HomeMy WebLinkAbout24306-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25322
Date OCTOBER 21, 1997
THIS CERTIFIES that the building.
Location of Property 3610 BRIDGE LANE
House No.
County Tax Map No. 1000 Section 84
Subdivision
ACCESSORY
uu'~OGUE¢ N.Y.
Street Hamlet
Block 5 Lot 11
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULy 16, 1997 pursuant to which
Building Permit No. 24306--Z dated AUGUST 13( 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 ACCESSORY INGROUND SWIPING POOL WITH FENCE ENCLOSURE
AS APPLIED FOR.
The certificate is issued to
BRAD & DENISE DANIANI
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL INSPECTION CERT.
PLUMBERS CERTIFICATION DATED
N/A
~17783 - DATED AUG. 29, 1997
N/A
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIJT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
,~....~..~~..~....~.. ......... ~/..~..
..... .~_~..x/.......~....~ ..................................
...~......./~=.~.._~.,./........//..z.~...
,o ~.~'~./.......~....~~ ....... '../~.....~.. ........ ~.~. ...... ~'.~.......~-,,,,-~
..~ ......... .~ .............. ~..~. .......... ~....~m......~.~.., ..................................................
Map No. 1000 Section ...~...~... ........... Block ....~ ...... Lot No.
County Tax ........................
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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:
I. 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-disposai(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 c6mpleted site plan requirements.
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
~' i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~r,m~ng pool $25.00, Accessory building $25.00,
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 - , .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ate .... .9. I /. ? ........................
New Construction .....
.... Old Or Pre-existing Building .................
Location of Property...4.~ ..........................................
House No. Street Hamlet
Onwer or Owners of Property...~.~.~'.. ......i.~.~.~3.]A?~..'.~.c..~..~?.~f%~C......; .................. . .
County T~x t',~ap ~o i000, Sention...~, ........ Block ................ Lot ......................
Subdivision .................................... Filed Map ............ Lot ......................
8ealth Dept. Approval .......................... Undermziters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $..f~j~..5:.~..~. .................
APPLICANT
DATE: ~/29/97
ELECTRICAL INSPECTION SERVICE INC.
375 D UNTON A FF~UE
EAST PA TCHOGUE, NEW YORK 11772
(516) 286-6642
17783
APPLICATION No. ON FILE
VILLAGE: Cuteho~ue
ADDRESS: ~t~ l O Rrlrt~, Lrm~,
ISSUED TO: Brad Damiani
TOWN: SouthoM
EVTRODUCED BY: Hattk's Electric Inc.
was examined on 8/29/97
LIe No: 2675E
and found to be m compbanc¢ v~th the NaOonal Electrical Code
LOCATION: Base- 1 st
Der. Garage
2nd 3rd Attic
SFiqTCHES RECEPTACLES FIXTURES HEATERS FANS G.F,L AiR. COND.
2 2 1
DISHWASHER DR Yt~ CLOTHES WASH. GAR. DISP. RANGE OVEN SMOKE DETECTOR
FLrRNACE OIL GAS ] CII~ ] MOTOP~ BEI~ TRA~. SERVICED1SCONNECT
I
I
I
OTHER
EQUIPMENT
Outside,Res.
1-500 watt pool light
1-11/2 HP motor
1-40Amp. timed switch
POOL
NO VISUAL
B U1LDING FERMIT No.
BLUE ORIGINAL YEll.OW COPY
PINK COPY OFF/CE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNn~ATION 1ST [ ] ROUGH PLBG.
[ ] FOUNr~ATION 2ND [ ] INSULATION
[ ] FRAMING [ ~FINAL
[ ] FIREPLACE & CHIMNEY
DATE , ~//~~ INSPEC~T'OR ~-~~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[]FRAMING [~*~NAL ~'/~
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No .... g.1.6.6.3 1 ....... Date ........ ~[.a.]t. ~.7. ................ ,198..6.
THIS CERTIFIES that the building ...... .o. rt~ r f.a. nl~)y..al.v/..e.l.l.~n, g: ..................
Location of Property ... 3.6 l 0 ............... B.r. ~..d~e...L[a.n.e. ................. C. u..t.c.h.o.g.u.e
House IVo. Street Ham/er
County Tax Map No. 1000 Section .... .Sfi. ..... Block ........ ~ ...... Lot .... .1.1 ...........
Subdivision.. ... ...... X ...... ............ Filed' Map No.· o ..... X. ....
conforms substantially to the Application for Building Permit heretofore ~ed in this office dated
.... lq oves~bec..1.3'. .... 19~[5. pursuant to which Building Permit No ...... 1. 4..~.2.8. Z. .........
dated ...... N o.v.~n~ 1~ e r.. 1. 3 ......... 19~.5.., 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 .........
0 ne.- f. ami~Y, dw.e ~g ~
The certificate is issued to .............. B~t.fi.l~. ~..D.E~ ~ $.E..I) .A[q.I.g.~ .~ ....................
[owner, ~(e~e~( c~r~(~g~(
of the aforesaid building.
Suffolk County Department of Health ,Approval ............... ~.--.~0.-.1.8.~. ................
.UNDERWRITERS CERTIFICATE NO ~ 7, q ~ 9.8 3.
Rev, 1/81 ' · '-' ..
Examined ....... f/,/.-~...., 19 .~/
Approved ....... ~'/~. ~)...., 19.~ Permit No...~.
TOWN HALL
o,~OUTHOLD, N,Y, 11971
TEL.: 765-180;~
BOARD OF HEALTH ......
3 SETS OF PLANS .......
'FORMNO. 1 SURVEY ......... ·
TOWN OF SOUIHOLD CHECK ..........
BUILD[NGDEPARIMENI SEPTIC FORM ............. :
NOTIFY
CALL ................
MAIL TO:
Disapproved a/c .....................................
(Buil?f1~g'I~l~c t or)
APPLICATION FO/,~BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit
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 sir,
or areas, and giving a detailed description of layout of properW must be drawn on the diagram which is part of this ap
cation.
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 issued a Building Permit to the applicant. Such per
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 Occupa
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance:
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descri[
The applicant agrees to comply with all applicable laws, ordinances, buildip,~ code, hou/si~ code, and regulations, ant
admit authorized inspectors on premises and in building for necessary insp~iop~, z // , ,
"(Mailing address of%pplicant)!
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buik
(as on the tax roll or latest deed
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CON, TRACTOR'S MUST, BE SU. FFOLK COUNTY LICENSED
Builder s License No..,fd.i/rsrl~, ...........
Plumber's License No .........................
Electrician's License No. ~.~t~ .'7.~..~. .........
Other Trade's License No ......................
1. Location of land on which proposed work will be done2 ..............................................
I ddqa. Lm, o .C .... ..........
.......................... ., ..............
House Number
County Tax Map No. 1000 Section...~.~. ........... Block ..... ~ .......... Lot...![ ...........
Subdivision ..................................... FiledMap No. ~.¥~/...~..... Lot .............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...P..I~...~.~J~,~.~....D~I..~.....: ......................
b. Intended use and occupanc, y.. 1{~ .~.~--~... l~ ~.. ~{~0.~. ~f~,~...~)]..~..l.~...
3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .. ~ .....
Repair .............. Removal~ .............. Demolition .............. Other Work..~L-~... J .....
h~ ~(Description)
4. Estimated Cost .. "7~.O~ s.~ ...... Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ..............
If garage, number of cars ......................................................................
6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ...................
7. Dimensions of existing strUctures, if any: Front ............... Rear .............. Depth .............
Height ............... Number of Stories ......................................................
Dhnensions'of same structure with alterations or additions: Front ................. Rear ................
Depth ...................... Height ...................... Number of Stories ....................
"8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............
Height ................ Number of Stories ...........................
9. Size of lot: Front.. ]~ ,.~4.~ ........... Rear...2--/..2., .~.~. ........ i 'i);;i~'
10. Date of Purchase ............................ s~,~m.e of Former Owner ...........................
1 1. Zone or use district in which premises are situated., r..~..'~.. .............. , ............................
12. Does proposed construction violate any zoning law, ordinance or regulation: ~ ..........................
13. Will lot be regraded ...... e,. · · .,. ~ .~- · · · .... , .....Will excess fill be r~moved from premise1Z_ . Yes
14. Name of Owner of premises l.,~}~~1~[~... Address ~_.~h~ ~.... Phone
Address 1.~ ~,,l~{~e.~.J.. ~>., ~... Phone
Name of
Name of Contracto~~,~,~e~k t q . I.,~-~l~,.l....~~. Addressl~.d.~. ~ ...... Phone No.~.t~ .-. ~ ( ~.~.
15. Is this property located within 300 feet of a tidal wetlahd? *Yes ..... No ~..
· If yes, Southold Town Trustees Permit maybe required.
F
PLOW DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro
property lines. Give street and block number or description according to deed, and show street names and indicate wheth,
interior or corner lot.
STATE OF
COUNTY OF.. 'oferd.t.lV._ .... s.s
~tl 4.~/.~.'..~.~...-~..,? k.-0..r'7. ....... being duly sworn, deposes and says that he is the
(Name of in~viduald,,,;signing contract)
above named.
He is the ............. ~eP-J~.. .................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th
application; that all statements contained in this application are true to the best of his knowledge and belief; and that t~
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
Notary Public, . ....... :...~ ......... County
. '~C~o&o
CO.