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Home My WebLink About34647-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33703 Date: 05/11/09 THIS CERTIFIES that the building FIREPLACE Location of Property: 560 CLANK RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 135 Block 2 Subdivision Filed Map No. Lot NO. SOUTHOLD Lot 3 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 1, 2009 pursuant to which Building Permit No. 34647-Z dated MAY 1, 2009 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 FIREPLACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to MATTHEW & EILEEN CAPPABIANCA ( OWNER ) of the aforesaid building. SUFFOLK COUNq"fDEPART~ENT OF HEALTHAPPROV~J~ ELEt-rRICAL CERTIFICATE NO. PLIERS CERTIFICATION DA-r~u N/A N/A N/A Rev. 1/81 ~ Form No. 6 Ill III TOW~ OF SOUTHOLD ~'~1 ...,~ ~ 9f~ I~L.~/ I B~LD~G DEP~TMENT ~ATION OF OCC~CY CERT~ICATE ~s applimtion must be fill~ in b7 ~wdter or ~ ~d ~b~ to ~e Bulling ~ent wi~ ~e folBw~g: ~ ~or new building or new nsec I. F~ a~eY of prop~ wi~ amte l~0on of ~ ~l~gs, pm~y 1~, s~t~, ~d unns~ m~ or to~p~c fmcs. 2. F~ ~proval ~m H~ ~t. of~ supply ~d s~sposal (S-9 fo~). 3. ~pro~l of elec~c~ ~la~ ~m Bo~ ofF~ Unde~tem 4. Sworn s~t~ent ~m plm~ ~g ~ ~e mld~ ~ ~ s~tem con~ l~s ~ ~ 10 of 1% l~d. 5. Commemial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer respomible for the building. 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 andunusual natural or topographic features. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Oeenpaney is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelllng $25.00, Alterations to dwelling $25.00, Swimmang pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certilicate of Occupancy on Pre-existing Building - $ I00.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy ~ P~esidential $15.00, Commercial $15.00 Date. 0"~///d~ ~ New Construction: Old or Pre-existing Building: Location of Property: Owner or Owners &Property: Suffolk County Tax Map No 1000, Section Subdivision 9, l,Q~4 7 Permit No. ~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~2~'.b~_> 33?03 House No. Street Block Filed Map. Date of Permit. /w/~tg/> ~ Applicant: Underwriters Approval: Final Certificate: (check one) Hamlet (check one) Apl~i(ant Signature ' FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUII~DING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34647 Z Date MAY 1, 2009 Permission is hereby granted to: MATTHEW & EILEEN CAPPABIANCA 132 N.MADA AVENUE STATEN ISLAND,,NY 10310 for : CONSTRUCTION OF A FIREPLACE AS APPLIED FOR PER MANUFACTURERS SPECIFICATIONS. THIS REPLACES BP# 32171. at premises located at County Tax Map No. 473889 Section 135 pursuant to application dated MAY Building Inspector to expire on NOVEMBER 560 CLARK RD SOUTHOLD Block -0002 Lot No. 003 1, 2009 and approved by the 1, 2010. Fee $ 150.00 ~AAut~ Signature Rev. 5/8/02 ORIGINAL FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 32171 Z Date JUNE 30, 2006 Permission is hereby granted to: DONATO CAPPABIANCA 3124 ROCKWATER WAY VIRGINIA BEACH VA, 23456 for : CONSTRUCTION OF A FIREPLACE AS APPLIED FOR PER MANUFACTURER'S SPECIFICATIONS at premises located at 560 CLARK RD SOUTHOLD County Tax Map No. 473889 Section 135 Block 0002 pursuant to application dated JUNE 30, 2006 and approved by the Building Inspector to expire on DECEMBER 30, 2007. Fee S 150.00 ~d/S gna~tu i re Lot No. 003 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL ~FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: INSPECTOR DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ,20__ Approved ,20 Disapproved a/c PERMIT NO. ~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Survez Check Septic Form N.Y.S.D.E.C. Trustees Contact: Expiration ,20 ,, .~ Z ~ PPLICATION FOR BUILDING PERMIT Mail to: Phone: 20 ,,.... - INSTRUCTIONS ~-~-a.~s ap~pliCation MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with4 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./ /~rwas~(~''~~ Mt,,.~2 ~ l~ll~4~llll~l~. ~~l~l~ ~~'~ - S' tu- -a~ -'ca otrfi'ame, if a corporation) -.. x [, New York l~l~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ,,,~z~-/.~ ~,,'~,~,~,~i Z%~n.~q..~;'z_~"24t,' C~/~/~ (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 *'l }~ (Name) Block o0l,, OO Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 'ag b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Estimated Cost If dwelling, number of dwelling units . 61 [t~ If garage, number of cars ~1~" Addition Alteration Removal Demolition Other Work ~';,~9oZ~ 6 (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor ,dl~4 If business, commercial or mixed occupancy, specify nature and extent of each type of use. t41 ~q 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear _Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front ~x Rear ~ Depth _Depth 10. Date of Purchase _q!t~'' Name of Former Owner 1 1. Zone or use dis~ct in which praises ~e situated 1 2. Does proposed construction violate any zoning law, ordin~ce or regulation? YES 1 3. Will lot be re-~aded? YES NO ~11 excess fill be removed ~om prmises? YES NO~ ~ ~P~ 14. Nines of Owner ofpremises~t~ ~qgP~/~e~s~ Phone No. Nme of~chitect Address ~ t6~ ~ 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__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE/~EQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO/ 16. Provide survey, to scale, with accurate foundation pl~l~'~~'~ft313erty lines. 1 7. If elevation at a~.t0oint on proper~ is at 1 0 feet or belo~u~'~rt~ViCle topographical data on su~ey. STATE OF NEW YO~) SS: CO~TY O~ ) ~[~d ~fO being duly sworn, deposes and says that (s)he is the applicant (Name of individml si~ing contract) above nmed, (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. Swom ~t~before me this .~ ~ff)~ _ day of \3111A1 . . NotaryJrublic MELANIE DORO~K! NOTARY PUBLIC, State of New Ym~ No. 01D04634870 Qualified in Suffolk County na~pplicant TOWN OF SOUTHOLD PROPERTY RECORD CARD OWN ER FORMER OWNER STREET VILLAGE Ef DISTRICT SUB. LOT ACREAGE· + TYPE OF BUILDING RES. ,~/0 LAND ,fi eO SEAS. IMP. VL. TOTAL O'-O0 FARM DATE COMM. 1ND.t CB. MISC. I / I ~ (~_c / / ~ , , J ~//~j AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE F(]rm Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushland., House Plot Ac re Value Per Acre Total Value ' ~ ~ I Foundation J Extension /~~(~ _- 5-!o I I , ._,, Basement Extension ?~ ~ ~ ~/~ ~t. Walls Extension Fire Place Porch ~ ~ Attic ~ ~ /~ R~ms 1st Flor Breezeway Patio /~ ~ R~ms 2nd Floor Garage Driveway O.B. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE I OF OCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. APPROVED AS NOTED "-"~iF,," '15rO'iLDfr.:~ ~?ARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. 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