The URL can be used to link to this page

Home My WebLink About15493-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Budding Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... Z ~ 5.8.5. 5. .... THIS CERTIFIES that the buddlng Location of Property . 3.15.. . House No County Tax Map No. I000 Sechon Subdivision .... X ..... Date ..~.17.'..19~.7 ..... alter & cgpx~r~.~a[gg~.9~n~ to ~ellin ...... ~%o~[.Rqa~ ......... ~t~t~ck Street Ham/et [07 .Block . 8 .... Lot .. .20 ...... ·. Filed Map No .... X . .Lot No. X conforms substantially to the Apphcahon for Building Permit heretofore filed in this office dated · .NQy. e. rglg~ir .3,0~ 1986 pursuant to which Building Permit No .... 1.5.4.9..3.Z ......... November 14, 1986 dated ............ was Issued, and conforms to all of the reqmrements of the applicable provisions of the law Tlie occupancy for which this certificate ~s issued is . . Alter & convert garage attached to existing building. Tile certificate is ~ssued to ...... of the aforesaid building Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO CHARLES CISERO ' .... N/A N806662 PLUMBERS CERTIFICATION DATED: 5/23/87 Rev 1/81 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) Ne 15493 Z Budding Inspector. Building Inspector Rev ~/3D/gO APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N.Y. 11971 Instructions Thru apphcat~on must be filled in typewriter OR ink, and submitted in dupDcate to the Building Inspec* tot with the following; for new buildings or new use 1. Final survey of propertv w~th accurate location of all buddings, 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. Commercml buildings, Industrmi buddings, 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 apphcable. Bo For ex~sting buildings (prior to April 1957). Non-conforming uses, or buildings and "pre-ex~st~ng" land uses: 1. Accurate survey of p~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 buddings. 3. Date of any housing code or safety ~nspect~on of buildings or premises, or other pertinent mforma- t~on required to prepare a cemflcate. Fees 1 Certificate of occupancy 85.00 2. Cemflcate of occupancy on pre-exist~ng dwelhng 3 Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 New Budding ........... Old or Pre-exlstmg Building .......... Vacant Land ............. Locatlon of Property .'~. I..~'..~.,~..'~..'¢~...o.~p,.%~-~.. ~.~..,~. ~ ~o~,~ Hou~ No. Steer Ham/et Owner or Owners of Property ~ I~ ~ ~t S ~ County Tax Map No. 1000 Section ~ O~ Block o ~ Lot ~ Subdivision ............ Filed Map No ....... Lot No ......... Permit No.[ ~.~..~-.~.~..7.:. Date of Perm,t ?!.1.~.~?.~. Apphcant ... ~..~.~..?~. ·..'~. · ! .~..~)'".'~...[..~..~... Health Dept. Approval ............ Labor Dept Approval Underwriters Approval Planmng Board Approval Request for Temporary Certificate ................... Final Certffmate ....................... Construction on above described budding and permit mee~papplicable codes and regulations. . Rev 10-10-78 ROMEO BUILDERS, INC. SOUTHOLD, NEW YORK DESIGN RESIDENTIAL CONSTRUCTION CABINET WORK THE NEW YORK BOARD OF FIRE UNDERWRITERS ]r] O0'~'~l BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 v,,t,~ Aixil 30, t~87 4..,,,.t,o.~o o.f,~ 447978/86 N 805662 THIS CERTIFIES THAT ~1~ C~, 315 W/s ~y~l~ ~, ~tt~k, N.Y. u~s examtn~ on ~ ~3 ~ ]~8 7 and fo,trial to be ~n eo.tphant e utth the retttttre.tenti of thts Board 3 ~ 3 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS TIMECLOCKS i IUNiTHEATERS MULTI-OUTleT DIMMERS SYSTEMS SERVICE DISCONNECT OTHER APPARATUS S E R V I C E 1G.F.C.I. Ruland ~l,~t. ~o. P. O. Box 413 [vlatt~ ~ N.Y. 11952 Lmu~£42E GENERAL MANAGER This cetimhcate must not be offered m any manner, return to the office of the Board ,f incorrect Inspectors may be ~denhfled by their COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTEEED IN ANY h4.AHNER TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y 11971 CERTIFICATION TEL. 765-1802 Building Permit No. /~ ~q-~ ~ Owner C A~I~s C, ~cm (please print) (please prznt) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber'S sl~-- Sworn to before~thls ~ day of. ~/-/ , Notary Notary Public JOHtq P BRISOTTI NOTARY pUBLIC, Slate of New york No 4732613 QuaJd:led m 5u[[oJk CounW 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ *,~1~ REMARKS: I NSPECTO~~ 76S-~.802 BUILDING DF, PT. INSPECTION FOUNDATION IST []ROUGH PLBG. FOUNDATION 2ND [1INSULATION FRAMING []FINAL REMARKS:~ (~" 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL DATE 765-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE /2~/Z/~//~ INSPECTOR OUNDATION OUNDATION ( 2nd ) iOUGH FRAME & PLUMBING iNSULATION PER STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: '~-/'l~ 6go. I~l l~[e*~ Nov. -4 , 198'0. FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, NY 11971 TEL,: 765-1802 E×ammed 19 8 Approved /0 .et~'~P }t~, 19171~ Pemlit No ] ~-tll~ '~ Disapproved a/c APPLICATION FOR BUILDING PERMIT Received .......... ~19. Date[,o .19 F INSTRUCTIONS a Tins 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 buddings on premises, relationship to adjoining premises or pubhc stree or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this app cation c. The work covered by tins application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Building Inspector will issued a Budding Permit to the applicant Such perm shall be kept on the premises avadable for inspection throughout the work e. No building shall be occupied or used in whole or in part for any purpose whatever untd a Certificate of Occupant shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ~ Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demj~lon, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code, housing fod~J and regulations, and t admit auth°nzed inspect°rs °n premises and m budding f°r necessary mspectl°nT//'//' ( d~-----,~. (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 .. . ~ .~ e~,,.~-r,.... .. Name of owner of premises ~')H,,4q~- t..**-, ~ $ L.-'-'~--o .... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and tltle of corporate officer) Builder's License No l I. c~ . .. Plumber's License No Electrician's License No Other Trade's License No Location of land on which proposed work will be done ltouse Number Street County Tax Mdp No 1000 Section ~[ o.~ Block Hamlet .. . Lot Subdivision Filed Map No Lot (Name) State existing use and occupancy of prenuses and intended use and occupancy of proposed construction a. Existing use and occupancy t ~ ,~ ~("t~. b Intended use and occupancy ...... 3 Nature of work (check which applicable) New Building ..... Addition ...... Alteration Repair .... Removal ........ Demohtlon .. Other Work ...... 1 '~1:', (Description) 4 Emmated Cost ......... .~ ............. Fee ........................... : (to be paid on filing this application) 5. If dwelling, number of dwelhng units .I. . . Number of dwelling units on each floor.,. ~. ....... If garage number of cars 6 If business, commercial or m~xed occupancy, spemfy nature and extent of each t_ype of use '-":','~D~ "~ 4-0' :r' ' 7. Dtmensmnsofexistmgstructures, tfany Front 4~-~ ~ ... Rear .. q..~.~..~ .... Cpi- ....... ~ .... Height ~.'-~. +-... Number of Stones . I ........ Dm~enslons of same structure with alteratmns or additions' Front . ,q'.~.-.~. ~ ..... Rear . ~..%'~?. Depth 'tx."l ."~. ~ . Height ~ '~"~ ~' ....... - ...... Number of Stones . ~ ........... 8. Dlmensmns of entire new construction Front ..... Rear ......... Depth .......... Height .......... Number of Stones .................................. 9 Slzeoflot Front ~.o~~.o .... Rear . .~'~'2..'~ ......... Depth 10. Date of Purchase ......... Name of Former Owner 11 Zone or use d~stnct m which premises are situated ......................... 12. Does proposed construction v~olate any zoning law, ordinance or regulatmn' .. . 13. Will lot be regraded ~o .. W~I1 excess fill be removed from premises Yes 14 Name of Owner of pretm~es'Q~ .~ ~' ~x,~' Address,a4~.-gL~.~..~.~. qC?.. PhoneNo ......... Name of Architect · . - ~ ......... Address~3L~. .~?~Y.h~-° Phone Name of Contractor ~t t'7~. ~, ,~,~ ~.~, ...... Address ........ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dtmensmns fron property hnes Give street and block number or description accordmg to deed, and show street names and red,cate whethe interior or corner lot STATE OF NEW;YO,PyK,., [ . S S COUNTRY OF .~. · ~'~' fl~,~&~ .... bexng duly sworn, deposes and says that he ,s the appl,can: (Name of xndwtduaI stgmng contract) above named. He ~s the Y ................. (Contractor, agent, corporate offmer, etc.) of smd owner or ownem, ~d zs duly authored to perfo~ or have performed the sa~d work and to m~e and file apphcat~on; that all statements contained m thxs application are true to the best ofhzs ~owledge and behef, and that work will be perfomed m the m~ner set forth xn the apphcat~on filed therewxth. Sworn to before me this ..... of Notaw Pubhc .... . ~. ~ . County . ...................... N~ ~ ~. ~2~, S~k~ (Signature of apphcant Te~ ~pires ~m~r ~, ** ........ 765!~02 9 ~ ~'0.~ ~ FOR THE ,