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HomeMy WebLinkAbout15928-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Offme of the Building Inspector Town Hall $outhold, N Y. Certificate Of Occupancy No ZI6740 Date March 29, 1988 THISCERTIFIEI; that the braiding ...O.n..e .f.a.m..~.ly .d..w~ell. zng. Location of Property . 300 MA.P.L.E L.A.N.E .............. G.R. EE.N.Pp.R.T ...... House No. Street Hamlet County Tax Map No (000 Section . 35 Block . 5 ...... Lot .5: .4 ......... Subdlmmon ............... FHed Map No. . Lot No .......... conforms substantially to the Application for Budding Permit heretofore filed in this office dated .. A. pril ]5.,.,19.87 pursuant to wtuch Bmldlng Permit No. 1.5928. Z. ......... dated A p r.i 1 15.,, ..198..7 .... was issued, and conforms to aH of the requirements of the applicable provisions of the law. The occupancy for wluch tlns certificate is issued is .... One .fa.mz. ly..d~e.l.l.ln.g,, d.e. ck, attached garage, front porch. The certfficate is issued to JOHN AND ANNA GIANNARI S (owner, t~c.Eo~ ~zyd~}tl~ }~ Xx ....... of the aforesaid braiding. Suffolk County Department of Health Approval 86~S07.23' ! . De.c. 22.:..1.98.7.. ..... UNDERWRITERS CERTiFiCATE NO ........... .N.843.898....N o.v....I 8. ,...19.8.7. ..... PLUMBERS CERTIFiICATION DATED: Bertsand Plumbing & Heating 3/22/88 Building Inspector Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. (THIS PER COMPL.ET NE 15928 BUILDING PERMIT MIT MUST BE KEPT ON THE PREMISES UNTIL FULL ON OF THE WORK AUTHORIZED) Z D~e ....... ~.~ .................. ~.~. Permission is hereby granted to: ,~ ..~.....~.~....~:..~.....!.!.~.A~ ~.-~' ~-- ~ ' ~ ' .~.~A .~... ' ,o ........................................... -~A ...... ~ ................ ¥~. o, ~,m,,, ,=,~ o, ....~..........~.~.~.....~......~~ pu~uont to application dated ........~,~ ...... ..~ ................... , 19.~...~.., and approved by the Budding Inspector· Building Ins~ctor Rev. 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Th~s apphcat~on must 6e idled m typewriter OR ink, and submitted m ~=,,~mmm to the Budding Inspec- tor w~th the following; !or new buddings or new use: 1 Final survey of property w~th accurate [ocatlon of all buildings, property lines, streets, and unusual natural or topographic features 2. F~nal approval of Health Dept. of water supply and sewerage dlsposal-(S-9 form or equal). 3. Approval of electmcal ~nstallat,on from Board of Fire Underwmters 4 Commercial buddings, industrial buddings, Multiple Residences and slmdar buildings and installa- t~ons, a cert~hcate of Code comphance from the Architect or Engineer responmble for the budding 5 Submit Planning Board approval of completed rote plan requirements where apphcable. B For ex~stmg buddings (prior to Aprd 1957), Non-conforming uses, or buddings and 'pre-existing" land uses 1 Accurate survey of property showing all property hnes, streets, buddings and unusual natural o~ topographic features, 2Sworn statement of owner or prewous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buddings or premises, or other perhnent mforma- tlOn requ{red to prepare a cert~hcate. C Fees Addzt~ons $25.00 POOLS $25.00 1. Cert~f~cate of occupancy New Dwellzng $25.00, Accessory ,$10 00 Business $50 00 2. Cert~hcate of occupancy on pre-existing dwelling $ 50 00 3 Copy of cert~flcate of occupancy $ 5 00, over 5 years $ ]0.00 4.Vacant Land C,.O. $ 20.00 5.Updated C.C. I $ 50 00 Date ...................... NewConstcuct~on ..... Old orPre-ex~stmgBuddmg . Vacant Land ........... House No, Street Ham/et County Tax Map No 1000'Section ...... Block ......... Lot Subd~ws~on ........ Fded Map No ....... Lot No ... Permit No /..5-.~ ~ D'ate of Perm,t .J//??. Apphcant ........................... Health Dept Approval ........... Labor Dept. Approval ................ Underwriters Approval ........... Planmng Board Approval ................. Request for Temporary Cert~hcate Fee Subrmtted $ ..... , ,Final Certificate Construction on above d scribed budding and permit meets all applicable codes and regulations Apphcant ...................... 6 & S ~lectr~c Box 215 $ourhold, N,Y. 11971 Ltc, This cerh{~cote m~st not be altered m any manner, return to the off,ce of the Board If incorrect Inspectors may be ~denhf~ed by the,r credentials COPY FOR BUILDING DEPARTMEIqT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MA. hillER. TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit N©. /5~ owner ~~ ' (pleas~ print) Plumber (please print) I certify t~at the solder used in the water supply system contains less than 2/10 of 1% lead. (piumber' s signature) Sworn to before me this .~o~.~,a/ day of 19 o~P Notary Public, I ._T~r,~-,~ County Comm~s;~on ~ ~ ~1; t~ Notary Public OU~DATtON (1st) OU~DATION (2nd) OUGH FRAME & ?LU~BING :;SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIO~AL COMME~;TS: 765-1802 BUILDING DEPT, INSPECTION ~FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING ROUGH PLBG. INSULATION [ ] FINAL DATE 765-J.802 BUILDING DEPT. INSPECTION ] F~JNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE /~//**~/~/~ ,NSPECTO~~~_~ ~..**~i~ 765-1802 / "~BUILDING DEPT. INSPECTION FOUNDATION 1ST [~/ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~/]/FRAMING [ ] FINAL / ~'~ 765-1802 ~ ~d~UILDING DEPT. ~ INSPECTION [ F/~OOUNDATION 1ST [ '~//ROUG~7-'~'''' PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL DATE: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND ~NSULATION [ ] FRAMING REMARKS: FINAL DATE INSPECTOR 1) H~TING EQUIPME~ ~ MEET 7813.23 - 75% EPF. ~ THE BEST OP MY ~EDGE, ~GE 45 ~ 75 DEG~ES PAHRE~EIT. U~ T~ESE PLUS A~E 3) WATER H~TING PER 7813.31 THRU .38. IN COMPLIAZCE WITH THE CODE. 4) PIPE INSULATION 7813.19 5) WI~S - ~LE GLASS. Examined .~%-'%'~. -~ . Approved~ ~ Dmapproved a/c .. BOARD OF HEALTH ..t~._~'.~.. 3 sE rs ob P>>Ns FORMNO. 1 SURVEY .. ,~.~ TOWN OF SOU/HOLD CHECK ~~'~ BUILDING DEPARTMENT SEPTIC FORM .. ~.,.~. ....... TOWN HALL SOUTHOLD, NY 11971 HO~ ~.~. TEL.: 765-1802 CAL~ ............ , Ig~l Date ~?~7'- /.5'~ ,19' (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tlus application must be completely filled m by typewriter or in ink and submltted to the Bmldmg Inspector, sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showmg location of lot and of bmldmgs on premises, relationship to adjomlng premises or pubhc sir or areas, and giving a detailed description of layout of property must be drawn on the dmgmm which cation. c The work covered by tins apphcatlon may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Budding Inspector will issued a Budding Permit to the apphcant Such pe shall be kept on the premises available for mspechon throughout the work. e. No budding shall be occupied or used In whole or m part for any purpose whatever until a Certificate of Occup shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmanc, Regulations, for the construction of buddings, additions or alterations, or for removal or demohtlon, as here~n descn The applicant agrees to comply with all apphcable laws, ordinances, budding cpde, housing code, and regulatlons, an, admit authorized inspectors on'premises and m budding for necessary ~p~tmfi~ T7 (L~4gnarnre oi appl'lcant, or name, if a corporation) (Malhng address of apphcant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bull (as on the tax roll or latest deed) If apphca..q~s a c/rpor?~tlon, signature of duly authorized officer ~ALL' CONTRACTOR'S MOST BE SUFFOLK COUNTY LICENSED Builder's License No~. .. Plumber's License No ..~. ~t/ .7'-( ~- Electrician's License No , Ot ~er Trades License No, 0 C4; ~ ~- Fa-__ - I Locatmn of land on which iproposed work wdl be done /~'///~/'~ ~- ~ ('-/~ [louse Number County Tax Map No 1000 Section 3,oZ-. . . Block ~'-- Lot Subdtvm~on Fded Map No Lot (Name) 2 State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction a Existing use and b Intendeduseandoccup~ncy-'- 4 5. Nature of work (check which applicable) New Bmldlng Repmr ...... R~moval ....... EstlmatedCost 7~ / ?.O.t 0 O0 ..... Addition ...... Alteration . .. Demolition ...... 4~' {[ ~r Work ........ , ,~][[N~ (Descnphon) ... . .. ...Fee .... . .. . .. ........... . ' (to be paid on filing this application) Number of dwelling units on each floor .......... If dwelling, number of dwelling umt~ ..... If garage, number of cars ...... ~ ...... If business, commercial or mixed occupancy, specify nature and extent of each tk'pe of use ........... Dimensions of existing structures, if any Front... '~'.t5 ajjg/~. Rear .. C~ .~ .. . Depth.. ~,-.a//t/,/6A'~, Height ....... Number of Stones &-vo~_. : t.. ' ....................... · r. . Dunenmons of same structur? with alterations or additions Front ..... Rear ........... Depth ..... .... Height ...... Number of Stones ... "8 Dimensions of entire new cohstruchon Front ..... Rear ...... Depth .......... Height Number of Stones 9. Size of lot Front ................ Rear ................... Depth ................ 10. Date of Purchase ..... Name of Former Owner ..... 1 1. Zone or use district in which premises are situated ..................................... 12. Does proposed construction violate any zoning law, ordinance or regulation .................... 13. Will lot be regraded . ' ~ .;4'' ' ' . .... Willexcess fill be removed from premises Yes (-N 14 Name of Owner of premises" . .... Address .......... Phone No .'J ?2'r KI ! ~ Name of Architect ........................ Address ....... Phone No ....... Name of Contractor ............. Address .... Phone No .... 15. Is this property located within 300 feet of a txdal wetland? *Yes ..... No ..... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all bufldmgs, whether existing or proposed, and indicate all set-back dtmenslons fror property hnes Give street and bl6ck number or descnptxon according to deed, and show street names and mchcate whethe interior or corner lot. STATE OF NEW YORK, S S COUNTY OF ..... (Name of individual signing contract) above named. .... being duly sworn, deposes and says that he is the apphcan 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 apphcatmn, that all statements contained m this application are true to the best of his knowledge and belief, and that th work will be performed in the manner set forth m the application filed therewith Sworn to before me thru [~2 .... da_y!f . . ,19 Notary Public, .~-~-:~'A~....,~.. County ~. 470T~, .S~{~}? ~ (Signature of apphcan/ ,F-~ O A~r~ ,/ Ad"II'R'O VA L ~ERVlCES. SUFFOLK COUNTY OEPT. OF HEALTH SERVICES -- FOR APPRovAL OF CONSTRUCTION ONLy [ [ .. ~..~. m.:~l ' SUFFOLK CO. TAX MAP DESIGNATION: D/Sr. ~. ~I.oCK POI.. G~S C~ a/ f ~ BLDG, DEPT~ T, OV~ OF $OUTHO~ ~ UR V~ V~FZ:~ Si:At'fOLK ¢0. H~A~.TH [~lr]'. ! .H,S. ~ ..... C~ TO T~ ~A~A~ ~ THE ~K CO. ~. OF ~ALTH ~ ~i ANT SUFFOLK COUNTY OEPT, OF HEALTH ~VlCES -- FO~ A~PROVAL OF, ~.s.~.~.: .... ~ ~K CO. TAX MAP ~, ~. r~Z ~. '~ ~r ~ - ~~ '".'~ . . . ~ , J ~ '~wr~ J ~ ' ~.J L ~- i~ ~AD FAMILY DWELLIN~ O~ILY disposal and ~v~ter su~ly tacili~i~s ~ ~ been inspects-. ~Y ~s Oeoa~ment a~/~ and CO. HE,e,~Tt~ ~ ~"II;ROV~ TH~ WAT~R'~Y AI~D g~"WAG~ S"Y~'t'~M~ FOR THI~ RE~I~CE WILL C~F~M TO T~ $TA~R~ OF THE ~WF~K CO. OE~, OF HEALTH ~ev~CES. , i ~ ' ' ; ! Phone 47%0400 GREENPORT. N,Y. 119o,4 Road :Il I K !L © O-F-~L, 9~ 0 , C r FQL~ >-,l : '~S e < Phmle 477-0400 ~ ~ain Road ' ~'¢ ~ G REENPORT, N;Y, 11,944 T :~: ON T , ],SCALE ;p C~ 50- C~£~ ,~." ,o F r 3Z: H~ o3, Main Road GREENPORT. N Y. 11944 J Jil Phone 477-0400 ~ Main Road ~V~ F 5/- '9* '1 '1