HomeMy WebLinkAbout26370-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31906 Date: 10/05/06
THIS CERTIFIES that the building ACCESSORY
Location of Property: 560 KING ST ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 26 Block 2 Lot 35
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 29, 1999 pursuant to which
Building Permit No. 26370-Z dated MARCH 3, 2000
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 ACCESSORY 10' X 14 ' STORAGE SHED IN THE REQUIRED REAR YARD AS
APPLIED FOR.
The certificate is issued to JOHN A & ARLENE TOMMASINI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
A", /�
Ah ize Sig ature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT 1'
TOWN HALL
765-1802 I ,I - 4 2';76 ;
APPLICATION FOR CERTIFICATE OF OCCUPA�CY— j
R�b, . y
This application must be filled in by typewriter or ink and submitted to the Building Department witGtIiel�bw*i5—J
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 the solder used in system contains less than 2/10 of I% 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 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- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
p
Date. L � �/
New Construction: 1/ Old or Pr -existing Building: (check one) s
�Location of Property: L Q �r!c\ C �� n e� 1,E4
House No. Street Hamlet
Owner or Owners of Property: �� t-t') k yn ��
Suffolk County Tax Map No,1000, Section �' Block c-;2,, Lot 3
Subdivision Filed Map. Lot:
--�^^
Permit No. Date of Permitf� a'� Applicant s► y, .t IL-f064
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 42
r ,
App
Co �3r966
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. 26370 Z Date MARCH 3, 2000
Permission is hereby granted to:
JOHN A TOMMASINI
PO BOX 458
ORIENT,NY 11957
for
CONSTRUCTION OF AN ACCESSORY STORAGE SHED IN THE REQUIRED REAR
YARD AS APPLIED FOR.
at premises located at 560 KING ST ORIENT
County Tax Map No. 473889 Section 026 Block 0002 Lot No. 035
pursuant to application dated FEBRUARY 29, 1999 and approved by the
Building Inspector.
Fee $ 35 . 00
Authoriz d , ignature
ORIGINAL
Rev. 2/19/98
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ULATION
[ ] FRAMING ] FINAL
[ ] FIREPLACE HIMNEY
REMARKS: 40� a"ev,�
DATE �� INSPECT
3 70 ;!-,
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] i ULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: Jla A /:�:
/Abgwe- _L! Ae4
l/tie -v
DATE INSPECTOR
. F1oLD INSPECTION REPORT DATE COMMENTS �J
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0
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II II
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II
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FOUNDATION OND) II - tcc,
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INSULATION PER N. Y. Ir
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STATE ENERGY II it
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FINAL IIIIII I'� �I
33
DITIONAL COMMENTS_zz
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a _ TOWN OF SOUTHOLD PROPERTY RECORD CARD
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LAND IMP. TOTAL DATE REMARKS v[
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LIDI7loLA'S 1%f,11)GEri �4CfuM. PaoPffttr I.INfi
BOARD OF HEALTH . .. .. ..........
FORM NO. 1 3 SETS OF PLANS .. .. ... ...... ..
TOWN OF SOUTHOLD SURVEY ................ ........
BUILDINGDEPARTMENT CHECK .........................
TOWN MALL SEPTIC FORM ..... ... . . . ........
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY: �7
CALLA lffifw.om'-)Im .
Examined.................. 19.... MAIL TO:. ./W l ek.F)C:K..57.1E
Approved..... /L L ...., �?u Permit No. ................ ...................................
Disapproved a//c'`.................................. ...................................
........................................... ........
` F1 ................
H$ldicg 7nspec
2 9 ..; AP KATION FOR BIIILDING PBBMIT HiQ qq
L_._._.. i Date. �.1. .. . .,t9•?AOa
T INSTRUCTIONS
a. his application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan s6owiog location of lot and of buildinga on mmises, 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 application.
c. be work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be.kept on the premises available for inspection thro*mt the work. Certificate of
e. No building shall be occupied or used in whole or in part for any purpose whatever until a
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS HmREBy WM to the Building Department for the isa oce of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Camty, 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. Die applicant agrees to 0001017 with all applicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in build1ifor necessary inspections.
f A ..&L.l............
(Signatcae of applicant, or name, if a corporation)
Mailing address of applicant)
State whether applicant is weer, leasee, agent, architect, enginser,'goneral contractor, electrician, plumber or builder
Aper N`f�.................................L.....t........................................
Name of owner of premises ...>�a�:�.'&.J...Tgw' —;.OF!.... M. LLY.1.....................................
(as on the tax: roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name
and title of corporate officer)
Builders License No. .........................
Plumbers License Ro.
Electricians License No. .....................
Other Trade's License No. ....................
1. Location of land on uticn proposed work will be done..............................................................
5lo0... J�?C..S �........QR16.01 ..........................................................
House Number street Madet
County Taz Map No. 1000 Section ...... �..... Mock ..Z........... Int .. ..es .......
Subdivision ................ Filed Map.No. ......... .. Int ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .............................................................................
b. Intended use and occupancy''............. .................................................
S�E� toXt4
1. Nature of work (dn&which applicable): New Building /..... Addition .......... Alteration ..........
Repair ............ Removal ............. Damolition ............ Other Work ............•...................••
(Description)
i. Estimated Cost ..3j r ... .... fee ..............................................
(to be paid on filing this application)
5. If dwelling, amber of dwelling units ............ Number of dwelling units on each floor ................
Ifgarage, number of care ......................................
6. If business, commercial or mixed 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 ease structure with alterations or additions: ..Froot—.............. Rear ...............
Depth .................... Height .................... umber of Stories ...............
8. Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
Height ......................... Number of Stories .....................
9. Size of lot: Font .................... Rear .................... Depth ....................
10. Date of Purchase ..................... Name of Roarer Owner ........................................
II. Zane or use district in which premises are situated ...............................................................
12. Does proposed construction violate Bary zoning law, ordinance or regulation. ........................
13. Will lot be regraded .................... Will excess fill be removed from premises: M NO
14. Nares of owner of premises ........................... Address .............................. Phone No. .............
Name of Architect .................................... Address .............................. Rhone No. .............
Name of Contractor ................................... Address ...............................Phone No. .............
15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ..........
*IF YRS, SODIHIID 10WN PUMT MAY Bg MWM.
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 amber or description according to deed, and show street owes and indicate
whether interior or corner lot.
SMIC OF
0J11N[Y OC�.
...........................�� ...being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named, /
4l9�t l,l ..D.. tC�r? --........
11e is the ................... .. .. ...�..... :...... .. .. ....
(Contractor agent, to officer, etc.)
of said owner or owners, and y 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 beat of his knowledge and belief; and
that the work will be performed in the meaner set forth in the application filed therewith.
Sworn to behethis
o .. . Y.l. 19.
Notary :lie
�
GLEW .(Signature of Applicant)
� of Now
No.01GLSA878ti06 York
CWaIMW in Suffolk
Commledon Fxpires Dec.8.
I
A 2 . B. v srED
DATE: B.P.
FEE
3/2 do - �
- -'A'I.E• 2, ° � 'a I
:�BY: -
NOTIFY BUILDING ARTNI AT
765-1862 9 AM TO 4 PM FOR THE
¢ wIrIY -rJT -
{ �•11141�wy FOLLOWING INSPECTIONS:
-K ANSIC,�iF FOR 7. FOUNDATION - TWO REQUIRED-
-_ L'
E Vk f POURED
2 ROUGH FRAMING & PLUMBING
Ly
-
3. INSULATION
4. FINAL _ CONSTRUCTION MUST
AMP BE COMPLETE FOR C.O. ,
ALL CONSTRUCTION SHALL MEET {
IoXG� I THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
E CODES. NOT RESPONSIBLE FOR
j DESIGN OR CONSTRUCTION ERRORS
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I I r � 1S UNLAWFUL
OUT CERTE � l`
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