HomeMy WebLinkAbout23646-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24834 Date JANUARY 10, 1997
THIS CERTIFIES that the building NEW DWELLING
Location of Property 880 FARMVEU ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 121 Block 07 Lot 11.0
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 7, 1996 pursuant to which
Building Permit No. 23646-Z dated AUGUST 26, 1996
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 ONE FAMILY DWELLING WITH LOFT & ATTACHED 2 CAR GARAGE &
COVERED PORCH AS APPLIED FOR.
The certificate is issued to FARMVEU ASSOCIATES
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-96-0065 - DEC. 19, 1996
ELECTRICAL CERTIFICATE NO. 13978 DATED DEC. 12, 1996
PLUMBERS CERTIFICATION DATED DEC. 28, 1996-GAH PLUMBING & HEATING
ilding Inspector
Rev. 1/81
FORM NO. 2
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)
N° 23646 Z Date ......... . . ... .................. 19Y
Permission is hereby granted,tq:
U�
to . . . . . . . . .... ,lrl , wi ,e� %' l . fix4.44 ..... .. . . ..,G�9 -.
of premises located at .......... O...L.....
/. ?.?.�a . ........., .� r.:.:............................................
......................................................... ...... ................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section .... .121...... Block .........�„7........ Lot No. A/...............
pursuant to application dated .............6i,"-f..7.................... 19./,lQ., and approved by the
Building Inspector.
Fee S• Q...`.4r
...... ............... ... ................... .....
Building�I. ..*or -
Rev. 6/30/80
Form No. 6
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 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 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 Buildinia - $100.00
3. Copy of Certificate of Occupancy - .25,C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, -Comm rcial $15.00
Date . . . . . . . . . ��` f`''" . . . . . . . . . . . . . . . . . . . .
New Construction. . Old Or re-exis ' Build �
Location of Proper r2 . . . . . . . .
� :, .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House No. U1 Street Hamlet
Onweror Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. � / . . . . . . .Block. .P. 7 . . . . . . . . .Lot. . . /.( . .v . . . . . . . . . . . .
- 7
Subdivision. . . . , C�'LYv�_. .(/ .. . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . .. . . . . . . . . . . . . . . . . . . . . .
Permit No. Z . . .Date Of Permit. . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . .
ii ( ' l3 7Y
Health Dept. Approval. ...{.`.. . ( . . . .`. . . . . .Underwriters Approval. . .(. . . . . . . . . . . . . . . . . .
PlanningBoard Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . �. .�. . . . . . .:_
. . .-. . . . . . . . . . . . . . . . . . . . . . . .
4,� . �� •` APPLICANT
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Sournc;c. vewv-Ion< _
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OFF;CE OF THE BUILDING INStPECTOR
TOWN OF SOU7Hf(DLD
C R T I M C A T
DA'^y ���lO / b
owner:
� a3Sa r_IZ '
i
Cer-_-:i . .d. .7e SC_�er used _:1 -1e aZar SUMC177 S,7S—l:aM
=onta=ns less -zan 2/10 ci _ _aac .
(�?=mr'ers n u=a)
�wcr- �:e ie zzr= me
QTc 7—_'
AIRY E LSA=
to*#bark
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ NAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE 11171 INSPECTOR ;2, 4
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
MARKS:
DATE INSPECTO �'�
F I I I.0 I NSPIXT 1 011 RIiPOR 1, nA 1 li (:OMMIsNI'S
POIIM)A'I'1ON ( I;'1')
POUNI)A I I ON (2NW I c i\
------ ----------------
12()11(:11 FlIAF11'. I,
0
1'I.IIFI11 l NC:
INSULATION PER N. Y .
STATE. FINF.RCY 412
(:ODE,
47
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: � �Y✓
DATE I <<' INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ROUGH PLBG. �
[ ] FOUNDATION 2ND [ ] INSULATION
[
"F MING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
G
DATEINSPECTOR .4�
ass-isos
BUILDING DEPT.
NSPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
U 7
DATE ! J INSPECTOR Ja4,4 /�-�
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
[ 7 FRAMING [ NAL
REMARI 8: 9✓A3Z�u - t�'"f!/v Z��iu �-�-
13
DATE y INSPECTOR"
M-1802
BUILDING DEPT.
'NSPECTION
[ ] OUNDATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE �'� INSPECTOR .M�
suiwiNa DE".
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTO
MARTIN F. SENDLEWSKI, A.I.A.
ARCHITECT - PLANNER
(IIII
November 1, 1996
Mr. Gary Fish,Building Inspector
Town of Southold
P. O. Box 1179
53095 Main Road
Southold,NY 11971
RE: Mele Residence by Schembri Homes Inc.
Dear Mr. Fish:
As per your request,this letter is to confirm that the following items are acceptable
substitutions on our drawings, dated July 22, 1996:
1. Optional roof rafter(RR) support at front wall of living room: (2)2"x4"
vertical posts at each RR, (1)2"x4" under RR cut to match pitch and(1)2"x4"
along side of RR, nail together to provide tie down for hurricane protection.
2. 3 112" nominal dia. solid wood turned columns are option for "typ. posts" noted
at porch.
If you have any questions, please call me. you.
Sincejely,
Martin F. endlewski, AIA
MFS.jp
(F&e CAMSWORKSWbMISOMELE.WFS)
209 EAST AVENUE 0 RIVERHEAD, N.Y. 11901 ■ (516) 727-5352 0 FAX (516) 727-5335
BOARD OF HEALTH
f . .. . . . . . . . . . .
FORM NO. 1 3 SETS OF LANS . . '
TOWN OF SOUTHOLD SURVEY . . . . ._. . . . . . . . . . . . . . .
wn BUILDING DEPARTMENT CHECK. .L O: .S .
AUG
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
BLDG.DEPT. .q, Q y
TOWN OF SOUTHOLD �� CALL .?Cry 1-5!_�L . . . . .
7.
Examined Z ?.., 19`4 MAIL T�: . . . . . . . . . . . . . . . . . . . .
APPApproved - �l•- 19 6 Permit No� .:f:.°.6 ... ... .....................
- -� ... ......
Disapproveda/ .................................. ........... -- ....................
... .........1=... .. /
iilding Inspector) .
APP CATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. This application mist 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 mist be drawn on the diagram which is part of
this application.
-c. The work covered by this application may not be caumnced 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 HEREBY MAM to the Building Department for the issuance of a Building Permit pursuant to the
Building pone 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 forremoval r demolition, as herein
described. 'lime applicant agrees to comply with all applicable laws, ordinanc ildi c housing code, and
regulations, and to admit authorized inspectors on premises and in building r s ions.
.(Si tore of applicant, or ••••,-if• corpora 'on)
(Mailing address of appl' ant)
State whether 1i�mmm owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............ ......... ..`. .....................................
Name of owner of remises ..hlY.iL! .......... .. .....................................
(as on the tax roll or latest deed)
If applicant co ra on igmture of duly authorized officer.
- . .•
(Name and ti •e f•corporateofficer) ••.•. --+-
Builders License No. .. ....
Plumbers License No. .�... .. ..........
Electricians License No. .....................
Other Trade's License No. .................... / /1 /v�
1. Iocation of land on which proposed work will. be done.... ..................... ................... ........
.......................................................................................................................
lb use Number Street ``Hamlet
County Tax Map No. KM Section ......... Block ..�.....•-..-. Lot .t✓.!............
Subdivision .............•........................ Filed Map No. ............... Iot ...............
(Nam)
2. State existing use and occupancy of pr s and i toWseoccupancy of proposed construction:
a. Existing use and occupancy ....... 1 ..........................................
b. Intended use and occupancy ..........*.. .........................................
I. Nature of work (check which applicable): New Building. .......... Acklition .......... Alteration ..........
Repair Removal ............. Demolition ............ Other Work ..................................
(Descriptim)
4. Estimated Cost ....!.... ... ....... fee ..............................................
(to be paid on filing this application)
5. If cl,aelling, rxni►er of dwelling; units .':.. tkidner of dwelling units on each floor ................
If garage, rxnber of cars ..........�... ........
G. If business, commercial or mixed occupancy, specify nature and extent of each type of use......................
7. Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
height Number of Stories ......................
Dimensions of sane structure with alterations or acklitions: Front ............... Rear ...............
Depth .................... Ileigl►t .............. ' ../... TAM)er of Stories ...............
8. Dimensions of entire new construction: Front ..((4 4......... Rear .fe. ......... Depth .����....
r
lleillnt ... ................ .UM)er of Stories ........ 9
9. Size of lot: Front: ..�� J...........•. Rear ...� ... .I ...... Depth ...� :G. ....
10. Rite of Purchase ..................... Name of Former Owner ........................................
11. 7xine or use district in which premises are situated ................................
12. Does proposed construction violate any zoning law, ordinance or regulation: .......
13. Will lot be regraded .. ............. Will excess fill. be removed from premises: YGS
M. Mimes of Owner of pranises ........................... Address .............................. Plxxne No. ...............
M
Mite of Architect . ..................... Arklress Phone No. .......4..^.....
Mine of Contr<xtor Acklress ..........Phone No.
15. is this pmperty within 300 feet of a tidal wetland? * MS .......... la7 .
*IF YGS, Samiltz m4N TRIISPI s PrRMr MAY nil's RFS piRrD.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give street and block nunber or description according to Gleed, and slxw street names and indicate
u,4nether interior or corner lot.
SCA'll;
oF txv� ,
. ss
(7lJIJNIX .� ..
ll r-•
... .........being duly sworn, deposes aril says that he is the appl.icanL
(Nave of individual signing contract)
alxnre nr►med,
Ileis the ..... ...............................................................................
(CiuLractor, agent, corporate officer, etc.)
of said owrner o , aril is duly author i zed to perform or have per forn►ed the said work and to make and f i to this
appl icalior; Lhat: all statements contained in tllis apps icalion are tree to the best of hi.s knowl.edp_P arxl lx,Hef; aril
that Lhe work will be per.foruned in the rn><nnner set forth in the application filed trerewitu.
`I<xnrn to 1►efU>;Pyrr) this �—
............7.. clay oA
Notary Rib is ...........
CLAIRE L GLEW (Signature of Applicant)
Notary Public,State of New York
No.4879505
Qualified in Suffolk County
Commission Expires December 8,15...E
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THE LOCATION Or WELLS, SEPTIC
TANKS AND CESSPOOLS SHOWN
HEREON ARE HELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
Unauthorized alteration or addition to this document to o ddotion of Section 7209 SURVEY OF: j 3
of the New York State Education Low.
Certifhisbe if to
Mile mp run only to the person for Thom n Is prepared , A9 of 46�
L
m AM behalf a the Title Cempmy.01ovsrnmmld Agmoy and Lending Inetitulim �V�
Wbd hereon,and to the 0881010040 el the lending Institutions or"seouent owners. _
C=of Nle document not b88rN01 the profeelonal's Inked seal or embossed sed f TV�Al-�Art—
1 IA/t�yVr`T� / I o v, 1 Or—
shall
r—
shag not be considered a vdkl hue oopK // V t/' �`I
The offsets(or ossdimensions)use
drown her88n koe sbYotw40 to Nproperty Iin40 are / 1 'lv I /U Yw—r—
for a peolga puryose and use and Nanton 0r0 not Intended to be
the er40 ��}��� L1}�'1 /2 �(� `�'
fen
ntotnIn01 wale,poale, patloe,dm�9 88�• addition to bugdingebeNE� I
cansbuatlonPitn
iM*Aston"of right of ways end/or oca"ant" of record. If a Al;-- ars 0 VEY DATE: 6 I 210 SCALE:
not quarmteed. C* DESTIN G.GR F
CERTIFIED ONLY TO: DESTIN Ge GRAF
a LAND SURVEYOR
5 87 y
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73 WOOOLAWN ROAD
901 DESTIN G. GRAF N.Y.S. LIC No. 50067 A ROCKY POINT, NEW YORK 11770
PHONE (516) 021-3442, N.Y.S. UCENSE No. 80067
TAX I.D. No. x)o - I
122-D2
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�AVY\A\ff-A RoA cA [Sd�
THE LOCATION OF WELLS, SEPTIC
TANKS AND CESSPOOLS SHOWN
HEREON ARE FIELD OQSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
unauthorized alteration or baton to this document I.a "Gil- of section 7209 SURVEY OF. O I
of the Now York Slate Edu.ouon Low. / Ji_
Certifications be Indt oth hsrsan shag run only to the pr.an la whom n i prepared A A n Of ���� /l.' ,bAf—
and an his behalf t Ws 11W Company.gowmwnanld Agency and Lending institution 1V,J�r �w '�
listed horoon, and to the aselpase of the lending Institutions or subeoqu.nl owners. f
Copley of this document not tarInq Ihs preleaslend's inked coal a embossed sed � Yl�l I oV�� Or
"Aog M not aanddowns drb a valid true asPK
The offset(or ase and use
.haven hereon tem structures to o guide
re the INat are / 1 tOLA 12u�L-k / � YOr—
la a sp"dSo purpose and ties and thordan an net Intended to Id" the rection of �/�1�y-�� �I
fens.retaining wags, pis.Iwtios.pfanwg areas, addition to buildings a��Vr-: N
I 1
aon.truauon �I[ �jThe..steno of right of ways and/a easement"of record. If a� O,Q R YLY DATE I 2t+Ce SCALE
not guaanteod
CERTIFIED ONLY T0: o DESTIN Ge GRAF
LAND SURVEYOR
B r 73 WOODLAWN ROAD
By FS' �. ROCKY POINT. NEW YORK 11778
DES11N G. GRAF N.Y.S. LIC No. 50067 lONA PHONE (314) 821-3442. N.Y.S. LICENSE Na 80007
TAX I.D. No. 000 — 21 — 0-1 - I(,D
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THE LOCATION OF WELLS, SEPTIC
TANKS AND CESSPOOLS SHOWN
HEREON ARE FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
t
Unauthorised dtrotlon or addition to this document Is a vIdatlon of Section 7201 SURVEY OF:
of the New Yak State Education Low. _�,,
d
Certification*behalf
if t Indicated hereon shall"a y, only to the Prean for whom n b prepared 4
and an his beAd/to the 71Ue Corr,pany, Governmental Agency and Lending Ineututlan �/+ (vWi� �rp�►-/�`
Noted Aaeon, an to the asslgness of the lending Institutions a subsequent owners.
Co W of this document not bearing the professional's Inked sed or embossed sed l� Al'
` M.A-r�`r� / I O�� p� ;
shall not be considered a valid true copy. R ' �t �/�1/^ � `y/ �/ '
the offsets(a dimpurpose
and use
shown hereon from structures to the property lbw ore r 1 �v r 1 v� dev; 1 ��^�
for a specific puryoss and uss and therefore re not Intended to guide the reotlan of
fenoes,retaining walls, pods,patios,planting area., addition to bulldings a any other,
construction.
The existence of right of ways and/or sosementse of record. If any, not ro iaF N I t♦
not guaranteed. �P V VEY$DATE: i i o q�, SCALE:
CERTIFIED ONLY T0: DESTIN G. GRAF
�s a LAND SURVEYOR
I o Ll 6V.0
LTA
73 WOODLAN'N ROAD
STIN G. GRAF N.Y.S. LIC N0. 50067 FFS �. ROCKY POINT. NEW YORK 11778
PHONE (316) 821-3442. N.Y.S. LICENSE No. 30067 I
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CODES. NOT RESPONSIBLE FOR � _
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and all I"pectlonn as required an obtain eertiridate or
ocpu nney do behwlt OS the comer.
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that nnYd, re aponeibility, In the aole reepd"Ihility of the
NEW YQRK STATE
IsNl;lt(:Y CONSERVATION CONSTRUCTION CUUE ❑ I❑ 8 ❑ ED FM
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MINIMAL NO]PS:
All LuIIJhIR enveWpe elemmtls JLld equtnDl mmm1114 whhh me wlmlde uF Lnldbrp aadshnc
shall bo IHoluleJ Ily K vnllut telurdet Inched cot lie wllHer Wenn side al lir Imnlallai. — — — — -'t -+- - T
Iluulnllon to bd Ihdnlled lu a nenner mot Imide,cmn111uity or i mantlon nl!dale Ilm, n111 7 rl_1y rl--y. rl - rl-
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StAb edge Iluolellun 16ali couratnl to cede inplirem st,
All Noun and w(lolows ld toed cafe regnlrennmis An air hdilbnllan
kleplero to cofittm to cork In,fredn Ilr A alt Inllllmllon rcguht...mts.
HVAC syslem to capfonn to sale impdreoenb. 1z O N I O _ I .�/I I = I o I I
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SURIAIAIIY OF'1'OTAL'1'11IMMA , HATING - - - .
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