HomeMy WebLinkAbout15484-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
0fflce of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20580 Date MARCH 10~ 1992
THIS CERTIFIES that the bulldln~ ADDITION
Location of Property 2850 DEEPHOL~ DRIlrE
House No. Street
County Tax Map No. 1000 Section 123 Block 4
Subdivision Filed Map No.
MATTIT~CK~ N.Y.
Hamlet
Lot i3
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed ~n thls off~ce dated NOVEMBER 7~ 1986 pursuant to which
Building Permit No. 15484-Z dated NOVEMBER 12, 1986
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
· ssued ms ADDITION TOEXISTING ONE FAMILY DWF/J.INGASAPPLIEDFOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTME/q~ OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
EDWARD & CHRISTINE VIOLA
PENDING - MARCH 2r 1992
N/A
Building -Inspec~r -
Rev. 1/81
lvO~ NO. ·
TOWN OF SOUT~OLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Yo
BUILDING PEICMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No. 15484 Z
County Tox Map No 1000 Section . .l ~,~.~.~... Block ..... ..~. .......... Lot No .... J...~ .........
Budding Inspector
~ee S~"'~./
Building Inspector
Rev 6/30/80
Form No. 6
TOWZN OF SOUTIiOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This applicatzon must be filled zn by typewrzter OR znk and submztted to the buzldzng
inspector with the followzng: for new buzldzng or new use:
i. Final survey of property wzth accurate locatzon of all bumldzngs, property lznes,
streets, and unusual natural or topographzc features.
2. Fznal Approval from Health Dept. of water supply and sewerage-dzsposal(S-9 form).
3. Approval of electrzcal installatzon from Board of Fire Underwrzters.
4. Sworn statement from plumber certmfying that the solder used mn system contazns
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar bu~ld~ngs
and znstallatzons, a certificate of Code Complmance from architect or engzneer
responsible for the buzldmng.
6. Submzt Plauning Board Approval of completed szte plan requmrements.
For exzstzng buildings (prior to Aprzl 9, 1957) non-conformzng uses, or buzldzngs and
"pre-exzstmng" land uses:
1. Accurate survey of property showzng all property lznes, streets, buzldmng and
unusual natural or topographzc features.
2. A properly completed applzcatlon and a consent to inspect szgned by the applzcant.
If a Certificate of Occupancy is denzed, the Buzldzng Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certzfzcate of Occupancy - New dwellzng $25.00, Addmtmons to dwetlzng
Alteratzons to dwellmng $25.00, Swzmmzng pool $25.00, Accessory buzldzng $25.00,
Additzons to accessory buildzng $25.00. Busznesses $50.00.
2. Certifzcate of Occupancy on Pre-exzstmng Buildzng - $100.00
3. Copy of Certzficate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .... U../~...~....~./., ./f?..~,. .......
New Construction. Old Or Pre-existmng Building.. ,.~.
Location of Property .................................
House No. Street Hamlet
Onwer or Owners of Property .....................
County Tax Map No I000, Section .............. Block ........... Lot ....................
--
Subdivision ................................... . Filed Map ............ Lot ................... .. .
Permzt No.~f.~,.~.~..~. ..... Date Of Permzt....~..
Plann~_ng Board Approval...... ............ .. . . ..
Request for: Temporary Certifzcate ........... Final Certzcate ..........
Fee Subm~_tted: $ ......... Oo ~. ............... '
............ .........................
Co ~ 3d_5~'0
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
PO Box 1179
Southold, New York 11971
FEBRUARY 8, 1989
DATE:
NAME: EDWARD & CHRISTINE VIOLA
ADDRE$S~ 2850 DEEP HOLE DRIVE _
MATTITUCK
RE: BUILDING PERMIT ~ 15484Z ADDITION
SEC. 123 BLOCK 04 LOT 13
This Building Permit has expired. You are now in
violation of the Town of Southold Zoning Code.
Please contact our office, this matter must be
corrected.
Victor G. Lessard
Principal Inspector
OUNDATIO ~ (1st)
OUND^ TI 0I,~ ( 2nd )
OUGH FRAME &
?LUMBING
NSULATION ?ER N. Y.
STATE ENERGY
CODE
FINAL
ADDITION~
COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [~'~U~TION
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I~,~TJ~N
[ ] FRAMING /["-]I=!NAL~
REMARKS: ~
78S4,802
BUILDING DEPT.
INSPECTION
[.~ON IST [ ] ROUGH PLBe.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
REMARKS:~
INSPECTOR~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
REMARKS:O,
FINAL
...,,,,:, ,./,;.,,
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
Town Hail, 53095 Main Road
PO Box 1179
Southold, New York 11971
FEBRUARY
DATE:
NAME: EDWARD & CHRISTINE VIOLA
ADDRESS: 2850 DEEP HOLE DRIVE
MATTITUCK
RE: BUILDING PERMIT ~ 15484Z ADDITION
SEC. I23 BLOCK 04 LOT 13
8, 1989
This Building Permit has expired. You are now in
violation of the Towu of Southold Zoning Code.
Please contact our office, this matter must be
Y o u~r s,.~.~r.~L¥ ~
Victor G. Lessard
Principal Inspector
THE Wt
sYSTE~
CONFO,
sUFFO
SUFFO
SEI~V
CONST
DATE
~SR'
AP} ~C
Examined b~.~ I ~. , 19~.t~
Approved
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
D~sapproved a/c
APPLICATION FOR BUILDING PERMIT
NOV ' 7 198S
~.~g Rece3. ved ........... ,19..
INSTRUCTIONS
a. Tins apphcatlon must be completely filled in by typewriter or m ink and submitted to the Building Inspector, with
sets of plans, accurate plot plan to scale· Fee according to schedule
b. Plot plan showing locatmn of lot and of buddings on premises, relatmnsinp to adjoining premises or public stre-
or areas, and g~vmg a detmled descnphon of layout of property must be drawn on the diagram winch ~s part of tins app
cation.
c. The work covered by tins apphcahon may not be commenced before ~ssuance of Bufldmg Permit
d. Upon approval of this application, the Building Inspector will issued a Bufldmg Permit to the apphcant. Such pern
shall be kept on the premises avadable for mspectton throughout the work.
e. No budding shall be occupied or used ~n whole or m part for any purpose whatever until a Certificate of Occupan
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Bufldmg Department for the ~ssuance of a Bmldmg Permit pursuant to t
Bmld~ng Zone Ordinance of the Town of Southold, Suffolk CounW, New York, and other apphcable Laws, Ordinances
Regulations, for the construction of buildings, additions or alteratmns, or for removal or demohtion, as hereto descnb-
The applicant agrees to comply with all apphcable laws, ordinances, bufld3~g code, housing code, and regulations, and
admit authorized inspectors on premises and m buildmg for necessary ms~ns
(Signature of appllffant, or name, if a corporation)
(Maflmg address of applicant)
State whether applicant is owner, lessee, agent, arcintect, engineer, general contractor, electnman, plumber or bmld.
Name of ownerofprem,ses .~.~/~f.~4 ~ ~../~/.~z/.~.~. ~/./,j~.q ...
(as on the tax roll or latest deed)
If apphcant is a corporation, s~gnature of duly authorized officer
2
(Name and title of corporate officer)
Bmlder's, License No 'x~ ~zeEf/
Plumbers ~icense No .. . -~ .....
Electrician s,Llcense No __ ~ .
Other Trade s License No . __ . '%<..
Location of land on which proposed work will be done
House Number Street
County Tax Map No 1000 Section / ~- 3 Block
Hamlet
· Lot
Subdivision .... (N'am~) ....... Filed Map No ......... Lot .
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a. Ex, shnguseandoc&~hpancy / .7~/¢ /~C~/4~'7~-~E. .......
b. Intended use and occupancy /~32>//-~..A/ /--'~''
3. Nature of work (check winch applicable) New Building ' Addmon..../..... Alteration
Repair ........ Removal .......... Demolition ......... Other Work ...........
~/o/O/ -- .~.~_..~ (Description)
4 Estmaated Cost t~ Fee
(to be paad on f'dlng tins apphcation)
5. If dwelling, number of dwelling units . .. / .. Number of dwelling units on each floor...¥..7'd"~7~....5. ....
If garage, number of cars ...................................................
6. If busmess, commercial or mixed occupancy, specify natu[e and extent of eac_h, type of use ..
7. Dmaenslons of ex~stmg structures, ~fany Front . .Z~' . . Rear ..
Height ........... Number of Stones
Dtmenslons ofsfime structure w~th alterations or addinons Front ...2Z/~. ....... Rear...~.2.~ ............
Depth . . .,~f ........... Height . . ./.,.6-.,~, ,, ~, ...... Number of Stones ..... .~ ...... .~ ......
8. Dmaenslons of entire new constructmn' Front .. f_/.6, ...... Rear . ...~.f .... Depth .. ~.../ .........
Height /~.. / Number of Stones ....... / ................. · ............
............ ' e 72LC "'
9 Size of lot Front .... ,7~.~. ....... -,~ R ar .............. Depth ..................
10 DateofPurchase....A,{O.tf.e.~..~<~' /.5/fff,~:-. .... 13I~me of Former Owner .../)~/.~..~..k/.~-..~..'5. .......
11. Zone or use district ~n winch premises are situated ..../(~.SY.O..~_77,'~/,_ ..........................
12. Does proposed construction violate any zoning law, ordinance or regulataon' ... ~/.~. .................
13. Will lot be regraded ....,/V'~, . ............. Will excess fill be removed from premises' Yes (No)
14. Name of Owner ofpremise_s '5.~'~..W..~.~/. .5./~'~ .. Address .............. Phone No .......... ."7'".
Name of Architect .... /:ri~...~..~.. ......... Address ............... Phone No.. ~. ~.'~"~...
Name of Contractor . . .~.~..'~..~... -- ' :... Address ................ Phone No ...............
PLOT DIAGRAM
Locate clearly and dlstmctly all bufldmgs, whether exlstmg or proposed, and. indicate all set-back dimensions from
property lmes, G~ve street and block number or descnptmn accordmg to deed, and show street names and indicate whether
mtenor or coruer lot.
STATE OF NEW YORK, S S
COUNTY OF ...........
...... .~.t~./.~.--.~.' ~/.~..~ .............. bemg duly sworn, deposes and says that he is the applicant
(Name of individual slgmng contract)
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and ~e this
apphcatmn; that all statements contamed in this apphcation are true to the best oflus knowledge and belief, and that the
work will be performed m the manner set forth m the applicataon filed therewith.
Sworn to before me this
.......... ~...'~ ...... day of ..... .'~....t?f~-~/. .......... 19..~
~[otary Pubhc, ~.~2 ,~. /~)~- ~..d~.... County ~. 1,~.'~!~~ .
~ ~'tllttle. ~, ~ ~ ~ -'-' -:----'-- ' ature'°f apPhCant)
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
~ neP, UPANCY
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANCY
soLDER uSED IN wATER
suPPLY sYSTEM cANNOT
ExcEED 2110 of I% LEAD.
APPROVED A~ NOTE~
If copper tubing ia used
for water distributing
system; piping shall be
of types K or L only
1