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Home My WebLink About14035-Z FORM NO. D 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) N° 14035 Z Date ...... .. ........._3.................... 19-9"' J` — Permission is hereby granted to: f 77 ...... ...�.... ...1.. ............... 1 to ........... .... . . . .. ..... ..... .... ............................................................................. at....premises............. at ........... ... ..?v. . .... . ... ....... .................. ....................................... ....................... ..... .... .... . ... .......'....C.'....... .......:................ ................................................................................................................................................................. County Tax Map No. 1000 Section .......J6............ Block .... . ........... Lot No. ...Z...... pursuant to application dated ......'!.f..l... ... . ..........[... ........ 19,5J and approved by the Building Inspector. Fee Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY t. 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. For existing buildings (prior to April 9 , 1957) non-conforming uses, or buildings and e-existing" land uses: Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 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. Fees I . 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . , , ,August 4,,, 1999. . . . . . . . . . . . . . . . . . . . . c!w Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . .X . . . . . . . . . ocation of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . Crescent:Avenue . . . . . . . . . Fishers, Island. . House No. Street Hamlet -iwer or Owners of Property. . . , Addie. D.. Valentini. . . . . . . . . . . . . aunty Tax Map No 1000, Section. . . . 6. . . . . . . . .Block. . . . .7. . . . . . . . . .Lot. . . . . . . lbdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . klupp Gali . . . . , No. .Z11148 . . . . . . . .Date Of �SZ�tX. . . �1ug; 0,19 8 2. A 1 i c a n t. leo & Addie Valentini . . . . . . . . . . 2.11Lh Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Tanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . 'quest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .X . . . . . . _e Submitted: $. . . ,50;00 , , , , , , , , , , , , , , , , , , , , J. . . . ,��, � . . . . ... . n Steph . Ham, III . _ _ . . . , _ . 3 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y: 11971 TEL.: 765-1802 Examined . 3. . . ., 19T'� Received . . . . . . . . . . . , 19 . . . ApprovS . . . . . ., 19 6/ Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. . f �.( . . . . . . . . .. 19:51 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 street. 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 permi 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 Occupanc-, 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 th( Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o: 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 tc admit authorized inspectors on premises and in building for necessary inspecti0. S. , (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . . . . . . . . . . . . . . '. . eu�44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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: -115�w. . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 1 - 11111 . . . . . . .C . . . .4%. . . . . . �. House Number Street Hamlet County Tax Nfap No. 1000 Section . . . . .l/. . . . . . . . . . . Block . . . . .~r. . . . . . . . . . . Lot . . . . . . . . .. Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteratio . . . . . . . Repair . . Removal . . . . . . . . . . . . . . Demolition . . . . ... . . . . . . . . Other Work . . . (Description) 4. Estimated Cost . . . . . . . . .6�/� . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . 1`� .mil/ . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . ... . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify natilre and extent of each pe of use . . . . . . . . . . } 7. Dimensions o existing structures,if any: Front . .A . . . . . . . . Rear / . . . . . . . . . . Depth .fl. . . . . . . . . . Heigh . . . . . . . . . Number of Stories.s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . ... . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . .II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be . . .re graded !/Q g • . . . . . . . . .Will excess fill be'lremoved from premises: Yes o 14. Name of Owner of premises 1t6 ��t/yT//!�/ . , Address �i.5&�C*�.ZS -1IY4>. . .Phone No. Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . ... . . . . . . . . . Phone No. . . . . . . . . . . . . . . . PLOT DIAGRAM 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. i to t -------------- STATE O2NE YO K SS C'f;�' �l(l /COU Y . . . . . . . . . . `y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . .AP-X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1. . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized tb 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. Sworn to before me t/hi�sd . . . . . . . . . . . . . . . ..Y .`. . . ay f. . . . . . . . . . . . . . . . . . ., 19�� Notary Public . . . . . . . . . . . . . . . . . Count SYLVIA K. ROUSE ` NOTARY PUBLIC, Slate of New York No. 4674306-Suffolk County �� WHIRIM18R PARIM MINI] A I9P_4 (Signature of applicant) MATTHEWS & HAM ATTORNEYS AND COUNSELORS AT LAW 45 HAMPTON ROAD SOUTHAMPTON, NEW YORK 11968 PHIMP B. MATTHEWS (1912.1992) 516-283-2400 STEPHEN L. HAM, III FAGSIMILE 516-287-1076 e-mail:Matthamesq@aol.com BARBARA T. HAM August 5, 1999 Mr. Edward Forrester, Building Inspector Town of Southold Building Department Town Hall 53095 Main Road P.O. Box 1179 Southold, NY 11971 Re: Application for Updated Certificate of Occupancy for Addie D. Valentini (SCTM No. 1000-006.00-0-1`fl0-016.001) 9 Dear Ed: In connection with an application for an updated Certificate of Occupancy for the residence and deck on premises owned by Addie D. Valentini and situate at Crescent Avenue on Fishers Island, I have enclosed the following: 1. Completed Application for Certificate of Occupancy, signed by me. 2. Check to the Town of Southold in the amount of the $50 application fee for the updated CO. 3. Copy of current Certificate of Occupancy Nd=Z-114�covering the one family dwelling. 4. Survey of the subject premises for Michael L. Laughlin prepared by Chandler, Palmer & King, dated August 2, 1999. Mr. Edward Forrester August 5, 1999 Page 2 In connection with an application for a Certificate of Occupancy to close an open building permit for a shed on the same property, I have also d a completed Application for Certificate of Occupancy covering opekpermit number 14035 June 3, 1985, together with my check to the Town of Southo for $25 to cover the application fee for this CO. Please let me know if you need any further information or documentation before you can proceed to have any necessary inspections performed in time to have these CO's issued by August 20,. Sincerely, ��e- 4a-t-, Stephen L. Ham, III SLH/cvh Enclosures r N F / t PIRATE COVE MARINE ` 1 _- S 86'34'20" E 217.15' N/F w o• K YOLA SCAGLIOTTI � oa u, ca t� I + EDGE OF (AWN MAINTAINED BY OTHERS z 2 ' -A IRON PIPE i, S 86'34'20" E 218.00' Zy ` LEACHING POOLS y SHED ?' LOT 2 < SEPTIC TANK t°Q, AREA= 3.506 ACRES s �- EXISTING SIDEWALK O G POLE " ��\O # 103 N 03 25 40 E �i 203.45, POLE t �,. -' o SATELLITE DISH EDGE OF POND ' IRON PIPE - - POLE# 151 f -POLE O 2oa.a9' NOTES: S 84'14952" W 38.00' 170. 1.) U%J%JM IvMIE- urSTAiv%,LJ nr%L13E rviL�iSJML FROM U.S. COAST & GEODETIC SURVEY TRIANGULATION STATION "PROS" POLE) 102 + MONUMENT `�' ro / N 4143.47 4 ,s' 2.) TAX REFERENCE: w 1279s3 DISTRICT 1000, SECTION 006, BLOCK 7, LOT 16.1 / MAP REFERENCE: o + ^ o PLAN SHOWING SUBDIVISION PREPARED FOR IRON PIPE - Z GALILEO VALENTINI FISHERS ISLAND, NEW YORK JULY 1980 / CHANDLER, PALMER & KING, SCALE: 1'=40' ++ DRILL HOLE a= N/F 0 +, MARY MEYER POLE# 150 lij Lv to HMO MONUMENT o SURVEY MAP / w PREPARED FOR + .. �- C w 910.00 V N 14 31 20 E + 208.71' GUY WIRE (TYP.) / /p RON PIPE / 5 83423 179.83 � l.i w M CHAEL L. LAUGH Li N ' + S 83•42 30 -W — + 245.00' AVE U E l POLE# 1013 - - --- MADELINE CRESCENT AVENUE & MADELINE AVENUE ao Zo o ao FISHERS ISLAND, !AONUMENT --`'— GRAPHIC SCALE IN FEET NEW YORK - REVISIONS !" CHANDLE:R. PALMEFZ 49c KING OF NF '-�.� �, 4,-- C� D H.S�y9 DATE DESCRIPTION �� Architecture, Engineering and Surveying Cl GUARANTEED T0: 110 HROADwAY NORYMCH, CTOBDBo eso-ees+-s�7 vFAXeats-ana-7em :• � � N m COMMONWEALTH LAND TITLE INSURANCE COMPANY A D (� "�, •• MICHAEL L. LAUGHLIN «• IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR �� o �o TITLE SURVEYS OF THE NEW YORK STATE LAND TITLE �- �v�J� DATE: AUGUST 2, 1999 ASSOCIATION. TITLE f 70991867 SCALE: 1 " = 40' SHEET 1 OF I