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HomeMy WebLinkAbout16398-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~YRTMENT Office of the Building Inspector Town Hall Southol~, N.Y. CERTIFICATE OF OCCUPANCY No Z-17195 Date AUGUST 12~ 1988. THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 2300 PINE TREE ROAD PECONIC, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 02 Lot 09 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 27, 1987 ~ursuant %o which Building Permit No.16398-Z dated AUGUST 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 ONE FAMILY DWELLING WITH GARAGE & ATTACHED WOOD DECK The certificate is issued to PETER & SHEILA IZZO (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-110 - JULY 28, 1988 UNDERWRITERS CERTIFICATE NO.N-023548- JULY 26, 1988 PLUMBERS CERTIFICATION DATED JUNE 23~ 1988 K & K PLUMBING & HEATING Rev. 1/81 if'ORM~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6 3 ?~ Z ~ote ...,~.~-~.........~ ........ , ~.~.:/. Permission is hereby grantedJ[~-~ /s -- ~ ~.~..~.~~,......~.~.~. ...................... ./,..~..~ ................................................ ..~.~...~.4.,....I.z.~.~. ...... .~..~..~.~, ,, ...~~.~...~...~,..~ .... ............................................. County Tax Mop No. 1000 Sect)o~X../,.,O,,,.~., ...... Block ..... .(~...s~... ..... Lot No ..... ...C~..3 ........... pursuant to application dated .~.~..~....~...~. ......... , 19.~..~, and approved by the Building Inspector. Building Inspector ~R~v. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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--iS-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~perty showing all property lines, streets, buildings and unusual natural or topographic .featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 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. Certificate of occupancy New Dwelling, $25.(10, Accessory,,~$ ~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ~,~/~-~ New Cons tPuc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............................ ~ .............................. . House No. , I, Street Ham/et County Tax Map No. 1000 Section . ../ .......... Block Lot .... Permit No ...... Permit ....................... .. . Health Dept. Approval ........................ Labor Dept. Approval ..................... L.. Underwriters Approval ........................ Planning Board Approval .......~,~ ......... .,. Request for Temporary Certificate .................... Final Certificate .... wi/ ................ ' Fee Submitted $ .......... ~..; ............. Construction on above described building end--ts, all al~plical~e cod and lations, es ragu Rev. 10-10-78 FIELD INSPECTION _..FOUNDATION ~'"( 1 s~t ) FOUNDATION ( 2nd ) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL COMMENTS ADDITIO~ COMMENTS TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit NO. Owner '--~'~e_(- (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to befor~ me this Notary Public Count/ ' (plumber'S signature~ Notary Public 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~FINAL ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~'~NSULATION FRAMING ~r j F~NAL REMARKS: ~~,,~ DATE _ . ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :~ND [. ]~ FRAMING [~/'FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST I-~'/ROUGN PLBG, FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ["] ROUGH PLBG. [,] FO~IDATION/ 2ND [ ] INSULATION [C'~FRAMING [ ] FINAL , INSPECTO~ 765 -1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [/'~"~NDATION 2ND [ ] INSULATION ? ? INSPECTOR '~' BUI LD 176~I~G8~D2EPT. NSPECTION [ ] F~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS:~ ~ DATE ~///~/o///~? INSPECTOR, S~OK~ DICTgCTOR:-2 T~ACK R V ! SAbVATORE C. PRATO ~[ BOX 208 elI41M~ ~ SUFF ,L , SINGLE FAMIi FD(P!RES TWO YEARS THE WA SYSTEM CONFOF SUFFOL SUFFOL CONSTR DATE: _ H. S. APPROV SUF~ DEED: L 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 19~..~. Permit No. J .~.~.~. ~..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Aeceived ........... ,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 givh~g 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................................ Nameofownerofpremises . .../p.~.'(..C..~...'X/... T~_~~--~ ............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... i./.. Plumber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section .... ~9~ .......... Block ....... ?~ ........ Lot .... ~... ~[ ...... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy..~¢~ f...~ ............................................... b. Intended use and occupancy . .~. [~~ .................................................. 3. Nature of work (check which applicable): New Buildin . ' Addition. ~ ..... Alteration .......... Repair .............. Removal .............. Demolition ........... i' Other Work ............... ~ tD0 D(3~ ~'o I (Description) 4. Estimated Cost ........ ~; ............................. Fee .......... i .......................... (to be ~paid on filing this application) 5. If dwelling, number of dwelling units .............. Number of dwelling un s on each floor ................ If garage, number of cars ~ ' 'i ............................ 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 ............................ i ...................... Dimefi'sions of same structure with alterations or additions: Front ............ i ..... Rear .................. Depth ...................... Height ........ _ rx., ........... Num!~ertofl Stories .......... ,, ........... 8. Dimensions of~ entire new construction: Front . . ' .~Q .... Rear . .'~'.~ Det~th . ~0 ' . Height ...'~.( ...... ~..imumberofStories ~ ...... ,i.lr. iljiiiill' - '" ........ 9. Size of lot Front .~(.0. .~ ~. Rear ~ ~r n~,,,h ' ' '~2.~&~ ........... 10. Date of Purchase ......... t.~.~.~..... .~ lSlame of Former Owner i ~.~.. ~k~l~'7~.. 11. Zone or use district in which premises are situated /~,_~.~.I~.L~.'~{..~Z{/ ...... iiiiiiill .............. 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~) ....... 13. Will lot be regraded ..... ~ ....... C ..... ~... .... Will el{~ss fill be removed from premises:, t,Ye$ ... ~/No 14. Name of Owner of gremises' ~.~I'~..~,. .~-f.~.~.. . Addres~(~,~.~Q .~...~:~h ~0. Phone No. ~l'%-q(- ... .~. !c/.~ ...~ ... Name of Architecff~.~b~. ~_f~ .Q-C~.(>~b[~..~k'~. Addres~s ~.l~.~ff~5~~one No. ~.~L~..~.'~.(.~.. Name of Contractor .......................... Address ............... .... Phone No..~ ............ 15. Is this property located withtnl4)0 feet of a tidal wetland? *iYes ..... No · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 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.)i of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application;that all statements contained in this application are true to the best of hisi 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 ............ ...... Notary Public, . ............ .~.~ ............... ~23~ty ' ........ NOTARY Y0fk (Signature of applicant) ~. 4707878, Suffolk Co Term Expires Me,ch ~0, f , EXPIRES TV PLEASE NOTE RODERICK VAN TUYL P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK it I. the appltoant's responsibility to mah~tain adequate sanitary distance between all water suppty and sewage diel:Kleal facl!i~ies. SUFFOLK CO. HEALTH DEPT. APPROVAL h.S. NO. -.' FAMILY DWELLING ONLY' YEARS FROM DATE OF APPROVAL sTATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (si APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF COnSTRUCT,ON O~LY ?UL N DATE: -l~lT H.S. REF. NO.: g736~, ~PPROVED: ~ SUFFOLK CO. TAX MAP DESIGN~ON: DIST. SECT. ~L~K PCL, OWNERS ADDRESS: DEED: TEST HOLE SEAL 35 SURVEY OF PROPERTY A T PECON1C TOWN OF SOUTHOLD SUFFOLK COUNTYt N.Y. 1000 - t04 ~ 02 - 09 Scale I" = 30' Sept. t7, 1987 Nov. 6, /987 (foundalion local Prepared in aCcordance with the minimum standards for title surveys as e~tablished by the L L A. L s. and approved and adopted for such use by The New York Title Association. . State Land 2-,ER TIFIED TO PETER IZZO NOTE' LOT NO'S. REFER TO 'MA1=' OF NASSAU FAFIMS" FILF..P tN SUFFOLK COUNTY CLERK'S OFFICE'AS MAP NO, tl79 FILED MARCH ~8, 19,35 NO~, & ENG~EF MAIN ROAD SOUTHOLD~ N.Y. 87 - 752: ~o~ 65 L.O1' B. O. H. # 87 SO 110 ,CERTIFIED TO PETER IZZO NOTE, LOT NO'S..~..F_,R TO "MAP OF NASSAU FARIdS FILED ~ ~FOLK.,~TY CL~K'S OFFiCE.AS MAP NO. 1179 PROPERTY. A T PECONJC - TOWN OF ,SUFFOLK COfJNT~'~ N.Y.. Jooo - f-04 -,02 -o9 Sept. 17~ : d; for fitb ~rveys ~s ¢ .~r ~udh use by The New ~ork JSE tS UND~,WFUL ::iTHOUT CERTIFICATE ©OCUPANCY If eORoer tubing la used for '*rater distributing sYstem; I~iPingshall be soLDER uSED IN WATER uPPLY sYSTEM CANNOT ~xcEED 2/10 of I% LEAD, ~ £uMBER CERTIFICATION ON LEAD cONTENT BEFORE CERTIFICATE OF OCCUPANCY APPROVED AS ~OTF. O NOTIFY B~JILDI[~IG DEPARTMENT AT 765-1802 9 AN TO ~ PM FOR THE 'i ,I ,f eL_ 1 ............. -) 17