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HomeMy WebLinkAbout10871-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .g I 0B.84... Date ...... F.e.b..~9.a.~.y..1.8 ............. , 19.8.2. THIS CERTIFIES that the budding ................................................ Location of Property ...7.2.(? ............... ~!o..p.~.e.qh..o?..D.~..i.v.o ......... Ou~cehogue House No. Street Hamlet County Tax Map No. 1000 Sect]on . 09.5. ....... Block . ...Off. ......... Lot .. 9.1.8.: .19 ........ Subdiwsion .9.~.e.g°.n.. Y.~.~.~...E.$.t,..a.t.e.s. ....... Filed Map No..6.2~.1 .... Lot No...1. c) ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated e~ 1087t Z ·..q~ ?~.embev .3.. , 19~..©. pursuaut to which Building Permit No ...................... dated . . .~qP ~;em.I?9.~..1.8. ........... 19.8..0, 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 priva~;e one-family dwelling. The certificate is issued to Staller Associates (owner, te~ of the aforesaid building. Suffolk County Department of Health Approval . .~ .0.-.,g.Q r.6.O. ,...~/.5./.8. ?.~..~ .o.b.e.P.'c...3..,..~!~..~.~?: ~. UNDERWRITERS CERTIFICATE NO ......... ly ~5.3.5.6. .27. ................................ ./ ?. : Building Inspector Rev. 1/81 BUILDING P,ERMI~ (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S UNT!L I~ULL COMPLETION OF THE WORK AUTHORIZED) Permissi~ is hereby granted to: ~t premiso~ ~ocotod at ............................................... r'"" ................ ' ......................................... County Tax Map No. 1000 Section, p~rsuant to application dated Building Inspector. 6 3. O0 Fee $ ........................ LOT 19 J .............. ~ Lot No ........................ ..... ~ 1~.. ., end opproved by the BUilding Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hell Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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· 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 unusua~ 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: 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 / New Building . ~.. ........ .Old or Pre-existing Building(X)., ....... ~/Vacant Land ............ House No. Street C_ ~:'~ ~¢.2~,~./~ Hamlet Owner or Owners of Property ...... ./-..C~'4'~ . .~..r~.-~p:C~ .t_~ '].~/4~.~. .............................. County Tax Map No. 1000 Section ,..C~.~-~. ....... Block ...LTL. .......... Lot ./..~;/..~. ......... Permit No ........... Date of Permit .......... Applicant. ~.I.Z.~,· ~.../~. ~/~:'2.Z?..'?: ........... Health Dept. Approval . ,O, (~' {~ (.) L bo Dept Approval ·.. ....... -/z .......... Planning Board Approval .................. Underwriters Approval.. ~,~¢~"~)" Request for Temporary Certificate ..................... Final Certificate ................. Fee Submitted $ ............................. mu321 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ', ~ R~K 038 THI~ CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant nomad on the above application n~mber in the prvmises of in the following location; [] Basement [] 1st FI. FIXTURE FIXTURES OUTLETS IECEPTACLES SWITCHES NCANDE$CENT FLUORESCEHT 16 32 17 [] 2nd FI. Section BIo¢ k Lot and found to be in compliance with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS tULTI-OUTLET SYSTEMS NO OF FEET E R 'V I C E NO OF CC COND A W G* PER ~ OF CC COND 1 2/0 OTHER APPARATUS. I~G.F~ L t-,/4,5 OF HI-LEG OF NEUTRAL 6 YopIoz Ave. ~*,ack~o~',..,.,, ~,4.5.. z1763 lie. 2677-E GENEnAL MANAGER This certificate must not be altered m any manner return fo the office of the Board if nco~rect, inspectors may be identified by their credentm CO~ FOR B ILDING DEPA TMENT. THIS ¢OP~ OF ~ERIIFI~AT~ NOT B~ ALIE~EB N ANY MAN~ER ~--_OL~ C~ 14 FfEAIV'~F-- ..5 Al) DITIOt,,JAL_ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ....... q/'(..~.., 19 Z~.'? Approved ....... ~..q/./..~. ·., 19.~./). Permit No../.~..~.Z/~ Disapproved a/~ ...................... L>.~..~r~:-. . (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No....~..~...~.~../.... Date...~./~ ............ 1~... INSTRUCTIONS a. Thts application must be completely filled in by typewriter or 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 g~ving 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 approval of this application, the Building Inspector will issue a Building Pemdt 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 Budding 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, ~using code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary ~n~e~ns. ..... .V. ............... (Signature of applicant, or n~ if~orporation) (Mailing addresTf applicant) State whether applicant is owner, lesseepg~/architect, en~neer, general contractor, el¥ctrician, plumber or builder. Nmne of owner of premises·..0.~...C~../~....~. I~.uO.....~...[.~.~... t .~ ................................ (as on the tax roll or latest deed) If ap~pl~ca~ is a~r~rporatmn, signature of duly authorized officer. (Name and title of ~orporate officer) Budder's License No ......................... Plumber's License No.~., ~[~.~. ~ .~..~. J.M..Ct... Electrician's License No..~.o .0.,..~.~.~ .C~ ..... Other Trade's License No ...................... ~ff__.f~ .~..1~"~ ~. 1. Location of land on which proposed work will be done ................. ;.-..v....~.,r~v .~.~. ............... ... ¢. .'c. ............ ....................... House Number Street Hamlet County Tax Map No. 1000Section .O.~..~.. ............ ~....~.2..~.~... Lot.~.~.,..~q ............ Subdivision .O~-~G~O~..(J~oJ.. ~-F/~..F~.S ...... ffil~TM'ap No. ~.j~./. ....... Lot ...lq ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~.__~.0~ .~...~. .... .: ....... : ....................................... b. Intended use and occupancy .... [ .......................................................... 3. Nature of work (check which applicable): New, Building ..........(/' Addition .......... Alteration .......... Repair .............. Removal .............. Demolition ............. Other Work ............... t.~i3 .~., .O.O.~.' (Description) 4 Estimated Cos ~ 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. Dimension.s_of, entire new construction: Front...~'.~. ......... Rear .~. ~. .......... Depth ~.~ I-[eight . .I -.'.~ ........ ,~ ~ Number of Stories . .~. ................................ , ..... t ............... 9. Sizeoflot: Front . .~.(0 ....... i ........... Rear. ~&~.. ................ Depth ~.~O. ................ 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 law, ordinance or regulation: .~5~ ............................ 13. Will lot be regraded ..t{~,~...' .... ~d.~.'.". ...... Will excess fill be removed from premises: Y. es 14. Name of Owner of premises .~..~.. ~. ............ Address ................... Phone No ............... Name of Architect . .~-~ ....... i .................. Address ................... Phone No ................ Name of Contractor .~/~. ~g[r.~:.~p...~..~. ~. ~_~Address 1~.7..-tN/bY. ~ 114.... Phone No./~. ~... ~l. 9{.... PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ;number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF .NEW ~4~RI~,/./t{ :S.S (Name of individual signing contract) above named. Heist e --C traoto), agent, corporate officer, etc.) of said owner or owners and is duly authorized'"Ry~erform or have performed the said work and to make and file this applicationi that all statements contained in this application are true to the best. of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this (Sigffature of applicant) N0, 52.8125850, Suffolk Ecrm Expires Match 30, SURVEY FOR VITO RA~DAZZO SUFFOLK COUNTY DEPARTMENT OP h~L~H S~I~ES LOT 19, "MAP OF OREGON VIEW ESTATES" AT CUTCHOGUE OAT~ AUO 28,~980 FOR APPROYAL O~ CONSTRUCTION ONLY ~WN OF SOUTHOLD SCALE 1"=40' DATE ~//~ HS R~. NO.~ SUFFOL~ COUNTY, NEW YORK NO. 00-402 ~PROVED ~ ~[w YOR~STATE EOUCAT OH LAW OF NOT BE 'ON IDERED TO BE4 VALID TRUE COPY ' NGUARANTE[~ INDICATED HEREON ~ALL RUN ~LY m HEALTH DEPARTMENT -DATA FOR APPROVAL TO ~STRUCT THE ~RSON ~OR WHOM THE SU~EY IS PREPARED ~. STA~E ALDEN W YOUNG, PROFESSIONAL ENGINEER SUBOIVISlON MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON ~RIL 4, 1975 AS FILE NO, 6241 AND LAND SURVEYOR N Y-S MCENSE NO 1~845 HOWARD W, YOUNG~ LAND SURVEYOR ~ ~ L~T~ ~ W~L(W),SEP*~C TAN[(ST)a CESS~OLS(CP) SH~N H[R~ N Y S LICENSE NO 45893 ARE ~ FIELO OBSE~ATIONS ~D OR DATA OBTAINED F~OM OTHER S ,  ~0 00' ~ =IY~,O~' ' ' ....... ~ ~ VITO RANDAZZO .~ LOT 19, "MAP OF OREGON VIEW ESTATES" JULY ~,, .. · JAN. 1981 ~ ' ~ ~' ~ ,'? 1~0.~ AT CUTCHOGUE OAT[ AUG. 28, 1980 I" 40' ~ ' , ~WN OF SOUTHOLD SCALE: = ~' , SUFFOLK COUNTYt NEW Y~K ~0. 80-402 HEALTH DEPARTMEN~-OATA FOR APPROVAL TO C~STRUCT ;~A~ FO~ WHOM THE SU~EY l$ PREPAREO ~ ~,% ~ ~ OFH~LTH '--ICE~ PURPOSE AND ARE NOT TO,E USEO TOESTABLISH ~L ;~ ~ OS~ANDER AVE~E YOUNG * YOUNG STAKE ALDEN W YOUNG~ PROFESSIONAL ENGINEER SUeDIVI~ION MAP FI~ED IN THE OFFICE OF THE CLERK OF ~FFOLK AND LAND SURVEYOR N Y.S UCENSE NO 12845 HOWARD W. YOUNG~ LANO SURVEYOR