HomeMy WebLinkAbout11937-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24833
Date JANUARY 10, 1997
THIS CERTIFIES that the building
Location of Property 280 B~IN ROm
House No.
County Tax Map No. 1000 Section 81
Subdivision
ACCESSORY
SOUTHOLD, N.Y.
Street
Block 1 Lot
Filed Map No. Lot No.
Hamlet
19
conforms substantially to. the Application for Building Permit heretofore
filed in this office dated AUGUST 23, 1982 pursuant to which
Building Permit No. 11937-Z dated SEPTEMBER 28, 1982
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 ACCESSORY INGROIFND SWIMMINO pOOL WITH DECK S%PRRODI~D & FENCE
The certificate is issued to VINCENT & ANOELA GRIFFO
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-045929 -- JUNE 22, 1995
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
FORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z13103
Jan. 3 ~9~
Date ................................ , ·
THIS CERTIFIES that the building ...... .P.o.o..1..(.w./...f.e.n.c.e. ) ........................
Location of Property .,2..89..... Basin Rd. . .... Southold
t~ouse mo. Street Hamlet
County Tax Map No. 1000 Section . .0..8 .i ....... Block .... .0 .~ ......... Lot....0.1.9 ...........
Subdivision...P.a..r.a.d.J;..s.c..P.e.;..(.S.e..c..13 ..... Filed Map No..3. 7..6.1...Lot No..P/.O...2 .a.3. ....
conforms substantially to the Application for Building Permit heretofore fried in this office dated
.~.u. cj.. 23 19 8.2. pursuant to which Building Permit No. 11937 Z
dated ..... .S.o.~.L.. .... .2.8. :} .........19 .8.2., 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 .........
The certificate is issued to ................. y.I. bJ..C.E.N.~...&. ANGELA GRIFFO
(owner~lessee e~tenamq.
of the aforesaid building.
N/A
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO ..................................................
Building Inspector
Rev. 1/81
TOWN OF SDUTH. ~ D ~L'
BUILDING D!PARTMi
TOWN HALL
SOUTHOI.'D, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE P EMIS~S UNTIL BULL
COMPLETION OF THE WORK AUTHORIZED)
N°. ~1937Z Dote ~v i '~'
Permission ~s hereby granted~ -~
......
Building Ipspector.
Rev. 6/30~80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
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 Inspec-
tor with the following; for new buildings 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 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 installa-
tions, 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-existing"
land uses:
1. Accurate survey of pZoperty 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. F~es:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $15.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
. Oate~ ................
New Building,,. ,~,.,,,...OIdorPre-existingB~ldi~g .... ,f..-~,,..,. Vacant Land ...........
Locatmn of Property .... ~. ~9. ......... . ....
Owner or Owners of Property . . ..d-. ..........................
County Tax Map No. 1000 Section .... ~.~r-~/ ....... Block ..... (~. ] ....... Lot ..... ~../..~...
Subdivision. ,~, · ./. ........................ Filed Map No. ~'.7,~. ..... Lot No... c~ ~ 3
Permit No...'J.~?.7.Zr. Date'of Permit.. ~/~
Health Dept. Approval ...... ~/.~
Underwriters Approval .........
Request for Temporary Certificate
............. Labor Dept. Approval ...... .~ ...............
............. Planning Board Approval .... ~?../~. ..............
................... Final Certificate ...... ~ ...........
Fee Submitted $ .... ~ .................
Construction on above described building and~p/~mi~eets ¢, ~-p-p~able codes and regulations.
Rev. 10-10-78
NEW YORK STATE OEPARTME~F OF E,~VIRONMEkrFAL CONSERVATION
R eg u~tory Af f~r6
Bldg. 40. SUNY--Room g19
Stony ?~ook. NY 11794
(516) 751-7900
k reuie~u has bce~ made of ~'ow~ p~wposal ~o: ('o~x~gt ~¢-~
Therefore, no perml~ under A~cle 25 (TZd~ Wet. ntis) of the Environment~,~
Co~Serv~on Law is requ~d sinae th~. propo6al is beyond State mandated
.iw~isdio.~on pw~ua~t to .thia a~.
DJL.RN,.¢z
THE NEW YORK BOARD OF, FIRE UNDERWRITERS P~ ~
805z[8§[ BUREAU OF ELECTRIOIT~ ~ , , ' '
o~y S~ eJ~trJcaJ equipment ~ ~scrlb~ be~w a~ int~uc~ byr t~ applicant ~d on the a~e appllcat~n number ~n the p~m~s of
AN~LIA GRIFFO ~ B~IM ~0~, ~OUTHOLD ~ ~.Y.~
a~, .xa,n~ned o. JU~ 19 ~1995 : a.d found to be in ~omPl~nce ~9'~ NaO'o..l El~ctdcal Code.,
DRYERS
OTHER APPARATUS:
~NO VISUAt, DEP~JCTS~ "~ elect~.'ical
survey has been made of the. Exposed
R v I E
A W G. NC) OF HI.LEG NO, OF NEUTRALS
electrical equipment in the ~, ~ ........ ...... ,
premises indicated." '~No obgious~ . ,, , '
t~sa[isfactory condi'~ion WaS found~ , '
, ~S~EPREN P~RRICONE
P.O'.BOX 41
MA~ITUCK, NY, ~1952
AMOUNT
ASE REMIT BY CHECK OR MON~
FIELD INSPECTION COMMENTS
FOUNDATION (Ist)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
o
FINAL
ADDITIONAL COMMENT
i
l
F~T TITLE:
DRAWING TITLE:
PROJECT TITLE:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL,: 765-1803
Disapproved a/c ..... · · · J'~ .........................
(Buildin~ Inspector)
APPLICATION FOR BUILDING PERMIT
Application No. ('{~..~./~.. .........
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submittedirma:itvt~ 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 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 approva~ 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 in 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 all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized iuspectors on premises and in buildings for necessary inspections.
. .O ......
(Signature of applicant, or name,, il' a cor~.,~oration)_
, yoo o ....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ,V./'4/.Qe. .~.~...'~7'./~.A/. ~..~./(e'% .... ~- ./'./~ .~..~. ......................................
(as on the tax roll or latest deed)
If appjicant~is a coronation, signature of duly authorized officer.
Builder's License No.. ,O~..7'.? .................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ...................... ~, . ,,
1. Locationoflandonwhichproposedworkwillbedone. ~0 /~WcJ/',,, /(-~c~. '//'~/'o.c/~J'e
House Number / Street Hamlet
County *a:~ Map No. I000 Section ~ / Block [ 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...~./.?o~.L¢....f~-.t~. ~:/.):-.../7. e.t 1~,/~ ~¢1; / ~cc ?.fe.~-'e,~' ..................
b. Intended use and occupancy
·. . Rcmova~ ..... .. ....i3~ni,~:,::~ ..... __. ... (~mer Work ..............
I~ ~$~ /~.p,~e,ty~,~/d.J'~/,,~,~ f'b,! ,~ 7'l/tjX. /'r, 7~,/';'~ t,*'4/( (Description)
4. Esti~nated Cost .... ~..~/.~.QQ ....................... Fee .............................
i (to be paid on filing this application)
5 Ifdwelti tuber fd elli gu its N mberofd elling units on achfloor
· ng nu o w n n ............... u w e ................
If' garage number of cars
6. If bvsiness, commercial or mixed occupancy, spec/fy nature and extent of each type of use, . ........... , ........
7. BimenSionsofexistingstructures, ifany: Frontt?.~ .~.~J.0~:~'.c'~'. Rear ~., .~f~.~."~e?..:°. Depth~?.e..~.~..:~,.f¢~$
Height/~. ?..~.~'...~.*'.~i ..... Number of Stories t~..m.~, r~..x~t'At~'l...~tR.d~f/.a.. (.t../'~.¢2' ...........
Dimensmns of same structure w~h alterations or additions Front ................. Rear ......
Depth ~ ................... :.. Heigt~t ...................... Number of Stories .....................
8. Dimensions of entire new constr¢ction: Front ,~.,~ ............ Rear . .J.~. .......... Depth . .q~.. .........
Height ....... Number of Stories ................................... ' · · .. ........
....... i ./T' '
9. Size of lot: Front .................. Rear ...... O. ............. e ..................
10. Date of Purchase .... /.:t/7.~.~.i .................. ~ame of Former Owner ~.~.d ~.~J .~../:/.~.~.t)'. ..............
11. Zone or use district in whxch pr~mlses are s~tuated ..... t~.....~.gt. ~.e.~r~t+.l ...............................
12. Does proposed construetion violhte any zoning law, ordinance or regulation: ...A/~ ..........................
13. Will lot be regraded .~.~[..~.~.6....~t'./~ .............. Will excess fill be removed from premises~.~, Yes . '. No
14. Name of Owner of premises Vt.~,¢,,.T. *..~..~'J¢/.~.~t.;f-[-, Address ................... Phone No~¥~
Name of Architect .......... : ................. Address ................... Phone No ............ j...
~.. 1,/~. ......... J .......... ~. Address .... ~ ........ ~,ff..'~.. Phone
Name of contractor ,/,;t/~:.~:u L~?~e~t~ d'ao .7'e,.,$~o No.O././:.~'.,~.~...~,~..
PLOT DIAGRAM
Locate clearly and distinctly allj buildings, whether existing or proposed, and. indicate all set-back dimensions from
p]mperty lihes. Give street and block number or description according to deed, and show street names and indicate whether
ihterior or corner lot. :
STA~E OF NE~ YQI~,
(Name of individual sig~g contract) '
above named.
He is the .....................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is d~ly authorized to perform or have perfomed the said work and to m~e and file this
application;that all statements contained ~ this application am true to lhe best of his knowledge and belief; and that the
work will be perfomed in the m~ner set forth in the application filed therewith.
Sworn to before me this
................. day ? ....... ,
N9ta~ Pu¢lic, ................... Count
, Term ~xpire~ M~h 80, lOl~