HomeMy WebLinkAbout16548-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certi[icate O[ Occupancy
No. Z-16582 Date January 14, 1988
THIS CERTIFIES that the building .R. efi. o.v.a.t.e..e.x,i.s.t.i.n.g..R.e.a. 1..E.s.~.a.~.e..O.f.f.i.c.e. ...........
Location of Property ...2.9.9.5.0. .M.a.i.n..R.o.a.d. ?..P.e.q.u.a. sfi..A.v.e... ..... C.u.t.c.h.o,g.u.e. ,..N.e?..Y.o.r.k. ......
House No. Street Hamlet
County Tax Map No. 1000 Section .. 1.0.2. ....... Block 03 .Lot 0 I
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Pem~it heretofore filed in this office dated
October 20, 1987 16548 Z
..................... pursuant to which Building Permit No ......................
dated ........ October. ..... 21, ..............I 987 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 .........
RENOVATION OF EXISTING REAL ESTATE OFFICE AS APPLIED FOR
The certificate is issued to NICHOLAS ALIANO
..................... ....................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. PENDING - November I I, 1987
PLUMBERS CERTIFICATION DATED: N/A -- j~
Rev. 1/81
FORM NO. 0
TOVtH OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD~ N. Y.
BUILDING PERMIT
CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NO_ 165~8 Z
Permission is hereby granted to: ~ i ~ /~/'1 ,
..... ~..~..~ ....... ~ ..............
..~...~...~ ............. ~ ..............................
...9~.~.~.......~.:~.:.....u..~...~.~~. ...... ~
..................
~ .... ' ~ ~..~..~.~~ ..~. ~.~....~
at premises located at ...'~...~...~. ...~..~ .................................
County To× Map No. 1000 Section ..... L.O.....-~.. ...... Block .....0..4,'~ ....... Lot No ......~"1 ............
pursuant to application dated .... C~..~..~ ....... ..-~....~.. ............ , 19..~...~..., and approved by the
Building Inspector,
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ~J ~J to the Building Inspec-
tor with the following; for new buildings 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 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 pZgperty 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: ^dditions $25.00 POOLS $25.00
1. Certificate ofpccupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
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
NewtOns truc t J on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ...9~.~. ~. .................
Owner or Owners of Property .... ./.~ ~ ¢./4'.c¢J. ~ .,(: ,, ,'((,"~..//. (. ~ ./'(;..O ................. '..
County Tax Map No. 1000Section /~ Block .~. J Lot ~ (/
bdwimon ........................... /. · z..Filed Map No ........... Lot No ..............
Permit No,/?,, ,~, ,(7z'f. Date of Permit...~.~.(~/?..~.ApplJcan,..~../.~.~'. ,~'?.J~,~..~'. ,~. ~ .~. ~ ~. ........
Health Dept Approval ' Labor Dept Approval
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and/per~ t meet~s a ~P"~licable codes and regulations.
Applicant ..........................
TOWN OF $OUTIIOLD
OFFICE OF BUILDING INSPECTOR
ILO. BOX 728
TOWN ItAI,L
SOUTIIOLI), N,Y. I 1971
A/~v~;t.~a,~ la~ 1987
TEL. 765-1802
M~¢~o~ ~2~lt~O
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reaaon.'].
/~ An application for Certificate of Occupancy
is not on file.
/~ No Underwriters Certificate on file.
/_-_~ The check is(outdated/n~h on .fil~.) $~(/
/~/ No Health Dept. Approval on fi. lc.
/-_'/ No final inspection has been made.
P](2ase contact ()ur offJ. ce on this matter.
Thank you for your cooperation.
Building Permit t~ ~_ ._~ _f_ ._~_ ~ Z
Building Dept.
***/~/ No Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
FOUNDATI~DN" (1st)
FOUNDATION (2nd}
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF SOUTLIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
A/~ v~4~,~ 1,1~
TEL. 765-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because ~of the following reasons.
_~'
/~An application for Certificate of Occupancy
is not on file.
/--v~ No Underwriters Certificnte on file.
/~ The check is(outdated/~.)~50.~
/~/ No Health Dept. Approval on file.
/-~/ No final inspection has been made.
Please contact our office on this
Thank you for your cooperation.
~uil~i~g r~r~it # 1_ .k 5 q ~L z
Building Dept.
***/~/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
matter.
!
Examined .O.¢~/'.~..~.l.., 19~..'7.
Approved .O..e~..0~...~.1.., 19'i~.~. Permit No..].~..~".q'..~..~.
'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
CHECK ..........
SEPTIC FORM .............
NOTIFY
CALL ................
MAIL TO:
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMTT
Date /O '- 02 0.) 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 stree
or areas, and giving a detailed description ofj~ll~ut of property must be drawn on the diagram which is part of this appl
cation. ~ t~ [ ~"~ .....
c. The work covered by th ~a~l~l~llti ~ rn~3f I/8,~b~commenced before zssuance of Buildmg Permzt.
d. Upon approvai_o~t~& ~[es*~ ,tk~ell~14~lS~t~ill issued a Building Permit to the applicant. Such penn
shall be kept on the p~tliis~it~ tllable~[~ ~[~lb~ttk. r~t{~ ~e work.
shall have been granted
APPLICATION IS H~ ~i~5 t~hlOCt~'~. Department for the issuance of a Building Permit pursuant
to
tt
Building Zone Ordinance~k~lg' [~'~,~n _~,~ _.~uffolk County, New York, and other applicable Laws, Ordinanc.e,s (
Regulations, for the constlla~:~ )nl~b~[~ Iliads, additions or alterations; or for removal or demo?zon,,as he,re.re, descn~,ej
The applicant agrees to co~l~
admit authorized inspectors lklJ ~remises and in building for necessary insp~e~i~.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
whether applicant is owner, lessee, agent, architect, engineer, general contra~t rls~e~}~aj~q~or builde
State
..............................................................
(as on the tax roll or~~ DEpA~yM~ r
7~5-1ffi2 9 A~ TO 4 ~ ~ THE
If applicant is a corporation, signature of duly authorized officer. F~L~NG
.............................................. ~
(Name and title of co,orate officer) - ~UG~ F~AMING~ ~ ~UMBI~G
ALh CO~TRACTOR~S NUST BE SUFFOLK COUNTY ~IC~NSED ;~.
Builder's License No .......................... 4. FINAt.
Plumber's License No ......................... ALt CONSI'~UCTIO*t
Electrician's License No ............ ........... ~W~.T~
Other Trade s License No ...................... , ~99~ ' ~- ' "' ' ";' ' ~ :~12f~" : '
1. Location ofland on which proposed work will be done: f~..~..~0.~.~..~.J..~..~.~('~.~
.... . .. .
' ' ...................................................... ' ' '¢ .................
House Number Street
County Tax MapNo. 1000 Section .~../~ ..... Block ..... ~ ............ Lot...( .............
Subdivision .... ~ ........................... Filed Map No ............... Lot i .............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Ex,sting use and occupancy ... ¢ .... (¢. .. ~.~.~.~ ...............................
b. Intended use and occupancy ~ ~ ~ f ~ ' ' '
Repair ...c-~. ......... Removal .............. Demolition .............. Otger ,S~ork ...... C.:!. '. .....
4.
Estimated Cost ..... .......................... Fee ............................... , .......
, rte be paid on filing this apphcatlo, n)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage, number of cars .... ~ ..................................................................
6. If business, commercial or mixed occupancy, specify nat.ure and extent of each type of use ./~.'eg.{.:~.r'.? .~..~..~ .J~.~'..
7. Dimensions of existing structu3es, if any: Front .... /.q. ( ........ Rear ... [~ .~ ....... Depth..~..O. ~ .........
Height ./. ............ Number of Stones ...~. ................... ' ....... .......... .... ~. ..............
, .... (
Dimensio~s~9/f same structure w~th alterations or additions: Front .../. ~' ........... Rear ..................
Depth . .J...~.'. ............. ;'... Height .../El .e ............... Number of Stories .... ./ .................
-- 8. Dimensions of entire new cons~rnction: Front .......... . ..... Rear ............... Depth ...............
,I-te~ht ........ N tuber of Stories ..........
Size of lOt:PurchaseFront .... (.~ O21 ' ... Rear .. Name '~' .0..)'..of., ............ Owner Depth ................
Date of .... . ,. ~ .?: ................. Form. er ............
'~Zone or use district m which p.reiaises are siluated... O. ¢. ( / .t4.. :~. ,~.-J.~ . .....
/ ,.P/ -
./
STATE OF NEW YORK,
....... :../.\,I.(.C.g.O.[.~.S..i.{.'7'..((.~.../d...Q ....... being duly sworn, deposes and says that he is the applicant
(Name of individual si~ning contract)
above named.
He is the .................... : .....................................................................
i (Contractor, agent, corporate officer, etc.)
of said owneL or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements cor~tained 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 ,
- · '- ..ch. 77 '
.................. -.: r...day!o/ ........... ' .... ' ......, 19...
Notary Public ....... i .... County
HELEN K. DE V0E plicant:
: . No, 470787,8, Suffolk County~
i ~efm F. xplres, M~rch
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