HomeMy WebLinkAbout34250-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33366
Date: 10/31/08
T~IS CERTIFIES that the building ACCESSORY
Location of Property: 2085 SHIPYARD I2k
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 38 Block 1
subdivision
Filed Map No. __ Lot No. __
EAST MARION
Lot 23
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 22, 2008 pursuant to which
Building Permit No. 34250-Z dated OCTOBER 22, 2008
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" ACCESSORY CARPORT AS APPLIED FOR.
The certificate is issued to RICHARD J ROSSETTI & SUSA/~ RACKETT
(OWNER)
of the aforesaid building.
SI~FFOLKCOb~I"fDEPART~4ENT OF }~AL~"dAPPROV~%L
EL~L-i~ICJkL C~RTIFICA~ NO.
pLI~BERS CERTIFICATION DASD
N/,~
N/A
Rev. 1/81
TOWN OF SOUTHOLD *~ I~ I'~ ~ ~1 ~/ g i '
BUILD~G DEP~TMENT
TOWN HALL
APILICATION FOR (ERTIFK 4TE OF OCCUP~ y
This application must be filled in by typewriter or ink and snbmitled to the Building Depamnent with the following:
A. For new building or new use:
Final su~ey of property with accurate location of all buik]ings, propc~%, lines, streets, and unusual natural or
topographic features.
2. Final Approval kom Health Dept. of water supply and sewerage-disposal (S-9
3. Approval ofelect~Scal installation from Board ofFi~e Undemqqlers
Sworn statement kom plumber ceaifying that the solder used in system contains less than 2/10 of 1% lead.
5. Conm~ercial building, industrial building, mulliple residences a~d similar buildings and installations, a ce~ificate
of Code Compliance kom architect or enginec~ responsible f%r the building.
6 Submit Planmng Bond Approval of completed silo plan
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land rises:
1 Accmatesurveyofpmpe~%,showingallp ope , linc,sucels, huildingandutmsualnatnralortopographic
features.
2 Aproperlycompletedapplicalionandconscm u,m pc~l:;iancd b5 t eapplicant lfaCellificateofOccupancvis
denied the Buildinff Inspeclo~ shall slate Iht icax<,ux I[ie~el}~ ii1 wNting to the applicant. '
C. Fees
I Ce~tificateofOccupanc} -New(we ?$ 51~,J x,d,htu-,n I,)d',,,dlin~$2q00>,&Iterationstodweiling$2500,
Swinmaing pool $2500, Acc(ssoU' buihtilig $25¢u~. A&lili~n< to accessory building $2500, Businesses $50 00
2 Ceitit]cate of()CCUlganc5 on lhe-cxistin~ Iguihlilqn $1 (N
3. Copy of Certificateof'Occupancy $ 2~
4 UpdatedCcltificateof()ccupa~x:y Sq00~
5 l'empo~a~yCe~lificateof(>ccupam:y lhcsi<icnti:d% 4 N ¢?rmm~e~cialSi500
New Constm,ction:
Location of Property: .'.'.~O ~
House No
Oid ol Pre-¢xistu;~ ~ lildin~ ~ (check one)
~rcel Han~et
Suf~blk C6unty Tax Map No 1000. Sco~;o,,~ o~?~
_ Lot
Snbdix ~sion Filed Map
Pelmit No '~ k[~ 0 Date of l'u,m~l. &pi>lie, ant:
Health Depl Approval: _
Plalming Board Approval:
Request for: Temporalw .emncate
Fee Subnfitted: $ 0-....~- ~
t lndep,vriters &pprova[: _
kinal Certificate: ~ (check olle)
Applicant Signatu7 ~/ '
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. 34250 Z
Date OCTOBER 22, 2008
Permission is hereby granted to:
RICHARD J ROSSETTI
PO BOX 391
EAST MARION,NY 11939
for :
CONSTRUCT ACCESSORY CARPORT STRUCTURE "AS BUILT." ADDITIONAL
CERTIFICATIONS MAY BE REQUIRED. THIS PERMIT REPLACES BP 32096.
at premises located at 2085 SHIPYARD LA EAST MARION
County Tax Map No. 473889 Section 038 Block 0001 Lot No. 023
pursuant to application dated OCTOBER 22, 2008 and approved by the
Building Inspector to expire on APRIL
Fee $ 150.00
/ Au~ i ~ Siqnature
ORIGINAL
Rev. 5/8/02
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)
PER~IT NO. 32096 Z Date JUNE 12, 2006
Permission is hereby granted to:
RICHARD J ROSSETTI
PO BOX 391
EAST MARION,NY 11939
for :
CONSTRUCTION OF AN ACCESSORY (CARPORT) STRUCTURE AS BUILT
ADDITIONAL CERTIFICATIONS MAY BE REQUIRED.
at premises located at 2085 SHIPYARD IJt EAST MARION
County Tax Map No. 473889 Section 038 Block 0001 Lot No. 023
pursuant to application dated MAY 10, 2006 and approved by the
Building Inspector to expire on DECEMBER 12, 2007.
Fee $ 150.00~ed!i~~
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] ROUGH PLBG.
[ ] INS~UL'A~ON
[ 'I' FINAL
[ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENL=TRATION
DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRA2VII1NG &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
/
Examined tS" /Z~, 20
Approved /~'2- :~, 20~
Disapproved a/c -/gt
Expiration ,20
10
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO.
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Forat
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
APPLICATION FOR BUILDING PERMIT
Date Nc~ i o ,20 oto
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 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.
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
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, v ~/ ~,, /~
(M~ailing address of appllcant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises P-.ic%o,O 3'. ~-.osse~ ~ 5ktsrx~ N, ~o.c.r.~rtt-
(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.
Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
Block ~ i,~ ,' ;.,,,;~'~,,,[,~.. '-~
Filed Map No
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy c,[cw~ln~ea 'rz~¢ ~or~c' ~4~( k~x~/~e~'ac~c X,~,~r~ is~(xc~
b. Intended use and occupancy o,\~,~,~o~w,, '6o,~(~ect:' - ~:>f Iocfxk/,,Jekack~/\J'"~
Addition
Other Work
4. Estimated Cost ~/¢,
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
Alteration
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~q/f~
7. Dimensions of existing structures, if any: Front ~O/~ ~<~ ~ .R.o~ _De4~l
Numher'of Stories
Dimensions of same structure with alterations or additions: Front t3//~
Depth Height Number of Stories
Rear
8. Dimensions of entire new construction: Front N/la
Height Number of Stories
Rear .Depth
9. Size of 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? YES NO__ t'd
13. Will lot be re-graded? YES NO__Will excess fill be removed from premises? YES NO M / A-
14. Names of Owner of premises -~X~ aC 0q24' Address
Name of Architect Address
Name of Contractor Address
Phone No.
Phone No
Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES __NO __ * 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 v~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
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:
COUNTY OF ,~L~O !
,5'~tSo~rl ~c4~hl--- ~$St'ht~ ot~d ~J~%' being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) abo~
(S)He is 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.
20
RECORD CARD /~/-~?
/~M-,Y~'-t-~¢ TOWN OF SOUTHOLD PROPERTY
OWNER STREET '-; "'~-- , VILLAGE
LAND
:AGE
NEW
Farm
Tillable
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
SEAS.
IMP.
VL
TOTAL
Gzeo ~ ~/
DISTRICT SUB.
ACREAGE
TYPE OF BUILDING
FARM COMM. ' [(IND. CB. [MISC.
DATE REMARKS
Est. Mkt. Value
BUILDING CONDITION
NOP, Cv~AL BELOW
Acre Value Per Acre
LOT
Total
M. Bldg.
Extension
Extension
Extension I
Breezeway
Garage
Foundation
Ext. Walls
Fire Place
Patio
Driveway
Porch
Porch
Bath
Floors
Interior Finish
Heat
Roof Type
Rooms Ist Floor
Rooms 2nd Floor
Dormer
-I
-t
50
DEEDS.
~T
,OWN OF
[dOM
SUFE CO. TAX h'IAPr I0,.,~)-" ......
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