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HomeMy WebLinkAbout18840-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19397 Date SEPTEMBER 27, 1990 THIS CERTIFIES that the building REPAIRS Location of Property 21605 MAIN ROAD Mouse No. Street County Tax Map No. 1000 Section 108 Block 3 Subdivision Filed Map No. CUTCHOGUEf N.Y. Lot Lot No. Hamlet I1 conforms substantially to the Application for Building Permit heretofore filed in this office dated ~'~_~RUARY 23~ 1990 pursuant to which Building Permit No. 18840-Z dated MARCH 6f 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 REPAIR FRONT PORCH OF EXISTING NON-HABITABLE DWELLING. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 JOSEPH & GLORIA YACCARINO N./,~ B~±iding Znspector TOWN OF $O~THOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING P EIU~,IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 18840 Z Permission is hereby grant.ed to: /-~ .... ~.o...~......... ...... .... ~..~~~_.~.~,....,,...z/...7/~ .. ~,~..~.~ ....... ~.~/~.?~ ....... ~,,,~.~-.~..._~ .... at premises located at ....,~.~..~....~............~..~...;..'~..~...~ ................. .~ .............. : ......... County Tax Map No. 1000 Section .... .~.~...Z ......Block ............. .~...... Lot No ......... ././.. .......... pursuant to application doted ......... .~...,~. .............................. , ]0...,~,-~., and approved by the Building Inspector. Rev. 6/30/80 :. ...... . APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTt~LD BUILDING DEPARTMENT TOWN HALL 765-1802 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 liues, 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 Alectrical installation from Board of Fire Underwriters. Sworn state'eat from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. r 5. Commercial building, indus.trial building, multiple residences and similar bui/dings and installations, a certificate of Code Compliance frem'arohiteot or e~gineer responsible for the building. 6. Suhm/= Planning Board Approval of completed site plan requirements. For existing buildings (prior to "pre-existing" land uses: April 9, I955) non-conforming use~, or buildings and Accurate survey of property showing all property lines, streets, building and ... unusual natural or topographic features. A properly completed application and a consent"to inspect signed by the applicant. If a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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-exisging Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. UpdaL~d C~rtificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.90, Commercial $15.00 :~ew Cosstruction ........... Old Or Fre-existing Building ............. Looation House No. Street Hamlet Onwer or Owners of Proper ...................... o ....... . County Tax M~'p No ~000. Section. L.~,..~. ...... Block...~.: ......... Lot .... ~<. ............... subdi~ision ......................... ' ........... Filed Map ............ Lot ............. '; ........ ~lealth Dept. Approval .......................... Underwriters Approval ........................ ~ planning Board Approval ........................ ~equest for: .Temporary Certificate ........... Final Carticateo...~...... .. Submitted: TOWN OF SOUTLIOLD OPFICF, OF BUlhDING INSPECTQR P.O, BOX 728 TOWN IIALL SOU'I'IIOLD, N.Y. 11971 September 13, 1990 TEL. 765-1802 Joseph & Gloria Yaccarino 4304 Ludwig Lane Bethpage, N.Y. 11714 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /~// An applicanion for Certificate of Occupancy is not on fil~. (ENCLOSED) /--/_,/ :]o Underwriters Certificate on file. /Z The check is(cR~g(FaX~Yd~VJnot on file.) $25.00 /~/ I:o !Iealth Dept. Approval on file. /~/ t:c: final inspection has bec:x made. P]ease contact our office on this matter. Thank you for your cooperation.' Building Permit II 1 8 8 -4 0 Z Bui ldin~! Dept. Ilo Plumber solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) FOUI~DATIO.U (1st) FOU!~DATIO:! ( 2nd ) EOUGH FRAME & .PLUMBING INSULATION PER N. STATE E~IERGY CODE Fi::AL ADDITIONA'L COMME[ITS: TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL ~OUTf4OLD, N.Y, 11971 .k~,~. ~,. TEL,: 765-1802 Examined .......... 19 ~ D[s=~proved ale / (B~ding inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 3 sr. TS Or.~'L,t~S t~.. SURVEY W~. ........... cHECK ~/~...~C:,.C.~ y.. SEPTIC FORM ............... NOTIFY~ CALL MAIL TO: a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, will sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, reIationship to adjoining premises or public sire or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap! cation. ¢. The work covered by this application may not be commenced befor~ issuance o£ Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such shall be kept on the premises available for inspection throughout the work. , ¢. No building shall be occupied or used in whole or in part for a[ty purpose whatever until a Certificate of Occupa~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Dep:n-tment for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Reeulations, for the construction of buildings, ad~ditions or alterations, or for ~cmoval or demolition, as herein describ~ Th~ applicant agrees to comply with all apulicabte laws. ordir,ancez, hui!4;ng cod~, housinz, code, m,d ............... ................ .... ... (Mailing address of applicant) State wh~her applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ ............... ..................................................................... ameofo, nerof remises .... .... ..................... (as on ti~e tax roll or latest deed) Ir applicant is a corporation, signature of duty authorized officer. ...... (~,/ame'and 'title or corpc~r'ate enter) ........ Builder's License No ..... . . .~... ,'~(~'. ............ Plumber's License No El i /an' Li N ect~ c s cense o ....................... Other Trade's License No .. · 1. Location of land on which proposed work w,[l[ be done; . ' . llouse Number Street Hamlet County Tax Map No. 1000 Section ...I. 1~..~. .... ; .... : Block . .3 .............. Lot../// ........ Subdivision Kilcd Map No Lot ...... (Name) 2. State existing use and occupancy of premises and m tended use a~occupancy of proposed constrt~ion: ....... ............ and occupnncy ..... 3. Nature of,troth(check which applicable): New Building .......... Addition .......... Alteration ....... ~. · Repair .. ~r. .......... Rbmoval .............. Demolition .............. Swimtuing pool. Tennis Courtu ...... ~o.- Accessory 8uildlng .......... Fence ~.~,..0thor ~ork~ff~ ~,~._ ~_~ ~rz-~,~ ~,7,~f Dee ~'r~ 4. BstimAtc~ ~ost '.~ ~.. ~.~ ........................ Fee ...... ~..g .~ .................... ~ · - · · (to be paid on filing this application) S. Ir 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 StoHes ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... tlei~t ..................... . Number of Stories ..................... 8. Dimensions ofentir= nexv construction: Front ............... Rear ............... Depth .............. .~ ~.~ mumber m'Stonc~ · . ...... 9. Size of lot: Front ...~ .............. Rear... ~ ............. Depth ./,~ ..... ~ ....... I 1. 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 exc~s.fill~_~__~_., . ..be re$ov~ from premises: Yes .... No N~e of Architect ....... ~ ................... Address .................. '.Phone No .............. N~e of Contractor ..... ~ ~.l~. ..... : ........ Address ................... Phone No ...... ,,. .....~ . , 15.Is this property located uithin [ 00 feet of a tidal uetland? · If yes, Southo~d To~n Trustees Permit may be required. PLOT DIAG~M Locate cle=ly ~d distNctly ~I bu~dNgs, whether existing or proposed, ~d, indicate ~I set-back d~ensions from prope~y ~nes. Give street ~d block number or description accordNg to deed, ~d show street names and ~dicatc whethe~ interior or corner lot. d STATE OF NEW.-Y~RK, ° S COU,~tY OF.. ",//( .~44.c'..'~ ..... °' r~ loc lC ~ d~ 7~- /I ~eC. ............ Z ...... being duly s~vorn, deposes and says that he is the applicw . . (Name'ofindividual signing contract) above named. (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 ti application: that all statements contained in this application are true to the best of his knowledge and belief; and that t Work will be performed in the manner set forth in thc application qlcd therewith. Sworn to before me this ~ .... . y of .......... ........... . '.., 19, Notary Public ~tz~-~-r~.... ....... County JOSEPH G. La NOTARY PUBLIC, State of New Yort~ ...... · ~// / /5~ ., ...... No. 41-2272025 ,5/' ,/ . (S~onature ofapplica~ Qualified in Queens Cou~t~ ~;,/ ~ommJs~;'>~, D"-:'."3 Dec, 31, 19,1, ¢ ' 8:5'- I0' ~ 50" E I00.00 ...............................