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HomeMy WebLinkAbout21280-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22253 Date APRIL 9~ 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 1040 HOLBROOK AV~iNUE House No. Street County Tax Map No. 1000 Section II3 Block 6 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 13 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 19, 1992 pursuant to which Building Permit No. 21280-Z dated MARCH 23~ 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 ACCESSORY SHED WITH DECK & BOARDWALK ADDITION AS APPLIED FOR The certificate is issued to CAROL BLASUCCI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING - APRIL 8~ 1983 Rev. 1/81 / ~ilding Inspector lvOK~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. ¥. BUILDING PERMIT gl'HiS PEPd~AIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N~-N? 21280Z Permission is hereb¥_oran~ted to: ~. , ..~,.~....?~,....~ ............. ., .................... ....... ,t prem,se, ,~oted ot .../.~...~O......'~....d.~--.~--~.,. ................................................... County Tax Map No. 1000 Section ....... ././......~. ...... Block ......... ~. ......... Lot No .......... ,/.~.'~. ....... pursuant to application dated ...... ,.~..~/../~.. ..................................... , 19...~...-~..., and approved by the Building Inspector. ~'~,~'d~ ~/~h~ 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 figled 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-~onforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildimg 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 Inspsctor 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 Certific~e of Occupancy - Residential $15.00, Commercial $15.00 ~ Date ...~../.~...~.~ ........................ . New C°nstructi°n' ~ i j i j~.'~.' Old Or Pre-exis-t~ B'uildi~g~/~; ............... ~et~...~....~..' Location of Prope .............. ~.~....~.~ ....... ii. . House No. Street Onwer or Owners of Property .................................................................. County Tax Map No 1000, Section ..... //.~....Block ......... .~. ..... Lot ........ ~...~. ......... Subdivision ................................... . Filed Map ............ Lot .................... . Permit No..~/~...~.~..~....Date Of Permit.~./...~..~...Applicant..~./.....~/ Health Dept. Approval ..... ~/~. ................//~///Underwriters Approval ......................... Planning Board Approval .... ~..~. ............... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $.~ ...................... FL OANT OU~IDA'TION (1st) OUNDATIOU (2nd) OUGH FRAME & D;SULATION .PLUMBING / ./ ?' ... PER N. STATE ENERGY CODE FI;IAL ADDITIONA'L COMMENTS: Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO.. 4103 DATE: .... i2/17/92. ISSUED TO Peter.. ~ .C.arpl. B~$ucci ........ Pursuant fo the provisions of Chapter 615 of the Laws ~he S~a~e o~ New York, 1893; and Chapter 404 of the Laws of State of New Yor~ 1952; and the Soufhold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, ~RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance wlfh the Resolufio~ of The Board adopted afa meeting held on ~/17 ... 19 9g, and in consideration of the sum of $ 150,00 paid by of .. Po~t ~V~sh[~g~o~ N.Y. and subi~cf fo the Terms and Condiflons llsfed on the reverse side hereo~, of Soufhold Town Trustees authorizes and permits fee following: A G~a~d~the~ Pe~mlt [o~ A0~5~ docA, 1Z~X3~ w~]A ~ ~0~5 Elo~ [~ How~ds ~c~ oE M~tt~tucA C~ee~. all in accordance with the detailed specifications as presented in the originaflng application. IN WITNESS WHEREOF. The said Board of Trustees here- by causes ifs Corporate Seal fo be affixed, and these presents fo be subscribed by a ma[orlty of said Board as of this dat, e. New York State Department of Environmental Conservation Building 40--SUNY, Stony Brook, New York 11790-2356 Thomas C. Jorllng Commissioner March 11, 1993 Stanley J. Isaksen, Jr. P.O. Box 294 New S~ffolk, NY 11956 Re: Order on Consent Dear Mr. Isaksen: Peter Blasucci We have received the photographs for the above referenced Order on Consent that you submitted, They are acceptable as pFoof of compliance with Sched~lle A page fo~lr. The case is now closed. Thank you for your cooperation. CC: Peter Blasucci P.O. Box 1259 Port Washington, NY 11050 Very truly yollrs, Jennifer B. Piazza Encon Program Aide ~TATE OF NEW YORK DEPARTMEN~ OF ENVIRONMENTAL cONSERVATION ..X In the Matter of the violation of : Articles 15, and/,or 25 and 71, as indicated below, of the New York State Environmental : conservation Law, by : oRDER ON coNSENT Respondent(s)· ( county{ .x ~ WHEREAS, Article 15, Title 5, of the New York State Environmental Conservation Law (Protection of Waters) prohibits conducting any regulated activities in any of the navigable waters or protected s%reams of the State without the requisite permit, or in noncompliance with the reqltisite permit; and ~ WHEREAS, Article 25, Title 4, of the New Yor~ State Environmental Conservation LaW, (Tidal wetlands Act) prohibits conducting any regulated activities on or adjacent to any tidal wetland without the requisite permit, or in noncompliance with the requisite permit; and , Environmental Conservation (DEC) W~EREAS, the ............. ........................ O~ ~ .... in that has documentetI-a v~ola~mon ~ and section -, ~T~CL; _, Section __ ' R~soondent(S) caused and/Or permitted to be caused, .... - - ; and ~ .... ,~=~,~ affirmatively waived ~EREAS, R~spondent(S; n=~{~?~-~_~nc in this matter in the his/her/Its/their right %o ~ pUDIi~ u"~=~ ~ the entering and manner provided by law and having consented to issuing of this order, agree(S) to be bound by ~he te~S and conditions contained herein.. NOW, having considered this matter and being duly advised, Initials Dept. Page I of 5 ORDERED, that with respect to the aforesaid violation(s), there is hereby imposed upon Respondent(s), a penalty in the sum Dollars~ of which ~ k~-a~=~/~% (S =oo.~u ) D~llars shall be ms~e p~yable to the Deosrt~eDt upon exec tion of DolLars to be s~{spended provided Pespo~dent(s) strictly adhere(s) to the terms ~nd conditions outlined in this Order~ incluCing $chedtlle A~ the camp!lance schedule attached hereto and ~de a part hereof; and it is further ' ORDEgED, that nothing contained herein sl~a!! be construed as preventing the Department from co!lecti:~g regulatory fees where applicable; and it is further ORDERED, that this Order shall not become effective until it is executed by the Regional Director on behalf of the Commissioner, and the date of execution by the Regional Director shall be the date of e×ecution of this Order; and it is f~rther OgDERED~ that in those instances in which the Respondent,s) -- . , IL~, Of . -.- - , ,--~S OF .... O_,nez b= cbanged~ s)he/it/they ~hall msk~ wrltt~n appl!cavion~ se?ting forth the ql-ounds for the relzef so~.lght~ to the Comm!ssioner, c/o Lori J. 9iley~ Pegional Attorney~ New Yark St~t~ ..... D~m~-rn~=~t._ ....... of Environmental Co~servetion: Buil~'. .... !DS State University CampLls, Stony Brook~ New York 11790-2356. and it is ft%rther .............. ~'~'~'~, tl%at PSs~'~[~{~ ~ ~-~]i~-i-Y strictly adh~7~-' terms and ~ "m"- = -- ..o,~..1,..zo,~ outlined in this~.~=o=l~"'-- a~d in Farts _, a,~,.,/~. !ii of $zhedv!e a ~he '~ .... = ............ . , comp!~, ..... sc!~edule attacb=~ a~d made a part 1Aerer~f; ~nd it is f ORDERED, that any change in this ~,-~- ._ ,..r~.~r shall n¢,t b~ msd~ or become effective, except ~s specifically set' forth by written order of the Commissioner, such written order beii~g made eiuher tipon written application of the Respondent(s) or upon the Commissioner's own findings; and it is further O~DERED, that this Order shall be deemed binding on the Respondent(~)~ it/bis/her/their successors and ~ssig~s ~u~ all persops~ firms ~nd corporstio!ls acting ~Imder or for it/hlm/her/them, ~noluding, but not limited to those who may carry on any or all of the operations-now being conducted by Re~pomdent(s)~ whether at the present !ocat~on or st any other in this State. ?HOMA$ cz_, J©FLYNG Commissioner of Environmental Conservation By RAY E. COWEN, P.E. Regional Director Initials Dept. 9esp. P~ge 2A of 5 ~oNSENT BY RESPONDENT (Individual) Responden. t acknowledges the authority and j lrisdiction of the commissioner o'f Environmental Conservation of the State of Ne~ York to isstte the foregoing Order, waives ptlb!ic hearin~ or other proceeding~ O-d~r.and constants to th~ lsmlanc~ ~l , STATE OF NEW YORK) coUNTY OF ) On the ~[ day o~ ~nv~V{ 19~ before me personally NOTARY pUBLtC, STATE OF HEW ~ORE ~[~]. No. 30-4725371 H~ARY P{TET.iC qualified in N~ssau C0un~ ..... ~mmissi0n ~ ~ 30, 19~ ~ CONSENT BY REsPOF~ENT tcorpora~:on[ Respondent ackl:owledges the e~tthority and ]~.tr[se.!....~on ~$mmissione: of Environmental conservation of the State of New Ycrk to is~:e the fo~goiDg o:~r, weive~ ?lb!it hearil%~ of other -i: this matter, ~ccepr.~ the terms and cot:~tioas ''~ ~orth ~n the O~er ~d consents to the is~tta~ce theueol. NAME OF CORPORATION NAME AND TITLE ~ STATE OF NEW YORK) ,. ,.,I.,N _ Y '~"" On the 4 day. of . 19 , before me personally came , to me known, who being dnly sworn, deposed and said that he resides at that he is the of Respondent CorporatiOn and that he signed his name for~ and on behalf of said Corporation with fttll authority so t~ do. NOTARY PUBLIC Page 3 of 5 SCHEDULE A Compliance Schedule for Ar~o!e 15 and/or 25 - '. ..... I ~ ---GE NERAL-.RE QUIREMENTS: ..... Lm/%~ed j~r. ely, Respondent(s) shall cease and desist from any and all future violat/ons of the New YoEk State Environmental Conservation Law and the rules and regulations enacted pursuant thereto. Respondent(s) shall submit photographs of the completed work, if any, required under this Schedule, to the Depa~',L~ent wit/lin five (5) days of its completion. All submittals to the De.6ar~,ment required under Lhis Order shall be made by Respondent(s) as follows: ~n. couv tc the Legal Affairs Office, Region One, New York StaEe Deoar'L~ent of Environmental Conservation, Building 40, S.U.N.Y., Stony Brook, New ?ork 1i7~0-2356; - a~d - 2) One copy to Regulatory Section, ~ureau of ~-[a~.ne H-~-bitat Protection, Region One, New York Sta~e Depa=~ent of Environmen~=~al Conse~--vation, Building 40, S.IJ.N.Y., Stony Brook, New York 11790-2356. ~ ii. REMOVAL REQUIREMENTS: w~hLn thk-~-t (30) days from the dats of the execution of this Order, Respondent(s) shall have removed t~he st_--~tcTures and/or fJl which are the s%tbject of th_is order. Removal Spec~.cations ~% No Removal Required initm!s Dep=. Page 4 of 5 Wi~tn thirty (30) days from the date of the execution of this Order, RESTORATION REQUIREMENTS: Respondent(s) shall s.ubmit to Department, an approvable restora- tion plan and time schedule ~or implementation of saki plan. Approvable in the dontext of this Order '-shall mean-apm~ov~bt~bY~'the DEC with- minimal revision. M/nimal revision ShaLl mean that Respondent (s) incorporate (s) the revisions required by the DEC and resubmits the plan for approval within fifteen (15) business days of receipt of the DEC's comments. Th/s plan shall include: ~ Regraa~ng. ~ Plant/rigs in ddsturbed area. I-~ specLfications ~-~ other No Restoration Required. Upon approval by the Depa~h~ent, Respondent(s ) shall implement the-- approved restoration plan in accordance with the approved tLme sched%de · Respondent(s) shall maintain all restoration rmqu/red under Order for a ~-~,,nn of f/ye years from the dat~ of the completion of the restoration. sa/d maintenance shall ensure a success ratio of at least 85%. Dept. Resp. Page 5 o~ 5 WA£L IVJF ARGENTI£RI STORY WOOD FRAME RES. WATER BO° O0 '0.0 'E 3000' MAP OF DESCRIBED PROPERTY SI TUA TE I ATTITUCK, TOWN OF SOUTHO£D SUFFOLK COUNTY, N.Y. N/F Gl?GAS SURVEYED FOR: CAROL BLASUCCI GUARANTEED TO: CAROL BLASUCCI TOWN OF SOUTROLD EMIGRANT BANK for SAVINGS AMERICAN TITLE INS, CO, ,/.5 glO. 4 TM~ I000-115-06 -IZ SURVEYED /70CTOBER~ SCALE: I"= 40' Guarantees ind|coted here on shall only to the person for whom the su~ey is prepared, and on his behalf to the title ccmpcny~ Govermental Agency~ lendlng institution, if I]sted hereon, ond to the assignees of the lending institution. Guarantees are not transferable to additional institutions er subsequent owner~ SURVEYED BY STANLEY ,). ISAKSEN, J~ P.O. BOX Cop~es of this su~ey map not bearing the Land Su~eyors embossed seal shall not be considered lo be a valid tr~ ~Py. ~uthodzed alteration or addJtlon su~&y ,~ ¥~olation of Section 7209 92~491 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .... ~ ....... i 3 t,b h lC (Description) 4. Estimated Cost ........ ~ ~t~. C~'g') ..................... Fee ...................................... (to be paid on filing this application) $. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify na~t.u.~.e arkcl extent o f each type of use ..................... 7. Dimensions of existing structures, if any: Front ......... :. ·. ~,.. Rear ...... · ........ Depth ............... Height ............... ~umber of Stories ................ Dimensions of same struotur with alterations or additions: Front Depth ...................... Height ...................... Number of Stories .......... ~ .... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............ Height ............... Number of Stories 9. Size oflot: Front ...................... 'Rear"""iiiiii"""""'~'~,;~"''""'"'"''"'"'"-'"""'"'"--' 10. Date of Purchase .................... . ......... Name of Former Owner ............................. 11. Zone or use district in which premises ,re situated ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 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 .......... j .' Name of Contractor .......................... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes...)<... No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and 'block number or description according to deed, and show street names and indicate whether interior or corner lot. APImQ D AS 765-{fl02 O AM m 4 P~ FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION ~0 REQUIRED FOR PO~ED CONCRETE 2. ROUGH ~ FRA~ING ~ PLUMBING 8E COMPLETE FOR C.G. ALL CONSTRUCTION SHALL MEET ,THE REQUIREMENTS OF THE $~ATE CONSTRUCTION & ENERGY CODES. N~ RESPONS}BLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK .... ......... /f.~../.~.~..~??..~.~/. .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application am 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. Sworn to before me this .... /¢ 77/ . .day of. d~C2~Z?~---~ 19 ?.~'. /] / Notary Public ................... ~ County I /. STEPHEN F. THOMAS' . ................................ Notary Public, State of New York ........ No. 30-4634377 of applicant) Qualified in Nassau County , Commission Expires August 31, 1994 /"~ ..4,-/~, "/ T N OF SOUTHO -Ir i "' BUILDING DEPARTMENT i TOWN HALL i SOUTHOLD, N.Y. 11971 Disapproved a/c ................ BOARD OF HEALTH ......... ~/3 SETS OF PLANS .......... ]~SURVEY ................... CIIECK .................... SEPTIC FORH .............. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date. !.o./.'fi. [ ~.~. ........ 19 . . ~ a. This apphcation 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 scat'e. 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 descrip}ion 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 availableifor inspection throughout the w6rk. e. No building shall be occupiedior used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Buildin~ Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Towu of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction o.f 'bu~ldings, additions or alterations, or for removal ~)r demolition, as herein described. The appticant agrees tO edmplywlthianapplicable laws, ordinances, building code, ho~'~'~q, de, v~nd regulations, and to admit auth°rized-in~p¢ct0rsOn premises-and in building f°r necessaT, inspecti°ns' ~...:.. --- i (Signature of applic~nt,~or name, if a corporation) j (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of pre.mises . .~.4 .~,.0 ~... ~.L. ~..~[q~..i. .................................................. ~ (as on the tax roll or latest deed) If applicant is a corporation, signaturej of duly auth~orized officer. (Name and title of corporate officer) Plumber's License No ......................... Electrician's. License No ....... : ................ Other Trade's License No ...................... Location of land on which proposid work will be' done House Number '~ ' Street Hamlet County Tax Map No. 1000Sectof .Jl.},.a~ Block ...0~'00 Lot... Subdivision ................................ Filed Map No ........ Lot ....................... 2. State existing use and occupancy ~f premises and intended, ~se an~l occupancy of proposed construction: