HomeMy WebLinkAbout15321-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z-15974 Date July 22, 1987
THIS CERTIFIES that the buildhlg One Family dwelling with attached garage · 'g ' Ob'o'd ' ~l~'c'l~ .................................
Location of Property 65 Greton Court & 1500 Grand Ave. Mattituck, N.Y.
County Tax Map No. 1000 Section .... 1.0.7. ..... Block .. 0..2 ........... Lot ....3... I. 2. .........
Subdivision .~/. 9..g.r.? .t .o.n..E..s.t.s.. ............ Filed Map No. 644 7 .Lot No. I
conforms substantially to the Application for Building Permit heretofore filed in this office dated
September 18, 1986 . pursuant to which Building Permit No. 1532 ! Z
dated.................September 24, ........... 1986 . wasissued, 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 ATTACHED GARAGE & WOOD DECK AS APPLIED FOR
The certificate is issued to JAMES LISANTE & JOSEPH LUKASZEWSKI
..................... ....................
of the aforesaid building.
Suffolk County Department of Health Approval 86- S O- 12 1
UNDERWRITERS CERTIFICATE NO... Iq 791720
PLUMBERS CERTIFICATION DATED: February 7, 1986
Building Inspector
Rev. 1/81
FO~ NO. 11
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)
N? ~5321 Z
Permission is hereby granted to: ~ ~ __
..... ~.,.L~.~.~~...~..~ ........
~,.~.~..~..~.J ..............................................
· ..~.~&~..~...H..,.....u..~.....~.- ~ .
,o ..~.~...~.....~.~_},~?~.~....~~_ ~ _~_ -,~. ~ ..........
o, premises Iocoted at ...~..~...~.....~...../..~......~.~......Ip~J~.~..~.~~
County Tax Map No. 1000 Section ..... ~,..~.~. .......... Block ..... ..C~.;;~. ........ Lot No.....~.,.!....~'... ......
....(Z~~...)...~. ............. , 19.~...~., and approved by the
pursuant to application dated
Building Inspector.
~ee ~...~..s.~.:.t'....o...
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
,~ ~, w~ ~,I 5OUTHOLD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted m~ 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-(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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of pZ~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 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:
1. Certificate of occupancy New Dwelling $25.Q0, 'Accessory ,,$t0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certiflcate of occupancy $ 5.'00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5. Updated C.O. $'50.00 Date ............./~./. ~/./.
NewCons%ruction...~.. Old or Pre-existing Building ............ Vacant Land .............
Location of Froper~ ............... ~ ...............
House No. Street Ham/et
Owner or Owners of Property ¢,S.. £L a .u.
County Tax Map No. 1000 Section .. ~. ~..~ ....... Block ...(~...~... ....... Lot.. ~ :../..~. ......
Subdivision..~'~.C~-~. ~'... ~.~' .~,~7~.~.,J'. ..... Filed map No...'~' .~..~.~.Lot No... ~. .........
Permit No.Z~.. ~ ,~/?Date of Permit .~.~. ~.~../~'Applicant.. ~..' .~..~/..4~..~...%z~..J~.o..,'?. ~.'...
Health Dept. Approval ~ ..... Labor Dept. Approval ........................
Underwriters Approval'~/"-/P}/I/'"'J'q/~].~./~./.~.2,,<U~.:¥f/..Z,~,~.,D...Planning Board Approval ...................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and perm. it meets all applicable cDd~s and regulations.
App cant " .. ~ .........
Rev. 10-I0-78
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
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. ~~
/~/- No Underwriters Certificate on file.
/~ The check is(outdated/~ot on file.)
/? No Health Dept. Approval on file.
/5/ No final inspection has'been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit It [ -~ 3 ~ .L- Z ~ J~
***/~ NO Plumber Solder Certificate on
file.
( all permits involving plumbing being
issued after April 1,1984 )
TOWN OF $0UTfIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 11971
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. ~~
/Z/- No Underwriters Certificate on file.
/_~ The check is(outdated/~ot on file.)
/-_~ No Health Dept. Approval on file.
/Z/ No final inspection has been made.
Please contact our office on this matter.
Thank you for~ your cooperation. ~6~
Building Permit tl _~ j 3 ~ ,I, Z ~
***/--__O~No Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
ES .,OHH STREET,
~.,~ ~ ~' ~ ~"~""~"~*~"~"~ ~/~ N 791720
THIS CERTIFIES THAT
only the electrical equipment ~ ~scrlbed below and int~duced by t~ applicant ~med on the above application number in the premises of
James Lisante and Joseph L~aszewski, Gr~ Avenue, GretonCo~t, ~ttituck, N.Y.
in the following location; ~ Basement ~ Ist Fl. ~ 2nd FI. Section Bilk Lot
Jm~uary 28, ~987
FIXTURE L I FIXTURES I RANGES ~C~KING DECKS [ OVEN~ [DISH WASHERS EXHAUST FAN~
DRYRRS I FURNACE MOTORS ~ FUTURE APPLIANCE FEEDERS PECIALRECPT TIMECLOCKS~/ .,~~lu"""~*"~ ~VI%~%~'* _ o,~.s~
3 F 1 30
SERVI~ DI~ONNECT ~ NO. OF ~ S E R ~ V I C
)THER APPARATUS:
2-G.F.CI.
2 Smok~ Deteotor
Judy P~sil lo
Pat Lane
l~attituck, N. Yl1952
Lie923OOE
GENERAL MANAGER
This certificate 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 B01LDING DEPARTMENT. THIS COPY OF CERT F CATE MUST NOT I~E ALTERED IN AHY ~AHNER.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 7fi5-1802
CERTIFICATION
Building Permit No./~3
Owner.~ ~, ~J_~_/?_(~_~47 ~-, ~ u (please print)
Plumber~D /~/~. ~--~. ____
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber ~ signatu~)
Sworn to before me this
"7 day of
9_4F7.
Notary Public, fff../~'ff~ County
Notary Public ~ J
No~,' Public',G?a~ o~ t,h~w Vt,,
NO. 52.9703725 Suffolk County
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND I' ] INSULATION
[ ] FRAMING
FINAL
REMARKS:
7GS-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION 2ND []INSULATION
FRAMING []FINAL
REMARKS: ~,~ ,
INSPECTOR
BUILDING DEPT.
INSPECTION
FOUNDATION IST []ROUGH PLBG.
FOUNDATION ZND []INSULATION
[]FINAL
[ ] FRAMING
REMARKS:,
DATE INSPECTOR
76S-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [] ROUGH PLBG.
FOUNDATION 2ND £ ]INSULATION
FRAMING [ ]FINAL
7GS.1802
BUILDING DEPT.
INSPECTION
FOUNDATION ~IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
]FRAMING [ ]FINAL
DATI='
INSPECTOR ~ ~(~
FIELD INSI~CTION
FOUNDATION
FOUNDATION (2nd)
COMMENTS
INSULATION FERN.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
~I0 I F
( dwelling
O. ANRIG
13° 42' IO"E.
EASEMENT TO TOWN
191. 00'
OF SOUTHOLD
50'
.~r~ _,
LOT 3
LOT I ( dwelling )
(vacant)
6~
CERTIFIED TO :
JAMES LISANTE
JOSEPH LUKASZEWSKI
Prepared in accordance with the minimum
~tandards for title surveys as estabtished by
the LI, A. LS. and approved and adopted
for such use by The New York State Land
Title Association.
>'gCON~ C SURVE¥ORS
P. O. BOX '909
MAIN ROAD
SOUTHOLD, N,Y. 1971
JOSEPH
AT
SURVEY FOR
JAMES LISANTE
LUKASZEWSKI
MATTI TUCK
TOWN OF' SOUTHOLD
SUF'F'OLK COUNTY , N.Y.
000 107 02 03. ~2
SC ALE I" = 50'
JUNE 9 , 198 6
OCT.
17, 1986
46.~
LIC. NO. 49668
ENGINEERS , P. C.
ELEVATIONS ARE
ASSUMED DATUM
LOT NUMBERS REFER
1-O"MAP OF GRETON ESTATE~"
FILED IN THE SUFFOLK
COUNTY CL ERK~S OFFICE
SEPT. 20~ 1976 AS MAP
NO. 6 447
REFERENCED TO
~llO I F
13° 42'10"E.
vacant)
The water supply & sewage disposal sy~-
tem~ tor this residence will conform to the
standards of the Suffolk County Deparl-
menl of Hea~th Service~.
{, dwelli, ng)
O. AN RI G
191. 00' /m~o~
EASEMENT TO TOWN OF SOUTHOLD ~'
50' o
LOT 3
LOT ,I ~ (dwelling)
CERTIFIED TO : ~
JAMES LISAN TE .,_0o z,'~"~ ~
JOSEP~ LU~ASZEWS~ ~' ~0 ~'~' ~u' .o~- . .......... -...~
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Hx ~ k ~[,,, ~ ~ ~-:~,
FO~APP~VAL OF CONSTRUCTION ONLY ~'1~ t~''1:'r,.'''
(~~ dAMES LISANTE sc ::~':' o:
60SEPH LUKASZEW~KI
SINGLE FAMILY DWELLING O~6Y,,.~. ~,. ~ ~
~PI~E8 TWO YEA~8 F~O~ DATE O~~Z '~ ~
Prepared in accordance with the mimmum TOW N -- OF' SOU TH 0 L D
standards for title surveys as established by
the LI.A. LS. and approved and adopted
for such use by The New York State Land
Title Assoeietien ·
16) ~
P. O. BOX 909
MAIN ROAD
l ~.Y.S. L~C.
~0 RS
5020
SOUTHOLD , N.Y.
SUFFOLK COUNTY , N. Y.
I000 - 107 02' - 05.12
SC ALE I" = 50'
JUNE 9 , 198 6
NO. 49668
ENGINEERS , P. C.
LOT NUMBERS REFER
TO"MAP OF GRETON ESTATE~"
FILED IN THE SUFFOLK
COUNTY CLERK'S OFFICE
SEPT. 20, 1976 AS MAP
NO. 6447
ELEVATIONS ARE REFERENCED
ASSUMED DATUM
TO
. 86 - 320
I0'I 'F
DWELLING ONLY
NO.
O0
WATER
DEPARTMENT AND
O~
LOT I ~_
n S,T,
LOT
dwelling )
vacant)
0
CERTIFIED TO :
JAMES LISANTE
JOSEPH LUKASZEWSKI
46' 18
Prepared in accordance wi;'h
s~andards {or titio sui'voy~ ct~ c:k:?ii:i.-:c} by
the LI.A.L$. and c~pproved
for such use by lhe New York Sta~e Land
Title. Association.
MAIN ROAD ~
SOUTHOLD, N.~. ~I971
):~,Y.S. LIC. NO. 49168
'~/2~)S ~ ENGINEERS P.
SURVEY FOR
JAMES LISANTE
JOSEPH LUKASZEWSKI
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY , N. Y.
I000 IOZ - 02 05.12
SC ALE I" = 50'
JUNE 9 , 198 6
OCT. 17, 1986
DEC. 29, 1986
LOT NUMBERS REFER
TO"MAP OF GRETON ESTATE~"
FILED IN THE SUFFOLK
OFFICE
MAP
COUNTY CLERK'S
SEPT. 20, 1976 AS
C. NO. 6 447
ELEVATIONS ARE REFERENCED
ASSUMED DATUM
TO
8 6 - 320 C
Examined .~.~...~.~...1~....~., 19~.~
~;~ FORM NO. 1
"' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-1803
Appr~>ve~. lleo,~..~...~..0t'., 19~..~. Permit No. 1 .~.~.;-~-..~.}...~
Disapproved a/c .....................................
............................... .......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
a. This application must be completely filled in by Wpewriter 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 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 necessary insl~ctio.~s. / r- ,-
....,, ,,- .....
(Signature-' --of applfcant, or name, if a corporation)
..... ...... ....
(Mailing address of appiicarit)
State whether '".Pl- , a' ': ,)wner, lassee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Name of owner of premises .~.~--'.~../.~.C ~.. ~.15 ~. S~... :-t. :. ~?~<~.'..4~ .~ ~ ~ .C~.~ ~. ~ ....... (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly~uthorized officer.
..............
(Name a6¢title of co,orate officer) ·
~nildefs Lic~s~ No ........ /~ .~ .............
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ...................... ~ct4,q ~
1. Location of land on which proposed work wil! be done .... .~..C~ .77°..~....,~: ?.:..'. '....~ ......................
House Number Street Hamlet
County Tax Map No. 1000 Section ... ~ .O. ~ ......... Block O ~ · Lot. O-'~' / P~-
Subdivision ....... fZ(. ~..~. 7~°. .A/.. ~ .3. '7"/] ~'C~3 . . . Filed Map No..~. ~.'~. ~. ..... Lot../. ...........
(Name)
2. State existing nse and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... .~..~..(i' .~../.c.J .~.~.. ...............................................
/ .e/. ./2. '
b. Intended use and occupancy .. .~..,~..,,~.../. /.t/?. ~.~./. //~.c¢~ (~ ./.~ ....
~'"'/idditi ' ' '~'
3. Nature of work (check which applicable): New Building.......... on.......... Alteration . .... ..~..
Repair Removal Demolition ' Other Work
~ (Description) --.
· ~'"'~>~"9/0 o c~ '
4. Estimated Cost ........... ~ o q Fee ......................
5. If dwelling, number o f dwelling units ............... Number of dwelhng u~lts on each floor ................
If garage number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear ..... i ........ Depth ...............
Height Number of Stories
Dimensions'of same structure with alterations or additions: Front .......... i ...... Rear ..................
Depth ...................... Height ......... ~ · .~. ~ ........Number Of ~.ories .............. ~. .......
"-8. Dimensions of entire new construction: Front f,.o .t:~'... Rear ..
' :a- '7_. / r'"
Height .... ~.. ....... Number of Stones ............... ' .....
9. size of lot: F ont S.o. 7' "' Rear :rr7... . "i' ' i'"..
10. Date of Purchase ......... f~.'. ............... Na~e of Former Owner
.
1 1. Zone or use district in which premises are situated ~. .......... i .......................
12. Does proposed construction violate any zoning law, ordinance or regulation.
.~ ~ ~ ......, ................
13. Will lot be regraded ........ f'. ...... ~, ....... Will e~xce.ss fill be removed from premises: "'~;~'' '(~)
14. Name of Owner of premises ~[f.,~/~'fl.l~T~. .......'~'#/C.~t~d~t~/~'........... .. ...... . Phone No. ...............
Name of Architect ................... , ........ Address .............. ..... Phone No ................
NameofContractor ./~...,~.<'/.Z-..47/. ....... P.h.?n~ .?.~.?.
15. Is this property located within/300 feet of a tidal wetla~;'*¥~'; i. .
· If yes, Southold Town Trustees Permit maybe required. : PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, ~ndicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF .............. ... S.S
........... ~.?...~..../'PT. ~..~.... ~.t....~..~..J..Z...~,j~being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract) /
above named.
He is the ................................................................................
(Contractor, agent, corporate officer, et6.)
of said owner or owners, and is duly authorized to perform or have performed theisaid work and to make and file this
application; that all statements contained in this application are true to the best of Ills 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
............. f.~.., dayof ..~. ........... ,19.~.~
~~~7 , pplicant)
OC.c~IPANCY OR'
'USE IS UNLAWFUL
'WITHOUT CERTIFICATE
~ OF OCCUPANCY
,: t~ ~'~',~? ~ . ' ~PRovED AS ~T~
. ,, ,- ,'_. , , ~ 765.1802 9 AM, TO 4L PM .'=OR THE
F~ POURED CON~ETE
2 ROUGH FRA~INEi · PLUMBING
~y, ,~,~:~C' ,,~ :.. , ] 3. INSULATION
4. RNAL. CONSTRUCT~N MUS~ ~
~ ' r~ ' ', .' ' ~ BE COMPLETE FOR C.O.
~LL
ME~
'- A~ CONSTRUCTION
~HE REQUIREMENTS O~ THE NY
~ '"' ~-" I ~A~ CONS~U~TION & EN~GY.
~D~, NOT ~NS~LE ~R
~ ~IGN OR CG~S~ON ER~RS,
tnltM~n CERTIFICA T/ON
gj~TiRCAI.,EA~ ~_ ENT sEFORE
SOLDER USED IN WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 e~ tg~ LEAD.