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HomeMy WebLinkAbout21344-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22511 Date AUGUST 9, 1993 THIS CERTIFIES that the building Location of Property 1425 CENTRAL DRIVE House No. County Tax Map No. 1000 Section 106 ADDITION MATTITUCK, N.Y. Street Hamlet Block 2 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 12, 1993 pursuant to which Building Permit No. 21344-Z dated APRIL 19, 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 ADDITION~ 2ND STORY AND DECK ADDITION TO ONE FAMILY DWELLING ~he certificate is issued to EMANUAL FRANGAS AND WIFE (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING 813447/93 PLUMBERS CERTIFICATION DATED AUGUST 9, 1993 /~u~f~ding Inspector Rev. 1/81 FOB3~ ~qO, 0 TOWN OF SOU'/HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NgN? 2134~Z Permission is hereby granted to: ...... ~..~:~ .2 .............................. -~.....~~...~..~.~....~~......~~.~ ~, premises' ,~a,ed at ~~....~~.~~ ............ ~~~ ..................................... Co..~ ro~ Mo~ No. ~00o s.~.o....~.~ ....... .m~ ........ ~. ....... ~o~ No ...... ~ ............. pu~uant to application dat~ ..... ~..~ ............................ Building Inspector. Rev. 6/30/80 Fo m No. 6 765-1802 ~PLICATION FOR CERTIFICATE OF OCCUPANCY ~~.~Ut'~{OLD_ 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: I. 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 fo~). 3. Approval of electrical installation from B6ard of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Co~ercial 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 requirement.~. 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 appli.cant. 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 $15.0q, Co~arcial $15.00 ~e~ gons~ruc~toa ........... O~d Or Pre-extsEtng~t~dtng,,~~~ ........ . House No. Street Hamlet Onuer or Owners o~ ProperEy ...... , ........... .................. ............ ........... ............... t ...... Health Depr, Approval ........................ ~nder~rSrers Appro~al,~ Planning Board. Approval .......... . .. ;,,,, .... ,. Reques~ for: Temporary Certificate ........... F~nal TOWN OF SOUTIEIOLD OFFICE OF BUILDi?IG INSPECTOR P.O. BOZ ;28 TOWN HALL SOUTHO£D, N.Y. 11971 TEL. 765-! 802 CE R T I F ICAT I Ot~ Building Permit NO. {please print) (please print) I certif.y that the solder used in the water supply system contains less than 2,/10 of 1% lead. (plumber's signature) Sworn to before me-'this Nota'.7 Pub'~ic, ~ ~ Lb,. County ANTHONY J. ENRIGHT Notary Public, b'~tate of New York No. 4979701 Co Ou.alE. tedin Suffolk County ,~ mm~ssion expires April 8, 1 ~ 7GSJ.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~INAL DATE ~//~///~'~'~' INspECTOR~-/-'~/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] ~.SULATION FRAMING [//J FINAL BUILDING DEPT. DATE INSPECTION [ ] FOUNDATION 1ST [~/R~UGH PLBG. 765-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [,--]--ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ~'[~MING [ ] FINAL ~UND^TIO:! {2nd) ~UGH FRAME & -PLUMBING ~SULATION PER N. Y. STATE ENERGY CODE FIHAL COMMENTS: ~-~ MA'P LOT C. A'PTA I H M ATTITIJ~i.K INLET TOWH OF' .,,¢I0 IJT H 0 ,~LIFFOLK, ~/~ I"= 36' Exa nined .............. 19 Approved ................. 19... Permit No ...... Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 ( B~filding ,l~'fsp e ct o r) APPLICATION FOR BUILDING' PERMIT B~ARD OF HEALTH ......... 3 SETS OF PLANS SURVEY CIIECK . CALL ................... MAIL TO: INSTRUCTIONS a. Tiffs ap~lication 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 o£ buildings on premises, relationship to adjoining premises or public sti'eets or areas, and giving a detailed description of layout of property mu~t be drawn on thc 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 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 Certificatd of Occupancy shall have been granted ~y 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. Thc 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 inspection~ /~ W~,¢-__~ . ......... ............ -- ' ~. d?"F2 o/[e~ , (Signatur~ of applicant, or name, if a corporation) .. ............... : ......................... ' .... ~2Y~ Z/¢'?-.~"~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. (a on ti~ 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 ...................... I. Location of land on which proposed work will be done ................. .~ .......................... House Number Street Hamlet Cotmty Tax Map No. 1000 Section ./. :*. ~. .......... Block ~ ' Lot .~. / .... ' .... Subdivision .............. ' Filed Map No ............... Lot ................ (Name) '~ State existing use and occupancy of..Eremises add intended use and occu anc of vrovosed ~o ruc ' ' -' ... P y _ _ nst tmn. ~ pair .............. RemOval ...... : ....... Demolition~ .: ........ Other Work 4. Estimated Cost ...... ' · escr on ! (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each If garage number of cars ' floor If business, commercial or mixed occupancy, specify nature and extent of,each type of use 7. Dimensions of existing structures, if any: Front ............. . · Depth ......... ~.. ~.. Height ............... Numlber of Stories ..... i .. Rear .............. ' ................... Dimen ionsofs'~e tu ewlthalte rio dditio :Front s a struc r ra ns ora ns ............ 8 De ..... :t? ,. , .Height · · ...... ,..,,m,o~luxatones ., ........ Dimen ion of t]ren trpct n: F ........ " · s s 'eh ewcons lo rant .............. ; Rear ............. De Height ' Numbe f St ties ' pth 9 Siz of lot: Froht ..... . ....... 10 Date of Purchase ~ .......... Depth ................. ........... , ......... ~ ........ ,. Name of Former Owner ....... I 1. Zone or use district in which pre,mises are situated ...................... 12. D°es pr°p°sed construction violate any zoning law, ordinance or regulati 13. dl Io regra .' ' ', ,"~L;,,' :.5-~:~ · · Will excess fill be removed from premises: ., , 14. t,~ am e o ~ uwner o ~ p rem]scs/,t ~wT~://~ ~7.,7././t.~. ~.,¢,Add ress : .... Phone' Name of Architect ....... , ............... Address ................... Phone No. 15.' I.s this property within 300 feet of a tidal wetland? *Yes ........ No ........ " ........... · If yes, Southoid T.'own 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. ,ye street and block number or description according to deed, and show street names and indicate wh~ther interior or corner lot. STATE OF NEW YORK, COUNTY OF ........ ........... ~..'~/. · I/~,Z,-~ · · .' ......... being duly sworn, deposes and says that he i~ the applicant (Name of individual signin~ contract) ~bove named. . age t, cor'p ae fi .......... . ,f said owner or owners, and is duly authorize-e-e-e-e-e-e-e-e-~Uto perform or have performed tl~e said work and to make and file this pplication, that ail statements contained ' 1 ;o.~.,-,.. · m t ho -vp.cauon are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner ~et forth in the application filed therewith. ' ,worn to before me this . ! .................... day of.. .. ' :Otary Public ........... ........ County · , , ~o. 4822563 SuffolkCounly~/J- · ' ' ' ' (Signature of applicant)