HomeMy WebLinkAbout23301-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 2-24637 Date SEPTEMBER 23, 1996
THIS CERTIFIES that the building ACCESSORY
Location of Property 1090 STARS ROAD EAST MARION, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 4 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 12, 1996 pursuant to which
Building Permit No. 23301-Z dated MARCH 14, 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 ACCESSORY ONE CAR GARAGE AS APPLIED FOR.
The certificate is issued to VINCENT LONGO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
u' dind inspector
Rev. 1/S1
FORM NO.3
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)
Date .............!�� .............. 19..7.. .
N2 23301 Z
Permission Is hereby granted to;
. .s. ....... r ....... ...............
to .... -,am...... � -......
.:.. .�.. ....4r..... ....... ...... ....... .. 1...... ...L.k-...................
dam` .' ....
1 . . . .. . .....
......................................................................... .....................................................................................
..................................................................................................................................................................
at premises located at............1Q..9a...., ....la,..........................................................
.... G .................................................
County Tax Map No. 1000 Section .............4�...... Block....x................. Lot No. .. ....................
pursuant to application dated .................... &'t ..6?.� ..... 19-Y..�..., and approved by the
Building Inspector.
.. ml,
Fee$.. ..........
. .................... .... ........... ..........................
Building Insp for
Rev. 6/30/80
t � rI
Form Nc. = � LS u V C;
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TOWN CH SOli:HOLD
BTUILDING DZP_.R?EN: SEP 91996
-own :LLI
7e5-1-802 RLOG.DEPT.
TOWN OFSOLD.,d
OF OCCL?ANCY
_. _..is app-_tabon must o =_--__ by ,pewrit_r OR ink and submi-ed to the ouilc- 2
_-.spector w-t.. tae fo'lac_ng: for new bui ._ng or new use:
1. ?ilial survey of property with accurate location of a'-- builaings, pr p erty --nes,
Streets, at1C urllSna- natural or tODOgr lip nld, reatures.
_. -_nal ADDrova_ _rom Healtn Dent. of 'water supe-v and Sewerage-diSDOSal(S- 9 form) .
2. ADDrova- of elactrical instal'-atior. from Board of -_re Under-w iters.
4. Sworn statement from plumber cert_f}ring that the solder used in system cor_tains
less than 2/10 of !,`, lead.
Commercial ouilding, ndustrial building, multinie residences and sim'_'_ar bu=dings
and installations, a cert_='_tate of Code Compliance °rom arch'-sect or engineer
responsiole for the building.
6. Submit Planning Board Approval of completed site plan. requirements.
2. =or existing 'ou--_dings (prior to April 9, 1957) non-conforming uses, or buildings and
npre-eXis�inen lana uses:
1 . Accurate su=ey o: proper snow: g roverty Anes. Streets, JL'it Ci 7g anc
unusual natural or zopograpaic- -eat..._es.
2. A proper-.,' completed, application and a consent t0 inspect signed by the aDDlicant.
of Occupancy __ denied, the Building =nspector shy- state the
reasons therefor en w__ting t., tae appl—,cant.
_. nees
_ . Cert_:icat>_ of Occupancy - New dwe'-'_lag 525.00, Additions .o dwe__izg .._:,.00 .
Alterations to awe"ling 525.00. Swimming poo' S=5.00, Accessory bu_lding 525.00 ,
Additions t.. accessory bu--ding 525.00. Businesses 550.00.
2. Cert__icate^o'_ Occupancy on Pre-e::is r<n£ 3uilding - Si00.00
3. Copy of Gert'_ficate of Occupancy - .25c
L. UDCated Certi_icate of Occupancy - S50.00
5. Temporary, Certisicate of Occupancy_ - Resident'_a'_ S' 5.0 , Comm.ercia= S15.00
Bat=_ . . . . /l 'r. . . . . . . . . . . . . . . . . . . . . . . . . . . .
yew Construction. . . . . . . . . . . Ola Or Pre-emisting Building. . . . .
ocation of Property. . . J O.Q4. . . . . . . . . . . . . . . . . . .SJ79iC5 . lQl1. . . . . . . . . . . _ �fT. /rt/`iP�o v . . . . . .
House No. Street Hamlet
:Inwer or Owners of Property. . � P (( . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
aunty Tax Map No 1000, Section. 3./. . . . . . . . .Block. . . (. . . . . . . . . . . .7oz.
:�. . . . . . . . . . . . . . . . . . .
;ubciviscon..^. . ro[t gip. . C'LPk'F.T . . �!!n�.p^JS. . . . .i-ed Map . . /5 . . . .Loz.�' . . . . . . . . . . . . . . . . . . .
Term_: No. . d 3 .39J. 2. .Daze Of Pe mit. .d7•/1•�. . . .ADD-_c.ani�4J�. J��if)4y.�J.l `r+�E. /i!iP6t,'ou ,f3 '.✓rYf+C;
;ea-, tn DeDt. ApDrova-. . . . 1Y / . . . . . . . . . . . . . . . . .Undei-wr-t-rs Approval. . "/I . . . . . . . . . . . . . . . . .
-lir.^.cad, Board Approval. . . . . . . . . . . . . . . . . . . . .
.ecuest for. _emDorarv{{ Grart--_..ate. . . . . . . . . . . _=ia_ Gestate. . . . . . . .
ee Submitted: S . . o�,� . . . . . . . . . . . . . . . . . . . .
6_4�. 514 . . . . . . . . . ' . . f'� . :. . . . . .f
ci0�a(6� �) AP?LT_CAY
FFOI/C
o� Gyp
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Town Hall, 53095 Main Road p • g Fax (516)765-1823
9y'�pl v �� Telephone (516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
May 30, 1996
Bob Kehl ' s Home Improvements
28545 Main Road
Orient, NY 11957
Re: Vincent Longo - SCTM#1000-31-4-3
Prem: 1090 Stars Road, East Marion
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23301-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
f llil.11 Illil'f•,C C r Utl Illil'UII'IUA'I'I; CUrlrllitl C:;
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ , ] I/NSULATION
/
[ ] FRAMING [ �] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
l
��f
DATE INSPECTOR
BOARD OF HEALTH . . . . . . . . .
FORM NO. 1 3 SETS OF PL\NS . . . . . . . .
TOWN OF`SOUTHOLD CHECK SURVEY .
MAR 1 2 igg6 BUILDING DEPARTMENT . . . . . . • • • . • • • • • •
TOWN HALL SEPTIC roam . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOTIFY ;
//� aye,
CALL
Examined . �A//dta� ,, 19Q1(` 7 / MAIL T0 :
Approved . .'.r°(.a.lr�„ 19/.�� Permit No c7�!
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�
� . . . . . . . . . . . . . .
Building Inspector)
APPL ION FOR BUILDING PERMIT
Date . . . . . . . . . . . . . . . . . .. 19 . . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
4sets 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 appli-
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 hrspector 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 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
i�nrspections.
. . . (,,JOB, ,.�/L//�S. .li��,//��,.�/t!¢'�ive�/h�•�Tr . .
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . .
f�N e.TGX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . .0/. N,4°/ "!r. . . .�Q�j�® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
Builder's License No. . . . —1.3. U � hT
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
J7-11 �CoA �. . . . . . . . . . . . . . . . �!r� 3 T 14.%elps✓ . . . . . .
House Number Street Hamlet
County Tax Map No. 1000 Section . . . 3 . . . . . . . . . . . Block . . . . . V. . . . . . . . . . . Lot . .J. . . . . . . . . . . . . . . .
Subdivision . . .XP.KNq, , . . .woo Q3 . . . . . Filed Map No. . .5.3. 5. . . . . . Lot . . . �. . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . . . �!. . Qt✓�CCr ✓(. . . . �i✓L�/t/ �'pi✓Si�kC.. ems/
b. Intended use and occupancy . . . . . . . .('!//C C C ri✓
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration, . . . . . . . . . .
Repair . . . . . . . . . . . . . . Remov4i'1 . . . . . . . . . . . . . . Demolition . . . . . . . . , . . . . . Other Work Ak 'x..,
{- (Description)
4. Estimated Cost . . . flVfq, . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . .
Ifgarage,number of cars . . . . .OA/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures, if any: Front . . . .G.s. .y.. , . , Rear . . .W.y. . . . . Depth . . .
Height . . . ./. g . , . . . . . . Number of Stories . . . . .®.,I.e? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure withalterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . .
lg I Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . .
Dimensions mensions of entire newconstruction; Front . . . . ✓.Vy.. . . . Rear . . / 9"r'. , , . , , Depth . .AQ. . . . . . .
Height Number of Stories . . . .4!?UK . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot. Front . . . AQ/. . . . . . . . . . . . . . Rear . . . /.4/. . . . . . . . . . . . . . . . Depth . .v2d4 . . . . . . . . . . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . , . . . . . . . . .
11. Zone or use district in which premises are situated . . . T'-9 t
12. Does proposed construction violate any zoning law,ordinance or regulation: . . . . ..rV.4. . . . . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded . . .!1/Q. . . . i . . . . . . . . . . . . . . . . . Will exc ss fill be removed fr m premises: Yes
14, Name of Owner of premises /N.??.vU./#! ,fw?.4: P. ddress /.a.3 �r,� 9,AUF.Phonallo. /..7�a:d�,r-7aey
Name of Architect aB , i . . . . . . . . . . . . . . . Address Bt?0! ��:Y. Phone No. . . . . . . . . . . . . . . .
Name of Contractor �/!�. . . . . . . . . . . . . Address gs2s, �!� ?�fgs�Phone No. . 5A 3; 3 S'4 7 .
15. Is this property within 300 feet of a tidal wetland! *Yes. . . . . . . . No. . )C. . . . .
If yes, Southold Town Trustees Permit may be required.
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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
37
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STATE OF NEW ..
COUNTY K S
Individual lignin . . . ' ' . . . . • . being duly sworn, deposes and says that he is the applicant
(Name of
g contract)
above named.
He is the . . . . . . . . . . . . . . . . . . . . . .
. ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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 this
application; that all statements contained in this application are true to the best of his knowledge and belief;and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me his G� /,
. . . . . . . day of. �. . . ., 19 l:r!
Notary Pub .c
CoA
950 County 1 /
C1.AlR L.Gt. � V
Notary Public,
. . . . . . . . . . . . . . . . . . . . . . . . . .
Qualified in Suffoll4 County (Signature of applicant)
Commission Expires necember 5,19.._.
71
;WA'LTJj DEPT StOFFOLK CO.HE ILTH DEPT
Qjl l H,.S. No.
AR- LRTY OF OP
PR
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0-71
STATE NT OF INTENT
AT i THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL-
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130WN' OP WUTHOLD' r WY SUFFOLK CO. DEPT. OF HEALTH SERVICES
(S)
APPLICANT
9 S7 HEALTF-S
. SUFFOLK COUNTY DEPT. OF
it SERVICES - FOR APPROVAL FOR!
186 CONSTRUCTION ONLY
DATE:
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APPROVED,
2 7 cm
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SUFFOLK CO. TAX MAP DESIGNATION:
6 DIST, SECT. 'BLOCK PCL.
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OWNERS ADDRESS:
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APPLICANT
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APP 011 DASNOTE�33 /
DATE: B P q
I I t A '1 NOTIFY BUILDING 0 E T
765-1802 8 AM TO 4 OR THE
- '•.6-"Iw'93 F'"y �!;,lA ^� FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
r FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
F
� 3. INSULATION
4. FINAL . CONSTRUCTION MUST
BE COMPLETE FOR C.O.
�-_----
'- ---"-"""—`-""- /' ALL CONSTRUCTION SHALL MEET
------�...._ - ' �------ THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
_._
--� UNDERWFICATE DESIGN OR CONSTRUCTION ERRORS CODES. NOT RESPONSIBLE FOR
RITERS CERTI
REQUIRED
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