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HomeMy WebLinkAbout16386-zFORM NO. 4 TOWN OF EOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27107 Date: 05/30/00 THIS CERTIFIES that the building ADDITION Location of Property: MONTAUK AVE. (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 5 Lot 5 FISHERS ISLAND Subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 27, 1987 pursuant to which Building Permit No. 16386-Z dated AUGUST 27, 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 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ARTHUR ~ BERNADETTE WALSH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A PENDING 05/26/00 05/09/00 MARIO ZANGHETTI, JR. Rev. 1/81 1~0~ NO, ~ TO%VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 16386 z Permission is hereby grOnted to: ,~...~.../~,~~ ~~ .... 5¢ at premises Iocoted at ..................................................... ~ ................................ ,......,,, ............... ,- ........ County Tax Mop No. 1000 Section .......... ~ .........Block ........ ~ ....... Lot No ......~ .......... pursuant to application dated ......... ~ ............. ~ ............. , 19.~..~and approved by the Building Inspector. Fee $. ~...~..~...~....~...... Rev. 6/30/80 Form No. 0 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 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. App~ovtLi ot cJ, uctrical lnsLailatiou ~uom Ooard O~ Flru Undurwri~era. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/I0 of i% 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 buzldlngs (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 bnusual 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 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-existinR Buildin~ ~ $100.00 3. Copy of Certificate of Occupancy - . 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 .. .............................. New Construction ........... Old Or Pre-existing Building ................. Location of Property ........................... ~.~ ............. .- ......................... Ileul~t, No. ' ' ' Onwer or Owners of Property ..... ~,/'~.l.q.,~ .~./ County Tax ~ap No i000, Section ........... Block ............ ... . Lot ......... ............. Subdivision .................................... Filed Map ............ Lot ................. ..... Permit No.Z.~3.~..~. ...... Date Of Permit..~./.~.~./~.~ ..... Applicant./~..~.~. ........... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Beard Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~.. ..... TOWN OF SOUTHOLD~ OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTtIOLD, N.Y, 11971 CERTI FICATION TEL. 765-1802 Building Permit No. 16386 Owner Arthur J. Walsh ' (please print) Plumber Mario Zan~hetti Jr. (please print} Date',May 9th,, 2000_ _. I certify that the solder used in the water supply system contains less than 2/10 of 1% ,lead. N~ Publi~ 8tare of New York No. Ouatlfleo In Suffo[k County Term Expires 1~1/~ CONc. WAlK S 70'44' o~C~ AB,~A" J'OlOm sq'~' eo~ I ¢ ~oc~°s BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~(~AL REMARKS: NOTIFf bull DiNG bFPAk'IM~ IXl~' A'I' I. FOUNbA~ ION iV,/') FOR P(qU,', D (7ONe:R[ 2. ROUC~ ~ RAMINft ?, pl UMBING 4. FINA' r-': , :'J" ~I,UN MUST TIqE R~Ot"q;~t:N]': r)F TI-iv N.Y. S%~TF CONVFRUCF!ON & I~NERGY COU['fi. NO]' RScPONSIL:Lf7 FOR DESIGN (')q CONSTRUCTION ERRORS. [~ ~ ,~ oo,~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO?;N HALL SOUTHOLD, r.l,Y. 11971 TEL.: 765-1802 Disapproved a/c ....... : ............................. (Buihling Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and subm'itted in triplicate to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plct plan showing location of lot and of buildings on premises, relationship to adjoining promises or public stre or areas, and giwng a detailed description of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon apprcval of this application, the Building Inspector will issue a Building Permit to the applicant. Such per: shall be kept on the premises available for inspection throughout the work. e. No buildiag shvll be occupied or used in whole or in pan for any purpose whatever unt~ a Certificate of Occupar sh~l have been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance of a Building Pe~it pursuant to ' Building Zone Ordinance of the Town ~f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descfib The applicant agrees to comply with all applicable laws, ordinances, building code, housiug code, and regulations, ~d admit authorized inspectors on prenfises and in buildings for necessa~ i~ections. ~ /. ~ __ (Signature of ap~icant, or name, if a corporation) ~ , _ (Mailing address of applicant) - State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, e!ectHcla~, plumber or build o~ or owner ......... .... ........ .... (as on the tax roll or latest deed) If applicant is a corporation, si~natura o[ duly authorized officer. (Name and title of corporate officer) Builder's License No. / 3 .~. g ~:r -H'~. 55q P Plumber's Licens= No ......................... Electrician's Licenso No ....... ~.qS.'.... Other Trade's License No ...................... I. Location of land on which proposed work will be done ...................................... ......... /'¢fO ,,OT,4t4/¢ c,'E!_ ((.4¢.():...~-.¢.ff4.~ House Number Street Hamlet County Tax Map No. iO00 Section ...... ~ .......... Block .................. Lot ................. ", · "- p N ..' .. L.,~.~.n ..................................... Fncd Ma o ............... Lot .............. (Name) ".~' 2. Statc exisfin~ use and occupancy of premises and inteuded use and occupancy of proposed construction: 'x x, Existing use and occupancy .~.4(~. .... ~.(~.. T~o ~E ~e a ' ,,...,.'. , ~ ~3'~eM~ ). 1. 2. ;. 1, Repair Remos'al Demolition Other Work o o o (Description,) i (to be paid on filingthis application) If dwelling, number of dwellii~ig units ..... 9.~ ~ .... Number of dwelling units on each floor., f. If garage number of cars I~ business, commercml or mt~ed occupancy, speedy nature and extent o~ each type o~ use ................... ..... , _. . Dm~ensons of ex stmgstmct~res, lfany Front ...... '2 ....Rear .... ~... ~.. Depth .. ~ ~ Nhmber of Stories .... Height ....................................................... Dimensions of same stmcture'with alterations or additions: Front ~;' ~ Rear g( Depth ~.~ ~ 2 ~" Height ~-~ ~ ~ Number of Stories Dimensions of entire new construction: Front / ~.'. ~ Rear ~ ~ ~ ~.. Depth Height . .2~f.~ ....... Nt~mb~r of Stories ....... ~ ...................... ' ............. . ........ S~ze of lot: Front ....... 2~...' .......... Rear .... ~Vs .ff.' ........... Depth ..... ~q.' .......... ....... Nume of Former Owner ... ~. ...... q. ............ Date df Purchase ~..~.~ 729 ....... ~- ~ ua · ~ Zone or use district in which premises are situated .....~.~ ?t~.gq~ .................... : ............ Does proposed construction violate any zoning law, orfliaance or reg.lafion: . ~. ~. ~ Y./S~V~ Will lot be regraded ....... ,..~ ................ Will excess fill be removed from premises: Yeo N~ Name of O;,,'n~r of premises ~.~.q.~..~.~.~... Address ~.~q ~9~(t..~ffg... Phone No.~4 Name of Architect ..... ~.~ ............. ... Address ................... Phone No ............... N~e of Contractor ..~ ~ ~ ...... Address ~tXZees ~s/a~ Phone No.~(~.'.l~ PLOT DIAGRAM Locate clearly and distinctly all buiklings, whether existing or proposed, and.indicate all set-back dimensions fron roperty lines. Give street and bloqk nmnber or description according to deed, and show street names and indicate whethe I ~o' ~ 04' ~tel-ior or corner lot. TA'FE OF N~RYf~I~ CONNECTI~.UsT OUNTY OF. ?fi.~ .L. qN.D. qN...2..' ' OLD LYME .... ~8 .~./~.q.g .... ~ .......................... being duly s;vorn, deposes and says that he is the applic:.n (Nanie of indMdual signing contract) e is the .......... {?. ,/-~,., ,~, ~ ,/~, ....... ] ........................... (Contractor, agent, corporat~officer, etc.) ~' said owner or owners, mid is &fly authorized to perform or have performed the said work and to m&e and file tiff )plication; that all statements cofitained in this application are true to the best of his knowledge and belief; and that th 'ork will be performed in the maimer set fnrth in the application filed therewith worn to before me this SEVENTH day 6f AU. GUS. T. 19 8.7.