HomeMy WebLinkAbout25729-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICAT~ OF OCCUPANCY
No: Z-26495
Date: 06/07/99
THIS CERTIFIES that the building ALTERATION
Location of Property: 360 JASMINE LA SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 1 Lot 6.10
Subdivision Filed Map No. -- Lot NO. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 30, 1999 pursuant to which
Building permit No. 25729-Z dated MAY 14~ 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 INTERIOR ALTERATION (FINISHING 2ND FLOOR-4 BEDROOM MAXIMUM) TO
EXISTING ONE FAMILY DWELLING 'AS BUILT' AS APPLIED FOR.
The certificate is issued to MICHAEL & ROSE ANASAGASTI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
H-063693 04/01/99
05/25/99 MICHAEL ANASAGASTI
ilding Inspect~
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. 25729 Z Date MAY 14~ 1999
Permission is hereby granted to:
MICHAEL ANASAGASTI
PO BOX 414
SOUTHOLD~NY 11971
for :
INTERIOR ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR (FINISHING 2ND FLOOR) "AS BUILT"~ 4 BEDROOM MAXIMUM.
at premises located at 360
County Tax Map No. 473889 Section 070
pursuant to application dated MARCH
Building Inspector.
JASMINE LA
SOUTHOLD
Block 0001 Lot No. 006.010
30 1999 and approved by the
Fee $ 75.00
Authorize~S'ignatu~e
ORIGINAL
Rev. 2/19/98
.: . TOWN OF S00~H0~ ~ ~
BUILDING DEPARTMENT 54i~
TO~ ~L
/~~ ,. 765-1802
~ .. ~,~~ ~PLICATION ~R CERTIFICATE OF OCC~CY
A. Th~E~on must be filled in by t~ewriter OR ink and submitted to the build:
~spector with the following: for new building or new use:
i. Final su~ey of .property with accurate location of all buildings, property
streets, and unusual natural or topographic features.
2.Final Approval from He~th Dept. of water supply and sewerage-disposal(S-9 fo%u
3.Approval of electrical ~stalla[ion fr~ Board of Fire Unde~iters.
4. Sworn statement from plumber certify~g that the solder used in syst~ contaim
less than 2/10 of 1% lead.
5. C~ercial building, ~dustriai build~g, multiple residences and s~ilar bull,
and installations, a certifi~te of Code Compliance from architect or engineer
responsible for the building.
6.Submit Plannit Board ~prov~ of completed site plan requir~ents.
For existing bu. ildlngs (prior to April 9, 1957) non-conforming uses, or buildings
'-'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 stg~ed by the appltc~
If a Certificate of Occupancy is denied, the Building Inspector shall state th=
reasons therefor in writing to the applicant.
C. Fees
~ 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling~
Alterations to dwelling $25.00, Sw~ming pool $25.00, Accessory building $25f0(
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $i00.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date...... ........................ . .. ...
New Construction ........... Old Or Pre-existing Building .... .~. ...........
Location of Property..~.~.9 .............. .~.~..~..~.~.~.~.
House No. Street Hamlet
Onwer or Owners of Property ..................................
county T= 1000, section....V. -- ...... - ......... Lot .... ......
Subdivision ............................ .... . ... Filed Map ............ Lot .................
Permit ................ uate Of Permit..~.~L~..~ !?..Applicant..~(~.~ .d-'~-~.~-~;
Health Dept. Approval .......................... Under~iters kpproval...~ .............
Fee Submitted:
Planning Board Approval .
Request for: Temporary Certificate ........... Final Certicate...~ .....
c0- o%
THE NEW YORK BOARD OF FIRE UNDERWRITERS
...... ~- BUREAU OF ELECTRICITY
~ 40 FULTON NEW NY 10038
STREET,
YORK,
Date APRIL G1,1999 Application No. on file 179125?9/99 H M63693
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premlses of
HICHAEL AM/LSAGP~TI, 360 JAS}*LTN~ L~aNE, SOUTEOLD, NY
in the following location; [] Basement [] ;st FL [] 2nd Fl. Section Block Lot
was examined on ~*'~.g~CH 25,1999 and found To be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKIN~ DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS FLUORESCENT OTHER
DRYERS D~MMERS
SYSTEMS
NO, OF FEET
OTHER APPARATUS:
PbDDLE Fb_NS -P - 2
G.F.C.I:-2
$HOKE DETECTOR: -4
S E R V I C
NO. OF HI-LEG O, OF OF NEUTRAL
HICHAEL A~ffi. S ..... T_
JASMINE LANE
SOUTHOI~ NY, 11971
FEE PAID
AMOUNT
PLEASE REMIT BY CHECK OR MONEY
ORDER TO THE ORDER OF THE NEW
YORK ROARD OF FIRE UNDERWRITERS
AS CASH SENT BY MA~L WILL BE AT RISK
OF SENDER,
Per.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CER~ I ~ I CATION
Building Permit No. ~b7~
Owner: ./~lCJ~/ ~~%
(please print)
Plumber:
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
umbers Slgnature ~
Sworn to before me this
~ ~- day of
Nota Publl ,
County
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
,......---
INSPECT~
PROVIDE OPENINGS FOR
EME ,RI~EN~ESCAPE AS
REqU ,I;j~Z)_ IAi,PART. 714 OF
STATE BUILDING CODE.
~- t I .: ...,t __..,1'
PRO~OE ANTi'SCALD AND/OR
THEWMAL SH,~CK PREVENTING
DEVICES AS TO PART. 902.$(K)
N.Y. tl,"ATE BUILDING CODE.
PRO IDES KE. DETECTING
/ ALARMDEVICES
~AS TO PiA.. 72u
'~ N.Y.$ 8UlkDING CODE.
c.I. os~T
PLUMBER CERTIFICAT/OI~
ON LEAD CONTENT B~FOR
~ ~.CERTIFICATE OF OCCUPAN,
SOLDER USED ~IV WATER
SUPP!_Y SYSTEM CAN
EXCEED 2/10 of 1% LEAD~I
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
APPROVED AS
'
FEE: 'w'7.~" ~') B~
~ BUILDING DE!
765-1802 g AM TO 4;
1- FOUNDATION - TV
, _ r-Dp I~OU~D CONe
'L ..... '" "~"llOI[~H ~
PLUMBii~.t~Ec..... o ~,
ALL Pt.UMBING WASTE
· It, WATER LINES NEED
TESTING BEPORE COVERING
/5
If copper tubing is used
for water distributing
,^ ~ystem; piping shall be
rv oftypes K or L only
UNDERWRITERS CERTIFICATE
REQUIRED
4. FINAL - CONS.rRUCTION M, S~
BEC'"OfffIP'cEI~ FOR ]~.0.
ALL CONSTRUCTION SHALL MF ET
THE REQUIREMENTS OF THE N Y
STATE CONSTRUCTION & ENERCY
CODES. NOT RESPONSIBLE ~oP
DESIGN OR CONSTRUCTIOh EPROHS
UNDERWRITERS CERTIFICATE
REQUIRED
REQUIRED
RTE
I-'LUMB!NG
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I/NSULATION
/
[ ] FRAMING /~ [~ FINAL
[ ] FIREPLACE & CHIMNEY
REMARK-~: ~
DATE
INSP ~E~
[ELD ]INSPECTION REPORT
DAlE
COI~IENTS
OUNDATION
(~ST) ~
0UNDATION
(2~D)
OUGH FRAHE &
PLUH~ING
.NSULATION PER N.
STA~E ENERGY
CODE
ADI)I~IONAL C~S:
~OBH NO. !
TORN OF SOUTHOLD
BUILDING DEPAR'I'HENT
SOUTHOLD, li.Y. ! 197 i
TEL: 765-1802
3 SETS OF PLANS ...............
SURVEY ....................... .
CBECK
SETTIC FOBH
NOTIFY:
c, L
MAIL TO: ..................
Data...~..: .......... ,I ...
a. This aRplicatim ut be *~pletely filled in by typewriter or in ink and ~,~.tted to the Building Inspecto,
' ~ete of plmm, accurate plot plan to scale. Fee accordir~ to schedale.
b. Flor plan ~ l~ca~ion of lot and of buil&i~ eo ~.~ises, relationship to adjoining premises or public
a~reets or a~ese, aod 8tvi~J~ a detailed descrip~ioa of la~r~r of property mint be d~,~a oa the dingra~ ~hich is part,
this appllcatie~.
c. ~e ~ covezed by this applicatiee my ~ot be cc~e~ced before issu~ce of Building eez~:.
d. ~ ~e~c, ml of thia a~licatiee, tie Building hu~ector ~11 issue a B~lding Pe~mlt to the applic~n/. ~k
pemit shall be lmpt ee the ~dsea available for i~spectio~ thrc~&heut the ~rk.
e. No Imildi~s ~lmll be occupied or used in ~hole or ia ~ for any l~pose dmtever u~til a Certificate of
APPLICAT[I~i 1~ I~sux ~ to the l~ilding Depa~l~e~t for the isana~ce of a l~ildi~& Pemlt gorsuant to the
Building Zcme O~dt~e of the Tam of Southold, Suffolk Cou~, ~ York, and other applicable L~m, Ordi~ces or
il~ulatioos, for the c~n~ructi~ of Mldinga, ~itiona or alterscions, or for ~ or ~litica~, as herein
described. The applicant agveea to ~.ly vith all applicable la~s, ordinances, l~ilding code, housing code, and
....
(I~aili~ of appllc~t)
State ii, ether applicant is mr,, lessee, agent, architect, engineer, ~ral contractor, electricim~, plmber or bui
If applicant is a corpar~io?~ s~atore of duly auli~rired officer. ~ [~.[NN(] D~PARI~iENT AT
lJ ! t AM TO 4 PM FOR THE
~ IIOU~IJ o ~ & IqJJMBING
Builders Licanse No ...........................
4. ~INAL - CONSVRUCTION MUST
?l~bers L~ No .......................... ~E COMPL~Je FOR C.O.
ElecL~ricians L~e No. ALL CONSTRUCTION SHALL ME~,
..................... THE RECIUJREMENTS OF THE N.Y.
Other Tracle~a License No ..................... STATE CONSTRUCTION & ENERGY
. . -o t oIJ RESPONSIBLE FOR
~ ~r
3. Itature o[ ~ork (check ~.tdctl applicable): ~ Building .......... klditic~ ......... Alteracioo ..........
l~epair ............ V~val ............. Demolition ............ Other l~ork '. ~..'Y.~.~. ~ .... .~. i~..4'.TuR !..~.~...
~ 0)escript Jun)
... ..... ..............................................
(to be paid tm filing this application)
5. If duelling, ntnber of d~elling units ............ N~ber of a~elling units ca each floor ................
If. garage, ntzaber of. Cars ......................................
6. If business, c~...ercial or mixed occupancy, specify nature and extent ot: each type of. use ......................
7. Dimensions of. existing structures, if any: Frout ................ Rear ............... Depth .................
Ilelgh~ ......................... Nt~ber o~ Stories ............... .. . ..
Dir~nslons of same stnicttwe ~tth alteraticms or additions: Frout ............... Rear ...............
Depth .................... Height .................. .. Number of. ~tories ........ . ......
8. Dimensions of entire ne~construction:' Froot ............. ........ Rear ........... Depth .............
Height .................... . ... . Number of. ~orica. ......... . ........ ..
9. Size of. lot: Frout .................... Rear ................. Depth .......
I0. Da~e of. Pcwctmsa...............·..... Nme of Foorer Ouner ..................................... . . ..
II. Z~e or une district in ~ich pmaines are situated ..................................................
12. Does piovoned c~ustruc~ioa viol. ate any zoning la~, ordinance or rngulatian: ........................
13. I4111 lot be regrnded ..................... I~ill ~a~ss f.ill be remo~d from p,,~fia?s:,. YES bio
~ of. Architect ....... gAdress .................... Ph0~ No ............
~ of Contractor .................................... /kldress ............................... Fnone No ............
15. Is this pmpert~ wi~in 300 feet of. a tidal ~etland? t 1~5 .......... hi) ..........
PLOT DIAGRAI4
I~cate clearly and distinctly all buildings, daether existing or proposed, and indicate all net-back dii~nsioo, s
frc~ v, operty lines. Give street mad blook oo~ber or description eneording to deed, and sho~ street nares ~nd indicate
dnether interior or Carnet lot.
duly sworn, deposes and says tim~ be is the applicant
,9~rn to before me this
...... cX ....
(Cootraetor, agent, oorporate offiCar, etc.)
of said e~mer or owners, and is duly authorized to perform or have parf~nred tim said ~ork and to make a~d file this
applicatlun; that all statements contained in this application are true to the best of his koo~ledge and b~liefl end
timt the work will be performed in tim maoner net forth in the application filed there~th.