HomeMy WebLinkAbout14930-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPAtlTMENT
Office of the Building Inspector
Town Hall
Sou~hold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17318 Date SEPT. 19, 1988
THIS CERTIFIES that the buildin~ ALTERATION
Location of Property 2440 VILLAGE LANE
House No. Street
County Tax Map No. 1000 Section 026 Block 0t
Subdivision XX Filed Map No. XX
ORIENT
Hamlet
Lot 16.1
Lot No. XX
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 19, 1986 pursuant to which
Building Permit No. 14930Z dated JUNE 3~ 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 ALTER EXISTING ONE FAMILY DWELLING.
The certificate is issued to PIERRE GAZARIAN
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N853567 FEB. 16~ 1988
PLUMBERS CERTIFICATION DATED KING PLUMBING & HEATING 9/19/88
B6[ldin~ Inspector
Rev. 1/81
TC~VN OF Sou'rHOLD
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.o 14~30 Z
Permission is hereby granted to:
................
..... ...~....?..~...~Z .....................................................
..~.~.....~....¥.,. ...... t.~.~E.? ................. ~ ,
o, premises ,~a,ed at ...~..~.~.~.......'...~.~..~...~...**..~......~~..* .....................
County Tax Map No. 1000 Section .... ..~...-2m,.~.. ....... Block ..... ..~...~ ........... Lot No ...... L~...'..,.~ .......
pursuant to application dated ....... ~.~.,~.~ .................. , 19.~..~.,-- and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - [802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in Wpewriter OR ink, and submitted m~ to the Building Inspec-
tor wlth 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.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic featu res.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing cede or safeW inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions 825.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling.$25.O0, Accessory I$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date .. >/94~-~ ....... l ..........
NewC°nstructi°n ...... Old or Pre-existing Building ..... Vacant Land
Location of Property
House No. Street 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 ~ ~t~'l
Health Dept Approval Labor Dept Approval
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Cer~:ificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building andjd'~rmit meets all app~,~b e codes and regulations
Applicant. ..
dO
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000~"~ BUREAU OF ELECTRICITY
onJy the electr[~at ~uipm~t ~ ~scrjbed be~ ~o~ int~du~ed b~ t~...p~cant ~ on t~ above a~ic~t~n ~r in~ premises of
in the following location; ~ Bmsement ~ Ist FI. ~ 2ud FI. 3rd., floor se~t~,,, m,~ £o,
~,..e~.,,~iae~oa February 11~ 1988 .ndJoundtobelnco.,pli.ncew~ththereqt re,nentsqfthisBoard.
20 51 30 20
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS
EXHAUST FANS
DIMMERS
SERVICE DISCONNECT S E R V
-- OF CC. COND
2/o
°'~."A'~oom 'heaters = 4-1. o 5kw. ~ 18- ~.. 0k~., 3-. 65~.,
3-Smoke detectors
i c
A W O. ), OF NEUTRALS A. w o
NO OF HI-L~O OF HI-LEG OF NEUTRAL
1
Arthur Ruroede
Main Road
Orient, NY 11957
Li~2334E.
This certificate must not be altered in any manner; return to the office of the Board if incorrect.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE
GENERAL MANAGER
may be i~entifled by their credentials.
I'ERED IN ANY MANNER,,
TOWN OF $OUTHOLD
OFFICE O1~ BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No.
(please print)
~ (p~ease print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber' s s~nature)
Sworn to before me this
[ ~ day of
Notary Public,
County
Notary Public
4707878 Suffolk
FIELD INS[~ECTION
1.
FOUNDATION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
Ye
FINAL
ADDITIONAL COMMENTS:
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
. P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
December ]7, ]987
Pierre Gazarian
P.O. Box 5
Orient, N.Y. 11957
Dear Mr. Gazarian:
In reply to your letter of December 9, 1987
please be advised.that your B. P. #14903Z has been
extended for 6 months.
The new expiration date is June 3, 1988. If
the work is not completed by this time a new permit
will be required.
VGL:hdv
Y o~u r s truly,
VICTOR G. LESSARD
Exec. Admin.
December 9, 1987
Mr. Victor Lessard
Executive Administrator
Southold Building Department
P.O. Box 1179
Southold, N.Y. 11971
Dear Mr. Lessard:
I would greatly appreciate your extending building
permit #14930Z to June 3, 1988. This permit is for
work in progress at my house: 2440 Village Lane,
Orient.
Thank you for your kind attention to this matter.
PG/rm
rely your,~,
Pierre Gazarian
P.O. Box 5
Orient, N.Y. 11957
7r, S4.o,
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST ~- ] ROUGH PLBG,
FOUNDATION 2ND [ ] INS~tLATION
[~FINAL
DATE
INSPECTOR J~ ,~
TWO REQUIRED
I~;IEP CONCRETE
FRA~ING & PLUMBING
CONSTRUCTION MUST
NO'
OR
o
~E FOR
SHALL MEET
& ENERGY
',ESPONSIBLE FOR
INSTRUCTION ERRORS,
h
E
0
0
FORM NO.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined . .~..~...~....., 19
approved...~ ~-~'Y{4....5..,' 19~. ./o. Permit No.) ~ .~...~., .'~-'..
Disapproved a/c .....................................
application No ..................
(Building Inspector)
APPLICATION FOR BUILDING PERM IT
Date .................. , 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,/~nd regulations, and to
admit authorized inspectors on premises and in building for necessary inspectio!~.
(Signature of appl~??~ a.c .orporat?~)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......... pI~RRE..GAZAR~ANT-.-QW~E~ ...........................................................
Name of owner of premises ..... ~ .I.E.R.R.E...GA~ A..R .IAN' ...................................................
(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../..0.~. ....................
Plumber's License No.. ( .O. ?.?. 7..~. ...........
Electrician's License No...~..~. ??..~. 5 .........
Other Trade's License No..(?.~ .................
1. Location of land on which proposed work will be done ..................................................
2440 VILLAGE LANE ORIENT
House Number Street Hamlet
County Tax Map No. 1000 Section ....... 2..6 ......... Block ..... 1 ............. Lot...~.6.:.1 ............
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 ...... 0~IE..F.. g~I.~.I~. 1).
b. Intended use and occupancy SAME WITH ALTERATIONS '~",':" ~:'
3)i ~ature o~'~work (check which applicable) New Building Addition .. Alteration X X
~ ll~epmr ............ Removal Demolmon . Other Work .....
: .......
4(~g][t~ated
........................ ...........................
Cost..
~ ~.~ ~.'.:'~:~ ~ -~ ~ ~ ~ (to be prod on fihng thru applicatmn)
~I~well~/n~ffib~r ¢ ~ ~willing [unit s ............... Number of dwelling units on each floor ................
If garage number of cars i
6. If business, commercial or mixed occupancy, specify natur~ and extent of each type of use ........
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
tteight ............... Number of Stories ........................................................
I)~ i f tm "th alt t' add' ' F Rea
ens ons o same s cture wi era lOllS or ltlonsl ront ................. r ..................
Depth ...................... Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
tteight ............... Number of Stories ........................................................
Size of lot: Front ' Rear Depth
Date of Purchase .......... q .................. Nmne of Fomer Owner .............................
Zone or use district in which pr~mises are situated ..................................................
Does proposed construction violate any zoning law, ordinance or regulation: ................................
Will lot be regraded ...... .~ ~ ............... ,.., Will excass fill be re¢oved from premises Yes No
NameofOwnerof remises fl'~~ ~Z~I~- ~ ~ ~o~ ~ ~nu~,~-, Sl~-7'zSTT~
P . · ............. ~dd ........... t ,,,~,~ ~o .............
Nme of Architect .......... ' ................. Address ................... Phone No ................
Nme of Contractor .. ~ ~..~¢ ~. ff~{ ~ q ~(.. Address . .q~{~e.. X~ ~.. Phone No. U¢ r. $ 72. ~.~ ~..
10.
11.
12.
13.
t4.
PLOT DIAGRAM
Locate clearly and distinctly all: buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether
interior or corner lot.
SEE PLANS
STATE OF NEW YORK,
COUNTY OF ......... !S.S
............................. , .................... being duly sworn, depose~ and says that he is the applicant
(Name of individual signing contract)
above named.
He 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 contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manne? set forth in the application filed therewith.
Sworn to before me this
........... ~ ...... , .....day of ....
$otaryPubl:c, .I. ~ :~ ~.Jdp¢~-- 7~A-~ .' ~..~,~7 .J~...
........... ~. ........