HomeMy WebLinkAbout14567-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
ZI5514 December 17 86
No .................. Date ................................. 19,..
THIS CERTIFIES that the building ....... ~ r e ~gh o u~.e. ............................ ;
Location of Property .... 4 $ J 0.0~. M ~ iA. R o ~.~...: ..................... S. 9 .u.t.h. q .1 ,d .......
House IVo. Street Hamle~
County Tax Map No. 1000 Section .0.~ ~ .....Block .... ~. . .Lot .... 9.2
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore fred in this office dated
Jan~ .1.5 86
................... 19 ... pursuant to which Building Permit No...I.4.5. 6. .73 .............
dated .... I~ ¢ ~o.... ~ 5 ................ 19.8..6, 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 .........
Greenhofise . .
The certificate is issued to . . SALVATORE CATAPANO ...................
...................... · · '
of the aforesaid building.
N/A
Suffolk County Department of Ilealth Approval ..........................................
UNDERWRITERS CERTIFICATE NO N 7 3 3 .7 0 3.. .
1/81
Building Inspector
TOWN OF SOUTHOLD
BUILDING D£PARTMEt4T
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
1~.o 1~67 Z
Permission is hereb/gronted to:
.~.~.~.~......~.~.~ ............
....~.~.~..c...~'...~...
~~.~....~...;.'t.~.....U..~.L.~. ....... ,--,,
,o
ot ~remi,e~ ,oco,e~ o, ~..~./.~.~ ....... ~.~....~.~ ............ ~'~"~','~;~ ..............
County Tax Map No. 1000 Section ,.,.~.....~.,,.~. .......... Block ...... ~ ............ Lot No.....~...~..
Building inspector.
Building Inspector
Rev, 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Tow~ Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
/~.~J~,~_ Instructions
A. This application must be filled in typewriter OR ink, and submitted m I~a~aa to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property wi~h 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 iprior to April 1957), Non-conforming uses, or build|ngs and "pro-existing"
land uses:
1. Accurate survey of pZ~t)perty 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.
Fees:
1. Certificate of o~upancy $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
5. Updated C.O. $15.00
NewC°ns tructi°n ...... Old or Pre-existing Building ............
$15.00
Vacant Land .............
Location of Property ...................
House No.
Owner or Owners of Property .............
County Tax Map No. 1000 Section ... ~) ~ ~.
..... Block ............... Lot ..... · .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No /~'-~.ZZ Date of
........ Permit .......... Applicant ..................................
Health Dept. Approval .... ~~ ........ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval . ,.,. ~;, ..............
Request for Temporary Certificate ..................... Final Certificate ......... ~ .............
Fee Submitted $ .............................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~]' es JOHN STREET, NEW YORK, 3,
.~ ~.,~.,o. ~o. o.~,~ N 733703
THIS CERTIFIES TNAT
only the electrical equipment as ~scribed belo~ and introduced by t~ applicant trained on the ab~ applicatiot~ ~umber in the premises of
Sal ~p:~,~o~ Rt. 25 ~outhold~
in the following lo. aLlan: ~
~an~ary ~V~6~ ~tFI. ~ ~.a~. Fl. Section ~loe~ Lot
FIXTURE
OUTLETS RECEPTACLES SWITCHES
FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST
INCANDESCENT FLUORESCENT MERCURY
VAPOR
DRYERS FURNACE MOTORS
FUTURE FEEDERS TIME CLOCKS UNIT HEATER MULTI-OUTLE DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT
OTHER APPARATUS:
S E R V I C E
NO~ OF CC, COND
1
OF CC COND,
3/o
NO, OF HI-LEG
AW, G,
OF HI-LEG
OF NEUTRAL
3/0
Glenn Bradley
Box 382
GENEI~AL MANAGER,
Per_
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, i
~IENT. THI: IN ANY MANNER.
FIEL.D tN,B[)ECTION
FOU__N~_T I O__N ._
(1st),
COMMENTS
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
,~ CODE
TOWN OF SOUTHOLD
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 fo Certifi.c~te of OccuPancy
is not on file. ~ ~
/--/ No Underwriters Certificate on file.
/~_ The check is(~d~-~/not on file.)~
/Z/ No Health Dept. Approval on file.
/Z/ No final ~n,spect~on has been made.
Please contact our office on this matter.
Thank you for your cooperation°
Building Permit # ./,, Z// ~ ~ ~ Z
Building Dept.
***/-_/
No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
765-18~Z
BUILDING DEPT.
INSPECTION
[ ] FRAMING
REMARKS:
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION 2ND []INSULATION
[]FINAL
DATE ~INSPECTOR '~~
FORM NO. 1
TOWN OF SOUTHOLO
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
., 19.~
., 19~ ¢. Permit No./..~..~."~. ? .~..
Disapproved a/c .....................................
(Buildiug Inspector)
APPLICATION FOP, t~UILDi[qG PERMIT
INSTRUCTIONS
BLDG. DEPT.
TOWN OF SOUTHOI~,,
ReceSved ........... ,19...
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, or public streets
part of this appli-
or areas, and giving a detailed description of layout of property must , z
cation.
e. The work covered by this application may n
d. Upon approval of this application, the Building Inspector will
shall be kept on the premises available
e. No building shall be occupied or used in whole or in r ~, 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 in§pections..__ ~ ~_
· ~~... L~..~..~...~.... ~: ........
(Signature of applicant, or name, if a corporation)
.... .... :..0....,...
(Mailing address of'applicant) ~g~'y :_
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumoer o o ' .
........................ , .............. ]' '.' ':'5 ......... ............
Name of owner of premises .... ~.? ( .~. %./.~., .~. ~. ..... .(.~. ~.~...~..~ .e .... .~. 16.% .~.o...~' .cz: .~7.~ .......................
(as on the tax roi1 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 License No .........................
Electrician's License No .......................
Other Trade's License No ......................
Locationoflandonwhichproposedworkwillbedone. .~.f/,':56' ~[ t7~,~'~ r5¢~t~,rT~d/o~ !j~...
Itouse Number Street Hamlet
County Tax Map No. 1000 Section ..... .'~. .......... Block .... ............. Lot.../?.~....~! .¥~. ....
Subdivision ................................ Filed Map No ............... Lot ...............
&'a;~)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing' use and occupancy ..... ~P~ ........ ~/'- .~i. ~.~.~.'(./~..~. '.'~..~.~. ......................... ......
b. Intended use and occupancy ...... /.5.°'x.~,~....¥.- .~-k'..~-~.'-~fi.~.L~.~ ~ ...... ~~. .............
3. Nature of work (check which applicable): New Building ' Addition ......... Alteration
Repair .............. Removal .............. Demolition ............. Other Work. ~ ..........
CTr ~. e ~- ~ ~5~r (Description)
[to be p~d on fihng this application)
5. Ifdwelling, number of dwelling units ............ '... Number of dwelling units [on each floor
If garage number of cars '
6. If business, commercial or mixed occupancy, specify n~apd extent of eachJy~f~f use .....................
7. D~ensions of existing structures, if any' Front ~: Rear ~- Depth..~ '
Height .. ~ ........ Number of Stories . ~ ......................... ~ ...........................
D~ensions of same structure with alterations or additions: Front ' Rear ..................
Depth ...................... HeiSt .......... ~ ~ .......... Number of S~ofies ......................
8. Dimensions of ~ntire new construction: Front ... ~.~ ....... Rear ... ~ ~ ...... Depth .. Z~.~ .......
Height .... ff .......... Number of Sto~es ...Z..' ....................... ...........................
9. Size of lot Front ..... ~(~. ~ .......... Rear .... ~.5 ............ Depth ,. ~ ~ ................
10. Date or Purchase ...... 7~/~ .............. Name of Fomer Owner .. ~.~(.~../~¢~ff~ ......
1J. Zone or use district in which premises are situated ....... ~ ....... . ...... ~ .................. .. .
12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~d.C .......................
13. Will lot be regraded ..... .~..~ .................. Will excess fill be removed from premises: Yes
14. Nme of Owner of premises .~. ~.~¢.~. Address ................ '... Phone No ................
Nme of Architect Address ' Phone No.
Nme of Contractor . . ~.,.~-~.~ .... Address ~Phone No ....... ~; .......
PLOT DIAGRAM / ~
Locate cle~ly ~d distinctlg ~1 bufld~gs, whether existing or proposed, and. indi'cate ~1 set-back d~ensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
~6~fi~V~D AS NOTED
NOTI~' ~U~LD:~G OEPART~ENT A~
FOR o{]UR~O CONCRETE
2 ROUGH F~AM{NG & PLUMBING
3. INSULATIO~q
" ....
4, FtN~t (, ~)~,:,TR JCTION MUST
~)N~TRUC~ ION SHALL ~EET
THE R~Q(Ji~F~E~ S OF THE N,Y
STATE CONSTRUCTION & ENERGY
/
................................................. bemg auI~sw or~~~plicant
(Name of individual signing contract)
~bove named.
~e is the .............................................................. ~ ...........................
(Contractor, agent, ~orporate officer, etc.) :
~f said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this
~pplication; that all statements contained ~ this applieation are true to the best of his ~owledg~ and behef; and that the
york w~l be perfo~ed in the m~ner set forth in the application filed therewith.
gwom to before me this
~ ~~ ~ ~[( ~, (Signature of g~pll)ant)
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