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Home My WebLink About22914-zFORM NO. 4 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCUPANCY No E-23807 Date AUGUST 7, 1995 THIS CERTIFIES that the building ADDITIONS Location of Propert~ 40735 COUNTY ROAD #48 House No. Street County Tax Map No. 1000 Section 59 Block 7 Subdivision Filed Map No. SoUTHOLD, N.Y. Hamlet Lot 29.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 1995 pursuant to which Building Permit NO. 22914-Z dated JULY 31, 1995 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 ENCLOSE EXISTING PATIO AT ~EAROF EXISTING ON~ FAMILY DWELLING & A FRONT DECK ADDITION "~ BUILT". The certificate is issued to JOHN & MARY PEROTTI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspect~ FORM NO.3 TOWN OF $OUTHOLD BUILDING DEP.A~TMENT TOWN HALL SOUTHOLD, N.Y. N.O BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN~L FULL COMPLETION OF THE WORK AUTHORIZED) Date ..i.~.~.' ............................................. 229i4 Z CounlyTax Map No. 1000 Section ....... ~ ....... Block ......... ~ ............ LotNo ........ ....~..~..~...~.. pursuant to appllcation dated ..... .~./..~ ...................................... 19~......~... ..... and approved bythe Building Inspector. Rev. 6/30/80 ,JUL BUILDING I)EPARTI.IENT TOWN IIALL 765-1802 A. This application must be filled in by typewriter OR ink and subraitted to the bnilding inspector with the following: for new building or net~ use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Fiual Approval from Hehlth Dept. of water supply and seNerage-disposal(S-9 form). 3. Approval of electric~-ul 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,l\a certificate of Code Compliance from architect or engineer responsible for the buildihg. 6. Submit Planning Board Approval of completed site plan requirements. B. For 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 reasous therefor in writing to the applicant· C. Fees 1. Certificate of Occupancy - New dwelling $25-00~tions 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 Buildine - $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 ....... . .. New Construction ........... Old Or Pre-existing Building .............. Location of Property ........................ ?..~. ......................................... ltouse No. StreetHamlet Onwer or ONners ,.,f Property ........ .~...~.~,..~.. County Tax 000, Section ..... ..... ....... ........ .... ~ bd' ' ' ,~ .~. ?~ .................Fi,od ~ap ............ ~ot ........... ...... ~' '/' ' Appli Ilealth Dept Approval · ' ......................... Underwriters Approval .............. Planning Board Approval .................... Request for: Temporary Certificate ........ Fi te ........... APPLICA'IION FOR CERTIlrICATE OF OCCUPANCY FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION ( IST) P o 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/U~SULATION [ ] FRAMING ~[ ~/] FINAL [ ] FIREPLACE & CHIMNEY RE:MARKS: _/~--~ ,~~ / -- DATE I NSPECTOR~~' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 BOARD OF HEALTI[ ......... 3 SETS OF PLA~S .......... SURVEY ................... CIIECK .................... SEPTIC rOa~! .............. t,O~ LFY , CALL ................... HAIL TO: (Buildi,g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildh]gs on premises, relationship to adjoining premises or public streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept ou the premises available for inspection throughout the work. e. No boilding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall 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 luilding Zone Ordinance of tile Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or {egulatinns, for the construction of buildings, additions or alterations, or for r/~oval or dem~olj~n, as herein described. ['he applicant agrees to comply with all applicable laws, ordinances, buildin~/~9/de, h..cu~c~, and ~gulations, and to dnfft authorized inspectors on premises and in building for necessary inspec~o~ ' "~~l~'e: ifa corpr}~a'~Z '~X' ' (M ailing a_d d re s~:~p~n t ) grate whether applicant is owner, l~see, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. ~. r~.~. .~r~. . . ?. ~. . .,.~. ~ .~. . ........................... . ........................ ,~,n~ o~ ow.er o~.~,.,~ .... ~.~ ~... ~..~ h ~.. ~ ~ ~ 7.~.~ ............................... (as on the t~ roll or latest deed) f applicant is a corporation, sig.atnre of duly authorized officer. (Name and title of corporate officer) Bu Ider s L cense No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No. ...................... · Location of land on wlffch proposed work will be done. Ilouse NumberStreet Hamlet County Tax M.~,, ~o. ,000 Sect,o,, ...... ~.q ......... Bloek ...... 7 ........... ~ot....,~.... ?.: ~.. SubdMsion ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupaucy of prem ises and intende~se and occupancy of proposed construction: Ex 3. Nature of work (coeck wit ch ap[ i:cable)' New Bui dir g Addition J Alteration .......... Repair .............. Remora .............. Demolition .............. Other Work ............... (Descr on) 4. Estimated Cost ........................ Fee .................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... · If garage, number of cars ....... i ................................................................ 6. If business, commercial or mixed o~cupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, ii' any: Front ............... Rear .............. Depth ............... Height ............... Numbe? of Stories ........................................................ Dimensions of same structure with !alterations or additions: Front ................. Rear .................. Depth ...................... !Height ...................... Number of Stories ...................... 8. Dimensmns of entire new construction: Front Rear Depth Numbe~ of Stories ............................................. tteight ............... ........................................................ 9. Sizeoflot: Front ............. i ......... Rear ...................... Depth ...................... 10. Date of Purchase ............. : ................ Name of Former Owner ............................. 1 I. Zone or use district in which prcmiies are situated .................................... ~. ~ ............... 12. Does proposed construction violate!any zoning law, ordinance or regulation: ................. i .............. 13. Will lot be regraded ........... ! ................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..... ; .............. Address ............. ...... Phone No ................ Name of Architect ............ ; .............. Address ................... Phone No ................ Name of Contractor ........... , .............. Address ................... Phone No ................ 5. Is this property within 3001 feet of a tidal wetland? *Yes ........ No ......... *If yes, Soothold Tow~ Trostees Permit may be required. PLOT D~AGRAM Locate clearly and distinctly all bu!ldings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty Ii,ms. Give street and block number or descriptioh according to deed, and show street names and indicate whether nterior or corner lot. b p p aG~, OCCUPANCY OR/' USE IS ~LAWF~ WI~9~[ ~ATE "OTI~ BUILOI"a OEPAm~'AT 76~-1802 9 AM ~ 4 PM FOR FOLLOWI~ 1. FOUNDATION - ~0 REQUIRED FO~ POURED CONCRETE 2. ROOGH - FRAMING & PLUMBIN~ 3. I~$U~TION CONSTRUCTION MUST 8E COMPL,~E FOR C.O. ALL CONSTRUCTION $HALL T~E RE~UIREMENT$ OF THE ~.~ ~TATE CONSTRU~ON & ENERGY N~ RESPONSIBLE FOR 06SKIN OR CONSTRUCTION ERRORS r^'r~ oF Nl~W ¢I~.~./c_ ~ ~ DUN'FY OF .. ~.'?.}~';"7 .... - ,,:o ~ ~ ................. ,. '.: .......... ~ ................ being duly sworn, ~e~ose~ (N~ me of individual signing cgntract) ~ove named, l ~ is the [ (~ontractor, agent, corporat~ offi~r, ~t~.) said owner or owners, and is duly mdhoriz~d to perform or have performed the said work mid to make and file this phcatmn; that all statements conta n~d~ in thig application ar~ trtm to/lie b~st of big knowledge and bdi~f; and that th~ ~rk will be perfonnSd in the manner ~et fOrth in the application filed theTewith. ?om to before me this /~. ~, of ~x~ ,. ~C ............. - .... ....... , ...... .... ~,,~.a '1~ ~%k, ai~ ~ ~ ~ ~ ~ (Signature of applicant) JUL 1 ~ 1995