HomeMy WebLinkAbout24423-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25663 Date: 04/21/98
THIS CERTIFIES that the building ADDITION
Location of Property: 2095 ELIJAHS LA MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 108 Block 4 Lot 7.12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 20, 1997 pursuant to which
Building Permit No. 24423-Z dated OCTOBER 23, 1997
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 DECK ADDITION ON THE REAR OF EXISTING ONE FAMILY DWELLING AS
APPLIED FOR "AS BUILT"
The certificate is issued to VITO & EVELYN DELUNA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Buildi g Inspe f
or
Rev. 1/81
FORM NO.3
i
TOWN OF SOUTHOLD
BUILDING DEPARTMEM
TOWN HALL
SOUTHOLD,N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
24423
Date......OCTOBER.......23.......................... 19...97...
Permission is hereby granted to,
VITO & EVELYN DELUNA
...........................................................................................
148 WOODCLIFF DRIVE
....................... ................ . ...............................................
MATTITUCK,NY 11952
..................................................................................
to DECK ADDITION ON THE REAR OF A SINGLE FAMILY DWELLING AS APPLIED
............ ..........................................................................................................................
FOR AND (AS BUILT)
..................................................................................................................................................................
.,. . .... .,.................................................••........I....................• .................................................................
..................................................................................................................................................................
................................................................................................................................ ...............................
2095 ELIJAHS LA MATTITUCK
atpremises located at.......................................... ....................................................... . .................
................................................................................................................................................................
County Tax Map No. .... 473889 Section ....P: ........... Block ......0004..... Lot No. „007.012...
pursuant to application dated .....AUGUST..........20....................... 19.......97..., and approved by the
Building Inspector.
75.00
Fee$.........................
....... '�. . . . ..!. . ...� .........................
Building Insp for
Rev. 4/30/80
Form No. 6 ';mOmaA L10I5 TO
TOWN OF SOUTHOLD �5 k 2-cLa 1 e- G-b MQ Z
BUILDING DEPARTMENT c���� •n�4k �Q S
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. Ftnal 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 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 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 Building - $100.00
3. Copy of Certificate of Occupancy - _ 450,'.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .. . .. . . . . . .. ... .. . . . . . .. . .. . . . . .. . . . . . . . .
New Construction......... . Old
,,Qr Pre-existing Building...... .. ... .... .
Location of Property... .5 ........ ��� 5. .......... . .. . ... . ... . .�J'�,,... . . .
House No. Street Hamlet
Onwer or Owners of Property.. .. .. .. . . .. .. ... . .. . . .. . . .. ..11... .. . .. .. .. . . . . . . .�... . . . . .. . . . . . . .
County Tax Map No 1000, Section-1.9Z. .. ...Block. .. .. .1... • . • • •Lot. . . . .I. .�C�.• • • • • • • • • • -
Subdivision.. . . . . . .. . . . . . . . . . .. . . . . ... . . .. . . .. .Filed Map.. . . . . . .. . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No.;' .�Z3. .Date Of Permit. . .. . . .. . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . ... . . .... .. . . .. . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. .. . . ... . ... . . ... . . . . . . . vv
Request for: Temporary Certificate. ... . . .. . Final Certicate.�. . . . . . . .
Fee Submitted: Qom. . . .. . . .. . . . ..
Q�QiC - -SJ
. . . . . . . . . . . . . . . . . . .
3 APPLICANT
ro�a.��63
765-18a
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBti.
[ ] FOUNDATION 2ND [ ] 1 CATION
[ ] FRAMING [ FINAL (V,0a6-2-y-cl-&
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE �� 3 S � INSPECTOR
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BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
....... TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . - . . - - . . . . .
.. TOWN HALT. SEPTIC FORM
AUG 20 1W SOTEL L765-1802 11971 NOTIFY:
CALL
Exanined:.j l 19. ` �MAIIRd1'O . . . . . . . . . . . . . . . . . . . .
Approved f-�� ., 19.... Permit No. l..T:P.:.✓. .........................
Disapproveda/c .............................. ....................................
.......................................... ...... ....
• ilding•Inspector)••
t
APP CATION FOR BUILDING PERMIT
Date. . . . . . . . , 19
INSTRUCTIONS
a. This application mist be &n pletely 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 commenced 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.
APPLICATION IS HERM MANE 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
described. 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 buildi r ssary inspections.
. ..... .4vrla................
.(Signature licant, or name, if a corporation)
iJ.. .... E .. r ls� .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber r builder.
....D.. i.►l. . . ..............V ..... .... .. ..............................................................
Ne of owner of ...... . .. .....�......(. .. ....................... 1�P RO D AS NOT
Name
(as on the tax roll or latest deed) DATE.��
if applicant is a corporation, signature of duly autt rA� S CERTIFICATE [4 �IAILDING DEPA A7
//.—, E�UIRE� 765-1802 9 AM TO 4 PM FOR THE
(Nare-and•title•of-corporate•officer)
..•-. •..•. - `` ' FOLLOWING INSPECTIONS:
1, FOUNDATION • TWOREQUIRED
FOR POURED CONCRETE
Builders License No. ........................ P. ROUGH - FRAMING & PLUMBIN^�
t" y SULATION
Plumbers License No. ......................... � I � Q . s 'gA - CONSTRUCTION M'1w+'
Electricians License No. Br' COMPLETE FOR C.O.
,4.. ry� 1' TV
Other Trade's License No. .................... /n - REQUIREMENTS OF THE 111,V,
1. Location of land on which proposed work will be done.....e?- de (iP— E CONSTRUCTION & ENERGY
N01�D9 "7/ ani ` L� - -'�� o
........................... ..�...�.. . ..�.�..1 .. CONSTRUCTION........
lkxuse Number Street Haanlet
County Tax Map
+ No. 1000 Section
cc.A0.'Q0�,,Q.Q.. Block .Dy 4.Q...... LotD1aaZ
Subdivision 0i 5..lam:..W :.... Filed Map No. � ..('�.' Lot .....1.........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed const ti
a. Existing use and occupancy ...... �. ... ....F.�/ / .�1�:�! 7 .... Y r
b. Intended use and occupancy ..... ���/ .. � /. .. f!//�� ;� ......
k�iiJ1W isp'1't
3. R►lure of work (ci►eck ul►id► applicable): New I1oilding .......... Acklition ..�O.. Alon
Itelxiir ............ Itc„►oval ............. ile►mlttion ............ Other Work ...1� .tera iG. .QY. Eff�',
'(Description)
4. Estiu4►ted Cost .J�x?............. fee ............................. .................
//
(to be paid on filing this appticatiIjO
'i. If: ckx ling, rrrnirer of. dwellir►g units .....1...... i7►nirer of chaelling units on each floor ................
Ifgarage, timber of cars .................:7...................
6. if bosiness, crmrercial or mixed occupancy, specify nature and extent of each type of use......................
cc
7. Dimensio►ls of existing str►rctures, if any: Front.....oI Y.... Rear ..... .e...... DepU► ...1 7..........
Ileigl►t ......................... Nu►ber of Stories .....�..........
Dimensions of sane structure with alterations or additions: Front ..... ...... Rear .... .......
Depth .......0.1....... height ...................a N►nber of Stories ....Zr ......
8. Dimension dt entire new construction: Front ....T--?5........ Rear ...44J....... Depth ..�Z$5........
Ileito►t ......................... Unber of Stories .....................
'c
9. Size of lot: Dint ......1� ..
5 ...... Rear .....1�5. ........ Depth .....
?I. ..........
10. Date of hirc.hase .A V.1_1-.13..... N.-me of Former (X.n►er `�C`�'� `\;.�!1 CMA�n...............
11. Zone or use district in wl►idi premises are situated ...........................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...:[/O...............
13. Will lot be regraded .........I .... ..... Will excess fill be removed from premises: YES
/YEES NO
14. Nates of (Mier of premises ...V�:1.�!. �pi.��l�G. Ackiress .9-20 ...�:��'(.r!1�:�[. Phone No.298.. �.....
\,,� J--
M:r►►e of Arc3►itect ............QkM,2,................ Address .............................. Yfux-te No. ..............
Note of Umtractor ... Acklress ..........lime No. ..............
15. is this property within 300 feet of a tidal wetland? * YES .......... NO�.�..
*IC YI;,S, S(l1llil(1i.D•IMN IRDS IM-3 PE-1441T MAY i3E RE(�JIRIiD.
PLOT DIAGRAM
I,cx.ate clearly and distinctly all. buildings, whether existing or proposed, six] indicate all set-back dimensions
fraro property lines. Give street and block nrnber o description according to teed, and slow street nacres and irxlicate
iA)etlwr interior dr corner lot.
SS
COI IN IL6,A...–T
.... ..T, e Lk�..........Ix'.ing duly sworn, (kaposes arxl says that he is the applicant
(Mine of i►xlividual. signing contract)
alxrve iurrred,
Iki, the ................. .... .......................................................................
(C,rnagent
tracu , ..corporate officer., etc.)
or said cm►er or omx-rs, nrxl is ch►ly mithorized to perform or have performe-d the said work and to make arxl file this
-iIq)I ication; that all statements ccntairx-d in t1►i.s application are true to the best of his knimledge nix) lxil.ief; roil
that the work will be perfonr►ed in the nwimer set forth in the ap l.icatiom filed therewid►.
Sk,Rrn I_o Iref .p nr_ this
`.day 119..
Notary 1'►d►l tc .........
(S ;i►ature )pi •ant) .. .
1Mit
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gLv =PRevelEb Dec
SURVEY FOR
SCIFOLK COUNTY C"ARTML-, LI ter. VIM DELUN.4 Q EVELYN DELUNA
LOT NO. 9, EL/✓AHS LAN£ ESTATES,SECT. / AW /3,1904
FOR APPROVAL OF CONSTRUCTION ONLY AT MATT/TUCK DATE: DEC. 21,/905
TOWN OF SOUTHOLO SCALE: / "=SO
DATE HS REF. NO SUFFOLK COUNTY, NEW YORK N0. 83-1123
N UNAUTHORIZED ALTERATION OR ADDITION TO THIS 64VARANTEEO
SURVEY I{A VIOLATION OF SECTION 7209 Or THE C/NCAw T ANCE CQ
APPROVED NEW YORK(TATE EDUCATION LAW SIE O iv%
*COPIES OF THIS SUMVEY MOT KAMN{ THE LAND S4 M►'`
SUR VE VOM'S IMKEO SEAL ONEMBOSSED SEAL SMALL
HOT Of COP DEMO TO K A VALID TRUE COPY D W O
MGUARANTEES INDICATED HEREON SMALL RUN ONLY 10 O� `O 1 -
HEALTH DEPARTMENT-DATA POR APPROVML TO CONSTRUCT THE PERSON FOR WHOM THE SuRvEY If PREPARED G
AND ON NIS BEHALF TO THE TITLE COMPANY,GOVERN- I
M NEAREST W�T� rAHN MI.'t * OUNCE OF WATER I PRIVATE ►UBLIC� MENTAL AGENCY AND LENDING INSTITUTION LISTED p
R BUFF CO.TAK MAr 01{T�SCAIOM LQL BLACK 4 LOT N[REON,AMD r0 THE ASSIGNEES Or THE LENDING
NTHEME Alli MD DWELLM{ WITHIN 100 FEET Or TICS PROPERTY WS7ITUTNON. GUARANTEES ARE MOT TMANSFERABLE
OTHER THAN THOSE SHOWN ,)IEREDM. TO AM TIONAL INSTITUTIONS OR SUBSEQUENT
M TME WATER SUPPLY AND SEWAGE DHSPO{AL SYSTEM FOR THIS NO OENCE OWNERS .�.
WILL CONFORM TO THE STANDMN Or THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY UNE{ ,matt
OF HEALTH SERVICES. TOEKI{TING STRUCTURES ME FOR A SPECIFIC � �•
PURPOSE AND
ARE NOT TO
E USED TO ESTABLISH
APPLICANT- PROPERTYLINESOR I" THE ERECTION OF FENCES D IAA'D SVR')E+0�
ADDRESS
TI` 400 YOUNG a YOUNG RIIVERHEEA�NEW YORE
NOTE, Bl+MONUMENT 6+STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER
SUBOJV/S/ON MAP)"/LED/N THE OFA7CE OF THE CLERK AND LAND SURVEYOR N.Y S.LICENSE NO.12845
OF'SGLF•F" COGWTY ON FEB.14,1974 AS P7LE NO.0065. HOWARD W.YOUNG, LAND SURVEYOR
M THE LOCATION OF W4L(W),KrrIC TAMK(ST)GCESSPOOLS(CF){MOWN HEREON N.Y.S.LICENSE NO.I5093
ME PROM MELD OKEMWTIOM{MOOR DATA OBTAINED FN711M OTHERS
RRANDIS A SONS INC. 1046
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