HomeMy WebLinkAbout32770-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32244 Date: 03/13/07
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 57635 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 63
SOUTHOLD
(STREET) (HAMLET)
Block ~ Lot 23
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. 32770-Z
dated
FEBRUARY 5, 2007
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 "AS BUILT" ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS\
APPLIED FOR.
The certificate is issued to WILLIAM A & PORA CAPONE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~~ ",..,"~
Rev. 1/81
.,
.
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
1AR I 2,
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 the solder used in system contains less than 2/1 0 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
Date.
~/; 2. 107
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Old or Pre-existing Building: (check one)
Location of Property S 7? 35 Il1:Li h Kd - ~ <YYu+J.zo lei
House No. Street /l Hamlet
Owner or Owners of Property: W / III t2 YY) 't /> IA y tl Cd po 17 t= ,
Suffolk County Tax Map No 1000, Section "113.1 R~ Block a:;r?~ Lot_C/2.3
Subdivision 0& Filed Map. _ Lot:
pe~0-8.;(17 ~Date of ~~it. ;;< ) z;j 07 Applicant W \ \ l \ D... M ;-- P u y CA..
Health Dept() l1Proval:C % ~ ' Underwriters Approval: _ C Itf61"L ~
New Construction:
Planning Board Approval: _~___
Request for: Temporary Certificate_
Fee Submitted: $ 2 S'. ~
-
Final Certificate:
(check one)
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c_~ -c 3,2) 'f t
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.
32770 Z
Date FEBRUARY
5, 2007
permission is hereby granted to:
WILLIAM A & PURA CAPONE
57635 ROUTE 25
SOUTHOLD,NY 11971
for :
AS BUILT ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP # 28559
at premises located at
57635 MAIN RD
SOUTHOLD
County Tax Map No. 473889 Section 063
Block 0003
Lot No. 023
pursuant to application dated N/A
and approved by the
Building Inspector to expire on AUGUST
5, 2008.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
3}-770<.
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT CONSTRUCT1ON
REMARKS:
[ ] ROUGH PLBG.
[ ] I~ATION
[,.{FINAL
[ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT PENETRATION
~
DATE Jlr/o7
It.
INSPECTOR
~0srf}
7&5-1802
BUILDING DEPT.
INSPECTION
[ ] FOUND~ 1ST [] ~H PLBG.
[ ] F DATION 2ND [~NSULATION
[ FRAMING [ ] FINAL
.
[ ] FIREPLACE & CHIMNEY
REMARKS: Wa~ ~~
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1-~~ ~~1~
DATE
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FIELD INSPECTION REPORT DATE COMMENTS \
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OWNER
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I'ORMER OWNER
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RES, J.. Ii)' i SEAS.
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LAND IMP,
TOWN OF SOUTHOLD PROPERTY RECORD CARD
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STREET
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LOT
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AGE
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TOTAL
TYPE OF BUILDING
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FARM
COMM. CB.
Mkt. Value
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BUilDING CONDITION
ABOVE
NEW
FARM
Tillable
Woodland
Meadowland
House Plot
Total
--
NORMAL
BELOW
Acre --t- Value Per Value
Acre
,
FRONTAGE ON WATER
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I FRONTAGE ON ROAD 7~ E~;'-'- S" ,...,. ~l . ..s- ~ Q
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! DEPTH
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I
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Porch Ext. Walls H ~G Interior Finish t.!/t:)LL !LR. I
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8re8.i.B ..1~ it ,- /L.~ 'Fire Place AI r, Heat If r: lOR. I
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Garage Type Roof Rooms 1st Floor I
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Patio IRecreation Room Rooms 2nd Floor !FIN. S ,
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Total i ~- I !
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ,
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
Examined
Approved
Disapproved ale
PERMIT NO.1!- giiCJ-b:-
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans V
Planning Board approval
Survey V--
Check
Septic Form
N,Y,S.D.E.C.
Trustees
Contact:
"Z..
,20
(" 20 ---z:;
'-
Mail to:
Expiration
,20
Ghone:.lrr ipS - ;'){p2q
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or
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In
APPLICATION FOR BUILDING PERMIT
,)"" u.l ~ ? _ ,20 D7 ~
, L_ ' INSTRUCTIONS
a. T~i6atl~n in1S"r-t;f-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 oflot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South old, 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
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
'.;:,,1
I 2 7'/)
Date
(Signature of applic 0 e, if a corporatioIj)
S1ft;:?J5 rVlai ~ l?cJ .~l.tfhn1cJ
(Mailing address of applicant) II q 1]/
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
() /1) I'le r!S
Name of owner of premises \JJ I LLU_h1 ~ PIA r tt {], ~ 0 Yl e..
(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 No.
Electricians License No.
Other Trade's License No.
I. Location of land on which p!2Posed work will be done:
571035 ma..J Yl Koctd- 5011..+'" 0 I cL
House Number Street
Hamlet
"" .. ~.'1" ", ,-, "I
County Tax Map No. 1000 Section Oh3.0D
Subdivision
Block 03 00'1.-
Filed Map No.
Lott) 23 .atl "
Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy one farrll 1( res i denl"f>- .
b. Intended use and occupancy one -family res, dencc
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work V new .S .de s+oof
CAfe.r bne-K (Description)
~ers+o e.odi;{teVe\ f-'foonf\a)
(To be paid on filing this application)
Number of dwelling units on each floor
3. Nature of work (check which applicable): New Building
Repair V Removal Demolition
dl8'DO,
4. Estimated Cost
Fee
/
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. hL1..-
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
10. Date of Purchase
I~/p . q f
,I, /91
I .
Rear c;f.FIP
Depth-1Q/". 17
(!a.ro I 5. Ca.se,
9. Size oflot: Front
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? YES_ NO V
13. Wi1llotbere-graded? YES_NO ./ Will excess fill be removed from premises? YES_NO_
14. NamesofOwnerofPremises~ddress57('35' n1Jupll?d~~b~ '7b5'3"'""Z.'L
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO L
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO_
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines. -See a,-+icLcneL
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
)
lA.V"'tl
(Name of individual signin contract) above named,
OWVle.r
(Contractor, Agent, Corporate Officer, etc.)
ovte-
being duly sworn, deposes and says that (s)he is the applicant
(S)He is the
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.
~-~~
ELIZABETH A STATHIS
NOTARY PUBLIC. State of NewYortc
No. 01ST6008173. Suffolk Cou!lty
T eon Expires June 8. 20-'<. Ce
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TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY-
. elf/DO - 63 ~ 03 - 23
<':"'SCALE 1"= 40' ,
. :f~{~t'~OCT. 17, 1994 .
~;~.r;\;' :fSEP.T. /5, 2000 ( c.r/illcallan )
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