HomeMy WebLinkAbout26875-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27731 Date: 06/05/01
THIS CERTIFIES that the building ADDITION
Location of Property: 510 YOUNGS AVE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 64 Block 1 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 5, 2000 pursuant to which
Building Permit No. 26875-Z dated OCTOBER 25, 2000
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 REAR DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ROBERT P MADDALENA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized Signatur
Rev. 1/81
FORM NO. 3
TOWN 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)
PERMIT NO. 26875 Z Date OCTOBER 25, 2000
Permission is hereby granted to:
ROBERT P MADDALENA
1 WINFIELD DAVIS
CORAM,NY 11727
for
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
at premises located at 510 YOUNGS AVE SOUTHOLD
County Tax Map No. 473889 Section 064 Block 0001 Lot No. 004
pursuant to application dated SEPTEMBER 5, 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Authorize ignatu
ORIGINAL
Rev. 2/19/98
f
Foitn No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
` 765-1802
APPLICATION 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 accurate location of all 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 ofFire 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) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets,
building and
unusual natural or topographic features.
2. A properly completed application and a.consent to inspect signed by the appii 'a €.
If a Certificate of Occupancy is denied, the Building Inspector shall state the .,7
reasons therefor in writing to the applicant.
i
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.0&, /'
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-existing Building - $100,00.
3. Copy of Certificate of Occupancy - .25i0
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . t-. . . ;!i.�:�!!. . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
t 5�0 . . . . . . . . . . .. . . .. � . .
Location of Property. . . . .
House No. Street Hamlet • . •
Onwer or. Owners of Property *. .d.. . . . . . . . . . . . .
. . .
County Tax Map No 1000, Section. . .
. 1 . . . . . . . . . . . . . . . . .
. . . . . .Block. . . . . . . . . . .Lot. .
Subdivision. . .. . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit Nod.&. .7� _Z,Date Of Permit. . . . . . . . . . . . . . . .Applicant�4�'�!'�!,'�, ,N;JG4�?0%y)� {a
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval ,
Planning Board Approval. . . . . . . . . . . . . . . . . ... . . . . .
Request for: Temporary Certificate. . . . . . . . . . . a Cert te. . . . . . . . . . .
Fee Sub itted• ,p? .;ad , , , , , . .
. . . . . . . . .
APPLICAN --
r5 ��
Town Hall,53095 Main Road Fax(516)765-1823
P.O. Box 1179 Telephone(516)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMEN`r
TOWN OF SOUTHOLD
June 4, 2001
Robert Bohn Contracting
P.0• Box 55
Peconic, NY 11958
RE: 510 Youngs Ave• , Southold, Robert Maddalena
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy because of the
following reasons:
xx An application for Certificate of Occupancy is
not on file• (Enclosed)
No Underwriters Certificate on file•
xx The check is (not on file. )$25.00
No Health Department Approval on file•
No final inspection has been made.
No Plumber Solder Certificate on file•
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 26875-Z
Please contact our office on this matter. Thank you for
cooperation•
SOUTHOLD TOWN BUILDING DEPT•
T65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING f}''P FINAL
[ ] FIREPLACE 6 CH14 NEY
n- /2 / A =,
DATE�� U INSPECT
76s-isoz i
BUILDING DEPT.
INSPECTION !
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I LATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS•
—�s
.DATE � �� INSPECTOR
.D INSPECTION REPORT DATE COMMENTS
==____________________=====oaa
ii
4DATION OST)
I� u
�I 7
NIDATION (2ND)------------------
_ II
---------------------- --- i
ii --
z
:H FRAME &
PLUMBING - -----------------
it ij
ILATION PER N. Y. Jol
;TATE ENERGY
CODE
p . e7
asle (� '
Ill ---�
II
Ill -----II -
IUuI
II- -
FINAL I ii
u
II
ADDITIONAL COMMENTS:
___________________________________________________________
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H
O
Z
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ro
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if
33 BOARD OV UEALTEI ....• .
5 3 SETS OVPLANS'•...............
SURVEY ...... . .•. ......r ;.. . .... . .
N.°
TOWN OF SOUT110I.D
BUILDING DC['AR'i'HCNT C1lECR .......•• . :'.. . . . . ... . .
TOWN HALL SLYTYC FORH ...• • •. . . . . . . ..
SOUT1101•D, N.Y. 11971
TEC.; 765•-11102 NOTIVY t
CALL999.. .. . . . . . . . . . . .
HAII. TO; . . .. .1
r�.n{li t ..V• •V.. .i•.�i•I•.1✓ ...............
. ...... .
Approv(xl...� ...,•
l)isap<)r_wed a/c ......................•............
.... ................. ........I.. w
•(Wildina lns*tor) .
APPLICATION FoR BUILDING 1131HIT
•Date.. .....• '[ •,
INSTRUCTIONS
a. 'riris application oust be eocnPletely filled in by typew
riter or in ink and Mixuitted to die Wilding Inspector wi
3 sets of plans,, accurate plot plan to scale. Vee according to scWIU1e. sea or public
b. Plot plan slxuing location of lot s i Cho+ o#: la �C'of perty�austilV dran on tl%e sgran%a1jtd► In port of
streets or areas, rind aivina a detailed p
this a[4)11catior. Penuit.
c. llie work covered by this application may not W crnmenced wilt l issuance of Iwildiag
&rclr
d. Upon approval of duia application, the building Inspector wl>j issue a Ikiildi�vomit to tl'e applicant.
permit sliall be•kept on the premises available for inspection 01ro4=t the work' tever until a Certificate of
e. No building slwll be occupied or used in thole or in part for purpa8a
()ccupanq sliall have been granted by dw Ik,ildivig Inspector.
Pursuant to the
l�I;Pi.IC1 naj IS in= twx to the Wilding Department for the issuance of a liuildi�1'�enaitprdic�ea or
wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Y.>irj
Regulations, for the construction of buildings, additions or alterations, or for recmval or demolition, ss herein
described. The applicant agrees to comply with all applicable laws, ordinances, building code, hau8in8 O0de'
regulations,iat)d to adult authorized inspectors on premises and in building'for necessary inspections-
(Signature of applicant, or gugW, if 8 corporation)
•� �) /' y/1
•• • • • •• • • • ••
•
.illb...... .�5.� G.�?.Y..�l.�s ....
(Haili% address of applicant)
State Whether applicant is owner, lessee, agent, architect, engineer,*general contractor, electrician, pluaber or Willk
4'E.car►4.. !?: 4�Rr......................................,......................................
t of owner of premises ...:" •..:1::41EtR7r..��.�11!9.r?o?q"NAF :................................
(as on the tax roll or latest deed)
It api)l' ant is a corporation, lure of ly ault•1 l officer.
enc] title of co ate.officer)
Tk3ilders License No. •• •• ••• •
Plucrbers License No. �
Electricians License No.
Other Trade's License tb. ....................
1. [ocation of lmxl on rAddi proposed wink will be dcm.................,......................................�....
.5/o Y4� mfr�. .� ."q�....................... ............
. ........... U=Ut .............
1louse tk%lber Street
county Tax hap No. 1000 Section .. �........ block ......��....... lot ....� .....:.
riled tlap No. ........:...... lot ...............
Subdivision ...................................... ..
(Nene)
2. State existing use and occupancy, of premises and Intended use and/Oc)c`upaan'cy Of PMPased construction:
Si� 4,4f • i ...,`i s f••4�Yi'•FYI. :::iii r...•.••••..................
a. rtzdstirk-use and occupancy ..........s.. ....�.'
1). Intended U" aril occupancy .........i•.._' _•.••T...........................................................
l+tttttre of work (dm*%Aildt applleaLta)l New ilullding .......... &&Rion .. .. ...
Alteration
llepeir ............ Rdstnvat ........:.... Demolition ,............ Other Work .....................,............
(Necription) .
Latimated Cost 4.940 .. fee. .............................................. .
oto be pald.dmn filing this opplicotion)
If Aftlling, nkstbar of "111na unita ............ I1<o er of c>~relling :mita ata eacia floor .......... ......
If garage, uunier of care ........................6.............
If NisInesa, eannerelal or mlx4 occupancy, specs fy nature and extent of endo type of use......................
Dimensions of existing structures, if aeyt rront................. hear ............... Npdv .................
Buight Nktnber of stories ..................
Dimensions of smn atnnctnre with alterations or'acklitionnt Front ............... hear ...............
p ............ llelght Kmt>er of stories ...........
nittensions of entire new construction: Pront .............:.. tear ............... (eptly ... .... .......
naiovt ......................... Rriber of stories .....................
Sire of lot's th'mt ..............4..... Rear .................... nepth ......I............
.
(l. lege of Purdiase ..................... Nome of lronner (klner ..................................... .. .
1. Zane or use district in which premises are situated ................................................ .... ......
.. ...
2. Does proposed construction violate any zonina lav, ordInanes or regulationt ........................
3. Will lot be regraded .................... Will excess fill be removed from prerniaeat YES NO
14. Name of Owner of premiaea ................:......:... Acklress .............................A.. 1'hotne No. ............
Name Of Architect ......................t............. Address .............................. Phone No. ............
Ntre of Contractor ..............:.................... Mdreas ...............................Phone No. ............
IS. to this property within 300 feet,of a tidal wetlarxl.? * YRS .......... M ..........
kip Ylrs, 90IfY1m ma 2'RUSIn 1'gmff M&Y In mllft z. "
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, erd Indicate all set-back dimensions
from property linea. Glvva street anti block rmber Gr description according to deed, and em street 'narea aril indicote
t.(vetlter Interior or corner lot.
SES wRt6y
want a= H-'W YtxtK,
4
............. . .................belle; drily warn, depo9ea avxt says dint he in Lhe oppi.ie mut:
(Nate of itxl ichml signing contract)
above twxt+ed
Ile is the ......•... .................................... .................................................
(Cantraetor, agent;corpornte of.Cider., etc.) ,
of said a+»er or owners, mel Is duly authorized to perform or hrrve lverformail the said work mel to wke otxl file this
filgnllcnticm; dintfill state3nettts contained In this nlrplicaticm are true to tine best of bla ktxvledge mel b6lief; cnxl
(lint Live vurk will be perlbttnecl in the nxm*r set forth In the application filed ttaerewith.
urn Lo befor me tills
.. cin of
NoLary Public
•SItItuat:ure of Appl c at)
Not$ry Public,State of'New York
No.4951364
Qualified in Suffolk Cour
Commission Expires May 22, 10 0
BUILDING I'I I -TII'I1 I`I~A�IILI 1 �1K_ I I `I
Applicant) Q Date
Owners Name: C' !�/�• __ Reviewed:
Architect) Date c��C/VEngineer: __ Submitted: /
S('TM 11:
District: 1,000 Section _ Block _�_ Lot
Project(, Subdivision
Location C? r � � �"�' yLL�= -- - -
Name.
Single 8c separate Required
ccrtuficanoll No
Req Req.
Conine I�uttict Lot sirs _ /actualILot coVcragc
Req Req SD Req '
IPront Pard �Propose - [Side Yard Proposed [Rcar Yard � Pro posed 7
Project Description:
AGENCYJERMITS Permit
REQUIRED FOR REVIEW N.A./ NO YES Number
Suffolk County Health Dept.
v
New York State D. E. C.
Town Trustees /
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone: /se
Notes.:
I
f OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICAT Lj
OF OCCUPANCY
APPROVED AS NOTED
DMA is.p
FM
BY.
NOTIFY BUILDING DEP ME AT
785-1802 9 AM TO 4 M FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED „ -'
FOR POURED GONGRE-i E
2 ROUGH - FRAMING & PLUMBING >c4 j
3. INSULATION
-
4 FINAL - CONSTRUCTION MUST r!r'' L Tc. /
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR .�- ;r }` ji� 7-
DESIGN
DESIGN OR CONSTRUCTION ERRORS
c.
34 �
1 .
i �
LAG PIOI---, 13
TO E-KI 3
/j,\3 rq docs
)('4 a4Lv,+jr4-f,,o
cit
S-rs mEcr egor
to
7c, Lf
MAP OF
q �1 C:--SCR/ ED PROPERTY
It
NSOU THOLD
�.. ,., T '1 GF SOUTHOLD
S_.',=-r CLK CCUN TY, N. Y.
� s
SUP,KEYED FOR ROBERT P. MADDrLENA
JOANNE MADDALENA
STEINACNER TM i000-064-01-04
o /F
N SURVEYED 16 DEC., 1999
SCALE 1"=30'
Wi
AREA= 10,000 Sr,
REMNANCf OF 2��•�0 OR
N 79' 24' 00" E t.6'� - z - - - -
2 RAIL FENC£ FENCE POST
— N 0.2' 0.23 ACRES
A FOUND E 0.0'
CONC 4' H/MNE CONC. MON
MON 31.7' 120'
20' GUARANTEED TO
ff ^� pp 2 1/2 STORY — O
�J
at' FRAME s.0' (,t N,�F GAMMON ROBERT P. MADDALENA
`� CJ1 p� JOANNE MADDALENA
BRICK $ RES N O FIDELITY NATIONAL TITLE /NS. CO.
CONE Sw �'s " ta.4' O O CENJOANT MORTGAGE
0 O 31.7' ` 40.5' N GARAGE FOUND O
+ CONC MON.
- Z CC) DRIVEWAY
o FOUND C'ONC MON. 2.3= /2.3
END FENCE tt1�OD FfNCf Q,9' Wt70D FENCE FENCE
S O.B' ,CORNER
S 79. 24' 00" W 1 STORY WOOD 200.00 w o.2'
FRAME RES. SURVEYED BY
,0-n sfop Ym t''ncolh riz!ad clteration or addition to the ��,�tt��t��rrrr'`'
-d * . i:_ �_r,n :cr wh r^ the survey 'k;Ney is a viclatian of Section 7209 of STArNL ' % ,V' 911CSE JR.
i� pre pt red, cno on h:s behalf to the the New York State Education Law, P.0• QQ •?$��;</t ;•,i ,
Govern•entct Agency, NEWcSl7F 6tSK, t x 11956
N/F WOLFF -:ir,g irs,. cr.., it listed hereon, anda not bearing 631 :��`— 35
tt,-s cs::cnees of the lending institution.
copies of this survey map t�
al shall
ucrontees cre nct transferable to the Land Surveyors embossed se ;c
additional institutions or subsequent owner. not be considered to be a valid trueEYOR
COPY-
Ys' LIC�'�+ ►�4�. '
4