Loading...
HomeMy WebLinkAbout13489-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14546 Date June 23 86 THIS CERTIFIES that the building ...... O..n.c..~..a.m.i.~.y....d.w.o.~..1 .i.n.~. ........... . Location of Property ..... : .2.3.8..0..H.E.N..R.Y..S..L. PECONIC House lYe. ' Street ' 'ltl~t~/e~ County Tax Map No. 1000 Section 74 .Block 01 ..... Lot 44.9 Subdivision ~.a~ .9.f. ?.@99.n.5:g..K.n. ql..1.s ...... Filed Map No ......... Lot No. 8 conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... 8.~pg....1.} ....... ,19 .8.4. pursuant to which B~filding Permit No. 1.3489.Z .............. dated ... 9.c?.:..2.3 ................. 19 .8.4., 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 ......... ..... q~.?..f.a.m..~.~y..a.~.~?.~.~..n.%. ........................................ :~. .......... The certificate is issued to ANGELO ACC&RDO ..................... ?oh;,'o;~IZ~;,tt~,~,t ..................... of the aforesaid building. Suffolk County Department of Health Approval ...... .1.4-:$9:.1.3..9 ......................... UNDERWRITERS CERTIFICATE NO .............. .N.6.7. .97.6.3. ........................... PLUMBERS CERTIF IC IATE 6 / 23 / 86 Building Inspector Rev. 1/81 FO~F,M NO. 0 TOWN OF SOUTHOLD 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? 13489 Z Permission is hereby grante~ ................. ~ ................................. ~ .................... :T ............ j ........... ~ ................ ; ........................... at prem,ses located at ........... A .............. ~..~...~. ................ .~-%J~.. ..................................... Building Inspector. approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This appBcation must be filled in typewriter OR ink, and submitted m ~ 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 p~operty 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ................ New Building ...... ~...... Old or Pre-existing Building ............ Vacant Land,. ............ Location of Property .. °~"~,~..~i ~.~ .~..~ House No. Street Ham/et County Tax Map No. 1000 Section ~.. Bl°ck d~ ........................... Lot..~//.~.; .~. ........ Subdivision ................................. Filed Map No ........... E6~N~5" .............. Permit No ........ Z_.. Date of Permit .......... Applicant .................................. 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 j~ermit m~ts all/3pplicab~e'cod, es and regulati~r~s. Applicant ............... F1E~D I~SPECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N, STATE ENERGY FINAL ADDITIONAL COMMENTS loooass THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY , ~hg 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~ly the elec trlcal equipment ~ described below and introduced by t~ applicant trained on the abo~e application number in tl~ premises of ~qelo Accardo, E/~ Henry Lane, 25Q0'~/0 Ro~ 48~ Pec0nic~ NY in thefollowing location; ~ Basement ~ Ist Fl. ~ 2nd FI. Section Block Lot was examined on ~e~E~a~ 14 ~ 1985 and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS 28 IECEPTACLES 43 SWITCHES FIXTURES RANGES OVENS DISH WASHERS FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATER: MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SRRVICE DISCONNECT S E R © NO O E ND' OF "~C COND. 2 OTHER APPARATUS: *~uture a~liance fee(lets.~ 1-2~14, 1-2~12, 1-G.F.C.I. 1-Smoke detector I C E NO OF H~ LEG~ A~ W, G NO OF NEUTRALS A W~ G, OF HI-LEG OF NEUTRAL Electrical Ventures P.O. Box 151 Center Moriche$, NY 11934 Llu~847 This certificate must not be altered in any manner; return to the office of the Board if in COPY FOR BI IILDING DEPARTM ~OPY~ may be by their credentials. I ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building~Permit No. /~~ Owner ~/g~ ~Z~ ~ ~ C~ /(~lease print) Plumber ~ ~( ~d~ ~ (p~ease print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 19~ · Notary Public, z~ County x%~ (~umber's signature) Notary Public ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 Approved .~ .'~..~..'1. ·., 198~. Permit No. ! .~..~..~9..~. Received ........... ,19... Disapproved a/c ..................................... ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 cl_~gwr~ on the diagram which is part of this appli- cation. - c. The work covered by this application may not be commenced bef¢e issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issu. pd a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the wor~:. 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 Law% 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, build admit authorized inspectors on premises and in building for necessary.ins/~ . "( Sig~ on~. e, h~/~in,~ and r eg_u/~'Ons' and tO re/of applicant, or name, if a corporation) State wh~-~licant is owner, le~;--~gent architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Locati~ of land on which proposed work will be (]one... ~ .~.; .... /. .................................. /~..~?.,~..< .~..' ~. ~ = z...~':...:..~ .......... / ........................ House Number Street Hamlet cou ty, x p o. 000 ,o ........ o Subdivision .... d .Q .~ ~:.~..~ ~. ~. Filed Map No ............... Lot...~. ~ ....... (Name) 2. State existing use and occupancy of.p~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............. ~ ......... .............. ]. · · .. ........................ b Intended use and occu anc . .............. ................. ........................ 3. Nature of work (check which applicable): New Building .......... Addition.; ........ Alteration .......... Repair .............. Removal ............ Demolition .......... :... Other Work ............... ~..qf. ,~ ~'~ ~: (Description) 4. Estimated Cost ....................... Fee ......... i ............................ '" (to be! paid on filing this application) 5. If dwelling, number of dwelling units ................ Number of dwelling un!ts on each floor number of c~rs i ~,..'." If garage .................................................... .......... .... 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 ...... i ....... Depth ............... Height ............... Number of Stories ........................... ; ............................ Dimensions of same structure with alterations or additions: Front ........... i · · .. · Rear .................. Depth. ..................... Height ...... ; ............... Number of Stories ..................... 8. Dimensions~of.~nJire new construction: Front....,t~...~. ...... Rear...~..~, ....... Depth .. ~.~. ......... Height . .~r ~.. ......... N~umber of Stories ~ '~-~ .......... i ...... ..... 9. Sizeoflot Front ~P.O . . 'l~;~r '~'4' 'i ' . ... Depth '.~'.'*'?' ' 10. Date of Purchase ............................. Name of Former Owner i ............................ 1 1. Zone or use district in which premises are situated ........................ i~,~ ...................... 12. Does proposed construction y, i61ate any zoning law, ordinance or regulation: ... ! ............................ 13..W?ll lot be regraded .... ,~. ~..-Y .................. Will excess fill be removed from premises: Yes No 14. ~ame of Owner of premiSes .................... Address .............. 2 ....Phone No ................ Name of Architect ........................... Address .............. j ....Phone No ................ N e of Contractor ~ .~..'Y~.~. Add am .... ............ . ress ................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ifidicate 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 NF~'~)RI~,? a/. S.S above named. being duly sworn, deposes and says that he is the applicant Sworn to before me this ~, ;-.day of... .~.~:.., 1 Not~:y~~~Public .................. ~,~.~... County (Signature of applicant) He is the .......................... ~ ......... . ............. i ............................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly a~"~to perform or have performed the shid work and to make.and file this application; that all statements contained in this application are true to the best of hi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith.