HomeMy WebLinkAbout16220-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17399
Date OCTOBER 11, 1988
THIS CERTIFIES that the building
Location of Property 3020 BRIDGE LANE
House No.
County Tax Map No. 1000 Section 85
Subdivision
ONE FAMILY DWELLING
CUTCHOGUE, N.Y.
Street Hamlet
Block 2 Lot 21
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 8, 1987 pursuant to which
Building Permit No. 16220-Z dated JULY 13, 1987
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 FAMILY DWELLING WITH ~ARAGE ~'ATTACHED WOOD DECK
The certificate is issued to JOHN & JOANNE CALABRESE
(owner, ~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-S0-201 - 9/26/1988
UNDERWRITERS CERTIFICATE NO. PENDING - 9/12/88
PLUMBERS CERTIFICATION DATED 9/8/88 ~ F2tST END PLUMBING & HEATING
Rev. 1/81
Building Inspector
TOWN OF $OUTHOLD
BUILDING DEPARTMEN'r
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NE 16220 z
Permission is hereby granted to:
County Tax Map No. 1000 Section ..... ..~),..~...~.. ..... Block ....... .~.~ ..... Lot No ........~....~ ............
pursuant to application dated ....... ...,~.~...L~.....~. ....................... , 19.'~..'].., and approved by the
Building Inspector.
Rev. 6/30/80
TOWN OF SOUTHOLD
Building Department
Town Hall
--~ / Southold, N.Y. 11971
/~P~PLICATION FOR CERTIFICATE OF OCCUPAN
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
natural or topographic features.
2.Final approval of Health Dept. of water supply and sewerage disposal--iS-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 bu ildings.
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: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling.$25.O0, Accessory ,$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ I00.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O./ / $ 50.00 Date ....~r¢~:.
NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land .............
House No. ~J street Naml~
Owner or Owners of Property .... ~h, .~. ~ ~c~ - ~, o~
County Tax Map No. 1000 Section Block <' '- · Lot,,
Subdivision ................................. Filed Map No ........... Lot No ..............
Health Dept Approva %[:2' %O" 2_0 J ,.c~..Labor De t A
......................... p · pprova~ ........................
Underwriters Approval..~.. ................... Planning Board Approval . .................... .
Request for Temporary Certificate ..................... Final Certificate .... ~ .............
Fee Submitted $ ....... :~. ...... -. [[ ~..~ ....
Construction on above described building and permit meets all applicable codes and regulations,
Rev. 10-10-78
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [//J/INSULATION
[ ] FRAMING
[ ] FINAL
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ~OUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING [
PLBG.
] INSULATION
] FINAL
DATE.~~/~
~,~ ~ 765-1802
/ /' ~ BUILDING DEPT,
NSPECTION
~.~[ ] FOUNDATION 1ST [~rO~GH PLBG.
FOUNDATION 2ND [ ] INSULATION
.~I~ING [ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
REMARKS: ~/~//-~,-,-~_~ ~//~,//~~
DATE
"/ /
INSPEGTOR~/~ ,~
765-1802
BUILDING DEPT.
INSPECTION
[ LJ./FOUNDATION ZND [ ] INSULATION
FRAMING
FINAL
/ ?/
765.1802
BUILDING DEPT.
INSPECTION
~FOUNDATION 1ST [ ] ROUGH
PLBG.~
[ ] FRAMING [ ] FINAL
REMARKS-. ~
FOUNDATION 2ND [ ] INSULATION
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
//
FRAMING-- ~ ,r~INAL
REMARKS:
DATE
INSPECTOR~
OUNDATI~'~ ~ _~lst)
OUNDATIO~ (2nd)
'OUGH FRAME
PLUMBIN~
'NSULATION FERN. Y.
STATE ENERGY
CODE
FINAL
iONAL COMMENTS:
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No. /~
Owner ~(~ ~/~
(please print)
Plumber E~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber' s signature)
Sworn ~o before me this
Notary Public County
TOWN OF SOUTLIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUI'IIOI,D, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
We are unable to complate your Cartificate
of Occupancy because .of the following reasons.
/--//An_ application for Certificate of Occupancy
on
/~/ Lo Hoalth Dept. Approval on file.
/~/ ~o final inspection has been made.
Please contact: our office on this matter.
Thank you for your cooperation.
Bui l~j~?/ [)opt.
'~**/~/ ~to Plumber Solder Certificate on file.
( all permit,s involving plumbing being
.[s.':ued after April 1,1984 )
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF: ELECTRICITY
(>('~'()~q,;tI U'~,, ' ~q~ JOHN STREET, NEW YORK ~EW Y~RK I0038
in the fol owing Ioca~i~;,, ¢~ ~s~ee& e ~ I st FI. 2nd FI. Section Blck Lot
FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES FLUORESCENT
DRYERS FURNACE MOTORS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
BERVIC~ DISCONNECT S E R V I C E
OTHER APPARATUS:
NO, OF CC, (~OND
PER ~'
GENERAL M/INAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be
their credentials.
COPY FOR ~U!LDINGp[pART~ENT. THIS COPY OF CERTIF!CATEMg~? HOT ~E.~LTERED IH ANY/vlANNER.
'~ FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL,: 765-1802
Examined..t.~-~ .[ ~ ·., 19~[.~.
Approved
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERIVllT
BLDG. DEP'F,
3'OWN OF SOUTI4OkD
Received ........... ,19.. ·
Date .................. , 19...
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 0 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~d~ing code, housi~6'Ojte, and regulations, and to
admit authorized inspectors on premises and Ln building for necessary vti~ns. ,
~~ant~or name, .if a corporation)
.... ~.4~. ../.'t. ~..z. t.o~. .~.F.I. . .
.... 5..,...r~...c. 3.h ?~.~. ~....~.:~. :...~:~ 3.., ....
(mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... ~...~~...~!~.~Y.. i?..~. ~. ~?. t. ~..¥? :.~. ~
Name of owner of premises ...'~..~.~...~...Q~..o-r.~..c%.~?..~..~..~...I5 .... .~.~'~.~ ~.~9.~..~...Q..eL.~.~. ¢..~.~..~ · . ............. (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 ...................... ,~ 0o~ O
1. Location of land on which proposed work will be done .... ~'~}~.%.~...~..&..g).~'. .............. .~.~ .....
House Number Street Hamlet
County Tax Map No. 1000 Section ...~.. ............ Block ...~x ............. Lot...~.~ .............
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 .... .~..°~.q .~.~..3V ................................... ...............
b. Intended use and occupancy ..... to. . .~ .x .... ~. . -, ............................
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