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HomeMy WebLinkAbout17055-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19047 Date MAY 15, 1990 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 505 WEST CEDAR POINT DR. SOUTHOLD, N.Y. House No. Street Harslet County Tax Map No. 1000 Section 90 Block O1 Lot 007 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 13, 1988 pursuant to which Building Permit No. 17055-Z dated JUNE 2, 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 DORMER ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PAUL & CORINNE FERDENZI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-044312 - NOVEMBER 9, 1988 PLUMBERS CERTIFICATION DATED MAY 8, 1990-MATTITUCK PLUMBING & HEATING it ing sp~ector Rev. 1/81 FORM NO. D 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 017055 Z Dote .......~~z 19.~~ Permission is hereby granted ~`~.y... . ~ ,p .......r at premises located at ........~~..J~..~......Gf~'....~,~'aut.....l.d~?~G!fPy.~.....c;!'(.t Caunty Tox Map No. 1000 Section .............~~..D... Block Lot No....... pursuant to application doted 19.~U, and approved by the Building Inspector. ~o Fee Build I actor Rev. 6/30/80 ~ - - ~ ~ ~ s,i ; r~ Form No. 6 t` ~gg _ ~ iY TOWN OF SOUTHOLD ~4~ N~ ~Y BUILDING DEPARTMENT TOWN HALL FPS 765-1802 .~®~N OF S~O~ APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the fallowing: 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 Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2J10 of 1~ 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: 1. 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 Che 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 Building - $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 $151.00, Commercial $15.00 Date .o New Construction...... Old Or Pre-existing Building. Location of Property...: ©`~....WJ:.~7....~~1~. /].l~rG!~........~1,©~f!T1.~:G~ House No. Street Hamlet .~~L ~~C' <?,,/J Lid Z / Onwer or Owners of Property. r ~...fJ.G~~J County Tax Map No 1000, Section. .Block..~~ :~C? .....Lot...G~ Subdivision......... ...Filed Map............Lot...................... J Permit No.~~ ~O'~.5.....Date Of Permit .~~.D.F....Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval / Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ ~~%tti? ~ 3ti . 0 ~ f fay 7 APPLICANT ~O~~~F~~,CO/' TEL. 7G5-1802 ! _ TORN OF SOYJ~'IIOb,O t.1:'i ~ ~ 1 OFFICE OF BUILDIAIG INSPECTOR ;~f o P.O. BOX 728 ~i L~ ~ tP =ir 31 jva rn C?s'i~ -e TOWN HALL j~0 SOUTHULD, N.Y. 11471 ~Y ' 1 x~ TowN o~ soy wc~c~ C E R T I F I C A T I O N Date Building Permit No.~ ~ , Owner (please print) / (p ease print) ~ S certify that the solder used in the water supply system contains less than 2/10 of 1; lead. {plumber's signature) Sworn to befor: me this ~1G~T~/day of , v 0~ ~-c~ 19~. ct~.~ Notary blic tlotary Public,~s~~~/L~ County EOIIHR.JAt2(SON NalrY~~Ner?Yait Quo~led fn Suffolk County Torm Expires Feb, t8, 1992 55~ THE NEW YORK BOARD OF FIRE UNDERWRITERS Nnt;"~ 7.14ht7'? BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date Nt>V.EMHk:k 1)9:19>3R APPlicationNo.onftle Gib.?.9iRRR/RR N Od43'i. THIS CERTIFIES THAT only the electrical equipment m dmcri6ed he/oro and introduced by the eppBeont rwmed on the shove application numher in theprooueee q/ PAII[, tikk;l)F'N7)~.: CEnAR HhACH E7R. Nk:ST: _StritPHU611, N~Y. in thefollou~inp locategp~$FLJ Beeeplplrt ~ IAt FI. ~ Ynd Fl. Sertion Block lot arm examined on O1((~~~Tt~ ~~~;RRRK II~. L ``t17i }S and found to 6e in complicnre rrith the reyuiremend of thia Brwrd. pXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASNERf EXN T FANS OUTIETf TALES fWITCMEt INCANDElClNT PIWNbCEm V AMi. K. W. AMT. K. W. NAT. K.W. NAT. K. W. M1T. M.I. 7R 2R 3d )K DRYERS RJRNAC! MOTORS tUTUR! AtT1uANCE tHOERS f/ICIAIRK'~T lYAICIOCKt eNl UINYNEATERS NUUI.OUTIET OIMAtERf AMI. K. W. ql N. I. GAS H. I. NAT. NO. A. W, a. AMT. AMP. AMT. AANt. TRANS. NAT. N. P. fTSTL7Af AMT. WA115 NO.OF RRlT ti 1 7 1,2 - 'DISCONNECT NO.Of S E R V 1 C E ',';jOAT. ~ AW. Tree ~ 1 J tw 1 / tw 7 A tW 3 J AW NO. ~CCeCOND. ~ Cc COMA. ND.OF NI•aG ~ ~ HI No.Or NEYTtAa ~ • . G. l OTNER M?ARATUS: MOY'tiK`i•1-~7. H.P., rs.A'.!',T'.-5 St'It3KF' RF:'CFa:TOk.;-2 SAGM & I,kAfsMANN TNC.. ti', tt, BhX 7"I6H SOITCHOIIll, Ny, 1.7 4'} I OlI~A IAANArM 1) t,YCE,NSE; NO. 3635-F: ptr This nrtificate mutt not be ahersd in any manner; return to tM office of tM Board if incorrect, Inspectors may be identified by thRir credeMialt. COPY FOR BUILDING DEPARTMENT. TINS COPY OF CERTIFIGTE MUST NOT tE ALTERED IN AIIY MAMMIRR. .'1ELD i~~Si=C:iU;i ~~Uni~ ~ COMMENTS \ a o (~~t, J. ` ~ N _,.V_ _ _ _ _ y FOUtJDATION (1st) c~ ~ C1 FOUNDATIOtJ (2nd) _ 2 ~ ~ O , r yC~ 0 .z ~1 ROUGH FRAME & PLUMBING ~ 1~` ~uio yp 3. ~ m~ IIJSULATION PER N. Y. y~ d~ STATE ENERGY CODE x C1 ~o ~e 4 . ~ FINAL ~ a ~ a ADDITI A M~ .9~ x` • _ x ~v H r\ 9 ~ w O z _ \ r~ H S d m ~v H 7'~5-1802 BUILDING DEPT. INSPECTIt'N [ J FOUNDATION i5T [ ] 1200011 PL6G. [ J FOUNDATION ZND [ ]INSULATION [ J FRAMING [ ]FINAL REMARKS: r _Q.~~ ~ -~ae~ .o~La~~~~. V ,t ~ l DATE INSPECTOR s t a._..,.__. ~-.~,~..,.w.--.~-_---~.-- 7is-iN2 suILDINO DEPT. I NS~CTiOt~ [ ]FOUNDATION 1sT [ ] ROINiN i~LB~i.;~ [)FOUNDATION ZND [ ]INSULATION [ ] FRAMINQ (~F1NAL C~ '~'yI ~G ~l/~- Cam! ~IiN ~°.Q//~f~A ,"a/I/i1 N/~/ ! ti ~~r'~. ~ ~ _ ~1 , ~ ,ems , DATE ~ INSPECT~~ , / 7sS-1802 / BUILDINGS DEPT. lNSPECTlON [ ]FOUNDATION 1ST ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [)FINAL REMARKS: (,~L-, c DATE INSPECTOR ~ ~ ~ ~ . BOAKD OF HEALTH ,,~~tt~~ 3 SETS OF PLq NS QLI.I:. j~ ~FORMN0.1 SURVEY I:K•.... 1 3 ~ ~ TOWN OF SOUTHOLD CHECK ~Y ~ BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY ~P'C SOUTHOLD, N.Y. 11971 CALL - TEL.: 765-1802 - ii ` ~ MAIL T0: Examined . C?/.~!........., 19 ~ Approved 19~PermitNo~~~~~~ ~ Disapproved a/c /(Build~nspector) APPLICATION FOR BUILDING PERPAIT a4"~ Date . 19~f'9". 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, buildin ode, housin de, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec o (Sig ature of app icant, or n e, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. r Name of owner of premises ~Z a (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~B~~~OI,KiCOUNTY LICENSED Builder's License No. ///1111xx77 Plumber's License No . . Electrician's License No . . Other Trade's License No . _ _ _ I. Location of land on which proposed work will be done. ~'S ..~1.~. ~ r Sc~.~? ~ . House Number ~ Street Hamlet County Tax Map No. 1000 Section ! ~ • • • ~ • • Block . ~Q........ Lot . ~ . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended2use and occupancy of proposed construction: a. Existing use and occupancy ST°n "f~"!~7//~L ....y... ~ ~ . b. Intended use and occupancy . 3. Nature of work check whic a P ( ^ pplicable): New Building Addition . Re air • Removal Demolition ther Work . E, ~ sc n) 4. Estimated Cost ~r 6~ Fee ) w ` (to be paid on i i ion 5. If dwelling, number of dwelling,units Number of dwelling units otr•e oor . If garage, number of cars 6. If business, commercial or mixed occupancy, specify natu~ a and extent of each ty a of use 7. Dimensions of existing structures, if any: Front •~,9........ Rear Depth a~..cr....... . Height ~..,3 Number of Stories y~ Dimensions'of same structure w .1 ' ~ ith alterations or a dd itions: Front ! Rear ; De th ...Height . Numberrpf,.$tories p ......f,........_ S. Dimensions of entire new construction: Front . ! I Rear (.....Depth ~ , , A (v Hei ht Nu g 3 r~ber of Stories ~ ` 9. Size of lot: Front . •Q ' . Rear Depth o~ . ~ . 10. Date of Purchase .Name of Former Owner a~.`/~eL /~s,~!~c{;Q'1~T, , , , , , , . 11 I2. Lone or use district in which premises are situated . Does proposed construction violate any zoning law, ordinance or regulation : ~ . 13. Will lot be regraded , . ....Will excess fill be removed from premises: Yes No 14. Name of Owner of pre ises ~ G?~tr'!~!L(... Address y~4. ~/~/~q'hone No.~.~~ :7/. z 7... . Name of Architect ~ . ..Address ...................Phone No... . . * of Contractor .G Vame P P Y ~f Add~D~ Z....CGLr~(Ly..~Phone No.7 ~f(.:jlU'?.K~... . 15. Cs this ro ert located' Cf e within 300 feet of a tidal wetland? *Yes No y s, Southold Town Trustees Permit ma be reqqu~ired. PLOXI' DIAGKAM Locate clearly and distinctly alj 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. I~!I STATE OF NEW YORK, S.S COUNTY OF ~ . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (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 the work will be performed in the manner set forth in the application filed therewith. Swont to before me this f...~ 19~~ da o ~ 3........... Notary Public . v~... County HELEN K OE VOE r NOTARY PUBLIC State of w Yak Tem ,Exgre~sYMir~e ~ ~ (Signature of applicant)