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HomeMy WebLinkAbout16736-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT• Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . Z- 16644 Date. , February 1 1., 1 988 THIS CERTIFIES that the building C O N-S T R U C T A C C E S S.0 RY S H E D Location o f Property „3065 County Road #48 Mattituck, N.Y . House IVo. Street Ham%i County Tax Map No. 1000 Section .14 1. . . . . . . .Block . . . . 2. . . . . , . ,Lot , . . .14. ...2. Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . .. . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated February 4 . 1988 pursuant to which Building Permit No. 1.. . . . Z February 1 1 , 1 9 8 8 dated . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . ... METAL ACCESSORY SHED AS APPLIED FOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . The certificate is issued to . . ANTHONY & DENISE ANT;ONGEORGI of the aforesaid building. Suffolk County Department of Health Approval . . . . . . .N/A . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . .N/A PLUMBERS CERTIFICATION DATED: N/A . . . . . . . . . . . Build"g I spector Rev.1/81 FOR NO. 2 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) N°16736 Date .... .. /..'........................................... 19 Permission is hereby granted to: ........... :::.'/. . ....... .................. ... ® .J�... ..rrr. . .—A-6................................ .......V.a)4�......`�,.r. !.......f/la-2-- to ... ............... . .... .e;ar�...... .. ......................... ...... .. ...... ............. .. .. ........................................................................................................ . at premises located at .... ................................................................ ................................................................ ................................................... �( :: �. .....:............................................ .......... ......................................................................................................................................................:.......... County Tax Map No. 1000 Section ......../�/.... Block .........�...-........ Lot No. .��. P. - ... pursuant to application dated 19 , and approved by the Building Inspector. Fee $. .. ............... .X/u�iliidiinjg7tnWspe�tior ............................ ... Rev. 6/30/80 ti 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 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 property 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: 1. Certificate of occupancy New-Dwelling,$25..0.0, Accessory��$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 'years $ 10 . 0 0 4 .Vacant Land C.O. $ 20 . 00 5.Updated C.O. $" 50 . 00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . NewConstruction. . . . . . Old or Pre-existing Building . . . . . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . . . .. . . .vei,��. 7r . . . . . . .`. . '.' 1.�,�: . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Owner or Owners of Property .1'7! S.z. .. �_-.S:.2 . . 14 . . . . . �ot . . 14County Tax Map No: 1000 Section . . . . . . . . . . . . ✓?�. .r'..�:.�!.�.�.f. . . Subdivision .. . . . ../. . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit Noll'/.7 k? .Z Date of Permit - ��l� .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval ... . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . .. . . . . . . Underwriters Approval . . . . . NA. . . . . . . . . . . . . . .Planning Board Approval . . . . NA . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . X . . . . . .q P Y .Final Certificate . . . . . . . . . . . . . . . . . Fee Submitted $ . . . .10.00 . . Construction on above described building and permit meets all applicable codes and regulations. Applicant . . . , , ANTHONY ANTONGEORGI . . . . Rev.10-10-78 cc 1 W4 ' BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY . . . . . . . . . . TOWN OFSOUTHOLD CHECK . . . . . . . . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . TOWN HALL NOTIFY &OUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 �Q MAIL TO : Examined Approved . . . . . . ., 19r�Permit Nc,4 7.6. .� RMA Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FRI- BLDG.FEB 41988 . . . . . DEPT. Oy TOVdi! OFSOUTHOLD ' (Suildi nspector) APPLICATION FOR BUILDING PERMIT. Date . . . . ..8 8. . . . . . . . .1 19 . . . INSTRUCTIONS e 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- cadon. 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 ap licant-agrees to comply with all applicable laws, ordinances, building code .housing code, and regulations, and to admit authorized inspectors on premises and in building or necessary inspec ions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) . . . . . . . . . . . . . . . . . . . . * * * . . . . . . . * * . * . . . . . . . . (Mailing address of applicant) State. whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . • • • ANTHONY ANTONGEORGI (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 BE SUFFOLK COUNTY LICENSED Builder's License No. . . . . . . . . ... . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3065 Route 48 Mattituck , New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number - Street Hamlet County Tax Map No. 1000 Section . . • 14 1 • • • • , Block . . . .2 . . . . . . . . . . . . . Lot . . 14...2 Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. _. ..,dy�. . . . .. . . . . . . . . Accessory Shed b. Intended use and occupancy "` 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . S h e d Alteration f.?Repair . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . .2 0 0...0.0 . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . 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. Dimeii'soris;of existing'-structures-,if'any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . Height( , r: .. . . . Number of Stories . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N!a Dimen'sions'of same structure with'alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . it .,. . . :',::. . . . . . Height . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . S. Dimen`sibns of entire new construction: Front . . . . . .. . . . . . . . Rear . . . .i� ... . . . . . . . . Depth . ` . . . . . . . . . . . . �. . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size f lot:,-Front . . . . . . . . . . . . . . . . . . . . . . .Rear . . . . . . . ... . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. 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. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . 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 may be required. 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. k.A v !^']ll� MOT am: / B.P /6 d o f By. � P' t FA_�TIFY WILD$� �U TK v i � �CY i � P -l ANTO ,� � y `` 1s4S- (•:wy� %JE- IS U i lGr F"T RTI F I CATE Or _Ayl l ANC! C r-_ F0,2 C.0, STATE OF NE S.S COUNTY OF . . . . . . . . . . . . . . . ../h O./�t /. . �. i being duly sworn, deposes and says that he is"the applicant (Name of individual s4gning contract) above named. Heis 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. Sworn to before me this day o . . . . . . .•. . . . . ., 19� Notary Public, . . . . . . . . . . . . . . . . . County CLAIRE L GIEW • • • . . . . . . . . . . . Notary Public,State of New York (S ature f applicant) No.4879505 Qualified in Suffolk County Commission Expires December R: