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Home My WebLink About23394-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OG~umANGY No Z-24600 Date SEPTEMBER 6, 1996 THIS CERTIFIES that the building Location of Property 360 SIGSBEE ROAD House No. County Tax Map No. 1000 Section 143 Subdivision ADDITION & ALTERATION LAUREL, NEW YORK Street Block 01 Lot Filed Map No. Lot No. Hamlet O5 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1996 pursuant to which Building Permit No. 23394-Z dated APRIL 30, 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 ADDITION, ALTERATION & ~ENOVATION TO EXISTING ONE FAMILY The certificate is issued to DWELLING AS APPLIED FOR. (~3~ES A. TIMPONE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION CERT. %12459 - JULY 11, 1996 PLUMBERS CERTIFICATION DATED AUG. 21, 1996-MATTITUCK PLUMBING & HEAT. u~_lding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUIt. DING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .................. ~"~'"' .......................... ] 9.,¢~... 23394 Z Count/Tax Map No. lO00 Section,,., ,~, ,,~,~.. ........ BIock...,.~,, ,~,, .......... Lot No ........ ~ ....... pursuant to application dated .....~...~---~(,,~. ........ ~,,,~.,..~,.,, .......... 1 g,...~..~...., and approved bythe Building Inspector. Fee $,,...2 .,~.,~,~... Rev, ~/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~N ~iALL 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: 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/I0 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. 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 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 Date ..... ~.~..~...~..~ ..... ~ .~ ~ ............ New Construction ........... Old Or Pre-existing Building....~. ............ Location of Property .... ~.(~. ....... ~.~-- ....... ~ .......... .~..~.-C%-L~b~.~-~ .......... House No. Street Hamlet Onwer or Owners of Property ..... ~.~..~.~f-~...~.~.~. .................................... County Tax Map No 1000, Section..[ ....... Block ..... .~..~ ....... Lot ......... ~ ......... Subdivision .................................... Filed Map ............ Lot ...................... Permit No.Z~.~.%.~..~-~...Date Of Permit .... -- . .~.'.~.~.~..Applicant..~+.~-~-,..~..~.~..~. · .... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... APPLICANT Town Hall. 5309§ Main Road P. O. Box 1179 Southold. New Yock 11971 Fax (516) 765-182;I Telephone (51 G) 765-1~302 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD .CERTIFICATION _DATE 9uiiding Permit No. 2~,...~.-'°~ Owner: _.~J~O_~ ~P~ (please print) (please print') contains less than 2/10 certify that the solder Used in the water supply system of 1% lead. / Sworn to before me this ~,/,, clay of __~ ,. 19,e'~ Notary Pub~ :/,~, ,, County Term ~From ~ BOECKMAN CONSTRUCTION CORP PHONE No.,': 2985319 Aug. 2? 1996 10:13AH P02 OCCUPANCY OR USE iS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY IDRAWING NUMBER j~2o O01 0 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROU~I~LBG. [ ] IN/SfJLATION [~}/~INAL [ ] FIREPLACE & CHIMNEY REMARKS: INSPEC~~ )isapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 APPLICATIO~ FOR BUILDING PERMIT 3 SETS OF~ANS . · SURVEY ~ ........... CIIECK ';;2,; ............... SEPTIC .............. f ......... FLAIL TO: INSTRUCTIONS a. Tiffs application must be completely filled' in by typewriter or in ink and submitted to the Building Inspector, with 3 ts of plans, aCanrate 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 ' areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appff- .tion,~i - c. The work covered by this application ma,, no~ be c ' ' - ~ ommencea before issuance ~f Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit MI be'kept on the premises available for inspection throughout the w6rk. e. No building shall be occupied or, used in wh~le or i~ prat ~ any ~rpose whatever until a Certificate of Occupancy all have been granted by the Buildin~Jg~,~t~.~Sv~:~,.~~ .~'~( ~f,j,~ APPLICATION IS HEREBY M.~D~ {~'~}/~Bi~il~i~½~!b~n~}ri~t~ hiding Zone Ordinance f th ........... ~ ~, l~,~11~,, ~P~, it, ursuant to the .?lat~.ns, for the construction off~ufldmg~, additions o~ alterai~ons, ~r for removal or a~-,,: ...... ' .... ~r ~. appl cant agrees to comvlv with a~?an'nH~hli~T~,l,a"~¢~'~2~2' ,%,WS}Pg ........... v.~,,,u,mv., ~= hereto oe~nuea ~; .... ~_~: .... - - . ,, ~,gq~r?~?,?,,,~,.~u,~,,~,,~e~,.~;o~-~g code, housing code, .and regulations (Sig ppi nt .... ) nature of a ~ca ,0r na~ ff a corporatmn ate whether applicant is owner, lessee, agent, a[chitec~,, ~agino ~,z eneral contractor, ei~ctrician, plumbed, or builder. · ~me of owner ofprem/ses ~ ~ ~ ' ]ppheant ~s a corporation ,signature of duly aut~'¢~3&;}~g'~fi ' (~ame and title of co.orate officer). ,,~ ~. Builder s License No ..... ~.~ · · · .' '..~ ...... 3 Plumber's License No ......................... Electrician's License N~ .... Other Tradc's License No ...................... Location of land on which proposed work will be'done ' Ilouse Number ........... Street Handet '" Co,my Tax Map No. I000 Section ....... [.~.5 ...... Block ..... 1 ........... ot.. ........... Subdivision ' ..................................... Filed Map No ............... Lot ............... (Name) ~tate ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: ' Existing use and occupancy ' ~. Intended use and occupancy 3. Nat,ure of work (check which ~pplicable): New Building .......... Addition .......... Alteration ..... Repair ........... Re~oval Demolition 0th ~t~k~ 5~'",':~ ' ' ' (Description) 4. Estimated Cost ....... [{~,~ ~O (to be paid o Ifd Iii ~ it $. Ifg~ve ng, numberofdwellin un s ............... Numberofdwc~lling units on each floor.. 6 rage, number of cars ... ~ .............. · ............ If business, commercial or mix~-d · ,: ,o~.cupancy, specify nature and extent of each type of use ........... 7. Dimensions of existing structm,es if any Front .... · ......... Height ............... Nmn her of Stories ..... ' .......... Rear .............. Depth .... Dimensions of same structure ~yith alterations or additions: Front Depth ' Height ................. Rear 8 .......... ~ ......................... Number of Stories · Din~ensions of entire new const~ction: Front ........ "' Height Number of Stories ............................ Depth · · Rear 9 Size of lot: Front ' .... ' Rear 10' Date 0f Purchase .......... + ............................... ,. Depth ...................... · ' ............................ Name of Former Owner ............................ 11. Zone or use district in which pr~mises are situated 12 Does proposed Construction violate day zoning law' ;r~in'anc;'o'r're;~laiio~': 13. ",gill lot be regraded . . .'.. ~ . .... ' ' ' ~ ",' ........ u ......... Will excess fill be removed from oremises, y 14. mameotuwnerdf remi c.. ~.~ - ' es No p scs .. ~ .... .~. . · · C~('~;19/..g'... Address . ~.t~,~. . . .t'~p . Name of Arch~tee . · ?~,tlf~t.~.._.~.~..:. Phone No. ~.."~.'.~.~J .q: marne o! tJontraetnr ~,~w.t~3 /.~..,~,. · ,~dd ....................... rnone r~o ...... .... Address ~,~¥.lf-{~...1~. 0.'~,..' Phone No. ~.'~ ~.'7~.~. {'~.·... 15. Is this property within 300 feet of a tidal wetland? ~Yes ........ No .... · If yess Southold ~own Trustees Permit may be required. ' .... .... [ PLOT DIAGRAM . . Locate clearly and distinctly all'[buildings, whether existing or and. indicate all set-back dimensions frlom property lines. Give street and block ~umber or description accordingly;°p°sed' inter/or or corner lot. deed, and show street names and indicate whether [ " PLUMBER CERTIFICATION i ON LEAD CONTENTBEFORE N'lql0VBI AS II01E0 ',I CERTIFICATE OF OCCUPANCY o^m ~=~'.# ~ SOLDER USED IN WATER NOTIFY 'BUILDING DEPARTMENT ATSUPPLY SYSTEM CANNOT m-leO2 ~ A~a TO'4, t'M FO~ TH=' EXCEED 2/10 of 1% LEAD. FOLLOWING INSPECTIONSi, : ' 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE [ 2.ROI.KIH . FRAMING & PLUI~SING S.INSULATION 4. F NAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE ,REQUIREMENTS OF THE; N,¥o STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE DESI.GN OR CONS~RUCIION ER~ IORS .'ov v OF . ./5.. 's.s .... ? ~('h~e of individual signing C,ontract) )eve named. · " PLUMBING ALL PLUMBING WASTE & WATER MNES NEED TE~TING lB, Et=ORE COVERING If. copper tubing, ia used mr water distributing system; P/ping Shall be UNDERWRITERS CERTIFICATE . REQUIRED OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY .......... being duly sworn, deposes and says that he is the applicant · said o e U ~ / " aut;honz"~o-peI' of~rrm or have performed the said work hnd to make and 1 plication; that all statements contained lin this application are true to the best of his knowledge and belief; and that the ~rk wil be perfo~ned in t~e manner set ~n~th ;, ~h .... ,'om to before me thi~. --- ~ .......... e appucauon mca tl~erewith. ........... ........ ' ' C~IRE L. GL~ . [ ' /I///~ // / / ~ No. 4879~O5 ~ ~/ ' ' ~ ff~/~ ~ .......... ; .... ; ........... ~fmd m Suffolk CouflW i ~ Quar' ' _ ~--~ t9~ (Szgnature of applicant) Commission Expires uecemuu~ ~, ~ , '