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HomeMy WebLinkAbout23840-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24904 Date FEBRUARY 13, 1997 THIS CERTIFIES that the building ADDITION Location of Property 4055 HALLOCK LANE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 112 Block 1 Lot 6.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 1996 pursuant to which Building Permit No. 23840-Z dated DECEMBER 5, 1997 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 . INSTALL A NEW HEATING SYSTEM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH RIZZO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED NOVEMBER 1, 1996-LAWRENCE TRAPASSO ui ding Inspector Rev. 1/81 FORM NO. f 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) ° 23840 Z Date Permission is hereby granted to: �85 2-�' .. .... dr.. . . ...��..C... .. 1* .................... ............ ....... .. . . . ..... .� � , f t0 .�.. ....... .�'L. . F2�..�!r .. ...... .. . .. . . ..�,....................... .... .. .. ............................. atremises located at .......................................�Y. . .,. �r� / �� ............................................................................... ..... .. ........... ................................ ................................................................................................................................................................. County Tax Map No. 1000 Section ...... Block ............/...... Lot No. .......... pursuant to application dated ......................�!?r .. ................. 19.Z.6, and approved by the Building Inspector. Fee $...�. ............ kll ............ ............... :...;a ................. Building Inspector Rev. 6/30/80 Fo r rf i No. 6 TOW,\1 OF SOUTHOLD I'U I LD INC, DEPARTI-ILNT TOWN IIALI, 765-1802 APPLICATION FOR CERTIFICATJ.-' 01" OCCUPA"CY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 1 . , or new use: Final survey of property with accurate location of all buildings, streets, and unusual natural or topographic features. lilding's, property lines, 2. Final Approval frotil' Ifealth Dept. of water supply and sewerage-disposal(S-',) form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4.' Sworn statement from plumber certifying that the solder used in system contains 5. less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and itistallations,l\a certificate of Code Compliance from architect or engineer 6. responsible for the building. Submit Planning Board Approval Of completed site plan requirements. B. For existing buildings (prior to April 9, pre-existing,, land uses: 1957) non-conforming uses, or buildings and 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 Buildir,Q - $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 New Construction. . . . . . . . . . . Old Or Pre-existing Building. lr' .. . . . . . . . Location of Property. . . �(25-_51. . . . . . . . . . . . . House No. StreeL Hamlet Onwer or Owners (.4 Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax I-lap tj-o 1000, Section..— . . . . . .Block. . . . . . .I Lot. . . . . Ti Subdivision. ;; . f ... . . . . . . . . . . . . . . . . . .Fited Map— . . . . . . . . . .Lot. . Permit No. . . . . . Date Of Permit. . . . . . . . . . . . . . . .Applicant A. Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approva" . . . . . . request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . :wee Submitted: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Co �a q 0 • 'ram`� Town Hall,53095 Main Road Fax (516) 765-1823 P. O. Box 1179 Telephone (516) 765 1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No . Owner: J y S e"Q k (plea e print) Plumber: L A(,op£ryC-c- Tycz GtxS�c) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead.. (Plumbers Sign ture) Sworn to before me this day of ,/1/o j 19 Q u Notary Public, State of New York No. 52-4352699 Qualified in Suffolk County Notary Pub 1C y� t� `'(, County %r+Commission Exoiras March 3u 19�7 I.loll Ill!rolvi. DMA. I'M I IIDATI ON F-MINDAT ION lto11(:Il FRAHR & 11.01-1111 NO ------------------ IN.'NILATION 1)1-'I( ti . STATIF R.111-.Imy ---------------------------- C-12 F I HA I. LL --------------------------------------- BOARD OF HEALTH FORM NO. 1 3 SETS OF PL,\:IS . . . , , , TOWN OFSOUTHOLD SURVEY . .. . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECI: . • TOWN HALL SEPTIC FOR:I . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 � � TEL.. 765-1802 t:Or I F'f ; Examined . . . 19 CALL . . . . . _ _ _ . . . . . . . . . " . t1AIL TO Approved . . . ., I .�I?ermit No. G: . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . _ . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) A (CATION FOR BUILDING PERMIT GG Date . . 0.�:4. . . . . . . . ., 19% r INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with .,ts 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 stree, r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl ation. 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 permi call 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 Occupant call have been granted by the Building Inspector. APPLICATION IS HEREBY.11;IADE to the Building Department for the issuance of a Building Permit pursuant to th wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tc Imit authorized inspectors on premises and in building for necessary inspections. (Signature of applica t, or name, if a corporation) (Mailing address of applicant) -.ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . ? . . . . . . . . . .. . . . . . . . . ...... . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . ame of owner of premises i 2 C, . . . . . . (as on the tax roll or latest deed) appli2ais a torpor on, signature o my aut iorized offi r. (Name and title of Orporate officer) Builder's License No. . . . . . . . ..a. . . . . . . . . . . . . . . . . Plumber's License No. . . .` ? Electrician's License No. Other Trade's License No. . . . . . , , . , . . . Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . ' . �. . . . . . . . . .W.A.l.�.a�K . .t-!�(ye . . . . . . . . . . . .rn !. f h -�R� . . . . House Number Street . .. . . . ' . • . Hamlet County Tax Map No. 1000 Section Subdivision . . . . . . . . . . . . Block . . . . Lot . . .�:'.t . . . . . . . . . . . . . . j . . . . . . . . . . . . . Filed Map No. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction.- a. Existing use and occupancy . . . .7-> J . . . . . . . . ... . . . . . . . . . . . . . . < . . . . . . . . . . . . . . . . ... b. Intended use and occupancy •s� . . . . . . . . . . . . . . . . . . . . . . . . -3., Nature of work (check which applicable air . . ): New Building . . . . . . . . . . Addition . . . . . . . . . .Rep . . . AI. . . . . . . . . Removal teratior. . , ,", , , • • • • • • • . . . Demolition . . . ... . . . . . . . . . Other Work .4E69.P( 44 4. Estimated Cost . . . �©.0,0 6 (Descrip ion) . . . . . . . . . . . . . . . . . . . . . . . . Fee (. : . . . . . . . . . . . . . . . . . . . . . S. If dwelling, number of dwelling units . (to be paid on filing this application) If garage, number of cars . . ' ' . • • • • . Number of dwelling units on each floor . . . . . . . . . . . . . . xed occu a. . s . . . . . ' . ' ' ' ' ' ' ' . . ' ' • • • • 6. If business, commercial or mi • P Y, P Y nature and extent of.each type of use . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . Height Rear . . . . . Depth . . . Number of Stories • • • • • • . • . . . . , . Dimensions of same structure with alterations or additions: Front ront Rear . . . . . . . . • . . . . . . . . : Height . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front • .Height . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . Number of Stories . . . . . . . • • . . . . . . 9. Size of lot: Front . . . . . . . . Rear . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase � " " . . . . . . • • • • • • • • • • •, Depth . 11. Zone or use district in which premises are situated. . . . . ... . . . . . . ... Name of Former Owner . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or Iebl:lation:13. Will }ot be regraded . Will excess fill be removed from p y ' 14. Name of Owner of premises .�. '?L remises es Name of Architect h • • • • • • Addressr-t("4 1e�Zi sr. ev. phone Nos q .' g19t, if . Name of Contractor , �r2U ' ' ' • • • • Address . . . . . . . . . . Phone No. Z Address—0 7i .. . .. . .v 5. Is this property within 300 feet of a Vq hone No. tidal 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 dimensions frorr. )roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. � � UNDERWRITERS CERTIFICATE ,v REQUIRED n y ' ' r G;fi;"'I'�, i'� ° � � ,'fit 1AA'�1 P O WIN A IL e 'a'e., n a 765-1802 9 AN4 TO 4 4ts OIE THE FOLLDV'INi0INSPECTIONS: 1. (--,Dt.eP��tr�^^pApTI�c�lN�I P.p-��p'TWO CREQUIRED rl. C� �I I� ls413 & PLUMBING 3. PF' GULATION 4. I=6i4ar`-A. a CONSTRUCT ION MUST T.C) BE COMPLETE FOR C.O. 0 V L Eel D C(L)��'�,��"1��T�t. /t��M�. ALL CONSTRUCTION HALL MEET ® s a f✓y]��T'��/.y[�F�_ a' y J r l� 'iT THE REQUIREMENTS OF THE € Y; riA ti v tl �. �E OONSTRUOTION At ENERGY �":� ' ✓"a., ,�� L t,p P�`�'.`1�- �` a CODES. NOT -RESPONSIBLE FOR A{•��iR'���.��v�T,�+�e°.".t�."'•.���r`¢n'iy'�`�it R a eo'd�, Fb P'' ,oy���`' DsSgLS 4p p W VpnV N ERRORS 4 . kTE OF NEW YORK, UNTY OF . . . . . . . . . . . . . . . . . •S.S S50 being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ve named. sthe . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.). . . . . . . . . . . . . . . . . . . ' ' ' ' ' ' ' aid owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ication; that all statements contained in this-application are true to the best of his knowledge and belief;and that the < will be performed in the manner set forth in the application filed therewith. m to before me this . . . . . .da of. . . . .✓. . . . . . . . . . . . .. 19 try Public, . . . . . . . . ✓t 1 /`�.��: • • • • • •�-•`'�: County - VITO E. FF; al!llCFil — • Notary Publ?c. ,•;�w . . . . . . . . . . . 52-;�,,-.,r.`� York No. . . ' �' j (Signature of applicant) Qualified in Suffolk County S17 s t _Commission Exnires March 30,i 9_ ?.i / kM OIL BURNER Certificate of Inspection Name Joseph Rizzo Aop# 14021 Location: 4055 Hallock Lane, Mattituck, NY 11952 �1 Applicant: Petro/Reliance �A Address: P.O. Box 788 , Smithtown, Ny 11787 �l Tel.No. 686-1954 uc-No, 29 1—RE Expires: CJ ..ELECTRICAL INSPECTION SERVICE, INC. » 375 DUNTON AVENUE / EAST PATCHOGUE,NEW YORK 11772 TEL: (516) 286-6642 1/7/97 Date Inspector �II� or