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HomeMy WebLinkAbout17324-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17459 Date OCTOBER 26, 1988 THIS CERTIFIES that the building ADDITION Location of Property 505 BAYER ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section I39 Block 3 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5, 1988 pursuant to which Building Permit No. 17324-Z dated AUGUST 17, 1988 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 LEONARD F. & AVE MARIA SPANO (owner, } of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 rows xo. 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) N~ 017324 Z Date ......~~.7 19.Q8 Permission is hereby granted to; at premises located at ..t.~z!!.,.? •%^~'.~.'.`~.7~.''7.l...... ......~..j7l/~.~ Caunty Tax Map No. 1000 Section ........~`3..f~..... Block ...........~....GGggLot No.......f~.......... pursuant to application dated 19(J.Gl., and approved by the Building Inspector. Fee ~.:1..C/ . ..........`'---,z.7r. .c.~~~ uildi Inspector Rev. 6/30/80 ~ ~ FORM NO. 6 ~IJ' TOWN OF SOUTHOLD ~ {g~ Building Department Town Hall Southold, N.Y. 11977 BLDG. DEPP. 765 - 1802 TOWN OF SOU7HOL0 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~e~ri_ to the Building {nspec- torwith the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal?. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5, Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory -$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ~~,,eeGG S.Undated C.O. $ 50.00 Date ~~`..6..~ (o~...... NewConstruction,,,,,,OldorPre-existin Buildin Vacant Land 9 9 Location of Property , `~.t~l.'6.ca~~~.>.. , , House No. G`J~ Street Hamlet Owner or Owners of Property ~`:e"~--~"~;~, , , . County Tax Map No. 1000 Section q Block ....`g.......... Lot , , , Subdivision .................................Filed Map No. ..........Lot No. . Permit No. ~.7:3.~.~. , Date of Permit ..........Applicant . Healih Dept. Approval .Labor Dept. Approval , , . Underwriters Approval . .......................Planning Board Approval . , . Request for Temporary Certificate .....................Final Certificate , . , , . Fee Submitted $ . . Construction on above described building and mit m~ejeJts a!I applicable c des and regulations. App I icant ~{..a,° ac~-rcv.'~ :G . Rev. 10~10~78 Rec. 3603 c.o ~ 1 ~~s~p i z ~.c~~^ ~ so i. ~ ~ z ~ i T_,~~ ` v i. , ~r b~ ~ ~ i ~a ~ " r~ molk ~o 1~---~ 3S o A - ~ ~ . ~1 blacktop driveway d ~ ~ ~ A ~ ~ 1 ~ i.~' c S ~ ~ ~ ~ 3~ ~ Q ~ r ~ \ , o~ 00;3 ~ L1 ~ rn~ .~c~l ~ ~ .3 7 m~~f b 1 ~ o . o ~ o ~1 ~n ~1 Gl I ~ ~ ~ ~ ~ ~ 1~ ~~1 62AN7' ~ y ~ C ~0 y D 0 z, ~ ~ o yam.. y ~ ~ ~ ~ r~ D ~ (J L ,5 r, aoso~aHo€ os~mo ~o~x ~ ~ ~ ~ ~:m~gA ~ r~ ~au ~ f~j I S \ ; o^bo o'er h ~~~;dmt Eo~B ` f7 ~ ~U~Q~i000~ FFN~ T;r 1, 1,1 ~ iq ~~~y~PNAB oy ~ i<P ~ W x~~=a sa~ro Aso ~.D ~ ~ ~6 ~ ~ ~ r'1c:LD I;:SPC:iU:+ ~~UniE ~ ~CMMGNTS a ~ ,.a ~ = ~ H H FOUtIDATION (1st) ° FOUNDATIOtJ (pnd) m~0 - - 2. z o O P,OUGH FRAME & Q~~ PLUMBING ~~ll ti H 3. m m INSULATIOf1 PER N. Y. y ~ STATE ENERGY CODE x ~ c,o ~ - ® ~ ~ 4 . ~Q .3 ~ _ FIIJAL - ~C1 ~ er 6 ~ o ADDITIOfIAL COMMENTS: x~ d ~ ro \ " ~Q H 9\ • y H O Z [*7 a\ • r H . - m o H r'' 173 zy o- . 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~ INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ r/~ DATE / ~ ~P a O INSPECTOR r ~ ~~~`w 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~INAL c REMARKS: ~ ~ ~=~~~%'~_r.~ ~~~w n p ~r ~,v-,~ rr t DATE~INSPECTOR t,~ A P b AS NOTED DATE:/ ~ B.P, M /~-3~ fG ~o FEE: BY: N~'IFY BUILDING DEPA ENT AT 78b-1802 8 AM TO 4 P FOR THE FOLLOWING INSPECTIONS: f'~ ~U S f 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH .FRAMING 8 PLUMBING 3. INSULATION FINAL - CONSTRUCTION MUST \ BE COMPLETE FOR C.O. ~ -1'" ALL CONSTRUCTION SHALL MEET a=- THE REQUIREMENTS OF THE N.Y. - l BTATE CONSTRUCTION m ENERGY CODES. NOT RESPONSIBLE FOR DE&!GN OR CONSTRUCTION ERRORS ~ ~ r - 'I I w,m.,....Y...,. ~ n S ~ ' /~1. 4....,... r~ Po s r . _ l ' ~ -wuw• \ • w ~ _~,o/ ~ p I ,~'~~i ~ . C G A '~~U - ; ~ l ~ 7 . <Sf4` ?r ~ x~dAE c~ i~G ''/e' "she ~,~.,~G I{ y N ~ P°5r ~ X ~ ~8 ~ /~osi C,~/a~M1 ~~K ~ ~ LAT~iS SlD~S ~o~ ~ BorT~M . a , ~ 3`N ~ c~~~~C dot ~ s fm,~ ,vcg.,v~ ' r ~,1 GSA v i ~ M-~ AR ,CO ~ Ml C/~.~.c,i'iUr ' :1 `~i s i /ooh /~os7 _ r 1'~' ~ 1 1 _V'r"'~~' ~ ~ 2 Li96 ,Ro~7s ~o A~~'~.~ f.9C,E' ~~~f h • •~f ~ j ~ ~~.,`~,~~~~.~a2~:....{xa?.'I BOARD OF AEALTH . l~'J i FORM N0.1 3 SETS OF •PLANS • • SURVEY . TOWN OFSOUTHOLD CHECK . SI.DO.D6PT. BUILDINGDEPARTMENT SEPTIC FORM TOWN OF SOUTH LD TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY _ TEL.: 765-1802 CALL MAIL T0: Examined ~GG e ~ 19`~1~ Approved ...4/~ 19~t! Permit No. ~1`~~ ~~~,I'~ I d Disapproved a/c D r~~~~ ~ BLDG. D F'T• 'f~WN OF SOUTHOL But ng Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . 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 Depaztment 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 removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins a tons: (Siggature of applic~ or am e, if a corporation) (Mailing address of applicant) State whethyerr;~, ap131id'ant, is owner,.lessee,~,agent;' ar'Chltect, engineer, general contractor, electrician, plumber or builder. • / Nameofownerofpremises .o~.C;Ct~ss-n 1,,,,1~,• ~~!('...~.Gffn.~%...,.,?~J.l~I2!J•••••••••••••••••••••• (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. ~ Piumber'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 County Tax Map No. 1000 Section I.~~....... Block • • , , , , , Lat 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 ~ W I l 1~.~ . b. Intended use and occupancy t~Cl :E. • • ~.1..~C;K . , . . 3. Nature of work (check which applicable): New Building Addition . t! Repair Rempval , Demolition Other ~~~7~~C~ 4. Estimated Cost Fee ~ ~rr~~•:f,°a, :=.,t": .P, . . (to be paidling this ap ication'~""" 5. If dwelling, number of dwelling',units . Number of dwelling units on each floor . If garage, number of cars . . 6, If bysj~ss, EQB11r~~F.Sd~ p~Ip.?xed occupancy, specify nature and extent of each type of use . 7. ~lfn~tis~d)1~~~ f esisYitizg`.`ste~ures, if any: Front Rear , Depth . ~~ioht ~Ittnjber of Stories . , . P , .f . 4th alterations or additions: Front Rear , . pim~h si it cture w • • Height Number of Stories . . . " 8: Dimensions of entire new construction: Front Rear , Depth . Heighx . Numjber of Stories . 9. Size of lot: Front . , .I~ , Rear Depth . 10. Date of Purchase ...........'i . . ............Name of Former Owner . p misesaresituated 12. Does proposed constru thou violate any zoning law, ordinance or regulation : . . 13. Will lot be regraded . Name of Architect I ' ' ' • R'~ll excess fill be removed from premises: Yes No 14. Name of Owner of premises ...~li Address , ........Phone No. a9~:-.~"8/.`~ . ................Address..,........,.......Phone No. Name of Contractor .Address . .Phone No..... . IS.Is this property located within 300 feet of a'tidal wetland? *YES....NO.... *If yes, Southold Towrti 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 ~~G~ G ~ PA~C~ pCCV ~~~~~uL ~5E ~ C~R"tlF1CA~"E ~II~~®~ ~A~y ®CC~ ~r STATE OF NEW YORK, S COUNTY OF i (Name of individual signi • • • ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant ng contract) above named. He is the I'~, ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly, authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this ...............c~/.,J,~.....d-ay/ofJJ~~ , 19~~ Notary Public, ...~~{.~f~iN/.. ^:(~il~...... County NEIEN K DE VOE uy~e'~~~ ' • ` ~ . N6TARY PUOLIC, Shte of New Yak (Signature of applicant) No. 4707878, SuNdk County Tam Expires Meren 30,19._..