HomeMy WebLinkAbout17487-z.- .
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22865 Date FEBRUARY 7, 1994
THIS CERTIFIES that the building ADDITION
Location of Property 630 CEDAR DRIVE SOUTH EAST MARION, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 3 Lot 11.15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 29, 1988 pursuant to which
Building Permit No. 27487-Z dated OCTOBER 4 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 GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to MICHAEL & PAMELA ACEBO
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-260384 - DECEMBER 16 1992
PLUMBERS CERTIFICATION DATED N/A
Bui ding Inspector
Rev. 1/81
n~osas 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 U ~ 17 ~ 8 ~ Z Dote ....~. ~~!~h~........T .................. 19.~.a.
Permission is hereby granted to:
.~~~:.~~~.....~?:.~:.....i± J..9..~.9...
at premises located of
:......................................................
County Tax Map No. 1000 Section ......x.31....... Blockq......Q...~....i.~~pLot No....~~.:.~.5^........
pursuant to application dated ..~4.::::'>.`.~`1+....`~~...1........., 19..~f..4., and approved by the
Building Inspector,
Fee $.~ .:.............
~~ ~
..............................g..~.................................
Buildin I actor
Rev. 6/30/80
.~4
Form No. 6
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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 Pire Underwriters.
~ 4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of l~ 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
L. 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 Euilding - $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
Date ..FC:''...~'...!9~i~ .........................
New Construction.......... Old Or Pre-existing Building .................
Location of Property... ,630 ....... .. .... . CcpA2 Opp/~ soor4, ..... , .... ~AS; w~t~~r1 .. , .. ..
... .. . . .. .......
House No. Street Hamlet
Onwer or Owners of Property..:"~~'`~ PR~^nr~-1R Acc30 ......................... .............
County Tax Map No 1000, Section... a31.......Block..... 03...,....Lot.,,,,l,ll5
Subdivision.ulb~?o~Ni.cllSSwtA(Lion~ Sr~ci 2 ,,,Filed Map............Lot.....~.~ ..............
Permit No ................Date Of Permit................Applicant.r:'~IS`.iS':L.~.3.~. ... ..
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate.. ~.....
Fee Submitted: $...2.~ .......................
~.~., ~(7/~~~777 ..... .~-~ Q~,~ ..........................
" ~ .~. APPLICANT
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~~VAI Uf CONSTRUCTION ONLY
ENT-DATA FOR APPRONIL TO CONSTRUCT
NI. $ RlO VRCi Or WAT[R~ IRIVITC _PVRUC_
r~oD ucnDN OJI AIncN 97_LOr 11.14.
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SURVEY FOR „
MICHAEL J. ACEBO & PAMELA S. ACEBO
LOT 44, IIHIGHPOINT AT EAST MARION, SECT. 2"
AT EAST MARION onrE~
TOWN OF SOUTHOLD scALE1
SUFFOLK COUNTY, NEW YORK No.
N UNAUTN01112 C0 ALT[RATI ON OR AD D1710N TO TH17
lURVEY R A VIOL AT10N Or lE CTION 7200 OF TNC
NEW YORK STATE COUCATION LAW
M COPIES OR TN13 3UIIVEY NOT ~f.AR NO TNC LAND
lUR VCYOR•3 INNEO SEAL OR CNR03l ED 3CAl !MALI
NOT 1E CONSIDCREO TO RE A VALID TRUE COPY
NOUMAMTQS INOIGTCD N[nCON !HALL nUN ONLr 70
TIC PCRION POR WNON THE lURVCY IS PREPAR CD
AND ON NI3 OC NA LF TO TNC Tl tl[ CONPANY100VF/1N-
N[NUL AOCNCY AND Lf NpIM6 INl TITUTION LIlTCD
IIERE 011 AND TO TILE A3310N C[S Or TIIC LCNCIYO
FEB. 6 , 1987
OCT. 3 , 1985
111 = 501
85 - 1009
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG,
DATEy~ INSPECTOR
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ INAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS frtc~~..~
if~N1041i~ BUREAU OF ELECTRICITY
83 JOHN STREET, NEW YORK, NEW YORK 70038
Date P>fiS:F1P1NiaR 1Fir)t1t37 Applica[ionNo.onfile (~3r3@C99219"L 4P :?6N39n
THIS CERTIFIES THAT
only the electrical equipment os deacri6ed below and introduced by the applicant named on the above application number in the premises of
~il'CtlAl~t= OCEEIi), fi3~ ~:FD+Ift 11N1Vut Fi~hrT C+i~r;]:ON, N. Y,
in the following location; ^ 8oaement ^ lat Fl. ^ 2nd Fl. ~ ~~ .Sert(on Block Lot
)}f~''(.~fi f{F Pi la Q1~ra.~yl ¢nd ound Wbe in eum lianre with the rer uiremenLcq this hoard.
uqa examined art f p ( l
RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
FIXTURE
ECEPTACLE$ $W17CHE$
OURET$ INCANDESCENT FWORESCENi OTHER M1i K. W. AMi K. W. PMi K W, AMT. K W AMC M, P.
3 Fl 1 i
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPEUAL REC'PT TIME CLOCKS ggLL UNLT HEALERS MULtI.OUTLET DIMMERS
AMT. K. W. Oll H. P. GA$ H P. AMi NO. A. W. G. AMT. AMP AMT. AMPS. TRANS. qMT H P. SYSTEMS
NO.OF FEET AMT. WAIIS
SERVICE DISCONNECT NO.OF $ E R V 1 C E
AMT. AMP. 1YPE METER
EQUIP. ~ ~•YW ~ A9W 3,d 3W 3,e' 4W NO. OF CC COND.
PER ,e A W. G
Of CC COND NO Of H4lEG A' W G'
OF H4lEG NO OF NFUTRALS A W. G
OF NEUTRAL
OTNER APPARATUS:
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AR~'41UR V. 7CiNCr1;' 1,"t.C, R2.1 ~2
ERAL MANAGER
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C(Itlt"I~~CrUEI r NE r 11935 ~ G
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This certificate must not be altered in any manner; return to the office of 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.
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U,Y BOARD OF HEAT TH
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~ TOWN OF SOUTHOLD SURVEY
CHECK ~•
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BUILDING DEPARTMENT SEPTIC FORM '-:'.. _ ... , ... ;
TOWNLDG pEF,i
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OF TOWN HALL NOTIFY
SpU1}
IpLp SOUTHOLD, N,Y. 11971
TEL.: 765-1802 CALL
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Approved . 4"c~':v,x~y ..7.., 19~} g . Permit No. ~ ~ .`~ ~.? . ~:
Disapproved a/c ................ ................... .
.............................. .... .
............s.~a-d oc.c- d~---.,
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ~jrP?:..21........, 1989.
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 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
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 inspe t' ns. ~, 4
( 5nature f applicant, or name, if a corporation)
P,o,~ax X37 FJ~.~T wwc,u~l ~~~ ng3~l
..............................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
O w..l erg
................................................................................................
Name of owner of premises . 4'!~! ~''!A~i-..'}. P~~"`.F~... AcE&o
................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
..............................................
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No. ... ~.'!~.N~?~ ............. .
Plumber's License No. .....~ ................. .
Electrician's License No. `.-i.~ !`! ~~
..............
Other Trade's License No. IN. /'1 `.1S 1 p F , , , , , , ... .
1. Location of land on which proposed work will be done . ................................................ .
... 63~ ....................C,r.AA2..0¢~~t~...So~~~.l........... F~5~... ~~o~l
.......................
House Number Street Hamlet
County Tax Map No. 1000 Section ....03~.......... Block ...... ~3 ........ Lot ....~ ~; ~ ~, , , , , , . , , ,
Subdivision 4~16NP0~~1,1„ ljT.. s:AST.. wJ~2tOn1...S~C'r 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 ... SI^16uc..:YAt"^iLY DwE~1.{~.IC~ ~"d~,fi#~..t3g{~,.t'=
............ Yt10'{' lA i4 6f W~ ,JDs E{~+3 vgYpv~ ............. .
b. Intended use and occupancy .... C'A ......................... `*""'a °; rs,ri?tr~? ..; ;.,:<t,:,.,.~; ......... .
• • . "if ~., ~F • 1 .s t ~ . •
,. ,, - ,.~.w ~
,,.~
3. Nature of work (check which applicable): New Building .. ~'"'..... Aad;t;on ..X...: iterat.o„ ......... .
..... Remov
Repair ........ , al ..... . ........ Demolition .............. Oh ~k .............. .
1•°`_* _ (Description)
4. Estimated Cost . ,~IZioo0.. t.l ........................ Fee ................... „ -
(to b~ paid on filing this"~ppIication)
5. - If dwelling, number of dwelling units .. - ........... Number of dwelling units on each floor . "" ............ .
If garage, number of cars .... zi ................................................................. .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . , .-- ............... .
7 Hei'ghtsion~s~of existing stru Numb if any: Front ...... `,R~ .... , ,Rear ...~0......... De th .. ~? ......... .
~ p
er of Stories .... ~! .............. . ...................... .
...........
Dintensions'of same structure wit~t alterations or additions: Front ....... . ......... Rear ................. .
ept .........
Height .../.R ..........Numb Height ..... '., ... , .,,..........Number of Stories ........... , y ........ .
8. Dimensions of entire new / SOniotion: Front .....aO..:::::: Rear : ; ::.26? : ; :::::: Depth :: a6; :: ; :::::
er of Stories ...... ! . .
9. Size of lot. Front ...... Rear.....,llo,,,,,,,,,,,,, Depth ..25,`t,................
10. Date of Purchase ... !`!~s ...................... Name of Former Owner .tJFkti . "^~4€4•............... .
11. Zone or use district in which premises are situated ..~ ;~t44~... FAw~4~(, , ,Ow~u.lNCS , , , , , , , , , , , , , , , , , , , , , , , , ,
12. Does proposed construction violate any zoning law, ordinance or regulation: .. X14 .......................... .
13. Will lot be regraded ... ,yq ....' ............... . .Will excess fill be removed from premises: Yes ® '
14. Name of Owner of premises M~(w~ru, d, , Wjwew!KE'~oAddress 3~K:?3?. f??~. `."^4?-1O^) , ,Phone No.4Z~ `~6z,8, , , , , , , ,
Name of Architect 4RA!~!H .3'C..o'it^.+E?, ...........Address ...S?~~F............ Phone No..S?~~C......... .
Nazne of Contractor Ry!cT. ~:~, aWN~ :............ Address ... ~+"+~ ...........Phone No.. S?-.""~........ .
15. Is this property located within 300 feet of a tiidal wetlandY *Yes ..... No X ..
*If yes, Southold Town Trustees PermitPLO~ DIAGRAM ed.
Locate clearly and distinctly all }iuildings, 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
SEi,~. ^J~RJif.`r Cv?`~
STATE OF N YO , r
COliNTY OFE~~~~.1.~~.. , ~•S
• • • • • ~)~`•~~•t'• •~' • • ~'C`~"~ ' • • • • • • • • • • ......... being duly sworn, deposes and says that }te is the applicant
(Name of individual signing contract)
above named.
(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 ttte
work will be performed in the manner',set forth in the application filed therewith.
Sworn to before me t-hiys~
...............~~day of ....„ 19~.~
Notary Public, ..1,./,~,-'„r'~-r/t,l'• . .. ... County I//~~~
NcIMy MIbNe, 4 ~tIMM'VaAt . i~ ~~~~(.`~ Y:- :............................ .
n...rs.w~~re..w ~ (Signature of applicant)
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TK [yttinrb SURVEY FOR '..
r oFF4xtmENr of MEAE MICHAEL J. ACEBO 81 PAMELA 5. ACEBO
lAT 44, IIHIGHPOINT AT EAST MARION, SECT. 2°
FEB. 6 , 1967
~JVAI OF CONSTRUCTION ONN ~qT EAST MARION 047E OCT. 3,1985
SOWN OF SOUTHOLD SC4EE= I' 50
' U5 REF. NO._ --- N0. B5 - 1009
--~--- SUFFOLK COUNTY, NEW YORK
--~___.__... ]U~VlY ea11 vC0.4npH nCf fecTDlOx o1 9NDF TN[ Ia ~' St Fj F, OF iVt.w ~ -
MEN TOIIK STATE CWCITIOX U'~ ~
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]Vn VCY011] IMKEO lE1L On CHEOS]CV ]UL ]HALL O~ r0 pt
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MOUAKANTLU IMDICAtEp N[11CpX LIALL nUX dlY lp .j
ENT-0474 FOR APPRONIL i0 CONSTRUCT TN[ rcn]Dx [Dn WHOM rH[ mnvn a HKEnn[D ~,
AMO d XI] KHALi RI THE TIiL[ CWFANT.OOVGX-
`X NLS KfDUKCC CC MATLA~MIMTC_iV0.1[_ NCXTAL Ap[NCT AXO L[NOIN6IN]iITUT10x Ll]iC0 ~I
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