HomeMy WebLinkAbout25088-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25977 Date: 09/18/98
THIS CERTIFIES that the building ALTERATION
Location of Property: 440 HAYWATERS RD CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 111 Block 2 Lot 3.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 24, 1998 pursuant to which
Building Permit No. 25088-Z dated AUGUST 12, 1998
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 ALTERATION TO AN EXISTING ACCESSORY CARPORT AS APPLIED FOR.
The certificate is issued to ALFONSO MARTINEZ-FONTS, JR.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
O/
uil ing Inspector
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. 25088 Z Date AUGUST 12 , 1998
Permission is hereby granted to:
ALFONSO JR MARTINEZ-FONTS
EL PASO,TX 79922
for
ALTERATION TO AN EXISTING ACCESSORY CARPORT AS APPLIED FOR.
at premises located at 440 HAYWATERS RD CUTCHOGUE
County Tax Map No. 473889 Section 111 Block 0002 Lot No. 003 .001
pursuant to application dated JUNE 24 1998 and approved by the
Building Inspector.
Fee $ 35 . 00
Building nspecto
ORIGINAL
Rev. 2/19/98
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F UNDATION 2ND [ ; FINAL 1 ULATION
[ FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: / /I
DATE ? 0 INSPECTOR
Form No. 6 ;, -•r t
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 buildint
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 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 buildin
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. r For existing buildings (prior to April 9, 1957) non-conforming uses, or, buildings an
"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 applicant
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
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 Buildine - $100.00
3. Copy of Certificate of Occupancy - .25v.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . .. . ./(�7 /. . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . .. ..// Old Or Pre-existing Building. . . .L!:�. . . . . . . . . .
Location of Property.�b. !":r:y(.il�C7eX /�A Cc�TCdfD¢dLr
House No. Street Hamlet
Onwer or Owners of Property.M'2� M/ZS A-6nld'o /Ltf��-�NGs2-:�U�
County Tax Map No 1000, Section. . . ((( . . . . . . .Block. . . . .� . . . . . . . . .Lot. . . .`.®� t' . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...Filed Map. . . . . . . . . . . .
�Lot. . . . . . . . . . . . . . . . .
Permit No. , s� �, , , ,Date Of Permit. i11.21V. . . . . .Applicant rDA", .M ;
Health Dept. Approval. . . . . . IV,1.4. . . . . . . . . . . . . . .Underwriters Approval. . . . . .N� . . . . . . . . . . . . .
Planning Board Approval. . . .N� . . . . . . .. . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . �. . .
7...
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . _
. � �. . . . . . . . . . . . . . . . . . . . .
. . . . .a�lG SL S PLICANT
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Alfonso Martinez-Fonts, Jr.
4935 Vista del Monte
El Paso, Texas 79922
September 7, 1998
Re: Application for Certificate of Occupancy
Building Permit 25088Z
Property location:
440 Haywaters Road
Cutchogue
Dear Sir/Madam:
Enclosed is my completed Application for Certificate of Occupancy on the above referenced
permit and location. Also enclosed is my $25.00 fee and a copy of the property survery.
I hereby grant my consent to inspect to the appropriate parties from the Town of Southhold
Office of Building Inspector. As there is usually not anyone at the house during weekdays, please
feel free to inspect the premises at your convenience. The carport which was enclosed and is the
subject of the building permit is unlocked.
If you should have any questions please do not hesitate to contact me at 915 546-6670 (day)or
915 845-2656 (evenings). Thank you in advance for your usual kind assistance.
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BOARD OF NEALTN . . . . . . . . . . . . . . .
FORM N0. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
mi If TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DRPARTMENT CiIECK . . . . . . . . . .. . . . . . . . . . . . . . .
{ 4c TOWN IIALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOl1TIIOI,D, N.Y. 11971
TEL: 765—I802 NOTIFY:/
r 99�a r '1 0 CALL J!e. ..� . . . . .
Exanined .. .:./. ., 19 MAIL MAILTO:'..�.ld114J. .
AI>tmrovtKl ../ .., 1911 Pennit No. ................ ..�[I:�V:A.fa�.� ..�5 ............
Disapproved etc ........................I......... .io°:wT•4 6�y�.�G !dL,.-.64.J ..
(Ifuildhng a/
tor
FOR BUILDING PEitMI'f ,,((
Date.`l..''. �4i•✓. . . . . . 199 .
iNSTRUCTIONS
a. 'this application must be completely filled in by typewriter or in ink and stdmitted'to the Building Inspector wi
3 sets of plans, accurate plot pian to scale. Fee according to sdherhile.
b. Plot plan slowing 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 mist be drawn on the disgranx4il h is pert of
this application.
c. 'one work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector wilf issue a Building Permit to the applicant. Such
°0 permit shall be kept on die premises available for inspection thrrnighout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of
iq Occupancy shall have been granted by the Building Inspector.
APPLICNMN IS HEREBY WME to the Building Department for the issuance of a 1luilding Permit pursuant to Line
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable iaws, ondihannces 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
regutations,,and to admit authorized inspectors on premises and in building for necessary inspections.
dd /�/... ..................
(Sig ture of applicant, or name, if a comporation))
—n'- --- — — -- -- --
----(Maili�address gf a , l ca_nt). __, -
State whetbei,gppl i cantIsy our, lessee, agent, architect, engineer, general contractor, electric,--plurber or lui lde
tm. . .r'..g........ 'r i!il .. Aw!:i7.G .......... .................
c3; i1C�' R lTi6 "'T� hl �(as on the tax roll or latest deed) -
�'t34�' 1?�";C1.1�"ht:l'n nth#
<'
if bjiliti'ca{ht idtA��blpot$ ibr�p at
gnature of duly authorized officer.
iii:"➢?�:w at her{Nrgl :,�
•••i...•••.•.•.• •.r.•...rri'�.1(•`••�ir • • •............•....
(Name and t'i'CIV of c6i*6t0-%off,,ce.r)
V llui'ldere i.icense`No1 . .:i.;'/ � t .
1 1, .r:3
Pludoers Licerae No: ....:;{:}..........I.......
Electricians License No. .....................
Other Trade's License No. .................... -
9, - !saat-ici of '`auri oi; ,A.idi proposed work will lu: ckxme..............................................................
.........`fyo.......t�a Wa ��s....���:........................ v� � � ..........................
Rause Number Street !a liaalet
Gxnmhty Tax Mpg). IO[10 Section �.�.3.5.k-.!.. Block I`.:...z...3:� int ................
Subdivision ...... ................................. Filed Map, No. ............... hot ...............
r V.n1e)
2. State ex;sting use and r,.ccu,aancy of premises and intended use said occupancy of proposed construction,
a. Faristing usp_ and o.:cupancy
.. .......or. ?.U.CC......................................................
em ClDf Q ...C ..........................................b. intended up,- rnd rx.:vpancy ...., .
., ;,,n;kir rattx�.t314#�
- :ndi:x'ftRk:z.d3f
7. Muure of work (check nbidh 'Irpldcable): New Building ........_ Addition .......... Alteration
Its xnIr ............ Removal ............ Daniel Ition ............ Other Work ............................ ..
1 (Description)
4. Idstiuxuted Coat ........... fee ..............................................
(to be paid on filing this application)
5, if rkIalling, onber of dwellllhg units ............ tininer of dwelling units cin each floor ..... ..... ......
Ifgarage, nnber of care ...L..................................
fi. If Ixneihheea camercial or min
mf occupancy, specify nature and extent of eadh type of use......................
7. Dimensions of existing stnuctree, If any: Front................ Rear ............... Depth .................
height ......................... Nidxer of Stories ......................
Dinhensions of sere structure ,with alterations or aklitione: Front ............... Rear ...............
Depth .................... ItnIlght .................... tlnber of Stories ......;........
fS. 111hnenslahs of entire nen
otxnR traction: Front ................ Rear ............... Depth ..............
Ilaiglit ......................... bailer of Stories .....................
9. Size of lot: Front .................... Rear .................... Oeptlh ......i.............
IO. Ikhl'e of Purdiase ............�'......... Nam of Former Owner ........................................
II. Zane or use district In wln{di
premises are situated ..............................................................
12. Does oro sed construction vi
proposed olate any zoning lar, ordinance or regulation: ........................
1:1. Will lot be regraded .......!............. Will excess fill be removed /A on a��ses: / YES NO
Hates 14. Nae of tlwner of premises//I4rl. ACC:.�11:�1:"�PA? b�&
/ klresa4..../..�f::.�..�..[�(....... Noon NO. 7�Y;J�JU3
Name of Architect .......... ......................... Address .............................. Phone No. ............
Nnre of Contractor ..=�f./.,(J...�� 2-:�f1d :.... Akklress ..f:..A. ''?�..16 ...........Nanc No.
15. Is this property within 300 feet.of a tidal wetland? * YFS .......... NO ..........
*IF YIS, S(AlnrlD lum I=IltP£i Petter HAY nI RRQIIMD. �
PLOT DTAGRAH;
locate clearly and distinctly all buildings, whether existing or proposed, and Indicate all set-back dimensions'
fr(m property lines. Give street sjnl block number or description according to deed, and allow street nares and indicate,,
hAne(Iner interior or corner lot.
S� � �f f il�✓ d
NQTED
OCCUPANCY O � x
USE IS UNLAWFUL � ��t3 �P E AT
7iR IW2 9 AM TO 4 FOR THE
WITHOUT CERTIFICATE 1111 """° ION!- E
I t?OUNOM'ION • TWO REQUIRED
FOR POURED CONCRETE
OF OCCUPANCY $. NSULATIONRAMINO 9 PLUMBING
UNDERWRITERS CERTIFICATE 4. FINAL • CONSTRUCTION MUST
/!L, REQUIRED 6E COMPLETE FOR C.O.
e ALL CONSTRUCTION SHALL Mr.ET
THE REQUIREMENTS OF THE N f.
MME (X? N1J / / STATE CONSTRUCTION & ENERGY
11 r'"I/ SS
0XINIY (A? .. S.& CObES. NOT RESPONSIBLE FOR
�/�1y DESIGN OR CONSTRUCTION ERRORS
(Halk! of individual signing crL ( � x rug duly sworn, deixnses and says that he ie the applicant
�. nSD... �..
t)
adxuve need,
Ifa in Ole ...................4N .V.............................................. i
r......................
(Contractor, agent;-corporate officer, etc.)
of said sumer or owners, aa(1 Is duly authorized to perronm or have Ixarfonhx:rl Lim said work nix] to make and file this
+1170 leation; that nil statements oxitalned in this application are true to tlhw beat of his luvvwledgc: and belief; a
(foal the work will be performed In t
he nxnoner set forth in the application riled thereKitn.
:)warn lonhs this
da of .. d. ..l9.C'�.g
Notary nbLic ... .. .. i... .... ... f
(Sigrnture of q>ihl3cnnc)
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