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Home My WebLink About23729-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24869 Date JANUARY 29, 1997 THIS CERTIFIES that the buildin~ Location of Propert~ 18400 MAIN ROAD House No. County Tax Map No. 1000 Section 115 Subdivision NEW DWELLING MATTITUCK, N.Y. Street Block 6 Lot Filed Map No. Lot NO. Hamlet 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2, 1996 pursuant to which Building Permit No. 23729-Z dated OCTOBER 8, 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 OWE FAMILY DWELLING WITH ATTA~HED GARAGE AS APPLIED FOR. ELECTRICAL INSPECTION CERT. PLUMBERS CERTIFICATION DATED The certificate is issued to STEPHEN FORMAN, Jla. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RlO-96-OO66-JAN. 22, ~13995 DATED JAN. 20, 1997 OCT. 17, 1996-ROBERT BERTORELLI Rev. 1/81 1997 il~ng Inspector I~OK~ NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N,° 23729 Z Date ...... ~..~ ..................... County Tax Map No. 1000 Section ........ Z,/....~..... Block ...... ~ .......... Lot No....Z ................. pursuant to application dated ............ ~...~ .............. , 1 .9~..., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTtlOLD BUILDING DEPARTMENT TOWN HALL o 765-1802 kPPLICATION 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 contairs 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. F~r existing buildings (prior to April 9, t957) 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 Buildin~ - $100.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00' Date ....... 2auqar2.14t.lqq2 .............. New Construction ........ X.. Old Or Pre-existing Building .......... Location of Property ......................... ~K~%~l.Q~%~q ............ M.a.~qq~ ............ House No. Street Hamlet Onwer or Owners of Property ...... General Stephen Forman , Jr. County Tax Map No 1000, Section. 11~ .Block.. 06.00 L~ 001.000 Subdivision .......... Ma~i~uck.E~ta~e~ .... Filed ~ ..... Mup ........ Lot ........ 5. Permit No...23729f~ ...... Date Of Permit ..... 1O~ .... Applicant.~.l$%~ Custom Builders,.~nc. Health Dept. Approval ...... RlOv96w00~ ......... Underwriters Approval ......................... Planning Board Approval .... Request for: Temporary Certifica ....... F/na~ Certi~a~--e} .~ ........ eeSubmi ted: $ .......... ' ...... 17:::i ....... , ' y mo ......... ;4PPZdC?tZlOA ?m. Cdev FILE b?J L4( IE: 1 O0 OH ; ~ 1' PINK pP£;SfDE,VT Date Oct6ber 17, 1996 Building Department Tow~ of Southold Town Hall Southold, New York 11971 Re: Building Permit No.: 23729z OwNer: Fessman (Now Forman Our Job ~205 GentlemeN: I hereby certify that the spider used iN the water supply system for the captiD~ed job co,tails less than 2/10 Df 1% lead. Very truly yours, BERTSAND PLUMBING AND HEATING Swor~ to before me this 17th.., day of o_.~_t~Z~t~.r.., 199.6 Notary PUblic EILEEN M. ROACHE Notary Public, State of New ¥orl( No. 4826942 Quatified in Suffolk County Commission Expires Janue~ 31. I FII';I,D Itl;il'l:;CIl()rl RF, Eg~{?' FgUHI)^'I' tON 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [/~OUGH PLBG. [ ] F~UNDATION2ND [ ]INSULATION / [~/] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE / FA~/~ INSPECTOR/*" o X '~-AUSR404 95068508 X FORM NO. 3 TOWN OF SOUTIIOLI) BUILDING I) EPAP, TMENT TOWN CLERK'S OFFICE SOUTIIOI,I), N.Y. NOTICE OF DISAPPROVAL t LE/~SE TAKE NOTICE that your application dated .,, .... ~..~ ........... 19 .~. County Tax Map No. 1000 Section ......... Block ............ Lot / Subdivision ................. Filed Map No ................. Lot No .................. IW 1/80 765-X8~2 BUILDING DEPT. INSPECTION [ ] FOU~I~ATION 1ST [ ] ROUGH PLBG. [ i~/FOUNDATION ;ZND [ ] INSULATION FRAMING REMARKS: ~.~ [ ] FINAL BUILDING DEPT. INSPECTION [ v~FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ]INSULATION [ ] FRAMING [ ]FINAL .... ".-~,~,~.i/? - .. // 76S-1802 BUILDING DEPT. INSPECTION / FOUNDATION 1ST [/-~ ROUGH PLBG. [ ]/E~UNDATION2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY R~EMARKS: ~ ~/~/-~ ~.~-~ ~,~ ~ DATE '~/~: 'NSPECTOR~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] .~LATION [~,~'"FINAL [ ] FIREPLACE & CHIMNEY DATE 'FORM NO. 1 TOWN OF SOUTHOLD * ~- BUILDING DEPARTMENT. TOWN HALL 8OUTHOLD, N.Y. 11971 ,-- TEL.: 765-1,802 ed ................ '/ ...... ~ .... A~RMIT INSTRUCTIONS Received ........... ,19,.. BLDG, D L:PT. , TOWN OF SOUTHOLD Date .,..ap~.y. ~1, .... ¢.., 199.6.. a. This application must be completely filled in by typewriter or iu ink and subnfitted to tile Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordiug to schedule. b. Plot plan showing location of lot and of buildh~gs on prenfises, relafiouship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on tile diagram which is part of tiffs appli- cation. c. The Work covered by this application ~nay 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 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 MADE to tile 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 alteratious, 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 name, if a corporation) EAST ISLE CUSTOM BULDERS, INC. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... BUILDER .............................................................................. Name of owner .of premises ........... .ti*do. Fessroan .................................................. (as ou the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ~"' ' (Niii~¢ and title of corporate officer) Richard Oppedisano~ President Builder's License No .......................... Plumber's License No .... 1.4~7p ................ 2697E Electrician's License No.... .................... Other Ttade's License No ...................... Location of land on which proposed work will be done ............................................... .,,,. . .... I.g.4:. C. O. .................. . ......................... ........ House Num, bet Street Hamlet County Tax Map No. 1000 Section ... 1~ ............ Block ...~ .............. Lot...L .............. ·.. ' c .......... 4453 Subdivision ..... ~a.g.t.i.t~ k ~.t:~.t~.. Filed Map No ............... Lot ............... (Name) State e. xisting use and occupancy of premises and intended use and occupajlcy.o~f proposed construction: a. xJstillg use an occupancy .......... v~cant. .la.r~ ....... .... .. ~. ; ; ~ . . . .,; J . .. . ................ b. Intended use and occupancy one family dwelling ; 3. Nature of work (check which Repair .............. Ren ~oval 4. Estimated Cost .... $65e000 ..... 5. If dwelling, number of dwelling units pplicable): New Building .. x, .' ..... Addition .......... Alteration .......... ............ Demolition ............ Other Work ............... (Description) .................... Fee ................. '; ?. · .~. ............. '~ (to be paid on filing this application) Number of dwelling units on each floolqn.~. .s.t:.o..c~...o.n.l.~... If garage, number of cars i 9ne cac 6 If business commercial or m'xed occupancy specify nature and extent of each type of uso 7. Dimensions of existing structures, if any: Front .... n/~ ........ Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of same structure witi;, alterations or additions: Front ................. Rear ................ Depth Height Number of Stories ~,. · ' 45' Rear .57 ~ Depth 8. Dimensions of entire new. constlruction: Front .................... ,~ ................ Height 1,6" '.. Number of Stories one 9 Sizeoflot: Front 1231 ?~.' Rear..200-00]. ... Depth 133.92' ....... 10. Date of Purchase . ~.o~d ~ ~-,~ ................. Name of Former Owner ......................... I 1. Zone or use district m which pr~mises are situated .... one .fam£3.¥ .................................. ..... ation: .... :n~ ........ . .... 12. Does proposed construction vlollate any zoning law, ordinance or regul .......... 13. Will lot be regraded ....... ¥~s. .................. Will excess fill be removed from premises: ' Yes / .................................. 14. Name of Owner of premises .. jja.c~. F.~$Og~ll ..... Address ¢ o Build~c Phnnn No .... Name of Architect ...... qo. nAZ.~ .M.a.l.m. .......... Address i 0~ S.h.~w Ave,..,..I~.l.i~Phone No 581-0003:? ~ Phnnn Mn 727-6023 Name ofContractoiEa.~.t..~.~.Z.e icu~t.om Build .r~, Address .~7~ .,~bp~.l;qA..A.V.~... .......................... ........... nc'. : Meflfdrd, NY 11763 Locate clearly and distinctly al property lines. Give street and block interior or comer lot. SEE ATTACHED PLOT DIAGRAM buildings, wl~ether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate wheth~'r ./ STATE OF NEW YORK, $.8 COUNTY OF., ~ ............... ......... R~.~b~r~ .0~. ,d.~ sano .............. (Nar0e of individual signi ng contract) above nan~ed. ,,, , being duly sworn, deposes and says that he is the applicant He is the ..... h. ,~<~cl~qt. .................................................... ,. .................. (Contractor, agent, corporate officer, etc.) of said owner or,owners, and is dui! authorized to perform or have performed the said work and to make and f'de this application; that ali statements contained in this application are true to tile best of his knowledge and belief; and that tile work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... .3.1.s.t , .......... day of] .. . .July .... 19..9.6 Notary {aubh ' ~tl~¥o/k. County , ...... TFIANB ~FFI TAX ,,~ (- j, I:,A~ 21 / ({. rarely) _. , Su{} FtlIOR TO RECOtlIIING OR FIl.,IhiG, 3. Sp.c,[Add. TOT. ~l IG. T^X family {t w~,,llin i~ Hell ColD' I ~,1~ i ~1 ~ N,~I ~oual Fil i,', i()(}0 f J .) 0U (.,(),rJl} 00l ,'.)U0 I'US,~ , c-' (.~,.,Ibc'F,( ' Tille Nmlfl}er UR: Ill, CORD & RETIIRN 'FO , [ Sultolk County Recording & Endorseme~t Page (Deed, Mortgugc, elc0 SUFFOLK COUN'IW, NI~'~W YORt(. ,)r tlAMI.E1 of 3J;-~ I.!; )l;Uck II'-, 8 f~TW[ :N ^ i, ,-~, IhtWal i IYmgandhe"ge, t: ~dahtitluck, Towa of Soclthold, SuEfolk York, known and described as Lot No. 5 on ac,.erta~n- - ' map el~t it:'l od, "N ~ ' at~.ituek Estate8, Ins." fJ,.),ed iu ~he Office of the 4.153 a;~(J bel. ng tl. emefe~:ro~ to Nortg~qorrheze:l. rl by Irde ~t.r'e dated October 3, 1985, recozdad in Liter 9897 at Page 480, and more ~articuJ. arly bc~tmd~d and d~sc'~'-¢~ . .rlb._d as IfolJ_ows: BEGINNING a~, a ruor!tlnle~l~ se~. in tile southerly side of Nain Road at the extreme easterly end of an arc of a curve cOrulecting, th~_ m~t.._,,..,._.~.,'lv ~ide o[ Cardinal Drive wJ.L:h Lhe $otlt'llerly side of Main Road: RIJNNI'N~ THENCE Nc)rt:h 88 deg. 08 miD. 20 sec, ~:h~ ~outhezly r~tde of Na.i~l Road a dzsta~c.o off ~0,;-,00 feet: 1HEFC},~ Sot]Bh .[ deg, 5! min. 40 sec. East a.d].st:anc:~ 00 THENCE South 88 des, 0B m~n. 20 eec. West a distance o~ 92 feet: ~o ti'e ea~t-erty ~lde o~ Cardinal Drive; [HI. NL.B thF3 rD[ .OWll]g tl'ire~ COurt, os and dis~.anc'e~ al, ollg t:he ea~.erly side of Cavclinal Drive 1 ;.qrth 6 deS, 3? mtL~, !0 sec Rase a distance of.,o'".58 ('eOt; 3 ALong art arc ct' a curve bearin~ to t:.h~ r-i~ht radius e[ 50.00 feet a distance of 78,54 feet to th~ pOi~lt or place of BEGI~f ~[JB,JRC7 Tf) ali ~nstrument_8 of record. BEING AND INTENDED TO BE tl'~s same premises ccm-veFecl Lo deed dale'" ?/].;,'gb and'recorded 8/11/95 iz] Liter 11717 (p ~'70 tN WI'I'N[9~ WHER[O~ the p.')d'ty O! he r~ p,3rt h8~: .'$u y Oxecuied ibis deeo H~e day anti ,/eat' fu ¢{ ;ihevo w~ dlofl -¢ c~ oO