Loading...
HomeMy WebLinkAbout13967-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13467 Date May 22 98.5. THIS CERTIFIES that the building porch enclosure Location of Property 460 Donna Dr. Mattituck House No. Street Hamlet County Tax Map No. 1000 Section 115 .Block 15 ..... Lot 22 x x Subdivision ........... .x ................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .Iglgy. 2.~ .......... 19.8.5. pursuant to which Building Permit NO. 13 9. 6 7 Z dated .... l~lay. 2.2. ................ 19.8.5., 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 ......... ..... ~.~¢~,Qsur~ .o,. An ~x.i.s.~..i.n~..~9.r.c.h.. 9.n. ?.. 9.n.e.~ .f.a.m.i.~.¥..~e..~.~.i.n.~.: ........ The certificate is issued to Jack & Elisa Cecchino ................. ?o;;,;;,'~ ' ' of the aforesaid building. Suffolk County Department of Health Approval .............. .N/.A. ...................... UNDERWRITERS CERTIFICATE NO ............. .N/.A. ...... Building Inspector Rev. 1/81 TOV/N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13967 Z Dote ................ T Permission is hereby gronted to: ,.....'.,~...q.~......~....~,.~.... ................ ~-~.~ ...... ~......~~..~.',..___,__,' ........................................ ~ .................. ' ........ .~ ~,, ~,,ed ~, .**.~..~.~.....~.~.~.~,~..~,....~~~ ............ County Tax Mop No. 1000 Section ......... .J...J.....~.. .... Block ....... ./....~..~.. ..... Lot No. .~..Z__ pursuant to application dated ............... ................... , 19.~..~., Building Inspector. and approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in d~p~icate ~, A, This application must be fi[led in typewriter OR ink, and submitted~ ~ ~V,, ?.~o~he 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~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 preoare a certificate. C. Fees: 1. Certificate of occupancy $5.00 ~ 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ........ .~N Old or Pr isti g Building Va Land ,.=vv u~, ,~,,-~J- ......... e-ex n ............ cant ............. House No. Street Nam/et Owner or Owners of Property ................................................ County Tax Map No. 1000 Section ..... /../.~ ..... Block .... ~. ~.~. ....... Lot.. ~- ~'- Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ......................... Construction on above described building and,permit meets all applicable codes and regulations. R~. lo-lo-7a FIELD ~NS'P2CTION FOUNDATION (1st) FOUNDATION (2nd} 2. ROUGH FRAME & PLUMBING INSULATION FER N. STATE ENERGY GODE FINAL ADDITIONAL COMMENTS COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT' TOWN HALL 9OUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined....~..~.~..~.., 19~?. Approved ..... .'~kq~ .~.~.~·., 19~.~.. Permit No. ! .~..cl..Iq'~...~. Disapproved a/c ..................................... .... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 .ets 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ration. 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 ~hail 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 ~hall have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Btfilding Permit pursuant to the ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~.egulations, for the construction of buildings, addiQons or alterations, or for removal or demolition, as herein described. ['he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to tdmit authorized inspectors on premises and in building f°r necessary i~pe~°ns'~.~t ~<Z~~,tP_-/~-.,~ M'7~ ~¢e,o-,-~ · ?X .M.< ....... (Mailing address of applicant) ltate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... . Location of land on which proposed work will be done .................................................. ............................................ ......................... House Number Street Hamlet County Tax Map No. 1000 Section ..... 1 {.~. ........ Block ...... ~...~.. ....... Lot.. '.~..: ~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................ b. Intended use and occupancy....e-~..~~. ~.. ~..t~. ~. C .~..0..~.,,4 .~ ) ....... 10. 11. 12. 13. 14. Nature of work (check which a'pplicable): New Building ..... ' .....Addition .......... Alteration . Repair . .~, ...... Removal .............. Demolition .............. Other Work ............... / Zg--ar-9 1 ~' ~] (Description) Estimated Cost .......... Fee ' (to be paid on filing this application) If dwelling number of dwellin~ units Number of dwelling units on cacti floor If garage number of cars i If business, commercial or mixOd occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth i Height Number of Stories Dimensions of entire new conslruction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front .......... i ............ Rear ...................... Depth ...................... Date of Purchase ' Name of Former Owner Zone or use district in which p~emises are situated ..................................................... Does proposed construction vi~late any zoning law ordinance or regulation. Will lot be regraded .........i .................... Will excess fill be removed from premises: Yes No Name of Owner of premises ~ Address Phone No Name of Architect ......... ! .................. Address ................... Phone No ................ Name of Contractor . Address Phone No "I Locate clearly and distinctly a~l property lines. Give street and bloc} interior or corner lot. AP?~OV'E£ AS NOTED E ---- BY. FE :~ , ' .... ~OTIFY CUI~I~ DEPARTMENT AT 765-1802 9 AM ~TO 4 PM FOR 1, FOUNDATIO~[- ~0 REQUICED FOR POUR[~ ~CONC~[TE 4. FINA¢ - CO~*S~DGTIOM BE C~4Pl.YTE FOR C. O, ' TNE ~[OUIR~M[NTS OF THE STATE CoN~TR~CTION & EM[RGY CODES~ NOT ~ RESPONSIBLE FOR D~IGN OR CO~STRUCTION ~R PLOT DIAGRAM buildings, whether existing or proposed, and. indicate ail set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF ....... ' S.S ................................................ being duly sworn, deposes and says that he is the applicant (Name ofind!vidual sig ~ing contract) above named. He is the ..................... i .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dt ly authorized to perform or have performed the said work and to make and file this application; that all statements con :ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann ~r set forth in the application filed therewith. Sworn to before me this. ................ [ ....... day o:f....~ el4L. ............. 19ff.S. Notary Public, ....~,~.....~i..~.~ ....... County Y .., ~ NOIA~Y ?USL[C, Stato o! New York ..... .,,.f. ~ .~. ................................ l'ormll Expires Marc) 30, 19J~7 (/' '