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HomeMy WebLinkAbout22975-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23850 Date SEPTEMBER 5, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 105 PRIVATE RD. #31 SOUTHOLD, N.Y. House No. Street' Hamlet County Tax Map No. 1000 Section 77 Block 3 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 15, 1995 pursuant to which Building Permit No. 22975-Z dated AUGUST 29, 1995 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 ENLARGE OPENING ON EXISTING GARAGE AS APPLIED FOR. The certificate is issued to ROBERT & SUSAN PADUANO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspec or Rev. 1/81 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) Date.............`". ....� ............................... 19........... ... NR 229752 Permission Is hereby granted to; �I`�`."�/G-/ �.... ..w!............. 6 615- ..60-5z- � �...... ............... .......... .....1Z9J/...................... to . . .........r...................... — ...... ...../. . / �-/ ^......... X/J '+//� .................:'' . ................. ..................... ........................................................................................................................................ .................................................................................................................................................................. ...................................................I........ ���.��! 'l�,Q..............................r..... ................................. at premises located at........ �v}/ ................:....... .... ......................C .. 0 ........................ ..............................I...........� r1 .4............................................... ............ County Tax Map No. 1000 Section ...... ........... Block......r,�........... Lot No. ..... ........,. pursuant to application dated .................... ...................., 19.... ., and approved by the Building Inspector. �v Fee$....? ........... ....................... Building Inspector Rev. 6/30/80 Cam- ojiak, y I r To, 0.Lo- f73� TOWN OF SOUTHOLD N AUG I BUILDING DEPARTMENT d Iaa� TOWN HALL � 765-1802 T (C �- APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 1.7 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 a 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial .$15.00 Date . . . . V��. . . . . . . . . . . . . . . .. . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . k_ . . . . . . . . . �� / Location of Property. .j.?: . . . . . .� . .�'-e�� . . . ..... . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.._!. . . '.� ??o . ounty Tax Map No 1000, Section. . . . . . . . .Block. . . . .3. . . . . . . . .Lot. . . Z . . . . . . . . . . . . . . Subdivisi.on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .FJ.l.cd Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . 'lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . �tequest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . "ee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . G',�.c-5 C00 . . . . . . . . . . . . . . . . . . . .. BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS• ooi) -7 / kz-lz DATE �� INSPECTOR i BOARD ' OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PL."%2IS . . . . . . . . . AUG 15 1995 TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . - - TOWN MALL SEPTIC FORH . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 i:OT I FY CALL ...r_ . . . .r. . .7G p. .. Examined . . . .� �.�. . . . .. 19 9. IIA I is TO Approved . . . . .�/ 19/. �. Permit No. . �o o'��•��( . . . . .. . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . ( !/ ui ng Inspector) APPLICATION FOR BUILDING PERMIT ' Date . �r. .. . . . . . . . . . 19q) 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 scliedule. 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 description of layout of properly 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 Building Permit. d. Upon approval of this application, the. Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on fire premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in hart for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS 1-EEIt1313Y MADE: to the Building Departttrent for the issuance of a Building Pennit pursuant to the Building lone 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:.' . . . . . . . . . . . . (Signal ttyte oC a >>licant or name, if a con roration I l .., . I ) . �... . . . . . . . . . . . . . . . . . (Mailing address of applicant) Slate whether applicant is owner, lessee, 'agent, architect, engineer, general contractor', electrician, plumber or builder. � . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . Naive of owner of premises . . . . � . . .� �,� .��.. . . . . . . . . . . . .. . . ... . .. . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1 . Location of land on which proposed work will be done. 75. . :�` C;, £ .4�1'a� , . ; . . . . . , . , • . , . . , House Number Street Hamlet County Tax Map No. 1000 Section . .d: . . . . . . . . . . Block . .3 . . . . . . . . . . . . . . Lot .L,.r . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 1 Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . < �. . �f b. intended use and occupancy . . . . . . . . . . . . . . . . . . =. . . . .'. . . :.. . . . . . . . . . . . . . . . 3. NalUre of work (check which applicable): New Building . Repair . . . . . • • . . . . . . . Addition .�. . . Alteration . . . . . . . . . . 1 . . . . . . . . Removal Demolition q • • ' • • • • • • • • Other lVork . _ 4. Estimated Cost . .�/�•• � � .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . . . . . . Num If garage, number ber of dwelling units on each floor . . . . . . . . . . . . . . . . of cars 6. If business, commercial or mixed occupancy, specify nature and extent of.ea. .h type of use . 7. Dimensions of existing stnictures, if any: Front . . . . Rear Ileigllt • Depth . . . . . . . . . . . . . . . Number of Stories . . Dimensions of same structure with alterations or additions: front . . . ' .• . . . . . . . . . . . . . . . . . . ' Depth . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . Ileiglit . . . . . . . . . . . . . . . • Nurnber of Stories ' 8. Dimensions of entire new construction: Front . . . . . . Rear Ileight . . . . . . . . . . . . . . Depth .-Number of Stories 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . : . . . . . . . . . . 19. Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Date of Purchase th ' • . . . . Name of Fortner Owner I I. Zone or use district in wilicil premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . 13. Will lot be regraded . . . . . . • . . . . • . • • . . • • . . Will excess fill be removed front premises: 4. Name of Owner of premises . . . . . . . . . . . . . Yes No ' • • . . . Address . . . . . . Phone No. Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Nance of Contr r acto . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . ... . . . > Address . 1'Irone No. 5. is this property wiLhin 300 feet of a Lidal wetland? *Yes No. .. . . . . . . . . . . . . . . . *If yes, Southold Town Trustees Permit may, be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back climen§ions from )roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. APPROVED AS DOTED - DATE: 9 B.P.# .w IV FEE: J BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM;TO '4 PM 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 N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION. ERRORS TATE OF NEW YORK, OUNTY OF . . . . . . . . . . . . . . . . . S.S .9A • . . . . . . . being duly sworn, deposes and says that lie is the applicant (Nance of individl 2rl signing contract) )ove named. -e is the . . .�//��,b.l^!Fr'GC .p`o�' . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . ... . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in this-application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. ,vorn to/before nle this . . . . . ./ � day of. . . . . . . . . . . . . . . . . ., 19 . .�� otary Public, . . . . . . . . . .�"a—C� eounY t . . JOYCE M.WILKINS Notary Public,State of New York . . . . . . . . . . . . . . . . No.�49152246,SuffolkCoun (Sig � nature of applicant) Term Expires June•1.2,19 01 Ot-6 9 Id. I ` I I I 1 i