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HomeMy WebLinkAbout13222-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Lt 4 .~ 3.6, ........ Date ....... i~l?y..25 ................... 19.86 THIS CERTIFIES that the building..c.o.q ~ .~r.u,~ t;, 3..r.~ ~.o.v.~l;~..2c~ .p.ch..~.e,a..q.f. ?.e.q t)ory Location of Property ,,.2 ? 9 D.5 ................ iq.& 5,¢. g.d. ............. ~ g.~.qg 9 A/O · Street Hamlet County Tax Map No. 1000 Section .... .I .0.2. .... Block ........ 1 .......Lot ........ 1,~, ,1 ..... Subdivision .......... X .................... Filed ~ap No...~. ..... Lot No ....... .~ ...... conforms substantially to the Application fo~ Bui]din~ Permit heretofore filed in t~s office ·.. ~.a,~. 3.1 ........... ,19,8.z~ pursuant to which Building Pe~fit No ....... 1. 3. .2.2.2.~. ........ dated ........ J ~.e.. ~ ~ ............ i 9 ~.~., was issued, and conforms to aQ of the requirements of the a~pllcable provisions of tee law. The occupancy fo~ which this certificate is issued is ......... ,.. £.~ $ .t,~'.~ c ?,. ~..~,e~.o.~.~ ~..iq ~ ~'c,h. ,~'~.a..c~..z~.~ ¢ ~,.o.~.~ .......................... The certificate is issued to ............ ~S.~.C ~J~..[~]~/[,~,~. ]~ .. ,C. ,.. ~ ~[.U.~.C..~ .................. of the aforesaid building. Suffolk County Department of Health Approval .................. ~l./.g, .................... UNDERWRITERS CERTIFICATE NO ....................... S 693.9.~ 0 ................... Building Inspector Rev. 1/81 ... J'O'P-~ 'HO. 0 TOWN OF Sou'rHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~s~ z oo,,....~.~ ..... .~ ........ .,~.:~.:/ Permission is hereby gra~Xf~ t_~o)-) ._~ . %...~.~ ~ ~,~, ~ .~~.~.....~..~..~ ........ ~.~.~.~.~ , ,o ..~.~..~...~.~..~.....~....¢...~..~....~... ......................................................................................... s ~w o~ ~ gd:. ~... .~ ~ . .... at promi~ I~nt~d at ........... ............... ............................... .~....r...+ ............................... County Tax Map No. 1000 Section ...... !...0......~... ...... Block ......... J. ........... Lot No ......L.~..L..! ....... Building Inspector. © Fee $ ........................ Building Inspector Rev. 6/30/80 F I~'LD IT~SPECTION COMMENTS FOUNDATION (lstl FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING 3. INSULATION FEE N. STATE ENERGY ODE ADDITIONAL COMMENTS: May 3 , !9 5. , ,: ,apt, u..~io,,~Voo./it.~ ,, 3~108g/85 ...... : "~l only theeleetr~culequ~pmenta.~descrtbedbelowandlntroducedby the upplicant ~tned on the above ~pplicatlon number ia ~cred.Hea~ Road; G ~ff~ Street & H~d Road, tc gue,:N.Y. the/ollowing Ioc~tlon~'. B~eme,~t 1st FL ~ 2n Fl. ~ ' , Section ]'~ Block FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application 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- lions, 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 House No, Street Hamlet Owner or Owners Of Property . , ,~..~', ,~..~,~,. ,J?...~..~.....~.: . .(~.°.....~...~..~..~-~ .J. .... County Tax Map No. 1000 Section J ~ ;2, Block Subdivision ................................. Filed Map No ........... Lot No. Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval Request for Temporary Certificate .~ .................. Final Certificate. ~.~.~,~... Fee Su bm itted $....~ .... (~.~ ......... ~,. ~,~[ q q~5~ Applicant~~ Rev. 10-10-78 TO ANTHONY J. LORIO R.A. 507 Main Street PORT JEFFERSON, NEW YORK 1].777 Phone 473-1311 / GENTLEMEN: WE ARE SENDING YOU ~ Attached ~ Under separate cover via [] Shop drawings [~ Prints ~ Plans [] Copy of letter E~ Change order [] [] Samples _the following items: [] Specifications COPIES DATE NO. DESCRIPTION ~_ ~ ~%~ ~-~ - _ THESE ARE TRANSMITTED as checked below: ~ For approval F2 For your use I~ As requested [] For review and comment [] FOR BIDS DUE E] Approved as submitted [~ Approved as noted [] Returned for corrections [] 19 ~ Resubmit copies for approval E3 Submit _copies for distribution [] Return____corrected prints [] PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO_ FORM 240-2 - Awila~l e t¢om ~lnc, Gro~on, Mass 01450 SIGNED: ~' '" · TO ANTHONY J. LORIO R.A. 507 Main Street PORT JEFFERSON, NEW YORK 11777 Phone 473-1311 [] PL£A$~ R£PL Y [] NO REPLY N£C£$$ARY 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-180:~ Examined .~k~'4-.I. .~ ...... , 19~.tl. Approved . ~,3,k';<~. ! .~. .... , 19~. ?. Permit No.j. '.~..~..a-.~...~r Disapproved a/c ..................................... Received ........... ,19... (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 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 YxIrk, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or,/fg~ removal oJ 9'/emolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bt~I'dj~ode, ho~s~g code, and regulations, and to admit authorized inspectors on premises and in'building for necessa~L_~ ~ /K-'S~ign_atu. re/f applicant, or nam e, if a ~o~poration) (Mailing address of applicant) State whether applicant is ~, architect .... o ...... , o____.al con ........ :!:??ici~n, pl .............. or. ...................... . ',.. ',. .................................................. Name of owner of premises . . .'~'~...~..f~..~ .U?..?f....~...1~..-17....~.:..~.: . . .~...~...~.. ?..J~.. .................... .f (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.....1~..t~..b~..17.%..b~...~.: ...... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ['t~-z~l}'~ l~---~t22> - ~-O'I'¢:2~:2<:~t.-M~- House Number Street Hamlet County Tax Map No. 1000 Section ...... ! .~...7~. ......Block ........ [ .......... Lot ..... I..~/.]. ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................... 2;~.. ............. b. Intended use and occupancy ............................................. . .... .................. 10, Il. 12, 13. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration ......... Repair .............. Remoyal ............ Demolition .............. Other Work ............... Estimated Cos .......................... Fee ......................... . ............ , ~" (to be paid on filing this application) If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage number of cars If business, commercial or mixedloccupancy,, specify nature and extent of each type of use ..................... Dimensions of existing structures', if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure wiih alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Si of 1 F ' Rear Depth ze or: ront ............ ; ...................................................... Date of Purchase ............ ~ ................. Name of Former Owner ............................. Zone or use district in which premises are situated Does proposed construction violate any zoning law ordinance or regulation: Will lot be regraded ...... ~,,r~m*.,. t.a~w,~r~,~'. · · Will excess fill be removed from premises: Yes No N,,tme of Owner of premises .~"~i~...-~.~+~.. Address N tme of Architect'~ .~.~.~.. ~' ~.°. ~l.Q. · ., · · · ..~.r~ Address .~.~..~. ....~C4~5.. I.I'1. . .~.~. ,.. Phone No..4'.~.~". . .....1~.... Name of Contractor .......... i ................ Address ~I~.'~A.?~.~?.. Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines, G~ e street and block number or description accordmg to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S'~S (Name of individual signin~ contract) above named. of said owner or owners, and is duly lauthorized to perform or have performed the said work and to make and file this application; that all statements contained m this application are true to the best of his knowledge and belief; and that the work will be performed in the manner 8et forth in the application filed therewith. Sworn to before me this Botar~ Publle. Stat~ of New York No. §~. 04~7965, Suffolk C. oantF,~../. ~' C/ / (Signature of apphcant) .. - ~or water c~istriButing es K or PL UMBER CERTIFiCA TI:ON ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY APPROVED AS NOTED DATE: 6./~/, f t;, B.P..~ / ~ ~'~"~-...-'~ ~: ~ ~Y' U-~.~- ~OT~FY ~u~~ ~A.~T~,~T A~ 765-1802 9 AM TO 4 PM FOR T~ FOLLowING INS~ECT!O~S: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ~. INSuLATiON BE C~MPLETE FOR C. O. ALL CONsTRUcT[ON SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONsTRUcTION & ENERGY CODES. NOT RESPoNsIBLE FOR DESIGN OR CONS~UCTION ERRO~, SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2,/I 0 of 1% LEAD. 7 ---