HomeMy WebLinkAbout17345-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17341 Date SEPTEMBER 22, 1988
THIS CERTIFIES that the building ALTERATION
Location of Property 370 DOGWOOD LANE EAST MARION N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 38 Black 5 Lot 3
Subdivision Filed Map No. Lat No.
conforms substantially to the Application for Building Permit heretofore
Filed in this office dated AUGUST 10, 1988 pursuant to which
Building Permit No. 173452 dated AUGUST 22, 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 isALTERATION TO FINISH SECOND FLOOR OF ONE FAMILY DWELLING
The certificate is issued to ANDREW J. FANIZZI, .7R. & ELEANOR FANIZZI
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N204902-JANUARY 21 1975
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
F08M NO. D
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N o 017 3 4 5 Z Date ...i?~~/?~;.~ RSC7.~ 19.1~~
Permission is hereby granted to:
..............~.....~ti~a~
......p...........~~..~:t.-....~..~,r
to ..........G~f~:~~Y3.~ ........~.....1%L................
..................oz:I.~
~ L~ .
at premises locate at 7 .......J..Y
...............................~~....°~r..!.........
.............................................l...l...%..3....~........................r....
Caunty Tax Map No. 1000 Section Block ......l:T Lot No....~................
pursuant to application dated ...........~e~ 191. f, and approved by the
Building Inspector.
Fee $...~~!..d~~...
7,, ~
~ ~di" ~'p
Building Inspector
Rev. 6/30/80
ti ~ i.
FORM NO. 6 r D
' TOWN OF SOUTHOLD
Building Department
Town Hall ~ 2
Southold, N.Y. 11971 \
765 - 1802 BLDG, DEFli.
APPLICATION FOR CERTIFICATE OF OCCUPANC T VJN pF SOUTHO,.,.,„•.
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec-
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. ~J-
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 Dwellino,$25.00, Accessory•$l0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, oven 5 yeazs $10.00
. 4.Vacant Land C.0. $ 20.00 ee~~
S.Updated C.O. $ 50.00 Date ........l.~ ~b.~,~~.....
NewConstruction y/,Old or Pre-existin Buildin Vacant Land
• 9 9
Location of Property 7 , , ,~,Q,(,~,WO~p , L,~q.y~ ~jq S,?P; , M,~ 2lrJ n/
House No. Street ~Hamlef
Owner or Owners of Property , ,~:ov;LtlZ~,1%w, ,FigN/ `Z-Z/. P~.: , ~r,,~ (t/ r .
County Tax /Map No. 1000 Section ~ , , , , , , , , Block Lot /~y , ,
Subdivision 4~L~. a;~-^", , , , , , , , , , ,Filed Map No. , ,Lot No, . ~ , , , , . , '
Permit Nop.~ 7.3.`f $7Date of PermitCa~,~:?-~~,gpplicant .1,q~,a,+•;~;~; , ,~'d;~;?~~:
Health Dept. Approval . .Labor Dept. Approval
Underwriters Approval .4is:G44~%"','~r. , ...Planning Board Approval .
Request for Temporary Certificate , , , , , , , , , , ,Final Certificate t~ ,
Fee Submitted $ ~".J~~.'f ~.C~• • • , ~
Construction on above described building and permit meets a/ll~applicable codes and regulations.
Applicant a~,~~-
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Memorandum from .
BUILDING INSPECTORS OFFICE
~ TOWN OF SOUTHOLD
TowN HALL, $OUTHOLD, N. Y. 11971
765.1802
Sept. 15, 1988
Dear Mr. Fanizzi:
Please fill out the enclosed application
for your Certificate of Occupancy.
Return it along with you check for $25.00.
Also if any electrical work was done you
will need an underwriters certificate.
Thank you,
I
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ICI
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BOARD OF HE~ILTH
3 SETS OF PL.1NS
FORM NO.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC PORDf
TOWN HALL
SOUTIiOLD, N.Y. 11971 NOTIFY
TEL.:765~1802 CALL
Examincd.4"":~4.~.nn.^.,.,19~1pY MAIL T0:
Approved ,~d~..., l~p. Permit No..~.~,~,y:-~Z-- n~ //7
Disapproved a/c ~2~ ~'tG~. ~G
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .~'~~.~..L.~~......, 154
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate piot 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 Department 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
Re;ulations, 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, housinti code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspectiG~~
l:: ~ Q~i(~~/~
~S gi O,atiire of app cant, or nam tf a oi; rporauon)
' (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............Q.c,~. N c= ~
Name of owner of premises ~!~R~?.~!~ ~~!?.I;~:Z,I„v,2,,, f`~N~~/~T.~,,,,,,,,,,,,,,,•••.••
(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. ,,~'C .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . . .
1. Location of landy~on which proposed work will be done . .
House Num bcr Street ~ ~ ~ • " " " " "
' Hamlet
County Tax Map No. 1000 $eet10? Blpck ~ , , , , , , , , , , , Lot ~ .
Subdivision ..~a2 Q,livz;/Z5 ~~,~J.~. ~~r, Filcd C\tap No. ;C~ Lot ~ 1. .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S ~ .~i.~?.G-~'-
b, Intended use and occupancy ~ c p--
3. Rehr of work check a•hichlapplicable): New E3uilding '
( • • .Addition Alteration
P • • • • • • . Rcptoval Demolition ,Other work . • . • • • • ~ • •
4. Estimated Cost ~~,r/0.~~ . , . • . • • • • • • • (Description)
. Fee . ~S/ r~~Q .
5. If dwelling, number of dwellir; (to be paid on cling this application)
g units . Number of dwelling units on each floor ,
If garage, number of cars .
6. If business, commercial or miycd occupancy, specify natu~ a and extent of each type of use . . .
7. Dimensions of existim~ stru NUres, if any: Front , ,'?F, 6, Rcar 6 ~
Height , Depth ...~:'.b .
ntberofStorics.......~.~?
DD`mtlnsions~ fame structure with alterations or additions: Front . , , 1~,6 , , , , , , , , Rcar ,~j,~
r
8. Dimensions of entire new cons} • ' Ilcight , , , , ' ' ' ' •
" " • • • • . Nurrrber of Stories . ~ y'? ; ,
tntction; Front , Rear , • • • ~ ' ' ' ' • ' '
Hei°ht .Number , , Depth , .
of Stories .
9, Size of lot: Ftont ..1 Q..0,. ! Rcar • .......g 6 .r......... Depth ~ .
10, Date of Purchase q -T- 6 F3• • • • • • • • • • ,
' ' ' ....Name of Former Owner ~t42.k~n'~Ks, .Q ,
ne or use tstrtct m which
P p remises are situated
12. Does ro osed constructton vt'
polate any zoning law, ordinance or regulation: .
13. ~Villlotbere~raded d
° • • • • • • tiVill excess fill be removed from premises: Yes No
14. Name of Owner of remises b , , ~7`arywr zzr y' 7-ki )
p ~ • • • • • • . •2 Address bda wnoDl,~.. L .I!? •Phone No. 7?:',USi 8
Name ofArchitcct ,Address .
Name of Contractor. ••••••••PhoneNo
IS.Is this property located within 3100 feet of a tidal wetland? *YES....NO..OC.
*If yes, Southold Town Trustees Permi[dmas be "Phone No
PLOTDIAGRAM required.
Locate clearly and distinctly alb buildings, whether existing or prpposed, and. indicate all set-back dimensions from
property lines. Give street and blocll number or description according to, deed, and show street names and indicate whether
interior or corner lat.
i!
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it
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STATE OF NEw YORK,
COUNTY OF S'S
(Name of individual sip Ili • • • • • ~ • • ~ • • ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant
°ni~tg contract)
above named.
He is the , , • •
• . . ..I, , , (Contractor, agent, corporate officer, etc.), , , , , , , • , • • "
of said owner or owners, and is duly',autltorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
work\vill be performed in the manner $et forth in the application filed [herewith.
Sworn to before me this
.................19 day of.! ~g
19
\otary Public, , , , , , , , ,i~ L , , , , , County ~
NELEN IC DE'YOE • r~ I~~ :t,~~_ • • : ~ r&T'~~~7i17,p-y .
NOTARY PURtIf„ State of New Yak , , • • .
No. 47U7S'7S. SuNplk Cou
Term Ezaires Match b0, t4 (Signa[ure of applicant)
i