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Home My WebLink About22215-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-23246 Date SEPTEMBER 21, 1994 THIS CERTIFIES that the building Location of Property 450 BAY ROAD House No. County Tax Map No. 1000 Section 116 Subdivision ADDITIONS UuTCHOGUE, NY Street Block 2 Lot Filed Map No. Lot No. Hamlet 18 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 8, 1994 pursuant to which Building Permit No. 22215-Z dated JULY 30, 1994 was issued, and conforms to all Jf the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is FOR DECK ADDITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARIO & JOAN SHORTINO of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A B~ilding Inspector FORM NO.3 BUILDING DEPARTMENT TOWN HALL SOU'[HOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 22215 Z Permission is hereby granted to: MARIO & JOAN SRORTINO 20 }lEST ~ DRIVE PATCHOGUE, N.Y. 11772 to CONSTRUCT DECK ADDITION TO EXISTING ONE F~ILY D~LLING AS ~PL~D ~OR. 14ARI0 & JOAN SHORTINO 450 BAY ROAD CUTCROGUg, N.Y. at premises located at ............................................................................................................................... Section ..................................................... CountyTax Map No. 1000 116 Block ........2. ................. Lot No. 18 pursuant to application dated ..... i...~...8.~ .................................. 19...~A .........and approved bythe Building Inspector. Fee $......Z'~~ ~ AblENI)F.D PLANS 9/20/94 TO INCLINE ANO'rkm~R DRC~ ~.~7..-~ ,.OCATEU ON som s~u~ o~r .ousE. ~.--->~z~¢/ d .~ 6/<;// .. Rev. 6/30/80 Form No. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-t802 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 '.'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 - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 D te ........... New Construction ........... Old Or Pre-existing Buildin~ ................. Location of Pronertv...~?~...~m~ ~ ~.~J~ J - House ...... ...... ......... Onwer or Owners of Property...~../~, ~~.~.~.'. ..................................... County Tax Map No 1000, Section...//.~ ....... Block .... ~ ......... Lot.[./.~. ............... · ............... Pi~ed ~ap ........... ~t ..... ~ ........... PermitSubdivisi°n' i~i~No... .~ ~.~.'~i i~'~f Permit.. ~?/..~/.~....Applicant..J~4~ .~.~7~..... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporar~rtificate ....... iii. Final Cer~ate ........... Fee Submitted:~q~j$..~.~ ..................... /.~..~ oO (- FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION /ND [ ] INSULATION [ ] FRAMING [~'~'AL REMARKS: ' , I__. BLDG, DEP'E I xan,ined. Disapproved a/c ' APPLICATION FOR BUILDING PER~IT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1197~I TEL.: 765-1802 BOARD OF HEALTH /3 SETS OF PLANS /..-~.--'S U R V E Y . . SEPTIC FORH ............. CALL .............. HAlL TO: 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 mu~t be drawn on the diagram which is p/~rt 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 i~sued 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 reguiations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, 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 . .t~ a~.r:./cn . O.a~. .~J.~t., . /?.cO.. ' .. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) gu'lder s License No. ' ........ Plumber's License No ............... . .......... Electrician's License No ....................... o0CC PA C¥ OR CE T{FICATE· 0F.0CCUPANC¥ Other Trade's License No ...................... Location of land on which proposed work will be done .......... ~ .................. ' ' ' llouse Number Street Hamlet County Tax Map No. 1000 Section .. ~[~ ........... Block . .~ ...... ' Lot...'..[~ ........... Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.. ~.~5~.. b. Intended use and occupancy ...... ~.'.~a--~;~ ~': :~ 2;/ · 3. Nature of work (check which applicable): New Building .. Addition .... 2; · ' Repair ~ ~ ........ ........... Removal .............. Demolition .... . ........ : O il~ ~r ~"]~,~.~,~:i:/ ....... · ~' i ~' ' ' .... . (Description) 4. Estimated Cost. · ...... .... Fee ...... (to be paid on fili].~ ~i.s application) 5. If dwelling, number ofdwellingiunits . .~zl,/o~.. ...... -. ' · . Number of dwelhng un]ts on ea~fluol::;~.-; ............. · If garage, number of cars .... [ ................................................................... 6. If business, commercial or mi.xed occupancy, specify nature and extent of,each type of use ./(-/.,4r-:'., ......... ~ ..... 7 Di nsionsof ' 'ny tructures 'f any Fr t R Depth · me exlstl s , , 1 on ............... ear .......................... ,.. '. Height Nun~ber of Stories J~ ~ Dimensions of shine structure with alterations or additions: Front Rear Depth ' t Height ' Number of Stories 8. Dimensions of enhre new construchon: Front .~g,d~ ~*,- ~. ~ Rear gZ,f. Height ............... Number of Stories ..-9.. La~.~.. ............. 9. Sizeoflot Front [.~. ~ ' Rear ~2-Z",~'cfi ~ '" .... ~,.,;,( >~e~/,,;~.[~'~, ........ 10. Date of Purchase . ,t~,n..t'.. ~; ].../.?.~4>. .... · ....... Name of Former Owner O~l 5~.~. ~ 1 1. Zone or use dmtnct in which pr~m]ses are mtuated ~7. i6~-¢4'~(.~ ....................... '... . 1 2. Does proposed construction violhte any 2Loning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ fl~/~;'(/f[q~.'~l/'/ck'~.~i~ Will exc~g fill.~.~.be r~ved from premises: ~t/~'Yes No 14. Name of Owner of prem~ses ~..~...Address .'-f .... ~.*.~__~ ....PhoneNo. Name of Architect ...... i .............. Address ..... ~ ............. Phone No ................. Name of Contractor. ~2. e .~[.~i I. ~..o~..~O.' ', ...... ·' ~Addres-s 2/',~/~/!~' '~74'~'d~' Ph°ne 15. Is this property w±th/n 3100 feet or a tiaax wet±ana~ eyes.,. ;'J/.~ ~If yes, Southold Tiown Trustees Permit may be required· ', 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 humber or description according to deed, and show street names and indicate whether interior or corner lot. el,.,.. FOLt.OWiI~G 2. ROUGH. FRAMING & PLUMBING 3. INSULATION . BE COMPLETE FOR C,O, ALL CO~S'rRucY~or~ SHAt.t. MEET $~ATE CONSTRUCTION & ENERGY CODES. ~OT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STAT OF s.s COUNTY OF .... . · - .... L ...................... (Name of individual signing~contract) above named. being duly sworn, depose~ and says that he is the applicant ! (Contractor, agent, corporate officer, etc.) f sam owner or owners, and m duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this'application are ~rue to the best of his knowledge and belief and that the work will be performed in the manner se~ forth in the application flied therewith. Sworn to before me this ~ iI