HomeMy WebLinkAbout23421-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24949 Date MARCH 20, 1997
THIS CERTIFIES that the building ADDITION
Location of Property 445 OSPREY NEST ROAD GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 35 Block 6 Lot .32
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 24, 1996 pursuant to which
Building Permit No. 23421-Z dated MAY 8, 1996
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 CONVERT EXISTING CARPORT INTO A GARAGE ADDITION TO EXISTING
ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RALPH GRANDINETTI
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-407355 - JANUARY 3, 1997
PLUMBERS CERTIFICATION DATED N/A
X-�
B ild'ng Inspector
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)
or
Date ................. 19Z ..-
................. ..... ........ ....
N2 23421 Z
Permission Is hereby granted-to:
.........('.Loe. *......... .......
... .... .... ...
to . ............ ....Q?� ,........ ...0 .fit .�r!d�Z�r.'...'�... .
.. .�-.. , -- -tom. ' .. ..................... �,
... ..............................................................................................................
...................................................................................................................................................................
....................
at premises located at.............. lC ./ .,1`,, .-................................
--------- -
.............I...... .................................... .. .. .....
County Tax Map No. 1000 Section ..........3,�... Block........4e............. Lot No. 3. '...........
pursuant to application dated .................. .. ........... 19..?�...... and approved by the
Building Inspector.
Fee (.��............
... .....
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
' BUILDING DEPARTMENT
t �� MAR � � � TOWN HALL
�
765-1802
ELDG.DEPT. I
TOWN OF SOUTHOLD f PLICATION 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% 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 Building - $100.00
3. Copy of Certificate of Occupancy - .251t�.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . Old Or Pre-existing Building. . . . . . .. . . . . . . . . . rni '
Location of Property. . :.�5. . . . . .�S re.Y. . C!'� . . . . . . . . . . .( rOnc �( . .' . .�`�i.�l . . . . . . . .
House No. Street Hamlet GG
Onwer or Owners of Property. . . . . !�.GR�1d6V1(-, !. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . .85. . . . . . . .Block. . . . . .. . . . . . . . .Lot. . . . . . -:. . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No.aa1 W.� . . .Date Of Permit.R�:�. Y. ti.iQC .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . .. . . . . . . . . . . . . .
Request for: Temq,)"t-
rary Certificate. . . . . . . . . . . Final Certicate. �. . .
. 0-0Fee Submitted:/ $
. . . . . . . . . .04:":: . . . . . . . . . . . . . . . . . . .
�� -'2 y y y APPLICANT
765-1802
BU LDING DEFT.
1 PECTION
646"UNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE � INSPECTOR
41
76s-isox
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE 3 �� �7 INSPECTOR ,(i�
J
C) 3
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: C�6Y
I�X
DATE IO INSPECTOR �
l
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ j ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[/✓FRAMING [ ] FINAL
REMARKS:
DATE INSPECiE1�g��'��
rowl
(,of It If;I I I*ii
1:0111111ATI 0 11
..........
Fummet'l,loll -------
------------ -------------
RMIGII FRAPIP"
.......... ....................
..........
------------------------- ---------
----------
----------------------------
OIf 1,1;lt 11
STATIF, ....... 111
CODR, ..........
S4
. .........
F I I I A I.
---------------------
----------- ----------------- -----ma-A 1)1)IT I Of IA 1. it if!11-I'S
----- ------------------ -----------------
..................
-----------
BOARD OF HEALT11 . . . . . . . . .
FORM N0. 1 3 SETS OF PLANS . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . .. . . . . . . . . . .
BUILDING DEPARTMENT CIIECI: . . . . . . _ . _ . . . _ . . . .
TOWN HALL SEPTIC FORH
SOUTHOLD, N.Y. 11971
�i TEL.: 765-1802 t:OT I Fy ;
Examined . . 19A� CALL . . . . . _ . . . . . . . . . . . .
•� / a MAIL TO
Approved . . . . . . . .WM4 -
. . . . . . . . . . . . . . . . . . . . .. . . . . . .O/. . 19 �? Permit No. .l. . . . . . . _ . . . . . . . . . . . .
Disapproved a/c )LICATION
. . . . . . . . . . . . . _ . . . . . . . . . . . . .
. .. I .
Building Inspector)
FOR BUILDING PERMIT
Date . . . . . . . . . 19
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 schedule.
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 property 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 the premises available for inspection throughout the work.
. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
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 ins e�ctio s. '
. . . . . . . . ..7. . . . . . . . . . . . . . . . .
(Signature of appl" ant, or nam f a corporation)
U:. . . . . . . ... . . . . . . .�. r
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . .
Name of owner of premises �? vyc2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as-on the tax•roll or latest deed)
If applicant is a corporation ignature of duly author'zed officer.
(Name and title of orporate officer)
Builder's License No. . . . . .�. . . .. . . _ Nam• . . . _D LI I_� 1
Plumber's License No. . . . . : . . . . . APR 2 4 199
• i
Electrician's License No. . . . . . . . . . . i
BLDG. DEPT
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . .TOWN OF SOUTHG�_''
. . m. `-
1. Locattioonn of'land on which proposed work will be done. . , • , , , • . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . .
Mouse Number d" Street y Hamlet
County Tax Map N
000 Section 73 �. !. . . . Block . . . .2-� �. . . . . . : . Lot . . . .4!;; 3 Z. . . . .
Subdivision . . . . . . . . . . . . . � . . . . . . . . . . . . . . . . .Filed Map No. . . . . Lot . . . 7 . .
(Name) . . . . . .
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . , • , , . . . . �l'� ) , . , .
b. Intended use and occupancy . . . .P2 , , , , , • . . !j... . . . . . . . . . . . . .. . . ...
•3. Nature of work (check which applicable): New Building
Addition . . . . . . . . . .Re air Removal Alteration . . . . . . . . . .
Demolition
Other Work . .
. . . . . . . . . . . . .
4. Estimated Cost (Description)
�. . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application. ) . . . .
S. If dwelling, number of dwelling u its Number of dwellingu
If garage, number of cars . . . �- nits on each floor . . . . . . . . . . . . . . . .
6. If business, commercial or mixedoccupancy,�. . . • . . . . . . • • • • • • • • • • •
s ecif
specify nature and extent of-each type of use . . • I, ,
7. Dimensions of existing structures,if any: Front. .2-3 Rear ? �— . . . ... ' ' ' '
Height . . . . . . . . . . . . . . . Number o Depth . . . . . . . . . . . . . . .
f Stories
Dimensions of same structure with alterations or additions: Front -� .. . . . . . . . . . . . .
. ` . . . . . • ' ' . ' ' ' ' ' .
Depth . . . . . .. . . . . . Rear . .?- ?— . . . . . . . . .
Height . . . . . . Number of Stories .8. Dimensions of entire new construction: Front Rear . • • • • ' ' ' ' ' ' '
.Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . .
9. Size of lot: Front ��"" Rear. . . . . . . . . . . . . . . . . . " I . . .. "
10. Date of Purchase . .0 Z f�7�. Depth . . . . . . . . . .
Name of Fopner Owner . LZ
11. Zone or use district in w iich premises are situated . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . .. .
13. Will lot be regraded . . . . ,s Will excess fill be removed from premises:14. Name of Owner of premises Yes No
address . . . . . . . %9-• ! -ee , Phone No.
Name of Architect Address
• . . . . . . . Phone No.
Name of Contractor . . . . . . Address
15. • Is this property within 300 feet of a tidal wetland? *Yes
.. . . ."•'. Phone No. .�!`.??•',95`�7, .
*If yes,- Southold Town Trustees Permit may—be required.
• ' No. • I• . . '
PLOT DIAGRAM
i
Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
Ae
04
en :�k 9
ZI
®r
STATE OF NEW YORK,
COUNTY OF . . S.S
• • • • • • . . . . being duly sworn, deposes and says that he is the applicant
(Name individual ning contract)
above named.
fie is the . . . . . . . . . . . C����. . . .�-
(Contractor, agent, corporate officer, etc.) • • • ' • • • • • ' • ' ' ' ' .
)f 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 are t best of his knowledge and belief; and that the
rue to the b
.vork will be performed in the manner set forth in the application filed therewith.
iworn to before me this
.
. . . . . . y�•,
• . . . . . . . . . . . .day of. . ../� � . . . . . . . .,
40tary Public .ti�,�, .,� � ; � 44County
HEL.ENE.I)..HORRIE .
Notary Public,'State of New York • ` • • • • • • • • • . . . . . , , •
No.4951354 ignature•of applicant)
. . .
Qualified in Suffolk County
Commission Expires May 22, 19
Il
iy1
. !-'NEW,-:�YORK.;I:B�OARD: 'OFi�, FIRE,.:,UNDERWRITERS,'.-,i-{,�'-: ' PAGE1
- :)i THE;'
1001071' :�f ......
ELECTRICITY:1W.1''.
ij
BUREAU OF
JOHN STREET--NEW'Y6Rk,i;NY1d638
7 P7 `!7,
Date JANUARY'Oi,1997 11312399
7
;THIS CERTIFIES JF
t it
oi��the electrical equipment as described below andintroduced by`i"'applicant'--''-'d U. !"rmifi on above application qfi�number in'the
If if
2111:
7
GRANDINETTi;i`.t 45jilOSPREY'NESV 'll I'
r
n thefollowing location;,.`L�.J Basem6ne Egi t4i. 2nd Ft..i: GAR/,OUT
P Block--'lI_-f',
DECEMBER 27 '1996'.
','-and ie in compliance with-the National_6e"Ctilcal Code.
geas examined on jo�ud to j.
FIXTURE FIXTURES RANGES;,:-.- COOKING DECKS OVENS-i it DISH WASHERS I EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES •INCANDESCENT[FLUORESCENT OTHER -AMT::+f1•.K:W..i;1 'AMT.' I K.W. AMT. K.W. AMT.-[! K.W.-I. A
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FUTURE FEEDERS -- lI' UkITHEAThS MULTI-OUTLET I=-:1DIMMERS=I1_1i_;
DRYERS, FURNACE!MOTORS.: fUltE XiiPIIJXkC1' 4Tj
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PROVIDE V4 FIR. FIRE
LIVING I RATED SEPARATION TO
AREA PART. 717.3 (f) (1) OF -- I kPRR QED AS NOTED
��(V
N.Y. STATE BUILDING CODE. DATE: B.P.#
Y:
GARAGE I NOTIFY BUILDING DEPA
765-1802 S AM TO 4 P FOR THE
FLOWING INSPECTIONS:
N
N N 1! FOUNDATION - TVJO REQUIRED
FOR POURED CONCRETE
2-2x10 HEADER WITH 1/2" ( i 2j r;000H FRAMING & PLUMBING
s + ,
_ PLYWOOD TYP. 3} INSULATION
! yt, s � R 4` ��j FINAL CONSTRUCTION C.O.SHALL
MUST
l': i•, s=,_ tis' � ' C ----------� BE COMPLETE FOR
TPUCTIONMEET
"IMI !LL CONS
ST'E REQUIREMENTS OF THE N.Y.
ATE CONSTRUCTION & ENERGY
IT
` y' `la ti _ ! j ; I fO COi.)ES. NOT RESPONSIBLE FOR
CIESIGN OR CONSTRUCTIONS ERRORS
..-. r.--• �'�a� Ire •, µ 'fi 1
UNDERWRITERS CERTIFICATE
6'4 — -105 -t-- 6-4 —'I REQUIRED
1�------- 231