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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32548 Date: 08/22/07
THIS CERTIFIES that the building ALTERATION
Location of Property: 235 SOUND
(HOUSE NO.)
County Tax Map No. 473889 Section 99
BEACH DR
(STREET)
Block 1
MATTI TUCK
(HAMLET)
Lot 17
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JULY 30, 2007 pursuant to which
Building Permit No. 33280-Z
dated
JULY 30, 2007
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 ALTERATION & INSTALL SLIDING GLASS DOORS IN PRESENT FRAMEWORK OF AN
EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to HELEN MAHARES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMEIIT OF HEALTH APPROVAL
N/A
N/A
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
~:!:!!:---
Rev. 1/81
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I beD" DEPi.
\' TOWN OF ~UTHOLD
Form No.6
TOWN OF SOUTHOLD
BUILDING DEP ARTMENT
TO\VN HALL
765-1802
PPLICATION 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 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.
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, Conunercial $15.00
Date.
Location of Property: ^ 35' SOUN l)
House No. .
/bEACH Df<..
I Street
V (check one)
!l1 II /71 TVCk
tfY Ilfry
Hamlet
New Construction:
Old or Pre-existing Building:
Owner or Owners of Property: J-f ~ L t=;y S.
Suffolk County Tax Map No 1000, Section 91
Subdivision
Pemlit No '3.> J.. <;?'O 2- Date of Permit.
/VlAH~RS
Block I
Lot
I,
Filed Map.
Applicant:
Lot:
Health Dept. Approval: ____.w
.__~ Underwriters Approval:
Planning Board Approval: __._
Request for:
Temporary Certificate
Final Certificate:
c./
(check one)
Fee Submitted $ :20. 0 ()
J~ J: ~
Applicant Signature
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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.
33280 Z
Date JULY
30, 2007
Permission is hereby granted to:
HELEN MAHARES
235 SOUNDBEACH DR
MATTITUCK,NY 11952
for :
ALTERATION & INSTALL SLIDING GLASS DOORS IN PRESENT FRAMEWORK
OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. (THIS REPLACES BP#17635Z)
at premises located at
235 SOUND BEACH DR
MATTITUCK
County Tax Map No. 473889 Section 099
Block 0001
Lot No. 017
pursuant to application dated JULY 30, 2007 and approved by the
Building Inspector to expire on JANUARY 30, 2009.
Fee $
50.00
ORIGINAL
Rev. 5/8/02
I'OBM NO. .
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>
33;2<6 a- ..:c
N~.~7e35 l
Date ....J..~~.......~~........, 19.~~
Permission is hereby grante~:
. ~
.....................~.....U.................................
...~..~.~.]...............................................
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to ...~.:'1:..~~....S.g..J.~i...Qi.~...~..~..~.~~...~...~....
+-~..ti...;~..~....~.~~.~.~........
at premises located at ..P.:?~..~....~.<;',..c;..Q,...~.~.......~.C?...u:.~c1....................
..%..............................................il".....................................................................................................
.....s.......~::t:.~.....t.Y.1.s.J1.~......... ................................................................................
County Tox Map No. 1000 Section ........9..~.9..... Block ....9....1.......... Lot No. ..1..1..................
pursuant to application dated ....JJ.d':l,'.?..~,.,.~......~.I........... 19.11, and approved by the
Building Inspector.
Fee $.0.'1.,.:::::::-:-......
....;.~....... ..............~..,..........,.....
ulldlng Inspector
Rev. 6/30/80
33 ~Yt) Z-
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRucnoN
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
~ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
~rl4- ~
DATE '{ ~ ?>o7
INSPECTOR ~~
/7(P3S-
765-1802
BUilDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PlBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ v{FRAMING [ ] FINAL
DATE I J...
?? INSPECTOR
~~,2LD ~:;S:;2C:l0:J
1.
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAt1E &
PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
4 .
FIilAL
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ADDITIONAL COMMENTS:
.
FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD, N.Y. 11971
TEL.: 765-1802
Examined .N~.~,191.~
Approved N~'.~.~ .~.: 19~. Permit No.1. 7.~.~$?
R e c e i ve d . . . . , . . . . , . , 19. . .
................................:./J...........
YJ~. ................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
1n~ f~.r3rr1--6b7
111~"r n-~,
iI9~2.
Disapproved ale ................ . . . . . . . . . . . . , . . . . . . . .
/
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Date. ./'i.G.Y...... .,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, housing code, and regulations, and to
admit authorized inspectors on premises and in building for neces~~~. i~s~~~t~~~4~ .<. . . .~ . . . .' . . .
OCCU PANCY OR (Signature of applicant, or name, if a corporation)
WIUrHSEoulSrUCENLAWFUL ..... .6~. .~l7. .&11.7(; /<<.~/(?g
ITlFICATE (Mailing address of applicant)
State whether applicant is owner~fes~~~Hrn"'SX.itect, engineer, general contractor, electrician, plumber Ot bp~der.
Vz.__~~ .
. .. .~~~t?? . ... .. . .. .. . . .. . .. . . . . . . . . .. . . ., . . .. .. . . . .. . .. . . t{;p,~'O AS.;1CTrl)..... . ...
'1._ .,+ ~ _ --7...-, _ L '",_ .-L I .,. /~'l~.i I ., I ~ ("""~
Nameofownerofpremises . ./:'./4;~. t':'.~.. /-;/~U+':~.... ;]~'\!~~!.,;.~e?t~!_Ll.G,.ih)....~..
(as on the tax roll or lat~~tdeed) .~. - :::L G', L. .
If applicant is a corporation, signature of duly authorized officer. ,"')1 ,,- ... n ..:'J.:r.:;:
-,(..~.. ...." 1.-.' . _1 \ '")R '1" "_~
Electrician's License No. ......................
'."V '. ...... ""('1"-
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FeR .' DL,'n -.., "":C,'l(t{c.:rr.-
2 ROUGH FRAMING & "LUM8ING
3. INSULATION
4. FINAL .. CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHAll MEET
THE REQUIREMENTS OF THE N.Y.
STATE CO~ . ENERGY
.......~.~.f..~~~.
(Name and title Ofcorp.o~~ffiCer) 5'S9~
Builder's License No. . ./I/t;. .~.~ ~
Plumber's License No.
Other Trade's License No. .....................
I. Location of land on which proposed work will be done.
............ ,_............................ ,-............................. ... ............... '.
House Number Street i Hamlet
fit! '
County Tax Map No. 1000 Section .................. Block ..... / . . . . . . . . .. Lot... /.7. . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a.Existinguseandoccupancy ...~~.......:.... .... ...... ...........
b. Intended use and occupancy .~......~... .~~. . . . . . . . . . .
...
9.
10.
II.
12.
13.
14.
3. Nature of work (check which applicable): New Building....... . ... Addition.... ...... Alteration
Repair .............. Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . .
4. Estimated Cost. . . . d./btlt? . c:.'~ ~. . . . . . . . . . . . . . . Fee..... . . . . . . . . . . . . . . . . . . . . .(~~~~~~~i~~~ . .
" .., (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 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. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Size of lot: Front . . . . . . . . . . . . . . . . . . . . .. Rear...................... Depth ......................
Date of Purchase ............................. Name of Former Owner .............................
Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Does proposed construction violate any zoning law, ordinance or regulation: ................................
Will lot be regraded ............................ Will excess fill be removed from premises: Yes No
Name of Owner of premises .. . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . : . . . .
Name of Architect .. . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . ~ . .
Name of Contractor ... . .. .. . .. . ... " . .. ...... Address. ... ..... .... ... . .. Phone No. .. ... ....... .....
./...
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.
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STATE OF NEW YORK,
COUNTY OF . .. . .). .'. , . . ,. '. I; S.S
... '.:>';\ii~ii~Mi..ic;~~t;;c't)" . .. . .... being duly sworn, deposes and says that he is the applicant
abo~wi'J'~ !'IO_"11'1
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
.. .. .. . .. . .. . . ~ /. . . .. ..day of .. .. .1.1 (J:t!-::. .. .. .. .., 19 r{
No"~PuW;'. . ..~<~~~:JlK"... Co""~~. ~/If# ~,,/.....,....
No. 470787R, $"\1':" CountyF9 (Signature of applicant)
Term Exlli''' Moo en 3D, 19