HomeMy WebLinkAbout21302-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~RTF~NT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26853
Date: 12/28/99
THIS CERTIFIES that the building
ALTERATION
Location of Property: 3960 OLE JULE LANE
(HOUSE NO.) (STREET)
County Tax Map NO. 473889 Section 122 Block 4
MATTITUCK
(HAMLET)
Lot 26.1
Subdivision Filed Map No. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 2, 1993 pursuant to which
Building Permit No. 21302-Z dated APRIL 2, 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 CLOSE IN EXISTING SCREENED PORCH ADDITION TO AN EXISTING ONE FAMILY
DWR?.T.TNG AS APPLIED FOR.
The certificate is issued to CARLO DEGAUDENZI & WF.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H 059678 04/29/98
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
FO~e NO. ~
TOWN O~ SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
N-°N? 2130~Z
//P_~rmission i.s hereby granted to: .~
~ ~' ~... ,~......~...~~..~ ........
....... /.~.~..~...../.~.~ ................................
,o ...~. ..~....~......~...~....7~.....~~.~~.~~... .~.....~.
....... ...... .......
at premises~/~ated at..~..~,1~.......,/.~.,...~.....~..6~'.'2?~. ...............................................
co~n~ Tax ~op No. ,0o0 Sec, io~./..~..~... B,~ .......... ~ ...... Lot No....~.:.../
pursuant to application dated ..,~/.~....J~----~f' ....................................... , 19,~.~..., and approved by the
Building Inspector.
Fee $...~.~.!,~..
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
,]?!,~,~,~j~,~3~[!!9~;p.~.~.,~A~PLICAT%ON 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).
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
Vpre-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
· 'v '*' ..-ll~ . · -Add{tions to dwelling $25.00
1. Ce.t~r~cata of Occupancy ~ New d .... ~5o00~ ,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
A~ditions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .. 19 ...........................
New Construction ........... Old Or Pre-exis~ing Building...~J... ..........
Location of Property...~.~ ............ 0.9~...~.~.~.~ ......... ~~-~ .......
House No. Street Hamlet
Onwer Owners of Property .~/~ ~ ~.J~-~- b.~ .~~ · -- ·
County Tax Map No i000, Section..~.~ ...... Block ..... ~ ........ Lot .......... ' ..........
Subdivision Filed Map Lot · -.
Q~. .~F~ 0~.~. mppli
Permit No.~.}.~ .... Date Of Permit. .... cant .............................
Health Dept. Approval................-.-.--.---Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate .......... .. Final Certicate ...........
Fee Submitted: $ ............................. ~, '-
t ..............
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 28, 1998
Carlo DeGaudenzi
3960 Ole Jule Lane
Mattituck, New York
11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
'-- not on file. (Enclosed)
XX No Underwriters Certificate on file.
XX
The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984),
BUILDING PERMIT # 21301-Z
Please contact our office on this matter. Thank you for
cooperation.
$OUTHOLD TOWN BUILDING DEPT.
SECOND NOTICE: FIRST NOTICE WAS SENT TO HORTON CONSTRUCTION.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 26, 1995
Gerry Horton - Horton Construction
Box 1442
Mattituck, NY 11952
Re:
Prem:
Carlo DeGaudenzi - SCTM#1000-122-4-26
3960 Ole Jule Lane, Mattituck NY
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
/x No Underwriters Certificate on file.
The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21302-Z
Thank you for
Please contact our office on this matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
;
I'
THE NEW YORK BOARD OF FIRE UNDERWRITERS
8o707Z7 SU.EAU OF E'ECT.,C,TV
~ 40 FULTON STREET~ NEW YORK~ NY 10038
Date APRIL 29,1.998 Application No. on rite 15895898/98 ., ~:'~' 1{~O59678 ~ (~ ~'
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application nu~tber is in the premises of
CARLO DE GAUDENZI, 3520 OLE JULE LANE, I~ATTITUCK, NY
in ttte following location; [] Basement [] ;st Fl. [] 2nd Fl. Section Block
was examined on APRIL 20, J. 998 and found to be in compliance with the National EJectrical Code.
Lot
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
FIXTURE RECEPTACLES SWITCHES
OUTLETS FLUORERCENT OTHER
DRYERS FURNACE MOTORS FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R V I C
OTHER APPARATUS: / ·
ENCLOSED ?ORCH-1
~NO VISUAL DEFECTS~ "An electrical
survey has been made of the exposed
electrical equipment in the
premises indicated." "No obvious
unsatisfactory condition was found.
CARLO DE/GAUDENZI
3520 OLE JULE LANE
MATTITUCK, 'NY, 11952
A, W G NO. O~ NEUTRALS A.W. G,
OF HI-LEG OF NEUTRAL
GENERAL MANAGER
Per 11
This ce[titicate must not be ~lte~ed in ony manne; etum ~o the oftice o! the board tt tnco ect. Inspecto s may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE'/ NOT SE ALTERED IN ANY MANNER.
OUNDATION (1st)
OUNDATIOU (2nd)
OUGH FRAME &
.PLUMBING
];SULATION
PER N.
STATE ENERGY
CODE
FI;iAL
ADDITIONA'L COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING [ .,]~NAL
765-1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ]INSULATION
FRAMING [ ~INAL
[ ] FIREPLACE & CHIMNEY
REMARKS: /'~
DATE
../~///~,.7-1 NS P E CTO R
3. Nature of work (check which applicable) New Buildin~ ...... ' ' ,
Re air _ · .......... ^oamon .......... Alteration . ~ .... ~..
P .......... · ....Removal ....... ~_..~. · · .Demolition .~...: ......... Other Work ..
4. ~zsdmared Cost .[./. ,- m~-- ~
..................................... wee ...... /: ,,,>.'..--r'7 .......................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
· If garage, number of cars ........................ ' .................................
6. If business, commercial or mi.xed occupancy, specify nature and extent of,each type of use .....................
7. Dimensions ofexisting structures, ifany: Front ............... Rear Depth
Height ............... Number of Stories ..........
Dimensions of shine structure with alterations or additions: Front
................... Rear ..................
Depth ....................... Height ....... · ........ ;.. Number of Stories .... '.., ........
8. Dimensions of entire new construction: Front .............. : Rear ............... Depth
Height ............... Number of Stories ............ ' ..............
9. Size of lot: Front ......... , .......... i.. Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner
I 1. Zone or use district in which premises are situated .............................
Does proposed construction violate any zoning law, ordinance or regulation: .............................
13. Will lot be regraded ...... ~5 "t' ' · 'x' ?-,' ..~ ....... Will excess fill be removed from premises: Yes
14. Name of Owner of premises (,~t~..q.. ~z~.~.~. Address Phone No ~ ·
Name of Architect . ~{... ~. ..... , ............. Address ................... Phone No ...... ~ ...........
Name of Contractor .~.o.C:~..~..c,.~..s~. ....... Address ............. ~ .... Phone No...~-.~...~:.~.~.q'~,,..
15.' 19 this property within 300 feet of a tidal wetland? *Yes..'.~. .... No .........
· If yes, Southold Town 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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NE4~'YORI~ / [~. S S ' '
COU ¥,OF. ' . , .
..... ~ ~... ~.. I~'.C}~. ~ .... . ......... being duly sworn, deposes ~d says that he is the applicant
(Nam~ of individual signing contract)
above named.
He is the....... ........
(Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is duly authorized to perfom or have perfo~ed the said work and to m~e and file this
application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
work w~l be perfomed in the manner set forth in the application filed therewith.
Sworn to before me this
..... . .... ¥~ ~' dayof ~ ~; ~''' 1~ .
., ' ' .
. . .' .. ..... :....
. No, 4879505, ._ / , . , . [ (S gnature of apphc~t)
~mml~lon ~lre8 D~m~
Examined v ......... , 19.~.~.
Approved ........... 19.¢3.. Pc=it
Disapproved a/c ............... i ......................
a. This application must be con
sets of plans, accurate plot plan to sc
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y, 11971
TEL.: 765-1803
/ . ~Buflding Inspector)
APPLICATION FOR BUILDING PERMIT
B~ARD OF HEALTIt
3 SETS OF PLANS
SURVEY
CIIECK ..-.- .... ~ ...........
SEPTIC
tORN
CALL ...................
MAlL TO:
Date ................ 1
INSTRUCTIONS
pletely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
de. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public st?eets
or areas, and giving a detailed description 6f layout of property must be drawn on the diagram which is part of this appli-
cation. ,
c. The work covered by this appilication 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 Southbld, .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 witl~ all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorizedinspectorsonpremiSesandin, building for necessa..~...?ctio~.n~.~ ......
-- ' (Signatur~ of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, l~ssee, 'agent architect, engineer, generai 'contractor, electrician, plumber or builder.
Name of owner of premises .. 0 ~ ~.. ~'\ 2-~ '
(as on the tax roll or latest deed)
If ~igl~ant is a cqrfpor~tion~ignatu~e of duly authoriie~l, officer.'
(Nant. e and title of corpo~e officer)
· Bu,ldersLicenseNo .... .......
Plumber's License No.
Electrician's License No ...... ; ................
Other Trade's License No
I Location of land on which proposed work will be'done
ltouse Number Street Hamlet
cotmty Tax Map No. Section . Block i ' Lot..
Subdivision '
....... ' ....... (Name) ' · ............. Lot ...............
· ...[ ...... . . .' .......... Filed Map No.
State existing use and occupancy ~f premises and inte
2; nc~a.d use and occupancy of proposed construction:
a. Existing use and occupancy ~-.
b. Intended d occupancy . . ' :? .....~, ..... ..,. ..................