HomeMy WebLinkAbout22373-zNo
Z-24734
FORM NO. 4
TOWN OF 8OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
~ERTIFICATE OF OCCUPANCY
Date NOVEMBER 15, 1996
THIS CERTIFIES that the building.
Location of Property. 2372 HAY AH.
~ House No.
County Tax Map NO. 1000 Section 144
Subdivision
ADDITION
MATTITUCK,' N.Y.
Street
Block 3 Lot
Filed Map No. Lot No.
34
Hamlet
conforms substantially to the Application for Building Permit heretofore
filedlin this office dated OCTOBER 7, 1994
pursuant to which
Building Permit No. 22373-Z dated OCTOBER 7, 1994
was i~sued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is UNHEATED ADDITION TO EXISTING OWE FAMILY DWELLING AS
APPLIED FOR.
The c~rtificate is issued to
of the aforesaid building.
ANTONIO & SOFIA BARUCCO
(owners}
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
UNDERWRITERS CERTIFICATE NO.
H-052636 - NOVEMBER 6, 1996
PLUMB~KS CERTIFICATION DATED
Rev. 1/81
Inspector
FOgM
TOWN OF $OUTHOLD
BUIL~I~4G OEPAR~MEN~
TOWN HALL
SOUTHOLD, N.Y.
N~ 22373 Z
BU~LDING PERMIT
[THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to':
.
................................................... .............. .................
CountlTax Map No. 1000 Sectlon.,..,.~..,~...,~,.. ...... Block .......................... Lo ......... ~,, .................
pursuant to application dated ........ .~.....~.~.. ...................................... 19,.~...~... ....... and approved by the
Building Inspector. ~
Fee $.., .Z.,~..',~...
Rev, 6/30/80
U0r,~ OF SOUYHOLD
BUILDING OEP :X-~T'_dEzNT
TOkn~
76f-[g02
AP. __CAT_ON /OR CERTIFICATE OF OC~UP,,NC,
This application must be filled in by :yp~¢riter OR ink and submitted co the building
inspecnor with the following: for new building or new use:
Final survey of propert7 with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Eealth Dept. of water supply and sewerage-disposal(S-9 form>.
3. Approval of electrlcai installation from Board of Fire Underwriters.
4. Sworn statement from plumber cercifyin§ that the solder used in system contains
less than 2/!0 of !% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and-installations, a certificasa of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval o'f 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 al! property !znes, streets, building and
2. A properly completed application and a consent to inspect signed by the app!ican~.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
r~asons therefor in ~ritin~ to ~he applicant.
C, Fees
1. Certificate of Occupancy - New dwelling S25.00, Additions to dwelling S25.00,
Alterations to dwelling $25.00, Swinging pool S25.00, Accessory building
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pra-existin~ Bui!din~ - SlO0.O0
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupant7 - JtO.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial
ate .... ..........................
New Construction ........... 01d Or 2re-mxist±ng Building .................
Location of Property...~..-~..7.,~f, .... .~...~..? .... .~.'~ ........................................
Eouse ~o. Street Hamlet
~ /~U~O / 3~o~/'~ ~A~CC~ .......
Onwer or Owners of ~_~___y ...........................................................
Count 000, seetion..Z.Y.K ...... .... ........... 2or .... .............
Subdivision ........................ '. ........... Yiled Map ............ Lot ......................
P-.m_~ No. .Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Under. ricers Approval ........................
Planning Board Approval ........................
.~PPL l CANT
FOUNDATTON ( lstl
FOUNDATION
2.
(2nd)
ROUGH FRAME &
~?LUMBING'
INSULATION PER N.
STATE ENERGY
CODE
Xo
FINAL
ADDITIONA'L COMMENTS:
10/13/199S 18:S2 21§-905-2476 NJ ROSENBLUM RA PAGE 01
MARTIN JAY ROS]t2~BL~, R.A. & ASSOCIATES
346 SOUTH FIFI~ STIaE~'T
im~.aDELP~A, FENNSYLVANIA 19102
I~ONE: (21~) 98~.128~ FAX: (21~ 98~-2476
FACSIMILE TRANSMISSION
NUMBER OF pAGES
MESSAGE:
PLEASE VERIFY THAT ALL PAGES HAVE BEEN RECEIV~-r~.
IF TRANSMIg$ION IS UNC!-E~kR, pLeASE NOTIFY SENDER.
~O.LO~IdSNI
'IVNI-I [
NOIJ,VllISNI [
A::ININIHO ~, ::lOVld=lUId [ ]
] ONIIN~ ]
] aN~ NOIJ,VaNI~Od [ ]
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ld HOI'IOU [ ] /$1, NOI/VQNflOd [ ]
NOII:)3dSNI
'Jcl:lQ ~)NIQllRE
ZOS'~'S9Z
18/13/1995
~ iI°ol' ~° ~v 1o. oo
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION l ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]IN~IJL~TION
[ ] FRAMING ~ FINAL
[ ] FIREPLACE & CHIMNEY~
REMARKS: , .~/~/~ ~
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[~]'I~NDATION 2ND [ ] INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACE & CHIMNEY
BUILDING DEPT.
~NSPECTION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE&CHIMNEY
REMARKS:
//~~ ~
THE NEW YORK BOARD OF FIRE UNDERWRITERS
' 8~63(~92 BUREAU OF ELECTRICITY
~' 85 JOHN STREET, NEW YORK, NY 10038
Dat~ NOVf:~ER 06,1'996 ~4pptication Mo. on file ~.2782596/96 H ~52636
THIS CERTIFIES THAT
ANTONIO & SOFIA BARUCCO, BAY AV~NU]~, MA'IT]:'I~3CK, N, Y.
iff the followlng h,cation; ~ B~,ement ~ Ist FI. ~ 2nd FI. Section Rl~k
~ exatnined on OC~B~R 30,1996 and found W be in compliance with the Nagonal Elect~cal Code.
Lot
FIXTURE FIXTURES RANGES ;OOKING DECKS OVENS EXHAUST FANS
OUTLETS SWITCHES FLUORESCENT OTHER
DRYERS
SYSTEMS
NO. OF FEET
E
pADDLE f~ANS -2
MOTORS: 2-F H.P.
A. WG
OF CC. COND.
C
NO. OF HI.LEG
NO, OF NEUTRALS
ANTONIO & SOFIA BARUCCO
17 SHI~RMAN AVMNU~
ROCKVILI~ CMN, NY, 11570
Per ~I.;ENEIEAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incqrrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Examined
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Disapproved a/c
APPLICATION FOR BUILDING PERMIT
gOARD OF HEALTH .........
3 SETS OF PLANS
SURVEY
CHECK ..........
HAIL
Date ................... 19...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets 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-
tcatinn.
c. 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 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 t~a~suance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Coun!,yj~'W ~Yor~, and other appilc%ble Laws. Ordinances or
Regulations, for the construction of buildings, additions or alterat~ns, or for r~mpval or den3~i~n, as herein described.
The applicant agrees to comply with all applicable laws, ordinanqges, building ~odJ, housing~odfi, axed regulations, and to
admit authorized inspectors on premises and in building for necess~ inspectio~s.j . ,; / J
· .......
'- (Signature of applicant,kffname, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises -x~'d-x~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
Builder's License No../~...c~.'~. V....~-~2~ '~
Plumber's License No ......................... '~~
Electrician's License No.. :fi~. ,~.../~.. ......... 7.7 ......
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
House Number Street Hamlet
Connty Tax Map No. 1000 Section ..... /.~.y ...... Block..~.~. .............. Lot...~...(2f. i ...........
Subdivision ..................................... Filed Map No ............ .... Lot ...............
(Name)
2. State ex/sting use and occupancy ofpremkes and intended use and occupaocy of proposed construction:
a. Existing use and occupancy ...,~.'.u..t4.~ .~.& ,c. o-~,t~6'g, o'~./.0 g.y' ' 'r'' : ': ,-,~
.............. ~.~ <~ ............................
b. lntended use and occupancy ,,~,'c~V~a ?~_c~"~,/Zu~ &.~./.~A';'/,c.'ecm~¢,~c)cr c.,.~,~
3. Nature of work (check which applicable): New Bu/lding .......... Addition ......... Alteration ..........
Repair .............. Remora! .............. Demolition .............. Other. Work ..............
~/~F3,.) r~3 ?~'~ (D ripti ) '
· ~" e$C on
4. Estimated Cost ............... ' / .o./. '- .-~ ...................... Fee ....
J (to be paid on,fih~g s: ation
5. If dwelling, number of dwelling units ..... ~. ~ ...... Number of dwelling units on each floor ................
If garage, number of c~s : . ~/~
........
If bus~ness, commercml or m~xed o~cupancy, specify n~[ur~ and extent of each type of use ....
7. Dimensions of existing structures, if any. Front [~ ~. Rear . (Z ~ De th ~ .....
Height .... ~ ~ ~ .... Numbe[ of Stories ..
D~ensions of same structure withlalterations or ad~o~Front 3 ~f Rear
Depth .... ~.~U ........... ~ Height ... ·
..... . ~ .~ ......... Number of Stones ......................
8. Dimensions of entire new construction: Front .... ~... Rear .... ~¢.~... Depth . .~
Height ...~.~(.~.. Number of Stories
9. Size oflot Front~ [.{~-r . '~;~r ' ' '~ ~'~x' ......... ~;~ ......................
10 Date of Purchase · Name of Fomer Owner
I I. Zone or use district in which premises are situated ...............................
'2 ......... ,...
12. Does proposed construction violat any zoning law, ordinance or regulation: .......................
13. Will lot be regraded i. . . Will excess .... r - ' '
....................... mi ae emovea trom premises: Yes
14. Nme of Owner of premises .... ~
· . ............... Address ................... Phone No ................
Nme of Architect ~ ' Address Phone No
Nme of Contractor ........... , ............... Address ................... ph?~~; ........
15. Is th~s property w~th~n 309 feet of a t~dal wetland? ~Yes ........ ~o.~ ......
~If yes, Southold To~n Trustees Permit may be required.
PLOT DIAG~
Locate clearly ~d distinctly ~1 bafld~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from
interiorPr°pe~YorlineS'eomerGiVelot.Street ~d block n ~mber or description accordhg to deed, and show street nines and ~dicate whether
STATE Ob' NEW YORK, ' <_
cou~Y OF .... ~%. ..... ?
.. ..... ...........
(Name of individual signing contract
above named.
........ being duly sworn, deposes and says that he is the applicant
He is the
(Contractor, agent, corporate officer, etc.)
I ' '
of said owner or owners, and is du y~ 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.
before me this .
................. i. ...... , 9'
/ ~[l~,-/t~Fdtt~ .......... ~.o ....... ... ~..
/ _No. 4725089, SuP61~Cour~- (Si nature cfa Ii )
' ~'~//ii; i§-2~ ~ pp cant
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