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HomeMy WebLinkAbout12907-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12993 Date November 19 1984 THIS CERTIFIES that the building One family dwelling 12~ Waterview Drive Southol. d Location of Property ~t3t;sb ~o~ ..................... County Tax Map No. 1000 Section .. 9.7.8 ....... Block ... 7 ..... Lot q 7 Subdivision ............................... Flied Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... F. e..b...2. 8. ..........19.8..4 pursuant to which Building Permit No. ~ 2 9 0 7 z dated ...... k4v~.c.b. 6 .............. 198.4. ., 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 ......... .... ~),~.~. f a;a~ 1 Y..d.~ ~ ~ ~/4n g ..................................................... The certificate is issued to JOAN LACAILLE ..................... ?o¥.'o;, (, x'rbf offx ..................... of the aforesaid building. Suffolk County Department of Health Approval .... ~.2. 7 .S.0.-.8. 9. ............................. UNDERWRITERS CERTIFICATE NO ......... Rev. 1/81 Building Inspector I~'OUM' NO. ~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OE THE WORK AUTHORIZED) 12907 Z Permission is hereby granted~to:~ ,__. , / ..c~.~.....~. .~ ............. ~,.~l.,.,..l./..~../... ...... ....... .................... ( ~b,~;~ ~. ' ' ~ ..... at premises located at County Tax Map No. 1000 Section ...,,0~.....~.. ......... Block ........ ~ .......... Lot No ....... I...~.. ............ pursuant to application dated ..~.~<~.....~..~ ............. ~ 19..~...L~.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and sirn~lar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate, Co Fees: 1. Certificate of occupancy $5.00 ! 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vacant'land C.O. $ 5.00 Date ...... '.°Z ,~..~2<~. ......... ,// Vacant Land ~ New Building ............. Old or Pre-existing Building ......................... , ~ Location of Property ................................... House Ho. Street Hamlet ..i' Owner or Owners of Property ..... ;'. ............................ County Tax Map No. 1000 Section ...O.~.~. ....... Block ..... 2 ........ Lot ..... /.'/. ....... . Subdivision ................................. Filed Map No ........... Lot No .............. Permit,o../[~.¢.0.~.~.. Dateof Permit :(~/~...Applicant...~.O.~.© ......... .u.~(.I.~..~'... :~. Health Dept. Approval ~ .Labor Dept. Approval ...... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~...0-~.. ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant.~..~..~ ....................... Rev. 10-1o-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW yORK 10038 .a,e ~o~,~t,,~r 12~ 19a4 .'~pp'ie,.tio.~'o. onS, le ~73~?/~ N 667504 THIS CERTIFIES THAT only the electrica~ equipment as described below and introduced by the applicant named on the above application number in the premises of Jo~n I~c~llle, Wa,t~rview Drive, N/S t~yviow, ~ut;bold, in the following location; [] Basement [] 1st FI. was examlned on l~)V~l~I' ~, 1984 FIXTURE OUTLETS 16 RECEPTACLES 27 [~ 2nd FI. Section Block andSound to be in compliance with the requirements of this Board. Lot SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET FLUORESCENT OTHER APPARATUS: E R NO, OF CC. COND A W.G. PER ~ OF CC. COND V I C E OF NEUTRAL G & S Electric Box 215 Sourly)id, N.Y, 11971 Lic 578 This certificate must not be aitered in any manner; return to the office of the Board if incorrect. Inspectors COpY:FOR BUILDING DEPARTMENT. THISCOPy OFCERTIF!CATE ~O T NOT BE LTERED [N ANY MANNER. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT 10-81-0177 S76 UNDER THE ENVIRON~TAL CONSERVATION LAW FARTICLE 15, (Protection of Water) ~ ~ ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) L_J ARTICLE 36, (Construction in flood Hazard Areas) [PERMIT ISSUED T~ 1 JACK ITALIANO BY ENCONSULTANTS, INC. J ~ADDRESSOEPERMITTEE ~ 7 West Gate Road, Lloyd N.Y. - 64 No. Main Harbor, St., Southampton~ LOCATIONO~""lE~"~g~s~id~,~m, buildng) . North side Waterview Drive~ GOose Creek~ Tax Map Dist. 1000~ Sect. 078,BIA.?,J DESCRIPTIONb~,"OJECT Parcel 17 Construct a one (am. dwelling 40' x 40' in area no greater than 55' east of wes) ern property line an~ '?~' lan~w&ra of ~imal we~±ands or nort~grn por~mon, of par~ Construct sanitarM system, min. of 100' landward of tidal wetlands on northern po-~f6n o~f parcel/a min. of 90' west of eastern propert~ line,and/or 1OO' landw~ of tidal wetlands of Canal. COMMUNITY NA~E (City, Tow~, Villa§e) TOWN Southold, (Bayview) Southold !COUNTY lFIACOMMUNIfYNO. DAMNO. [ Suffolk 1, The permlttee shall file in the office of the appropHa~e Regional 2. The permitted work shall be subJeCt to inspechon by an authorized order the work suspended if the public interest so requires. cepred expressly, by the execution of lhe application, the full legal respon- 4. Any material dredged m the prosecution of the work herein permitted 5. Any material to be deposited or dumped under th~s permit, either in at the Iocahty shown on lhe drawing hereto atlached, and, if so prescribed :hereon, w~thm or behind a good and substanhal bulkhead or bulkheads, such as wall prevent escape of the material into the waterway· 7. Tbat ff future operations by the Stafe of New York require an alteration '5-~.0-4 (9/75) GENERAL CONDITIONS 8. That the State of New York shall in no CaSe be hable for any damage or InlUry to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement oJ nav~gahon, o~ lor other purposes, and no cJa~m or right to 9. That ff the d~splay of hghts arid signals on any work hereby authorized is not otherwise provided for by law, such lights and signals as may be pre- scribed by the United States Coast Guard shah be ir~s~.~Hed a~d maintained iO. All work carrmd out under th~s permit shall be performed i~ accor- be iust and equ*table. If upon the exp~rauon or revocation of th~s permit, the applicant shall, without expense to the StAte, and to such extent a~d io such site to ~ts former condition. No claim shall he made against the State of New 12. Th~s permit shall not be construed as conveying to the applicant any P~rt 500 of 6 NYCRR (ConstrucUon in Flood ?Iain Areas hawng Special Ftood (SEE REVERSE SIDE) --SP£CIAI~'~ONDITJONS There shall be no distrubance to vegetation or topography a minimum of 45' west of eastern property line and/or 50' landward of the tidal wetland boundary.! The driveway shall be constructed of porous materials. Dwelling shall btibullt on piles 50 c. y. of fill ~ay be utilized for placement of sanitary system. If any decks are Constructed to dwelling they shall b'e placed a minimum of 75' landward of the tidal wetland boundary., Attachments DJL: cg c.c. LAW ENFORCK~ENT U.S.~. C.of E:. PER,HIT ISSUE DATE 7/26/s2 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. , / FOUNDATION 2ND ~ INSULATION FRAMING [ ]~FINAL REMARKS: DATE 76S4802 BUILDING DEPT., INSPECTION [ ] FOUNDATION XST [ ] RouGH 'PLBG~. ]FOUNDATION 2ND [/~/INSULATION [ ] FRAMING [ ]FINAL REMARKS: DATE i ~/~- ~/'~/ INSPECTOR BUILDING DEPT. INSPECTION~ ]FOUNDATION 15T [ ] RouGH pLBG; ] FOUNDATION 2ND [ ] INsuLATION ] FRAMING [ ~-]/FI NAL REMA DATE: INSPECTOR ,, ~ ~C FIELD INS?ECTION FOUNDATION (1st) FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: Examined...~ .°4t...c~.~..~...., 19~t.j. Approved . .~....O..&. & 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19~.t{. Permit No.}.~.~ .O.~. ~-... Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 [his 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 necessary~pections. · .*.,Tt~ d,~../3zez~...~.v. ~. ~. O.~e. ~.c ....... (Signature of applicant, or name, if a corporation) · ~.o&.o.~.,~.&..~....~....5'~Y-//~hO.././.Y7/ (Mailing addressg)f applicant) State Whetlier applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ~5. ~.~.~ .o.~ .~.. ............................................................................. Name of owner of premises . .~.~/~1 lt..J ...... .~.~'~.Z~ ./Z.~.~. .............. [ ............................ (as on the tax roll or latest deed) If appl~o~pora~ttio~duly authorized officer. (Name and title of corporate officer) Builder's License No .... /O?//. ................. Plumber's License No.'/~)14~.~...~...~. Electrician's License No.~,/b/~..~.~L~..~ Other Trade's License No...~J/.A ............... 1. Location of land on which proposed work will be done .................................................. ...... t ..o2 .o..~. ............. ~.~. ~z~...z>~...~..~. ............ ~,C~v~. ~ .................. House Number Street Hamlet County Tax Map No. 1000 Section .... .~..74~. ....... Block .... iZ ........... Lot... ~.Z ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... /z/t~./~.. ~.. ................................................... b. Intended use and occupancy ..... ~)AY.~. '.~-.~.g. ~q.~4/~:~.~,.~,,;~ ....................... / 3. Natureofwork (check which ap'plicable): New Building .... ~.....'Addition .......... Alteration .......... Repair .............. RemOval ............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost .~'(~r~- ~ .... , ...................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling hnits ............... 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...............Nu~berofStories.· ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ~.. Height ...................... Number of Stones ............ ~.../~ ...... 8. Dimensions ofeptlre new construction: Front .... ~ ........ Rear ... ~. ........ Depth ,-,~..'~..~ ........ Height .. ,,~. ......... Number of Stones ....... ,~. ...... ~, ................................ 9. Size of lot' Front ,d.O~ ~ . Rear ./.~. ~ . De,,th ~.~,.,o/) ....... 10. Date of Purchase .............................. Name of Former Owner ............................. 11. Zone or use district in which promises are situated .................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... t-JP ......................... 13. Will lot be regraded ......... !A? .......... Will excess fill be removed from premises: Yes )~ No 14. Name of Owner of premises ..., ................ Address ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ..,~a~,~.,~.~ 3~-,~d.. ~d//~.~Address ff, O~O~ ...... Phone No. ~&.~?r .,'~-. ~. .... Locate clearly and distinctly all property lines. Give street and block interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, iS'S COUNTY OF .... ............. x.f~.-~ ~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~ (~ntracto r, 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 conffdned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne? set forth in the application filed therewith. Sworn to before me this ................. c~.o~....day o~ ...... Nora .fy Public ............... i. ~'q~.._.~...d'..~... County (Signature of applicant) ~b. Iii . zo W < I; 0 0