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HomeMy WebLinkAbout15529-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail 5outhold, N.Y. Cerfi[icate O[ Occupancy No. Z15408 Date March 24, 1987 THIS CERTIFIES that the building . .A.d.d.i.t. ~_.o.n. ..................................... Location of Property 275 SOUNDVIEW AVE.' SOUTHOLD House No. Street Ham/et County Tax Map No. 1000 Section . .0.5.0. ....... Block 02 .Lot 05 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Nov. 19, 1986 .. pursuanttowhichBui[dingPermitNo..1.5..5.2.9.z dated.........N°v' ...... 28, ..1986 .. .... . 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 .o.n.e...f.a.m.i..ly. dwelling. The certificate is issued to MR. & MRS. ROBERT CONSTANT ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ..... N./.A .................................. UNDERWRITERS CERTIFICATE ...... N 797147 PLUMBERS CERTIFICATION DATED: March 16, I987 , / f/Building Inspector Rev. 1/81 lrO~.,~ NO. ~ TOWN OF $0UTHOLD BUILDING DEPARTMENT TO%VN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15529~ Z Permission is hereby granted to: ............. ........... at premises Iocotecl at ...~,'~...~.......~.~2....~1~....~,,~.....~ .............. ~.~. County Tax Map No. 1000 Section ....... ~[~...~...'~... ..... Block ...... (J~.~,~ .... Lot No ...... ..~...~ ........... pursuant to application dated ..... .~...~....~....~T.. .......... , 19.~...(le., and approved by the Building Inspector. Building Insf:~ctor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTI~OLD 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 .- ~ 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, Mu(tiple 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 property 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 ,$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 . .~.).). d.%~.;../.(?.,./.~.~..~. ..... NewCons%ruction...~... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .c~, 7.,~... ~ .U.I. . L.~-~..~ .... ~ .O, , .................... House No. Street Ham/et County Tax Map No. 1000 Section .... 0.~0. ...... Block ....~./.~. ....... Lot .... .~! .'%. ........ Subdivision .................... , ............ Filed Map No ........... Lot No .............. Permit No../. ~7~-~. f ;~. Date of Permit . .~..Applicant...~.bO.. ~ ...... ' .... : ....... ~,.. , Health Dept Approval '~ Labor Dept Approval ~/ Planning Board Approval Unde~riters Approval .............................................. Request for Temporary Certificate Final Certificate Fee Submitted $ . ,c~, ,~,'~0 .................. Constructio~n on above described building and permit meets all ap~p~ilicable codes and regulations. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 Oept. 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 Engini]er responsible for the building. 5. Submit Ptanning 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" lend uses: 1. Accurate survey of p:Coperty showing all property lines, streets, buildings and unusual natural or topograph ic featu res. 2. Sworn statement of owner or previous owner as to u se, 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.(10, Accessory ,,$10.00 Business $50.00 ~,~of-occu_~ncy on pre-existing dwelling $ certificate o~ ~ .50-. 0 0 over 5 years $I0.00 5.Updated C.O. $ `50.00 Date ....... ~//Old NewCons ~.ruc ~±on ...... or Pre-existing Building ............ Vacant Land Location of Property...~.7..~?..:O.L~.O.~.~,.~....~.. ?~. ...... , .~0..U-...~z)~./.~.. .............. House No. $~et Ham/et Owner or Owners of Property .......................... ,~/~/~, ~ .............. County Tax Map No, 1000 Section .............. Block ,., ,~, ,~., ...... Lot,, Subdivision ................................. Filed Map No ......... Lot No ....... ........: Permit No. /.~.,~-~ ? ~ Date of Permit. /.~/(¢..Applicant .~...~..'.~.©.. Health Dept. Approval ........................ Labor Dept. Approval ..................... ... U d it App I / Pla i gBoadApp n erwr ers rove ........................ nn n r rova ..................... Request for Temporary Certificate ..................... Final Certificate ...................... .Fee Submitted $ .... ~ ~/~ .................. ~onstructio~ on above described building and,~,per~,,t meets all applica?,~odes and regulations~z-~ Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 ~ March 9, 1987 449234/86 ..,e ~..,,~..,o.~o...~,,~ N 797147 THIS CERTIFIES THAT Robert Constant, $ounclview Avenue, EBt. Southold, N.Yo [] [~ Ist FI. [~ 2nd Fl. Section Block Los FIXTURES RANGES COOKING DECKS OVENS DiSH WASHERS EXHAUST FANS INCANDESCENT FLUORESCENT 2 MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: 1-G.F.C.I. E R V I NO. OF CC. COND [ A W. G, NO. OF HI-tEG C E COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERT F CAIE MUST,NOT BE ALTERED IN ANY MANNER. HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765.3690 Inc. CERTIFICATION Date March 16, 1987 Building Permit No. 15529Z Owner: John Bertani, Builder - Constant Residence Soundview Ave., Southold, NY Plumber: Henry J. Smith & Son, Inc. I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn before me this 16th day of March, 1987. Bernadette L. Taplin Notary Public, Suffolk County State of New York, Commission Expires Sept. 30, 1989 Notary Public ~f44893 2'65-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION I' ] FRAMING I~ ]'FINAL REMARKS. ~/~'*~ ~j 7GS.'1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST []ROUGH PLBG. []FOUNDATION ZND []INSULATION []FRAMING []FINAL DATE .... INSPECTOR ]65-1802 BUILDING DEPT, INSPECTION £ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: *'~* ~ ouNDATION (1st) OUNDATION ( 2nd ) 'RAME :NSULATION PER N. Y. ~ STATE ENERGY Z CODE FINAL ADDITIONA'L COMMENTS: Examined. J~.~ .~.'ij., 19~. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1803 Approved ~..~. ~'~., 19?le. Permit No. I ./,'~-.~..~.~..'~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 1986 Received ........... ,19... INSTRUCTIONS 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 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 inspections. .J.o (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. ............................................................................... Name of owner of premises .. ~.4. /, .Z~. ?..~....~.O//~ .... d'O.Ad ~'/.-77.~1~ J. .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. U (Name and title of corporate officer) Builders License No ..... -~../.Z.) .~./..~ .~.-TL.. Plumber's License No....~.~.~./d ~...~. '~4....J.~ff../,.Co A) Electrician's License No...~.~....~../.~.d'.- .~.~../k- Other Trade's License No ......... .fl./.~ ........ I. Location of land on which proposed work will be done .................................................. . . .................... ............ . d.c. z,o./ . x:.,.F., ...... House Number Street Hamlet County Tax Map No. 1000 Section ..~...~"F-~) ......Block ...... .~. .......... Lot .................. Subdivision ..................................... Filed Map No ............... Lot ................ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy...OjO.~. .... .~,~ tqcq. (..~crff... J~../~.¢.~'~.d fi~/.fi~.. .......................... b. Intended use and occupancy ....................... . ........... ' ............ ::.' ................... Nature of work (check which Repair .............. Rer Estimated Cost. If dwelling, number of dwellin pplicable): New Building ..... ' ..... Addition .... . .~.... Alteration .......... ~oval .............. Demolition .............. Other Work ............... (Description) (to be paid on filing this application) units ............... Number of dwelling units on each floor ............... If garage, number of cars ... i ................................................................... 6. If business, commercial or mixed occupancy, specify n,.at~re and extent of each t,y_pe~ of use ............ ~ ....... 7. Dimensions of existing structures, if any: Front ~.~ ..... Rear .:g'.~-. Depth. ~.O.. .... Height .... [~. ........ Nu.mber of Stories ...... ~ ..~. ................................ Dimensions of same s. tri~cture with alterations or addition~: Front ..... 3.~ ........ Rear ...~..~<.~ Depth ......... '~ ........ i · ·. Height ....... ; [~. ........... Number of Sto~es... ,,~. ............... 8. Dimensions of entire new consltruction: Front ..... ~. ~ff../.r... Rear... ~..tT.~..~ ..... Depth ...~..~..~ ...... Height .'~./~I~.~. ........ Number of Stories ... ~..~.~c~..(2~ ...... 9. Size of lot: Front .; ..... {.0. O ........... Re~; ..... / £.¢ ' ' ' .." '~)~th .......... .Sg..~.O. ~ ...... ........... 10. Date of Purchase ......... i ................... Name of Former Owner .............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vi¢l.at~any zoning law, ordinance or regulation: .... .A2... ......... 13. Will 10t be regraded ....... i ./~..~ ................ Will excess fill be removed from premises: Yes 14. Name of Owner of premises . i .................. Address ................... Phone No ................ Name of Architect ........ ! .................. Address ................... Phone No .......... , .... Name of Contractor ~.0.h~.. 2~:W~rR~. 1.. ~ .... Address/.,fl~0..~. ~O...~4~. ~ f)~-Phone No..~'~ .~.~../.~ .~... PLOT DIAGRAM . Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate 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. ' S S COUNTY OF...,,,.p,~lmr/aa. ~'' U..-~'.~../~./.~... ~ ' ........... · ~. · · · · · · ti~.~"At;t.~g}'. ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above namgd. He is th (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed tn the manner set forth in the application filed therewith. Sworn to before me this ........ ........ .~..0. ....day 4f.../~'.O~..(L:nffd...~.~g~-~.., 19 Notary Public ................. i ....~,.. ~.~ ~'. ~.(~(County I - EUZABL~ ANN NEVILLE (Signature of applicant)f I Notary Public, State of New York ' No. 52-8125850 Suffolk County Term Exp res October 31, 19~-~ II USED IN WATER .qOLDER --.. oANNOT su~?Z s.~o of ,~ EXCe~:u ~" PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY