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Home My WebLink About17000-zTOWN 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) N0_17000 Z Date .... ~/~/..;~.~... .......................................... , Rev. 6/30/80 ~OUNDATION (1st) ~OUNDATION ( 2nd ) {OUGH FRAME & -PLUMBING iNSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: g Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 2/10 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. 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 the 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 $15.00, Commercial $15.00 Date ...... ~.l.~?? ........................... New Construction .... XX ..... Old Or Pre-existing Building ................. Location of Property ~P~Q ~- KIDD DR. MATT. House No. Street Hamlet Onwer or Owners of Property ............................................................ .F.R.A. NK .& DEBORAH POLISTENA .. Subdivision .................................. Permit No. 17000Z .Date Of Permit .... .Filed Map ............ Lot ................... .. . ......... Applicant ........................... . . Health Dept. Approval ................... .... . Planning Board Approval .................... .. .Underwriters Approval ..................... ... . Request for: Temporary Certificate .......... Fee Submitted: $ ............................ Final Certicate ........... APPLICANT VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF $OUTHOLD May 3, 1990 DEBORAH & FRANK POLISTENA BOX 667 MATTITUCK, N.Y. 11952 Re: B.P. 917000Z above ground pool, fence and attached deck. 2000 CAPT. KIDD DR/205 LINDA RD., MATTITUCK Dear Mr. & Mrs. Polistena: I am writing to you regarding the above Building Permit. Your permit has expired and you have never scheduled an in- spection. A Certificate of Occupancy is required after you pass. Also you must have an Underwriters Certificate. The fee for the Certificate of Occupancy is $25.00. Please contact our office to set up an inspection. Thank you for your prompt attention to this. Yours truly, Secretary !fZO //\, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined ~../~.7 ......... , 19.~.~. Approved. 5¢.~. ...... ; 19 .~. Permit No..~. ~..6~, .d27./ Disapproved a/~ ..................................... ................. ... ...... BLDG. DEPT. TOWN OF SOO~OLD 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 t411it~rl~al'j~l~!~ection throughout the work. e. No building~ ~~.~b~d in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been grafl~~~Sl:rector. APPLICATION IS'~"~/'L~i~ to the Building Department for the issuance o~ant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applqil~RlJt~L~ws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as heroin described. The ..applicant agrees to,~,c~co,m,p]y Nj~lj~l~ql~pilcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspel~iT~i~I[~'~'~ in building for necessary inspections. _....,.~ ~ .q.e .-,,-,,.,--~. :~t~ .E~,. o~.g. . .*.~t~ .~.,~. ~ ~d. .1. ~z.. ! ~. E~.. ~ /:!. . ; ., ...... · ,~.~ ~..~ +It (Signature of appfi~d~, or name; if a corpora~i0n) :8~l~'J:i",x't~ .'..~,41vvO.i..lOq , -, ,(M,~ili~ng, address of applicant) State whether :chitect engineer gell;;al *lec' rieian, lumber or bnilder. Name of owner of premiselk~, .~.~...~ ~ ~ .~ .................................. T4'113 *~ jhS~ ~O1~1 ;r~ ' (as on the tax roll or latest deed) ','~ 3f41' atO i~Rt4VFI~I~, :}' If applicant is a 4o~g~iq~, ~ig~i'~/&l~Ul~ly authorized officer. ............ · A~O~tR~ !40m.OUI~.T~W3~ ~9.....: :'.'. .... (Name ahd title of corporate officer) Builder's License No.. DgO.~ ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... [~;~e ~'u~ b~r' ~' ........... Street County Tax Map No. 1000 Section . i~.~. ............ Block . .~-~ .............. Lot... ~ ............ Subdivision .~..:..~.-'t~ .6[.. ~~ ........... Filed Map No..~.~ ~ ....... Lot..[~5 ........ (Name) 2. State existing use and occupancy o~premises and intended use and occupancy of proposed construction: a. Existing use and occupancy. ,.q.~.. '~" ~1' ................ :' 's~: ~ ~',~ .................... b. Intended use and occupancy ~. 0' Q ~ &' paOt .,.. &e~.g: ~~ ................ 3. Nature of work (check which a~plicable): New Building ..... ' ..... Addition .......... Alteration ...... /3. Repair .............. Rem6val ......... Demolition .............. Other Work ~]/0t~..~./..~.O.0~ -- ~'~.~/~ )CZ~)('}OIX:~ II' v (Description) 4. Estimated Cost.. ..,~/;-.. ...................... Fee ...................................... *" (to be paid on filing this application) 5. If dwelhng, number of dwelling.unit · · N f d Iii unit h floe s.' ' ' ' . ......... umbero we ng soneac r ................ If garage, number of cars ..... ................................................................... 6. If .... business commercial or mixed, occupancy,, specify naturg! and extent of each typ of use ........... ~./. 7. DJmensmns of existing structures, ~f any Front .... ~..'2, .... Rear ,,. ~..'7,,~. Denth ~7-~ ...... }][eight . J.?(.~..~7.5 ..... Number of Stories...~ .................................................. Dimensions 3IqSame structure with alterations or additions: Front ................. Rear .................. Depth ~ Height Number of Stories 8. Dimensions of entire new construction:. Front .......... ... .. Rear . ............. . Depth .......... ..... Height ........... :. ~.TNurnber of Stories ............. ;, ................ ~ .~... ~./ .............. ,, .... 9. Size of lot: Front .,~, .~ .... ~i ........... Rear.../.t~(.9 ............... Dept~ 10. !)ate of Purchase .~t?-~[7.~... .................. Na, me of Former Owner t(/t~.~rq 11. Zone or use district in which premises are situated.. ~'~l l~O.~../.t~ ............. :', .~; ............ ...... 12. Does proposed construction violate any zoning law, ordinance or regulation: .~0 ........ i. ................ 13. Will lot be regraded .. ~.0... i ................... Will excess fill be removed from premises: _Yes , 14. Name of Owner of premises .~ .......... Address ................... Phone No.. c~..c,//.~':~[.$.~..VTf Name of Architect ..... ~"-'7... J ................. Address ................... Phone No. Name of Contractor.. ............. Address ................... Phone No. 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. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERIiFICATE OF OCCUPANG 'IMMEDIATEL ,, ENCLo$~ POOLiT0 CO UPON CO DE STATE OF NEW YORK, J:~'oRE COUNTY OF ........ . ......... (Name of individual '" s~gmng contract) above named. "IMMEDIATELY" ENCLOSE I~)OL ~0 ~ UPON COMPLETION BEFORE "WATER" A.PPItQ D AS N011D ncm~v ~-UiLO--~- O~ 788-t~2 9 AM FOLLOWING INSPE~: I. FOUNDAT~N FOR ;ou;;~~ 2. ROUGH - FR~ 3. INSU~TION 4. RNAL ~~N MUS~ B; COU~ ~R C.O. ALL CONST~ON ~HALL MEET THE REQUIR~ ~ THE N,Y. CODES. ~ ~8~NSIB~ FOR D~SIGN OR C~8~U~ON ERRORS being duly sworn, deposes and says that he is the applicant He is the ..................... ...... i&iJr' 'oi/,rl ............................ of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application am 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. Sworn to before me this ............... ......,.:o¢; Nota. Pu lic, ................ ount ~.. ~. PUBLIC, State pf=Ne. ?~k~, ... NO, 4707878, Suffolk oun~ S' J Term Expir~l~rch 30,1~9 ...~ ¥ _ ( ,jgnature o~ app! canu