HomeMy WebLinkAbout16772-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hail
Southold, N.Y.
Certificate Of Occupancy
No. Z-16692 Date March 7, 1988
THIS CERTIFIES that the building CONSTRUCT ADDITION
tocation of Property 680 Smith Road Peconic, N.Y.
House No. Street Ham/et
County Tax Map No. 1000 Section 98 ...Block 03 .Lot 32
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
March 2, 1988 . pursuant to which Btfilding Permit No. 16772 z
dated March 7, 1988 was issued, and conforms to ail of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ALFONSO & ANN B. LOSCO
..................... .....................
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
IPOIL~ NO. 0
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_I 6772 z
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ,, ~...mma to the Building Inspec-
tor with 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.
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-
lions, a certificate 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 p~operty 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
1. Certificate of occupancy New Dwelling. S25.00, Accessory,S10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20,00
5.Upda~:ed C.O. $ 50.00 Date ..........................
New C on s t r uc t, i on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ........... ~..~'~, ....................................................
Houee No, Street Ham/et
Owner or Owners of Property .........................................................
County Tax Map No. 1000 Section O cl ~ Block . . ~ .c~.'~.. Lot '~ ~
Subdivision ...... ~././~ ...................... Filed Map No ........... Lot No
'/~. 7~. ~. Date of Permity~/.'~. Applicant
Permit No: .....................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .?..~..'~. ......................
Construction on above described building and permit meets all applicable codes and regulations,
Rev. 10-10-78
Memorandum from ....
BUILDING INSPECTOR'S OFFICE
TOWN OF SOUTHOLD
TOWN HALL, SOUTHOLD, N. Y. 11971
765-1802
March 3, 1988
Philip J. Cardinale
Main Road P.O. Box W
Jamesport, New York 11947
Dear Mr.
Re: Building Permit Application
for Alfonso & Ann B. Losco
Cardinale:
Pursuant to our telephone conversation
of today, enclosed please find building permit
application. Kindly have said application
signed and notarized and return to this office.
Please also send check in the amount of
$25.00 for Certificate of Occupancy.
Yours truly,
SOUTHOLD TOWN BUILDING
y ish ,
Building Inspector
DEPT.
GF:gar
encl.
BUILDING INSPECTOR'S OFFICE
TOWN OF SOUTHOLD
TOWN HALL, SOUTItOLD, N. y. 11971
765-1802
Harch 3, 1988
Philip 3. Cardinale
Haim Road P.O. Box
3amesport, New York
1947
Dear Mr.
Re: Building Permit ApPlication
for Alfonso & Ann B. Losco
Cardinale:
Pursuant to OUr telephone Conversation
of today, enclosed please find building Permit
application. Kindly have Said apPlication
S~gnec! and notarized and return to this office.
Please also Send check in the amount of
$25.00 for Certificate of Occupancy.
Yours truly,
S~.~HOLD TOWN BUILDfNG DEPT
~ary FiSh,
Building Inspector
GF:gar
encl.
TO
CARDINALE & CARDINALE
Attorneys as Law
Main Rd. P.O. Box Drawer W.
JAMESPORT, NEW YORK 11947
(516) 722-4744
E)ATE
SUBJECT
'~PLEASEREPLY NOREPLYN~CEs~R3~?
]
TOWN OF SOUTIIOLD
OFFICE OF BUII,DING I ......
NSI I,CI(~II
TOWN IIALL
SOUTI1OLD, NEW Y(DI[K
CER'I II ICA'IE OF OCCUPANCY
NONCONFORMING I)REMiSES
Tills IS TO CEI%TIFY that the
Land
[ x/ Building(s)
I .1 Use(s)
located at 680 Smith Rd.
Pre C.O. ~- Z13578
Date- July 2,1985
Peconic
Street
ttamlet
shdwn on County tax map as District 1000, Section 098 , Block_ 03 ,
l,ot 032 _, does~not)conform to 'tile present Building Zone Code of the
Town of Soulhold for tile following reasons:
Dwelling does not meet 'side yard set backs & lot is insufficient
in width & area. Art. III Sec. 100-31, Bulk & Parking Schedule
On the basis of.information presented to tile liuilding Inspector's Office,
it has been determined that the above nonconforming /_~/Land /'-Y~ Building(s)
/--/Use(s) existed on the effective date tile present Building Zone Code of tile
Town of Soutbold, and may be continued pursuant to and subject to the appli-
cable provisions of said Code.
IT IS ?URTHER CERTIFIED thai', based upon iuformation presented to
the l{uilding Inspector's Office, the occupancy and usc for which this Certifi-
cate is issued is as follows: Private one family dwellinq with acc-
essory qaraq~.
The Certificate is issued to
of the aforesaid building.
JANNACEt MARIANNE T.
(owner, =l~s~ ~ ~m- ~-~
Suffolk County Department of Ilealth Approval, N/A
UNDERWRITERS CERTIFICATE NO. N/A
NOTICE IS HEREBY GIVEN that the owner of tile above premises I-LbS
NOT CONSENTED TO AN INSPECTION of tile premises by the Building Inspec-
tor to determine if the premises comply with all applicable codes and ordin-
ances, off]er than thc Building Zone Code~ and therefore, no such inspection
has been conducted. This Certificaleo therefore, does not, and is not intended
to certify that the premises comply with all other applicable codes and rcfula-
tions.
!:' ' ' '. s; ' . ' '
0
Lo~ ~5
OFFICE OF THE
ON MAY 27~ 1913
SURVEY FOR
ALFONSO J. LOSCO ~ ANN R LOSCO
PART OF LOT I.%, "INDIAN NECK PARK"
AT PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
DATE . JUNE 2t, 1985
SCALE: I" = 20'
NO . 85-647
SURVEY IS A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW
COMMONWEA~D TITLE
ALDEN W. ¥OUNG, PRC~FESSIONAL ENGINEER
AND LAND SURVEYOR N.Y..S. LICENSE NO. 12845
400 OSTRANOER AVENUE
RIVERHEAD, NEW YORK
~ IW'M ~ ~*'S~UIH OLD
BOARD OF HEALTH ......
3 SETS OF PLANS .......
'FORM NO. 1 SURVEY ..........
TOWN OF SOUTHOLD CHECK ..........
BUILDING DEPARTMENT SEPTIC P0RM ............. :
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1803
Ex amin ed . '.-q?/~. .......... , 19 .~..~
Approved .~,,~ ............ 19 ~. Permit No.~,
Disapproved a/c ........................... (.q .Z '.?.'.~' ~
JeBuild~ InsOector)
APPLICATION FOR BUiLDiNG PERMIT
INSTRUCTIONS
NOTIFY
CALL ................
MAIL TO: ~.~
Date....~.~.. 77/. ......... 19 ?.~T
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 inspections.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nmne of owner of premises ~-, ~ }~,x [- O~ t-~O , ......
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
......
'" (~q~d and title' g~ ~g~gr'a[; ~ffiggr') ......... '
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ..........................
Plumber s License No .........................
Electrician s License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
House(° ~NumberO ' ' '~27<'~' ' ' '-I~' ' ~ ............. Street ! ......... '~' ~ ' 't~m~e 't/r~t' ........................
County Tax Map No. 1000 Section ......... 9.?.~- .... Block .. O ~ Lot
Subdivision ...... .~.~./3c , Filed Map No. /{///J ' Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ... fzx.-~K-ql...~.. ?..~. · . . ~..' ...........................
b. Intended use and occupancy ............................. ~ .......................................
3. Nature of work (check winch apphcable): New Building Addition .......... Alteration . .'.
pai ~ "' ,
Re r .............. Remo al .............. Demolition .............. Other Work ...............
(Descrip~tion)
4. Estimated Cost ............. ,' ......................... Fee ......................................
i ' (to be paid on filing this application)
5. If dwelling, number of dwelhng umts ............... Number of dwelling units on each floor ................
If garage number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. D~menmons ofexmt~ng structures if any: Front ............... Rear .............. Depth ...............
Height .............. Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ' Height Number of Stories
Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
9. Size of lot: Front I Rear ..... Depth
10 Date fP has ' N of FormerO
· o urc e ........... ~ ................. ame wner .............................
1 1. Zone or use district in which premises are situated ..........
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ......... ~ .................. Will excess fill be removed from premises: Yes No
fp '
14. Name of Owner o remises ... ~ ................ Address ................... Phone No ................
Name of Architect .......... ~ ............. Address ................... Phone No ................
Name of Contractor Address : Phone No
15. Is this property located Within 300 feet of a tidal wetland? *Yes ..... No .....
*If yes, Southold Town TruStees Permit maybe required.
i PLOT DIAGRAM
Locate clearly and distinctly all buildings 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.
STATE OF NEWJYORK, . S S
COUNTY OF.
.~../.°e~' - · · · .~. · · · .~. · · .~'%~q. · · .~. ~ .... being duly sworn, deposes and says that he is the applicant
(Name tSf individual signing contract)
above named.
,,
He is the '
' (Cofftractor agent corporate ~fficer etc )
of smd owner or owners, ~d ~s duly authorized to perform or have performed the said work and to m~e and file t~s
apphcatmn; that all statements contained m th~s applicatmn are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~ner Set forth in the application filed therewith.
Sworn to before me this
........................ day of .~ .....................
(Signature/of applicant)
SUSAN M. ~RDINALE
N~ARY PUSLIC, State of New York I