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HomeMy WebLinkAbout21463-zNo Z-22564 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date SEPTEMBER 1, 1993 THIS CERTIFIES that the building. Location of Property 755 ORIOLE DRIVE House No. County Tax Map No. 1000 Section 55 Subdivision ADDITION Street Block 6 Filed Map No. SOUTHOLD~ N.Y. Hamlet Lot 15.6 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 28~ 1993 pursuant to which Building Permit No. 21463-Z dated JUNE 7, 1993 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JOSEPH & MARIE LIBERTELLI / i tor Rev. 1/81 FORM NO.3 TOWN OF$OUTHOLD BUILDING DEPARTMENT TOWNHALL $OUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ................................................. 2~463 Z Permission Is hereby granted to: ~~....~.....z~~..: ......... ............ .~..~~.~....~ ......... ,o ..~....~Z.....~.....~....~~':.... ~....~'..~,~.....~..¢ at premises located at.....' .7.~..~... ...................................................................... ..................................................... ~'..~~ ............................................................................ CountyTax Map No. 1000 Section ,,..~,,~...~-... ........ Block ......... ,~; ............. Lot No ........ ..,,~....0~..~..~., pursuant to application dated ........ ?,/'~....~. ................................... 19..~..,~~. ...... Building Inspeotor. Fee $...,,,,Z.~..~.~... and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 2/10 of I% 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .. ~.~.%q'...7~. ~4.;~=~ ................... New Construction ........... Old Or Pre-existing Building ................ . Location of Property ....... 4'.q.~ ............ House No. Street Hamlet Onwer or Owners of Property.,~o~... ~..+..~.e~g/V~.'.~ ..... .~. ~.~..Z-6~¢/ ....................... County Tax Map No 1000, Section .... ..~...~. .... Block....~ ........... Lot...~/..~...~ ............. Subdivision ................................ --- . Filed Map............Lot ..................... . Permit No. ~..I.?..~..~..~...Date Of Permit..~..~..O.~. ~....Applicant~.¢~.F.~.~..w..~.~.-,.~.~f~./.f61~1%~../7, Health Dept. Approval ........................ .. Underwriters Approval ...................... .. . Planning Board Approval ................... .. . . . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. t/¢ .................... FOUNDATION FOUNDATION (2nd) ROUGH FRAME & .FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: L,rZ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [] INSULATION [ ~]~RAMING [ ~INAL / / LISA DRIVE ~ Io - Lot 4 Area :'2042D..s.~ Lo~ 3'2. subdivision - "Highpoint MeoC~oCs, suffolk County File No. 8~/11,. SURVEY FOR D,B.M. COMPANY LOT NO. 4, 'HIGHPOINT MEADOWS,SECTiON ONE" AT SOUTHO LD TOV/N OF $OUTHOLD SUFFOLK COUNTY, NE~' YORK Sect .Two" NOV, AUG. Examined ..... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Disapproved a/c ' . (~dino ~mr/ APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... ~'~3 SETS OF PLANS ......... /SURVEY .................. .....~c lie C r ................... SEPTIC FOR~I ............. MAIL TO: 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 sti'eets 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 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 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.co,m, ply~,w4~t~all ~pplicable laws ordinances, building code housing code, and regulations, and to admzt authorized respecters on premmes and m building for necessary inspections. -- ': . . :d ~ (~nature of applicant, or name, if a corporation) ' '- ' ' ' . . (Mailing ~dress of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. . · (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....g>..t~..Q,~..~.. ' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. . . .7_ ~',o~- C)~/o.C.e~ '~.~.(./f..~. ........ ' ........... ' .......................... .... /.:?.?4.. ' ltouse Number Street Hamlet cotmty Tax Map No. 1000 Section ....... .~.Z Block ..... ~::?.. Lot. ,,'~.--~.'. ,~.. Subdivision ........ . ............................. Filed Map No ............... Lot ............... (Name) . 2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy · b. Intended use and occupancy · '3. 10. 11. ·12. 13. 14. 15, · Locate clearly and distinctly all property lines. Give street and block interior or corner lot. N f k(ch kwhi h4ppli bl ) N B ilding Addition Alt ti ' ature o wot ec c ca e: ew u .......... . ......... era on .... ; ..... Repair .............. RemovaI .............. Demolition ..... ; ......... Other Work .'.~...~.C,~ ....... .,~? ' . '. ~/7~. · (Description) Estimated Cost .. oO , . ' · '~' · · · ............ Fee (to be paid on filing this application) If dwelling number of dwellin~ units ' Number Of dwelling units on each If garage n'umber of cars ................ floor ................ If business, commercial or mix~d c?y h typ . occupancy, spe ~ nature and extent of.eec e of use ............... , ..... Dimensions of existing structures, if any: Front.. ....... Rear ., De th Height ....... Numb ~to, .... ' ' ' ' ........... P ............... io~ ' ~' ~ddi Dimens s of same structure With alterations or (ions: Front Depth ?. ' ~ ight .~. ................. Rear .................. ........ He ·,: ..... '.. Number of Stories ........... ~..~ ........ tm . Dimensions o entire new cons etlon. Front ........ ~ Rear ............... epth . .~. ............ Height ...~ ........... Number of Stories ...................... , ............... . ..... Size of lot: Front ......... , ~ .... ..... Rear ....................... Depth ...................... Date of Purchase .. F..].~.~. , · Name of Former Owner .'.~. ........................ Zone or use district in which pr mises are situated ................. ; .......... Does proposed construction violate any zoning law, ordinance or regulation' . ~,5 ..... Will lot be regraded t~ O · ' .......................... ........ ' ................. I"' Will excess fill be removed from premises: Yes ~ Name of Owner of premises .~:, ~..e-~tr~.~r~.e.£.~ .~.~3.I .~.ddress .'~.~.~. O£~f~ ~ ~ Phone No..7. C ~"~$ ~, 7 . Name of Architect I . ~,~,~ .... ' ..... ~,~'~',V',~ ~ , ' .............. Name of Contractor ......... I ................. Address ............. . .... Phone~o .............. ~. I.s this property within 300 feet of a tidal wetland? *Yes ..... '-'.. No...".. ..... ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from aumber or description according to deed, and show street names and indicate whether NOTIFY~BUIEDING OEPARTMEfqr AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1..FOUNDATION .- TWO REQUIRED FOR. POURED CONCRETE 2~ ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL CQNSTRUCTION MUST BE CQMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT. RESPONSIBLE FOR. DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YO,~,RI~ . S.iS coum-¥ OF .... · · (Name of individual signm~ contract) above named. . . being duly sworn, depose? and says that he is the applicant He is the ..................... : ...... ~ ...~. ~._. .................................. . .......... (C ]o ffi ) .... i ontractor, agent, cor orate o cer, etc. of said owner or owners, and is duly ~uthorized 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 stir forth in the application filed therewith. Sworn to before me this/f/~ [ ' . ......... .. w.. ' 19. No'tary Pu'blic, -- · ' / .... .............