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HomeMy WebLinkAbout12721-zFORM MO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17264 Date SEPT. 6~ 1988 THIS CERTIFIES that the building ALTERATION Location of Propert~ 3670 ROCKY POINT ROAD EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 21 Block 04 Lot 05 Subdivision XX Filed Map No. XX Lot No. XX conforms substantially to the Application for Building Permit heretofore filed in this office dated QCT. 12, 1983 pursuant to which Building Permit No. 12721Z dated NOV. 2~ 1983 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 ENCLOSE EXISTING PORCH ON EXISTING ONE FAMILY DWELLING. The certificate is issued to MR. & MRS. LEWIS STABILE (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEkLTH KPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N644241 MAY 15m 1985 PLUMBERS CERTIFICATION DATED Building Inspector Rev. 1/81 FOEM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ....... ~.~.....,e~::. ................................... v_~T~'~ ~:...,.~.~ ....... ................. ~ ...:..;...~.;.----.----~ ................ j,~ ~, ~ .~..~, ............... ~ ................. ~......'~ .................... ~. .......... ~ ......................... ~/~ '~ ~ ,--'~ u,, ~ . ~ .... ~-o '~ .~, .......... '.. -,k..,.~.~,~.~.t.....~....,~....,.~.'..;~ ,. ~..:~ .......... ~/F. Ft~-~ ....~,~.....~ ............................... at premises located at ..~..[~'..~. ~`~`~~]~.~J`.``~)~`~```~`~```~`~.`~/~`~C~>~`~`~?`~L/' ..... ....... .................................................................... ~ ..... ~.~..~. ....... County Tax Map No. 1000 Section ...... .~....] .......... Block ............. .~. ...... Lot No. pursuant to application doted .....Q~.,....~..~.,~......~...~.. ................. , 19..~.~.~, and approved by the Building Inspector. Bulling Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall ,~Jouthold, 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 o7 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: 1, Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3, Copy of certificate of occupancy $1,00 use--Fre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date.. ~-~... ~'~ .~./..~..~. ..... New Building ............. Old or Pre-existing Building ....~. ....... Vacant Land ............. Location of Property .~.~. ~7. (~ .......... ~'~ ~( .~.~R~. T ....... ZZ;z~,. ~.. ~ House No. Street Hamlet Owner or Ownersof Property ...................... County Tax Map No. 1000 Section .. ,?'..~/. ........ Block ....O..c7/.. ....... Lot .... .O...~.. ..... Subdivision .......... ~ ...................... Filed Map No .... 77. .....Lot No .............. Permit No.{ :2./7 .~ .~. Date of Permit cant ,.. Health Dept. Approval .... ,~' .................. Labor Dept. Approval ... ,'7, ................... Underwriters Approval ,~, ................. Planning Board Approval ,, ~, .................. Request for Temporary Certificate ..................... Final Certificate , ,~, :T ............. Fee Submitted $ ~.,..0~...~.. 1 ?[..~.~ ........ Construction on above described building and permit meets all applicable codes and regulations. Applicant. ~..(~.~;h~r ................... Rev. 10-10-78 ~oo~o?'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~[]D BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100.38. ..~ m~y :LS, ~,~m~: ~...~.o.~o.o.,~.~ ~o~-~ N 644241 THIS CERTIFIES THAT only the electrical equip~nent ~ described below and int~duced by t~ applicant ~med on tl~ ab~e application number in the premises of Stoabile~ w/~ Rocky Pt. l~d. ~ East M~rion~ in the following location; [] Basement ,~ 1st wasexaminedon i~ay 10~ 1984 FIXTURE OUTLETS IECEPTACLES SWITCHES FIXTURES NCANDE$CENT FLUORESCENT DRYERS [] 2nd FI. Section Block Lot andfound to beln compliance with the requirements of this Board. RANGES ,OVENS EXHAUST FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCK UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V I NO O~E~C~COND. A W O. NO. OF OF CC. COND. OF HI-LEG NO, OF NEUTRALS OF NEUTRAL G & 8 Elec. P.O. Box 215 Southold ~ NoY. 1c.5 Z8 E This certificate mpst not be altered in an), manner; return to the office of the Board if incor~rect. Inspecto(~ may be identified by their IlS' ,MANNER. . .. S883-.Z* CA~I,JAVA~ 5B2.08 FlAP OF P~OPE~TY Su~VSYEP For'& ,,~A21A~ '-EA$ ,_2 _AT EAST t,4Ar?_iON TOWN OF =¢OUTHOLP FIELD INSPECTION FOUNDATION ( 1st} COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY .,- qODE FINAL ADDITIONAL COMMENTS: CHESTER ORLOWSKI CUTCHOGUE, NEW YORK 11935 This is to advlne you that the job under buildin8 permit no. 12721Z issued to Lewis Stabile on 11/2/83 for Addition 3,. is completed ;, finn! tnnpertlon hal; ~'- ) has not ( x )--been done. and £n order to complete th{s f[le, it ia necessary that ;~ C,.rrlficate of Occupa,cy be issued. Please fill out the enclosed form, return nnme to tho above office with a cheek for $2S.00 payable to the ?o~n of $outhold. Please indicate to Whom thc Certlficnte of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or uae i:~ ual. awful without e Certificate of Occupancy. l'lense help nn tO cleat tip thief matter eo that leRnl action does not have to be taken. Thank yo~ far yo~tr prompt attention. Victor Lease r'd Rxecut lye Administrator VI,: I;n r eec I . I am returning your check FEE: ,,~, ~ BY: NOTIFY BUILDING DEPARTMENT A~ 765-1802 9 AF-'~ TO 4 PM FOR THE FOLLOWING ~.;?ECTf~NS: 1. FOUN~AT[C;N - TWO REQU~R~ FOR P~U2ED CONCRETE 2. ROUGH - FRAMJF:~ & PLUMBING 3. INSULAT!~N~ 4. FIN~!- CQ~5 .... :~T!ON MUST BE C~:~ ~ C.O. ALL CO~'C~n"C~O~ SHALL MEET ~HE REp,' '~:~,~>.,Tq OF THE N.Y. STATE CONqTRUCT!ON a ENERGY ~~. CODES. N'qT Er_F, ONS,BLE FOP. DESIGN Op. CONSTRUCTION ERR©nS I- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~JLATION FRAMING [/] FINAL REMARKS: DATE iNSPECTOR 3'65-1802 BUILDING DEPT. INSPECTION' [ ] FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION 2ND ~,'] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Examined ......... ........................................ , Approved L)o~v[~, ~_ 19.~..5... Permit No...l.......-].. ........................ Disapproved o/c ............................................................................................ (Building Inspector) APPLICATION FOR BUILDING FERMIT Dote ............................................. , 19..z...~:..... 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 at areas, and giving o detailed description of layout ofproperty must be drown on the diagram which is port 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 in whole or in port 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 Lows, 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 opp icob eows, ordinances, building code, hobs ng code, and regulat ons, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or nome, if a corporation) .................. (~ddress o{ applicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~:'r~: :f owner of premises ...~....'~....~..~ ~ ...................................................................... [f applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ ...~,.,.(e,.,,.~,,,.,,,: ...................... Plumber's License No ................................................. Electrician's License No. -- Other Trode's License No ...... 7. ....................................... ]. Location of land on which__proposed work. will.be done. Map No.: ................ ~ ..................... Lot No ...... '7 ............... Street and Nu. mber .... ~.~.6r:'P~.,..I..? ,~...~.~ ........... ~670 ' ! Mun.cipa ty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ...~....~ ....................................................................... b, Intended use ond occupancy . O .......... ~ ........................................ 3. Nature of work (check which[ applicable): New Building,. ................. Addition ......~ .......Alteration ................ Repair .................. Removal] .................. Demolltior ..................... Other Work ................................................ , .... 4. Estimated Cost ...... ..~,...~ .................................... F e /~' ~ (Description) i J (to be paid on filing this application) ' L 5. If dwelling, number of dwelling, units .......................... Number of dwelling units on each floor ..........'--: ................. If garage, number of cars '""i ......... 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 .~.....~. ........... Number of Stories ......... ~ .......................................................................................... Dimensions of same structure with alterations or additions: Front ...... ~. ....................... Rear ....~.. ................. 8. Dimensioos of entire new constructmn: Front ............. ~ ................. Rear ............ ~ ......... Depth ........................ Height....................~ Numbe~ of Stories .............. ; ....................................................................................................... 9. Size of lot: Front ............ '...~..~. .................................. Rear ............... ~..,~.. .................. Depth .,..~...~..~.. .............. ~ I 10. Datb of Purchase ....... Z..~..~.~..,~ .............................. Name of Former Owner ..~"x~,~...~ .......... 12. Does proposed construction via ate any zoning law, ord nonce or regular on: ........... ~ ..................................... 13. ' Will lot be regraded' ,.....~m'..J~ .............. -' Will excess fill be removed from premises: ( ) Yes (~-), No 14. 'N,meofOwner of premises.,._., ...... .~ Phone Name of Architect ..............i ......... ~ ................................. Address ....... .,'~..J .................... Phone No ....................... Name of Contractor .................... Addres ...: Phone No.~.~.~.T..~....~.~....~' ~ ] PLOT DIAGRAM Locat~ clearly and distinctly alii buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and blpck number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OFI NE~Y~C)R~,/ .~/2~ i S S ' C OU N,"T~ .0 F.~ ....... )" ' ........ ~~,~ I ................. being duly sworn, deposes and says that he is the appliconf '~ (Name of indivi~al signing contracf) above named. He is the ............................................ ~ ......... ~ .......................................................................................................... /,,--~(Cont~nt, corporate officer, etc,) of scid owner or owners, and4s~ -----'-"-*~-d,uly~tl;or;~-~rd~o perform or have performed the said work and to make and file this application; that all statemenlts contained in this application are true to the best of his knowledge and belief; and that the work will be performed in }he manner set forth in the application filed therewith. Sworn te before me this ~ ~_. .......... "'¥ ~[ , (Signature of applicant) ELIZAB~H ANN NEVILL~ T~RY P~BLIC, Stete at New I~o, 5~:81,2§850, Suffolk ~ountl/, e,'i~ EXDi~ ~tYch ~0, )9~L,~