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Home My WebLink About24674-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26193 Date: 12/28/98 THIS CERTIFIES that the building STOVE Location of Property: 13250 MAIN RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 11 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 22, 1998 pursuant to which Building Permit No. 24674-Z dated FEBRUARY 13, 1998 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 SOLID FUEL BURNING APPLIANCE TO CODE AS APPLIED FOR. The certificate is issued to MICHAEL Z HERBERT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r i ding nspec Rev. 1/81 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) Date.....FEBRURX...... ,3........................... 19...�$.... 24674 Z Permission Is hereby granted to: I MICHAEL Z HERBERT �I ................. .......... ................................................ P;0.:...B0X„1,15.0.........................................I....... . MA�'TITUCK,NY..11B ?..................................... to ......TN2TALL,.A..,9.QL1]?.. ..GRD.E...Aa..APJ?.L1.EA..kQ�t. ........................................................................................................................................................... i I ..................................................................................................................................... ............................ .................................................................................................................................................................. i at premises located at.............. Q.....M&T.N...RD...............................................1��.�.�t.?GX........ ........................................................................................................................................................ Count y Tax Map No. ....�#.7.;2.�$2..... Section ...11.4............. Block .....Q.Q.11........ Lot No. .Q.Q19............... I pursuant to application dated ....JAWARX........22.......................1 19...... and approved by the I Building Inspector, I Fee $........ .,QQ..... .. ... r..... ....... uilding nspector i Rev. 6/30/80 TOWN OF SOUTHOLD � p„ _ BUILDING DEPARTMENT LIE]_ _.�t=' y i,) TOWN HALL 765-1802 { DEC APPII�aATION FOR CERTIFICATE OF OCCUPANCY This #p li � m�-us�t, fi led in b typewriter OR ink and submitted to the building insp. -tli 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-O 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 - ' 451,�. - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .. . . .... . Z. . 1. . . . . . . . . . . . . . . . . . . . . . . v Construction. .. . Old Or p- e� existing Building. .. ... .... . . cation of Property. . . .. .... . .. . . . . . . ... . . . . . . . . . . . . . House No`.� Streeett� Hamlet Lwer or Owners of Property.. IV.Y.:`L� .. .... .. ._ ". ..-�� . .. .. . . . . . . . . . . . . . . . . runty Tax Map No 1000, Section. . .. .. . . . . ....Block. .. .. . . .. ... . .. .Lot. . . . .. . . . . . . . . . . . . . . . . ibdivision. . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . .. .FilQQed Map. . . . . . . . . .Lot. . . . .((. . .•. .... ..,,.�(.... . . . trmit No. . . Date Of Permit. . .. `.. ..��)• •Applicant. .� •1 .. . ... . • • - :alth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . .anning Board Approval. . . .. . . . . . .. . . .. . .. . . . . . / -quest for: Temporary Certificate. . . . . . . . . . . Final Certicate. .. . . . . . . . . . -e Submitted: $ . . . . . . . . . . .. . . . . . . . -•- �o ac�lqL2 00 GODIN Certificat . de Garantie CONTRE TOUT VICE DE CONSTRUCTION, DURANT UNE KRIODE DUNE ANNEE. C-7 r� Designation de I'appareil ........... a... ;:....... . .%... ;. '.................................. N° de Serie : ....................... .. ................................... 0................1 1 8 No de construction 0 Couleur �� PAYS DESTINATAIRE : ........................................................................................... �� o��gUFFO�,�co o� Gyp y Town Hall,53095 Main Road %t Fax(516)765-1823 P.O.Box 1179 Oy �� Telephone(516)765-1802 Southold,New York 11971 BUILDING DEPARTMENT TOWN OF SOUTHOLD December 18, 1998 Michael Herbert P.O. Box 1150 Mattituck, New York 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 24674-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. a�2-Y�- 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY�- REMARKS: C DATE_ ��INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE � �y f� INSPECTOR ,�'�G 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR TEED I` S1'ECTI0N JJDATE COMMENTS 3 H FOUNDATION ( 1st) cn FOUNDATION ( 2nd ) 2 . z O ROUGH FRAME & -PLUMBING- y 3 . r� INSULATION PER N . Y. y STATE ENERGY CODE 4 . • i ' FINAL 0 1ry1� ADDI NAL COMMENTS : x 00 H � 11� 9 ' H �S _ O z J T_MM L'J d• H BOARD OF HEALTH :. . . . . . . . . . . . . . iJ _ FORM NO. I 3 SETS OF PLANS ' TOWN OF SOUTUOLD SURVEY • . - - . . . _ BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . � TOWN HALL SEPTIC FORM JAN 2 2 I ) SOl1'1HOLD, N.Y. 11971 - - - • - • ' . - - TEL: 765-1802 NOTIFY: ULDG.lid=F'TTOWN O'SOUTHOLD g CALL Ixanined..... /�... 19_ `, ii ��LT� ^Q_ !� ..... 19. Pennit No. .....b.. ......��T�� .�... Approved... �.... •1 ....... ...................................................... (Iluildi is tor) APPLICATION FOR BUILDING PERMIT Date. .). . .�U". . . . . . , 138 INSTRUCTIONS a. This application mast be corpletely filled in by typewriter or in ink and submitted to the Building Inspector wit[ 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 mist be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throug1iout 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 IIEREBY 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. INZW .(Signature.of. applicant,.or. name, if•a corporation)- rM��Cia�gaan.ctiaz�r4�iai;�y w�S of.applicant).....--...•-..-- 3 State whether applicant is owner ibu�lect, engineer, general contractor, electrician, plut)er or builder. ....................... .... hIL'I... ........................................... ......... $ � Nameof owner of premi e's�. .�... `.�..� . ................................................................ (as on the-tat riill.or'latest deed) a �I If applicant is a corporation, signatire.:of._duly•"authorized officer. ........................... (Name and title of coiiorareoffi'cer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. Other Trade's License No. .................... I. Iocation of land on which proposed work will be done......1.....................�1........ ....... ................................. 1 ' ............................................................... house Number Street Hamlet County Tax Map No. 1000 Section .... ...... Block .......!.�...... 10. ......Z....... Subdivision ..................:pt................ Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of/pjr'amises and .tended.�occupancy of posed construction: a. Existing use and occupancy ... ...... ... ... � ................... b. Intended use and occupancy ............................................ 5.� r, ....................... 3. Nature of work (clk-ck vhicli applicable): New lkjilding .......... Addition .... ,,All 'eraLj.Qn ...... Repa i r ............ Removal ............. Demolition. ............ Other Work (Description) 4. Estimated Cost ......................... fee .............................................. (to be paid on filing this application) 5. If dwelling, mid)er of dwelling units ...... ----- fbiber of Ao-Aling units on each floor ................ IFgarage, rxmb-eer of cars ...................................... G. If business, comnercial or mixed occupancy, specify nature and extent: of eadi type of use.CLO.4..... . 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 .................... 11eight .................... Ainber of Stories ............... 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Iie Wit ......................... Number of Stories ..................... 9- Size of lot: Front .................... Rear ..................... Depth ..................... 10. Da-te 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: ........................ 13. Will lot be regraded .................... Will excess fill be removed from premises: YES NO 14. Names of Owner of premises ........................... Address .............................. Plxxie No. .............. Name of Architect .................................... Address .............................. Plxx-&-- No. .............. Name of Contractor ................................... Address ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * W!.S .......... No .......... *lF YES, "nal) lum Imsnx-is PERM MAY BE R3QJI1ffM. no'r DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions Fran property lines. Give street and block number or description according deecJ, and show street names and indicate iAietlwr interior or corner lot. MINIPUMP ft OCCUPANCY OR USE IS U1141LAWFUL F0W4WW"M$. WITHOUT CERTIFICATE � GV%WW OF OCCUPANCY 2. ROU3, INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Ss DESIGN OR CONSTRUCTION ERRORS QAJNIY Or ......... . . I" • . •. . . � ....being (Itily sworn, deposes allKI says that' he is the applicant: (Mine of individual. signing contract) aIx-jve named, lk- is due ....................... . ............................................................... (Contractor, agent,-corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to nuke and file this application; that all statements contained in this application are tnx, to the best of his knowledge aim] 1)61.ief; arx] that die work will be performed in the iminix--r forth in the application filed therewith. .%x)rn to before me this ...............M. ..... Notary Pm is ...... .UY011t .... ..... ....... ... CILS (Sigmit.�jre�i'Appl.i cant) . .. .. 01kc0�unw C1101*1 in SU"