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Home My WebLink About21014-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22289 Date APRIL 28~ 1993 THIS CERTIFIES that the buildinq Location of Property 1300 MASON DRIVE House No. County Tax Map No. 1000 Section 104 Subdivision ADDITION CUTCHOGUE, NEW YORK Street Hamlet Block 7 Lot 7 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 13~ 1992 pursuant to which Building Permit No. 21014-Z dated OCTOBER 13, 1992 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 ROOF ADDITION OVER AN EXISTING WOOD DECK AS APPLIED FOR The certificate is issued to PAOLA LAVAGETTO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ~~1 in~g~Inspector Rev. 1/81 FORM NO. S 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) N~N? 3101~Z Permission is hereby granted to: .... .£~........~.......~...~ .................................... .~~ ....... ~.......?.~ ....... ~ to .......~...~.~.~..~.~ ........... ~. .......... ..~.~..~.~.. ....... ~.:~.~ ....... .~..~ ....... ~ ................ ..~.~. ........... ...~/.~.~ .......... ~ .......... ~ ........ ~¥~.-~......~ ............. at premises located at .................... ./...~.~ ............. ~..'~..~-~.~ .......... ..~......'~...:. ................................. .............................. .~ .............. ..~~.~.~ ........... ~: ................................................ ............................. ~...../.~.~. .......... ~.~.~....~... ................................................. County Tax Map No. 1000 Section ..... ~,,~. ,~.,, ....... Block ..... ~...~... ......... Lot No......~..2 ............ pursuant to application dated ............ ,~.,..~.~.....~,~,. ........................ 19...~.....%..~,, and opproved by the Building Inspector. B611'dlng Insl~ctor Rev. 6/30/80 Form No. 6 TOWN OF SOU~HOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be figled in by gypewriter 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 f6rm). 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. 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, 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 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 - $i00.00 · 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 New Construction. ~ .... Old Or Pre-existing Building.. House No. Street Hamlet Onwer or Owners of Property ..... O..0. ...... .~. ~.~.~ ......................... :ounty Tax Map No i000, Section ......... Block ............. Lot ................... ubdivision ................................... Filed Map.. . Lot . :rmit No.: ~ / ~.Date Of Permit· '. .Applicant· .. ~...~... tlth Dept. Approval ........................ Underwriters Approval ........................ nning Board Approval . est for: Temporary Certificate ........... Final Certicate ...... {ubmitted: $ ............................. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000064 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~y the electrical equipment ~ ~scribed below and intr~uced by t~ applicant ~med on the a~e application number in the prem~es of PAOli) ~%VAGETTO, 950 BROADWATER DRIVE, CU~t'IOGU~, N.Y. in thefollowlng location; ~ Basement ~ Ist FI. ~ 2nd FI. 0[~ Section Bilk Lot ~sexamlnedon ~ 09 ~ ~994 and found to be in compliance with the NaHonal Elect~cal Code. FIXTURE ; FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLE~ SWITCHES FLU~ESCENT OTHER 3 2 ] 2 O~TeK~ FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: SHED- 1 (;, F, C. I: -3 S E R V I C E NO OF CC COND' A'W'G' NO. OF Hi.[EG A.W G. A,W G. PER ,e' OF CC. COND OF HI-LEG OF NEUTRAL NO, OF NEUTRALS BATTISTA ELECTRIC BOX 285 MAHSAPEQUA, NY, 11758 LIC.#2295-E GF. NERAL MANAGER Pet' This certificote must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their"~dentiols. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. OUNDATION (2nd) :OUGH FRAME & .PLUMBING -'I/SULATION PER N. Y. STATE ENERGY CODE Fi;IAL 765-1802 BUILDING DEPT. *INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~LATION [ ] FRAMING [ ,~NAL REMARKS: DATE INSPECTOR ~ . 7 TOWN oF sO [5THOLD- Incid6ntRePort (Use Auto Accide: ~t Pamphlet for Auto- Accident) (Use "Quick Fax'~ form for:employee injury) Date&Time of In eident : Type of Incident/Aeeidenti :,,Trip & Fall orBodily Injury Vehicle 2 Damage to Property Location oflnek Ont/Aeeidefit DesCription OfI: eid~fit/Aeeident DeScription 0fI~ jUries Injured's Namel ~Add~eSs &Date of Birth Medical care giw n~ ~: By whom.9 :: Wh a gi ? at carews '~en ~ ~ t0-spi~al? ~ -: HoSpital Name: &'Address :: ; i ~ ::: , o~edtoDep, Head. : . ~pte & Time:Re -:' t: : ;' ~ Signature:ofDeP .Head: ~:: ) ~ : Date &Time. 4/96 Edition~ Anyone iaken to~l witnesses Namo 3. Nature of work (check which applicable): New Building .......... Addition ......... Alteration ...... .~0~ Repair .............. Removal .............. Demolition .............. Other Work ~.'~..o~2.. "a · ' (Description) 4. Estimated Cost . .'.,~-,//~ ~}.~. ........................... Fee ...................................... (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 mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories . .' .................................... .................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories .............. t ....... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories .......... ; .................................. - ........... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 I. Zone or use district in which premises are 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 ................ 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 DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fro~: property lines. Give street and block number or description according to deed, and show street names and indicate wheth~ interior or corner lot. STATE OF,NE~-YOR, I~___ 'l ~." o o cou rr?. b.. ...... . :.. ' : r('~e'~f~d~iahal signing contract aboveflam~'d'.' ' ?' : ' "" ' ' ........ being duly sworn, deposes and says that he is the applicant He the of said owner or owners, ~d is duly authorized to perfom or have perfomed the said work and to m~e and file this application; that all statements contained h this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this Nota. Public, ~~~~ Count., // ...... N0.4879505 ~ --' 'f U ................................... ~--,~[~[~2 ~, * q ~- [ / / (Signature of applicant) i~T~ I~rtT i q ~oQ~TO~/}519F SOUTHOLD ~M~ yes , ~ '~IL~I[~ DEPARTMENT lJ ~ ......................... ~bWN HALL . ' . .~ - THOLD, NY.. 11971 ~160U '-" ~"EE;. 765-1802 Disapproved a/c ..................................... ,- . (~ildin= Inspector) APPLICATION-FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLAHS .......... SURVEY ................... ClIECK .................... SEPTIC FORH ..... ~; ........ hO, LP¥ , CALL ................... HAIL TO: INSTRUCTIONS a. This apphcaQon 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 ofqot 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 coverad by this application may not be commenced before ~ssuance 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 w6rk. e. No building shall be occupied i 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 Tow~ of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of ~uildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housin~ code, and regulations, and to admit authorized inspectors on premises and in building for necessary inslxrc~ions./'~' --' / (Sigliature of appl.~ant, or name, if a corporation) .............. State whether applicant is owner, lc ~see, agent, architect, engineer, general contractor, electrician, plumber or builder. ,,.,-~ __ .............. , ....... , ..................................... (as on tllg, Aax roll or latest~ SUILDIN(I DEPARTMENT:AT If applicant is a corporation, signatur~ of duly auth~orized officer. FOU.OWING INS,I~'~IONS: 7. / ,. .............. · -= '"" ................ ~o~ ~0UR~ (Name and title i ' of corporate officer) ,2. ROUGH - FRAMING & FMJMBING ' 3. INSULAI'ION . ;"' Builder's License No ......... ' ................ ~. FINAL '- CONSTRUCtiON MUST Plumber's License No .... i'' 5 BE COMPLETE FOR C.O. .................. ALL CONSTRUC~N ~HALL M~' THE REQU)REMENI'~)-OF THE N.Y. Electric?n s L~cense No ...... 'r .............. · · STATE CONSTRUCROM 81 ENERGY ~..-Or~. ~' ,~,.07". COl)ES. NOT RF..~I~ONIBLE FOR Other Trade's License No../.. , ................ .-.DESIGN OR CON~'I~I~IION FJ~RORS I Location of land on which ro os' d work will b 'done (9/'-% · .... g ................................. --. .................. ...... ................... House Number Street Hamlet 1000 Sectiop .... //2P.~ ....... Block .... ~ ........... Lot... ,~,. ............ County Tax Map No. Subdivision i Filed Map No Lot (Name) 2. State existing use and occupancy ~f premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. , ,.,., .,~, , ,,, ....... b. d v~.~ ,,'-~ -: , Inten ed use and occupancy ., .............................. > ~ ............. , ........... pRIVE ~ SURVEY OF PROPER T Y A T EAST CUTCHOGUE TOWN OF SOUTHOLD ~ SUFFOLK COUNTY, N Y. 1000- 104 - 07- 07 Scale 1" = 30' March 21, 1991 CERTIFIED TO: PAOLO LAVAGETTO AREA = 1.7,287 sq. f.~, (~o ti~ lin~ 0 S PECO'I~gt~ P.O. BOX 909 MAIN ROAD $OUTHOLDf N Y. ~. LIC. NO. 49618 '~'ORS. P.C. -- 11921 , Prepared in accord~e with the minimum etandarde for title aur~eye aa establiehed ~orthe LJ.A.L.S. and ap~raved and adopted eu=h uae bY The New York State Land Title Aeeooiation. \ OCCUPANCY OR USE IS UN~WFUL WITHOUT CERT]F]CATE OF OCCUPANCY