HomeMy WebLinkAbout23550-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24506 Date JULY 17, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 3295 PINE NECK ROAD SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 6 Lot 20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 11, 1996 pursuant to which
Building Permit No. 23550—Z dated JULY 1, 1996
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 WALTER GREEN
(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
YORK NO. 2
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 Z � .../........................ 19�.f7
. 23550 Date ................��.
Permission is hereby groat
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to
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of Premises located at ...............L .. /(..�...1. GlF,..._/.� t�...<`T. ..:.............................
.` 6J. ..................................................
......................................................................................................./.._.......................................................
County Tax Map No. 1000 Section .......... f..... Block .....So.........../Lot No. .�.!e..........
pursuant to application dated ...................� 1.- ! Q..`!........., 19.I..51�, and approved b the
Building inspector.
FeeS............ ............
11-57
......... . ............................................. ...................
Building Inspector
Rev. 6/30/80
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Town Hall, 53095 Main Road p • Fax (516) 765-1823
Southold, Now York 911971 At �.a�� Telephone (516) 765-1802
�
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 15 , 1996
John Bertani, Builder
1380 Oakwood Drive
Southold, N.Y. 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is not on file. ) ;25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file .
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23550-Z (WALTER GREEN)
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
FIELD i=PECr ION REPORT DATE COMMENTS
--------------------------
ii
II I! H
FOUNDATION ( IST) II II
II
FOUNDATION _ (2ND) --__-_ -_0 K
------ ----- -----
---- -----------
Ii
II
� I
II
ROUGH FRAME 6 Ij II
_JI-------'--------��_------ ------ -
„_.___-_- it
PLUMBINGit
n------ ------------- -----------------------
It
u �
11
II III
7------1------- ---------------
INSULATION PER N. Y. n ii
STATE ENERGY
n n
CODE
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u n
II u
FINAL I it
it
ADDITIONAL COMMENTS:
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------------ -------------- --
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ro
765-1802
BUILDING DEPT.
INSPECTION
[ .f FOUNDATION IST ( ] ROUGH PLBG.
[ 11 FOUNDATION 2ND [ ] IN ION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: Ot .� 7A r�
DATE INSPECTO
{iID Il U 15 R FORM N0. 1 ] SETS OF PL.1.7S
Mc f TOWN OFSOUTHOLD SURVEY .
JUN � f ICAB � BUILDING DEPARTMENT CHECK . . . . . . _ _ _ _
4 TOWN HALL SEPTIC FORA . . . . . . . . . .
BLDG.DEPT, SOUTHOLD, N.Y. 11971
qpW OFSOUTHOLD TEL.: 765.1802L t:OT I FY ;
�1 CALL
Examined , . . /. �. . . ., 19//� { NA I L TO
Approved . . S/. . . . . . . , 16' . . Permit No. ✓ � _ _ . . . . . . . .
. . . . . . . . . . . . . . . .
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Insp tor)
PLICATION FOR BUILDING PERMIT (/(
Date :J C LJ� k . .I I,. . . . ., 19�
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,wit
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 stir_
o...r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap
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 peii
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 Occupa
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
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessaryinspection,�j,, T
I d
(Signature of applicant, or name,if a corporation)
: . . . . . . . . .
(Mailing address of app scant)
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builde
Name of owner of premises . . . . . . . . . .l. . .1 ?. . . . l^r. .Q 1 . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation,signature of duty authorized officer.
. �.
(Name and title of corporate officer)
Builder's License No.,.'. . /c1 t 1 f • . . ' .
Plumber's License No.
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No.
1, Location of land on which proposed work will be done. . . . . . . . . . , . • . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .LI�-R._. Yom+?.( � . '." l.� . . . . . . . . . . . . . . . ?l$ ! . . . . . . . . . . . . .
[louse Number Street Hamlet
County Tax Map No. 1000 Section . . . . . .
' �!! . . . . . .: . . . Block . . . . . . . . . . : . . . Lot . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . Filed Alap No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . .
(Name) ,
State existing use and occupancy of premises and intended use and occupancyofproposed construction`.
a. Existing use and occupancy . . . :. . . . . . . . Q't . . ! IY�`1�. !4T, l,tlt . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy . . . . . . . . b m l': . .��we i l l . . .. . . . :. . . . . . . . . . . . . . . . . . . .
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteratio�t . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . Other Work . . dX,6_1(,
' (Descript.
4. Estimated Cost . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application;
5. If dwelling,number of dwelling units . . . . . . . .1, • • , • , , Number of dwelling units on each floor . . . . . . . . . . .
Ifgarage, 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 ofStories . . . . . . . . . . . . . . . . .,: . . . . ...
I. . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . : .. . . . . . . . . . . . . . Rear . . . . . . . . . . . . . .
Depth . . . . . ... . . . . . . . . . . . . . . . Height . . . . . . . . . . :. . . . . . . . . . . Number of Stories . . . . . . . . .
S. Dimensions of entire new construction: Front . . . . . 0. . . . . . : Rear . . . .o?ld. . . . . . . . Depth . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . u�•. 1 :. . . . . . . . . Rear . . . . 1.3 . `{ . . . . . . . . . . . Depth . . .�� �. . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . ." . . . . . . . . . . . , . . . . . . . .
11. Zone or use district in which premises are situated . . . . . . �c St.�4 Cv.�c4,t, , , , • • • • • • . . • • . • . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . . .n D. . . . . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded . . , . ' 00 . . . . . . . . . Will excess fill be removed from premises: Yes t
14. Name of Owner of pjxmises J�.I° S 6 CG-n-?: . , . . . . Address 3Q5 wdj.�-,&AA _,? .`( -Phone No. 212 4Q O10
Name of Architect .tVA+_ "4- .���P.4 Address . Q � e. .3 . . . . . . Phone No.�S�.C:�B?:. .
�ol�r. . 1� t� . . . v0 . . . . .;
Name of Contractor : e-S ! . . . . . . Address 13d1�0A, "lk �_ Phone No. 7NC-. �, , ,
15. Is this property within 300 feet of a tidal wetland? *Yes. . . . 9.1 No. . 'S . . . .
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions frc
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or corner lot.
��. (J-•� 1 t�•t i��
;TATE OF NEWORK, S.S
:OUNTY/ OF
. . . . . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
bove named.
e is the . . . . .•. . . . . . . . . . . . .G S1C e0f-0 V:_. 0.4'i7C ez�. . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . ... . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc,)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
'Plication:.that all statements contained in this application are true to the best of his knowledge and belief;and that the
ork will be performed in the manner set :forth in the application filed therewith,
vom to before me this
. . . . . . . . . . �.� �' . . .'. . .day of./. . �: UN�.. . . .•. . . . ., 19 �1�
)tary Public, . . . . . . f t�l , . . .\. . . . . . County,
� G. -�. . . . . . . . . . . . . . . . . . . . . . . . . ..
HELENE D.HORNE (Signature of applicant)
Notary Public, State of Now York
No.4951354
Qualified in Suff c-County 4!-`7
A.
CREEK
SURVEY OF 4979°30'40"E
PROPER T Y 13.94
A £R MARK
A T SOUTHOLD o
TOWN OF SOUTHOLD N WOODEN 6 WALL
SUFFOLK COUNTY, N. Y. "" WAI
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1000 - 70 - 106 - 20 Dw
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Scale 1" 40' O.Z,W FND FND
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Feb. 22, 1990 MON PSE
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Z:i
LANA
F NECK ROAD
N. .,6 L/C. NO. 49888
Prepared in accordance with the minimum PEC 6�d P.C.
aiandardi for title surveys as eslabNahed (5 18)
by the L.LA.L.S. and spproved and adopted ` P O B W
for such we b The New York State Land MA/N ROA
Title Assochillon
SOUTHOLD, N.Y. 11971
90 - 114A
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Ex15TIvJG HOUsg
it Eki5T1/.1C,. HOUSE
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APFASNOT�D r
DATE: a 35-3"�j
FEE:
NOTIFY BUILDING OF/
I
765-1802 9 AM TO 4 FOR THE
W FOLLOWING INSPECTIONS:
O
1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE
2x10 NDvSE BM W� — Neo fl er - 2. ROUGH - FRAMING & PLUMBING
2F2 LC�cy�R 3. INSULATION
5 F6 uR CkdrtE CECK --111`_ — 4. FINAL - CONSTRUCTION MUST
LL _ BE COMPLETE FOR C.OALL . �r
----- - --- ---- THE gEOUiREME VOTS OFALL THEMEET
Lde
PbLT _ STATE CONSTRUCTION & ENERGY
V AST _ CODES. NOT RESPONSIBLE FOR
yr
DESIGN OR CONSTRUCTION ERRORS
I I coQ I'O'k ''-0"
. oNC. ' F7'ti, f
f
OCCUPANCY OR
USE UN
"f�HOUT C� PUL
CRQSS___ Cl0N L. VATIDI�_
Or OCC
F, UP�NCY�P�CATE
SOHN BFRTANI `BUIL LER T-NC„
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