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HomeMy WebLinkAbout13475-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12996 Date November 19 .................................................. 19 .e.4. THIS CERTIFIES that the building ...~ .e?.~.~..c .e.~..~. 9.o.~..s..~ ?.u.q ~..uF?., ~.. ?.n.~. ~..~.~.e.d., .~.~.~.ic. Location of Property ...... .~.9.00. ?~.com ~.~..Bay..B3. vd ............... 4 au~.e.], ........... House No. Street Hamlet County Tax Map No. 1000 Section .... 1.~.~. ..... Block ..... 4. ......... Lot ~. 9..~..P./?..6. ..... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Oc t, 2 ,198..4. pursuant to which Building Permit No. 13475 Z dated ... 9c t .. 1. 9 ............... 198. 6.., 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 ......... .... .ppp.~.a..c.e.d..~. 9 p.f..s..~r.u.q t..ur.e..~...e.n.~..ar g.e...a.~.t.~.c... ............................ The certificate is issued to ...... ~ .I .C fl.. ~ .C .Cfi.~ .N..P.A. Iq...Z .A.R.I, ~ 9 ............................ (owner, t~yg4~eXoX ~)~0rO~,)X X X X of the aforesaid building. Suffolk County Departme~nt of Health Approval ...... ~ ./~ ................................. UNDERWRITER S CE RTIFICATE NO .............. ¢.f .N .6.1.7. 6. .3.0... (. 9 r $ ~ 5, z3 g 2[.) ............. Rev. 1/81 Building Inspector I~OBII~ NO. ~ 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) N? 13475 Z Permission is hereby granted to: ....... .../.z.~..~?~.....~..~./.~. .................. .... ~.~.~..~~..~.~..:...~ ........ ./.~.~.~/ ...... ...~.~.~ ........ ~.e~.......~.....~.~....,~.~.z..~/zz~ .................... i~,~, ............... ct premises located at .....~...~....~....~........~~.~...e.:.....~..~...~-.....~f- .~..., ....................... · County Tax Map No. 1000 Section ......... Block ........... Lot No ........ pursuant to application dated .Q~.~ ........ .~. ................. , 19.Z~. and opproved~l~y the Building Inspector. Building In.s~ector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ~,outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted~upllcctc 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 peoperty showing all property lines, streets, buildings and unusual natural or topdgraphic 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/ land use --?re-Ex±st±ng C. 0. $15.00 3. Copy of certificate of occupancy $1.00 Vacant land C,O. $ 5.00 Date ...~.0.~0. 7.~ .............. New Building ............. Old or Pre-existing Building ...~. ........ Vacant Land ............. Location of Property . .L;~.Q0...~.e. qo..n.Y.c..~, gy..~.~. ,'Y-0.....~.~.~.~.e..Z ~.~...~... ........................ House No, Street Hamlet ~ca I~CB~-B P.a~zar~z3o Owner or Owners of Property ................................................... County Tax Map No. 1000 Section .../.~. '°~' i ...... Block ...... .~. ...... Lot. · .~..~..~'..~'?J..~. · · Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~3~?~.. ~... Date of Permit .~0..-.~.~.~; .~.4Applicant .~.$~.~.:rrj..C.o~.~.~.~.~.~,,~g, ...... Health Dept. Approval ~ Labor Dept. Approval ' . ............ Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate .... ~'~.~1.~,[ ............. Fee Submitted $ ~....0.0 ........................ Construction on above described building and ~er~t me~t~/~applicable codes and regulations. Ap p ,i~an~/_~.../.~~ .~.¢~d~ ........................ ~ ~nfot~y D.~-~auers~ Pres. a,v.m-m-?a ~ '/~ ~,5 ~d ~/ Biltim Contracting,Inc. 1000276 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~)E, BUREAU OF ELECTRICITY V 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment es described below and introduced by the applicant named on the above application number in the premises of A. Panzanr~, 4900 Peconic Bay Blvd. S/S of St., Laurel, N.Y. in the fotlowing location; [] Basement :[] 1st FI. [] 2nd Fi. Section Block Lot was examined on ~eptember 19, ~98~ and found to be in compliance with the requlretnents of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES NCANDE$CENT FLUORESCENT DRYERS SYSTEMS NO. OF FEET E R V I C NO, OF CC COND* A W.O. NO OF HI-LEG A W, O, NO. OF NEUTRALS A W O. PER ,8' OF CC COND, OF HI-LEG OF NEUTRAL OTHER APPARATUS: Electric Room Heaters:l-2.5 KoW~, 2-2.0 K.W, 4~1.5 K.W., 1-1.25 KiW. 190 Wgs~ington Ave. ~ w~, ~/ ~1= COPY FO, pU LD~NG DEPARTMENT. TH S COPy O~ CER! F C~TE MU~Si NgT ~qE ~ FIELD INS?EC~TION DATE COMMEN~TS FOUNDATION ( 1st) __ FOUNDATION (2nd) ..... RouoH FRAME ~ FLUMBING STATE ENERGY - ~ODE ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date . .0.~$....3 .......... 198./5. INSTRUCTIONS a. Tins 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 Y6rk, 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 in building for necessary inspections· · .B.i..i.~.i.m.. ¢.o.n.t r,.e%.ir~g o ;mc .................. (Signature of applicant, or name, if a corporation) · ?..% % .v.e. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premmes' lV!i. 9.a..l~.q0..a.n.n...P.a.n.z.a.~..5.rip. .............................................. . . . (as on the tax roll or latest deed) If applicant is a corporation, signature 9f duly/authorized officer. (Name and title of corl/orage offibe, r~ / Builder's License No. ?{59 ..................... Plumber's License No ..... .N/A., . . ' ...... Electrician's License No....N/gr. ................ Other Trade's License No...N/A. ................ I, Location of land on which proposed work will be done .................................................. 4900 Peconic Bay. Blvd ............ Laurel .......................... House Number Street Hamlet County Tax Map No. 1000 Section .1.2.~. .............. Block .../4 ............... Lot .Del,.. 3.0. &P'/"fl .6.'. 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 ... . .............0ne Family..d.w..~..1.1.i.n.g ........................................ .0Me .F.a.m.i.l.y .d.w.e..1.1.i.n.g .w/.a. ttic' b. Intended use and occupancy . ................. · , ............................. 3.~F~~ 't applicable): ' New Building ..........' Addition .......... Alteration · .X. ..... .. ; Ri6~~~emo~al ........... Demolition ............. Other Work .............. ;: ~~~i~ L ..... (Description) , , ~ i~-O~ . ............................ ................................. ...... ~~ ~i ' go be pa,d on fihng tins apphcat,on) 5. It~~g~Utn, ¢nits ..... ~4 ...... Number of dwelling units on each floor.. ~.~4 ......... If garage, number of cars .... ~/g ............................................................. 6. Ifbusiaess, commercial or mixe4 occupancy, specffynatureandextentofeachtypeofuse ~'~ 7. Dimensions of existing stmcture~, if any: Front .~}r9 .......... Rear .. ~D.n~ ....... Depth . ~Zx ~ ......... Height ~-0 Nmber of Stories on~ D~ensions of same structure wi~h alterations or additions: Front . ~2.n9 ........... Rear . .[3r.¢ ........... Dep~ 11:~ ' HeiSt ~2x~ Number of Stories 8. Dimensions ore, tire new construction: Front ............... Rear ............... Depth .............. Height ZT-p. NumBer of Stories 9. Size oflot: Front .55r.0........ ......... Re~....55rD .............. Depth ...25~0 .......... .. · 10. Date of Purchase .~gZ · .~gBD. ................. Name of Fomer Owner ~r~g~.~e7. g~hnsg~n... I 1. Zone or use diJtrict in which prdmises are situated f2 12. Does proposed construction violkte any zoning law, ordinance or regulation: ¢9 .............................. 13. W~I lot be regraded .. ~/g...~ .......... : ........ Will egcess fill be removed from premises:N/a .Yes No '' s~ea Panzavxno ~} W. ~gh Sg.n e. n 14. Nme of Owner of~se ... ................. Address ................ Y..Pho e ~ · ....... Nme of Architect ~'...~g:.. 4 ................. Address .... ~X4 ..... . ......Phone No.. ~A .......... ~Nm~ 0f Contkactor ~}.~¢. ~.q~:..~9.' ...... Addres~.~g~. gr :. ~rg.~ne ~o. ?¢Zz~7~5 ..... PLOT DIAG~ Locate cle~ly ~d distinctly ~1i bu~d~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from prope~y ~nes. Give s~eet ~d block ,humber or description accord~g to deed, ~d show street nines and indicate whether interior or corner lot. STATE OF NEW YORK, i S.S COUtqTY OF. ~'o~.K ....... (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant Oph~ao.~.a22 . ~. tie is the ........................................................................... (Contractor,.agent, corporate officer, etc.) of said owner or owners, and is dully authorized to perform or have performed the said work and to make and ~e 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 , APPROV[D AS NOTED NOTIFY BUILDING DEPARTMEN~F 765-1,802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALE MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. -+ 7~"