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Home My WebLink About23307-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24624 Date SEPTEMBER i1, 1996 THIS CERTIFIES that the building Location of Propert~ 1200 PEAITY LANE House No. County Tax Map No. 1000 Section 109 Subdivision ACCESSORY Block 6 Filed Map NO. UuTCHOGCE, N.Y. Street Hamlet Lot 26 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 14, 1996 pursuant to which Building Permit No. 23307-Z dated MARCH 15, 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 INGRO~-ND SWIPING POOL WITH ENCLOSURE AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL INSPECTION CERT. PLUMBERS CERTIFICATION DATED Rev. 1/81 ANT~ONX & BE~NICH FP~CIANI #~200! - NAY ~4. N/A FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N_~ 23307 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ...]<./~f.... £. .......... ...~.7.z....u.~..-:......~....~ .................................... ................................................... ,o ~~z ....... ~~ ........ ~ ~ E :, ....... ~:,..:,..,.. ...... ~~,,.~_ ~..~.....~ ~~ ......... ~......~ ....... ~......~ ~ ........ ~.?... ...~~ ........... ~..: ...................................................................... ./... .................................. / ' Co,~ToxMa~No. ~000 Seot,o~ /~ ,oo~ ~: ~o, No ~ pumuant to application dated ........... '.'.':~l.'i:.~.','.','.',',','; ........... : : :::",';:::~'~...., Building Inspector, Rev. 6/30/80 TOWN OF $OUTHOLD r0k~I gALL 765-£802 .~3PLICATION FOR CERTIFICATE OF OCCUPY-iCY This application must be filled in by typewriter OR ink and submitted uo the building inspector with the following: for new building or mew use: !. Final survey of property with accurate location of all buildings, properny lines, streets, and unusual natural or topographic features. 2. Final Approval from ~ea!th Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical instaliacion from Board of Fire Unde~¢riters. 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 b~ildlng. 6. Submit Planning Board Approval of completed site plan requirements. 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 ail property lines, streets, building and unusual natural or ~opo§raphic 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 ra~so~s therefor in -~riting to she applicant. 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building S25.00, 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 - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00~ Commercial $15.00 New Construction... ~ ...... Old Or Pre-existing Building ................. Lpcation of Property ..... [2~q.~i~xi~.g~hqgu.~.N~X~.ll~ ............................. ~ouse No. Street ~amlat Onwer or Owners of Property ...... ~er~.~.Ant~o~ ~asqian~ ............................. County Tmx Map No 1000, Section .... ~Q~ ....... Block ..... ~ .......... Lot. 2~ ............ Subdivision .................................... Filed Map ............ Lot ...................... Permit No 23307Z .Date Of Permit. 3/15/96 .Aooticant. Bernice Fasciani Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval Request for: Temporary Certificate ........... Final Carticata ........... Fee Subminted: $ .... ~qq ................... ·...~.e.r.ni.c.e.F.a~ci~i ............................. .LPPLZ C~&JT ELECTRICAL INSPECTION SER~CE INC. EAigT PATCFfOGUE, NEW YORK 11772 (5~6) 286-6642 12001 DATE: 5(!4/06 APPL[CATION No. ON FILE CUrC~O~UE .... ro~.~ $orrcttozo ................. PILLAGE: ~RODUCF~ BE' ~ ~S ELEC~IC IN~. ~C ~o: 2675~E was ~minad on 5~1d-96 ~und fo be in comptian~a with t~Na~nat E~iaaI LOCATION: Base.. 1st ~ 2nd 3rd Ur a~_ar.,e ...... HotTub , .Pool · JOg, ........... Bet, OTHER OUTSIDE, RES. 1-20~ TIME CLOCK BUILDING PERMIT No, BLI3IE Ot~jGINAL YIBLLOW COPY PINKCOPYOFFICE I{I)U(;II I:l{^i, II~, & I'I.UHII 114f~ IN};II[.ATIOt! I'['.'1~, U. Y. $'I'AI'I~. (:OI)l~. Swlm~King (516) 744-8100 FAX (§16) 744-8292 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING [ ] ROUGH PLBG. [ ] INS~.~T-ION [/,~'I~NAL ] FIREPLACE & CHIMNEY REMARKS: DATE , INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]FRAMING [ ] IN~:~IL~A~iON [/~J~INAL REMARKS: ] FIREPLACE & CHIMNEY INSPECTOR 6 6 , ,f Z 0 i FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD. N.Y. 11971 TEL.: 765-1802 Approved ............ .~.t/.~.~. 19 .~. pennit No. ~'~3,~ CP 7~ .......... Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK NOTIFY CALL ..................... MAIL TO: /(A3u~ding p c or) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS · a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with sits 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 strec or areas, and giving a detailed description of l~yout of property must be drawn on the diagram which is part of this apF cation. e. 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 appl/cant. Such perm~ shall be kept on the premises available fo[ inspection throu-jaout 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, a,d, ditions or alterations, or for 3emoval 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. (St;g,r[a~4oy~pplic~n~, cxr name, ~f~a C6~l~or~n) '~ ' ..... .%.q, k .... ....... t .......... State whether applicant is owner, less. ce, advent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of r ' ~.~ ~$S ' '~}~ p em,des. ~1.~ ...... ~-~'.'2.[. ............... '; .,~ ;";;..";'&d-;....'..' .... ! (as on the tax roll or latest deed) ) :" - If applicant is a corporation, signature of duly authorized officer. ~I)~O~I~D ~ I~1'[~ (Nahe and title of corporate omcd) ' Builders License ~o. ,=~1..~.t.,;~.t~..~, .'fLX~',_.O_~'J Ua' ~S-180~ * ~ ~O_~ ~'~ ~Oa Plumber's License No. ~.. j/~ ~..-f.._~. ,,,,~. ~*-..~,.rl~/UL, '1. FOUNOATION - TWO .... ~ "'.Z~t-T~D~)T f'L'DT~:'!r,a'rr' m, mu~ CO~C,E~a , ,,'-~/~'"Tt~...l-~, ~ ~ '~,~ ~L.~lilii~til 1"_, ~ ROUGH FRAMING & PLUMBING Electric an s License No q~. ~ .t ~..d{_~O ' 3' ,NSULAT[ON , ' .......... ¢CU?^NC¥ · OtherTrade s License No .... ~ ./.~ ........... 4. m~aL - co~s'rm)cwloa ~V~tJST BE COMPLETE FO;-q iLO. 1. Location of land on which proposed work will be done. ~H~:._ ~q.E..~q JlR~,%!/J;['~ · 'f.S .Or. T~...; . .'~: (',.Y,... . House Numbor Street ~f~to ~ ~.~ -, County Ta~ Map No. 1000 S~ct~on ................. Block ................. Lot ................ SubdMsion ..................................... Fi]ed Map No ................ Lot ............... (Name) 2. State existing use and occupancy of pr~ndses and intended use aod occupancy of proposed construction: Existing use and occupancy ..... ,'2/ ',t~i' . ' .... ~ .......................... b. Intended use and occup~ncy ...~.~.X-~..~ J~~..~J.~.~2~..~/ ...... 3. Nature of work (check winch appl cab e): New Buildin- ' , . Add/q^.- R ' o · ....... ~ ............. /alteration .,~ ..... ep:ur .............. Removal ............. ., Demolition ..... [~ . ....... Other Work..j~./~5~. 4. Estimate'dCost ~ --(~(.~i[~ .ao , ! /(Descl-iption) .... -/ ......................... Fee .... ~ ................................ i(to be paid on filing this applic'ation) 5 ~fdx~elling numberofd ,' 'rig unjt~s .~./~ Numberofdwelli!ng units on each floor garage number of ca MJb. i ............... 6 If business commerci:i] )r mixed occupancy ......... ~/.'/.~ ............. · , ~ . specify nature and extent ofe~ch type of use 7 Dimensions ofexistint} strnctures if any: Front .............. ................ 'Rear i Depth Height Number of Stories ................ Dimensions of same structure with alterations or additions: Front i Rear Depth Iteight ................. ............................................ Number of Stories 8. Dimensions of entire new construction: Front ' ' .................... ............... Rear ,..: Depth Height ............ Nufinber of Stories ............... , 9. Size of lot: Front .~i~J.q~. ............. Rear v2/.31,q-.q.~ .................... 4bff...(9 .......... I0. Date of Purchase .......... ;... Depth ................ .... · .............Name of Former Owner ...... t t, z, one or use restrict in which premises are situat,,,/ ! .................... 12. Does proposed construction violate anv zonin-T~, ~]-,~[.,'~,~-~'~,'/~.~,' ' ' ',.''' I' J/,,,' ............................ ,.,. r~m ~o~ oe regraaecl ............... ,,., ............. Will excess fill,be ,re'noTed from premises· ' NameofArch't - ,,tn .. .,~ .... ,aa Tess tq~'~ ..... qY.b~cia'~/.Ploner'to, t~'t:.7.~.q~.,~... ~ ect. ~.,Atl~rl..._ ...... Aa,~r,~s . c,,q~,Sa% ¥ ..... · · · · ?amc.of· Contractor/~'0/l~ .T..l~ct~l¢cJi~.p}o, lt).~..tq,~..g.i~a~r~s ~.7../..0~...4,,q..,q, ji~0.~.~/1O/..~./07Phone No. '7.t-{.c/.-$/..f0... IS.is thxs property located within 300 feet of a tidal wetland? ~YES .... NO.~/f. ~If yes, Southold Town Trustees Permit may be requilred. 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 comer lot. STATE OF NEW YORK. COUNTY OF... ~,~O,h~,':~.6. [ J.~.... S.S ............ · (Name of individual signing contract) above named. (Contractor agent corporate offic~'' ) .......................... ' , ,et:. of said owner or owners, and is duly attthorized to perform or have performed thc said work and to make and file this application; that all statements contained in this application are true to tile best of his knowledge and belief; and that the work w//l be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public ............ ~ .... County · No. ~2-4526433 · · Qualhledln 8~olg~ilffff (Signature of applicant) ..... being duly sworn, de, ,oses and says that he is the applicant ,'4 ,J