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HomeMy WebLinkAbout15851-zFORM NO. 4 TOWN OF 80UTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19566 Date DECEMBER 6, 1990 THIS CERTIFIES that the buildin~ Location of Propert~ 9025 House No. County Tax Map No. 1000 Section 59 Subdivision ADDITION SOUNDVIEW AVE. 8OUTHOLD Street Hamlet Block 06 Lot 24 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31~ 1987 pursuant to which Building Permit No. I5851Z dated APRIL 3~ 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 ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ARVA M. D'ANTONIO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N842912 NOVEMBER 12~ 1987 7/17/89 MINE JACOBI /B ilding Inspector Rev. 1/81 FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15851 Z Permission is hereby granted to: ............. ~......~=~...l ........... ~ .............. ...... ~~..~,~_ ~ ~,~,~ .......... ~ ............ ~.]..I .......... ~.~"~ at prem,ses located at ..~. '...O....~...~.....~.~..~..: ........ ~ .......................................... County Tax Map No. 1000 Section ...... .C~.....~..~ ..... Block ...... ..C~...(~.. ....... Lot No....~.~ ............. pursuant to application dated .... ~;:~.....~.........~...! .............. , 19.~...~..., end approved by the Building Inspector. Fee $ .... t ............. Rev. 6/30/80 Form No. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~:ew Construction ........... Old Or Pre-existing Building ..... ~ .......... Location of Property .... ~%~ ~o~ ~v~ .~22~ ~ ll~q~ House No. Street Hamlet Onwer Owners of Property ~ ~ County Tax Map No 10OO, Suction ...... .~..%....Block..........~ .... . . Lot .... ~! .............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ....... %.Applicant...~ ........ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ate ........ ....................... For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Request for: Temporary Certificate ........... Final Certicate ........ Fee Submitted: This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3, Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or eugineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements.' THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY T~IS ~E~TIFIES THAT the electrlcal equioment ~ ~scrlbed belo~ a~ i~t~duc~d by the ~pplican~ ~m~ ~p the above application nu ~ber ~ the prem~ of ia theyollowlng locationl ~] Basement [~' ~t r~. [~ 2.d r~. garage seo,io, m~h Lot t~s examined on ~oYetl~er 2 ~ 198 ~ attd flound to be in compliance tcith the requirements qf this Board, FIXTURE FIXTURES RANGES ~OOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUOReSCENt 17 13 11 17 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS SYSIRMS NO. OF FEET DISCONNECT OTHER APPARATUS: 1-G.F.C. L SMOKE DETECTORS-1 S E R ' V I C E Pater Bogovie N. Bayv~w Rd, Southold, N~Y. 11971 lia.#137-~ GENERAL MANAGER This cerfificate~must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR~BU~LD!NG DEPARTMENT. THI~ COPY OF CER~IFI ~ED. IN ANY IvlANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. 15851-Z (p%ease printI Plumber ~,~ ~C~l · ~ffl%ase print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumb~-~ signature) Sworn to before me this [~ day of Notary Public, County Notary Public HERIN K, DE VOE NOTARY PLIBLIC, Stale of New Yodx ~ Plo. 470787~, Suffolk County ~erm Expires Uerch 30,19 .... OUNDATION (2nd) OUGH FRAME &/ // PLUMBIB-W' "4SULATION PER N. Y. STATE ENERGY CODE FINAL '765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST r ] ROUGH PLBG. { J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~NAL~ DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING ~- [~FINAL REMARKS: 765-1802 BUILDING DEPT. INSPEC~N FOUNDATION 1ST [j/] ROUGH PLBG. !,rr 765-1802 BUILDING DEI~. INSPECTION FOUNDATION ~.ST [ ] ROUGH PLBG. FOUNDATION 2ND [~NSULATION [ ] FRAMING REMARKS: FINAL DATE INSPECTOR 765-~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. [ ]/F~UNDATION 2ND []INSULATION FRAMING []FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL 765-1802 BUILDING DEPT. / INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS. /~'-~ ,.~*,~*,~,/~~. Examined....O~.. ~ .... ,19 .~.7 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-180:3 .~.~..~ .... 19~.9. Permit No....~fl..~?.1..'~. Approved Disapproved a/c ..................................... ................................ ........ (Building Inspector) APPLICATION FOR BUILDII~IG PERMIT INSTRUCTIONS Received ........... ,19... 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 pcrmit shall be kept on the premises available for inspection throughout the work. e. No building shail 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 regulations, and to - admit authorized inspectors, on premises and in building for necessa~...~ i~.. i .~. ~.i~s'~ . ........................ ~ ¢~ (Signature of applicant, or name, if a corporation) ..... .... I (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, gdneral contractor, e~ectric~an, pl ber or builder. Name of owner of premises ...... .~.~.~..~ .... ~.~t..~...~..~o~..q ~.~.o. ....................... (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 ...................... Location of land on which pro. posed work will be done..~.~.[..~..~4<..~.../~...~....~..~...~., ~..~..{gMY..~?.~'-?.~-t[, ....................... .................... House Number Street Hamlet - County Tax Map No. 1000 Section ..... .~..~ ......... Block ...... .[P ........... Lot...4..dr. ............ 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 C~ .a~h..~.0va~ '..~41 ~~ ~..~..'.~ b. Intended use and occupancy ~2~ ............ ~ .... ,..,::... ~. .... 3.Nature of work (check which applicable): New Building ..... ' ..... Addition . v/ Alteration Repair .............. Rempval .............. Demolition .............. Other Work ............... ' (Description) 01x o i, 4. Estimated Cost ...................................... Fee ...................................... : *" (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 busine~s~ co~m~ercial or mixed occupancy, specify nature and extent of eac t e of use .. · . :~·%~,.~,,:' ,, . , ~ , Y~ .......... ~ ........ 7. Dunen~o~;qf ~i~Bng~structur~, if any: Front ...~.o. ........ Rear . . ~ .o . De,~th....~.~ Heighf. i!.!!~'J.~r':'¢~2 ~i.. i Number of Stories · .\. 'i ...... .. ' ........ D/meStiZOs of_.~same structure .~th.:alterations or additions- Front ~ o o ' r ~ 0 o ..... , ......... ~. .................. Rea .................. Dep~!~ ~.uf'.n~/~. {~p~i:;Height ....... [.ur*. ............ Number of Stories ..... .~ ................ 8. Dimeii~i~ns o{s entire new cons~thl~l>ion: Front . :~,,.' ..... Rear .~ ~. De,~th ~o ~. Helgltt'~..[.~ .~./{ ~:,~ .~ .~ .~. Nu~m~ber of Stones .~ ................................................ 9. Size oflot:e~Fi~ont '~.e.~.:?.,.~4~¢~4~.. &.~.~.,~.,{. Rear ...................... Depth ...................... 10. Date of Purchase ..... 3.~.~.*. '~ ......... .' ........ Name of Former Owner ~'..~: ~.%~.. ~...?.h~.~. .......... 11. Zone Or use district in which prbmises are situated..~.~ .~.x.~.~.,.~.~.k-. )-.q .~...~q ~,.% ~..~ ...................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ....~,..~ .......................... 13. Will lot be regraded ....... .~ ............... .... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . [5~-.~ .~..~..~.' .~.~ ~. ~..~o Address ...~.°.~. ~ .~ o ~ ~a.~. *~.~Phone No...'~.,~.-.~. p.o.~ .... Name of Architect ...$.%~.s.~. ,~.~.~.~., .%. ......... Address ...~.%~.~.~,i+jx~.~ '~1'... Phone No...~.~ .' .%~. p ?.... Name of Contractor . .,~.: .~.,. t~.t.a,[.~.~ ........... Address . .q:~..[.li~.~.. ~.~,s,. Phone No...~ [ .~.'; t. o. ~.e[... ----' PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-hack dimensions from property ilnes. Give street and blockmumber or description according to deed, and show street names and indicate whether interior or corner lot. ...................... being duly sworn, deposes and says that he is the applicant (Name of individual sign"ing contract) above named· 44e 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 conthined in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~/~tg day of . .~..~. 19 ~..~ N ora .fy Public ........ _. ........... County N UNDAt'J. COOl=ER . ' ............ : .............. or,fy Publlo, State of New York, o/./' (Signature of applicant) 're No=.~.22565, Suffolk CountyA(~ rm I~Xp~re$ December 31, 19,~,~,._ ¥ 0 MAP OF LAND ~OuTHOL~ -'~cc~l~ : 40% ¥ 0 TOWN OF SOUTPOLD ~ MAP OF' LANO S,LJ f'~.V D..,"v' E D Ai2.v'A M. D' ANTONIO 50UTHOLD ,~OTIF¥ E4JILDi~IG OEPARTM~T AT ~F5 1802 ~ A~ FO ~ PM FOR THE FoL~ OWING ~N~P~CTION~: FOuNDA~R)N ¥~O ~6QUIRED ROUG~ F~AMIN~ ~ PLUMBING ~ATE CONSTRU(:~(~ & ~NER~ COD~ NOT ~6~LE ~ ~ OR CGNS~t~TION ~RS, / I,O' ., FLO0 . N J PLUMBER CERTIFICATION d~,~,, ~'~' ON I EAD CONTENT BEFORE ~!'"'"' ~-'~ ~"'~ CERTIFICATE OF OCCUPANCY ~---~OLDER USED, IN WATER SUPPLY sYSTEM CANNOT EXCEED 2/10 of 1% LEAD. If m~ tuNng. I= ~,,, fo/' water d/~tr~butmng . lystim; piping shall be ef types K or L enly rI ,. FLOOl% ~L ~ NI S-~_ CTt ©kJ 5 ,, Phone 47%0400 Main -GREENPORT~ N.Y. 1t944