HomeMy WebLinkAbout28689-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29093 Date: 11/22/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 29315 MAIN RD ORIENT
(HOUSE NO.) (STREET) (HAMLET)
Co~u%ty Ta~[ Map No. 473889 Section 13 Block 2 Lot 4
Subdivision
Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 26, 2002 pursuant to which
Building Permit No. 28689-Z dated AUGUST 26, 2002
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 TWO CAR GARAGE AS APPLIED FOR.
The certificate is issued to VALLO BENJANIN
of the aforesaid building.
( OWNER )
SUFFOLK COUIqTYDEPARTMENTOFH]~ALTHia_PPROVkL
ELEC/~IICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION
Rev. 1/81
N/A
1078121 09/11/02
N/A
A'utho;~ Si~atu~e
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28689 Z Date AUGUST 26, 2002
Permission is hereby granted to:
VALLO BENJAMIN
530 1ST AVENUE -SUITE 7W
NEW YORK,NY 10016
for :
CONSTRUCTION OF AN ACCESSORY TWO CAR GARAGE AS APPLIED FOR. THIS
PERMIT REPLACES BP#26168.
at premises located at 29315 MAIN RD ORIENT
County Tax Map No. 473889 Section 013 Block 0002 Lot No. 004
pursuant to application dated AUGUST 26, 2002 and approved by the
Building Inspector to expire on FEBRUARY 26, 2004.
Fee $ 195.00
Autho zed Sign~fture
ORIGINAL
Rev. 5/8/02
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. 26168 Z Date NOVEMBER 18, 1999
Permission is hereby granted to:
for :
VALLO BENJAMIN
29315 MAIN RD
ORIENT~NY 11957
CONSTRUCTION OF AN ACCESSORY TWO CAR GARAGE AS APPLIED FOR.
at premises located at 29315 MAIN RD
County Tax Map No. 473889 Section 013
pursuant to application dated OCTOBER
Building Inspector.
ORIENT
Block 0002 Lot No. 004
28 99 and approved by the
Fee $ 115.00
uthori e~Signature
COPY
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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 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:
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 - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. ~'-7- C)_..~
New Construction: '"---,3
Location of Property: ~
Houset"~qo. Street
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section \
Subdivision ..3-o.l-xa.x~ ~
PermitNo. ~c6Tzg~t~ O~ DateofPermit.
Health Dept. Approval:
Planning Board Approval:
Old or Pre-existing Building:
(check one)
Filed Map. Lot:
Applicant:
Hamlet
Request for: Temporary Certificate
Fee Submitted: $ ~_~"~. ~
Underwriters Approval:
Final Certificate."~ ~ (check'on)
Applicant S~ature
;--BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY
~ 40 FULTON STREET ~ NEW YORk, NY 1OO38
~. CERTIFIES THAT
g_.Upon the application of upon premises owned by
g--B.J. ELEC. CO. VALe BENJAMIN
· .BOX 16 ROUTE 25
-- STILLWATER AVENUE ORIENT, NY 11957
~ CUTCHOGUE, NY 11935,
~ Located at ROUTE 25 ORIENT, NY 11957
~ Application Number: 1078121 Certificate Number: 1078121
~ Section: Block: Lot: Building Permit: BDC: NS11
~ Described as a Residential occupancy, wherein the premises electrical system consisting
~ electrical devices and wiring, described below, located in/on the premises at:
~ STORAGE BOX, Detached Garage, Outside,
~ was inspected in accordance with the Nadonal Flectdcal Code and the detail of the installation, as set forth below, was
~ found to be in compliance therewith on the 1 lth Day of September, 2002.
Name QTY Rathe Ratinff Circuit Type
Appliances and Accessories
Electric Heater Unit 1 30
Wiring and Devices
Outlet 10 Fixture
Receptacle 11 General Purpose
Switch 10 General Purpose
Fixture 4 Incandescent
Fixture 6 Fluorescent
Dimmers 1 600
Receptacle 2 GFCI
Lighting track 24
Service
1 Phase 3W Service Rating 100 Amperes
Service Disconnect: i 100 CB
Meters: I
seal
I of l
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated,
BUILDING PERMIT REVIEW CHECK LIST
Applicant/ * , Date
Owllers Name: '~/to,, l lO lt~th I OCqtt(h Reviewed:
Architect/ Date
Engineer: Submitted:
SCTM #:
District: 1,000 Section: I ~ Block: e~ Lot:
Location.
Subdivision
Name:
Single & separate Required
cerOfication: (Yes / No)
Req Req.
Zoning Dis~ict: [Lol size: Actual ] [Lot coverage __ Proposed:__
Req Req. Req.
[Fronl Yard -- Proposed: ] [Side Yard Proposed: ] [Rear Yard __ Proposed:__
Project Description:
AGENCY PERMITS
REQUIRED FOR REVIEW
Suffolk County Health Dept.
New York State D.E.C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
Permit
N.A. NO YES Number
Notes:
[///~ F~NDATION 1ST [ ] RQUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ]FINAL
] FIREPLACE & CHIMNEY
REMARKS: ~
- /1/"
I /'[
INSPE~
765-1802
BUILDING DEPT.
[ ] FRAMING [ ] FINAL
] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] F~DATION 2ND [ ]INSULATION
/
[/~FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]./~JNDATION2ND [ ] INSULATION
[~/]' FRAMING [ ] FINAL
[ ] FIREPLACE & CH~I,~EY
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 'IST [ ] ROUGH PLBG.
i:
.D INSPECTION REPORT DATE
COP~IENTS
IDATION (IST)
'~IDAT I ON (~ND) , c~ ~
ADDITIONAL COF~IENTS:
FORHNO. I
TOWN OF SOUTHOLU
BUILDING DEPARTHENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL: 765-1802
BOARD OF HEALTH ...............
~ SETS OF PLANS .... ' ....
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
CALL ..................
Disapproved a/c ..................................
(Building I~tor)
APPLICATION FOR BUILDING PERHIT
INSTRUCTIONS
HAIL TO: ...................
a. This application mst be ¢~m&letely filled in by tyl~rciter or in ink and sul~itted to the Building Inspector
3 sets of plmm, aecttrate plot plan to scale. Fee according to schedule.
b. Hot plan aborting location of lot and of I~ildings tm premises, relatioaship to adjoining praises or Ix:blic
streets or areas, and giving a detailed descripcitm of layout of property trust be drama on the diagram ~hida is pan of
this application.
c. The work co,red by this applleation rmy not be cmmmced before ism of Building Penuit.
d. Upon appxa:~l of this application, the Building Inspector will issue a Building Pemit to the applicant.
pamit shall he kept on the prmfiaes available for inspaetion throughout the work.
e. Ro Imildi~g shall be occupied or um'd in ~hole or in part for any purpose ~natever tmtil a Certificate of
Occupancy shall ha~ been granted by the Building hml~tor.
APPLICATIC[~ IS ~ ~ to the Building Departm~t for the iasumme of a Building Permit pursuant to the
Building Z~ae Ordm of the Toim of Southold, Suffolk Cotmty, Ne~ York, and other applicable La~s, Ordinmaees or
Regulations, for the construetio~ of Imildln~, additions or alterations, or for removal or a~mlition, as herein
described. The applicant agrees to ec,~ly with all applicable l~m, ordimmee$, building code, housing code, and
regulations, and to ~it authorized inspaetors tm premises and in Imilding for neeessa~ inspsctlorm.
(Signature o ration)
· r"~ ............ /' ....... : ..................
(I~ailing ~da,-ens of applicant)
State ~hether applicant i$ mr, leesee, agent, architect, englseer,~ ctmt~ electrician, ph~her or Imil&
~ of o~mer of pn~tisc8 .............................
(as on the tax roll or late~t deed)
If applic~t i$ a corporatim, signature of duly anthorized officer.
(Nare and title of onrporate officer)
Builders License No .........................
Plumbers Lit~x~e Ilo ..........................
Eleetriciaan License No ......................
Other Trade's License No ......................
1. Locatitm of land tm ~hich proposed work vi11 be dane ...........................
......................... a
......... ..................... ...... .............................
ttonse l~mber Street Nailer
c~ T~ No. ,ooo ~ion ..... l...°. ...... Bio~ ..~.. ....... Lot ..~..V. ........
Subdivision ...................................... Piled liap No ................ Lot ...............
2. State existing use and oeo .mm~ey of premises and intended ~se ~ occupancy of prolaoeed constmctitm:
a. ~t~ng u~ ~ o~.--~ ...~ ........ ':..~.i~J.~.....~..~:/~/ .... l~d.~ ........
3. Nature of ~rk (check *ldch applicable): Ne~ Building .......... ~ddition .......... Alteration ..........
Repair ............ Rem,~ral ............. Demolition ............ Other
OO (Description)
~0,~.
4. Estimated Cost .i~...i ................... fee ..............................................
(to be paid on filing this application)
5. If d~elling, r~ber of d~elling onits ..... ~.'~..... lim~er of d~elling traits on each flonr ...--~. ............
6. If l~lsieess, c~mn~rclal or mixed occupancy, specify ns~ure and extent of each type of use ......................
?. Dirrensions of existing structures, if any: Front ................ Rear ............... Depth .................
Baight .......................... N~ber of Stories ......................
Dimensions of sa~ structure with alterations or additions: Front ............... Rear ...............
Depth .................... ltelght .................... lxl~ber of Stories ...............
8.oimensi~ of e,ti~ ~ ~st~tion: Mt ..~..0..' ........ ~ar ..~.O..~ ....... ~ ..~. ..........
,~i~t ....... ~..O.:. ............ ~,~r of Stories ..J. .................
s. si~ of lot: ~t ..S.4..~....~.t.~..~ ..... Rear .................... De~th ....................
I0. Bate of Purchase ..................... ltare of Former O~eer ........................................
II. Zone or use district in ~hich premises are situated ...~...°..:7...1~...~.?. ........................................
~z.~nss ~opo~ onnst~tion ~io~at~ a.y ~oning ~,, orai~e o~ ~lation: . ~.%~...eP.e!°...~...
13. 14ill lot be mgrmied . ....~O~P.. ............ t/ill e~eese fill he ~,~-d frran premises: YES lid
~. ~s of 0~er of e,'~ases. .. .~1~.2..~.:9.... aaaress .............................. eho~ ~o. ~..~-~.... ........
ltame of Architect .................. , ................. address .............................. Paoee 1to ..............
p~ulmrty within 300 feet of a tidal ~etland? * 'i~ V'~
15. Is this ....................
PLOT DIAGRAH
Locate clearly and distinctly all buildings, ~daether existing or proposed, and indicate all set-back dimensions
pro~rty lines, gi~e street and block r~ber or description scconling to deed, ~ sho~ street hanes and indicate
~ahether interior or corner lot.
deposes and says that be is tha applicant
f said r~r~r or ~mers, and is duly authorized to perform or have perfon~l the said ~ork md to rmke and file this
pplication; that all statements contained in this appl. lcatlon are true to the best of his knc~ledge and beliefi and
bat the ~ork wltl be performed in tie manner set forth in the application filed therewith.
Commission Expires Dec. 8,
iEO0 ~
:zy~o ~ O,c..
~ t~',~ B '-o " x ~,; q "
~ ~ 0~1 ~0~ ~
O ¥ -o
Fax:S16-4T/-2489 Ma~ 8 '98 15:42 P. 0'3
APPROVED AS t~OTED
DATE' ~[ ~'~/qq B.P# c~(~l~ '~
FEE: 'Il:'~ BY: ?' ~'~~'~''-- '
NOTIFY BUILDING D~ARTM~T AT
765-1802 9 AM TO 4 PM F~ THE
FOL~WlNG INSPECTIONS:
1 FOUNDATION - ~O REQUIRED
FOR ~URED CONCR~E
2. ROUGH - FRAMING & PLUMBING
3. INSU~ON
4. FINAL - CONSTRUCTION MUST
BE COMP~E FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRU~ION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRU~ON ERRORS
UND~ITERS CERTIFICATE
REQUIRED
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
SURVEY OF PROPERTY
SITUA TED A T
ORIENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-13-02-04
SCALE 1"=40'
AUGUST 14, 1998
SEPTEMBER 8, 1999 ADDED PROPOSED GARAGE
AREA = 132,261.84 sq. fi.
(TO TIE LINE) 3,036 ac.
N,Y,S. Lic. No. 49668
Joseph A. Ingegno
Land Surveyor
~HONE (516)727-2090 Fox (516)722-5093
THE EXISTENCE OF RIGHT OF WAYS
98-437A