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HomeMy WebLinkAbout16655-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18914 Date MARCH 23, 1990 THIS CERTIFIES that the building Location of Property 4250 BREAKWATER RD. House No. County Tax Map No. 1000 Section 106 RENOVATION & REPAIR MATTITUCK, N.Y. Street Hamlet Block 09 Lot 001 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 27, 1987 pursuant to which Building Permit No. 16655-Z dated NOVEMBER 30, 1987 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 RENOVATE & REPAIR EXISTING SUMMER DWELLING AS APPLIED FOR. The certificate is issued to GUSSIE CANNONE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-092242 - SEPTEMBER 18, 1989 ~ilding Inspector Rev. 1/81 FOB~ NO. B 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) No_ 166 ,,5 Z Date ...~-~....J~... ........................ ~ , 19..~..~ Permission is hereby granted to: at premises located at ...................... ~.~ ................... ~.~i~-'~.... ............... County Tax Map No. 1000 Section ...... /...~...~. ....... Block ...... .{~..CJ. ........ Lot No...~..~.L .............. pursuant to application dated .... ~..~.~......'~....~. .......... , Jg..~.?.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPART~IENT TOWN HALL SOUT~OLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY, DATE ................. NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING. -VACANT LAND ........ Location of Property .~.Z~'O /~~/~.~ ~ ' ' ............ Filed Hap ..... Lot Health Dept. Approval ......... ......... Underwriters Approval Planning Board Approval Request for Temporary Certificate ....... Final Certificate Fee Submitted: $ .................... APPLICANT rev. 10/14/88 ~-,~-~, ~- 3 ~1~.3 co ¢_.- I ?q~¢ ~v~ 10/14/88 FOP~ NO. 6 TOWN OF SOU~OLD BUILDING DEP/h~THENT TOWN HALL 765- 1802 · APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be filed in typewriter OR ink and submilt~ed to the Building Inspector with the following; for new buildings or new Use: ;i . I. Final survey of property with accurate location of all buiildings, property lines, streets, and unusual natural or topographic features. ! . 2. Final approval of Health Dept. o.f water supply and .Sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fzre Und 4. grwriters. . , Sworn statement from plumber certifying that solder used ii system contains less than 2/I0 of IZ lead. $. Commercial buildings, industrlal buildings, multiple reszdhnces and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings {Prior to April 9, 19573 n . ou-conform~ng uses, or buildings sod "Pre-existing" laed uses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A 4~roperly completed application, a consent to inspect szgned by the applicant and a C. ertified abstract of title issued by a title COmp~n~ which shall o a r z t o prior to April 9, 1957. · i P e e 1 i g Inspector shall state the reasons therefor in writing to the applicant. 3. Date of amy housing code or safety inspection of buildings lo: premises, or other pertinent information required to prepare a certificate. For Vacant Land 'Certificate of Occupancy: ]. An application for vacant land Certificate of Occupancy shai'll be submitted, and a certified abstract of title issued by a title cOmpanyI showing Single and separate ownership of the entire lot prior to April 9, 1957! shall also accompany the application. If a Certificate of Occupancy is denied, ,the Building Inspector shall state the reasons therefor in w~riting to the pplzcant. FEES: ~]- CERTIFICATE OF OCCUPANCy - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $~0.00. 2.. Certificate of Occupancy on pre-existing dwelling - $106.00. 3. Copy of Certificate of Occupancy - $5.00 - Over 5 yearsi- 4. Vacant Land Certificate of Occupancy - $20.00 : 5. Updated Certificate of Occupancy - $50.00 6. Temporary Cqrtiflcate of Occupancy ~ ${5.00 Resldeotla $50.00 Commercial TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL $OUTIIOLD, N.Y. 11971 September 29, 1989 TEL. 765-1E02 GUSSIE CANNONE 4250 BREAKWATER RD. I~,ATTIT1JCK, N.Y. 11952 To Whom 5h15 May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /_ An application for Certificate of Occupancy is ~ot on file. (ENCLOSED) ~Zf~, //_~/ NO Underwriters Cc. rtificate on file. "~ ._ The check i:;~m~.~ot ou file.) $25.00 ~/-~' /'_-/ No Health Dept. Approval on file:, /-_'/ No final inspection has been made. Please contact our office on Thank you for your cooperation. Hnilding Perm[i: I} 1 6 6 5 5 Building Dept. this matter. Z tlc] Plumber .~oldcr Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION FOUNDATION (1st) (2nd) ROUGH FRAME & ,PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMME 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL DATE ~,/~/~/~ /V INSPECTOR 11 3511,2 /)ate THIS CERTIFIES THAT THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8E JOHN STREET, NEW YORK, NEW YORK 10038 $i~iPT~714BE~ '18, '1989 Application No. onfile 57396188/88 I~I 092142 PACg 1 o~~equiprnent as described belmv and introduced by the applicant named on the above application number in the premises of TIIO14AS M~R$1CANO, BR.~liJ4ATii~ ,W?I~L,, POL~/13~ ~I~TTUCK~ in the followlag {ocatlon~ ~ Base.eat ~ Ist Fl. ~ 2nd FL Section Bilk Lot ~s examined on and found to be in compliance a'ith the requlre.~ents qf this Board FIXTURE ~E FIXTURES RANGES :~KINGDECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS CEPTACLES SWITCHES FLU~ESCENT OTHER DRYERS ~RNACE MOTORS FUTURE A~UANCE ~EDERS TIMECLOCKS DIMMERS MULTI-OUTLET SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: hl)I)ITTOt~I-- t TRAC~ Li£(,H l NO, OF CC, COND A W G, NO, OF HI-[~G A W G, NO, OF NEUTRAl A. W G, PER ~' OF CC, COND OF HI-LEG OF N~UYRAL SAGE & GADIgMANN INC. P.O.BOX 1768 not GENERAL MANAGER Per ~n manner; return to of the Board if BUILDING DEPA THIS COPY OF -: ALTERED IN ANY MANHER. ~U°uu~D ~/~'snD , Z,9 '.g'z/ :,. Examined..~.~.. ~v¢., 19 .t? 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . .~.~ ·., 19 Permit No. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH .~... 3 SETS 0~ PLANS ....... SURVEY .......... ~' SEPTIC FORM · NOTIFY CALL MAIL TO: 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, ,b~ildiog code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessar~nsl~ect~s. ~O ~_Cz5 ~{ ~ ~'i ~' e-~ ~[. [~ lt~~ re of e, ifa corporation) Stat, e,,whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.. G.-.~.~.S [ .~?.. C[2} ¥~ I'~. '.~..~ ~-___ ...... (as on the tax roll or latest deed) Ifi '~:n~a cj~ration, signature o f duly a~ized officer. (Name~id title of corporate officer) - ~L CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED 'Builder's License No../. ~ O ~) '~'_.~.2 ...... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ....................... Location of land. on which proposed work.will be done~..~ ~-J .~.~..~ ............................ ......... .................. House Number Street Hamlet County Tax Map No. 1000 Section,, . · ·/6.)~? .......... Block..~. ~.~. ............ Lot. ~..0./,×~ .......... Subdivision ......... '.~.' ........................ Filed Map No. ~ .......... Lot.../~..- ........ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy...:~/~.~. .... h.~{~)~..' ................................... b. Intended use and occupancy . .~..~. ~ .~...~.C.... ~ .... ..................................... 3. Nature of wo[~(check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair :. ~ ......... Removal .............. Demolition .............. Other Work ............... -1~ (Descriplion) 4. Estimated Cost . /~.t ~ Fee .~.?. ~ · (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling uhits on each floor ................ If garage, number of cars .......................................... ! .............................. 6. If business, commercial or mixed occupancy, specif, l,~jnj~lre~l~d extent of, oea~tj iii]q/of use ......... ,,~. ~.l ....... 7. Dimension. s 9J~existing structures, if any: Front...~.~.~. ~ ..... Rear '.~,ff. ~J?. i.~. ...... Depth ...'~) ........ Height . l~l~.' .......... Number of Stories... I.. .................... i ............. ~, .t. ~ ....... Dimensio~ns 9_frsame structure with alterations or,~dditions: Front '. ~.~.~..~.i~f. ..... Rear. ,..e~...~...t... Depth..~..~'f~. ................. Height.../.~ .................. Nunther bf Stories ..... ',8. Dimensions of entire new construction: Front..~_... Rear i .... ii ........ Depth i .............. Height ............... Nutmber of Stories 9. Size of lot: Front ~. ~.,.2,~. ............. Rear...4.~'!~i i i i i. iiii .~. 'b~i~ ' i~.'e.'~. ~ 10. Date 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: ..!../k~'~. ....................... 13. Will lot be regraded ....... ,~ ...... ' .............. Will excess fill beverlY, ed fronmnzemises: 14. Name of Owner of premises tE.. .%U tXO¢.ddress yes Name of Architect ........................... Address ............. i ......Phone No ................ Name of Contractor ........ ~ ................. Address .... : ........ i ......Phone No ................ 15. Is this property located within 300 feet of a tidal wetland~ ~es ..... No ~..~ ~If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildiflgs, whether existing or proposed, an&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. STATE O F NEW YJ~J~ Y//~' SS cot./ STY OF ' · ~.. ~,..~ ~ % ~ .............. being duly sworn, deposes and says that he is the applicant (Name ofin~i~dual signing contract) . above named. He is'the ............................... ; .., ~. ...... ,2 :'~ ................... (Contractor, agent, corporate officer,:~.) of said owner or owners, ~d is duly authorized to perform or have perfomned:$h~ ~r~ ~to m~d and file this application; that all statements cqntained h this application are true to the be?t d(~l tis knowledge and b~i~fi and that the work will be perfo~ed in the m~ner set forth in the application filed therewith* Sworn to b~fore m~~ ........................~ ~ ~~dayo ........... ,19~:~( r , Notaw~blic,~~~ County /~ ~ : ,, / ............... N~ PubiC, 8~te ~ N~ Y~ [ ~ (Signature of applicant) ~ No. ~79~05 ~ ~ Ouall[l~ In Suffolk Coun~ ~ Commlssion ~xp~ros Oeoamber 8, 19 ....