HomeMy WebLinkAbout16968-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17108 Date JULY 22~ 1988
THIS CERTIFIES that the building ADDITION
Location of Propert~ 505 WEST CEDAR PT. DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 090 Block 01 Lot 07
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 21~ 1988 pursuant to which
Building Permit No. 16965Z dated May 12, 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 DECKADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to
PAUL & CORINNE FERDENZI
(owner, )
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATE NO. N/A
Building Inspector
Rev. 1/81
TOWN OF SOUTHOLD
B~J~I.DIHG DEPA~TMEHT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby grante~:~ /1
....
.. ~ ....~. ~ .~...~[,~ ...... ' ...........................................................
~t premises located ot ..~.'~....I~.......~....,,~... ........ ~.....~..'..:........~.....~. :,....~ .....
County Tox Mop No. 1000 Section ...... ..~..~....~.. ..... Block ..... ...~...J .......... Lot No ....... .~..-/. ..........
pursuant to application dated ...~.........~..~ ..................... , 19~...~...,
and
opproved
by
the
Building Inspector.
Building Inspector
Rev. 6/30/80
Memorandum from · · · ·
BUILDING INSPECTORS OFFICE
TOWN OF SOUTHOLD
TOWN H^LL, SOU'rHOLD, N. Y. 11971
765-1802
August 16, 1988
Dear Paul,
I am writing to you about B.P. 16968Z.
When I did your C.O. I put the wrong
information on it. Please return the
original so that I can correct it.
Thanks.
Yours truly,
Secretary
FORM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink. and submitted m~ 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-
tions, 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
topograph ic featu res.
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 POOLS $25 . 00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.Q0, Accessory ,$10.00 Business $50,00
2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0
3. Copy of certJficate of occupancy $ 5.00,over5 years $]0.00
4.v o nt .and o.o. 20.0o .'2...--.;?/'
5.Updated C.O. $ 50.00 Date .....................
NewConstruction ...... Old or Pre~existing Building ............ Vacant Land .............
Locat on of Pro ert ~"(~"~"-- ~ C~: ~,~,-~'- ¢~'~")'~
House No. ~3 Street ~'~ /.~-z~ ~/ ~Z/~ ~' ~'~'t
Owner or Owners ofProperty/. .................. ./: ............. ...........
County Tax Map No. 1000 Section ............... Block ............ Lot
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No./.~..1~..~;~. ~. Date of I~ermit :~.~ .~/. &.f.~pp leant .~.~..~ .~.. ?.~.... ~ .~'..~./~...~..~.~'-./..~t~.~..
Hea th Dept. Approva .... ./~//ff .............. Labor Dept. Approval..../w'.~. ...... i..i..i.iii.
Underwriters Approval .... ~,/~, .............. Planning Board Approval ,. ,~',~, ................
Request for Temporary Certificate ..................... Final Certificat~ ,,, ~/,., .~¢"~,
C°nstructi°n °n ab°ve described building and/~ it nets a~lica,~, odes and regulations,,
Rev. 10-10-78
Co Zl?lO~'
FOUNDATION
(1st)
FOUNDATION (2nd)
ROUGH FRAME &
.?LUMBING
INSULATION ?ER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL
COMMENTS:
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
MAIL TO:
Examined....~0~ I..~.., 19~.~. ~Q_~ci:N~
Approved .'~"YT[5 J~.., 19~. Pe~it NoJ.~ ~. ~.. '~', ~ ]
Disapproved a/c ..................................... ~ ;i~, J'~'s~{ 2 ] ~' ~It
............................... ~'~ ........... ~ q-~,-~~ ' _- .............. ~,~. ~,~I~'
(Building Inspector)
APPLICATION FOR BUILDING PER~IT
....... ,
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
CHECK ..........
flEPTIC FORM .............
NOTIFY
CALL ................
19g
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 Iayout 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 wh~l,e pr in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Bmldmg Inspector
APPLICATION IS HEREBY MADE t.o, 1tig Bf/ildlng Department for the issuance of a Bmldmg Permit pursuant to the
Building Zone Ordinance of the Town of SOuthold'.SuffolI/County, New York, and other apphcable Laws. Ordinances or
Regulations, for the construction of buildings;'addi;tions or alterations or for remQval or demolition as herein described
The applicant agrees to comply w~th all applic&bl~ law~ ordinances, buildmg codeFhou~mg code, and regulatmns and to
admit authorized inspectors on premises and in building for necessary inspc~aqons.~j , ~ / .~O . ~, --
.....
(S~. of a~/_~131fca~nt, o~r n/g~r[e, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... . .C~..f.~z~-.m. r~.....~...~.g7~/:4 e;7. '.°~ .......................... ~, ..... ,, .; .......................
~ame of owner of prenlises ................................... ~; ~ ................. . ...................
(as on the tax roll orjatest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY
Builders' License No.. ~..'7.~..,~T...ff..f. ........
Plumber's License No .........................
LICENSED
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done~ .................................................
.... .87..0,_0.7 .......... .w. . :. . .c. ~. . .,~. . . {qe./~; r'j/e/v'~' So,//?/o~,~
House Number Street Hamlet
County Tax Map No. 1000 Section .... ?..0. .......... Block ...... / .......... Lot ..... Z ............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... ..O...P~"..5. ~..~.~.../?../~...../~. ............. &"L-"/~/4"~("' ..... . .....
b. Intended use and occupancy ..... .(~...~..&.~.../.~..q~../.g.__~.. ~-~ ' ,... i
.. ~.v., :q...,~:. . :. .,, . . . .................
3. Nature of work (check which applicable): New Building .~...-.~d~d ......
.......... ddition .... Alteration ..........
Repair .............. RemOval .............. Demolition .............. Other Work .............
: (Descrip~tion)
4. Estimated Cost ...................................... Fee ....................................
~ ~ (to be paid on filing this application)
5. If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................
If garage number of cars i...
6. If business, commercial or mlxeld occupancy, specify nature and extent of each type of Use ~. ................
7. Dimensions of existing structures, if any: Front ........... . ...... Rear .............. Depth ...............
Height ............... Number of Stories ....... ~ ' ' ' ' ' ~ . ........
Dimensions'of same structure ~ith alterations or additions: Front ................. Rear ..................
Depth ~ Height Number of Stories
Dimensions of entire new construction: Front ....... ~. ....... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
Size of lot: Front Rear : Depth
Date of Purchase ............................. Name of Former Owner .............................
11. 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
14. Nme of Owner of premises .~/~.~- .,/~..~..~.. .... Address .~,~.~. ~.":.~.../'.~..JT..~,¥.~. Phone No ................
Name of Architect ......... .................. Address ................... Phone No ...... L .........
Name of Contractor . ~2ZC,/~.Y.,..~?. ~.. ..... Address .~.~.O~. ~/.~..C~..7'.C .~. ~ .~/F[mne No. ~...3'~'...'2...O.~..O....
15. Is this property located!within~ "~ 300 feet of a tidal wetland? ~Yes .~... No ..... *If yes, Southold Town TrUstees Permit maybe required
: PLO~r DIAGRAM
Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and blocki number or description according to deed, and show street names and indicate whether
9.
10.
interior or corner lot.
APPROVED AS NOTED
NOTIFY ,~,UILOING DEPAR~I~I~ENT AT
765 1802 9 AM TO 4 PM ~ORITHE
FOLLOWING INSPECTIONS,
1, t:OUNDATION
FOR POURED CONCRETE i
2. ROUGH - FRAMING &
3. INSULATION
4. FINAL CONSTRUGTION I~
SE COMPLETE FOR C.O.
, ALL CONSTRUCTION SHALL
THE REQUIREMENTS OF 1'HEI
STATE CONSTRUCTION &
CODES. NOT RESPONSIBLE
DESIGN OR CONSTRUCTION ERRORS
STATE OF NEW, YORK, , ,~
COUNTY,49F ~... ~'~
..... //../. ....... / .......... ~ .........
(Name ofindividua! signing contract)
above named.
1
He is the. 2....~..r~...~.?..~'.r'/~.../~'. i
of said owner or owners, and is duly authorized to
application; that all statements con~ained in this
work will be performed in the manner set forth in the
Sworu to before me this ,
N~qtary Public, . ........... '
i ~ota~y Public, State of N,ew York~
No. 4822563, Suffolk County
I Term Expires December 31 ,? 9 o
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
, agent, corporate officer, etc.)
and says that he is the applicant
)rm or have performed the said work and to make and file this
are true to the best of his knowledge and belief; and that the
filed therewith.