HomeMy WebLinkAbout19116-zNo Z19280
FORM NO. 4
TOWN OF SOUTSOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N~Y.
CERTIFICATE OF OCCUPANCY
Date' AUGUST 8~ 1990
THIS CERTIFIES that the building
Location of Property 3610 BRIDGE LANE
House No.
POOL
CUTCHOGUE
Street Hamlet
County Tax Map No. 1000 Section 84 Block 05 Lot
Subdivision ISMARACRES Filed Map No. 5872 Lot No. 15
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 4~ 1990 ,
pursuant to which
Building Permit No. 19116Z dated I JUNE 8, 199Q
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 ABOVE GROUND POOL AND FENCE.
The certificate is issued to
BRAD & DENISE DAMIANI
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N140535 JULY 16~ 1990
PLUMBERS CERTIFICATION DATED
/ B~ilding Inspector
Rev. 1/81
l~O~ NO. ~
TO~N O~ $O~THOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, H. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N_~ '~9116 Z
Permission is hereby granted to: t
~..,...~_~...g.~..
~~ ................. ;..~. ................. ~ ............ ~ _~. ........................ --~.._...~. ...................
County Tax Map No. I000 Section ...... .C).~.~ ........ Block ......q'..~--.... ...... Lot No ........ J.! ..............
pursuant to application dated .......... ,A....~. ~....dj. ................. , 19.~.~...,
Building Inspector.
and approved by the
Rev. 6/30/80
Form No. 6
TOW OF SOUTHOLD
BUILDING DEPARTMEN~
TOWN HALL
765-1802
' APPLICATION FOR.CERTIFICATE OF OCC1
'ANC BLDG, DEPT.
~OWN OF SOUTHOLD
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 $15.00, Commercial $15.00
~0%'~ Date ...... .
Xew Construction.~..% ...... Old Or Pre-existing Building ........ ' ..................... "'
Location of Property .... ~.~. ........... ~. SC ~/O/~_ ~C
House No. Street Hamlet
Onwer or Owners of Property ..... ! ' '
County Tax ~'p Ho lO00, Section...qf.V. ....... Bloc~ .... ~ ...~ot. ;;
ubdi ision. . i : . CCZ ' - .... '...
................ Filed' Map ............ Lot ....... ..
Permit No../.~./.d d..~..~...Date Of Permit...~. d.~.'~.?.O...Applicant.~..~.~..~..,..~...~../~.. [~..A?; ....
[{ealth Dept. Approval .......................... Underwriters Approval
App ' ""'
Planning Board roval ................... .: .
· ~.._
Request for: . Temp~rary._~Certif~cate ........... Final Certicate..
Fee S-bmitted: , '1. ~_,~0 k~'~ --
. ) ,.. ...
Sl ?l ¢ ~ · . ....... ,z. . .~ ~. .~ . ~ ~ .. ~. . . .~. . . .o~. . ......
~o ~/Y ~ Fd A~P~ic~
FOU~__4DATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITION[L COMMENTS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
'J 0(}'{ 0g '~ BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 100318
~ ~b¥ t 6,1 ~0 695~;0190/90 ~ ~
Date Application No. on file
THIS CERTIFIE~ THAT
only the electrical equipment ~ ~scribed below a~ introduc~ by t~ applicant ~med on the above application number in the premlses of
in the folZowlng locatio.~ ~ B~ment ~ Ist Fl, ~ 2nd FL OIIT Section Bilk Lot
a~sexa.~inedon JllhY 02,.I.J.90 andfoundtobelnco, p anceu'iththerequirementsqfthlsBoard.
FIXTURE FIXTURES RANGES OVENS DISH WASHERS FANS
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
* ($Wl},tt,lIlq~ POOL) '~'b:i s certificate
cov~r~ eOml>l, iam'~,~ at' thr~ date
en~i,rona, m~t~; it -is advJsab'te t,,~
E R V I C
NO, O;E.%¢O"D. [ OF C¢
A W G HO' OF HI4EG
GARY DORO,SKt
COTC~K)GUF,,. NY, 11935
L'rC. #~941 -E
AW.G.
, OF HI-lEG
NO OF NEUTRALS
A. WG
OF NEUTRAL
This certificate must not be altered in any manner; return to the office the Board if incorrect. Inspectors may be identified by their credentials,
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
765-1802
BUILDING DEPT,
,INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] IN/$~JLATION
FRAMING [~FINAL
BLDG DE
TOWN OF SOUT,'-IC~ ~"~
FORM NO. 1
TOWN OF gOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD. N.Y. 11071
TEL: 7G5-1802
BOARD OF HEALTH
3 SETS OF PLA~IS ............
SURVEY .....................
Cll~C~
sE Tic';j .................
Disapproved a/c .
(Building inspector)
APPLICATION FOR BUILDING PERMIT
NOTIFY;
CALL ..~ ..................
NAIL TO-
:~x~builder.
FOR POURED CON~R~:'t~F ....
3.
4. FINAL CONSTRUCTION
BE COMPLETE FOR C C' tv~OST
ALL CONSTRucTioN SHALL MEET
THE REQUIREMENTS OF TH~ N
STATE CONSTRUCTION & ENERGy
COOES, N~ RESPONSIBLE
DESIGN OR CONSTruCTION ERRORS
INSTRUCTIONS
;~ .
a. Tlds application must be Completely filled in by typewr/ter or in ink and submitted to the Buildi~, Im'Pector, with
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 premiss or public streets
or areas, and giving a detziled description o£ liyout of property must be drawn on the diagram which/s pag o£ thiz appH-
cat[on.
c. The mvork covered by this application may not be commenced before issuance ut: Building Pcrml+_ - '
d. Upon approval of this application, the Building Inspector will issued a 13uilding Permit to the applicant. Such pe~nit
shah be kept on the premises available t'or inspection throu-_hout the work.
e. No buiidin~ shall be occupied or used in whole ori-n par~ fora.ny purpose whatever until a C¢~tificaleof Occup=cy
shall have been grmmted by the Building Inspector.
APPLICATION IfS HERE~Y MADE to the Building Department for the issuancn of a Building Permit pumu-nt to thc
Building Zone Ordinance of the Town of Southold, Suffolk County, New ¥o~'k, and other applicable Lav~, Ordinances or
Regulations, for the construction of buUdings, additions or alterations, or For ~;emoval or demolition. 3.m hc-~.in desc~bed.
Thc applicant agrees to comply with all applicable laws. ordinances b ' ' ,- ·
admit authorized inspectors on premises and in bu'ldin,- fa,- ,,r-~ ,. uildm= code, housm.~ c~dc, and re'~alanons, ~nd to
z.__= ....... ssary {nspecnons. { i
· . (,S.i~.nature ot applicant, or ~a'n~e; if'a'~o}po'r~t~on) *'
State whether applici~,~.is owner, lessee, agent, architect, engineer, general contractor ' '
(as on thc tax roil or la[cst ~802 9 A~/~
{F applicant is ~ co~o~ation, ~iSnalure oF duly authorized
'
Builder's License No: ... ~~ ....
Plumber's License o s .
Electrician's ~ccnsc No...~...~..
Other %ade~ ~cense No
· Location of land on which proposed work will bc done;
House Number Street. ..... Hamlet ' ' ' ~ ............... ·
Subdivision ~ '5 ~{{ed Map No. ~ g )~
(Name) ............ Lot
State · .. ',
ex sting usc and occupancy or premises and in tended use and occupancy of proposed constructiom
a. ExiSting use and occupancy
· Intended use and occupancy ............ .. t~
f. Nalure o£ work (check which applicable): New Building ......... AdditiGn ......... ,'~ltcrali~n ....~. ......
Rmepai .r .:. ............ R~movhl .............. Demoli,i;n ......... :. IJffilJJtj~[ .*~ j~ poe !'..;..
4. Estimated Cost .~.~. ,~..0.~. ~.(7 .......... ~-, . .
(to be paid on filing this application)
5. Ir dwctling, number o£ dxvclling units · · ' . Nombcr of dxvelling units on each floor .............
lfgarage, numberofcars ...... ~..2]]]..]]]]]]] ] ................................. ] ]..2 ......
6. If business, commercial or mixed bccupancy, specify nature and extent of each type of use ..................
7. Dimensions of existing structures ! if any: Front Rear Depth
Hcieht Numb)r of Stones
.... ~'~ ......... 'l~r~);~ ........
Dimensions ........................... ' '
f amc structure with alterations or additions: Rear
Depth ' Height ' ' i ~q'u',l'l g;; ;~ ........
..................... I .................. Stones
8. Dimensions of entire ne~v construction: Front Rear Depth
Height Numb'er of Stories
Size of lot: Front ,
' Rcar Depth
Date of Purchase ............ 1 ....................................................
............ ! .................. Name of Former Owner .................... .. · .. .
Zone or use district in which premises are situated '
Does proposed Construction violate any zoning law, ordinance or regulation: ...............................
Will lot be regraded .; ........ l .................. Will excess fill be rcmoved from premises:. Ye: .... No..
Name.of Owner of'premises .... I ............ ' ....Address ................... Phone No ............. ... .
Name of Architect ' Phone No
........... I ................ Address ................................. -- .
Name of Contractor .......... [. · · ' ..... Address ..... : ........... Phone No .....
15.Is chis property loeac.ed '~[~'~ 100 feet of 'a' C~dal **~tland? ~YES .... NO.
· If yes, SouChold Town lTruatees 'perra~ may be required. PLOT DIAGRAM
Locate clearly and distinctly all
property lines. Give street and block n
interior or comer lot.
STATE OF NEW YORK, i
COUNTY OF $'$
ufldlngs, whether existing or proposed, and, indicate all set-back dimensions from
~mber or description according to deed, and show street names and indic=to whether
.............................. ! ................... being duly sworn, deposes and says that he is the applicant
(Name of .... contract)
mthvtdual s~gnn}g
above nam'cd, i ',
He is tlc , .
I (c cfi ) ' '
· , g .,,.vrporatc o ccr, etc.O
of said owner or owners, and is dulyi;,uthorizcd to pe,rform or have performed the said work and to make and file this
application: that all statcments contai0ed in this application are true to the best of his knowledge and belief; and that the
work will be perfommd in the manner ~et forth in the application filed thcre~vith. ./
Sworn to before me this i
'
($ignaturc of applic=nt)