HomeMy WebLinkAbout24669-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25770 Date: 06/10/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 4326 WESTPHALIA RD MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 113 Block 9 Lot 10.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 28, 1998 pursuant to which
Building Permit No. 24669-Z dated FEBRUARY 11, 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 ACCESSORY TWO CAR GARAGE AS APPLIED FOR.
The certificate is issued to RALPH F. & ALBA RAGUCCI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 21375 05/13/98
PLUMBERS CERTIFICATION DATED N/A
t �
//iil ng 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)
Date..... ........................... 19....95...
24669 Z
Permission Is hereby granted to:
Ro.QANNQ.. ......................................
.......240-11,,.MARYLAND..AU.Ei...................................
........P.Rw0,4A.QLQN.1.w...11.34..2...................................
to.....G.QNQ190;T...AN..AG.QR.QS.QR,y.,.,2...GA.R....QARA.GE...0...T.H.R..RR.W.T.RZIP..YARD...W...A.
.........N.AT.�RFR.QN.T..,A.WF4 ANG... S..APR..lJAW..FS7RA..................................................................
..................................................................................................................................................................
........................................................................................................................... ... ...
..................................................................................................................................................................
at premises located at................4326 WESTPHALIA... D,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,MATT, TU,X........
....... ... .....................
County Tax Map No. ...,4,73889,,,,, Section ...1,13............. Block ....0009 ..... Lot No.
pursuant to application dated ...JANUARY 28,,,,,,,,,,,,,,,,,,,,,,,,, 19.....9B...., and approved by the
Building Inspector.
Fee 5...50.20...:.....
. ..................
Building Inspecto
Rev. 6/30/80
Form N o. 6
TOWN OF SOUTHOLD MAY 2Q Pi,,I
BUILDING DEPARTMENT
TOWN HALL OLDG,O
765-1802 TO �6 !
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 of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 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.
S. 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 applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
h reasons therefor in writing to the applicant.
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 - .25C
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.0/0, Commercial W.00
// Date . . :,� /lo'?,'/�,/,�, v. . . . . . . . . . . . . . . . . . . . . . . . . .
yew Construction. . .Y. . � /. . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
aLdA
vocation of Property. . ..41-3. . . . , W Vis.,.P F. . . . . . . . P,D. . . . . . . . . . .�� 1 (�T� ✓teF . . . . :��. . . .
House No. Street Hamlet
nwer or Owners ofProperty. .� S?`rp�. . . : ? G✓.cc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
;ounty Tax Map No 1000, Section. . J/.:A . . . . . . .Block. . 0 9 . . . . . . . . . .Lot./P-., �! . . . . . . . . . . . . . . .
,ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . .'. .-_. . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Q7! /o�.� Z ��/.�9�. . .A licant..f/�s�' o Goi.ISJ, G'oR?
,ermit No. . . . . .Date Of Permit. . . . . pp . . . . . . •
Iealth Dept. Approval. . . . . . . . . . .Underwriters Approval. . f� . � . . . . . . . . . . . .
'fanning Board Approval yV M 'D2e>
request for: Temporary
-- Certificate. . . . . . . . . . . Final Certicate. . . .
ee ubmitted: $. . .P.4� . . . . . . . . . . . . . . . . . .
I- . . . . . . . . . . . . . . . . . . . . . . . .
APPLICANT
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Unauthorized alteration or addition
to this survey Is a Noladm o1
Section 7208 of IM Now York Sim
Education law.
Coplss of INs swvey map net bmh
da lard surveyors MW OW or
embossed seal Nay notbacaWdsrad
to be a valid btu COPY. gyp
Guarantses InrBCaYd hwsen/1111/111100111
onlyto tha pewon forwhom dM waveY 20 rJ/
Is prepared,and on Ns behalf 10 M
title company.0ovemmmad spway and
lending Institution Awed trraan and
to da asaloneet of the W drg MIRIA n.
Guarantees are not trarulerada
to additional Inatituiions or abw011wnt
owners.
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ELECTRICAL INSPECTION SERVICE INC.
375 DUNTONA VENUE
EAST PATCHOGUE,NEW YORK 11772
(516)286-6642
21375
DATE: 5/13/98 - - - ,APPLICATIONNo.ONFILE `
VILLAGE' MatBtuck TOWN: Southold
ADDRESS: 432h Wexjphalia Road
ISSUED TO: Ralph Ragucci
INrRoou
was examined on 5113198 , and found to be in compliance with the National Electrical Code -
LOCATION: Base_ - Ist xx 2nd - 3rd Attic -
Det.Garage xx Hot Tub . . Pool
SWITCHES RECEPTACLES FIXTURES HEATERS FANS G.F.L. AIR.COND.
3 5 3 1 :
DISIIWAMER DRYER CLOTHES WASH. GAR.DISP. RANGE OVEN SMOKEDETECTOR
FURNACE OIL GAS CIR. MOTORS BELL TRAM SER WCEDISCONNECT
MSTM MBS PMM
OTHER "
EQUIPMENT
HUGOS. SURDI
PRESIDENT -
BUILDING PERMIT No. _ '�tus wlnLcacemustnotoeauaedmanymanna - '
jwpe nmaywde�ti&dbrth..d.,tial. BLUE .
ORIGINAL YELLOW COPYPINK COPY OFFICE -
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765-1802
BUILDING DEPT.
INSPECTION
[ VrFOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE � INSPECTOR
G�
M-1802
BUILDING DEPT. f
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ 1] SULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
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BOARD OF HEALTH �.. . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
R TOWN OF SOUTHOLD SURVEY • • •
l5 BUILDING DEPARTMENT CHECK
p`t t�„1+�'"`, TOWN HALL SEPTIC FORM r. . . . . . . . . .
( 11ji SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
F
CALL �AP� �,�,iSo�'].Z �FflS(
FLOG.U S'1
Fxani DouN OF SOU)HOL{h ds MAIL TO• . . .. . . . . . . . . . . . . . . . .
Approved.................. 19.... Permit No. .K2 ..... ....................................
Disapproveda/c .................................. ....................................
)13uildingIns tor)
AP ICATION FOR BUILDING PERMIT /
Date.ll�.�. . . . . . . . . . 19ft
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector with
3 sets 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
c. The work covered by this application may not be caarenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall 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 shall have been granted by the Building Inspector.
ARPLICM(M IS HMW MAD. to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein
descriUed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in building for necessary inspections.
................
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant) /q7
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...................... rY w�?P lT .. .a.o-✓.4.c o'.1.v P ,.......................................................
Nam of owner of premises .........
....................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Nam and title of corporate officer) `
Builders License No. .U%3-r#4...vla q........
Plumbers License No. ..=...................
Electricians License No. .. �O m� .C.......
Other Trade's License No. ....................
1. Ivcatiou of land on which proposed work will. be done.. n? ?ties 1.... l......t...
...................h1>xlC�at cc .. `�:..�1g5a:........
House Number Street hamlet
Canty Tax Map No. 1000 Section ...11... ........ Block ,.O. .......... Lot ........
Subdivision .....I.............................. Filed Map No. ............... Lot ...............
(Nae)
2. 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 ........ "'... V .. +...., . n�E.?.......A....Gg=.......................
3, Nature of. work Wiec:k which n�1licable): New Ihuildin,. .......... Ividition .........: Alteration
JS�Ers. G a ti fl✓AVA7a// (>
Repuur ............ Removal lei.......... Wnolition ............ Other Work .. t ...........: ....circ...
(Deacr i pt icon)
4. Esdulated Cost .....�. / o o.�.•II�:°....... fee ..............................................
(to be paid on filing this al)plication)
S. if chaelling, number of dwelling units ............ timber of chaelling units on each floor ................
Ifgarage, nnber of cars ......................................
6. If Ixlsiness, commercial or mixed occupancy, specify nature and extent of each type of use......................
7. Dinx:nsios of existing structures, if any: Front................ Rear ............... Repoli .................
Ikaiglnt ........................�i. IAnix:r of St.oriea ......................
Dimensions of sane structure with alterations or additions: Front ............... Rear ...............
DepW ..............:.:... lieigllt .................... Noliuer of Stories ...............
R. Wisensiot of entire new construction: r / '
.�, rtuctioo: From ...rx.c7�........ He, ..,.1.41.......... Depthq'1,!f,,,_„.,,,
height ............. ... .. Unix. of Stories "..0. .... ...
. z
9. Size of lot. Font ./...,),...:.i,......... Rear ..�Q(o.36 ...... 11e UI Y 7.�
10. Dare of P uramse w7.(f;3[�.�.III....... Una of barer OA)er t p ......A�� .•....
r ,e s>�n yam..5�':'. ..-:�............
II. Zcxe or use district in wllidn premises are situated ..............................................................
12. does proposed construction viollate any zoning law, ordinance or regulation: ..................
13. Will lot le regraded .......... Will excess fill be removed from premises: YES
14. tktires of. Owcer of Premises lZ�131,Pi{1 ALO/Y,(�i�G,voc (. lxktresso.3a .1.135•t�l �r c(C Plnrnce
Nine of Archlfeet �1Av.�o
... .4't2�................ kkiress�..'.......................... Ilnone No. ....../........
Mice of Contractor):65d,t.oK.9.�:sG,'.'.p 0............
15. Is this property
00 feet of a tidal wetland? * YIDS .�.... ND ..........
I (e Y
* 1 mn PERMIT illy ISE RGCil1IRE1l.
PLOT DIAGRAM
locate clearly and distinctly al4l buildings, whether existing or proposed, six] indicate all set-back dimensions
frons property lines. Give street mold block number or description according to (need, and allow street names and indicate
wlnetluer interior or corner lot.
I
SI'KIE (Hr NV WWK,
SSI,
UllfN1Y 0Ir
_...... ..(,.1.5.4?...�R..................lueiog duly sw()rn, deposes moi Rays that he is the applicanL
(&-vitt of individual. signing contract) li
alxrve nnted,
lie. it; file ....... t. gef?f 7-..I
(Contractor, spent:, ciorporaCe officer, etc.)
of said owner or owners, six[ is duty authorized to luerfonn or have performed the said work awl to make six] file this
application; Lhal. all sfat.emeuLs co l-4ined in Wis application are true to the IesL of his knowledge and lelief; and
thaL the work will be perfoncled in the uvinner set forth in the application filed Unerewith.
Sworn to Ix:fore se Lhis -
z�
. ..—..day of
KLaryPublic `./ :
(Sigrlat:ure of Applicant)
HELENE D.HORNE
Not..ry public,State of New Yorkl
No.B951364
Qualified in Suffollc County pg
Commission Expires May 22, 1
II
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7862 9 AAA TO 4 'M FOR 7IL
I LU'VVflN- r INSPECTIONS: '
=OUNDATION 'IL11(?REAIUECFL2 i
`�01: POURED CONCRETE Crl•1' f+- �
? ROUGH - FRAMING Rt PLUMMN(i
INSULATION
N IiPk i rp"1 L 4. FINAL - CONSTRUCTION MUST
X12 �`��� ('L`r^• RE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL IVIEET I , 3'E,,X rrl
_ THE REQUIREMENTS OF THE N.W,
Z—r �_ 1_____.- ` T t __-�___—._. ,r - `:'WE CONSTRUCTION & ENER(:V
_ per.. 2�.fi - l In OC - 4)ES. NOT RESPONSIBLE FOi
p4ocD CuL;S;GNOR CONSTRUCTION ERROR'--
41
RROR' —
I
eY
� (
r OCCUPANCY OR
�FpSE IS UNLAFUL
WITHOUT CERTIF CATEI / Y�
r
OF OCCUPANCY
L e F(A y.c
I
UNDERWRITER 'p- �._
'rF Fi nr0,e slt c c. — b S CERTIFICATE _ 3 ✓P n� �- ,"3' GT
14 �' �n '� REQUIRED
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