HomeMy WebLinkAbout11629-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No..g.1.1.4..5.7 .......... Date ..... ~..a..n.u.a.r.~..2.7. ................ 198..3.
THIS CERTIFIES that the building ................................................
Location of Property ... 33.0. ........ M~le./~v. er~u.e.. (p.v.t:.,, Rd...) ....... ~I~tg.t;J,l;ucJq...
House No. Street Ham/et
County Tax Map No. 1000 Section . .. 10.7 ...... Block . .03 ........... Lot .., 005 ...........
Subdivision .... X. .......................... Filed Map No...~, ..... Lot No...Z ...........
conforms substantially to the Application for Building Permit heretofore f'ded in this office dated
·..H.a.r.ql3..1.2 .......... , 19 .8.2. pursuant to which Building Permit No..1. .1.6.2.9...g ............
dated ...,p.r.~.J~ 28 19 82 w '
...................... , as ~ssued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
a p.r.J..y.a~.~. 9.n.~.-r.~.mS...~y .d.w.e~.J-.~.qg, ..........................................
The certificate is issued to ..... 0'~-~.$..C. RQ~ ..........................................
(o whet, ~ -o~'t~nal'lt~
of the aforesaid building.
Suffolk County Department of Healtlx Approval .12.'nSf .--.'l.g s..1/.1. 2/g3. t.. P,9.h.t,,./~...V £,l..la ,.
UNDERWRITERS CERTIFICATE NO ........ Iq..589 ~.'I.'[ ................................
ui ding Inspector
Rev. 1/81
N? 1~629 z
Permission is hereby granted to:
(THIS PERMIT MUST BE KEPT ON THE PP'E~I~$ UNTIL ~UL[.
COMPLETION OF THE WORK AUTHOP~IZED)~: :
~o,~ ....? ~'--~./.....~.~ ............. ,,..~
..... ; ......... i .......... ~..: .......
at p~emise~ Iocoted at
CoUa~ Ta~ Map No. 1000 Section ..... Z~..~....,, Bl~:k ;h.,-- .~." ......... .at No. ~ ..........
pursuant ~o application doted ..~~J .,92 ~and ~pprov~ by the
...... ~, .~,.m..,.~ ?,.......,
Building I~spector.
Fee I' ......~ ...... ;...
nspectot~
FIELD ~NS?~CTION
FOUNDATION (1st)
COMMENTS
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
FINAL
ADDITIONAL COMMENTS:
FORM NO. 6
TOWN OF SOUTHOLD
Building Depar~men~
Town Hall
SouthoM, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building lnspee.
tot with the following; for new buildings or new use:
1. Final sunzey of property with accurate location of ail buildings, property lines, streets, and unusual
natural or tooograDhic features·
2.Final approval of Health Dept. of water supply and sewerage disposal--iS-9 form or equal).
3,Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buiiding~ and installa-
tions, e 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-existing"
land uses:
1. Accurate survey of peopert¥ 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 informa-
tion required to prepare a certificate.
C. Fees:
~, Certificate of occupancy SB,00
2. Certificate of occupancy on pre-existing dwelling or land usa $5.00
3. Copy of certificate of occupancy $1.00
New Building ............ Old or Pre-existing Building(X) ...... =/Vacant Land"
Hod/se No, ' .... 'S;,'e;r ''' Ham/et
County Tax Map No .1000 Section ... [,~. ,~. ....... Block .~. ............ Lot ................
Subaiwson. . ~' .... . ....
~ ........................ Filed Map-No...:. ,~ .... Lot No. , .-'. .....
Health Dept. Approval'. .................... Labor Dept. Approval ............. ...... . ..
Under~vriters Approval ............ ..-.... · ....Planning Board Approval ..................
R t f Te vC tiff Fi ICe tiff '
aquas or mporar er cate ..... ................ na r cate ........ - .........
Construction on above described, building and pe~'n~it'~neets a,~pPLi, cable~co_des and ragu lations.
100O3al THE NEW YORK BOARD OF FIRE UNDERWRITERS
ii, l B'°H" 'UREAU Or ELEOTR,O, V
STREET. NEW YORK, NEW ~ORK ~OO38
THIS CERTIFIES THAT N
only the e~ctrical equipment ~ described below and int~duced by the applicar~t named on the able application number in the premises of
was examined on JDIILI~.~ 6 t 1983 and found to be in compliance with the kequlrements of this Board.
FIXI'URE Ii FIXTURES RANGES /COOKING DE
OUTLE m~,~PiACLES SW TCHES ~-- CKS OVENS
TS INCANDESCENT FLUORESCENT MVEA~¥ ~,~AT. K.W.
39 65 43 39
DRYERS FUR~NACE MOTORS FUTURE APPLIANCE FEEDERS SPECALEECPT. TMECLOCKS r BELL UNIT HEATERS
SERVICE DISCONNECT ~ ND. OF $ E R V I
· AMP TYpE EQUIP 1~2W I,~3W 3,~3W $~4W NO O~ERCC~COND A,W G.
-- ' OF CC. COND,
i zOO C~ x £ 2/0
OT~US~ppli~mC~ Iee~ler~; 1-~//14, 1-2#12, 1-3#6.
Lot
MUfTI-OUTLET DIMMERS
SYSTUaS ~S-
NO. OF FERT
E
~/0
J/ol~ora; 1-3/4hp.
2-/~oke de%ec~or~
1-4.~'w. ho~ wa~er hea~er
G.0. Electric
6 Poplar Avenue
b/edfordF N.Y. 11763
Llc#2677E
GENERAL MANA~iER
This certificate must not be altered in any manner; return to the office of the 8oard~f incorrect, Inspectoks may be identified by their cr¢dentia s.
COPY BUILDING THIS COPY OF ANY MANNER.
STI~VI~ G, TSONTAKIS,
D~a~ve~ 1~45~ Middle Rd.
Mattituck, N.Y. 11952
(516) 298-4533
April 23, 1982
Building Inspectors Office
Town of Southold
Town Hall
Main Road
Southold, N. Y. 11971
RE: Randazzo Building Corp.
Plan 9 4746.
Gentlemen:
Enclosed please find a copy of the revised drawing
essentially accomping your comments dated 4/9/82.
Yours truly,
SGT/d
Encl.
Steve G.
Tsontakis, P.E.
cc: V. Randazzo
,tance by the
m' ceilings for
dye treatment
veneer, wain-
~aper or ethel
assembly in such
ten the other.
paying ~zuesx.
rials as clay shale,
Gsneral provisions
e~dtt'lR protective. Assembly of materials and ~ccessor~es,
nciuding frames and haroware, in'stalled m a w,ll partitiom
floor, ceiling or roof opening ~o prevent, resist or re~ar~ me
passage of fire, llame, excessive ho~ or hot gases.
--lul~iliC. Construcm~ a~arra~ed Io operate other
redetermined temperature ~f t~mp ~ ,
~self.closlng. Arransed and equippe~ with elevates
which will ~nsure closing a,er having been opened.
premises. ~ lot, plot, or parcel ~t land including me buildmSS
or s~ruc~ures thereon
properlv line. Line establishing the boundaries nf premises.
repair. Replacemen~ m renewal excluding additions, of any pan
o~ a building, structure, 0evlce, or equipmem w~th hke or ~imHa~
materials or pa~s, for the purpose el maintenance ~f ~ucn nuild-
rog, ,tructure, devwe, or equlpmeut
required. Required b~ tins Code.
residual defleclion. Deflection resulting ~rom an appheO earl,
remaining after remova~ of such load
roof covering. Matenm applied 1o roo~ sofface fei protection
against the elements. Root nsulatlo~ snau ~i i~e deemed to
be a roof covenng.
~lf-closin~. See oefi~ition under opening protective.
shall. A~ used m th~s code , mandatory.
smoke pi~. Enclo',eo .assa~e, ~,ea to convey the products
stairway. One or more Hi~b~ ,,i stairs anu me necessary
oe~ow, ~ ~na -, '-, ~---I
Is'7~T ~m ............ ~. t.,~ -'dor~ An aft~c shall
-, Ftl,i--~all no be ue~mOr, ,o
.~a ~*,.*- ~ ..,~.~ moots the ~equirements
be de~med to ~e a story w,,~,~
habitable space,
street. ~horougnfare t]edicaked and accep~cx tar a mumcipalilv
FORM
TOWN OF'SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
File No ................................
To ~...4.~.~.~.~..~ ~ ........
·/' :'7' .~-.VX~.~..Z.~ &..~..~.'
PLEASE TAKE NOTICE that your~cation dated. Z~~...~.~ .... 19~
for pe~it to construct.., ~ .... ( ~24~,, ,~ ~.~ ~ ............ at
"Location of Property -~& ~ · .2 ................ c ~~ .~
h~se ~o~ ............ St~et Ha~/ot
~ounty Tax Map No. 1000 Section , .~. ~ ...... Block .. ~ ~ ...... Lot .~,~ .....
Fil p N ~ No .......
Subdivision ................ ed Ma o ................. Lot ...... -..~ ~ ..
is returned herewith and disapproved on the follow~g grounds .~, . ~3~~. ....
............. ~ '; ......... :.:_... ~// ~ ~ ~,
B~lding Inspector
1~0~ NO. !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
- ~r ..~ ................................. , ................. t No ...............................
Disapproved a/c ......................... ~i .......... ['">' ........................................
^ p,cot,on ..............
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate 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 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 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 rin 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 oil applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in, buildings for necessary inspect/[~ns.
, .,1-. ..I .4/1
......... ; .........
p' , c~ ~arr , ' p 'o )
..... .......
(Address of applicant)
owner, lessee, agent, architect, engineer, ~contracto~r, electrician, plumber or builder.
State
whether
applicant
is
Name of owner of premises .~..:~./~J. ......................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No..~..,/~JA..~..~..I..~.~...~.....~.~...~..C...;
Electrician's License No...~.'...~...~.......~....~C..I.......~' - "~-?~( '
Other Trade's License No ............................................... Subdivision
Location of land on which pr~osed work will ~ done. ,Map No/. ...................................... Lot I~o ............ ~ ..z.
Street and Number ....... e~.....~....c~.....~..~.a'g.(~..~.~ ....... .~....~....L..~.~.~.....,.~.~...~..f:5'. ..................... ~~'.~.x~.'
State existing use end occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy b ..~, O- ..~.
b. Intended use and occupancy ........................................................................ , ...... ..~..~.../~....'./,~ .................
County Tax Map No. Dist. 1000 Section /()?____Block 3 Lot
3. Nature of work (check which applica~
Repair .................. Removal:. ...........
4. Estimated Cast ./,~.~.Jg,~.~.~ ..........
5. If dwelling, number of dwelli'ng units
if garage, number of cars ...'.~,.. ..........
6. If business, commercial or mixed c
7, Dimensions of existing struct4res, if ar
Height ........................ Number of St
Dimensions of same structure with al
Depth ................................ Height ..
8. Dimensions of entire new constructior
-Jeight ...~....~.. J '
......... Nu~be~ of Star
9. Size of lot: Front ..J.!...~.. ...... i .............
10.,: Date of Purchase ...........'.?. ................
11. Zone or use district in whichipremises
12. Does proposed construction vliolate an
13. Will ,lot be regraded ....~. ~.?.. ..............
14. Name of Owner of premises~/.~),~'.~.....'
Name of Architect ...~.~..~.~.~
Name of Contractor 17.,~.0~ ....
Locate clearly and distinctly all buildir
property Jnes. Gve street and blbc¢ nun
whether interior or corner lot.
e): New Building.....~........' ..... Addition .................. Alteration ................
...~ Demolition: ................. i. Other Work .....................................................
~ /7z? ~ (Description)
........................ Fee ................ ~..u... ..................................................................
(to be paid on filing this application)
..... / ...................... N~mber lot dwelling units on each floor ............................
:cupancy, specify nature and extent of each type of use ............................
y: Front ............................ ;Rear ................................ Depth ....................
Dries .................................. ~ ..............................................................................
'erations or odditions: Front .................................... Rear ............................
......................... Number ofj Stories .............
: .................... ...... ear...E .................... De, th..3A ...............
es ................................. '].:,' ~:.' ' I ............................................. '~, ....... '~ ...................
..... Rear ...r.j.,~ .................................... Depth ...~.~..~. ......
......................... Name of Former Owner ..... .~ ................................................
are situated .....................................................................................................
, zoning law, ordinance ot' regulation: .... .~....O.....~. .........................................
Will excess fill be removed frpm premises: ( ) Yes (~xt) No
'q~..g,~ i 0~9~~'¢;~ .~.~.(.,..~Z.~- ~o..
.. ......... ......... . o.o No. ......
.~.~ ......................... AddJ~ess ,,~/..,~)....J.Z"J. tTZT/.J.....~Phone No .......................
..~..~.....CO..' ............ Add~ess/~'~'sP~u~t;~'~-'"'~6¢';'"--~----- Phone No.
PLOT DIAGRAM
~s, whether existing or prgposed, end indicate all set-back dimensions from
:er or description according to deed, end show street names and indicate
COUNTY 0~:~ ~., ......... fo.-,
above named.
is the: ...........................
of said owner or owners, ~'nd is duiy'Zr~t4~
this application; that ail ,statements/~f~*'~'~t~ ~icontaJ
that the work will be performed in ,the man~
Sworn to before me this ~
...... /..~..~T ~f
Notary Public,
.~. .................... being dul~ sworn, deposes and says that he is the applicam
~tracf) :
' eLL~.~L~perform or have performed the said work and to make and file
~ed in this application ar~ true to the best of his knowledge and belief; and
er set forth in the application filed therewith.
............. ............. .............................
ANN NEVILLE
StutU of NeW ¥~rl~
Suffolk Ceunty
30, ?. 9.~,~,,',,',,',,',,',0-
I
T T i
SUFFOLK CO. HEALTH DEPT. APPROVAL
H.S. NO.
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE OF
SUFFOLK CO.1 SERVICES.
SUFFOLK COUNTY DEPT. OF HE/
SERVICES -- FOR APPROVAL
CONSTRUCT ION ONLY
DATE:. -- ~-~---
H. S, REF. NO.:
OF
~FOLK CO. TAX MAP GESIGNATION:
DIST. SE:CT. BLOCK
S~AL
~ ~ ~ ,. , , ~ ~, . \ SUFFOLK CO. HEALTH DEPT. APPROVAL
, , ~ ~ , ~ t ~A~ '
".., . .~~.. ~ ' ' . ~' . ' , ~.~ ~,, ~'x ~.~ ~ro~ ~o
i ~, I ~ - ', ~ 0 <',~
, ~v X '-, "- ,- / '~' ~ ' ' ~ CO~TRUCTION ONLY '
~ ~. ' O ' '- ~ -- .:~Z~ ~o~Z~ DATE:: .........
~~, x ~ :. ~_ / ~._ X ~:~ ~' .,':( A~ROVED: , .......
' ' % ' ' I --~_'~ ~ ~ "
/ ~[ k A ~,,- ~o . .... m~. SECT. ~K ~L.
/ ~w~.~ x ' ,.~ ~ I ................... ','~ ....
this departme=~a Co.nd ~'~4- I ~ ' sEAL
addition fo fhis documen~ is a
viola;ion of s~c~ion 7209 of
OCCU?~T~C¥ OR,
USE IS L~HLAWFUL
WI'iH6~T CERTIFICATE
OF OCCUPANCY
£
7
'
b-..I
addition to th~s document is m
violation oF section 7209 of
the New Yo:k S~ate Education
Cop~es of t[~:s document not
bearing the eng[neeFs inked
seal or en~bo£sed soal sha~l not
be consld~red valid copies,
LC:)
L6CJ~L CObES.
z" hl~
gt i
d
_'Pi
O!
addition to this document is a
violation of sechon 7209 of
the New York State Education
Copies of this document not
bearing th-' engineer's inked
seal or embossed seal sh. II no}
be considered valid copies,