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HomeMy WebLinkAbout13558-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date June 6, 1988 THIS CERTIFIES that the building .... qn.e. cf.a.m.i.l.y, .d.w.e.l.l.i.n.g ......................... Location of Property .. .7.9. Q Uhl Lane Orient HotJse No.' ...................... 'S'ttJe~i ....................... 121~r~l'e~ County Tax Ivlap No. 1000 Section ..... 1.5. ..... Block ......... 5. ..... Lot ...... 2.4...1.5. ...... Subdivision ...Qxien~ .By. .Tile .8. e.~[..(S.e.q...3.)..Filed Map No...6.1.6. Q..Lot No...!6.5. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated October 29, 1984 13558Z ..................... pursuant to which Bnilding Permit No ...................... November 20, 1984 dated ............................. 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 ......... One-family ~welliP. g-with attached porch. RAYMOND & EVELYN MAZZOCHI The certificate is issued to ..................... ~o'~nb)~) ...................... of the aforesaid building. Suffolk County Department of Health Approval .... 14-S0-205 4/21/88 UNDERWRITERS CERTIFICATE NO. N792649 Richard Goelz, Jr, 10/29/84 PLUMBERS CERTIFICATION DATED: Rev. 1/81 Bnilding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13558 Z Permission is hereby granted to: ~....~....~,~ ;-. ........... ~.~.....~7./...~. // ......... ...~.~..,....,~,~...~ ~.,.,,~.,~'..../..~~ ...... ~ .......... at premises located at ....~.~..0'.. ......... ~.....~...~ ........... ,(:;~.~ .............................. County Tax Map No. 1000 Section ...... .~../...~,'~., ..... Block ......... ~, ........ Lot No.....~....~[.:.../...~.... pursuant to application dated ....~..~.....c~,..~. ................. , 19~,.~...., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 -. I-...~ 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: I. Accurate survey of property 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: Additions $25.00 POOLS $25,00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory',~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $~0.00 4.Vacant Land C.O. $ 20.00 .~..Z /.~'...~.'~ 5.Updated C.O. $ 50.00 Date .,. ¢? ..... NewCons truction ...... Old or Pre-existing Bu1{ding ............ Vacant Land ............. ....... ..... n ¢.r ............. Location of Property . ~ House No. Street Ham/et Owner or Owners of Property .v~, . · ~- · . ~ t. ............ County Tax Map No. 1000 Section ..(~ ./~.. ...... Block .... Q .~-- . Lot .O...~'~. Subdivision ................................. Filed Map No ........... Lot No../~.~.~,~ .... NoJ ~.~'- ~ ~. Date of Permit/~/~.~/~.~.Applicant Permit .... . ............................. Health Dept. Approval ........................ Labor Dept. Approval ........................ App ..... Request for Temporary Cer~:ificate ..................... Final Certificate ....................... Construction on above described building and. permit meets ailao ~ plicable codes and regulations. 5976 .................... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS £UL}U~.~ EUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK lO03~B THIS CERTIFIES THAT only t~ electrical equipment ~ ~scri~ed b~l~w a~d introduced by t~ appllc~t ~med o~ ~e a~ove ~pl~at~ ~er [~ the premises o~ in thefotlowinglocatlon; ~ Bas~nent ~ lst Fl. ~ 2nd FL Section Bilk Lot ~sexamir~don ~ 0~ ~9~ a~dfoundtobelncompllanceu'iththerequrenents~fthsBoard. FIXTURES RANGES OVENS EXHAUST FANS FIXTURE OUTLETS SWITCHES FLUORESCENT 2O DRYERS SYSTEMS NO. OF FEET ~'aaelboar~ts ~ £-13c~.r., lZSamps., l-Smot~e (*~t~=c tot V I C NO. OF CC COND ~ NO OFHI-[~G ~ A, WG A.W,G PE~ ~' OF CC. CONL OF HI-LEG NO OF NEUTRALS 957 SmtthCowa Aveaue ~on~mia, NY 11716 Llc# 211~. ' This certificate must not be altered in any manner; return to the office of the Board ifllnc~rrect. COPY· ~,OR BU?,D HG DEPAR'I'MEHT. THIS COPY OF CERTII GENEllAL MANAGER __ may be identified by their credentials. INi~N¥ MANNER. TO~N OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /'~%-'~-,.~_ Owner ~%.q~¢c- %- ~Z26cU(' (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signatu~e~v Sworn to before~e this day 19L. Notary Public ~Oit'$ County Notary Public COMMENTS .~ ~ F1ELD INSi'ECTION 1. FOUNDATION (1st) FOUNDATION ( 2nd ) /z~NSULATION PER N. Y. STATE ENERGY ~_ ~ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTI~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 November 20~ 1984 Key's Contracting Co. 957 Smithtown Ave. Bohemia, N.Y. 117~6 Dear Sir: Enclosed please find the Building Permit for Mr. & Mrs. Raymond A. Mazzochi, Uhl Lane, Orient. Please sign the application and have your sig- nature notarized and return it to us. I have marked the application with red asterisks where you should sign it and also please fill in the estimated cost. Thank you. Yours truly, Helen De Voe, Sec. 765-1802 BUILDING DEPT. INSPECTION r ] FOUNDATION ~ST ~'~/"OuG. "LBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING [] FINAL REMARKS: ~~.~ ~'~,,,0/~. DATE 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH FOUNDATION 2ND [ ] INSULATION ~_~/~/FRAMING [ ] FINAL REMARKS: DATE ..~/~'-/~-~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~FINAL /~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [~FINAL DATE INSPECTOR ~-~/~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~),t~v-m~..~..,~..~, 19 .~.~. Approved ..~. ~..[~...~, 19 ~. ee~it No2 ~.~. ~. Disapproved a/c ..................................... ............................ (Building Inspector) APPLICATIO~ FO~ BHI LDI~G PEBM IT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 approval of this application, the Building Inspector will issued 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 for necessary inspections. admit authorized inspectors on premises and in building ........../.x ~.~V~ (Signature of'applicant, or name, if a corporation) ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................................... Name of owner of premises '. ~ OM · 2.0¢./'[! (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and tit.le of corporate officer) Builder's ioense No... V../.! :. ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done...~..~..~.../.~..A~.~.... ~~..-~.. Ho~se Number Street '' I)&~n',;; ......~ ~'~ ~'(~'~ ....... County Tax Map No. 1000 Section .................. (~3[~--~ Block... {~---...J~.. '... ..... Lot ................... Subdivision Ot~ t lS'Wr dy r/]~,~ ~'~.,~jt Filed Map So.C~'.~.~....'~. ...... Lot /~'~ ' (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: //,4 c ,4 r a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ........ .~.//...~"... ~.~i .~?./..'~..~ ................................... 3. Nature of work (check which applicable): New Building ......... 'Addition . .i ........ Alteration . ~ .... . .... Repair Removal Demolition ~ Other Work ! (Description) 4 Estimated Cost .7. ~0 ...c~.... Fee ' '" (to belpmd on filing this application) / ' 5. If dwelling, number of dwelling units .............. Number of dwelling units on each floor ................ If garage, number of cars ............................................ i ............................ 6. If business, commerciai or mixed occupancy, specify natltre and extent of each type of use ................... 7. Dimensions of existing structures, ~f any: Front ........... Rear . .~ ...... Dept .............. Height Number of Stories ~ Dimensions of same structure with alterations or additions: Front ............ :. .... Rear .................. Depth ...................... Height ......... ~ ........... Number ot* Stories ........ 8. Dimensions ol~ entire new construction: Front ...~.~ ........ ! ' ' ~ ...... · . ............ . .......... . Rear ....... 1 ....... Depth . .~.; ........ 9. ...... ............ 10. Date of Purchase ............................. Name of Former Owner .i ............................ I 1. Zone or use district in which premises are situated .~, t)~ . 12. Does proposed construct~on v~olate any zomng law, ordmance or regulation: ...'~)i.c} ...................... 13. Will lot be regraded ..... ~ ~. .............. . ....Will excess fill be remo_v~d from premises: Yes 14. NameofOwnerofpremises'L~,.v,~.~k~.,,~j~,~oq.~l AddressB~-.~,q ..~o.R?. ~'/~lt}f:PhoneNo . Name of ArcMtect ...~..c~,,~ .~?.. ~ K~.~.I ......... Address .~.~.~-.~..~? .~[... ~ .... Phone No ................ Name of Contractor¥. 9.~.% .~9..~:..c~..- .............. Address~.~..ff.t~ ~k~.~..~tq,.. Phone No..'~0-~.'.~ .q.~. ~.[ .... .. rrm' DIAGRmC&,\ whe x' ' i . ,. Locate clearly and distinctly all buildings, there ;sting or proposed, and, indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and shoi street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............................................................ (Contractor, agent, corporate officer, etc.!) of said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this application; 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 Titl~ No. 114-S 6604 1111 WAS H I N ,~:l'O'i~D R IV E CENTERPOR"f, N,¥. LAND SURVEYOR LIC, NO. 46021 File No, PHONE (516) 423-0117 TITLE SURYEYONLYFOR RAYMOND & EVELYN MAZZOCIII GUARANTEED ONLY lO FIRST AMERIC~_.N TITLE INS. NORTtI SHORE ABSTRACT CORP. LOT(s) 165 I~AP OF ORIENT BY THE SEA, SEC. 3 LOCATION ORIENT, TOWN OF SOUTHOLD, NOTE: NO ESTABLISHED GRADE ---.?. N 18° 26' I0" 14/ S CO. BLOCK SUFFOLK CO. N.Y. DATE 1/14/83 STREET MAINTAINED BY TOWN 196.'57 18° 26' I0" E 223.'C:~ ., ', ',, ~. _ /~TMFNT 0 FOR APPROVAl OF C£ NSTRUCT[ON OF Single Fami!y Reside~lce O~fly DATE /o-/~-~'~ _HSREF. NO. D--~ APPROVED_ ~ ~ SINGLE FAMffY D¥~,,UI~ON~ - ~he sewage disposal and w~er su¢¢y fa~ ~ o~er ~enQ~ and f~fl~~ : / tiL ? L~4T 4 ~r .I If copper tubing is used for water distributing system~ piping shall be of types K or L only PLUMBER CERTIF£CATIO~ ON LEAD CONTENT BEFOR~ CERTIFICATE OF OCCUPANCY SOLDER U~,~, .~v i,>~.YS~z? SUPPLY SYSTEM CANNOT .EXCEED 2/10 o,f 1% LF-_~4D, APP~,C-.*SD AS NOTED FEE:"~ ~]j ~ BY:. NOTIFY BUILDING DEPARTMENT AT 7~5-1B02 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS ]. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CON'STRUCTION MUST BI C©MPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE DESIGN OR CONST UCTIO~N ERR'n'~S ,( ) -4" LE-~T ,/