HomeMy WebLinkAbout23428-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
PgBl
No Z-23475 Date MAY 21, 1996
V
THIS CERTIFIES that the building ACCESSORY
Location of Property 1405 CLEARVIEW AVENUE SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 9 Lot 31
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25, 1996 pursuant to which
Building Permit No. 23428-Z dated MAY 9, 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 AN ACCESSORY SHED IN THE REQUIRED REAR YARD OF A SINGLE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MATHEW & ROSEMARY DIPIETRO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspectdr,
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y..
CERTIFICATE OF OCCUPANCY
a L4I
No Z-23474 Date MAY 21, 1996
%,s
THIS CERTIFIES that the building ACCESSORY
Location of Property 1405 CLEARVIEW AVENUE SOUTHOLD BY
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 9 Lot 31
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25, 1996 pursuant to which
Building Permit No. 23428—Z dated MAY 9, 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 AN ACCESSORY SHED IN THE REQUIRED REAR YARD OF A SINGLE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MATHEW & ROSEMARY DIPIETRO
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspecto
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
N2 23428 Z
Permission Is hereby granted to:
......................... . /,L✓ ............
/�� �l� G�i��
............... .................... ................................... ................
............................1......................../......../.............. ..
r, . �... ... - .. . .. .......�.....
.... .. ........... ... .
...................................................r� ,,�.. F, ../- ...cl..` '..................... . ...................
at premises located at..........,,l.� c ... ./ .. .L ��r�s...T'..f.��. ........................
....................... ................................ ?;f...l„.�C;.................. ..................... . .....I......
County Tax Map No. 1000 Section ........... 7... Block.........9............ Lot No. ...�./...................
pursuant to application dated ..........:.... ' 19...7..(.., and approved by the
Building Inspector,
Fee$.....7 ...:��
......... . . ............. ...
Building Inspector
Rev. 6/30/80
Form No. 6
7 5 ��i
TOWN 0_ SOLTHOLD
BL_LDTOWI�DrEI.AA�L SAT 0{2
MAY 1 41996 =��
765-1802 .�f fIC-bS)
BLDG.DEPT.
T, \NN Q dIJ� T�S __ Y-'. AIPPLICz=IO FOR CiRTT_rTCATT OF OCCL"t",ITC-'
-• T111S aDpll.cation must be filled in by t,TPewriter OR ink and submitted to the bui lding
inspector with the followinz: for new building or new use: v
1 . final survey of property wit!? accurate -Location of all buildings, properry lines,
Streets, and unusual natural or topographic features.
2. _" nal Approval from Health Der. t. o: water supply and sewerage-disposal(S-9 form)
S. Approval of electrical installation from Board of 'Fire Underwriters.
+. Sworn Statement Zrom plumber certif,ting that the so-Lder used in system contains
less than 2/10 of '_;o lead.
Commercial Du1ld?no, indLlStrial building, multiple residences and szm-lar bulldZIIzS
and installations, a cert=ficate of Code Compliance from architect or engineer
responsible for the building.
m 6. Submit Planning Board ADDroval of completed site plan reouiremenzs.
�. =or existing buildings (prior to ADril 9, 1957) non-conforming uses, or build=ngS and
are-exist�ng" land uses:
1 . Accuratevsurvev of property showing all property -Lines, Streets, budding and
unusual_ natural or tODograDhlc features.
2. A DroDerly completed aDD lication and a consent to inSDect signed ' v the aDp licant.
If a Certificate Of OCC1^uanCy is denied, the Building !nSDector Shall Staca the
reasons therefor in w_itins: to the a-onlicanr.
' . Certificate of Occupancy - New dwelling S25 .00, Additions to dwelling S25.00,
Alterationst0 dWelling' S25.00, Swimming pool S25.00, Accessory building S25.00,
Additions to accessory building S-25.00. Businesses S50.00.
2. Certificate of Occupancy on Pre-existing Building - S100.00
J. Cbpy of Certificate of OecuDancv - .25c.
updated Certificate of Occupancy - S50.00
5. Temporary Certificate of Occupancy - Residential S10.00, Commercial S15.00
Date . . . . . . , '�1&1176. . . . . . . . . . . . . . . . . . . . .
New Construction. . . .V. . . . . Old Or Pre-etisting Building. . . . . . . . . .
-ocation of Property. . ® 5� . . . . .C� � UIrr . . .Jv". . . . .—V.uTY. . . . . . . . . . .
House No. /�S�treet /� Q Hamlet
)ewer or Owners of Property. . . lfTljc' . . ./.`" -5�� .I jll . . �!✓1./. .� /.%�Q. . . . . . . . . . . .
ounty Tax Map No 1000, Section. . . .7e. . . . . .Block. . . . . :/. . . . . . . . . .Lot. . . 3..1 . . . . . . . . . . . . . . .
subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .r.'/. .Filled Map . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
?erm_t No. . �T?C.� . .Date Of aermit. . ✓y/��1.�? . . .Applicant. . ��. . .Q Ill '✓L.S . . . . . .
=iealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters ADD-oval . . . . . . . . . . _ . . . . . . . . . . . . .
lannin2 Board ApprOvGl. . . . . . . . . . . . . . . . . . . . . . . . /
.eauest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
0e Submitted: S . . . .
� .'^. _ .
Form NO. 6 lus
' TOk1N OF SOUTHOLD
BUILDING DEPARTMENT C/�c7/2 L .�CG�Ssc7►� y
` MAY 1 4 1996 TOWN HALL
J •S/f 7 6 -18 0 2 £[�S
_j
BLDIG.DFPT.
TO NOOTHOLD CERT '_ICATE OF OCCLP ANC`APPLICATION i
`.'his application must be filled in by typewriter OP. ink and submitted to the bu'-idin_s
i:spec-or with the following: for new building or new use:
1 . Final survey or prODerty with accurate location Of all buildings, property lines,
streets, and unusual natural or zoDograDhic reatures.
2. Final Approval from Health Dept. or water suDDly and sewerage-dispcsal(S-9 form) .
3. Approval Of electrical inStallacion from Board of Fire under-writers.
4. Sworn statement from plumber certifying that the solder used in Svstem contains
less than 2/10 of 1io lead.
o. Commercial building, industrial building, multiple residences and Similar buildings
and installations, a certi=irate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planr_inz Board Approval Or completed site plan requirements.
S. Or existing bL'ildinzs Prior to April 9, 1957) non-conforming uses, or buildings and
'!pre—exis tina" land uses:
1 . Accurate-survey of property showing all property lines, streets, bu4"Id=ng and
unusual natural Or tODographic features.
2. A prODerly completed application and a consent to insDect signed by the applicant.
_= a Certificate Of Occupancy 1s denied, the Building iasnec-or shall state the
reasons therefor in wr tinz to the applicant.
1 . Certificate of Occupancy - New dwelling $20.00, Additions =o dwelling S23-00 ,
Alterations to dwelling S23.00, Swimming ?fool S25.00, Accessory building S21.00,
Additions to accessory building $25.00. Businesses W50.00.
2. Certi=irate of Occupancy on Pre-existing Buildins - S1OO.00
3. _ irate f pancy - .25�.Copy o_ Cer --
L. updated Cert-if irate of Occupancy - S50.00
5. Temporary Certi=icate of Occupancy - Residential S10.00, Commercial S15.00
Date . . . . . . .:s/131Q.6. . . . . . . . . I . . . . . . . . . . . .
Sew Construction. . . Old Or Pre-existing Building. . . . . . . . . . . . . . .
.,oration of ProDertv. . . . . �-'Y. . . . . . . . .(_._.*;C1I-" VJECti.) . . . ./I . . . _ L2T.//0.L6. . . . . . .
House No. Street Hamlet
)ewer or Owners of Property. . . . jd�l 7/f �--�. . � Y . .-'�110/e7�. . . . . . . . . . .
,ounty Tax `Sap No 1000, Section. . . . :70 . . . . .Block. . . . . .l. . . . . . . . .Lot. . . . . . . . . . . . . . . .
subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
No. . .�Z�?V .�.DaLe Ofi �eru�'1�.. .9/ �^.'. ApDl�Cant. .
-:ealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
'-arming Board ADDDroval. . . . . . . . . . . . . . . . . . . . . . . .
request for: Temporary
`Certificate. . . . . . . . . . . mall Certicate. . . . . . . . . . .
-ee Submitted. Z C . c. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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The
Carriage House
APR 2
51996
I AWNID'0
SQUT}{O D
765.1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ATION
[ j FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: � 477
DATE � � INSPECTO
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_ON fI LE IN T34E�. G�K-rJO3MTY-Cd-F 3{5 OFF i C E'AS
2 51996 ?
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= OWN OF SOU THOLD
f � / l is
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! G.1I TO
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CLEAPVI E W AVE
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s - cir-�•, yr. �r;x,.�,_;-.,;yam'-:_s,= "'-`i:�v�._Y:-2""r t"�'�'. ,_ - - - , � �.: •.� a
* HOARD OF HEALTH . . . . . . . . . . . . . . .
'n 6 0 nn FORM NO. I 3 SETS OF PLANS . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . .
BUILDING DEPAR'ITIENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
AMR2 5 Pt1nr_ TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
���0 SOUTHOLD, N.Y. 11971
TO SLDG.DE1'7 TEL.: 765-1802 NOTIFY: /
9
QU7LC?!_t� CALL �6.� . . . . . . .
F.�ninecm ...._.19 MAIL T . . .
19 Y WOO
.O........ ....................................
Disapproveda/c .................................. ....................................
...........................................?IONFOR
t
--- --`�. ..
Okictor)
APPLIUILDING PERMIT Date ,/�Yt,/C.. . 19y. . . . , 19.9r'.
INSTRUCTIONS
a. 'Ibis application mist be completely filled .in by typewriter or in ink and sulxnitted to the Wildingiiispector with
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of Wildings on premises, relationship to adjoining premises; orpublic
'streets or areas, and giving a detailed description of layout of property rtzist be drawn on Cite diagram wliidi is hart of
this application.
c. 'llte work covered by this application may not be conimnced before issuance of Building Permit.
d. Upon approval of this application, the lkjilding Inspector will issue a Iuilding Permit to the applicant. Such
permit shall be kept on Ute premises available for inspection throughout the work.
e. No Wilding 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 Ikiilding Inspector.
APPLICATION IS HEREBY KAitlr 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 lxtildings, additions or alterations, or for removal or demolition, as herein
described. 'Ihe applicant agrees to comply with all. applicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in Wilding for necessary inspections.
(Signature of applicant, or name, if a corporation)
Wailing address of applicant) 1f971
State r,Aiether applicant is owner, lessee, agent, arcliitect, engineer, general contractor, electkcian, plumber or Wilder.
...................0,u?N !2:..........................................................................................
Name of owner of premises ....... ....`... 0./,E ..................................................
(as on the tax roll. or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Nave and title of corporate officer)
Builders License No. .........................
Pltmixers License No. .........................
Electricians License No. ...............
Other Trade's License No. ....................
1. Location of land on whidt proposed work will be done..............................................................
..... `:°S ......CL ,cv�£�,J.....1�.✓. , - ..Sa�.,Tr o�A..!U:y....��9.z�...........................
11ouse RA)er Street Ilan]et
County Tax Map No. 1000 Section ..... Q....... Block ...... ........ Lot ...31........_
Sulxlivision ...................................... Filed Map No. ............... Lot ...............
Mime)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and.occurkincy ....... ...................................................................
b. Intended use and occupancy ..............A-JAV�1'¢! ��l/../� A/�!.�.$'....T.OS�c;S .._.....
). N-Ilure of txrllc (tJleeac %Ati(li al,l)licalrle): Iktildini; Nklilion ......... Alteration ..........
14--pair ............ RerltovaI ............. Dow)]i tion ....,....... Other Woiik ??'�P..��5'�QrZX••�Et�S .•_
(Descripticxf)
4. Est:itlrcled Cost: .?GOo C.1J3o0 Z-6 fee ...............................
(to lie paid'on filing this application)
5. If A el l ing, rxaiirer of owell ing units ........_... limier of owel l ing wil is on each floor ................
ifgarage, otsiber of cars ......................................
6. If. Ixrsiness, cnnmercial or mixed occupancy, specify nature aril extent: of each type of use......................
7. Dimensicxis of existing stn►ctures, if any: Front................ Rear Depth .................
Ileigl1L .........___ .......... Umber of Stories ........
Dimensions of scene stnxaitre with alterations or aAlitioos: Front; ...... ........... Rear ...............
Depth Ileiijrt .................. Mnirer of Stories .. .............
jv
g. Dinensiots of: entire new construction: Front .._. Rear ....A1 9......._ 1)epLh .t9-O........
Ileil;irl' .��pr!.�1iTl?L1f[t�._• Unher of Stories .....................
9. Size of lot: front Rear .................... Depth ....................
IO. Iktte of Purchase _____________________ Herne of Porrmer Owner ..... ...................................
11. Z ne or use district in tdric3n premises are situated ........................................................... ...
12. Does proposed constrtxaion violate any zoning law, ordinance or regulation: ...V ................
13. Will lot Ix- regraded .................... Will excess fill he rerioved frcxn premises: YES 11)
14. Hanes of owner of premises ........................... Acklress PIKme No. ............
Herne of Architect ..................... Mdress .............................. P11one No. ...... .....
None of (cxnt'racfor ............::....'...........:..:... lkklress. ............................:..Phone No. ...........
15_ is this properly within 300 feel: of a Lidal xaetland? * YES .......... NO ..........
*ir. YES, S(XJ11HD '111M 'iRI1SI11iS PERMIT MAY III? lu'plitl.D.
PLOT DIAGRAM
1<x:ate clearly atxl distinctly all Imildings, whether existing or proposed,.atxl-indicate all set-back dimensions
furs property lines. Give street arxl block nixiiier or description according to deed, and show street naves arxl indicate
whether interior or corner lot.
a 11 APPRO ED AS NOTED
✓� G C' 'r.�a' ®ATE: 7 B.P.#
FEE: 8Y
NOTIFY -BUILDING iDEP AT
765-1802�9 CAM TO PM FAR THE
ff\1 " R
P 1. FOUNDATION - TWO REQUIRED
UUMPANCY
FOR POURED CONCRETE
U q r IS UNLA 1 L 2. HOUGH - FRAMING & PLUiL48ING
3. INSULATION
4�. FINAL - CONSTRUCTION(MUST
�P� U T E PiTIFICATEBE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
(V%U Pa A 11 rru'y STATE CONSTRUCTION & ENERGY
C®DES. NOT RESPONSIBLE FOR
mwil. (M' "M Yin, ZESIGNZRZONSTRUC.TION.ERRORS
.......__.Iteuy; duly sworn, deposes alxl says that he is the appl icanl:
(Ncnxe of imlividual. signing contract)
alx)ve Ikrned,
Ikein [.he ..........D�N............................................ ....................................
(C)nLracLor, agent, corporate officer, etc.)
of said owner or owlx:rs, awl is duly authorized to perform or have perforlr:d the said work arxl to mke aril file this
application; that all. sLateneoLs contained in this applicaticxr are trnx-A to the best: of his krxtwledge atxl Ix;l.ief; alxl
Ihat. the work wi1.l. lie performed in the ukan er set forth in the application 17iled therewith.
'X-min to bef rre ne this
clay of .... 19.� ...
Notary Public .. -�,...........
�'s�ti `� •"" - lr'�; ...........(Sil;natur-e of Appl icanl) .
I -,_ --,-.- --,HELENE D.HORNE
(qo4 r11;Public,State of Now York
No.4951364
Qualified in Suffolk County
Commission Expires May 22, 19-4-7