HomeMy WebLinkAbout16346-zFORM NO. 4
TOWN OF 80UTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17773
Date FEBRUARY 17~ 1989
THIS CERTIFIES that the building.
Location of Property 2100 BUNGALOW IJLNE
House No. Street
County Tax Map No. 1000 Section 123 Block 8
Subdivision Filed Map No.
ADDITION
MATTITUCK, N.Y.
Hamlet
Lot 15
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 11, 1987 pursuant to which
Building Permit No. 16346-Z dated AUGUST 19~ 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 DECK & 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to MIC~2IEL & GEORGENE SHANAHAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HFALTH APPROYAL N/A
UNDERWRITERS CERTIFICATE NO. N031641 - SEPT. 6~ 1988
PLUMBERS CERTIFICATION DATED NOV. 10, 1988-LARRY CATALDO #P388
~~ Bui~l~inspector
Rev. 1/81
TOWN OF SO~THOLD
BUiLDiNG DEPAR'FMtq4T
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PEP-u~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Ne_
Permission is hereby granted to:
..."~..?..~...~.~...'7. ............ ~ .....................................
.~.~....~.:.~...,....u~'...~ ..... ~ ,
,o
- ""~ ~, U J
at premises Ioca~ted at ...e~..L~......I/' ~. ~..., ,~, ,.~.. ,,,~.,(~~, .................
counw To~ Mop No. ~000 Sectj~--,~...Z.~..~. ..... B~o~k ...... .~..~. ...... ~o, ~o....1.~ .............
pursuant to application doted .~../eJ=~....~.......J...j ............. , 19.~..~.., and approved by the
Building Inspector.
Fee $,....~...g .......... ....~....
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
E~uilding Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPI
Instructions
A. This application must be filled in typewriter OR ink, and submitted mlaammm 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 features.
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 similar 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 p~operty 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.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificateofoccupancy New Dwelling $25.00, Accessory '$10.00 Business $50.O0
2. Certificate of occupancy on pre-existing dwelling $100. O0
3. Copy of certificate of occupancy $ 5.00, over 5 years $~0.00
4.Vacant Land C.O. $ 20.00 .~ /'~'/P'~
5.Updated C.O. $ 50.00 Date .................
/
NewC°nstt*uc %i°n . ../... O~d or Pre-existing Building ............ Vacant Land ..........
Location of Property ~/;u.s~.N!..°.~.. . . . /~.(~.1~. ,~.'~. . ~. .O. .~, .O . .~.S.tr;~,t.2 . . . .~_~yZ~'~. l. ~?.~. .~. . ~y~n;e.t
Owner or Owners of Property .~.. ! .~ ~, .~..~....~. ..... . .~, .~J.. ....... . ./~. · .dd~. ......
County Tax Map No. 1000 Section .............. Block ............ Lot ...........
Subdivision ................................. Filed Map No ........... Lot No ............
Perm t No' /- -~3.~~ Date of Perm,t ~.~?' ~'/t ~.~..~.~.~.~...~....~. ~..~.~ .....
· ......... ~. ....... Applicant
Health Dept. Approval ........................ Labor Dept. Approval .......................
Underwriters Approval J,~, ¢I%.LG,C.I J ............ Planning Board Approval .....................
Request for Temporary Certificate ..................... Final Certificate ......................
$
Fee Submitted .............................
Construction on above described building and permit ?~L~,3~es and regulations.
Applicant. ~~.L.,..~,, ~ ........................
Rev. 10-10-78
UNDATION ( ls t )
UNDATION (2nd)
UGH FRAME &
PLUMBING
SULATION FERN. Y.
STATE ENERGY
CODE
FINAL
. ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [~NAL
REMARKS~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
~ [~/FRAMING [ ] FINAL
765-1802
BUILDING DEPT,
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [~INSULATION
FRAMING
[ ] FINAL
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [~ROUGH PLBG.
[ ~/~OUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
/-
JEM MECHANICAL ~ ,i LARRY CATALDO
General Contracting ,~r~m~ing & Heating
Douglas McDonald ~~8 8
UC ~t 110eOHI Ji~.l~~atr~$treet
4wagon Way I1~ ~ ~q~nk~hk~a, NY 11779
Ronkonkoma,NY 11779 II1~1 ~ ~ ~0 I~~-~eSe
N~WO ~' ~ - S J
ALL RETURNS MUST gE MADE WITHIN 7 DAYS AND ARE
SUBJECT TO A 2~% STCCKtNG & HANDLING CHARGE
~oot~8 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~ aNN
~te ~pplication ~o. on/lie
THIS CE~IFIES THAT
~., S~ANARAN~ 2't00 PARK AV~, ~A~I[~ ICK, ~.Y.
FIXTUII~ ~IXTUIf~S RANGES OVENS EXHAUST FANS
O(JTLET$ SWITCHES
FURNACE M~I'ORS
S~RVICE m~,t.~iliECT
S R V I C
A. WG+
NEUTRAL
S~I'~I,~Y, MY~ 11967
Per
I~ ~is cedifica, m~t ~t ~ ol~ in any manner; return ~ t~ offke of ~ ~rd if ~orr~. Insets ~y ~ Mt~ W~r/cmdenfials.
. ..................... l------L .... ----______~.
PARK AVENUE
MAP OF
DESCRIBED PROPERTY
SITUATED AT
T TI TUCK
TOWN OF SOUTNOI D
SUFFOLK CO., N.Y.
ARE~. 6, B43 SO F~ (O. IS?l Acres)
,/
ONE STORY
FRAME
HOUSE
52.00'
IV/FLY HANLON
HOG
CER T/FlED TO:
LONG ISLAND MORTGAGE COHP
CHICAGO TITLE INSURANCt- CO
FOR iW/CHAEL SHANAHAN.
seaJand
AJ J. su,rve, ying
~ engineering p.c.
I10 west main street
riverhead, new york 11901
(516) .%69-1717
April 21, 1986
I000- 123-08-15
dob N°- 86-1236
ScoW: 1"=20'
BOARD OF HEALTH .--/,-4~.
3 SETS OF PLANS .......
SURVEY ..........
FORM ............. :
'FORM NO. 1
TOWN OF SOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC
TOWN HALL NOTIFY
$OUTHOLD, N.Y. 11971
TEL.: 765-1802 CALL
MAIL
Exmnined .~ &~.W../.~.., 19g.7.
Approved %s..~..r'../. ~., 19~.7.
Permit No../..~..~...~...~Z.
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
· ¢.~.-...q.J.5.8...
TO:
Date ......... .~/././.. ....19~.' ?.
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 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 b~ occupied or used in whole or in part for any purpose whatever until {~ 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 inspection~sz / ~./~
(Signature of applicant, or name, if a corporation)
...~o..r4.~, ~.~..~..~??.c./..c ........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..... o...w ~.'..~5.. ...............................................................................
Name of owner of premises .../~../.6./..7/.~.~..~.. ~...~...~..¢.d. 0~.e~..p¢.a~....~.:..%(?.~.r~...,~..~./~...7~/... ................. (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of co,orate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
k~' . .........
...~./.o..~ .... .3.~ ~.~.~.o~.~...~O~..,.~ ~ ............ /~/~ ~.~.~. ~.~ ....' ...........
House Number Street Hamlet
County Tax Map No. 1000 Section .... [~ ......... Block ...'. ~ ........... Lot .... ~ 5 ............
Subdivision ..................................... Filed Map No ............... Lot ............... (Name)
State existing use and occupancy of premises and intended use and occui~anc'y of proposed construction:
a. Existing use and occupancy . 3'(~.!.~..o....~:~.,!(/ /~)z~,,/6~Cl,~.~5> w~ ..............................
b. Intendeduseandoccupancy ''5;,~ ~'5 ~'~x~ /
....... , ............ ~c&. ~ .~. ~ ................
3. Nature of work (check which a~plicable): New Building ..... ' ..... Addition Alteration
Repair .............. Removal .............. Demolition Other Work..
(D rip~i )
esc on
4. Estimated Cost ..
(to be paid on filing this application)
5.If dwelling, number of dwelling units...............I Number of dwelling units on each floor ................
If garage, number of cars .... . .....................................................................
6.If business, commercial or mixed occupancy, specify Ilatur¢ and extent of each type c~f use':'. ~ .~. ,
7..Dimensions of existing structures if any Front.. ~...~. .. Rear . ,~ D?pth -~.~ . .
Height Number of Stories ~" [ "' ' 'i '""i"' . '" .' .........
Dnnensmns'o~fsapje structure w~th alterations or additions: Front .... ~...c.3.. ........ Rear .. ~. .............
Depth .... :,~9/. · · 2 ....... !... Height ...................... Number of Stories .... .~. .............
~- 8 Dimensions of entire new construction: Front .... . Rear Depth
Height ............ .~.,,Ngmber, of Stories ......... ~. ....................... ;..,. / .....
9.
Size
of
lot:
Front
.... ~h...~, 7. I ..... ' ...... ; Rear ... ~. ~...( .......... Depth ....z/.~..C~. .............
10. = ......... ................ ·_____°wn;;" ...... , ...............
11. ict in whl~h/ffr~n~ises'ar; situated.. ~.a~. ~f.f.F.~,~.~.r .... ?~i~o....~.~i. ~..
12. Does proposed constructi2~n violate any zoning law, ordinance or regulation: ....B~7.a ............. .; ...........
........ . .
' · .... ........................ ~. ............ Phone No ................
Name of Contractor .. d.~.. '. ................. Address .... : .............. Plione No ................
15. lis this property located!within 300 feet of a tidal wetland? ~Yes ..... No ,,~...
· If yes, Southold Town TrOstees Permit may be required.
PLO-T DIAGRAM
Locate clearly and distinctly ali buildings, whether existing or proposed, and~ 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 OF NEW YORK, S.S
COUNTY OF .................
............................. , .................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ...................... i ...................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, m~d is dul'y 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 his 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
............. L./....., .... dayo~ .... ~ ........... 19 .~.
Note .ry Public .......... ~ County
HELEN IL DE ~OE //?// ~' / / '
NO. 4707878, Suff01kiC0unlYo',~ ............ '(' ¢'~f ....~' ...........
lel'm Expires M*~ch 30, IfL--~ (Signature of applicant)
APPROVED AS NOTFuD
~1I t I
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO ~- PM FOR THE
FOU,OWING INSPECTIONS:
FOUNDATION TWO REQUIRED
FOFI POUI~ED CONCREI'E
ROUGH FRAMING & PLUMBING
3, INSULATIOH
.., REou,.,.,..s o~ ~.~.., OF OCCUPANCY
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
P£UMSER CERTIFIC,4 TlON
lEAD CONTENT 8EFORE
CEFO"IFIC,4TE OF OCCUPANCY
' '~ ' ~' ~-> ' I ~'~~ ~
,
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