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HomeMy WebLinkAbout26617-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27248 Date: 08/15/00 THIS CERTIFIES that the building ADDITION Location of Property: 385 OLD FIELD CT MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 120 Block 3 Lot 8.21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 25, 2000 pursuant to which Building Permit No. 26617-Z dated JUNE 27, 2000 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 EMIL & ALBINA T BORRUSO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A .."Ori Signa re Rev. 1/81 FORM NO. 3 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) PERMIT NO. 26617 Z Date JUNE 27, 2000 Permission is hereby granted to: EMIL & ALBINA T BORRUSO 385 OLD FIELD CT MATTITUCK,NY 11952 for CONSTRUCTION OF A NEW DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 385 OLD FIELD CT MATTITUCK County Tax Map No. 473889 Section 120 Block 0003 Lot No. 008 .021 pursuant to application dated APRIL 25, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 T0�,-;N OF S0UTHOLD 3U%LDINC_ Dc?aRTME1IT TOWN 'IALL 7E5-L�o2 Gt- APPLICAT_ON FOR C'RT1=1C1Ti OOCCJPcN 1'q_), A. This application must be =Med in by zvn ewriter OR ink and submitted to the building inspector with the following: :or new building or new use: L . Final survev of property with accurate location Of all buiidin-5, property lines, streets, and unusual natural or topographic features. 2. --inal Approval from Health Dept. or water supply and sewerage-disposal(S-9 fora) . 3. Approval or electrical installation -from Board of Fire Underwriters. 4. Sworn statement from plumber cerci=yin- that the solder used in system contains less than 2/10 or Le 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. o. Submit Planning Board Approval of completed site pian requirements. 3. For existing buildings (prior to April 9, L957) non-conforming uses, *or buildings and "pre-existing" Land uses: i . Accurate survey Of pLODerty ShOW'1n- 311 property lines, streets, building and unusual natural Or topograDnic features. 2. A properly completed apDlication and a consent to inspect s; . , y 7 r f a Certificate of Occupancy is denied, the Building lnspe ;s `Mate tie r reasons therefor i_n *writing to the applicant. AU6 3 2000 Fees C. (� _ . Cert'-f irate of Occupancy - New dwelling 325.00, Additions to dw -2 OO-- Alterations to dwelling 525.00, Swimming pool $25.00, :access ry �uilddn'�u52�c_�Lj, Additions to accessory building $25.00. Businesses 550.00. 2. Certificate of Occupancy on Pre-existing 3uildins - 5100.00 3. Copy of Certificate of Occupancy - - .25c. 4. Updated Certificate of Occupancy - 550.00 5. Temporary Certificate of Occupancy - Residential SL5.00, Commercial 515.00 Date G - a4' - 9 � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . Old Or Pre-existing Building. . . . . . . . . Location or Property. . .3ks- 0D cJC T T U G k . . f House No. Street Hamlet Onwer or Owners of Property. q`� L . L � R R ZA SO County Tax Sap No 1000, Se ct`-on. . .Block. ... . . . . . . . . . .Lot. . . . . . . • • , Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . ;..t.. . . . . . . . .Filed Kap. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . Z—.Date Of Permit. . . . . . . .Applicant. . . . . L�'t! Health Dept. approval. . . . . . . . .. .:. :: . . . . . . . . . . .Underwriters Approval. . . ... . . . . . . . . . . . . . . Planning Board Approval. . . . ._, --- Request --or: Temporary Certificate. . . . . . . . . . . Final Carticate. . . . . . . . . . . Fee Submitted: 5 .t� . . .1�10 . . . . . . . . . . . . . . . . . � . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12PL1CA.NT Q6 �� BUILDING PERMIT REVIEW CHECK LIST Applicant/ Datej Owners Name: VP,+tMA X(USo Reviewed: x/2 7C) Architect/ Date Engineer: Submitted: ` �O SCTM #: District: 1.000 Section: Jo0 Block: Lot: Project --I/� Subdivision Location: 3 dIO( I ,,fd Cf- Name: Single&separate Required certification: (Yes/No) U Req. Req. i Zoning District: � '[Lot size: Actual. •92 40001 [Lot coverage '�._Proposed;-.�• ��� Req. �i �..�. Req. 4 k�r,.< Req. [Front Yard �Proposed: ��� ) [Side Yard 20 r�� Proposed: fC 1 [Rear.Yard Proposed 214 'J Project Description: /"rcl� AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A.. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees - Town Zoning Board approval. Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: Notes: D -� ��n ( �� S BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: Nbl Reviewed: 162-3,1(6 Architect/ Date Engineer: Submitted: '`, a0 SCTM #: District: 1.000 Section: )off Block: 3 Lot: Project Subdivision Location: 3K 0 l d C;td Name: Single&separate Required certification: (Yes/No) 114 Req. Req- y o� Zoning District: C [Lot size: Actual. �92 ¢0020] [Lot coverage -20—Proposed::-_�(d J] Req. r 4<57.7 Req. oIk/�tdr�c Req. [Front Yard ��Proposed: C- 1 [Side Yard �o Proposed: �/C 1 [Rear.Yard �Q Proposed Project Description: ��� �6 'd///c"-1 AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. v New York State D. E. C. Town Trustees Town Zoning Board approval: ✓ Town Planning Board approval: Flood Plane Elevation??? Flood Zone: Notes: G�Z� 0 r- a (4�7� j7i�-- 765.1802 BUILDING DEPT. INSPECTION [ OUNDATION IST [ ] ROUGH PLBG. [ ] FOU DATION 2ND [ J INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY // REMARKS: 1 ok - a2� ct4 ` �l DATE c7'0 INSPECTOR �""� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT � DATE - ---- _ --���-- COMMENTS - - - --- --_- II =---_-------------------------------- --------------- i ------------ -- II Gp�� II JI II I FOUNDATION ( fST) H Iji--- l'- -- -------- ----- - ------- ---------- --it Q� II II FOUNDATION (2ND) I i it r� -----------------________Irr-------= I� I " -�-- ;r------a ROUGH FRAME S �-- --j PLUMBING I II OA, II It �_--_JI It IIif INSULATION PER N. Y. II m Ian' m S A-- It STATE ENERGY CODE n u -It II p I� It 41 Illi jj � H I ---U II fi FINAL III�III II pl l� ADDITIONAL COMMENTS: C� to z� r\ - - d r� ro BOARD OF HEALTH . . . . . . . . . . . . . . . -FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . ' TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL Examined..C�.. .-?�3�....., "td� MAIL TO: . . . . . . . . . . . . . . . . . . . za �a� 6 Approved.. ... .......... .... Permit No. ..:..... . Disapproved a/c .................................. ...................... .. .. (Building/Inspector) R .L 5 A rYm APPLICATION FOR BUILDING PERMIT a� Flw"i� LUw y lj Date. . . • /- . . . . . . . . . , 20.E INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector 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 application. 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 issue 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 MALE 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 inspections. ................................ ............... ... ... (Signature of applicant, or nam, if a corporation) 3 5-6 ©L O !=i c/ al G 7. M 017 7/-/ia-c_4 ............................... .............. ....:. (Mailing address of applicant) " 95" State 5 Z- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plurber or build, ................................:...................................................................... .... ...... . ... ... Name of owner of premises ....... 1 L U 1.. 7.( S 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) BuildersLicense No. .................:....... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done........................................ . ............ ....... .. 3 2-5— C>GD 7/ zrLa C T MA7T1 Tubi-t �l .. ................................................................................................ .� . ..... .,. . ..... House Number Street Hamlet County Tax Map No. 1000 Section .. P........ Block ...�............ Lot .. : I..... Subdivision ...................................... Filed Map No. ............... Int ............ .. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................... ._............ ve G I� b. Intended use and occupancy ......:... ............................................ ....... ............ I. N Lure of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair ..... ... . ... Removal ............. Demolition ............ Other Work .................................. -</a v p 0-0 y (Description) 4. EsCin itecl Cost 7s v O ......... fee ....... .................................. (to be paid on filing this application) 5. 1f duelling, ixmber of dwelling units ............ Niurber of dwelling units on each floor ................ If garage, hxnber of cars ...................................... G. 11 lxhsiness, crmrhercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing stnrctures, if any: Dont................ Rear ............... Depth ................. Ikigiit ....... .................. Number of Stories ..........-............ Dimensions of sawe stnrcture with alterations or additions: Front ............... Rear ............... Depth ...... .............. Height .................... Number of Stories ............... 8. Dimensions of entire new constriction: Front ................ Rear ............... Depth .............. Ikeiglht ......................... Number of Stories ..................... 9. Size of lot: Front .................... Rear .................... Depth 10. fate of fthrchase ..................... Name of Former Owner ........................................ II . Zone or use district in whidi premises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be remnwed from premises: YES ND 14. Names of Owner of premises ........................... Address .............................. Phone No. ............. 11ure of Architect .................................... Address .............................. Phone No. ............. Nacre of Contractor ................................... Address ...............................Phone No. ............. 15. IS Lhis property within 300 feet of a tidal wetland? * YES .......... NO .......... *TF M,13, "MOD MM MMMS PERMIT MAY HE W4HRM. Pl.o"r DIAGRAM IL)cate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block ember or description according to deed, and show street names aril indica whether interior or corner lot. w ,+ a • M V n o h T N fl 0 SrA•ll: (N' w w Y(NW, SS 3 a O.Q ("INIY (N' .. ... . . . . ... . ... . . ....�. . I V 136 .. R til 5 .......... . ...........being duly sworn, deposes aril says that he is the applicant (Nam of iDdivid"al signing ccmtract) above rvred, '/ C Ike is Lhe .. . . . .. . . . ...... . . W N L ................................................................................. (Cc)Trtractor, agent, corporate officer, etc.) of said owner or c-zx,.rs, and is duly authorized to perforin or have performed the said work and to make aril file this application; Lhat nll statements contained in this application are true to the best of his knowledge and belief; and Lllat Lhe work will. he perfonTed in the manner set forth in the application filed therewith. .'A,,crrn Lo before up this - j"< . ..... .. clay of .�`T'" '�...... `20.�U.. Notary Ahblic .. L <s.:. .�?�......... ............ ................... UNDAJ.COOPER (Signature of Applicant) Notary Public,State of New York No.4E22563,Suffolk County Term Expires December 31,tB d r�cx Xr-7- �bK 4515 ��xgE�P,oRQ9 FaLTEO --gyp k W j I R�� J.n t t� _� Lev 6EQ. (?loflRo /'E�PT2AnC� 13AY w nv„ + -- -- -- —V — ECK:nG S<<lX�e. .IrK GEDAk 9 x 4 srs p ! !� it w:DE ZxG 3c'� sTs I t3aAm } ii a - 2A& f3sAM A-rop 4 y t i'o r5 7X�/ Posr $Ef' j/1 L'onC('iCTF Foo-Iin6i5 �f'I �T � c ALL Sy�oar 924924414-4r- Lumam CCA � L549M RbYEd AE NM�? r LDING D�RTMENT AT AM Td 4 MA PdRTHE �� "�,t;u y TUOI�U - TWO R D 2. ROUGH - FRAMING • PLUMBING 3. INSULATION �` 4. FINAL - CONSTRUCTION MUST _ � l i ► _____�Q R�OCEE� WITH FOR�.A�--- — – - - LL CONSTRUCTION SHALL MEET Ili" CC FANCY FRAMING UNTIL SURVEY THE REQUIREMENTS OF THE N.Y. tall STATE CONSTRUCTION a ENERGY OF FOUNDATION LOCATION CODES. NOT RESPONSIBLE FOR HAS BEEN APPROVED. DESIGN OR CONSTRUCTION ERRORS RA�1. SYTrn: �tx }�ioT (feA e RA,I s�pp�aTs Zx� e DA2 Clas ►�Maz-p-s a ua` CFZA-2 s r� L.us7MeS (o " O. C . FA -- - ------------ 77r _ I fl GGE55 pone- l�a7fiGE A/A�IeD r-oR SPR nkle2 a � yxy�a3T I 3p�r oloto • ��p �,n UEQs 6E axis- ccR �(:!T •A CcoKOin�To ! T c --Ta BE -7- S '' � BA/ZR u5o f�Fc K pun 2y �fiSM��1 SUFFOLK CO. HEALTH DEPT. APPROV, H. S NO. QIO- ?5 24) 1 VAC. GS, i VAC L7 - T STATEMENT OF INTENT ��+ G�6FiELD nV f ^ `y �' '� �' THE WATER SUPPLY AND SEWAGE DISPC COURT 5 WATER SYSTEMS FOR THIS RESIDENCE 'A 'C CON iC� " C IZr. ---- ----AT- -- ---- - - -CONFORM TO THE STANDARDS ANDARD OF SUFFOLK CO DEPT OF HEALTH SERVk (S) APPLICANT C'PcOL ( cr) — --__- '- ^'- SUFFOLK COUNTY DEPT. OF HEAL ! SERVICES - FOR APPROVAL F t* `a CONSTRUCTION ONLY DATE. GAD. wa r H. S. EF N 32 =-� tYr7t?rtX FieI APPROVED' ��c -b c P*� /c �u..c �.� G`l6 _ ,� �0 VI SUFFOLK CO. TAX MAP DECGNATIOC / DIST .SEC BLOCK r Li `-'t�'� I /G'x .30 ` tel'}J,c_a-rFJt r-/-F,S ;_S L:l?•.-r.�,C�-c,< .i, i r'To 3 OWNERS ADDRESS: a� =T. a y,' DEED L. �,/t P. mcu j 6I. i /-�,- At.J'. ��, .�`='�..•`'' TEST HOLE STAMP mm As � .�� ip I 14'M'.A`^'In✓ ewn6�rrliia i 7 I \ i• ' i j t:n:a Ftfvev'as a vbtfttm f1 Ea.'1Cn 72N01 14OrYa*ffiN- i 1 F:d rafa LW flow D AMa�104 !M 00 lHE ` oe �� i C_�us o!1i9s ttfMlY mfD nd Eeehu { I t4^i;.nd sutveyo'f b*&d sealer FOWxS — t �• I I I m-afvefdW4a00Y• 1 FOUNDATION - TWO REQUIRED I _ `�� / Q I c_,.ntffsFlcratea�eFf«+fn.f-., FOR POURED CONCRETE % I i ` 5: 2. ROUGH - F11J1MINf3 t PLUMBING -Q �- �_C-E : i a•r wzre.and lawhoh4ff 10 vvy 1 x -ee-re4 and m hmmai tl orcv 3. INSULATION - C "'�' r r r r. iil I I r ch .ny.y�,remmontal a0ercti x 4. FINAL - CONSTRUCTION MUST -� LOT tiQ S. r C eJ ,`'1AP O r �A.�!n I 5. i� 'T.t ; 1 on. ed�c oa.and Co �'ZI45 ^FFiCE fj'CJ. Z V, ��f1r �.l�i �Of..�. 1 11 1 I i arott•ansirt_nw BE COMPLETE FOR C.O. _ . _- _ . ._ ALL CONSTRUCTION SHAD. MEET -- _ . _ __. ! 1 THE REQUIREMENTS OF THE N.Y. .4660 LAtia STATE CONST'RUGT18N-*-ENERGVY CODES. NOT RESPONSIBLE FOR S-7019 30ow. 125.0 DE$ION OR CONSTRUCTION ERRORS ( ui i rpt oOc�r v` i ' MAP /ltyEIJD D-JUI+LE Z,1 5 A5 ;: U VEYE. AL:G.�G f I O a cr. 1199Q t , �_ --- 1 z ROPf Rf K VAN TUYL. P.C. j I � '•,:•i ( -s--w".�'k,—;Oc'-''�cj'w-� fes. _ •..�..T_...—•�� � j e 7 ae9 ,j LICENSED LAND SURVEYORSgo, uR aEw r O I y U • CREENPORT NEW YORK %_: x . � - - a � �� •, -- _ -_ --- -� - - - - __�.