Loading...
HomeMy WebLinkAbout6923-zFORM NO. 4 TOWN OF $OUTHOLD BUH~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificete Of Occupnncy No. Z6. O .83 ....... Date .............. A.u.g .... THIS CERTIFIES that the building located at E/S. lgas~au .. Point. ItQa~[. Street Map Nollass..Pi;, .. Block No ...........Lot No.~6~.&..66 ......~.t. cb.o~... ~:.Y, conforms substantially to the Application for Building Permit heretofore fried in this office dated ........... 0et. ·. 12- -., 19. ?~ pursuant to which Building Permit No. dated ......... Qct...12 ...... , 197~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ,issued is . Pr.$¥a.t.e.. on.~..f..a.m.~.],y..d.w~..~_~.~.ng ....................................... The certificate is issued to .Frank. J., .¢ac.ciola ......... Ow'~o.r ................... (owner, lessee or tenant) of the aforesaid building, Suffolk County Department of Health Approval $.x~..~..~X. g .$y~.t.e..~. ................. UNDERWRITERS CERTIFICATE No.. I~.t~6~...JuaQ.7...~.97~. HOUSE NUMBER ... ~ ...... Street .... Naaa~. Pcd.n~c. Road ................... ........ ........ Building Inspector ~ I~ORII~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N'. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6923 Z Permission is hereby granted to: ....... ]/¢~..~eo~,o.::~ ................................. ~ .............. .~t~l~gm~ ....................................... at premises located at .~[~t~..~.._~ _~ ........ ~a~axt.~.o$n.t;..~.c~ ........................................ ................................................. ~Iasaat~..~oiat. ~omd ............... C~te~ac~ ................................. pursuant to application dated .............................l~....t. ....... ~..2. ........... 19...~.3., and approved by the Building Inspector. ...... ~uildi~'~ Inspector j .............. FO~K NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location af all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and 'pre-exist'rig ' land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: ]. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building J Addition ................ Old or Pre-existing Bud ng J Vacant Land Location Of Property .......~. ~~!~7~-~j~~~; Owner Or Owners Of Property r~p-~ ~'~ ~'~ (-'~ ~-~0~-~. Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Permit No...~..,~....~......~'. Date Of Permit .~..d1~.(.~./.'~,~..Applicant ...~...../~......'~..../~.. ...... ...~..,......~...~1 Health Dept. Approval ............................................ Labor ~pt. Approval ................ ~.~..~ .................. Underwriters Approval .............................................. Planning Board Approval Construction on above described building ~r~ers/~l ~l~[e ~ regulations. Sworn to before me this ~' ~ ;~ day of ~ Nata~ PublJ .... County ~ '~ ~ , THE NEW YORK BOARD OF FIRE UNDERWRITERS p~e 1 8esse?3 OUR"AU OF "-ECTR'C.Y 85 JOHN STREET, NEW YORK. NEW YORK 10038 ~ J~Y ~3,1996 ~i~ ~o. o.~ 1~8196/96 H ~8288 THIS CE~IFIES THAT F~T OF JOAN CACCIOLA, 8425 NASSAU POlq~T ROAD, C~, N.Y. i. t~f~owi.~.tio.~ [] m~., [] ~. F~. [] ~ n. GAR/OUT teo~ .x.mlned on ~ 28,1995 ..~ :found to be in compliance v4th th~ Notionat Electrical Code. RXTUI~ RXTURIS IAN~IS OVENS [XSH WASHES EXHAUST FANS DRYERS FUIINACE MOTORS ~ tlIIOIRS TIM! CLOCK~ MULTI-OUR~T SYSTIMS NO, OF mmllS SIRVICE DISCONNECT S E R V I C *NO VISUAL DEFECTS, "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. 123(~ TRAV~R~ STREET P 0 ~X 1412 ~, ~, 11971 This c~'fifi~ote must not be altered in any runner; return to the office of tim Board if incorrect. Impectors 11 be identifie thor credentials. ____ COPY FOR BUILDINGDEPAKIMENT. THItCOPY OF CERTIFICATE ~ BE ALTE.qED ,~ THE NEW YORK BOARD OF 'FIRE UNDERWRITERS ~;8,b BUREAU OF ELECTRICI'~Y [~ 85 JOHN STREET, NEW YORK, NEW YORK i003B THIS CE~IFIES THAT P.Oacctola, 79B Hassau ~olnt R~., ~cnogue~ w~ exami~ on ~ ~t ~t~n B~k ~t 3, 197 a~fou.dto~i"~mpl~ncewitht~r~u;reme.tso/th~B~rd. INCANDESCENT FLUC~ESCEf4TRXTURES v" v" v" v" v" v" v~ SERVla~ DI,~:ONNE~T I NO. OF ] S 1 100 Pan. m*T~R x 1 OTHER AF~'ARATUS: R V I C E EXHAUST FANS DIMMERS 2 ~alant~l Elect~lc Co~p. 26 ~/da Ct. W. Babylon, L.Z.11?0~ cOPY THE NEW YORK' BOARD OF FIRE uNDERWRITERS BuREAu OF ELECTRICI~"Y : , · 85 JOHN STREET, I%~W YORK NEW YORK 10038 THI$CE~iFIESTHAT N 174082 in the Jbllowing Ioeatl 1st FI. [] 2nd FI. Section Block u~s examined on and fo~und to be tn compliance tvith the requirements of th~ Board. RXTURES . Fm'U~ ,~,'UANC~ ~,~S EXHAUST FANS DIMMERS OTHER APPARATUS: tiocorm: 1-3/4hp- 8'-0' creek lLsht, 1-3~ con ac un£c. 108b. eXee. 26 Mi. dB Ct:. I/. Babylon, L.X.XX704 COPY FOR BUILDING DEPARTMENT. THI~ COPY OF CERTIFICATE T BIK ALTERED !It ANY MANNER. BUILDING DE~RTMEN~-~t-7~ ~ ~ ~ TOWN CLERK S OFFICE ~ ~ ~ ~UTHOLD, N. Y. ~ ~ ~ ............................................... App ication ~o ................................. ~proved ................... ~.~.....,[..~...., 19...~ermit,o.~.Z.~...~ ...... ~ ~ ~ ~ Disapproved a/c ................................................. ~ ........... ~ --~ ~ APPLIGATION FOR B~JILDING PERMIT INSTRUCTIONS .~, a. This application must be completely filled in by typewriter or~ in ink and submitted in trp cate 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 prem ses or public streets or~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. ~ 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 issue a Bud ng Permit to the app cant. Such permit~C~ 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~L shall have been granted by the Building.Inspector. I- APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bud ng 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 demo t on, os herein described. ~ The applicant agrees to comply with all applicable laws, ordinances, building code, hous ng code, and regulations, and to [ admit authorized inspectors on premises and in buildings for necessary inspections. (S'gnature of opl:~fnt,~;; .......... or name, if a corporati;~) ...... . (Address 6f applicant)/9 ~'~'~'"-'~c ..... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ~u Ider. ........................ ......................................... . ... Name of own or p em:s ...................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .................................................. ._/ Plumber's License N° o ...... v. Electrician's License ............................................. Other Trade's License No ............................................... Location of and on wh ch os ' ~t'~ ~ ~,a, /~./'. ~.~ ~/~ prop ed workw be done Map No ...~ L _ ' ..;;... ot No ........................ Street and Number ...... ...~....~...~...~....~....~.......~.~..o.L.~....,~.' ... ~.~..~;.;..?...,...~..~.r~..~.o~..~... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~ ..e~.....~.....j.. ~.. ~-. ~ - V~-,~' b. Intended use and occupancy .?..~.. /.. /= /. /-/-~,44,~.. · ~.'" ~lature of work (check which applicable): New Building .................. Addition .................. Alteration ........... !~ .. Repair .................. Removal .................. Demolition .................... Other Work ................................................ ,... ~ .¥. (Description) 4. Estimated Cost ............................................................ Fee ....:...~. ............................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor .......................... If garage, number of cars ................................................................................................................... ~ .............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. 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 ....................................................... 1 1. Zone or use district in which pr~mises are situated ....................................................... .". ................................ ~ ......... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ........................................................ ]3. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .................................................... Address ............................ :... 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 dimensio'n~ from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior o~ corner lot. STATE OF NEW YORK; ~.c c COUNTY OF ................................ )' '~"* ................................................................................................ being duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. He is the .............................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of 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 stotements contained in this application are true to the best of his knowledge and belief; and tk, ar the work will be performed in the manner set forth in the application filed therewith. . Sworn to before me this ~ ........................ day of ............................................ , ~9 ......... Notary Public, . ................................................... County (Signature of applicant) d~( Z" I ZlC~ - , L GARRETT A. STRANG architect Main Road RO. Box 1412 Southold N.Y. 11971 516- 765 - 5455 BELOW is a dlagramat[c plot plan. Fill in the spaces to shaw the dimensions underhned, the north arrow, the street name, lhe distance /and the name of that street) If a corner plat, also show the side I .I ~ ~L J~ I, lC -- lot lines J~ ~ frontage of lot J~O- ~' ~~ street ~ame LI~?~ ~C°Ol~ ~'l FOLD o ' ' "'~"°" ' ~'"'" ~' - DESCR PTIONur~'~ i'~ ~ , .:- ~:- . _~ · ,, .~,. . ~ .... ~-, _ .. ... -. , , ~ ~, . ,..., ,.., ,....* ~.-, , ,.- , ...*.-, ,,,...~,....~.,. ,,,.-, ~ -"~ ~ '" FHA AND OTHER '" '~' ':: ~:" ~ ':'~"~ TECHNICAL REQUIREMENTS ,,,,I.i I ~ ,l' , ~, '- .", .. _~, .-., ~ ,I \~.l i~.~-: - , :~ ~ ill [~o ~., ''"''' *' '''" i ~ //, ~ ~ ~,::, ,~, :,::~ , ,~ , , , ...... , ....... ~,:~ ~-~ ! : , ~ u~ ! i~ ..... ' :,, ! .'1 Ii ii ,~ ~ ~, ~,~' I , : , ' : = , : i - -- ~ ~, > .~ , , , ~ ..... ~ DRAWN BY. APPROV"~"D BY design number sheet no, RUDOLPH A. MATERN A. I, A. design number sheet no. APPROV£D BY design number sheet no. ® ® { I I -' F DRAWN BY. APPROVED BY APPROVED BY design number I sheet no.