The URL can be used to link to this page

Home My WebLink About13501-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Plumbers No. Z18995 Date November 8, 1985 THIS CERTIFIES that the building ........ 0.n.e...f.a.m.i..17..d.w..e.l.l.i.n..g.. ................. Location of Property ... 2430 Brigantine Drive Southold House No. Street Hamlet County Tax Map No. 1000 Section ..... .0.7.9. .... Block . .4. ............ Lot .. ~..9 ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ...0.c. ~. 9 .b.e.(..9 ....... , 19.8. 4. pursuant to which Building Permit No. 1 3 5 01 Z dated ....O.q [..o .b.e.~.. 2. .5 .............19.8.5., 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 ......... .... (lne. £.ami~-y..dwe3-.].i~g ...................................................... The certificate is issued to ....C.A.R.M.I..N.E..M.:..&. DONNA MARIE BI SFIRITO (owner, I~;J~( ~r~t~EtX X X of the aforesaid building· Suffolk County Department of Health Approval . 1 4 - S 0- q .9 9 UNDERWRITERS CERTIFICATE NO... ? e n d in g 1 0 / 2 8 / 8 5 Certificate July 16, 1985 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 13501 Z Permission is hereby granted to: ~......~ .............. .~ .............. ....'.'.Z~...o....x,,....~..~ ............................................. ..~.....~....~.:~...j.~.~...s:.~. .... ,o...~.~.....~.....~......~.~...~.~.~. ....... ~....~ ot premises located o, ...~.....~...~....~......~.~.,..)..~.~..,...,,~..~.~,-~ · '--~,,, C~ .... County Tax Map No. 1000 Section ...... ,,0,.,,--).~. ...... Block ........ ..~. .......... Lot No ........ J...~ ............ p-rs,,ant to opp,,co,,on do,ed ....~.~....~ ................ ,...., ~.~.., ond opp~v,a by the Building Inspector. Bull~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD 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 ~ ~ 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 naturai 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- t[ons, 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 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 3. Copy of certificate of occupancy $1 .O0 4.Vacant Land CoO. $5.00 $15.00 Date .O~/.?.,.."~...~-.~?..~...~,,... 368 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. 2¢,~0 ~m±g~n~;±ne D~ive Sou~chold Location of Property .............. ~ ..................................................... House No. Street Ham/et Owner or Owners of Property .Q~;c~Jj3~. J~ .~(. ~c~Q~ .~a~i~ .DS. ~piz'J..~Q ................. County Tax Map No. lO00Section 079.00 Block 04..00 Lot.O19.000 Subdivision/~x~.~?/'Z~ ~./~/. ~.~..~'. ,~.~]z~z~7~..Filed Map No..,~.~Z~. ~'..Lot No..~:;i.~. ........ Permit No. /,~, '~'0/,'~-'Date of Permit ,~,?,~,: ~ .~Applicant .~, ....... ~, ............ /,~, .... ................ ,~.r/~/~ "¢ L/'~/~ ~,/.~, fi,, ~/~/rll¢ · pt App 1'.~.).4~.V, ././ /. ~''[ ...... Labor Dept Approval Health De . rove . ~ ................................ Underwriters Approval.; .-; ........... ¥ ..... lanm g Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $..~. '~.."'~ ...... i ........... Construction on above described building and permit meets all apglicable codes and regulations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 72g TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~/~//~ ~, (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Swor~%o before]me this 9/~ a y of~ , 1 // Notary Public Notary Public, ~L;/~/~Z/~County~// JOSEPH A. I-tAMM, N~lary P~blic, $ta~e of ~ew ~rk NO, 52-16534~0 Suffol~ County Cediflcate F/~ed in Sulfolk Cou~ ~erm Ex~ires Marc~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the elect~cal equipmen~ ~ described belo~ a~ int~duced by t~ applicant na~ed on the abq~e application nu tuber in the premlse~ of ~n~O D, 5p~z'ito~ 24;~) Dri~t~e Driv~ S~zt~ld, ~Y. in the/allowing tocation; ~ Basement ~ 1st Fl. ~ FIXTURE I OUTLETS RECEPTACLE.~ 50 DRYERS f >ir FIXTURES 42 [] 2nd FI. Section Block Lot and found to be in compliance with the r~equirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FAN~: FURNACE MOTORS FUTURE APPLIANCE FEEDERS ~IME ~LOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: 3~G,,'~,L, ;2-L. hnoke De.~ectors S E R 'V C NO. OF HI-LEG A. W, O OF HI-LEG NO, OF NEUTRALS A W, G OF NEUTRAL G.M.C.~bl~u-dt~ Ele~:trical Contractor, z~.Landing lie~ow t~ad · 5~qtLy%olvn, N.'ir. 11787 Lic, 176~E GENEI~AL MANAGER This certificate must not be altered in any manner; return to the office of the Board if ipcorrect Inspectors may be identified by their IN ANY MANNER. ./ FIELD INSPECTION COMMENTS FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL ADI C ~ENTS. // / P.o. Box 273 Lake Grove, N.Y. November 14, 1984 11755 Town Of Southold - Building Dept. Main Road, Southold, N.Y. 11971 Attn: Mr. Ed Hindermann Ref.# 13501Z - Building Permit Dear Mr. Hindermann, As per our telephone conv~sation on November 13,1984 - Enclosed please find the amended floor'for the rear e~tenBion, ~rom 10t x 16'4" to 14' ~ 16'4". Also, please be advised that all floor Joists in the entire house will be 2 ~ 1O's. Thank you. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE INSPECTOR 'FORM NO. 1 N'OWN OF SOU'I'HOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .C).~..~.*.., 19 .~.~. Approved .Q ~...~.~. ·., 19~.~.. Permit No. ~..~. · .~..}...~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... BLDG, DEPF TOWN OF SOUTHL :. 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 promises 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, addiQons or alterations, or for removal or demolition, as herein described. The applicant agrees to ~;moPnlYreWimtihse~llana~Pi~C~ub]led.lmaW~;;~deicneas~eS,,nb~ildi~iog~°de, housing c/oqe, and r~gulafions, and to admit authorized inspecto p .... g ry ' tspexpt' . . / //~ . , / (Signature of applicant,------~"or name, if a corporation) (Mailing hddress of applicant) - State whether applicant is owner, lessee, agent, architect, en~dneer, general contractor, electrician, plumber or builder. Name of owner of premises~ ['~t)3.~ .~..~...~..i.2 ~.i.¢. '.k .-~ .0...~..~(2~ ~ .~.~F.~.~5 t[ r-- .~ 5.5 OI' ~'i~. kO ....... (as on the tax rolt 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. Location of land on which proposed work will be done .................................................. ...... ....... .... .................... House Number Street Hamlet County Tax Map No. 1000 Section '~.~ ''~//- /.q. Block .t~ ~.~ 0 Lot I~t( .~ ~]d7 '/.,./ ,' . ...... Subdivision/t/~q. cJo. r./.'.~. .~...~?.t.~.~.~.~ ..........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 ..................................................................... b. Intended use and occupancy ~.~-~\ .... O..Cx., .(~. prope~y lines. Give street and block interior or corner lot. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair. ............. RemoVal .............. Demolition .............. Other Work ............... (Description) Cost '~(D~OO(~: ~O 4. Estimated .: ...................... Fee ...................................... 4, (t thi ppli ) o be paid on filing s a cation 5. If dwelling, number of dwelling/gnits ...... f ........ Number of dwelling units on each floor ................ If garage, number of cars ..... . ................................................................ 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimeg§ion§ o~f~ ex~is_t~g~l~c~llre~, if any: Front ...... ~ ..... Rear . . ..~7 Depth....~Z~.. ........ Dimensions 6f4a:m6-sh~6tah~q ~i~h alterations or additions: Front ....... .--. ........ Rear .... ~ ............ 8, Dlmensloh~'dn{lr~w ¢011s/mct~on: Front .... ~.~ ........ Rear ...-~. 1~ ......... Depth . ~.. ............ 1 1 .' Zone o~ use district in which pr~mises am situat:,t ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .ff~Q ........................... 13. Will lot be regraded . .I/~ ..... i ............, ....... Will excess fill be removed from premises. Y~ No Name Of Contractor fe.~...~...i ................. Address ?('~Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF ................. /7' 27' gR) v£ ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... ! ................................................... J (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements cont¢ined 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 Notary Public, . ........... Coun ~0. ~?0787~, Suffolk c0u,t~ _ ~ ~)~~ (Signature of applicant)