The URL can be used to link to this page

Home My WebLink About12143-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. 1.2..0.6.6 .......... Date November 4 198..3. THIS CERTIFIES that the building ................................................ LocationofProperty 575 Southern Cross ['l[~tJs'e~]ol .......................... Road Cutchogue Street Ham/et County Tax Map No. 1000 Section 1 1 0 ..... Block 05 02 8 ....... · ..............Lot ............ ~-: . ~ .~ Subdivision X N X ............................... Filed Map o. .Lot No. X conforms substantially to the Application for Building Permit heretofore flied in this office dated January_ 21 198.3. . pursuant to which Building Permit No. 12163 Z dated F e b r u a r y 7 19 8 3, 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 ......... a private one-famil dwell' The certificate is issued to GENE J. & GILDA F. CONTINO ~owner, ~h,¥~:t~/- ..................... of the aforesaid building. Suffolk County Department of Health Approval 8/8/83~ 12-S0-61~ Robt. A Villa P.E. UNDERWRITERS CERTIFICATE NO ...... .N. 61 1 4 y 2 Building Inspector Rev. 1/81 Pen~nission is hereby granted BUILDING TOwNHALL (THIS PEP~iT MUST BE KEPT ON'~H~ I~1~ I.~ !$ UNTIL ~ULL COMPLETION OF THE WoRK AUTH~Ri'zED) [ ~:, 121t3 Z .; D~.:.: :..,..~....., at p~emiseg located at County Tax Map No. 1000 ,Section. pd~siuant to application dated BLt!I ting I~spector. F~ 6/3o/eo . ..;:......'.*.- ' t IqO., ....................... ..~.~, 19'2~ and ~pprov~:l by the FORM N'O. 6 TOWH OF $OUTHOLD , Building Depoffmeht Town Clerks Office Southold, Iq. ¥. 11971 APPLICATIOlq 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 of all buildings, property lines, streets, and unusual natural or topographic features. 2, Final approval of Health Dept. of water supply and seWerage disposel--(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 ]957), Non-conforming uses, or buildings and "pre-existing" 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 os 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: 1. 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 Rte ............................ / New Building .,...~,/.. ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...................... /.. ........ ~...~.~-~,~.Tt/~..~f.~.....~,~.CD..G5 .............................................................. Owner Or Owners Of Property ..... .~Z'..~.~2.~ ........ .+......~..~;?.~.'.........~(~C~.[q:~.~:~3..~ ........................................ Subdivision .~/~J~L.......A~l~e~ ............................. Lot No ............. Block No....~... House No..~..Z,5..-- Permit No. ,,/~,~..~'..~. ..... Date Of Permit ~-../..'Zf.~.~...Applicant .... ~.~..Cv~..Jl./.'/.L..,i~4q,~,Z'.;,,.~.~',~, ............ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all ~pplicable codes~md r~eg/~ulations. Applicant ..,~., :J:'~ ...~...~...~....~ S,omtobeforemeth, is l '; ~'~"/:'4'" day of .~/k~..d.V..~.~.,..~.~,~..~. . (stamp or eeol) Noto~ Public .............. ~..{.~Coun~ , ' ~~- .... ~ .... I~-~Ry PUBLIO, 8~t~ ~f New ~ [ No, 5~-812585~', S~Jfolk COU~W~ 1O0O358 THE NEW YORK BOARD OF FliRT UNDERWRITERS BUREAU OF ELECTRICITY, ~- ~ 85 JOHN STREET, NEW YORK, NE ~/ ~ORK. 10038 THI~ CERTIFIES THAT only the electrical equipment ~ described below and introduced by the applicant ~a~ed on the able application n~mber in the premises of in the following location; [] Basement [] 1st FI, was examined on FIXTURE FIXTURES OUTLETS SWITCHES FLUORESCENT [] 2nd FI. : Section Block Lot and found to be in COml~lla~ce with the requirements of this Board, RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS MOTORS FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DIscONNECT OTHER APPARATUS: S E R · ~ ~V I C NO. OF HI-LEG AW, G, OF NEUTRAL 1/0 ~nt~r ~ri~ N.Y., 11934 This certificate r~ust not be altered in any manner; return to the office of the Board if ~EPARTMENT. THI,c GENE"AL 11 may be identified ANY MANNER. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G,ODE FINAL ADDITIONAL COMMENTS: 4 Italy,3{ ,NO, ! , · ~ TOWN OF SOUTHOLD' BUILDING DEPARTAJl.'NT ~ TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. ~.,..?. Permit No, .~.,'.~,.Z...~...~.,...~.... ...... D sapproved a/c -~ APPLIGATION 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 schedu e b. Plot plan showing location of Iot and of buildings on premises, relationship to adjoining premises or public streets o~ 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 thJ~ 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 throughobt 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 inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) · .. . (Address of apphcaKt) Sta~e wheth~er app_~ic~?~t is ow~er,~lessee, agent, archit.ec~jt, engine~er, general contractor, electrician, plumber o br~uilde~. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. //~ ~ ~ /~' ..-~..~.,. .. Plumber's License No ..... ~......~.....~.....~ .................... Electrician's License No..~...~....2...~ ..................... Other Trade's License No ............................................... Location of land on which proposed work will be done M~p No .................. Lot hJo Street and Number'~..~...... ,~_/ , ~ , /,: ..... ~.: ............ %_...:..?,..;~.:. State existing use and occupancy of premises and.intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............................................ ....... ............................................................................ b. I ntended use and occupancy ..'....~;~..'~....~~. .................................................................. 3. Nature of work (check which applicable): New, Building..~.... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ................................................ (Description) 4. Estimated Cost ¢~ .......................................................................................... [ (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 ....................... Z ................................................................................................................. 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 ...c,~....--~.'. .................... Depth .~..~.'. .... Height ....... ./..~.. ......... Number of Stories .... .~... ............................................................... ; ........................................ Dimensions of same structurff with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new cor~struction: Front ....~.,~. .................... ;. Rear ..~..~..~.. .................. Depth , .~...,.~.~, Height ...... Z,...~.. ..... Number of Stories / .................................................. 9. Size of lot: Front ........... ~..,..~..' ........................... Rear ....... ~....~.. ........................... Depth ..../...0~....~'...-~...../..~....7. ..... 10. Date of Purchase ................. ....................................... Name of Former Owner ........................................................ 11. ZonE or use district in which premises are situated ..................................................... , ............................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ../..f~...,..~.. .......................................... 13. Will lot be regraded . ......~: ...... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of prem ses~.~...,~.~.~.....,...~ Address ...~ ............... .__. .......... Phone No...'. ................... Name of Arch,tect ...... .-.'.~.~..~/~ .............. ~ ..................... Address .......... ~..... e No ....................... Narne of Contractor ..~....~..~.~ ....... Address .~,.~.~.i~...~,../../.~.... Phone No. ~.~.../...~.~..~... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property hnes. Give street and blbck number or descr'ption accord'ng to deed, and show street names and 'nd'cate whether interior or corner 1at. ~ STATE OF NE~'~j~RI(, , COUNTY OF .."'~-~.~J'., ....... .... ..~....~'.?..]'.,,~,....~?..g~.9.~,'/..9....'. ........................................ be ng duly sworn, deposes and says that he is the appticanl (Name of individual si~ning contract) above named. He is the ...~ ..... ~ ........................................................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the ~said work and to make and file this application; that aH statements contained in this application are true to the best of his knowledge and belief; and tha¥ the Work will be performed in [the manner set fo~h in the application filed therewith. Sworn to before me this ..... o, ........ No]~r Pub c,. .............. ~..,~....~oun~ 4..,..~ .............................. ~~..E ................... ,~ : L. :, SUFFOLK CO. HEALTH DEPT. APPROVAL I P,~,<~ t [. ' ' ' ' i .. ' ' '/~ . ".S. "O. F i~ / I // STATEMENT OF' INTENT ' " ~.~.~'~' s~ould Se. nc.f~. ~,~-,+ . ~~' THE WATER SUPPLy AND .~c'WAGE [DISPOSAl. ,/~operty t~ ~oc~d~- ".' ~'l:,.t. ,, ~;~c.~-e/¢ ~.~1~ ~. SYSTEMS FOR//~I.~ RESIDENCE WILL .- .......... ¥~.'u~er Su ,, '~ SUFFOLK C~IyL~r. ~ ,H~ALTH ~S~E,4~VlCES. .. I .~ · - ,,,- · . , , / ,,. . u. pes~iCmes an~/or ~;t,,,+ .~<~ ~ ;, W ... ,~.-~, ~ / ~peclal and,,~[--r-.. ,- ..... es. - APP/L~C~NT . ~ . ~ -. \ :.. ~ ~,,~. t// ....... -~-~:_. sE.VICES - FO. ^~"~ROVAL OF ~ i ~ '~ I ~'~ ~ ,- , / DATE: .... ADDR~: ' ~,.~~ '~/ ~f.T'lro ~ w~// I ,~'~-/"~2 [~,~'~ 11[ ,..,~/.. ,?-f. DEED: L. / t LICENSED LAND SURVEYORS GREENPORT NEW YORK .K ROOERIC, K VAN TUYL, P.C. LICENSEO LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H, S. NO. STATEMENT OF tNTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. Is) APPLICANT SUFFOLK SERVICES -- FOR CONSTRUCTION ONLY DATE: H. S. REF. NO.; APPROVED: COUNTer DEPT. OF HEALTH APPROVAL OF OVdNI~RS ADDRESS: TE~ ~AMP SEAL SUFFOLK CO. HEALTH DEPT. APf~OVAL H.$. NO. ~ , ............ V STA~E~[NT OF ~ ~o~ wins .~s~.c~ w,a~ ~rFOLK COUNTY ~PT. Or HEALTH SERVICES -- FOR APPROVAL OF CO~TRUCT~N ONLY 1~ Zl/ ~. ~7'. '- TEST HOLE ~AMP ......... 1~ t~m S~L SH~ NOT ~ C~l~ ~ ~ ~ [ pNlV TO ~E pErSON ~ WHO~ THE ............ ~ 11~ CO~~Y, GOV~TAL A~NC~ LICENSED LAND SURVEYORS GREE~RT NEW YORK AS NOTED DATE:' 13 P. I~ copper fubing is usec for water distributing syslem; piping shall be of types K or L only T ' "Ti J I1~ ' I I t I I / [ ~t'[EL~_ __ JO. , /'¥.:0 I Zq- '-O" _ _ · . / 0'- 0'__ ,,! 37-' 0 ~ 5z6TM