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HomeMy WebLinkAbout12875-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13013 Date . November 21 1984 THIS CERTIFIES that the building ...... .N.e.w...D,w.e.l. 1..i.ng. ........................... Location of Property 590 Willow Terrace Or House IVo. Street Ham/et County Tax Map No. 1000 Section . .0.2..6 ....... Block 02 ..... Lot 009 Subdivision..M.a.p.p.f., .W.i.l.l.o..w..T.e..r.r,a, qe. .... Filed Map No..~.49Y...Lot No. 16 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...F.e.b.: ...... .3 ....... 19.8. 4. pursuant to which Building Permit No. 12875 Z dated .......... .F.e.I¢, .......2.1. ....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 ......... ... Kew. One. ¥~raily. D. we J-~-.J,~g ................................................. The certificate is issued to ............. R.I..E.G.E.R. ~ JOHN & DOROTHYA ?o¥~¢~, '~e¥~b~; ...................... of the aforesaid building. Suffolk County Department of Health Approval .... 14 - S O- 03 UNDERWRITERS CERTIFICATE NO. N 6 6 5 3 2 9 Rsv. l/Sl Building Inspector 1~0~[ NO. ~ 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) Permission is hereby granted to~ ..... ~.~c~.....~..~ ...... ,o ...~~~ ....... .~.....~...~..i...~...~~ ......... ~ ....... ..:.~~.. at premises located at ....~....~. .......... .~...~ ........ .~.~...(~:~--.~..~ ....... ..~~ County Tax Map No. 1000 Section .... ..~.,.,~,,..,~, ..... Block ........ ~ .........Lot No ......,~,,~ .............. Building Inspector. Building Inspector Rev. 6/30/80 FIELD INSFECTION FOUNDATION FOUNDATION ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY FINAL {1st) (2nd) Y. DATE COMMENTS I ADDITIONAL COMMENTS: .. INSPECTION [ ] FOUNDATION ~.$T [ ] ROUGH P~BG, [ ] FOUNDATION 2ND [~ INSULATIoN [ ] FRAMING [~'] FINAL ~ REMARKS: DATE INSPECTOR FORM NO. 6 TOWN OF SOUTHOLD 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--kqsc~JpHcctc.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 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/ land 3. Copy of certificate of occupancy $1,00 use--Pre-Existing C.O Vacant land C.O. $15.00 $ 5.00 New Building ~J' Old or Pre-existing Building Vacant Land Location of Property .... . .~./..&,.L;..(¥,~j House No. Street Ham/et Owner or Owners of Property ..... .~. ~?,. ~...~?? .,~.o..,~. ..... .J?_ ................................ County Tax Map No. 1000 Section............... ock .............. . Lot.. ....... ;.... ' is' ~y lC co~ 'T/~/~ Subdlv Ion ................................. Fried Map~o.¥.,. t/. ..... Lot N . ..... P mitN ......... ~, Date of Permit ./¢.'.?....~.Appicant~...~.)-¢~¥. ~s'~?,~q~;:~ .... _. Health Dept. Approval ............... ~ ........ Labor D%)(./kpproval .......... Underwriters Approval .................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .................. ~/'""~'"':'7~ . . . all applicable codes and regulations. ConstructioLon above described buil~g an ~ ~ )'~-~:~ ~ ~ ~ppll ~ .......... ~;'.-"'~ ................................. lO01 V THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ~.. 85 JOHN STREET, NEW YORK, NEW YORK :tO038 only the electrical equipment ~ described below and introduced by t~ applicant ~d on ~he able application number i~ the prendses of Jo~ gcig~r~ Willow Terrace ~le, ~f St~t, 5~' to W~t, Orient~ N~Y~ i~ the following locatlon; ~ B~sement ~ 1st FI. ~ 2nd Fl. Sectio. Block Lot was examb~ed on ~0~ ~ ~ ~9~ and found to be i~ compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS NO, OF FEET NO OF CC COND. PER ~ C A. W G, A, W. G NO. OF NEUTRALS A.W. G OF CC, CONO OF HI-LEG OF NEUTRAL OTHER APPARATUS: l~ok~ Der ~tor 1--15,0kw I/e~t Pump 1--4. Skw~ ~bt Water H~ter, C~mrl~'~J, Hayler 11 Sequems L~te Ltc. 2242 PeF This certificate must not be altered in any manner; return to the office of the Board if incorred. Inspectors may be identified Co~¥ FOR BUilDING DEPARTMENT. THI.~ LTEREO IN ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................ , 19... Approved ................ ,19... Permit No ...... ' ...... Disapproved a/c ..................................... Received 19~ (Building Inspector) APPLiCATiON FOF~ BUiLDiNG PERMIT Date .... ~.eb,..3 ....... 1984 INSTRUCTIONS a. This application must be completely filled in by typewriter or in inl~ 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 drown 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 througkout 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, 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 regu!ation~s, and to admit authorized inspectors on premises and in building for necessary inspections. Nicholas Sarno RA (Signature of applicant, or name, if a corporation) ? O BOX 793 ............. C'o'tchor~ue; · WY ' t15>3 5 .......... (Mailing adWress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... grch~tec& ............................................................ Name of owner of premises . .J. oh!a..1%,. ~..l~91:9.t. hT~t..C.... ~_.e.g¢~ ....................................... (as on the tax roil 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. /-~J ,',' Electrician's License No ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ....... Wi.1,}ow. ~erraoe .Lan. e .W/s..506...89-'..f.~ora. ~<.ing. S.t., · Or.ie~t.,.N¥ ................. House Number Street Hamlet County Tax Map No. 1000 Section 026 Block 2 Lot.. ~ .~ Subdivision .M.a.p. pti..W..i.l.l, qw...T.e.r.r..a.c.e ............ Filed Map No..5..49.7 ......... Lot . .1..6 ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant b. Intended use and occupancy . .N~..w..o.n.e. ~.~m. 4 .ly qv;¢.~ 1J;n.g. 3. N ture fwork (check which applicable): New Building ... X ...... Addition .......... Alteration .......... R~pai~ ' RemoVal Demolition Other ~Vork i i I i (Description) E~timat~d Cost $ 7,5 00.0i Fee 4 (to be paid on filing this application) 5,:If dwelling number of dwelling Units. o. ne .......... Number of dwelling units on each floor .... -: ........... Ifgarage, number of cars .... i .tWO .......................................................... 6. If business, commercml or m~xedl occupancy, specify nature and extent of each type of use ..... N.~ ............. / 7. D]mensions of existing structures, if any: Front...NA .......... Rear .... 1,13. ....... Depth ....... NA ..... Height ...MA .......... Number of Stories .......... SA ............................................ Dimensions of same structure wi~h alterations or additions: Front ....NA ........... Rear ........ NA ........ ' Height NA Number of Stories Depth N~ 8. Dimensions of entire new construction: Front 0.0: -, 113.':,. .... Rear .9 ~ .' ~-.1,0 ': ...... Depth . 3.2 '.-~ 10." ...... Height .~ 8' Number of Stories 9, Size of lot: Front .../1.6.0,0 '.' .......... Rear ..... .1.6.0...0. ~.. ~ ,: ...... Depth $.4....6.~ ............... 10. Date o~Purchase / · v ........ J n o 12.,& 9 8 4 ....... Name o f Form&' Owner V...S ~ Go a.$wa i.3_or. ............. 11 Zone or us~ district in which prermses are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: .lqo ............................ 13. Will lot be regraded ... Pa.r.t~g.l.l.y .............. 'Will excess fill be removed fro. m premises: No Yes No 14. Name Of Owner of premises&Qhm l~.±eger. ....... Addres~SB..3.ncho. rage..D.~SP~one N05~6.58.7.-~fi 0&2... Name of Architect i'ticho.l.a~i. Sar:no .......... Address . .W?.s.L.. ~.s./.J:.i~..N.~... Phone No ................ Name of Contractor ......... i ................. Address PO..Box..7,~ 3 ....... Phone No ................ Cutchogue, NY 11935 516 734-5320 or 516 742-8828 PLOT DIAGRAM Locate clearly and distinctly alllbuildings, whether existing or proposed, an&indicate all set-back dimensions from property lines. Give street and block mmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. ............ .Nxch.o. la~. ~.arnO .................... being duly sworn, deposes and says that he is the applicant of ~nd~vldual s~gqmg contract) above 'named!Name .... '~' He is the A~chi. t.e~t (Contractor, agent, corporate o'fficer, 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 contsined 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 .............. ..... 19 - --- -' t,-/--' Notary PUblliC .... -:../....~-~~~ounty / l~g ~B[.[C, State el ~ow I~ualifie, diin Nassau Couat~5 ..... i , ~erra ~xui~e~ ~ar~ ~o, ~o__ (Signature of applicant) '% < ir-. ~< ~, UL:L Jr) io :0 i.a ,:q ~ :~1~% L,'_.Sti)~FOZ. K ,_.O,]NT~ HEALTH DEPAR ,~.~ -., 0~.~: NOV 2_ 198~.. :':- ~, ~F. fan.t}~ ., : ~' ; ,'r: hsvo been ~"~- ¢~20~ Of 6ono/'Lll Engineerin~ >'rUn '~' > 0 ~ -~ "4 © -< .q "r1 o o~1> 0