HomeMy WebLinkAbout25489-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27242
Date: 08/10/00
THIS CERTIFIES that the building ADDITION
Location of Property: 775 SHORE DRIVE GREENPORT
(HOUSE NO.) (STREET) (HAMLET}
County Tax Map No. 473889 Section 47 Block 2 Lot 20
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 9, 1998 pursuant to which
Building Permit No. 25489-Z dated JANUARY 22, 1999
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 WOOD STOVE INSTALLATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR "AB BUILT."
The certificate is issued to CIRINO RICCARDO ZAPPALA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
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. 25489 Z
Date JANUARY 22~ 1999
Permission is hereby granted to:
CIRINO RICCARDO ZAPPALA
168 MULBERRY ST
NEW YORK~NY 10013
for :
INSTALLATION OF A WOOD STOVE AS APPLIED FOR "AS BUILT."
at premises located at 775
County Tax Map No. 473889 Section 047
pursuant to application dated DECEMBER
Building Inspector.
SHORE DRIVE GREENPORT
Block 0002 Lot No. 020
9 1998 and approved by the
Fee $ 35.00
Authori z e~/Signatu~g
ORIGINAL
Rev. 2/19/98
BUILDING DEPARTM~N'[
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This appllcatiou must be filled in by t~ewriter OR ink and submi~';ed~:~"~
~spector with the following: for mew building or new use: ~~MOLD
1. Final sudsy of .property with accurate location of all buildings, property lines',
~Creet~ and unusual natural or topographic features.
2. Final Approval from Health Dept. of wager mupply and sewerage-disposal(S-9 fe~).
3. Approval of elec~rical ~nstallation from Board of Fire Unde~iters.
4. Sworn statement from pl~ber certify~g that the solder used in sy~t~ contains
leem than 2/10 of 1% lead.
5. C~erc~ build,g, ~du~trial build,g, ~ltiple residences and ~ilar buildings
amd ~mt~lations, a certificate of Code Comp'liance from architect or e~ineer
rempou~ble for the
6. ~u~t Pla~g Board ~pr~ of co~leged eite plan requir~eutm.
Fo~ ~eg~g bu~d~gm (prior to ~t~ 9, 1957)' nou-confo~ng uses, o= build~g~ amd
1. Accurate 8u~ey of p~oper~ eh~ ~11 property lines, streets, budding
~umu~ ~tural or topographic features.
2. A properl~ c~leted applicat~on ~d a consent to ~spect mi~ed by the applicant.
If a Cert~tcate of Occup~cy is denied, the Building Inspector ehall state the
reasons therefor in ~igtng to the applicant.
· I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw4mm~.g 9ool $25.00, Accessory building $25.00
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on pre-~xis=ing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~ .2.5~.
4. Updated Certificate of Occupancy - $50.00
5. Tempo~-ary Certificate of Occupancy'- Resfdenti~ ~5.00, Commercial $15.00
0 ...
Date
.7 7.C.. ....................
~t~.(l,u ,of 13ropertY .............. ' .......................lt_m'ml et
House No. Street
~er or Owaers of Proper~y .................. .'~" ..............
~n~ Tax Map No 1000, Section .... ~ ........ Block ............. Lot ..................
~ted ~-~ ............ Lot .... ·
, ' ~ t ......
of Fe it. ../:.{. Applican - -
~ ......
Unde~iters Approval ............
ml~h Dept. Approval ..........................
.auning Board Approval ........................ .~..
Submitted: $' ' ' ........
~ 1~ -~;.qo. . .. · ..............
r'l,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
ROUGH PLBG.
].~SULATION
FINAL
[ ] FIREPLACE & CHIMNEY
REMARK~
DATE ~//1~///~ /'I"N SPECTO~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]~JSULATION
[ ] FRAMING [~./] FINAL
[ ] FIREPLACE~H~NEY --
REMARKS: ~
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [, ] I~ATION
[ ] FRAMING [~] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS.
DATE ~~//~/
INSPECTOR
FIELD INSPECTION REPORT DATE COI~4ENTS
FOUNDATION (IST)
ii
INSULATION PER N. Y.
STATE ENERGY
,~-
0NDA~ION (IST)
'UGH FRAI4E &
PLUMBING
DATE
COJf'IEIJ'r S
II
ISULATION PER N. Y.
STATE ENERGY U
CODE ~
FIliAL ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ~NAL
[ ] FIREP~ACE~.C _IMNEY
BOARD OF
3 SETS OF PLA}IS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORIt ...................
NOTIFY:
CALL .................
HAlL TO: ........
APPLICATION FOR BUILDING PEElglT
I~STRUCTIO~S
ca~letely filled in by typaeriter or in ink ar~ stthaltted to the lluildi~g Inspector
3 ~ate plot pl~ to ~ale. F~ ~o~i~ to ~le.
b. Plot pla ~ lmti~ of lot ~ of hildi~s m p~s, mlatio~ip to ~joiui~ pr~8 or ~lic
struts or ~e~, ~ givi~ a &ail~ &~riptim of last of p~t ~ ~ ~ ~ di~i~ is ~rt of
~is a~li~tim.
c. ~ ~ mrM ~ ~is a~li~tim my mt ~ mm~ ~fore isle of hildi~ Pe~t.
d. ~ a~al of ~is ~limtim, ~ ~ildi~ ~tor ~11 im a ~ildi~ ~t to the ~limt.
.~t ~1 ~ ~pt m ~ ~s ~ail~le for i~tim ~t ~e ~rk.
e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~ ~r ~ ~ ~t~r ~til a ~rtificate
~m~ ~11 ~e ~n ~ by ~ ~ldi~ ~tor.
~I~ I~ ~ ~ ~o ~ ~ildi~ ~t for ~ ism of a ~ildi~ Pe~t ~t to the
~ldi~ ~ ~i~ of ~ T~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~r ~li~le ~s, ~i~s'or
~lati~ for ~ m~ti~ of ~ildi~, ~iti~ or alteraci~, or for ~al or ~liri~, ~ ~min
&~ri~. ~ a~li~t ~s to ~ly ~ ~1 ~li~le 1~, o~i~es, ~ildi~ c~, ~i~ c~,
r~lati~, ~ to ~t ~ri~ i~tors ~ ~s ~ in ~ldi~ for ~s~ i~i~.
........ .......................
(Si~e of ~li~t, or ~, if a co. ration)
~ih~ ~ess of ~lic~t) ~
State ~dle~her applicant is c~er, lessee, agent, architect, engineer, general ~tr~tor, el~trici~, pl~r or ~ildi
....... O~.~e~ ......................................................................................... ... . . .. .. . ..
If a~limt is a ~ratim, siam of ~ly ~ri~ offi~r. ~ ~-~ ._ ~ ~
t t,e o orate offi r) OCCUPANCY OR
USE IS UNLAWFUL
B~ilders License ~ ................ W~OUT CERTIFICATE
El~rrici~ Li~ ~ ......................
~r ~'s Li~ ~ .....................
1 FOUNOATN)N. ~ I~UI~ED
4. FINAL - CONS?RUCTION MUST
ALL CONStrUCTION SHALL MEET
THE #EOWREMENT$ OF THE N.Y.
3. gature of ~ork (check ~hich applicable): ~L~ l~ilding .......... ~klition ......... , Alteration
Repair ............ l~,~val ............. l)emal i~ioo ............ Offer ~ork
4. Estimeted Cost ff.~.O. ..................
(to be paid on filing this applicatioo)
5. I~ d~elllng, r~ber of d~elling ~mlts ...[. ....... humber of d~elling traits on eadt floor ................
If garage, r~ber of e~ra ....................
6. If business, ocmmreial or mlged occupancy, spaeify nature and extent of eadt type of use ......................
7. Dimensions of existing structures, if any: Front ................ Rear ......... . . .. .. Depth .....
}lelght ............... lq~ber of Stories ..........
Dimensions of ~ strocture with ' ' ' . .....
alteretloo~ or additions: Froot ......... Rear
Depth.... ...... ... .. .. ... lleight ........ l~ber of Stories ...........
8. Dimensions of entire new construction: Front ...... ... .. .. . .. Rear ............... Depth ..............
lleight .......... Nm~er of Stories .......... u....~
9. $1~e of lot: Front ................ .. .. Rear . ......... . .... . ... . Bepth ......
10. Date of hrrdmne ........ · .... ........ N~e of Former O~er ..................................... . . .
! I. Zone or use district in ~hich premises are situated ...................
~2. Does proposed coo~truetion violate any zoning la~, ordinance or regulation: ........................
13. I/i11 lot be regrnded .................... Will excess fill be forayed from premises: ~ NO
14. l~aes of 0~er of prmises .................. .. . . .... . Mdress .............................. Phone No ...............
Nam of Arddtoct ......................... · · · . . · . . . .. Mdrese .............................. Phone
Na~ of Contractor ....................... hddress ............................... ~ No.
15. Is this proper~ ,~i~in 300 feet of a tidal ~etland? ~ 3~S .......... NO ..........
PLOT DIAORAH
Locate clearly and distinctly all buildings, ~hecher existing or proposed, and indicate all set-beck dimensions
W'o~er~ lines. Give street and block r~nber or descrlptloo according to deed, and ~ street frames and indicate
~daether interior or comer lot.
e ~s me ..... (9~~ ...................
(~trect~, a~nt, co.rate offilcer, etc.)
~ ~d ~r or ~r8, a~ is ~ly ~Lhori~ Eo ~rfom or h~ ~rfo~ ~m ~id ~ m~l ~o m~ ~ file this
~].icati~; that all stat~nts c~tai~ in ~[s a~l. lcatloo are t~ to ~e ~st of bis ~1~ a,~ ~[ief~ aM
hat ae ~ will be ~r[o~ i, the miner ~t forth in ~e a~li~ti~ fil~ t~.
worn to be£o~e me this
.....
No. 495 ]
Commission Expires May 22,
($1gnal~re of Apptlci~/y