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HomeMy WebLinkAbout19170-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the B~ilding Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19494 Date NOVEMBER 8, 1990 THIS CERTIFIES that the building POOL HOUSE Location of Propert~ 4125 OLD NORTH ROAD House No. Street County Tax Map No. 1000 Section 51 Block Q3 Subdivision MT. BEULAH ACRES Filed Map No. 6984 SOUTHOLD Hamlet Lot 02.4 Lot No. 1 conforms substantially to the Application for Buildinq Permit heretofore filed in this office dated JULY 2~ 1990 pursuant to which Building Permit No. 19170Z dated JULY 2, 1990 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 POOL HOUSE AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A DENNIS DI TRAGLIA-ANTHONYMUETO Rev. 1/81 l~O~ 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) NO_ '191 70 Z Permission is hereby granted to: __~.~.,......~..........~.....~.~ ~ 7 / ,o ....~...~_/.....~...~.......~" " ........ ~.. ....................... at premise,I ~ t/'/~..~oca~eafat --~.~Y~..~....~...__.~.~--e~.....~.J..~....~...,~..~,./~ ......................... ....................................... ~..~~~/..~..~.../z..~..2....~. ............................... coun~ Tax ~o~ No. ,00o Se~,,on..~..../.. ............ B,~k ..... ~. .............. Lot No....~.b/.. ...... pursuant to application dated ...~.....~.... .................. , 19..~..~and approved by the Building Inspector. Fee $..~..~.~..~...... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 Ppre-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 - $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 $15.00 Date .... ~ .~. ~.<~?~o .~% .%~. .............. ... New Construction .... .v~.. . Old Or Pre-existing Building ..... Location of Proper ................................................ .. - .. . . . House No. Street Hamlet Onwer or Owners of ~ p y ........................ ~ .~'. ............ County Tax Map No 1000, Section .............. Block ................ Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No.../.~./.~. ....... Date Of Permit ................ Applicant ........................ ... .. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~. . Fee Submitted:~ ~d~O~$ ..... ~.~.:~.0. ................. ~~ /9~ ' ' ......... '~' 'k%-T' APPLICANT ~ ........ ~ 0 '% ........... ~ ........... FOUNDATION (1st) FOUNDATIO~'~ 2. (2nd) ROUGH FRAME & .PLUMBING rNSULATION PER N. STATE ENERGY CODE FI;IAL ADDITIO~A'L COMMENTS TOWN OF SOUTtlOLD OFFICE OP BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 October 3, 1990 ANTHONY HUSTO & DENNIS DiTRAGLIA 4125 OLD NORTH ROAD & HT. BEULAH AVE. SOUTHOLD, NEW YORK To Whom This May Concern, 9;e are unable to complete your Certificate of Occupancy because .of the following reasons. /--//An application for Certificate of Occupancy is ~lot on file. (ENCLOSED) /~_~/ No Underwriters Certificate on file. /_ The check .is(~X~'~nct ou file.) $25.00 /~/ No llealth Dept. Approval on file. /~/ No final inspection has been made. TEL. 765-1802 Please contact ()ur office on this matter. Thank you for your cooperation. l'h~ild(ng PermJ. t I! I 9 I 7 ,9, Z (POOL HOUSE) Build inif Dept. *'**/~/ tlc Plnmber solder Certificate on file. ?' ( all permits involving plumbing being issued after April 1,1984 ) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 ,~. i..~.~. TEL.: 765-1802 Disapproved a/~ff ................ ' ........... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK .................... SEPTIC FORH ..... ~. ~ .... NOTIFY~ CALL ................. MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date a. Tiffs applicr/tion must be completely filled in by Wpewriter or in ink and submitted to the Building lhspector, 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 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. ¢. Thc work covered by th/'s 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 BtLilding Permit pursuant to the Building Zone Ordinance of the Town of S0uthold, Suffolk County, New York, and other appIicable Laws, Ordinances or Regulatio. ns, for the construction of buildings, ad. ditions or alterations, or for/~emoval or demolitio ' ' The .apphcan.t agrees to comply with all applicable laws, ordinances, build:-~- -~--~ .... n,,as here~ described. admxt authorized inspectors on premises and in building for necess.~r~, iff~~,' n°us.~.~ .~L aha reg,ulatlons, and to - . ature of ap a~t,./o~ hen{ , if a co}per'non')' ' ' _ ~g. ffature of i~ ~nt,/o ~ . (~lailing adfiress of applic~l~t) ............ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) ~f appl'cant is a corporation, signature of duly authorized officer. Builder's License No ....... ,5'~..~/..~. ............. Humber's License No ......................... Electrician's License No ....................... Other Trade's License No .................... Location ofland on which proposed work will be done; · .... .... Il b ........ case Num er Street, ' ' ' amlet County Tax Map No. I000 Section ....... (Name) '" .... Lot ..... /. ........ State e ' ' . x st ng use and occupancy of premises and intended use and occtln'~n.. . . "~"'-Y Olproposed construction: a. Existing use and occupancy ........ '''',L' .................. ,--., ........ B. Intended use and occupancy ...... ~.~... I. Nature'of work (check which applicable) New Building ...........'"J:~- Addition .......... Alteration ........... Repair ....... ' v ~ · '' ....... Rtemo al~ ............ Demolitio~ .............. Swimming pool. ............ Tennis Court ......... Accessory Building...~,~"~'"~.....Fehce ....... Other Work ............ (to be paid on filing this application) ~. If dwelling, number of dx~telling uniis ............... Nnmber of dwelling units on each floor .............. If garace number of cars ~ i. If business, commercial or mixed oclcupancy, specify nature and extent of each type of use .................. 1 Dimensions of existing structures it~any: Front ' Rear Depth Heieht ............... . Numberlof Stories ............................................... Dimensionsofsamestructurewith41terationsoradditlons: Front................. Rear. . .... Depth ...................... Height ................... Number of Stories ......... ~ Dimensions of entire new construction: Front Rear Depth .... Height .Number of Stories ' ) Size of lot: Front ~ Rear Depth ' " ' 3 Date of Purchase Name of Former Owner ....... Zone or use district in which premises are situated ....... 2. Does proposed construction violate any zoning law, ordinance or regulation: ............. 1. Will lot be regraded .......... ZIO..:.;' ........... Wiil excess fill be removed fro'~ 'pr:~n'i~e's: ' ' y:: :::~ ;. Name of Owner of premises ..... ~'/.eg,.~.=. ..... '... Address .................. Phone No .... ~ ...... -- .... Name of Architect Address Phone No Name of Contractor ' ' Address Phone No 5.Is this property loe~te~ within 300 feet of a tidal wetland? ~YE8 .... NO.)~. mlf yes, Southold Town Tirustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly~all buddings, whether existing or proposed, and, indicate all set-back dimensions from roperty lines. Give street and b!ock number or description according to deed, and show street names and indicate whether ~tcrior or comer lot. TATEOFNEW~YORK-TZ'_ ~ . i OUNTY~F .~c~:~...~.,.~.. S.Si · . (Name of individual signing eOhtract) ~ove named. ~ ......... being duly sworn, deposes and says that he is the applicant ,Yom to before me this Notllr~ Public, State of NeW - . ~o. 4879505 Quslffi~ In Surfak CoOn~ ~m~lon ~lres O~m~ e is the .' (Contractor, agent, corporate officer, ftc.) smd o vnet or owners, and ~s duly adthomzed to perform or have performed the said work and to make and file this ~l~l,catmn: that all statements contained in this applic'ation are true to the best of his knowledge and belief; and that th~ ark will be perlbrmed in the manner sc~ forth in the application filed therewith. LOT I ON MAP OF MOUNT BEULAH ACRES FILE N°- 69B,rl,. F/LED MAY29, 1981 SITUATED AT $OUTHOLD TOWN OF SOUTHOLD SUFFOLK CO, AN ASS~JMED DATUI~ CERTIFIED TO: SOUTHOLD SAVINGS BANK PECONIC ABSTRACT IN~ FO,~ : ANTHONY MJSTO DENNIS D/TRAGLIA seaJand /J I surveying ~ engineering p.c. I10 west main street riverhead, new york 11901 (516) ::569-1717 March 13, 1987 Job N~ 84-501A 1000-051-05-2.4 Scale: I"= 40'