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Home My WebLink About22378-zFORM NO~ 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. No Z-2336~ CERTIFICATE OF OCCUPANCY Date NOVEMBER 21, 1994 THIS CERTIFIES that the building Location of Propert~ 1405 FOUNDERS PATH House No. County Tax Map No. 1000 Section 64 Subdivision Filed Map No. ADDITION SOUTHOLD, NY Street Block 4 Lot Hamlet 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 23, 1994 pursuant to which Building Permit No. 22378-Z dated OCTOBER 14, 1994 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 A DECK ADDITION TO AN EXISITING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CELESTINO & BRUNA BASTIJANIC (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS OERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Buildin~ I n s~ec~ FORM TOWN OF BOUTHOLD BUILDING DEPA.qTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22378 Z Permlsslon Is hereby granted to; CELESTIHO & BRHN~BASTIJANIC BOX 1687 - 1405 FOUNDERS PATH SOUTHOLH , NY 11971 t^ CONSTRUCT A DECK ADDITION TO AN EXISTING OWE FAMILY DWELLING .............. ~ ............ . u .......................................... - AS APPLIED FOR at nrem ses ooated nt 1405 FOUNDERS PATH, SOUTHOLD NY County Tax Map No. 1000 Section .......... .6..4. ........... Block ............ .4. ............ Lot No. 17 pursuant to app caton dated .........SE.P.~.R...,.2.].., ................... 19...9..4. .......... and approved bythe Building Inspector. Fee $....~,..~...~ .... Rev. 6/30/80 Form No. 6 OF SOUT OLD TOWN BUILDING DEPARTME~ (-{] 2 7 TOWN ~ALL / ~ ~ / 765-1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY T ~ DG, DEP'I: 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 2/10 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 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 '3pre-existing" land uses: 1. Accurate sgrvey 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 Occupancy - New dwelling $25.00, Additions to dwellin~25.00.~ of 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 Buildinm - $i00.00 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 7~. "~ ~.~.'~..? .~. New Construction ........... Old Or Pre-existing Building..._.. ............. Location of Property .... /~ .... ~.U. fV.~E%~..'P.J.~..= ............. ............. County Tax Map No Section. .Block ........ Subdivision .................................... Filed Map ............ Lot ...................... Permit Xo.~~.Date~ O~ Pem~g ............................................ . Applicant Health Dept. Approval.' ...................... .. . Underwriters Approval ................... . ... . . App j~ Planning Board roval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $...~ ....................... % 2~c~4~qqL~ ~q~p&&~, ................ .... .~.;~ ................... . ... . FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & :PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI~;AL ADDITIONAL COMMENTS: ~g_:× lo c~lk~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [~] ~rTION []FRAMING [ r-~*'FI NAL DATE 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [.!.~U~NDATION 2ND[ ]INSULATION [,~FRAMING [ ] FINAL DATE INSPE Examined ........ ,19~..~ Approved .... ~/.¢~. ...... 197~. Permit No..~. · .~..~...7~ Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD FORM NO. 1 3 SETS TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMJENT CllgCK TOWN HALL SEPTIC SOUTHOLD, N.Y. 11971 TEL.: 765-1802 OF HEALTH ......... OF PLANS .......... FORH .............. CALL .................. MAlL TO: INSTRUCTIONS ~. Tiffs 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- cation. ' c. The work covered by tkis 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 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on-premises and in building for necessary inspections. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ~/¢:~'///v' ~' //~/~ ~'~'4 (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 .......................... Plumber's License No ........ : ................ Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done ........................... ~. ....................... ....... . . . . ?, . .a . . .,Z./(.o. ./¢./. . . . .d./:.'./,. . . //Y. z r .................... House Number Street Hamlet County Tax Map No. 1000 Section ..... ~..x:.~. ........ Block ..... .~. ........... Lot ..... /..~/ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... [' ..... d,,:?.',-';; '.~.:.~.'.' .,.' ...................... b. Intended use and occupancy ............ '~.~".,':,:~.. ';'. ?, ..":',. ·..'..%: .................... k ( ' Apr ) 3. Nature of wot check which a lcable , New Building . , . Addition Alteration .......... Repmr .............. Rem vel ........... Demolition ............ Other rk ........ 4. Estimated Cost .......... I (to be paid on filing this application) 5. If dwelling, number of dwelling pnits ............... Number of dwelling units on each floor ................ · If garage, number of cars ..... 6 ~busin.ess · · ' ............................. . , co,,mm, erc~al or m~xed ogcupancy specify nature and extent of each type of use 7. vimensmns oz ex~stingstructu~e~,ifany: FrOnt............... Rear .............. .................... Depth . Hight Nib fSt e ............... um er o ories .............................. ' ......... io f sa ilth It ~ti dditi ....................... Dimens nso me structure w a er onsor a ons: Front .. .'. . Rear ............. ~D.epth .. .....~ .............. I' · Height ...................... Number of Stories .................... 8. u~mensmns ozcntire new cOnstrgction: Front ............... Rear ............... Depth ......... Hight ~q p f St ' ' 'e ............... um er o ories ............. ~ ....................... t ............. 9. Size of lot: Front "J ~'.. ~ Rear :1 ~' Danfh ! '7 '? ' 10 Date of Purchase~: ~ Name of Former Owner,~, 11. Zone or use district in which pre~nises are situated 12. Does proposed'construction viol4te any zoning law, ordinance or regulation: . .~.-o ............ r~ame ot ^rcmmcr .......... i, ................ Address ................... Phone No ............ ~.. Name of Contractor ......... 4 ................. Address ................... Phone No ................. 15. Is this property within T3p0 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold pwn Trustees Permit may be required. ... i 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 n~mber or description according to deed, and show street names and indicate whether interior or corner lot. 765-~802 9 ~M TO 4 PM FOR THE FOLLOWING ~NSPECTIONS: ~.FOUNDATION '~O ~EQUIRED FOR POURED CONCRETE ZROUGH - FRAMING & PLUMBING g. B~SULATtON 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR ALL CONSTRUCTION SHALL TNE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, coum'wr.:/ .. ........... s.s . . ~. ~~ . ~.t-f. '.~." · being duly sworn, deposes and says that he is the applicant ~, e otindividual signing/e"ontract) .... above named, He is the ...(~......f~../2'~ . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly aCthorized to perform or have performed the said work and to make and file this application; that all statements contained h~ this application are truqlto the best of his knowledge and belief; and that the work will be performed in the manner selt forth in the application filedtherewith. Sworn to before me this