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Home My WebLink About31266-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31281 Date: 11/17/05 THIS CERTIFIES that the building ADDITION Location of Property: 95 HIGHWOOD RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 9 Lot 53 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated pursuant to which Building Permit No. 31266-Z dated JULY 11, 2005 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 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHESTER L & ANTOINETTE A. CIAGLO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~RALTH APPROVAL EL~crKICAL CERTIFICATE NO. PLUMBERS U~TIFICATION DA'I'm~U N/A ~/A N/A Rev. 1/81 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 Department with the following: A. 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 thc 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of properly showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state thc 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 access6ry building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: ~ (check one) House No. (~. Street ,) · ~ Hamlet OwnerorOwnersoferoperty:("~---~xC-S4C-q'' {-'' ~ ~/3~.V~O'~V~ _~--tq_ 0[~. Suffolk County Tax Map No 1000, Section Block Lot Subdivision Permit No. Health Dept. Approval: Date of Permit. Filed Map. "~ -11' O~' Applicant: · Underwriters Approval: Lot: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ FORM NO. 3 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) PERMIT NO. 31266 Z Date JULY 11, 2005 Permission is hereby granted to: CHESTER L CIAGLO 95 HIGHWOOD RD SOUTHOLD,NY 11971 for : CONSTRUCT A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES 23339. at premises located at 95 HIGHWOOD RD County Tax Map No. 473889 Section 078 Block pursuant to application dated N/A Building Inspector to expire on JANUARY SOUTHOLD 0009 Lot No. 053 and approved bythe 11, 2007. Fee $ 150.00 i/S%gnature ORIGINAL Rev. 5/8/02 FOUNDATION (1st) - -I ?OUI4DATIO~ (2nd) ROUGH FRAME &. -PLUMBING INSULATION PER'N. STATE ENERGY ~ CODE FI;:AL ADD!TIO}I~'L CO:4~E~TS: APR I 3 IggJ SLOG, DEPT. TOWN OF SOUTHOLC , Examined ....... ¢'. ...... 19~.¢ Approved ....... .~/,~ .... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... flBu~ffiing Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... ... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH Z=z. .... I~/[IL TO: , ~"-.. _ ... 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 desctiption 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 Buildlitg 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 desctibed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admi,t authorized inspectors on premises and in building for necess~ary inspections, r-~ /~ -- (Signature of applicant, or name, ~a por ' )/l~ U(Mailing address of applicant) g State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · Name of owner of premises ~-~.%~., .~;..~.....~..~-..~. ,Q~, ,~.~...-~,....~..'..C.~.~. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. PEE.? (Name and title of corporate offic~ :§ CUPANCY OR Builder's License No ............... USt"l$ UNLAWFUL Plumber's License No .............. WITHOUT CERTIFICATE EIecttician's License No ............ 0F' OCCUPANCY Other Trade's License No ...................... NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ' 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTB~UCTION;.~VIUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ,-'~.-- ~ t r STAT.~_.(~ONSTRUCTION & ENERGY Location of land on which proposed work will be done..~{ ..... ./V~..l.~tXC~O.q,~. P.~ .~9T..R. qqRO. N..SLqLg...~9.~.. · ..~, ....... .~ ....... ' k ~ DESIGN OR CONSTRUCTION ERRORS ..... .......... , .... House Number S re a County Tax Map No. lO00 Section ....~ ........... Block q Lot ~ ~ 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 ....~...~.'x.~..~..~. ~ .q~.~....k.~ ............... : '&': .... ~ ................ b. Intended use and occupancy . .~-~.' .k, .~..~.....c?. 3.' . .~..~..~..~..:'...?,A~. ~-~..~.4.~.'. .C~.' .~ [ ..... 3. -Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....~..' .... Repair .............. Removal .............. Demolition ............. ~r .............. ~i~ O & oo . . (Description) 4. Estimated Cost Fee ..... ~,i .:; · .~.; .... (to be paid on f~ing 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 natuxe and extent of each typg of use ....--7 ........ . ........ 7. Dimensions of ex)sting structures, if any: Front .... .g.~. ........ Rear .... fi?. ....... Depth .. ~..q. ........ Height .... .,,9.5. ........ Number of Stories.. · ..~'. ................................................. . Dimension~tof same structura with alterations or additions: Front .... .g..t~..~ ........ Rear ... ~.s~?. ¢~ .......... Depth. ,2fl...4..0.~q.K..'7. ,/~. ~.3~.. HeiSt ..... ~ff., ........ Number of Stories .... ~...: .... ~ ......... 8. D~menmons of e~t~re new construction: Front ..... ~. ....... Rear .... ~ ........ Depth .. {~. ~ ......... HeiSt .... ~ ......... ~umber of Stories . ....~ ...... ~ ........................... ~... 2'; .......... 9. Sizeoflot: Front .... J~..: ............ Rear...~ ............... ~epth ..[~.~..c ............. 10. Date of Purchase ... l .~ ~ ~ .......... ......... Nme of Fomer Owner .~ .~. ~.q ~ []~ ~ .... 11. Zone or use district in which premises are situated.. ~0~ ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ................... i~. ..... 13. Will lot be regraded ........ ~ ............... ~,,Will e~cess fill be ~emoved ~0m premises: Yes 14. N~e of Owner of premise~~~~ ~~ .~. Phone N~e of ~ch~tect ........................... Address .... ~,~.. Phone No ................ Nme of Contractor ..... ~..; ................. Address ...~ ............. Phone No ................ 15. Is th~s property wZth~n 300 feet of a t~dal wetland? *Yes ........ ~o...~ .... ~If yes, Southold To~ Trustees Pe~it may be required. P~T DIAG~ Locate clearly ~d distincflg MI bu~d~gs, wh~er exist~g or proposed, ~d. indicate M1 set-back d~ensions from prope~ ~es. Give street ~d block number or description accord~g to deed, ~d ~ow steer nines ~d ~dicate whe~er interior or c~er lot. T ~p~l) i~a~ ....... !).~ .~ .~....~.x ..... . 4.~.~.~.~. :'~ly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. He is the ~.~ F ' (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is duly authorized to perfo~ or have perfo~ed the said work and to m~e ~d file ~is application; that all statements contained ~ this application are tree to the best of his ~owledge and ~lief; and that the work will be perfo~ed in the m~ner set forth in the application flied therewith. ~1~ L O~ ' · .' ............... ~ ~11~ 8~ ~ N~y~ Of applic~t) No. m~lon ~ir~ ~m~ O, 19 ~ /