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Home My WebLink About13034-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14389 Date May 9 ................................................. , ]9 86 THIS CERTIFIES that the building ...O.n.e..f..a.m.i.l,~/..d.v{e. 1..1.i.n.g.: ...................... Location of Property ...7.4 0..B.a.L; .b.e.r.r.L;..L.a.n.e. ................. .S.o,u. thold House 31o. Street Hamlet County Tax Map No. 1000 Section . 52 ........ Block . ~ ............. Lot ...1.7. ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .Ap.r.i. J:..4 ......... , 19 .8.4. pursuant to which Building Permit No...1.3..0.3.4.Z. ............ dated ...Apl:i.],. 4 ................. 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 ......... .... One. faraiSy..clWel J-.J, uq, .................................................... The certificate is issued to LUIGI & MARIA PERINUZZI of the aforesaid building. Suffolk County Department of Health Approval 14- SO- 6 6 UNDERWRITERS CERTIFICATE NO. N 7 0 3 7 6 5 Plumbers Certificate Jan. 10, 1986 Building Inspector Rev. l/ill TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1303~ Z Permission is hereby grante_d~' , , c~.~ , , ~.~....:..~.~.: ......................................................... , ' ............ ~ ............. .~ .....~ County Tax Map No. 1000 Section .... .~..~.'~...~.~;7.. ....... Block ........ .'~ .......... Lot No ...... )..'..'] ............. pursuant to application dated ..... .~/~..~.........~ ......................... , 19~..Lf..., 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 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. F[ne{ 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 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 $15,00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date .......................... New Building ~'~ ~' Old or Pre-existing Building Vacant Land Location of Property ....Z~. ~..:. ~'. ~.-/.~¥~.. ~..~..~..< :..~..f Y...~..~..~..~.~. ........ Ham/et House No. Street Owner or Owners of Propertv '~'/~ / ~- /~/~/~"~' ~/'~dv~2~'~-"~ ~ ££. County Tax Map No, 1000 Section .......... Block ............. Lot Subdivision. ~', ~,~,~, ~,~, ,~_~,~,~,:~.,L,~, ,T, .......... Filed Map No, -~.~,~.,..Lot No. ,[,~,-- ......... Permit No,/,~. ~./7/ ~. Date of Permit ~.~.-.?' OOApplicant Health Dept. Approval .... '. ..... ,-. ............ Labor Dept. Approval ........................ Underwriters Approval ,.; ....... an ng r r .................. ............... PI ni BoadAppoval Request for Temporary Certifica. a.a.~ ..................... Final Certificate ....................... Fee Submitted $... ?.: .07. ........ ~..~ ........... Construction on above described building and permit meefs.~t,cam311'~5~ codes and regulations. ~ ~¢// --, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date January 10, 1986 Building Permit No. Owner /////~/' (please~?rint) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (p~umber s signature) Sworn to before me this 10thday of January , 19 86 . Notary Public, Suffolk County State of New York, Commission Expires March 30, 1987 Notary -Public iooloTi THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy ~f~ 8E JOHN STREET, NEW YORK, NEW YORK 10038 o~te ~ 07, .1985 283e01/84 A~tl~ 0~ t 19~$ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES 2OOKING DECKS OVENS DISH WASHER OUTLETS SWITCHES DRYERS FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET EXHAUST FANS DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R I C OF CC. COND NA OF HI-LEG A W.G. OF HI-lEG i/o E NO, OF~EUTRALSI A W, G OF NEUTRAl i/o 11971 Lia95781~ This certificate m~st not be altered in an), manner; return to the office of the Board if incor?ect. Inspector~ may be Ident/~d~by their credentials ~EL~ INSPECTIOI~ COMMENTS FOUNDATION (1st) FOUNDATIOn! 2. ( 2nd ) ROUGIt FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIOblAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL,: 7654802 ~xamincd ................ , 19... liece:kved ........... , 1 9 · · . )isapproved a/c ........................... ] ......... ~ INSTRUCTIONS a. Tlds application must be completely filled in by typewriter Or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on ttie diagram which is part of this appli- ation. 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 w!ll issued a Building Permit to the applicant. Such permit l~ali 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 Occnpancy hall have been granted by the B~,tilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the luildiug Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ?gulahons, for the constructmn of bmldmgs, additions or alteratmns, or for removal or.~[tkm,4~herem des nbed. 'he applicant agrees to comply with all applicable laws, ordinances, building~code, hot~ing code, and rcj~lations, and to dmit authorized inspecto~ on premises and in building for necessary inspcoef6j~. ~, ~"~55~_~ _ /~ j/'~, ~5)" (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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. A.~../~...~..~../-:...L- ......... Plumber s License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on whic!~ proposed work will be done.. ~..r'jt .~. ;~...~../59...~. ~... ~.~ .................... House Number ~ Stree~ Hamlet 7 County Tax Map No. 1000 Section .......... mock..J ............. Lot I 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 ..... b. Intended use and occupaucy 3. Nature of work (check which applicable): New Building ....... Addition .,. i ....... Alteration ........ Demolition Other Work ' Repair .............. Removal ........................... . .............. (Description) 4 E tlmatedCost · ' · · " ......... °" (to be phid on filing this application) 5, If dwelling, number of dwelling units ............ Number of dwelling units on each floor ................ If garage, number of cars . ¢~"(~. ~ ....................................... ' ........................... 6, If business, commercial or mixed occupancy, specify natuLe and extent of each t~yp~ of use .......... Height ............... Number of Stories .. ~ ......................... : ......... Dimensions of same structure with alterations or additions: Front ............ i .... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... · Front Rear i Depth 8 Dimensions of entire new constructmn ............ ................................ Number of Stories lteight ........................................... ~ ........................... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 0. Date of Purchase ............................. Name of Former Owner ~ ........................... 1. Zone or use district in which premises are s~tuated ......................... ~ .............. 2. Does proposed constructmn wolate any zomng law, ordinance or regulation: .... i .............. 3, Will lot be regraded ..... ')5l~ ................... Will excess fill be removed from premises: 4. Name of Owner of premises .................... Address .................. Phone No.. Nmne of Architect ..; ........................ Address .................. Phone No.. Nmne of Contractor .......................... Address .................. Phone No ................ PLOT DIAGRAM I.,ocate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-.back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. ;TATE OF NEW YORK, S.S '.OUNTY OF ................. ................................................ being duly sworn, del~oses and says that he is the applicant (Name of individual signing contract) bore nmned. : le is the (Contractor,' agent, corporate officer, etd. ) ,f said owner or owners, and is duly authorized to perform or have performed thel said work and to make and file this pplication; that all statements contained in this application are true to the best oCfis knowledge and belief; and that the ~ork w/Il be performed in the manner set forth in the application filed therewith. ;worn to before me this z~...~.-. ......... day off...~. · . .-~. ............ 19 .~. ......... County :",~'~'~"" hEL[[' q I(. DE rOE -.,, ,. ' ' qqOTA[~¥ ?U[~LIG, State ol New York. ....... ~ L... t~ ~. · ,~'~,'"'~...~'~. · ."~..~--~--<---<---<---<---<-~,.,