HomeMy WebLinkAbout16328-zFORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22491
Date AUGUST 2~ 1993
THIS CERTIFIES that the buildin~
Location of Property 1900 GLENN ROi~D
House No.
County Tax Map No. 1000 Section 78
Subdivision
ADDITION
, .. SOUTHOLD~ NEW YORK.
Street Hamlet
Block 2 Lot 36
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 7~ 1987 pursuant to which
Building Permit No. 16328 Z dated AUGUST 12, 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 2ND STORY~DDITIONTOEXISTTNG ONE F~}4/~LY D~R~.INGAS
APPLIED FOR.
The certificate is issued to
FERUCIO & RI~% FR~NKOIA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVkL
UNDERWRITERS CERTIFICATE NO. H-035929 - JULY 16~ 1993
PLUMBERS CERTIFICATION DATED JULY 24~ 1993 - F. FRANKOLA
B~ding I~sp~ctor
Rev. 1/81
FORM[ NO. 0
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)
NO- 1~2~ Z
Permission is hereby granted to:
....
.~..-..~.~ .......... ~..~.~!~..~~ ...............
.... .~..~....~..:~.,....L.L.~.~..~ ...........
,o .....
at premises' located at ...J...~. ........... ~ ..~.~....~ ........ .~ ~~ ...........
County Tax Map No. 1000 Sect~,,,,,,.,O,...'),..~...., Block ....... ..~....?~... .... Lot No......~..J~.
pursuant to applicat,on dated .~~.~.....~. ....................... , 19..~..:1.., and approved by the
Building Inspector.
Fee $..J..~...~.-.%..~..
Building Inspector
Re~ 6/30/80
TO~N OF SOUTDOLD
BUILDING DEPARTMENT
TOUN UALL
SOUTDOLD~ NE~ YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE
NE~ CONSTRUCTION .~.
....... OLD OR PRg-EIISTING BUILDING .... VACANT LAND
~OUSE NOo ~TREET ~AHLET
County Tax Hap No. lO00 Section ...... Block ..... Lot*
Subdivision ....................... Filed Map ........ LoC ..........
Permi= No ......... Date of Permi~ Applicant
~ealth Dept. Approval .................. Underwriters Approval
Plauniug Board Approval ................
Request for Temporary Cur%ificate ....... Final Certificate .....
Fee Submitted: $ ....................
APPLICANT ....................................
~eV. 10/14/88
q i
POR~ ~0. 6
TOW~ OF $oir~IOLD
BUILDING DEPAKTHEST
TOwN IIAL~
APPLICATIOH FOR ~ERTIF~CATE OF
~is appllca~ion must be giled '
xn;type~i~er OR ink and submitted ~o the BuildlnE
~nspcc~or wi~h ~he io11~wxnE; forjne~ buildlnEs or ne~ use:
Final survey of property with accurate location of all buildlngs, property lines,
s~reets, and unusual inatural o~ topographic features.
2. Final approval of Health Dept.lof water supply and sewerage-disposal(S-9 form).
3. Approval of eleatrxcol znstall~txon from Board of Fire Underwriters.
4. Sworn statement from!plumber c~rtifying that solder used in system contains less'
than 2/10 of IZ leadJ
5. Commeralal buildings; industrial buildings, m~ltiple residences and similar~'
buildings and installations, alcertificate of code compliance from the Architect
er Engineer responsible for the building.
6. Submit Planning Boar~ Approval! of completed site plan requirements.
B. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" laud iuses:
1. Accurate survey of p~operty i .
sh~w~ng all property lines, s~reets, buildings and
unusual natural or topograph~c features.
2. A properly completcd!appllcatl/oo, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separateowne~shzp' ' of the entire lot prior to April 9, 1957.
~f a Certificate of pccupancy ;'
Izs denied, the Building Inspector shall state the
reasons therefor in writing tq the applicant.
3. Date of any housing Code or safety inspection of b~ildlags or premises, or other
pertinent informntio~ requzre~ to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
~ land~ Certificate of Occupancy shall-be submitted,
1. M application for vacant
and a certified abstract of title issued by a title company showing single and
separate ownership elf ,the entire lbt prior to April 9, 1957 shall also accompany
the application. IfI a Certificate of Occupancy is denied, the Building Inspector
shall state the reasbns therefor in writing to the applicant.
D. FEES:
I. CERTIFICATE OF OCCtrPA~CY ~- New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to D~elliog $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of ~ccupancy ~U pre-existing dwelling - $100.00.
3. Copy of Cartlfi~ate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certifidate of OcCupancy - $50.00
~. Temporary Certificate of Occupancy ~$ !5.0,0 Residential
Commercial
er. 10/14/$8
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~)@~1. BUREAU OF ELECTRICITY
~ EB JOHN STREET. NEW YORK, NEW YORK 10038
Date
THiS CERTIFIES THAT
o~y t~e electrical equipment ~ ~scrib~ be~w a~ tnt~uc~ by t~ applicant ~d on the a~ application nBmber in the p~mhes of
in the fotlowing locatlon; ~ Basement ~ Ist Fl. ~ ~d FL 0~'~ S~tion Rl~k Lot
~sexamlnedon ,! [~ [~ ~ ~.~ ~[99~ a~ found to be in eompliance ~ith the Na~onal ElectHcal Code.
FIXTURES RANGES OVENS DISH WASHERS FANS
DRYERS MOTORS TIMR C).OCKS UNiT HRATRRS MULTI.OUILRT
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT S E R
~O. OF CC. COND.
C
A. W G. NO, OF HI,LEG A W. G NO OF NEUTRALS A W~ G.
OF CC. COND OF HI-LEG OF
OTHER APPARATUS:
This ce~ificate must not be altered in any manner; return to th~ office of ~e ~ard if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST~NOT,. ~ BE ALTERED~ N ANY MANNER
0
LOT 19
'S
5UA2ANTEED TO THE FIRS'TAMER~.G&N
TITL6 IN~4~E CO.OF N~W YORK
~oPE~...L '"A -r ... ~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ R~OUGH PLBG.
FOUNDATION ZND [ ] INSULATION
~]~RAMING [ ] FINAL
765-18~2
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ .] R~PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ] FINAL
DATE
INSPECTO~ ~
UNDATION ( 1 s t)
UNDATION (2nd)
UGH FRAME &
FLUMBING
SULATION FER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N,Y. 11971
TEL.: 765-1802
BOARD OF HEALTH ....~.
3 SETS OF PLANS '~-:.-
SURVEY ..........
C~EC~ .~ .....
SEPTIC FORM ............. :
NOTIFY .
CALL
MAIL TO:
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .................. , 19...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with $
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 bt 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 regulations, and to
admit autttorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
(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) ·
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No .... ~ ............
Plumber's License No.. . t2Wkco-m,~-4% .........
Electrician's License No ..... ~ ........
Other Trade's License No ......................
I. Location of land on which proposed work will be done'. ~.,<~O
House Number Street Hamlet
County Tax Map No. 1000 Section 7~ Block ~ Lot. ?.
Subdivision .... ./~..~'.'.~..~.....~.J.~'. ?/..~..'~.'. ......... Filed Map No..~..°O.Y..? ...... Lot../?. ...........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~ ~ 5l ~9 ~A/~/ /~ ~-
b. Intended use and occupancy (¢2)~/~//¢ ~-~
3. Natui'e of work (check which a ~plicable): New Building ..... ' ..... Addition . ~ Alteration
Repair .............. Reft oval .............. Demolition .............. Other Work ...............
(Descrigtion)
4 Estimated Cost ~'O. ooo Fee
'i " (to be paid 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 m~xd:d occupancy, specify nature and extent of each ~type of use .' ............. .. ......
7. Dimensions of existing structures, if any: Front ..... ~.g.~ .~. .... Rear . .~',g..t_..~. ? ....Del~th .~./.t.-7.O.." ......
Dimensions'of same structure v¢ith alterations or additions: Front ...~ (~.~..g'.! .... Rear *i...~.C?. ~ .~ t ...
~Depth . . . .% ~ ............. i" Height .... ~.. .....? .......... Number of Stories .... fi- .................
vimensions et entire new construction: Front ..... .~.g. 7.6/... Rear ... ~...~:-r¢/ ..... Depth ~ t. I-;o..ti ......
~, .4 Nun~ber of Stories
Height ...............
Size of lot: Front . /oo t ! ...... · Rear..; .... /..o:,.t. .... ] ....... Depth . .?.z.°.../ ..............
Zone or use district in which pr~mises are situated ....... .~...~'..~.~ .o. ~/d.-f/?. L. .............................
Does proposed construction violate any zoning law,. ordinance or regulation: ................................
Will lot be regraded ........ ~ ...... k~t ........... Will excess fill be removed from premises: Yes / No
Name of Architect .......... , ..... : ........... Address ................... Phone No ................
Name of Contractor ~£c~...~/2 ~55o~ A~la~ ~7~o/ ./5o°t'c m,at-~,n PhoneNo.-?/g:Ty.~.~.~./.?~.
15. Is th±s property located w±th±n 300 feet of a tidal wetland? es .~.. No .....
· If yes, Southold Town Truistees Permit maybe required.
PLOT D1AGRAM
Locate clearly and distinctly all! buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block ~umber or description according to deed, and show street names and indicate wheth~er
interior or corner lot.
I0.
11.
12.
13.
, 14.
STATE OF NEW YORK,
COUNTY OF .................
.S
(Name of individual signi~tg contract)
above named.
being duly sworn, deposes and says that he is the applicant
He is the ......................
(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 contaiged in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner ~et forth in the application filed therewith.
Sworn to before me this
Notary Public ........ 7~r. ~..~.~.d'~ ....... County
I. EFI & I)E VOE ..........
g0~.~ t~StlC, S~ ol ~w ¥~ (Signature of applicant)
. o, 4707878, .S~_lk C0untyj~ o
~a~/= SO '=/"
72//¢ A/~m~¢~ /o/- $-
0.17'
o.o¢ 3 ~ 70
/?
0.~,5
O. zlO
0.05
0.0~
~EATING EQUIPMENT TO MEET 7812.23 - 75%
.~): H~A~ING 'CONTROLS TO:MEET 781~.13 :
RANGE 45 TO 75 DB6RF~ FAHRENHEIT.,
HEATING PER,:~813.31 THRU .38. ,
ri I( L3";~,:"'' ',,L .... ' :,
raINZX:788 - ~YJBLE .GEASS..,.:,.., , =.., '
BELI~/ AND PROFESSIONAL:
IN COMPLIANCE WITH THE CODE;
) ,
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CEETIFICATE
OF OCCUPANCY
APPROVED AS NOTED
NOTIFY BUILDING DEPARTMENT AT
765-1~')2 9 A~4 TO 4 PM FOR THE
FOLLDWtNG INSPECTIONS:
FOUNDATION YWO
FOR ~UREO CONCRETE
4, FINAL CO~TRUCT~ON MUST
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANCY
SOLDER USED IN WAT£R
SUPPLY SYSTEM CANNOT
EXCEED ,2/10 of
If copper tubing ia uNd
for water distributln~l
system; piping shall be
of types K or L only
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