HomeMy WebLinkAbout19962-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20288
Date OCTOBER 17, 1991
THIS CERTIFIES that the buildin~
Location of Property 200 FOUNDERS PATH
House No.
County Tax Map No. 1000 Section 64
Subdivision
ADDITION
SOUTHOLD~ N.Y.
Street
Block 2 Lot
Filed Map No. Lot No.
Hamlet
25
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 13, 1991 pursuant to which
Building Permit No. 19962-Z dated JUNE 20, 1991
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
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
SUSAN EGAN & SALLY A. McGUIRE
Rev. 1/81
BuiS~in~nsct°
/]
' -' ing pe r
IPORZf NO. ~J
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)
NO- 19962 Z
Permission Is~tere~by grant,ed to:
¥~~.~.~..~.~. ~ ..........
................. .......
.~,~....~.~:/...,...:,. :..~.~..~~ ~ ....
.................
at pre~i~s I~at~at ..... ~~~ ....... ~ ........................
............................................... ~~~/~: .....................................................................
C~n~ Tax Map No. 1000 Section ..~.~ ....... Bilk .... .~ ............ Lot No..~.~ .......
pu,uant to application dat~ ........ ~/~ .................................... , 19..~and appr~ by the
Building Insp~tor.
F~, S.~.~.
Rev. 6/30/80
TO~N O~ SOUT~OLD
BUILDING DEPA~T~IE~/~
T0UN HALL
.; SOUTHOLD, NEW YORK 1197:
.;/ 765 - 1802
OGT - 81991
APPLICATION FOR CEETIFICATE OF OCCUPANCY
Permit
Health
Planning goard Approval
NEW CONSTRUCTION .X ..... OLD OR PRE-EMZSTIUG BUILDINC ...... VACANT LAND
Locatio~ of Property.. ~ounders P~t? . Southold
HOUSE NO. STREET HAMLET
O~ner or Owners of Property ~qsan Egan '
County Ta~ Hap No. ]000 Section ~ Hlock 2 25
Subdivision ....................... Filed Map ........ Lot ..........
No. ~.~ -.Hate of Permit 6/20/91
' ' ......... Applicant ~pn Morizzo Builder,
Dept. Approval
.................. Underwriters Approval .
Raquesg for Temporary Certificate ....... Final
Fee Submitted: $ .... 25,QQ ...........
Certificate
'x
Inc.
I01
¢ o --t::
FOR// NO. 6
TOS~N OF SOUTIIOLI)
BUILDING DEPAETHENT
TOgDI I1ALL
765-
e~. 10/14/88
APPLICATION FO~, CERTIFICATE OF OCCUPANCY INSTRUCTIONS
This application must ibc filed in typeu-riter OR ink and submitted to the Building
Inspector with the following;; for new buildings or new use:
I. Final survey of property vith accurate location of all be]Idle'Es, property lines,
streets, and unusual natural or topographic features.
2. Final approval of D'ealth.~ Dept. of water supply and sewernEe-dlsposal($-9, form).
3. Approval of eleatrz~cal installatlon from Board of Fire
4. 5~orn statement fro~ plumber certifying that solder used ia system contains less'
than 2/I0 of IX lea!d.
5. Comercial buildlng!s, industrlal buildlngs, mltipla resldence~ and similar.'
buildings and instaillations~ a certificate of code compliance ;from the ArchltecE
or Engineer responslible for the building.
6. Submit Planning Boazd Approval of ao~pletad site plan requirements.
For existing buildingsl (Prior to Aprll 9, 1957] ,on-coafomlng i
and "Pre-ex~stlng" lau~ uses: ., uses, or buildlng~
I. Accurate su~ey of ~roper~y sho~ing all property lines~ street~, buildings and
unu~ua[ natural or ~opo~raphic features.
2. A properly complateO application, a consent to inspect signed by the applicant
. If a Certificaea of]Occupancy i~ denied, the Building [n~pacto~ shall state the
reasons therefor in,i~icing to the applicant.
3. Date of any housing}code or safety inspection of b&ild/ags or )remlsea, or other
pertinent infomtiOn required to prepare a certificate.
For Vacant Land Certificate of Occupancy:
I. h apOllcatloa for ~aaane land Certificate of Occupancy shall be
a d a certified abstract of tltle zssued by a title company showing single and
separate o~ershlp ~f,the entire l~t prior to ADr~I 9, 1957 shall also accompany
the a9pllcation. I~ a Certificate of Occupancy {s denied, theiBuildlng
shal~ state the reasons therefor in ~itiug to the applicant. .
I. CERTIFICATE OF ~CC~CY - New ~elling $25.00, Additious to ~elliug $25.00,
Alteration to ~elllug $25.00, S~i~{ng Pool, $25.00. AcceSsory buildlu~
Addieion to Acc~ss0ry buildings, $25.00 -'Businesses $50.00.
Z. Certificate of 0ccugancy on pre-ex{st{ng dwelling -
3. Copy of Certlfi:ate of Occupancy - $5.00 - over 5 years -
4. Vacant Land Cer;ificate of Occupancy - $20.00
5. Updated Certlfi,:ate of Occupancy - $50.00
6. Temporary Certificate of Occupancy -$]5.00 Residential
Co~ercla[
FOUNDATION
FOUNDATION
2.
ROUGH FRAME &
.?LUMBING
INSULATION FERN.
STATE ENERGY
CODE
(lst)
(2nd)
ADDITIONA'L COMMENTS:
FINAL
T
.......... : .............
LOT ~
JUN I 81 91 ?
....... $OUTHOLD, N.Y. 11971
~./.~., ./.. TEL.: 765-1802
Exan~in~d .... , ]9 .~/
Approved ..... ~ ...... 1~ Pe~it No ~-
Dsa roveda' . . PP / .................
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BOARD OF HEALTH
3 SETS OF PLANS .....
c. cK .......... :. :
SEPTIC FORM ................
NOTIFY~ Ron Morizzo
CALL · 7~5-5772
MAIL TO:
Date June 10, 19.9.1.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Ihspector, 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 l~yout of property must be drawn on the diagram which is part of tiffs appli-
cation.
¢. The work covered by tiffs application may not be commenced before issuance of Bu/iding 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 throuo~hout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
sb, all 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
B~filding 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 3emoval or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, build~ng code, housing code, and regulations, and to
admit authorized inspectors on prem!ses and k~ ,building for necessary inspections.
Ron Morizzo Builder, Inc.
'' (~ it di'hppl[ ~: e', if' :; lc;n)
lgn ure cant, o nam a corpor r
P.O Box 789, Soul:hold, NY ];1971
,.. (Mailing address of applicant)
State whether applicaht is ownpr, les?e, agent, .architect, engineer, general contractor, electrician, plumber or builder.
Buildelf ~;, .
Name of ownerofpremises · ' 'Susan Egan
'', ~ ',,- , . (as on the tax roll or latest deed)
If applicant is a corporationiqtg,n."ht~.re bf dtily authorized officer.
(Name and~tlfle Of cdrlSior~te offider)
Builder's License No. 67.72 HI
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
I. Location of land on which proposed work will be done:
200 Founders Path Southold
}lOUse Num bur ' Street, Hmnlet
County Tax Map No. 1000 Section ............ Block ................. Lot. /
Subdivision ..................................... Eitcd Map No ............... Lot ............. :..
(Name)
~ State e"
~' x sting use and occupancy of premises and intended use and occupancy of proposed constrt.ctinn:..
a. Existing use and occupancy Single family dwelling'
· Intended use an .S.i.n .........
b doccupancy glo family dwellzng'
y,-;~0 ~,, '¢', ',f~%~t 1~ ,~ .......................
3. Nature of work (check which applicable): New Budding .......... Addttlon .D.g~ ..... Alteration ...........
' i . · . ....Swzm~%B~,At~o~I ~,;j, ..........
Repair ..... Rl~moval .............. Demohtion .., ....... ' ~-. 'r · ,
T~nnis Court ......... A~cessory Building .......... Fehce ....... Other Work ............
~ 0O.0. i Fee $50 .QQ ''
4. Estimated Cost ....... ( ..........................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling u~its ............... Number of dwelling units on each floor ...............
If garage number of cars ~ ............
6. If business, commercial or m~xed occupancy, spem nature and extent of each type of use ...................
7. Dimensions of existing st~ctures~ if any: Front.., ............ Rear ................ Depth .............
Height ............... Number of Stones .....................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ...............
Depth ................. ~. HeiSt ...................... Number of Stories ..................
8. Dimensions ~f~ti~e new construction: Front .............. Rear ............... Depth ...........
Height Number of Stories
9 Size of lot: Front ' Rear ' Depth
10 Date of Purchase j Name of Foyer Owner ' .....
11 Zone or use district in which premises are situated ........
' ' ~ ' or regulation:
12. Does proposedconstructmnwol~teanyzonmglaw, ordinance ...........,... ........ · .. ... · -
iii .... N~.
13. Will lot be regraded ' ~ .W excess fill be removed from premises: Yes
N~e of Owner of premises OPg~ ~q ...: .... Address Phone No
N~e of Architect Address Phone No . ..
o ~orilzzo Buf~der aadro~ Sou~h~ld ...... PhoneNo 7~5~272.;...
N~e of Con,actor ~..~ ..... ~ ...................................
15.I~ th~s p~opetty located ~ithin 100 feet: of a tidal ~ecland~ ~YgS .... NO~...
· I~ yes, Southo~d ~o~n] ~rustees Permi~ may be required.
PLOT DIAG~M
Locate cle~ly ~d dist~ctly ~1 bufld~gs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from
prope~y 5nes. Give street ~d block umber or description accord~g to deed, ~d show street n~es and ~dicate whether
interior or comer lot.
API~,ROI~ED AS NOTED
· Nb~I~UILEiI~G Di~PA~Ig'I~:~,~ At
76.5-1802 9 AM ~ 4PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - ~0 REQUIRED
FOR POURED CONCR~E
2. ROUGH - FRAMING & PLUMSING
3. )NSU~TION
4, FINAL CONSTRUC~ON MUST
BE COMPLETE FOR C.O.
ALL CONSTRUC~ON SHA~ ME~
THE REQUIREMEN~ OF THE N.Y,
STATE CONSTRU~ION & ~ERGY
CODES. N~ RES~NSIB~ FOR
DESIGN OR CONSTRU~ON ERRORS
STATE OF NEW~fO.R~- S.S
COU~T¥ OF.. ~:: ¥'~' '~V~ ...... ,
~ o4' ~ ..... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above nam'ed.
~ is the ~ ' -
' (Contractor agent corporate officer etc )
of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file this
application; that all statements con{ained in this application are true to the best of his knowledge and belief; and that the
Work will be performed in the/n~nlr set fdrth in the application ~lcd therewith. /
Swom to before me this // I '
/ ; .. .... lg. .I.
.................. //f,/..say o~/~,f · .// .... .~ ~, i~C.' .
'" · ~ '/ '~ / :>'~'~)~C' .. ,
'// ............; ..
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