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Home My WebLink About14713-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupnncy No ..... Z 1 5D$.~ ....... Date ....0.c.~.qb. ? .v. ?.9., ................. 19 .8.6. THIS CERTIFIES that the building One family dwelling Location of Property ..q. lQ.0..S.o..u.n.d.v.~..e.w..~.o.~.d ................ .0.p.~.e.n..~.,. N:Y. ' House No. Street Hamlet County Tax Map No. 1000 Section . .0. ~. 5 ....... Block ...0.3. .......... Lot .... ~. 5. ........... Subdivision .................. , ............ Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in tiffs office dated March 26, . 14713. Z ..................... , 19 .86. pursuant to which Building Permit No ..................... dated . M a r.c.h .3 ~ ............. 19 .8.6., was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... One family dwelling with attached balconies The certificate is issued to ..... V i t o Ma ggi o ................ ...................... of the aforesaid building. Suffolk County Department of Health Approval 8 6-$ 0-3 ~ UNDERWRITERS CERTIFICATE NO N 7 7 4 8 3 9 ' Plumbers Certification dated October 27 19.86. Rev. 1/81 IzOEM NO. ~ 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) ~T.o 14713 Z Permission is hereby granted ~o.~, ~ ., , ...... ..Y..~ .......... ~.L~..~..~ ...................... ,o at premises Iocoted at ...~.~...0..?...~.~..~....0.~........~... ............... ..~.~ ............................. County Tax Map No. 1000 Section .....C~..)....~.'~.. ....... Block ...... ..~,...~ ...... Lot No.....,~.. ,'~., ............ ~ursuor~t to opp,,cot,on do,ed .....~.~..~....~..~ .................. . '9.~.~... and oppro¥~ b~ th~ Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Buildlng 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 .- ~mmmm 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 pJ~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 $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date .[~)~...~. :~../..'ii..~.~. ...... Newconstruct±on ...... Old or Pre-existing Building ............ Vacant Land ............. Cocation of Property .11. o..o tZ . House No. Street Hamlet Owner or Owners of Property . .V. [ .~..q....l~..t~..c~., .c~.~. Q .................................... County Tax Map No. 1000 Section O [ ~ Block ~> ;~ Lot. ~ 6 Subdivision..o.(~,t:.~. 'j~ .~. ~ .-~..~.~....~..~z.~ .... Filed Map No.,~ .~. ,~..~,...Lot No, ,,~,~ ......... of Permit ~,4~¢¢,=, ~q?~' Permit No.J.~.~./.~ .~.. Date ' 'ri ~../~ppdcant .~.c.~ .~...r~...~..G,.c,..~.~ ............... Health Dept. Approval .0.~.'~'... ~,~,~ .[.~.~.G .... Labor Dept. Approval . .-:~... Underwriters Approval ..... %.... %..~/.% .~.f..~ ........ Planning Board Approval ~- .................. Request for Temporary Certificate ..................... Fina~ Certificate , V/ ............... Fee Submitted $ ............................ Construction on above described building ~it _meets all_a,pplicable codes and regulations. Applicant .~ .~..~ ............................. R.~. ,0-,0-78 USO C*OI~TRUCTION CORP. ~,~. ,~0/~)(. Main Rd., P. O. Box 439 CO~-~ J.-CO..~I Jamesport, N.Y. 119,47 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTttOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ~%~q ~ ~ Owner ~ ~ O ~1~ (please print) Plumber ?~O/.~c..~- ~C~ ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to befor~ me this ~ day of~__7/~/~ , 19~ · Notary Public,~=~F ~//~ County (~lu~ber's szgnature) BARBARA STEPNOWSKI Notary Publio, State of New No. 48447t~ Corn Qualified in Suffo~ County mit~on Expires Mamh 30,11~/ -- - Notary /~ubli~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1135021 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1OO3E mt. October 17,1.986 App.e.,lo. No.o.f.,.419926/86 N774839 THIS CERTIFIES THAT ordy the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Vtto Haggio, 1100 Soundview Ave., Orient, N.Y. in Ihe followlng location; ~ Basement [] Ist FI. [] 2nd FL Section Block Lot tvas examined on Oct oho r 11, l 9 8 6 and found to be in compliance u,lth the requlrentents o.f this Board. FIXTURE FIXTURES 52 56 50 32 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT S RANGES K W, PECIAL REC'PT OTHER APPARATUS: ICOOKING DECKS [ OVENS [DISH WASHERS AMT K W A~T K.W MT J K' W -TIMECLOCRS1 7.0 DELL~L UNITHEATE'S M ~' ~ [UL!I-~O~J ~21T' V I' C 3/0 Z EXHAUST DIMMERS AWG, OF NEUTRAL G.F.C.I.-1, Smoke Detectors-2 Track Lighting- 32-'0"- 16-lites Three "C" Electric RT.1 Bx.45M- Sound Ave. Rtverhead~ N.Y,, 11901 GENERAL MANAGER Per 11 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 BUILDING~ DEPARTMENT. THIS COPY OF CERTIFICATE, MUST. NOT: ; , : BE,, ALTERED! IN ANY MAHHER. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~ [ ] FINAL REMARKS: DATE / ~/~/(~ INSPECTOR 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ I~NSU~TION FRAMING [ ] FINAL REMARKS: DATE ~/~' INSPECTOR /~~~ FIELD INSI~ECTION COMMENTS FOUNDATION FOUNDATION (1st) R~~& PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL Ye ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION [~UNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [] FINAL ~F 765-1802 BUILDING DEPT, JNDATION ~.ST ON ROUGH PLBG. 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL ,,.A~,. ~ /~ INSPEC~i'OR _/~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: ~-*/ ~~~ DATE INSPECTOR Examined..~.0~..~..~. ~. Approved . ..~. ¢-&.~...~..\. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19 ., 19 .~.1,. Permit No..~.q.~..~.~..~.. Disapproved a/c ..................................... ............................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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, and regulations, and to admit authorized inspectors on premises and in buildh~g for necessary inspections. (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. V. .g. io. Name of owner of premises ......................................................... (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 ................. · ......... Plumber's ~icense No...~ ........ Electrician s License No.~ ......... Other Trade's License No.............- ~' ......... 1. Location of land on which proposed work will be done..T.Z..~..~..~./..~.~.'..~.~.~.~, i ... ??.-.¢.~..~../.~. ............ · ................ ............... ................ House Number Street Hamlet County Tax Map No. 1000 Section .I.g..'.'7..~.'7..~K. ....... Block .................. Lot. Subdivision ..................................... Filed Map No ............... Lot .... ; .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. I~tended use a. Bd occ,upancy' 3. Nature of work (check which applic0ble): ..... ' ..... Addition ........ Alteration ..: ....... · Repair ..... ~. ........ Removal .............. Demolition ............ I. · Other Work. ........ , ....... ,, (Description) - 4. Estimated Cost ..... * ..................... Fee ........... : ........................ (to be p~id on filing this application) 5; If dwelling, number of dwelling units .... .~ .......... Nuinber of dwelling unit~ on each floor ................ If garage, number of cars . ~ .......................................... I ........................... 6. If business, commerciai or mixed occupancy, specifT nature and extent of each typ~ of use ...; ....... ,. ......... 7. Dimensions of existingstructt~res, ifany: Front·~.~.~... Rear . . .:.. Depth. '.~)~iiiiiiiii Height .~. ...... Number of Stories·.·~.: .e.-..t../. ................. ! ............. i Dimensions of same structure with alterations or additions: Front ............. j .... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ....... Rear ......... ,. De Height Number of Stories 9.. Size of lot: Front . leo .~ ................ Rear ...................... Depth .[.~_q~'! ............... 10. Date of Purchase . :... O'~./q~. ................ Name of Former Owner /}~0/. ~3J--. ........ : ..... 11. Zone or use district in which premises are situated .......... ... . . :. . ...... . ." ................. . . . . ... .. 12. Does proposed construction violate any zoning law, ordinance or regulation: j[~0..i ................... . ....... 13. Will lot be regraded ~r~.~ ........................ Will excess fill be removed] from premises: ~ No 14. Name of Owner of premises . ~76~0 ........... Address ~rOg.l~_~gt~.~t~._Phone No. 7/o~O~/..:~g~... .......... ^aaress ,$~'t.~r .~e. ...... rnone No. ~.$&.~.~.~.]~ ..... Name of Contractor dt, l~Ot:'. ~h'~t~M ............ Address~s~8~..~.~D.... Phone No. ~ ~.~.,~t~;/ ..... 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 2OUNTY OF .................. · ................................................ being duly sworn, deposes and says that he is tile appl~canf (Name of individual signing contract) above named. te is the (Contractor, agent, corporate officer, etc.) ff said owner or owners, and is duly authorized to perform or have performed the said work and to make and file 'this tpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this ........... .o?..~. ........ day of .... .~.'~. ~ ..... ; 19 ?..~ qotary Public,....~-c~f~....~. '., .. County (Sign~ of applic,'mt) A'7- SUFF~ SUFFOLK CO. HEALTH DE~. APPRovAL H. $. NO. ,, '~ S~ATEMENT OF INT~T ~[ THE ~ATER SU~LY AND S~AGE DIS~SAL ~ SY~EMS [OR~-, THIS RESIDENCE WILL ~ C~FORM TO TH.E STAN~R~ OF THE ~/~ .................. ,, ..... , ,,-,., SURVEYORS NEW YORK L BLDG. DEPT TOWN OF SOU-F;-- GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. ~-'~';~-~; STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES (s) APPLICANT SUFFOLK COUNTY DEPT, OF HEALth SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: APPROVED: E:J/ :"OLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PEL. OWNERS ADDRESS: DEED: L. ~*'~*/~ Pm TEST HOLE STAMP 4-d ::" .. SEAL I SUFFOLK COUNTY HEALTH H.D. REF. NO. SINGLE FAMILY DWELLING C ILY DATE THE SEWAE~E DISPOSAL AH?, WtTSR SU LOCATION HAVE BEEN iNSPE. G, 150 I~Y THIS FOUND TO BE SATIS ~RY. Manageme .... - oct. R~¢_,D~ IC. lC~NN VAN TUYL, P.C. LICENSED GREENPORT NE,W YORK SUFFOLK CO. HEALTH DEPT APPROVAL H.S. NO. ~--,~0-~5~1 STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (s) APPL I C ANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY CO. TAX MAP DESIGNATION: : SECT. BLO42K PCL. SEAL SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. pLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY OCCUPkNCY OR USE IS'UNLAWRIL WITHOUT CERTIRCATE 'OF OCCUPANCY APPROVED A8 NOTED NOTIFY BUILDING DEPARTMENT AT 766:1802 g AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2 ROUGr'~ Fr4AMING & PLUMBING . 3. INSULArlON 4, FINAL C~eJSTRUCTION MUST ' DE COMl:~Ll~'!r~ ;OR C.O. ALL CO~ HUCTION SHALL MEET THE RE(~UIREMENTS OF THE N,Y ETATE CONS'rRUCTION & ENERGY ' ', · CODES, NOT RESFONSIBLEFOR ' ', h~$1GN OR CONSTRUCTION ERROR;:, 1 d /~Z//' ENERGY NOTES - This construction conforms with part 5 Acceptable Pract. ice of the State Energy Conservation Construction Code. - Gross Wall Area - Total Glass Area ~,~ - Glass/Wall - All doors to have insulated glass or storm doors.. - Thermal insulation minimum Top floor ceilings R=~J=.05 Exterior Walls R=13 U=.08 Concrete Slab R= 6 - Thermostat - ~5°F to 75°F setting maxf~6m for heat. - Domestic hot water aquastat setting 140/max, - All mechanical systems shall conform to code. - All ducts and piping in unheated spaces shall be insulated per code. - This building is loca%ed.in a 6000 degree day zone. L 9. ~o not scale drawings, GENERAL NOTES: 1. ~c~tractor to check all dimensions & fie~d o0~tic~s b-~n~ beginning work, and be responsible for ea~e. 2. All co~rete ~to be 25~0 p.s.i, at 28 day test. 3. Footings t~ rest o~ virgin undisturbed soil. 4. L~er to be Bern. Fir %2. 5. F~=rs to be (2)2"x6" ~nless noted otherwise. 6. Electrical work to confom to the Patic~l Electric Code and any applicable local cc~e~, Provide min. of c~e smoke de,actor in bedroum area. 7. Double joists around openings & below · load bearing partitions Wktch run pax~llel to joists. 8. Ommtructic~ is to be in acco~ance. with prevailing codes and sta~vds. dimensions govern. 11713 $16-286-22-e$ FiLE N SNEE, T Ng ~ OF / Col?ar, 2x~ Ce//,h9 (m"P'lq 7 SOUTH COU3ffR Y ROAD, BELLPOR T. NEW YORK 516.286.2253 l, ,I $1&286-2255 II Ii 128 SOOTH COUNTR Y ROAD, BELI..POR~'. NEW YORX 11713 $1d.286-2233