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HomeMy WebLinkAbout21670-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23182 Date AUGUST 25, 1994 THIS CERTIFIES that the building ADDITION Location of Property 380 LUPTON POINT ROAD, MATTITUCK, NY House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 11 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 9, 1993 pursuant to which Building Permit No. 21670-Z dated SEPTEMBER 22, 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 A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEVEN & DIANE BELLAVIA (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buil ing Inspector Rev. 1/81 FORM NO.3 TOWN OF 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) Date e.?. 19. 0::9 N® 21670 Z Permisslon Is hereby granted o: 44--i.. ~ e-'~ ` . . ...T.......-y W.14. ...!.....9r~r............ a..a.............. ®oz~ r or-® at premises located at...cqi(fG7...~ e ` ..r' County Tax Map No. 1000 Sectlon.. //,:5 Block ..../0 Lot No. AV pursuant to application dated ........91.? 19.9x......., and approved by the Building Inspector. Fee S.... 4 s ullding Inspector Rev. 6/30/80 I2 M Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 BLDG,DFPT. rOWiVOFSOUTHOLpM APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 17, 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. B. 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 Buildine - $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 $1//5.00 Date ....C1~~.vs~ ..-m?j.)yq.7 New Construction... Old Or Pre-existing Buildin/g~ Location of Property... 3.13.() . L QP TOO. P01N J f, ( ~~ry jx 1 UC~cJ \I House No. Street Hamlet Onwer or Owners of Property.., slcVFN.~./a!MV C 8F-11AVIA County Tax Map No 1000, Section 115 Block fl.......... Lot..... 41 1 Subdivision ..f ..................................FFiiled Map........ ....Lot...................... Permit No. a!.67.U ..Date of Permit. ~I / a./73 ....Applicant S-rr_vc1V`DIANE AF11AV4 Health Dept. Approval... Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~..... 1 Fee Submitted: $,,,,,,'..5. U©..... Cc ~a~ IBS. ~f APPT,Tr;MT ~~o~OSpFFO(~-~OGy o ~ Town Hall, 53095 Main Road °y Z Fax (516) 765-1823 P. O. Box 1179 0 • Telephone (516) 765-1802 Southold, New York 11971 .j. 0! col ~ ~a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 11, 1994 Mr. & Mrs. Steven Bellavia 380 Lupton Point Road Mattituck, NY 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) No Underwriters Certificate on file. xx The check is (outdated/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 # 21670-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~o~OgOFFOLK~OGy o ~ Town Hall, 53095 Main Road CD Z Fax (516) 765-1823 R O. Box 1179 - • Telephone (516) 765-1802 Southold, New York 11971 .f. OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 11, 1994 Mr. & Mrs. Steven Bellavia D L5 lUi LS Q [5 380 Lupton Point Road Mattituck, NY 11952 BLDG. DEPT 70WN F, 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) No Underwriters Certificate on file. xx The check is (outdated/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 # 21670-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FIELD ON pD TE COMMENTS H O H FOUNDATION (1st) V FOUNDATION (2nd) 2. z 0 ROUGH FRAME & PLUMBING C ti 3. 3 yb m INSULATION PER N. Y. STATE ENERGY CODE 4.~ y FINAL ADDITIONAL COMMENTS: ^p C V Q~ z Gl m H r. D' < m F- mW o y 5 O m y m my 3 o wo me M GGO 5 z c o zi D 0 x m n n y m m x 82 22 FT w p .;.00,..;..'. . D ~D '.7C'Dr...••:. Ch'' . ~D x•n..;. . w 0.. S OD, a~ w00v: ~;0: ca ;'I ; : amp x m c mm ~0y,..... , . , D o .ZS . .O. S'.'.'.'.'. Do 2 m o m / NO M n - o.......,•..•, a 222.72 FT (,i (n -0 L7 ~O p rr p a O~ a L m .1 rt_ b Z ( o y m n 7C N ti NIP 16 90 E. ; O ~'1~ ~ D1 V P~ r _ - o ( ~ o T J Iz O n ~ =o a 0 O n 8~,~ ~ ly y rn i H ~ v ~ y a 6 x b a C~ n ti a a r v n' g M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL REMARKS: DATE l~ INSPECTOR /York State ueNa~ a roo , UI York 1790- ~ r idin~ ~46 g~NylSTlo~~~ook, New York 11792356 moo Thomas C. Jorling 666 ~~"v~~I Commissioner 3 ~d ~vl ~c rc Date: ~.//(Jc 15I53 ~'YIGC~ C / / ~I J Z Re: ~f 3 B r/OV7?>) Dear Based on the information you have submitted, the New York State Department of Environmental conservation has determined that:: a,~ .2 S- e52te y~'1.~~`fir ~zccq 23C r2-77 Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very 'tr»,ly yours, ~j Deputy Regional Permit Admini.strato i cc: t.i w.ee o..moea osoa BOARD OF HEALTH FORM NO. 1 f~ 3 SETS 01'PL,\:1S v S~TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK . ~ . , , . 4i' .,.w........_A..,.. TOWN HALL C FORK _ . IDVT SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OT i FY ; CALL apF: ~t c7 5,SJQ Examined.//°~ 19M MAIL TO: Approved 19l~3Permit No. Disapproved a/c _ _ . uil : o Inspectors) APPLICATION FOR BUILDING PERMIT 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 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 issu4 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. rte.. (Signature of applicant, or name, if a corporation) 3£30, Lv,~,~a?t„Poinf..R~~.(~?g~i~~c~C.N.Y.~~4sa (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. W.(VE A Name of owner of premises (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 . 1. Location of land on which proposed work will be done. 4.VP,TP 6 ?DINT House Number Street Hamlet County Tax Map No. 1000 Section Block ....11........:... Lot ..a / 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 P. Ai(y).A.&Y.. AEPP,E"CE b. Intended use and occupancy U TD, 5),~,R, , , 0k •3, Nature of work (check which applicable): New Building Repair Rejnoval . , . ' ' ' ' ' • • Addition Alteration . . Demolition Other Work . 4. Estimated Cost (Description) Fee . (to be paid on filing this application) 5. If If garage, tgnumber of cars . units . , , , , ; , , • , Number of dwelling units on each floor . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front . ' ' ' . • • • • • • • • • • Height Number of Stories . . • ' ' ' ' ' . • Rear Depth Dimensions of same structure With alterations or additions: Front • . . • . • . • . ' ' • ' ' ' ' ' ' ' ' ' ' Depth . Height . Rear . 8. Dimensions of entire new construction: Front . • ' Number of Stories . . . . . . . . Height Rear Number of Stories Depth 9. Size of lot: Fro;tt . . Rear . . 10. Date of Purchase .1-~ Zy ~ Z . . . . . . . . . . ' N a in e o f F c'r m-e'r * 0* w' *n'er' * Depth Name of Former Owner 11 .l~ypr re,t,1, , l3Si R tI , , , , , , . Zone or use distric t in which premises are situated , • , . • 2. Does proposed construction viol late any zoning law, ordinance or regulation: 9 . • • . • • • 13, Will lot be regraded Jl JO , . • • , , , • , • • , • , • , • • Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ,9A ;VeK.1(V617Address . Name of Architect • • • • • • • • • • • • Phone No......... . Name of Contractor . ' ' ' ' ' ' • • • Address ...................Phone No........ . Address . . Phone NO. . 15.' Is this property within '1300 feet of a tidal wetland? *yes. " " . *If yes, Southold Town Trustees Permit may be required, No......... PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. - I STATE O OF O} ~OJh 1' OF a }S • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing' contrart) :bove named. le is the c`7(.A) ?L2 fr (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly Authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the •ork will be perform d in the manners~t forth in'the application filed therewith. wom to before me t Z ...day of . 19 otary Publ ' • • • • • \ .County "LAIR L. GLEW Notary Public, State of New York a. 4879505 I Qualified in Suffolk County ~ ' • ' ' ' ' ' ' ' ' Commission Expires PQeember 8,19? 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