The URL can be used to link to this page

Home My WebLink About14587-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy NO. Z15545 Date March 25, 1987 THIS CERTIFIES that the building ...... O..n?..f.a..m.i.l.y. dwe 11 ing Location of Pro ert 12250 Soundview Ave. & Booth Rd. Southold House No. Street ............ County Tax Map No. 1000 Section . .0.5.4. ....... Block 07 . .Lot 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J an. 28, 1986 pursuant to which Building Permit No. 14587.z dated .M.a. .r .c.h..2.,..I.9.8..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 ......... .... .O.n.?..f.a.~. ~..~ .y..a.~..~ 5.I.~.-..g.,' .o.n..e..c.~. ~.. ?.a,r..a.s5 .a. ~..d..a.e.c..ky.. ..................... The certificate is issued to JOHN BERTANI BUILDER, INC. ..................... ~de'~,'~fx~¥~A4~'~' ..................... of the aforesaid building. Suffolk County Department of Health Approval 85 - S O- 208 UNDERWRITERS CERTIFICATE NO. N 79383 I PLUMBERS CERTIFICATION DATED: Feb. 24, 1987 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 14587 Z ~o~e ...,....'~.o~,...~ ................................ , County Tax Map No. 1000 Sect,og' .............. 0 .~.. ...... Block ...................... ~:D~ Lot No.....~ ................. cation dated ~~.....~..~.. ........... , 19.~,...~.., and approved by the Building Insl)ector Rev, 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N,Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE 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 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 Enginber 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: 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 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 Dwellin§ $25.Q0, Accessory,St0.00 Buslness $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50-. 00 3. Cop¥ of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.updated C.O. $ 50.00 Date..../~.~.O;..~.~.j..~.~.? ...... NewC°nstruc%i°n ...... or Pre-existing Building ........... Vacant Land ....... Old House No, Street Owner or Owners of Property , ~ ......... ' ............. : ................. ....... .... ........ .... .......... Subdivision ................................. Fi~ed Map No ........... Lot No .............. Health Dept Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... , ................. Constructio~ on above described building and permit meets all applicable codes and regulations. Applicant . . .~/..~.. ,~..., ~-~..~/~. ,...~;..~%,~ ........... Rev. 10-10-78 t~OOOlO7~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ..,~ - ~,.,~.,~.~.~.~,,. 4~s~2/~6 N 793831 John Berta~i Builder~ 12250 Soundview Ave, (&Booth ~d.)Southol~, N.Y. examined on February 9 ~ ] 9 8 7 and found to be it co. plibnce with the rettt~iret~tents q( this Board, FIXTURE OUTLETS 26 DRYERS RECEPTACLES 47 SWITCHES 36 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT SYSTEMS NO. OF FEET OTHER APPARATUE' G.F.C.I.-I~ Smoko DetectorS-3 R V I C AWG CC, COt'ID, G & S Electric Box 2]5 Southold~ N.Y., 1197]. GENEEAL J~NAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectoi's may be identified by their credenfia)s. COPY FOR BU!LDING~. DEPARTMENT. THIS COPY, OF CERTIF,ICATE.: K'RJST; i~OT, BE ALTERED· IN ·ANY MANNER. HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 755--3690 inc. CERTIFICATION Building Permit No._~5_8_7~ ........ Owner_~o]ln_~r_tani+_QO_~mund_vim~_v~outhold Plumber HenrZ J. Smith & Sonz_~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this _2~th_day of _F_o~m~r~v .... , 19 87 Notary Public, Notary Public Suffolk County NOI'ARY PUBHE. S~.t¢ o~ !%,¥ %':~t~ ~'IELD INS[~ECTION ,'OUNDATION ~'OUNDATION /~(2nd) ~OUGH FRAME & PLUMBING 3 o ?NSULATION PER N. STATE ENERGY CODE FINAL COMMENTS ADDI ;AL COMMENTS: 7GS-~,802 BUILDING DEPT. INSPECTION i~FOUNDATION ~ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ]FRAMING [] FINAL REMARKS: ~ ~)r-~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION IST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL DATE INSPECTOR 7GS-'~SG2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS:. DATE 9~.~./(~ i N spECTOR ~2~ / / ~///. ~,~'~/~c~*~ BUILDING DEPT. INSPECTION FOUNDATION IST [] ROUGH PLBQ. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING FINAL 765-1802 BUILDING DEPT. INSPECTION [~] FOUNDATION 1ST [ ] ROUGH PLBG. [~FOUNDATION 2ND [ ] INsuLATIoN [ ] FRAMING [ ] FINAL RE:MARKS: /)~//a,~ - ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,~'INAL REMARKs: DATE // '/ INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180~ Examined . .~...°-'3~.....2T. .....19~..{9. Approved . ./TQgv~eJ~...~. ..... Permit No. Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERIVIIT IBLDG. DEPT. __'m~, m ~,OU~0to,, -- 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. · .{.I0 ho. ~.e~,.,rm~...~..~.. !~..~c..~.,..~. .......... (Signature of applicant, or name, if a corporation) ....o.¥C ~/.oo.t¢. !..~.~,.&.~. .ol~. ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... Ja ~.~ .i ~e~ ............................................. ' Nme of owner of premises ...... .~. '].0 h ~.. /' ................................................ (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 License No.. ]~.'.~.~t,~. ........ Electrician's License No. Other Trade s License No ...................... 1. Location of land on which l~roposed work.will be done../, ........................... ' .................... .................. .4-6.0. ........ ~.o.o.v~.., E~. .................. ~ o.m~o/.¢~.. .............. House Number Street Hamlet County Tax Map No. 1000 Section ~./ Block F 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. Intended use and occupancy .... 0. O.e-~. DD Does proposed construction vi( Will lot be regraded ........ Name, of Owner of premiss Name of Architect Name of Contractor,~ 10. 11. 12. 13. 14. 3. Natureiofwar~(ciIl~ich applicable): New Building ...... Addition .......... Alteration ......... R ;~ i: ' . . ' epmr, ... ~l~ ~ ][ ~[~Rem~al ........ Demohtlon ......... Other Work ............. , l '~ (Description) 4 Estimated qp~J;"~" "~'~/~"7i O~ ' Fee · [~ ~'~ '1(~ ............................................................. , *'~ (to be paid on filing this application) 5. If dwelling, number of dweliinglunits .... ......, ..../ Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commercial or mix{d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing strnctur~s, ifany: Front ........ _.; ..... Rear .............. Depth ............... Heigh~ .... Number of Stories . ~ . ~ . . · . L . ' ~ ~ . ' .................... ~"~:$ }' 2 $]'',It Dzmenaons of same structure w~th alterations or ad&tlons Front .. ~z.; ~ ~ ~r.. De"th ~,.~-.x-~" ; ._,_~. ~ .. - ' .... }' ' ' · -- ............ I; · · ,,,,,~,x . .u ............ },.. ,. r, lumoer~Llllzlz~s ...... /... ;-.w ......... 8. Dimension.s~p~'A,~tire new construction: Front ..... g .¢.k£~ .~4 Rea~¢,~¢_., Depth ....-r~;..~f..~. .... Height .~W(~7. 4. . . Nm abet of Stories .... /. './.~. ................................................ /~.o /.~ ?. pth /. (/z.3.. Size of lot: Front ...................... Rear .................... De .................. Date of Purchase ...... t.// ~ ~.. i .................. Name of Former Owner .~¢.' ,tv, .~ ...................... Zone or use district i~ which premises are situated . ~ ............................................... late any orang law, ordinance or regulation.., t~ ~. ........................ ..~ ~..~. · ....., ........ Will excess fill be removed from,premises: Yes (~2 ~ bta /~ ¢C ~r4~ : ..... Address .$Y~]qol~/.~d,~fq~.~?P'~one No. Z~d.,I;q.~/ ....... : · .L:~2 .s-mC. ·.. :~... Address (DO., ~-, ~Cd,~.~./¢~... Phone No. W$.'2.'¢M;y-) ...... 3o.o,. ~a.,.l~4~. 4~O¢~.. Addregs ~,(..C9/.o.g,[-Y/~4 ~k~. ,. · Phone No. 7.6A7-. cl.,~'.~. ...... PLOT DIAGRAM Locate: clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc¢ number or description according to deed, and show street names and indicate whether interior or corner lot. ~'OagA~-~ d.~e> ~ -- S.S .......... t. ~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. He is the ~Z) ~OO~'~' i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dgly 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 man,er set forth in the application filed therewith. Sworn to before me this ........ i ..... 2~ .day ~of , Notary Public, . .............. i ........ 6q~'/'~'~°unty ~fal~l~llt~li'li~ll~ ~ ~, ~ d~_~ (Signature of applicant) ~ 0 I.- /? [.0o ~ SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y [000 054 07 - 08 SCALE I" = 30~ dUNE 6 , 1986 N.Y.S. LIC. NO. ~~ ~ ENGINEERS , P. C, . P.O. BOX 909 MAIN ROAD SOUTHOLD, N.Y. 11971 49668 P~epared in ac;ordance with the mtn;mum standards for title suweys as establisl~ed by · e L.I.A. LS. and approved and adapted ~r such ¥*e by ~he New York State ~c~ . Title Association. 86 - 15 2 B SUFFOLK G,OUN'rY HE. ALT, DEPAFffMENT~O~ ~INGLE .FAMILY I~IIV.E. LUNG ONLY ,~.(~' H.D. I=~F:' NO,.-:-" '.;:'," ~'~ -~t1'., .......... THE 8EWAOE I~! PC~AL AND WATER SUPPLY FACILITIES FOR THIS LOGATION HAY1 tlEEN INSPEGTED BY THIS DEPARTMENT AND ~ ?O ~ ~ ~ff ' - - S U R V E '~ OF PROPERTY SOUTHOLD )F SOUTHOLD SUFFOLK ~OUNT¥, N.Y SCALE I" - 30I JUNE 6, 198'6 NOV, 7 , 1986 ~.~.S. CIe. ~0. 4~8 ' ~51 ~~020 the L, I, ~ LS, and appmv~ and adopted P.O. BOX 909 , for ;u~ ~ by The New York State MA IN R 0 A D Title Association. 50UTHOLD~ N.Y.11971 r LE PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT 'EX 'EED 2/10 of I% LEAD. OCCUPANCY.OR USE IS UNLAWFUL WITHOUT CERTIFICATE oF OCCUPANCY T d r~ . 8'6" GR~I~NPORT. N V I]944- , ]Lo h 1 ri, -r imi Lr