HomeMy WebLinkAbout24496-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25438 Date: 12/16/97
THIS CERTIFIES that the building ADDITION
Location of Property: 65 PLEASANT PL SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 5 Lot 13
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 7, 1997 pursuant to which
Building Permit No. 24496-Z dated NOVEMBER 18, 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ALFRED & MARYANNE MARULLI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ui ing nspector
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOWHOLD,N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date.....NOVEMBER.....18........................... 19. 97
24496 """""
Permission is hereby granted to:
EDWARD C. BOOTH (MARULLI )
..........................................................................................
SOUNDVIEW AVE RD #2
..........................................................................................
SOUTHOLD,NY 11971
..........................................................................................
CONSTRUCT A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
to.............................................................................................................. .................. ......................
AS APPLIED FOR
...........................................................................................................................................................
............................. ....................................................................................................................................
..................................................................................................................................................................
................................................................ .................................................................................................
at premises located at.....................6.....5.....PLEASANT P.......................................SOUTHOLD...........
................................................................................................................................................................
473889 088 0005 013
County Tax Map No.
......................... Section ........................ Block ........................ Lot No. ........................
OCTOBER 7 97
pursuant to application dated .......................................................... 19................ and approved by the
Building Inspector.
75.00
Fee$.........................
...... .......... ,:`. - ... ..... ..............................
Bullding Inspector
Rev. 6/30/80
TOWN 07 SOUTHOLD ' l o w
3UILD1NNG DEPART`�`ITIrOlW71 HALL
•S(,
€�
763-1302 �
PPLIC.TION FOR CERTI =C" OP OCCL"PAN i;}; BLDG.DEPT.
N OF S UTH l
r•
A. T_•115 aDp Ii:.ati1
on must be l lad in by typewriter OR 1.IIk and Submitted to the buildiIIa
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.
Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) .
3. ADDroval--_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 Iro 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 ex=sting buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'.'pre-existing" land uses:
1 . Accurate survey of property showing ani 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 Budding 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 525.00, Swimming pool $25.00, Accessory.building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existin-a Building - $100.00
3. Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.0 mmercial $15.00
. . . . �� .?. '7
Date . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . .. . Old Or Pre-existing Building. . . . . . . . . . .
Location of Prop arty. . . . . . . . . . . . . .
House No. S trees Hamlet
Onwer or Owners of PropertyrJ.L ..... . . .i �..� ...... . . . . . . .! . .`. . .CC. . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. .. .�� . ... .Blocic. . . .�. . . . . . . . .Lot. . /`�. . . . . . . .
Subdivision. . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . .. .riled Map. . . . . . . ... . . .Lot. . . . . . . . . . . . . . . . . . . . . .
?ermit No.c� . .`.. ... .Date Of Permit. .l��! .7. . .Applicant./.'1::� . . . . . . . . . . . . . . . . . . . . .
Health Debt. ADoroval. . . . . . . .. . . . . . . . . . . . . . .. ..Under- nitersADDroval. . . . . . . . . . . . . . . . . . . . . . . . .
"_anning 3oard Approval. . . .. . . . . . . .. . . . . . . . . . . .
2eauest for: Temporary Carti_icafe. . . . . . . . . . . -inai Carticat_. . . . . . . . . . .
-ee Submi=sec. S .L ". : . �. . . . . . . . . . . . . . . . . . .
. . . . ....... . . . . . . . . . . . . . . . . .
AP?LIC?�?IT
70-1902
BUILDING DE".
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FO NDATION 2ND [ ] INSULATION
[ FRAMING [ FINAL
[ ] FIREPLACE & CFIIMNEY
REMARKS:
DATE �z /2 9 INSPECTOR
P 11:1.11 lrl:il'lil:l IUU Itl;l'UII1" N�fE - UutItII:111•!i
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BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
71997 SOUTHOLD, N.Y. 11971
1 TEI.: 765-1802 NOTIFY:
/�p� _ QQ, .. CALL . . .
Examined....A .ll...., 19.L.� J MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved...!1. .. ..., 19�..� Permit No. �7 1`•'�4% .....................................
Disapproveda/c .................................. ....................................
......................................................
... . .. .�...
(Buil ns • tor)
APPLICAT ON F BUILDING PERMIT DC
' Date. . . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. 'this application must be canpletely filled in by typewriter or in ink and submitted to the Building Inspector witl
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 mist be drawn on the diagram which is part of
this application.
c. '11w 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 throb mt 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.
APPL.ICKfICN IS HERBY MATE 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 building for necessary inspections.
............. ..... �:......... .!. .......
(Signature of applicant, or nage, if a co ration)
Aa�*21 soakov/0V / te, Sot/)yVLZ)
...................................................
(Mailing addres$ of applic„pnt).
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plu her or builder.
. !l ................................................................... ..... AM .
p ....n''.R .ALFM...M/ R .......... t .�. �It•
Name of owner of remises ! �.. ... ... ....
(as on the tax roll or latest deed) Now SAV
If applicant is a corporation, signature of duly authorized officer. "11.190 9 AM 10 4 M M M
......................................................... 1 X011 • '1
(Name and title of corporate officer) V C C U PA R C Y OR
'`� 1'�
3. *111111UMINI
lAnilders License No. U NLAWFUL 4. FINANSTRUCTION MUST... ...... ....• Pr�l HO
UT CIRTIFICATEALLB CONSTRUCTION C.O.
MEETPlu�bers License No. ...................
OCCUPALACy THE REQUIREMENTS OF THE N.Y.
Electricians License No. ......... STATE CONSTRUCTION & ENERGY
Other Trade's License No. .................... CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
1. Location of land on which proposed work will. be done..............................................................
.......... ......................ptc, Al .....P. / :...............: O ...............
llause Number Street Q Hamlet
County Tax Map No. 1000 Section ......v.Q...... Block ................ Int ...1.3.........
Subdivision .................................... Filed Map No. ............... Int ...............
(Name)
2. State existing use and occupancy ,off premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...IC.�,/rte/ .........................................................
b. Intended use and occupancy .....Ll C! ..............................................................
3. Nature of work (d►eck whid► applicable): New lluilding .......... Addition .... Alte"ation
Repair ............ Removal ............. Dermlition ............ Other Work Q �,/.\......................
-7 (Description)
4. Estimated Cost ..... / �............ fee .......... _
4. .....
(to be paid on filing this application)
5. If duielling, number of dwelling units ....1....... dumber of dwelling units on each floor ................
Ifgarage, number of cars ......................................
6. If business, eamnercial or mixed occupancy, specify nature and extent of each type of use.........1............•
7. Dimensions of existing structures, if any: Front.., .s�0'_.•. Rear 5b? Depth Q '
Height ....3 ................. Nrnber of Stories .1.................... ...........
Dimensions of same structure with alterations or additions: front ............... Rear .....
Depth .................... lleigl►t ..................1(.. Rnber of Stories ............... 1.........
..../K 1....... Rear �h,
fl. Dinmensions of entire new const'ruct'ion: Front 6. ,,,,,,, Depth
Ileig>ht Nihber of Stories .........
9. Size of lot: Front ...... Qb.4,....... Rear ....... ......... Depth J.50 ),
,...........
10. Mite of Purchase ../Jy. ..�.4��....... Name of Forrrmer Owner .... UP _..Cv6; r 1�...........
11. Zone or use district in whid► premises are situated ............................../................................
12. Does proposed construction Avi/olate any zoning law, ordinance or regulation: ...'j' ,,,,,,,,,,,,,,,
13. Will lot be regraded .....!../..........
��W��iiqll�l excess fill be removed from premises: YES
lei. Names of Owner of premises ../:MP. Address6 S_PC 7•pL;,5 Pthahe No. ?�S+V 75 .
Name of Architect Address .. V�11L1�-W.?fV'Gj ... Phone No.
Name of Contractor ... ... r .. . hklress �.p z. ,5Y
'Q0' . Al ,,,,,,,Plhone No. ?65-10 6
.� �; 0,
15. Is this property within 300 feet of a tidal wetland? * YES .......... NO
*IF YES, SCIMUD M4N TRUS'IIMS PERMfr MAY BE MQUIR[l.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whetlher existing or proposed, and indicate all set-back dimensions
frcn► property lines. Give street and block number or description according to deed, and show street names and indicate
hiihether interior or corner lot.
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srnl;at7�ra
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ommy or .....D.Ot CA MMMO-3P
T.33M JJA IT-MUTc Aria
-77 Y.4'1 3HT �ilf)�t�n �L ... :.lheir►l; (h►ly sworn, deposes aril says that he is the a l.icant
' 1714 OA
sgnhmmg rahtract)
alxnp ;:,I...'140Ii'3
Ileis tl►e ............,. ..�N.!! '.:CG` :1.................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owmmers, and is duty autlmori.zed to perform or have performed the said work and to make and file this
application; that all statements contained in this application are tnue to the best of his krxmledge and belief; nrrcl
that the work will be perf-onned in the manner set forth in the application filed therewith.
Sworn to before me this
.....2A .......day 'Pf .4 .. 19..97..
Notary Ndhlic ..���Cllc�Qh�!.. ..........
......4i
(Signature of Applicant)..
.
LINDA J.COOPER
Notary Public,State of New York
No.4822563,Suffolk County
Term Expires December 31,18_.x.
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USE IS UNLAWFUL..w.�_.__T..�..•_
WITHOUT CERTIFICATE �
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HEALTH DEPT:APPROVAI:.
sas
C'E510ETICE
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r .WATER SUPPLY-ANO SEW AGE_015POSAL`
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FOR._T1i15 RESIOENCEt'w1
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� COUNTY DEPT. OFHEALTH FFOLK
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' �, RI 3J �fi� •' � r•. � r •. r�i`.,.=-e s��:C H�REF.NO-��SC1:136
r APPROVED
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UI FOLK COc TAX M_AP
TDESIGNATION:
ISs �`SQGT2'� BLOCK' 'PCL
f! � .� -�ieio�, ..;;L�'�+.~V���'C ''. ;•-a,:- �i �:�,"�k'.''�e .fit _ .. ...� '!�'
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_j SEW-44I DEED:L.h{/JL.._
\ 7ES7 HOLE STAMP
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' AMENDED JL NE 12.
JUNE 21.1491325 -- �:�•''..'
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