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Home My WebLink About14452-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~LENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICA?E OF OCCUPANCY No Z-20657 Date APRIL 17~ 1992 THIS CERTIFIES that the building ADDITION Location of Property 2000 CAPTAIN KIDD DR. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 2 Lot 38 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 6, 1985 pursuant to which Building Permit No. 14452-Z dated DECEMBER 6~ 1985 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 DI~TJ.ING The certificate is issued to FRANK POLISTENA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H-002363 - MAY 5~ 1988 Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14452, Z Permission is hereby grante~r~ ..~.......u.......~........u.~....~ .~X~......~~.~, ......~:!.~,~.~.~...~..'~~...~ ................... .............. ~ .................... ~~~.~.~. .......................... ~"~'~~/~'~~ ..................... ~ ............................................................................................ ~"~~ ~,,~ ~ ~ No. ~0oo ~t~o, .... /.~..~ ........ m~ ..... ~,,~ ....... Lot No.....~.~ ....... Building Inspector, Fee $.~5....~.. ..... Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING pERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~2323 Z Date .......... ,,~ ................................ , Permissioni Is hereby granted to: . ...... ~.~.....¥~7.. .......................... ~ .................. ...... ~~..,..7~..~,..~...~.:.....~.~ ~o ..? .... c~. ............ ~.~.. ....... at premise, located at ...~..c;:~.~).....~'~/~.~...~/..~.~....~...~f..~,~...~....e~;.~¢~....~.~../...% ..~ ....... ...~ ....... ~...~ ................ ~ ........................ ~. ............................... .?....z~.~~..~...~.. ..~:.~.~..~.. ~.~./~ ....... ~..~.~ ............................... County TaXx Map No. ]000 Section .:,~.~,~,~ ....... Block ...,~-,~., ...... :~ Lot No....~,.~t~,,, ....... pursuant tb application dated ...,~..~..¢..~...;.(~../.'; ...................... , 19~.;~'~ and approved by the Building Ir~spector. Re¥. Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN t~LL 765-1802 A~PLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 accurat~ location of ail buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board .of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% 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. B. For existing buildings (prior to April 9, 1957) uon-conforming uses, or buildings and "pre-existing land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A ~roperly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinging pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $I00.00 3.Copy of Certificate 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 N · Date ................................ aw Construction .... ~ .... Old Or P.r,e-existing Building .......... Location of Pronert,,~-W'~Q~300 House No.' -- Street ............... , Hamlet On o ropert wet orwners ......... . .... County Tax Map No 1000, Section...<.O .~.~ ..... Block. Subdivision ........................... Filed Map ............ Lot .................. Permit No, J.~..~...7-[.7-'~. .Date Of Permit...I.?.l..~.t..~.~..Applicant. Health Dept. Approval ....................... · .. Underwriters Approval ........... Planning Board Approval .............. Request for: Temporary Certificate ~ ........ inai Cer ticate ..... ~ee Subm.it ted: $ ....................... 2o $1 .............. ' .................. THE NEW YORK BOARD OF FIRE UNDERWRITERS EUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW yORK 10.038 ,} ~{ Application No. on file only the electrical equipment as described below and introduced by the appllcent r~med on the a~ve application number in the premises of ~A~ ~'OhJ,~ TP, N~ 'q"' h}?,C/O h~'~P~, '<'~ .... ~' v Lot DRYERS [ FIXTURES ECI~P'I'ACLES SWITCHES NCANDESCENT FLUORESCENT FURNACE MOTORS ~ 2nd FI. Section Block and found to be in compliat:ce w th the reqt ire~ttents qf tats Botsrd. RANGES OVENS 'DISH WASHERS FANS SYSTEMS NO, OF FEET E E R V I C AW, G OF CC, CON~D i/~ NO O~ HI-LEG AWG, OF HI-LEG NO OF NEUTRALS OF NEUTRAL /O This certificate must not be altered in any manner; return to the office of the 8oard if incorrect. InspeOors may be identified by their credentials. COPY FOR ~UILDIHG DEPARTMENT. THIS COPY OF CERTIFI~TE MU~ NOT BE ALTERED IN ANY ~NNER. FIELD I~SFEC~ION COMMENTS FOUNDATION ( 1 mt) F,OUNDATION__ ( 2nd ) 2. ~OUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 7GS-'~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~ FRAMI~NG [ ]FINAL ."MA.,~S.'~ .~- ,~~ DATE INSPECTOR 0 0 7GS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~] INSULATION [ ] FRAMING [ ] FINAL DATE/~~,~ ~/~ ~INspECTOR ~ C,L-''''. FORM NO. 1 TOWN OF,SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' SOUTHOLD, N.Y, 1,1971 TEL.: 765-180~i 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 stxeets 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 issue a Building Permit to the applicant. Such permit shall be kept on the promises 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, Suftblk 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) .6~...co.¢:~.,..~..~. ~ .-~..~..,. ( ~ s:z~.. (Mailing address of appticm(t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or l~ttest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...09-).~..~.V~. ............... Plmnber's License No ......................... Electrician's License No.--~.....~...~.. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... ~ . . ~. . .a.-~.,. . ¢. ,~k.~. t,o~ ....................... ,,,l I .c../~.. C~¢t':. Ks,~. ~bx:...~.. Le~..e.4, o House Number 2~¢~x2o ~o 5~ ~.~St County Tax Map No. 1000 Section ... I ~ .......... Block ...~ ...... ,~._..., Lot..~. ~. ............. Subdivision .U.~ZJ[~-"I., .,x.t.~,' ~{~-S .... ....... Filed Map No. ....... Lot., .~ 2.~ ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .,, ........................... 3. Nature of work (check which applicable): New Building. .......... Adflition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... i (Description) 4. Estimated Cost ............................ Fee .,(,q....-C-. .... ~'~ ....................... i (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number o f dwelling units on each floor ................ If garage number of cars ~ '.... ' 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~pe of use ......... , t,r. · .~. · .J.i.,, 7. Dimensions Df existing structuresi if any: Front..]~,,~ .~ ......... Rear . .~. ~. ........ Depth ~..~ .~/~J,,~IQ Height .[~ ............ Number of Stories. ~ ................... /. ...................... / ........... Dimensions.of same structure with alteratio~s~9~r ~kd_d~.~i9111: -Front . ~ 2 ............ Rear .. ~. 7 ............. ~ ._ ,.~, i ..... oua'r.~,,r~'w-*f'~"r~q~(:~t~., ,, _ .,.-,. . _.t .... ueprn .~ .................. ,,. t~e~gaT ~.:~ t. ah' r~,,~ ~cr~tr'.,l-~' · rqum~er oz ~rones...~ .... _.~ ....... 8. Dlmensmns.of qntlre new construction: Froh~ ,..~O~ ....... :. Rear ...~ ......... Depth .~ ........... Height ...5)z3.'. ........ ~Number of Stories .. o~ ..... :. · ~ ..................... ,, ·/v. · · .~. · .,._._.,e,,.....~. 9. Size of lot: Front ....'~. ..... i .......... Rear .... [f,/D .............. ,Depth '~"f'~,~r~_' '/' '~'' 10. Date of Purchase . ~[..,np.[.D.fi.. !'. ................ Na_n)e of~'~ormer Owner ~t~O../~,ffffJ]/~.. .......... 11. Zone 6r use district in which premises are situated. P~. g !'(/~. 0..~..(01 .......... .. ........................... 12. D!?,es proposed construction violate any zoning law, ordinance or regulation: . ~qJ. ....................... 13. Wall lot be regraded ...~.0... ~l .................. Will excesj fill be removed from premises: , _ _ Yes 14. Name of Owner of premises .~fil'tr~. ........... Address . ,~-~...~.. ........ Phone No. ~ ~."..~.~,el¢;...~'~-~. Name of Architect . ' . ....Address ................... Phone No ................ 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/Y-ORK, ~.~ i~ ,. COUNTY OF .~..~f~... i;~'~ (Name of inaividual s~qing contract) above named. He is the ....... ~~ ' ' ' 'tractor , agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e ~d ~e this application; that all statements conhined ~ this application am true to the best of his knowledge and belief; and ~at the work w~l be perfomed in the m~ner set forth in the application filed therewith. Sworu to before me this Nota,~w~Public/. ................. , '~/'~:e~ ...~" ~ County ~o. 52.8125850, Stlf~olk Te[m Exaires March 30,, 1~ J i i , ri FORM NO. ~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' SOUTHOLD, N.Y. 1,i971 TEL.: 765-180~i BLDG. DEPT. TOWN OF SOUTHOLD Examined ................ , 19... Approved ................. 19.., Permit No ............ Disapproved a/c ..................................... Application No .................. ~. ~ ~ f,2323 7-. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 drown 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 issue a Building Permit to the applicant. Such perrnit 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 buildings for necessary inspections. ~..o~..hq.'9.....1¢...~.~:.~.uc. Jk...;.~..q. .......... (Mailing address of applicant)l State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....o, .~..u...~. ~ ................................................................................. Nmne of owner of premises .~. (-.Q~Y3.~--; ~'~-', .~..~}:230.t:~ .O~.~...~=: .~ .~.O...~ .~.~i~F/ ~ (as on the tax roll or l{~test deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. 9..tO..U~.; .~. ............... 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 0~ Block "~ Lot .......................... ~I~-o .................. Subdivisiori~.t~U}'.,.% .... \- .-~.'.' -t~t~.~e.5 .............. Filed Map No. Lot. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E×isting u~e an~ occupancy .~'(~.~.~...~-..m.; .~..~...O: ~. ~: .<.p W'O. ¢.~. ......................... b. Intended use and occupancy OV .°,~...%.~.:..~..~.. ~ ...... ?~..?.O.w..t~...~..O[..Y..O.O. · .~k.~ ................ / ~R~ ~pair .... ~[.~. ~. )~!~... RemOval .............. Demolition ........ Other Work~ ~'~l~re~li~; .... 4. st atedCost ..... t ~ Fee ~ ........ ' ,: (to be paid on filing this application) 5. If dwelling, number of dwelling pnits ............... Number of dwelling units on each floor ................ If garage, number of cars .. ~..~ ................................................................... 6. If business commercial or mixed occupancy, specty nature and extent of each type of use ......... r ............. 7. Dimensions of ~xisting structures, if any: Front,... ~ ....... Rear ...}.~ ......... Depth ~.~[5.~ 2~.~.) .' .....' .......... ~ . ' ..... ..t ........ ~ ................................ Hmght .... ~ ........ ~ Number of Stones .... Does proposed construction violate any zoning law, ordinance or re~lation: ~O ................ Will lot be regraded .... ~ .[0 .[ ................... Will excess fill be removed from premises: "..' Nme of Owner of premises . ~ ......... Address .... ~ ~ ....... Phone No. ~.3.x ~.~ Name of Architect ' Address Phone No Nme of Contractor ... ~ ~ .............. Address ..... ~ ..... Phone No ................ PLOT DIAG~ 10. 11. 12. 13. 14. Locate clearly and distinctly all property lines. Give street and block interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. buildings, whether existing or proposed, and. indicate all set-back dimensions from humber or description according to deed, and show street names and indicate whether ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sign lng contract) above named. He is the ...................... ~ ....................................... :: ........................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application;that all statements eont$ined~ -m this apphcation- 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 day oI- ...................... 19... Notary Public, ................ , ................ County (Signature of applicant)