of I
This certificate may not be altered in any WZj and is validated only by I,he presence of a raised seal at the locatio" indicated,
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FIELD INSPECTION DATE COHt1ENTS ~- _ 4.
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. FORM NO.1
TOWN OF SOUTH )
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
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Examined . ~.~ l.~..., 19 ~(
:-st . , ~ 9< . I Y: 0 ~(t:
Approved. . . . . y\.M'U.. . . . ., 19 . . . Penmt No. . . . . . . . . . . .
Disapproved a/c. . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . '.'
.
Received...... . . .. . ,19..
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(Building Inspector) .
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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, wit
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 str.
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ar
cation.: ,,' ,'." Ii
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 pel
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 Occupa
shall have ~een granted by the Building Inspector.
~
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinance
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descri1
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, an.
admit authorized inspectors on premises and in building for neces~~~~~~~~.. -;-.~ ~ .t:?-:-: -:". ,. .
(Signature of applicant, or name, if a ~~'tion)
fi(p'.. .P.d! f.. .70 XJ /:~1.J:f/.f'!r'/:(J /1!..f" 1/9./L
(Mailrng address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or built
. .. .. a.'<1/. f/l.E:/? .. . ......... . .. . .. . .. .... .......... ...... ... .. ............... ... . ...... . . .
Name of owner of premises ... W.J.I:.J.,.. ~ ff 11. . ~. . .9:: . .c::. 1-. .I'll.!!!!!. . . f... . . f.1! IF. rr. 1:<.[3;. . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ........ J:I.! I?: . . . . . . . . . . . .
~ Plumber's License No. ...... .1/ ~ . . . . . . . . . . . .
Electrician's License No. ... .I!.! !i:. . . . . . . . . . . . .
Other Trade's License No. .. #./IJ-:. . . . . . . . . . . . .
I. Location of land on which proposed work will be done.
. .$'.'I:1.r:. . .. 'r! Jf.f-f. P;fIJJ..J.8.. . .k~ t1.lY~ 1$. ... .. . . . ... .t1/f.-f+' /:f.<<? .k. .. . . . . . ,
House Number 1/3 Street '.' . /I' Hamlet, I <j
. ~ . ~7) I j ~""-:' l~' ~... . :.n ~ c'
County Tax Map No.. 1000 SectIOn.. .~ .'. .-...! .'...... .Block ........ ',' .'....... Lot ."nl!illc=r:.;.......
Subdivision. . ,-/::~t./.. E. .W.t?t:'?.R.. ....... . . .... Filed Map No. . .7Jfr..... . Lot 5. %. J.1~..f}f5
(Name). .
2. State existing use and occupancy of premises and intend~ use and occupancy of proposed construction:
a. Existing use and occupancy. . .R.E;.f/.l?ff (1/ f:/ ff ./....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . , . . .
b. Intended use and occupancy ... J: It? ~/9k.c. . .7. . *~ .t:!.i.:-. . ...?:J!.t;, p.. . . .. . . . . . .. . .. .. . . , . .
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3. Nature of work (check which applicable): New Building. ..... . . Add,tion .. ........ Alteration .......
Repair . (~! ). 1. IlL . Removal. . . . . . . . . . . . .. Del. lition .............. Other Work. -!:".C1.?-. . /.r(~ P
/. (Df-scripti.
4. Estimated Cost. . . . . . If ?!7?::. . . . . . . . . . . . . . . . . . . . . .. . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .'
.... (to be paid on filing this application)
5. If dwelling, number of dwelling units. . . . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . .
If garage, number of cars .....................................................................
6. If business, commercial or mixed occupancy, specify nature/an!l/,;xtent of each tIP' of ~e . . . . . . . . . . . . . . . . v
7. Dimensions of eXisting structures, if any: Front. . . . . ~ cr. .c? . . . Rear ... P.'f. . .~ . . .. Depth..::lt: ~.:?/ .
Height ..., ~ : p. ~/. . . . . Number of Stories. . . . . . . C?IY. ~. . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . .
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-7f Stories'. . . . . ..... ...... . . . . .. .. . . . . . .. . . .. . . ... . . . .. . 'j" .. . . ..
9. Size of lot: Front ......./.4.r-.~......... Rear...lt'.<?,.':"............ Depth .J.~~:.~. .~6iI,/t(..
10. Date of Purchase ............................. Name of Former Owner ..........................'
Ll. 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 ............................ Will exce~ ~I be ef).ov~ fro~ premi~es: Yes
14. Name of Owner of premises 'f..(~~~~I~ .1fIUJ,I(r:;.. . Address..~ k.J-.-1.,.~",~ ~~:. Phone No. .'l9,S7'f/..((?,?
Name of Architect. . .... .1Y,1/J;..... .. ..... ... Address.... . .. . '" ..... . .. Phone No. ..... .... .. . '
Name of Contractor . . . . . Nili:-. . . . . . . . . . . . . . . . Address ................... Phone No. .......... . .
PLOT DIAGRAM,.
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions ff(
property lines. Give street and block number or description according to deed, and show street names and indicate wheti
interior or corner lot. __,_~L I u,._, U \
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STA TE OF NEW YORK,
COUNTY OF . . . . . . . . . . . . . . . . .
S.S
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being duly sworn, deposes and says that he is the applic"
(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 th
application; that all statements contained in this application are true to the best of his knowledge and belief; and that tl
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
. . . . . . . . . . . . . . . . r. Y. . . . . .day of. .~. . . . . . . . .. . . ; ., llr..
NotaryPublic, ..~..?{.p.i.-.~~...... Co nty
HELEM K 0'1" VOt
NOTARY PUBLIC. Slate 01 New York
No. 4707818. Suffolk Coun~~
lelm h~"es MarCh 30. 19~
0.' \en .............
(Signature of applican
ITOI'OflllOQE
SE'rS'04-IIl" .
NICNE LOfT
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1/2"' COX f'LYWOOO SHEAntNG
ZII6IWTERS. 24H O.C.
lll8 RIXiE BOARD
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BACK-YARD BARN
12 . 16' CONCRETE SlAB
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APPROVED AS NOTED
DATE: &/n/~~ B.P. '# I<J.O(;S"~
I II
f:EE: :~f. - _BY: . r. L .
NOTIFY BUILDING DEPARTMENT AT
765.1802 9 AM TO 4 PM FOR THE
FOLLOWING INsPECTIONS:
l. FOUNDATION - TWo REQUIRED
FOR POURED CONCRETE
2. ROUGH. FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C. O.
ALL CONSTR:.JCTION SHALL MEET
THE REQUIREMENTS OF THE N. Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
O. CCUP AN.C <... Y o~.; Ul
1ft 1~8'lA\~~F
US.l.~;.,.~... ...~~~j'i:;t(j~. ~1"IF'CATE
TF" " C.",
. "'. La
~J ffCCUPANtY