HomeMy WebLinkAbout8217-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No z-22897
Date MARCH 11, 1994
THIS CERTIFIES that the building
Location of Property 150 SUNSET WAY
House No.
County Tax Map NO. 1000 Section 91
Subdivision
ADDITION
SOuTuOLD, N.Y.
Street Hamlet
Block ! Lot 5
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 30, 1975 .pursuant to which
Building Permit No. 8217-Z dated SEPTEMBER 30, 1975
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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to GRA~ FIORE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
Buildin~ ~nspe~or
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, iq. Y,
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 8217 Z
Permission is hereby granted to:
........................ ~.u.,..~.~.o.,~a. .....................................
at premises located at ...... ,~f~.ts...1. Y.8..&...L~9.....geda~..~leael~..Park.: ......................................
.................................................... .S....~....s..e.. ,¢...~..a.3r.~.....~..o.~..~:~p.:L.~,..... ~....~.:. ...........................................
pursuant to application dated .......................... .~..~.~..~......3.0. .......... , 19~.~'...., and approved by the
Building Inspector.
Fee $.....~..~.~...0~.. .......
Building inspector
TOk'i~ OF $OU'~HOLD
765-1B02
APPLICATIOL' FOP, CERTIFICATE OF OCCUPANCY
This application must be filled in by'.rype~ri~er OR !tO; a;~d ~ub~ll~d ~o the bulld~ng
~ncP~¢~oY wiuh th~ followit~g: for ne~ building or new use~ ~
I. Final survey of property wi~h accurate location of all buildings, property lines,'
~ s~rmets~ and unusual natural or t~pographlc features,
2, Final Approval from {}~ait]: ]3e~,. of wa~er mu ~.
3. PP~ and ~ewarags-di~posal(S_9 f6rm)
~or existing building, (prior cc April 9, 1957) nond6on~orm~ng , '
'~re-existing" Land uses: - uses, or buildings and
2, 'A properly completed applica~on and a con,sent ~o ,Anapest siSuad by ~he applicant'.
If a Certificate of occupancy ~ denied, ~he Bull~ing Inspector shall ata~e the
rea~on~ therefor in wYi~i~g '2c ghe apPlican~;
Fee&
1. Cer~lfioa~ of Occupancy - N~v d~e!l'ing $~$.00, Add!tio!~s ~o dwa~lll~g $25.00,
Alterations to dwelling $25,00. Swzm~lng pool $25.00, Accessory building $25.00,
Additions to accessory bulldin~ $25.00. Businesses $50.00.
2. C~rtificate'of Occupenay on Yre~exiszing ~u!lding - $100.00
,3, Copy of C~rtificste of Occupancy . $5,00 over 5 years - $i0.00
4. Updated Cer~tficage of Occupancy _ $50,00
5. Temporary G~r~ifl~ate of Oacupaney - Residential $15.00, Commercial $15.O0
S~orn snaaement from plumbs- ~a -~
less :nm; 2/10 of I% le~d."' · 'r-~}ing that ~he ~old~r used in syscom conuain~
Co'~mer-=z~ 3u£1dlng, indus~ria_ building, mul¢iple residene~ and similar bulld~$
a~d las~&,~a~ions, m ~or¢ifica~e of Code Complia/~fie from rchz~eet or engineer
respons!3:¢ for 5he building. , , a "
Subm%~ PAsturing Bo~rd Approval of'completed si~e plan r~qui~men~.
)aaEion oE ?roper~v .... . ..... ,.,.. ......., .......
llouse No. , ...... ~, ...... cC~
S~reet Hamlet
.................
............... .Da~ Of Par~l~ .......
......... Applicao~ ......
' ' ......... ' ................ Und~rwri=~rs Approval
~nntn~ Board .........................
Approval
for: Temporary Cart_flaate ........... Piaal Oe~ctca~ ...........
APPLICANT
FOP~M NO. 5
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLDr, N. Y.
ORDER TO REMEDY VIOLATION
TO Stephen Bu~gio
(owner or authorized agent of owner)
(address of owne'r or authorized agent of owner)
Southold N.Y.
PLEASE TAKE NOTICE there exists a violation of:
10 ~00- 2
Zoning Ordinance iZ't IZI.....;~.e.g.....1..0..Q'..~.O.....q...~2$ a &100-3~ &
Other AppJicabJe Laws, Ordinances or Regulations ...,,~..~'.,.~......~...V....~?...~....~J..0..0..~..?)+1
et premises hereinafter described in that ..,~'~..~:J,:~l.~,j~ .pO.q], ~k~ ~ ~¢...$~..~p~t yard
(stete chorecter of violetion)
area and Fence erected without permit or vari~ce.
in violation of .~..¢....~..~...~..e.~....1..O...O..-.3.0. r...q...(2)a & 100-32 & 1.0...0,-3F & Art XIV ses 100-1)+1
(State section or paragraph of' o~
Southotd
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned forthwith on or before the ............. ~.Q ...............
day of ....................... ~.1~. ..................... , 19..~.~..
The premises to which this ORDER TO REMEDY VIOLATION refers are situated at
So~thold
J~.~J~.e..'l;;...WfL~....(.~..~.t~...~.),..~....g.~..8.,~.~...~.~.~...~ of Suffolk, New York.
Failure to remedy the conditions aforesaid and to comply with the applicable provisions of low
may constitute an offense punishable by fine or imprisonment or both.
Building Inspector/
TOWN OF SOUTItOLD
Building Inspector's Office
Town Clerk Building
5outhold, N.Y. 765-,2660
~~/~ ¢' C
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no. ~q~ issued to
on ~!~!~ for ~' ~d~;~o~ o~-~o (~¢Jl,'~ '~... is completed and
a final %nspec-tion has ( ) has not ( '~ been done.
In order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out the
enclosed f~rm, return same to the above office with a check
for ~ payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very truly you~,
Victor Lessard
Executive Administrator
VL:
encl .
TOWN OF SOUTHOLD 2 --
BUILDING DEPARTMENT
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Ao
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
?prelexisting" 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
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 Buildinm - $100.00
$. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
j' Date .........................
NeWLocationCOnstructiOnof Pro~ert~, ........... ~/Z9 ~f)~ Old Or Pre-existing~l .~.~m..,~.Building~l~-- ........... ' 'x~' .~..~..~..~?~ ~'''
House No. Street Hamlet
Onwer or Owners of Property .................................................. , ............. .. .
County Tax Map No 1000, Section .... .~../. ..... Block .... ./. .......... Lot....~.. ................
Subdivision .................................... Filed Map ............ Lot ......................
~/7. '~.. . .~. ~?.~.~/.~...~. App li
Permit No ........ Date Of Permit.. cant .............................
Health Dept. Approval .......................... Underwriters Approval .........
Planning Board Approval ................... .....
Request for: Temporary Certificate .... ''.'''. Final Certicate ...........
Fee Submitted: $ .~-2.: ......................
Diml~proved a/~ ...... ~ -- ~
b. Plat plan showing location of lot ofld of buit~blg~ on premi.~,.relation~ip t.o. Odjoming premises ~'.., .l~b~' _~l~., M~ :
areas, and giving a detailed description of layout oflIK~oflY must be drawn on the dmgmm wh~ is Im~ M
d. Upon approval of this apflllcMian, the Buikl~ Imp~ctor wm roue a uulmmg yermit to tt~ aI~IlCg~I~
shall be kept on the premises available for Impection-fheough~. the work. ....
e. No building shaU be occupied or used in whole or In part tor any puq~se WhaTever until a ~l~ m ~ ~
shall have ~ g~t~d by the Building Inspector. ;-
APPLICATIC~ IS HEREBY/v~DE to th~ ~ulidlng Depar~rnant for the i~uance of a Bul .kl~. Pen~lt ~ to thel~
Building Zone Ofdlnanca of the Town of Sauth~. ._,. surfak Co~m-ty, New,York, and ?t~r.al~dlc~ble ~., ~ o.r~
Tl~e applicant, agrees to comply with all applicable lawl, erdinancel, building cede, ham ng eaae, cma mgum~am,
admit authonzed inspactor~ on premises ~ irt buildingl for necamary impactlam.
(Signature of applicant, or name, if o corporation)
So tho3.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .......... -~.]3~ ........... ~l~Cl~q ..............................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ........ ~T~0D~'~LG ...........................
Plumber's License No. ................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
Location of land on which p~ work will be done. Map No.: ..... .~.e.~.~.~...~...e..q.~..~.,.?..~.. Lot No..1...~..~....~....1...~.?...
Street and Number ............... ~....l~...~..e..~;....le..~. ........... .~.~1,1~,~1, .............................................................................
~l~llly
State existing use and occupancy of premises and intended use and occupancy of prepaid camtm~lon:
a. Exlslting use And occupancy .....,1~e.~.~:).~ .......................... ~ .......................................................................... ~..
b. Intended use and occupancy .......... ".. ....... ... ..V..~..'i~.......&fl..~l.~,.'J;.[g,~,. . ................................................................... =
Nature of work (check which applicable): New Building., ................. Addition ..~ ........ Alteration .......... ~.~.,.
Repair .................. Removal .................Demolition..; ................. Other Work .................................. :...~ ..............
(Description)
4. Estimated Cost ....................... z~,~.~.(~.~...~ .................... Fee ...~.~..~.~ ...........................................................................
(to be paid on filing this, application)
5. If dwelling, number of dwelling units ....... .o...Z~... .............. Number of chvelling units an each flbor ............................
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 ........ ~1.~. ............... Depth ,..J.3. ..............
Height .................... Number of Stories ........ oz;Le ......................................................................................................
9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................
10. Dote of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are situated ..~A?...cl:LS~ ...............................................................................
12 Does proposed construction violate any zoning law, ordinance or regulation: ....... Jl.~. ...........................................
13. W~II lot be regraded ..... ~ ...... ; ........... ~ill excess fill be removed from premises: ( ) Yes ( ) No
Name of Owner of premises ..... ~.~ll~e~..~,~ ..... ff..~ .... Address ~g~,~t,~ ......... Phone No. .....................
14.
Name of Architect .~'~...'~J~,.....~. ....... .~......~... ..................... Address ~.,A,~.~../.,..D...~.......~...~..~.:. Phone No.
Nome of Contractor ........ ..~..'......~.IR, O.~,~P.. ........................... Address ..... ,~.,o~.~..b...o...]:.g ....... Phone No.
PLOT DIAGRAM
~ Locate clearly and distinctly all buildings, whether e. xis. ting or pr..~osed, and indi~;ate all set-hack dimer~ions franl
property lines. Give street and block number or descnphon according to deed, and show street names and indicatd
whether interior or corner lot.
STATE OF NEW_YO,~.K... ' ~ ¢ c
F i~ll~:L-O I le ~ ~
COUNTY O ................................ I '
/
......................... ~O...]:~.......~...a.~..O~.~.~ .......................................... being duly sworn, deposes and soys that he is the applicarh
(Name of individual signing contraclO
above named.
He is the ..................................... ~!3.;J.,~1~1~ ...........................................................................................................................
(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 hi~ 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
Se f,
....................... day of ......................... .~. ................ , 19..~""-'~ / ) / ,'
Notary Public, ...................... ..~.~..J.~ ...... County ~~.~-;~.... ...........................
~ 0_' / ~'~ ~r ) r~ //~'~/ / '(Sl~(ature of applicant}
~H ANN NEVILLE --/ '
NOTARY PUBtIC, State of New york I
No, $2,$175850, Suffolk iC~9_~ :