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HomeMy WebLinkAbout23558-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24740 Date NOVEMBER 15, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property_ _5650 BERGEN AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 7 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 1996 pursuant to which Building Permit No. 23558—Z dated JULY 3, 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 ACCESSORY STORAGE SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to LISA MARIE LOBASSO & ORB. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A "'�L )- Z& it ig Spector Rev. 1/81 IOEM NO. 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° 23558 Z Date ........... ........... ... ................... Permission is hereby granted t 1.4 er1e. G2.£1 �............ �?b.. ?...../ .,...................... to . .4Poar kaAf ... .c„vi.. at premises located at ......... lr.�rd........t.... ...l ..................`.:...--........................................ .............................................................. ......................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section ......(l`�,....... Block ...... ............ //Lot No. .5�................. pursuant to application dated ................ 1.7..............., 19.�1a, and approved by the Building Inspector. � Fee 5• / •••' •• Building lnspectar Rev. 6/30/80 ' Form NO. TOWIN Or SOL-IHOL , TOWY HA_.l 4 In^S 765-i klL.tl;G. DE PT. TOWN OF SOUTPOLD ions IC TTO� FOR C:�.T=_.C?- OF OC=AN(,-7 — __.is app'_ica=ion must befes__ in by t,pewriter OR ink and suhmi=ted to the building i=spectOr =_ the 'aliDc-ng:ten=or aeW builc_g or new use: 1 . =izal survev of property w=th accurate location o' a'_1 buildings, propertc _'_nes, streets, and L•nL'sIIa'_ natural or toDograpE c features. _. ial 3pDrOS%2: from Hez=a Denc. Or avatar SDDnIy and Sewerage-aiSpOsal($-9 form) . Approval of elec=rz.cal instar;.anon _tom Board of -_re underwriter. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2i'10 of lead_ C. Commercial bu d sg, iadustrial building., multiple residences and sizi-ar bu sings and imstallarions, a cert'-ficate of Code Comniiance from architect or engi-ieer responsible for the bu:ldimg. 6. submit Planning Board ADDrov` or cotyle=ed sate Dian recuiremears. U. For gals=i g builcizgs (per Or =., :aril 9, 1957) non-con=orming uses, or buildings and "v_ re-eg-sting" land uses: 1 . Accurate suet' of properryshow=nga11 _ roper=v 'lines, streets, bulldiag and unusual natural or =opograp'nic =aatures. ^_. Aproner comnletee apnlicat'_on aac a consent =D inspect signea by tae apnl--ant. := a Cer= scat_ Of Occupancy is de _ed, rhe Bu lag =nspector shall state =he reasons =herefor in a--_ting the anD_=cant. 1 . Cerrificate of Occupancy - New dwelling 525.00, Additions to dwelling 525.00 . Altera=ions t., cwellirg 5^--5.00, pool 5-25.00, Accessory bu_diag 5^_5. 00 , Additions t., accessory build:Lmg 535.00. Businesses 550.00. 2. Cer=_=irate^of Occupancy on are-e-as=ink 3uilci-as - 5100.00 3. Copy of Certf.:lcatz of Occupancy - 25c 4. Updated of Occupant- - 550.00 5. Temnorary Cer:Ificate oZ Occuvancv - Res-den=ial 515.00, CDmmercial 5'_5.00 . / Date yew Construction. . . . 5! . . . . . - C1c 0r ?re-sting Bu_c-a g. . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..ocztion of ?roperry. _ ..��.5J. . .�L /� . . . . . .. . _ . . . ./ -4:M TY.W i . . . . . . . . . . . . . . . . House No, street Hamlet awer or Owners of ?roperrv. . rr. CS<? .oc . . . . . . . . . . . . . . . . . . . . . ;ounty Tax Map No 1000, Section. . I. .dosis. . . . . ?. . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . ,ubdivis_on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Man. . . . . . . . . . . .Lot. . . . . . . . . . . . . . e mi= No. . . . . . . . . . . . . . . .Daze Of ?e:.,_ic. . . . . . . . . . . . . . . .App3icant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . :ez_=h Dept. ADDroval. . . . . . . . . . . . . . . . . . . . . . . . .unde w-iters nDrova: . . . . . . . . . . . . . . . . . . . . . . . . . �aADDrOval. . . . . . . . . . .. . . . . . . . . . . . . a,-.ing Boar,', eauest f.,r. 'e�pora/r7^v' /„;e/=�=-=c==e. . . . . . . . . . . __ - Czrt_cZ:mS///. . . . . . . . .__ JL'Dm:=tad: �.�v' ! .YN . . . . . . . . . . . . . . . . . C���/•�+�l.E!' . . . . . . . . . . . . . 6". 5QJV� . . . . . . . . . . . . . . . . . . . 03 -�g7gt A»L =--:,. FfEI.O �`NSPECTION REPORT DATE COMMENTS `d FOUNDAVON, - ( 1ST) -- II --G-------'---- --------------------- ------------- ` I II II FOUNDATION -_-(2ND) I� p II ROUGH FRAME 6 PI.UMIIING I tl 11 rn INSULATION PER N. Y. STATE ENERGY u l CODE ell FINAL _ ADDITIONAL COMMENTS: � F tft\ x ro BUILDING oar. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBfi. ' [ ] FOUNDATION 2ND [ ] IN ON [ } FRAMING NAL 2,�Y� �ueus� DATE� INfP�Ci'OR TITLE NO AjJr r: ce , noe �w ENGEN � a60 °° o. 10 3L . N.74 100.00 1 % 3 U) . 4 Z 1 O 4• A to t 1l �;•... �'( MICS r tl_ x ,r `''-g.+f •_., 1 t s1 R TTt:1NOSRYe ; Y y,� a r}'i°�.� (• s ,x+� �,. �.. ._.i- C SURVEY FOR V o '. .'r-.NICHOLAS 81` E 14 CSteASSO ��`I fl z MA . , TTITU.CK li. r � . stK TOWN OF SOUTHO 0� x k fi�gg.. SUFFOLK'CO_UNTy} N, O a9 A°10 ' y ='GUARANTEED TOY: i_:'l+` >.INTER000NTYTITLE GUARANTY jr •-.-.___ }1r1 NDSA( F:? SCALE: I`,°•+{O` 1 ,.ANDMORTGAG[COMMNY � xti f WIl L1AM e4� SEPT II, l967 J��NaAsecAN�oeAsso" rE; i i MONUMENT I LAND IURY[YOit z =: 7LZJ c &07 7- lie GC O �1 / 'f`• 71- 7 44 Z)VqaA 4 0 F S� 11% d w0 40 _ QLL O n7.2 EJ� 3 0 I Y�cf JUN 1 4 PP', 4 i { - BLDG.DEPT. � TD�THQLG J SoAeocr5 X � j2,q IB �t• Lu�w vuiL� �3�C��v�"� 13�t S�ffo . { r i►z„ -�+ �Y}u5 wt wFSc� ce-✓��� f3 y T � � ov��m Bis It [rf 6 ik by J M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSU ON [ ] FRAMING NAL REMARKS: l' . DATE_ 3�INSPECTOR ' 60 0 1KIT UI1 11 P.111.111 . . . . . . . . . . . . . . . FORM No. 1 �I 9ETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SON'f110110 '.'eSURVEY !D I BUILTIINC DFPARTMEN"I' CIIECE . . . . . . . . . . . . . . . . . . . . . . . . . ���•� 4 ��QF TOWN MALI. 'zSEPTIC FORM . . . . . . . . . . . . . . . . . . . I�1.1 j Sourfloid), N.Y. 11971 �?",, /7,r-1 �/r7 'ITC.: 765- 1802 NOTIFY* .� _f `00 / 7 BLD FEST. TOWN p S li H0, 0 .D CALI, . . . . . . . . . . . . . . . . . . R+crnirxzd ... `� MAiL TO: . . . . . . . . . . . . . . . . . . .Apprrrvel. ............................. .. ! ofDisaprr c ............................... ........................................... .. ..... . . (hliI'' Tnnlx>clor) APP . CATION FOR ItUfl.PINC VERr11'r Dole. . . . . . . . . . . . . . . . . 19. . ' INSTRUCTIONS r a. 'this nppl icni ion mist Tip ccmpletply til le<1 in fry l y("rr i for or io ink mxi mtlmittpil tri the Hoi iding inspecln I sol.^. of plans, ncrrrrnle plot plan to scnle. Fro aocordinn In schedule. b. I'lol plan rlxraiop location of lot my] of 1xrildinns ar prr+nises, mIntirmship to ncljoininr pl-mire.^. or Ixrblic streets or areas, mxi giwirry; n ok=lailal rlescript iar n( layout: of property rnrst iledrmm ar the dinRr:m which is Imrl this nlnd icni irm. c. 'IIUp work roimrerl by Ibis a17r1 irnl icm erry ool lip cuull-swed fx'fore issomwe of Ikrilding Permit . d. lllxm npprrvnl of thin nl7rlien11 im, Ihr= Iklildirrf; Inspector will issrx• a IklildinR Permif to The n17rlir•1111 . c;, permit shall In, kept rm the premises awnilable for impecl.i"I throogji is file work. e. No fuildilrf, shall Ire wl-opierl or Itself in wtmfe or in Trnrl for noy p ipogf, wfmtpwer rmtii n (brtifirnte of Ocnq;Irxy slmll have lieeo pTmiled by Uy, Tkrildinl; lnspret"or. A177.I(WUl(N IS IFITRY MAIII4 To fire Ikrildinf; Por"rlurmf for the isscimicr• or a fkrildlop (await porsrrant tri rim Ihrildiop 7cxx_ lhilirmrx•e of flip Tcxnr of Sail"hold, P.rrffolk (sxmly, New York, mxi other applicable T:xws, Ordirmrrces or Rrfnrlat.iam, for Ille crxrstrtxtl icni or Ixtilditigr, Mkm ams or aitntnl.ictus, or for rrmmal or drnrrdil ioo, as herein (k,scrilrell. 'IIx: applicmrl ngrees to comply with all npplicnblp Im+n, ordirmrrr•ps, IxrildinR collo, Ixxlsinr crxle, mxi rrind nt irmn, illy] to :Irinit :nrllxn i>rrl innrx•cl ora on Orr+ni.^.es mxi in Iry'yI7li nnfaRe ennnry inslx=r• 'ems. (Sipmturp or applicant, or Tram, if a cnrlurol.ir, AA07 WESF S_r, 6.'KG y.el x!.11 z (FLaiI hip mklress of appl icant) Slate wle.11mr ipplicant is owner, lessee, nprnt, arddlecf, enf;ioePr, f;pmral ccnd:ractor, electrician, pladler or Ix,i (0 .... l........yy.. ..................................-( .................. ............. N:xm of ornler or prrmises ..L- �S/T. ✓// CJ✓'/..�.:�..�, C7.!' /U..Q/ .!.y?.................................. (as on the tax mil (rr InT:est Apert) Ir 11itAiamrl: is a corperratirxr, sif,mratrn"e of Ally m,U#ori7r 1 officer. ......................................................... (R-Tim mxl title of coTporale officer) Ruilclers Lice"re No. .... ..................... I'Irrrilers License No. ......................... Electricians T.iopnse No. ................ ..... OOrer Trnrip's Licprme Nn. ....... ............. 1. I,cxn(iom of larxi rm which prr>toserl work will Ile <knx=....1.�?.��.. �......`f�,%......�.t(Y..� .................. 1WR-77.71V(7.-W..................................................................................... Ikxmse Mnirer Sl.reet 113 ILmlet C Inly 'rax Itrp No. RX)O Sect iar .� . Block .. .... ...7..., fol ..... %1mliwislar ..... ................................. Filrvl MPvp Nn. .. ... .......... Ixrl ............... (N:me) 2. State existiM use nix) rx-clrparxy . o/f..rrr.nise1n Laxl i/m�pCr�xlerl(llisp�Qnxl fx-arpaxy�of ..mixrsprf,qem�+s'trwctioll: n. Existing Tire, mrd occolilxy ...I.... ... C ......c................................. ...... b. Tnterxlerl ase mxl mcoaxy ... . ... ........... i Rittrie al` wrxk (dick wl+itit ali3licatde): ti. Kai I dial; .......... Acklit ion . .. ... Aller+t ion . . ... ... Ite:lwrir ............ Itruxrval .... ......... Uu+r+l it ion ............ Other lkak ,�. ... .. L .-.-`•-'-`•(I):script icx+)...•. Ij tlL11141LEYI Cost �.�............. fefee .. .. . f oto he Ik+id cx+ filing; Ibis atgil i(:at ion) S. If ckx:lling, tna+feer of rl%x Miry( units tknix:r of ak•x:iling +units con eadt floor .. .. ..... ....... itgarage, axni,er of cats ................... ........... ..... ... S. If lxrainess, trrmuercial or mixed oc:crgrancy, specify awture trawl extent of each type of use... ..... .............. r. Iliueosions of existing sln¢:tares, if ally: FraLL................ (tear ............... Depth .......... ....... height Mnher of Stories .... ... ... ...... .. .... biaensicxts of scale structure vitt+ alleraficxls or acAlitiuns: Pros* ... ............ Rear ..... .......... Depth .................... lleight I. .............. ....�j..��N .. .dwr of Stories .. .......... . n ew 1. Dissensions of entire nctxrstnrticor: FrooL ....o2.I.'7.:.... Ilea, ... ,LafL. Ffi Ik:plh .. �. ... IIJOIL ........�. . r.r_T.J..... Nlni+er of Stories .. ......,C............ I. Sirs of lot: Front. ......(.©/fO /.(-7.... Itear ......���(. ...... Depllna....e—zp i.... IQ. Ikde of Hrrd+au G.E?T..l ./... tkaue of IYrrner (lonerL.!I?S.!�:j.':....... 11. 2rx+e or use dist,ict io +Arida pr'eoaises are situatect ...............................n..�............................. 12. I)o" prolnsetl cousLnrc:Lion violate any nwuaw: nosing la , ordire or regulatAorr: . ... ..!VY I............ t,3. Will lot Ile regralld .................... Wi/lI exress fill lie raanrveil frul� .......... raAlses: YLS NO 17 14. NLzaes of @Ater of premises .44} )Y 1 f7{ Cn it T.SoP.Aess hI / �j �✓ t./ ..... .... PiKxle pk). .. .......... . Nine of Ard+iiec:t .................................... Arklress ... ......... ............ ...... 11"re 1,k,. .. ............ PLne of Ccxrtracfor ................................... !ukl,ess ........... .................... Mr. ... ........ .... ... ....... 15. is this property within 300 feet of a final taeflamul? a YES ....... ... NO .. :.... *1F YGS, SYI)I1kin -judi 'l)(isluS 1' m.l. MAY W3 Ralillllrl9). PLOT I)IAGRAN Irx;aLe clearly said disfincLly all lxrildings, wl+elher existing or prolx'Ised, and indicate all set--Iwck dia+ensions frau proilerly lines. Give street soft block ruder or descriptim arcoiding to ,keen, ax) slat street nacos aril irxlicate daaloer inferior or rx+nx:r lot. �jCl�t ��,,,,,•—fl AP R VEDAS (VOTED DATE: cEE: BY: NOTIFY BUILDING OEP MAEP( ENT AT r i FOLLOWING INSPECTIONS: FOR THE s�"3 �Cy OR 1, FOUNDATION . TWO REOUIREDWg � FOR POURED CONCRETE ' a 9 , °f 2. ROUGH - FRAMING & PLUMBING r '" "g` � ,.altr 3. INSULATION ��� '��� A. FINAL - CONSTRUCTION MUST laDri a�� t � @:.9 ��� o ��(;il RE COMPLETE FOR C.O. ALL � CONSTRUCTION SHALL MEET f3 �� THE REOUIREMENTS OF THE N.Y. Pr ,�/ STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DFSIGN OR CONSTRUCTION ERRORS 1fQFf S`.; rJ" -Two f(O/L C49T XA1NlY (A� ....................... (6fr�f .... .. .. .. . ..... ... ...... .. .............. ... .. ... ... ......Ix:iny, duly y4ntr u, dutwxus atoll says that, he is the app( icaul. N:nw: of iawlivichml signing contract.) +Ixove aunwd, leis Iloe .... ... ... ... ..................... ........... .... ...... .... ...... ... ((kusls actor , agent., corlx+rale ol(icer, etc.) ,f said +AAoet of owners, cowl is duly authorized to Ix:rfonn or have Ix:rlornw:d Ibe said work :Awl to nrcke aowl file this gaplicatioo; that all statenenLa contaicx:d in this alldic:ation ani: Igoe to ll+e hest of his krxz+letige mot lx:lief; aixf hat the vnuk will Ile perfoauoed its the aumoef set lotlh iu the applicatiau files It"ewilit. kAAo fo lIefor�c�,Y+re this, .. ........1Z......(Illy of ..�.t 'C-.'...r. 19.%... NAary I'nbIis .�^. .... �J�-:...... ,�7}.. `.�. (N�Ge- 11�� LAL T. VALSOLA .11-JJ!! .. .. . ........... ........ publio$tateofNeWYoT (Siycu+tore of Apel fernO Notary No. 4912019 �Y,�p� Qualified in 14. Fel). ji;t? � r�mmission Espies