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HomeMy WebLinkAbout20657-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22849 Date JANUARY 26, 1994 THIS CERTIFIES that the building ADDITION Location of Property 525 TUTHILL ROAD EXTENSION SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 6 Lot 15.17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 21, 1992 pursuant to which Building Permit No. 20657-Z dated MAY 27, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to RICHARD FOGLIA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL. N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Z.Oilding Inspector Rev. 1/81 7~ FORM NO. 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) 19. t N02N° 20657Z Date 1::!".:7 Permission is hereby granted to: ' .N... t. `...rs or"d . ............/eslocated a at premat . U"..................................................................... County Tax Map No. 1000 Section Block 0(O Lot No......S ~.d.... pursuant to application doted 19.. ~!L and approved by the `E Building Inspector. l i Fee ir~v Building Inspector i Rev. 6/30/80 l`~ ~ ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL C~ y. 765-1802 llq l~ 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 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 "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 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 $ 5.00 Commercial $15.00 Date !I..°..b z9; New Construction..... Old Or /Pre-existing Building...... Location of Property.. r-.TU 1111~L.. .P !...........1~U OG~..........Y.'.~ ~ House No. l Street /J Hamlet onwer or Owners of Property..1\IGhrn1R~.. County Tax Map No 1000, Section..Q.`lr.`.5,~?U..Block ..........Lot..l Subdivision.... .........................Filed Map............ Lot.................... Permit No :7..... Date Of Permit ................Applicant............................. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final ti te... Fee Submitted: $ 011e .1/71j3 \ . C' . _ Co 2,Z&V 7 APPLICANT -1,- 1, I c15LD l.~~:1J:i FOUNDATION _{1st) c 7OUNDATION (2nd) r" 2 0 :OUCH FRAME & -PLUMBING 1 cq 3. I v m m :fISULATI0N PER N. Y. y STATE ENERGY CODE ' .~tbLter~ FINAL ADDITIONAL COMMENTS: m ro y 9 • ~ V H hi o m i- a ' r rn f - - - m H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ I~TION [ ] FRAMING [ FINAL REMARKS: 4 a ~ DATE I~ INSPECTOR r~„ [l\J~,. BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS MAY 2 1 1992 TOWN OF SOUTHOLD SURVEY _ _ . r l l ~4 BUILDING DEPARTMENT CHECK r ,1~i. ...<n.,...,.,. - TOWN HALL SEPTIC FORM P v , SOUTHOLD, N.Y. 11971 5_. . , , TEL.: 765-1802 ttOTIFY~ CALL . . Examined V 7, , , , , 19/l- MA I L TO: Approved 10-7....... 190 Permit No. 0.;0o-2 Disapproved a/c 14 . ( ding Inspector) APPLICATION FOR BUILDING PERMIT ~j Date v`. I........, 199 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 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations or for re ova or emolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, g c t usi g coc}e, and regulations, and to admit authorized inspectors on premises and in building for necessa in ion . (Signature of applicant, or name, if a corporation) 5a I-S TvTAZZ PD FIX (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ©VN a . .R.Q ~ ,e Name of owner of premises .....1 US \ ......I^ i.L .1.?~ ...j .....:.5.. . C (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. W N I.' Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done. House Number Street Hamlet O/ 50/ County Tax Map No. 1000 Section ~ .15.!: .10...o Block Lot 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 . b. Intended use and occupancy I ( ,7, PIT , , , , , , , , , . . 3. Nature of work (p~ check which a p' New Building Addition Alteration Repair Removal Demolition Other Work / U (Description) 4. Estimated Cost 1 /Q... 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 He Dimensions of existing structures, if any: Front . Rear Depth • • • Number of Stories . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . Rear s. Height . Number of Stories . . Hem g . . . . . . . Num.~.~....... ! Depth ~ F . 8. Dimen ensions of f entire new construction: Front ~ Rear . . . 1of Stories . 9. Size of lot: Front . . . Rear . Depth 10. Date of Purchase Name of Former Owner . 11. 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 N 7 •-q ~3 `~i/~,~: 'I~ 7 /r36 Nafne of Architect !I Address Phone No..... 7...."!1 Name of Contractor . . . . . . . 00 fee feet o of " Address well .....*Yes. . ............No.....No.... No 15. 14 this property Tr a tidal wetland? *yes...... *If yes, Southold Iwn 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. I I ~ I. 7Y~lG S II I li II STATE OF NEW YORK, S IS COUNTY OF • . . . • • • . ' ' ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant (Name o individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 'iauthorized to perform or have performed the said work and to make and file this application; that all statements contaigqed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s,et forth in the application filed therewith. Sworn to before me this / ....day of. /f . 0........., 19 . Notary Public, ^ County ' M. 1.KIN3 ' Notary ubl ic, State of New Yoj-/~ . (Signature of applicant) No, m9Expi esJune12Ct8 r SCHEDULE SPECIAL i ITEMS i CHECK ITEMS ORDERED ,2x x,6• ax 6' A/0% ao' 2 t/-,(y Y. J .`J P 5/ X6 X/O ~ 5 5vx6x 9 y, t 8 axb x/6' 9 y I .rS9rvrx'~~ 8r., ONC koR i 3 uT" r -~'^r t Xt ANC~a - r 4 , i R 3CtALV, Sc0ew9, 3oty . a G CHECK LIST 1 drum: _ COMPLETE INFO X PARTIALLY COMP P v r" ITEMS TO COME TC NO JT h 1 `'~~k~ °~I, gFsi ly" ECK STATUS ISTED ITEMS w ji~ID~ovaj CAS Psom# S-427)-B-- a ~sy~ ES FFE. Y Lkl Gy; t . hialI GLIN DING DEPARTA hT AT RK 76@-1802 F, AM TO 4 PNI Oil THE FOLLOWING INSPECTIONS: ES 7- FOUNDATION • TWO REOUIRED FOR POURED CONCRETE 2 ROUGH- FRAMING A PLUMRuNC NG STk 3 INSULATION n, Fl~d'.vL - scows mLICTION MUST - G PC RE C0lV6'PL.E'pE FOR C.O. ICA !ELECTRICA AIu CDN rRUCTION SHAD- MEET THE REQUIREMENT$' OF THE N.Y. 3 "'J ATE CO STROCV10N & ENFRCaY 1;t'es1!°:S NOT RF-RPONSI?LE FOR -ti+ v4,4F4 taP 4li Oki Li CEI~JN ESiRL1~.`,i 5",,:Y, . CA C DESIGN by DETAIL by CLIENT SHOW APPROVAL SCALE DATE CLIENT i ncennm SCHEDULE SPECIAL ITEMS CHECK ITEMS ORDERED Ana -al CHECK LIST COMPLETE INFO X PARTIALLY COMP P ~L% - ITEMS TO COME TC NONE NO r4l e, ~•n ri CHECK STATUS w OF LISTED ITEMS COPY ~Af COLOR SAMPLES PHOTOS ART WORK TRANSIES DRAPE FLOORING EXISTING PCS. ELECTRICAL f .,.tF Y.l (off l~.~i % T CASES DESIGN by DETAIL by CLIENT 1 SHOW CRATES APPROVAL SCALE JOB NO. DATE CLIENT LOCATION