HomeMy WebLinkAbout14661-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...~1~.3.8.3.... Date March 18, 1987
THIS CERTIFIES that the building ...S.t. 9.r.a.g .e..b.u. ~..1 .d.i.n.$ ..........................
Location of Property 540 ROCKY POINT ROAD EAST MARION
l~l~s~ ~o: ....................................... Street Ham/et
CountyTax Map No. 1000 Section . .0.3.1 ....... Block ....0.2 .......... Lot 22. 1
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit hereto, fore filed in this office dated
....... ¥.a.r.c.h...9.,...l.9.8.6 .~ pursuant to which Building Permit No. . .1.4.6.6. ! .Z .............
dated ...M.a.r.c.h...I.7.: . .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 .........
..... ~.r.s.e.r.y..s.C. 9 .r.a~.e' , .b.u,i. 1. d. ip~: .............................................
The certificate is issued to WALTER & LINELL GAIPA
..................... ?oY.'e;, ......................
of the aforesaid building.
Suffolk County Department of Health Approval ........ N../.A ...............................
UNDERWRITERS CERTIFICATE NO ................ P..e .nfl.~. n. g ..........................
N/A
PLUMBERS CERTIFICATION DATED:
I of 2 needed
Building Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. ZI6050 Date August 14, 1987
THIS CERTIFIES that the building .... 9.~.~.~.K~9.u.s.~ ..................................
Location of Property .. ?. .0 . .R .O .C .K .'( . .P .O I N T ROAD EAST MARION
House No. ' ............... 'S'de$i ....................... h$/dei
County Tax Map No. 1000 Section 9.3.I ......... Block 02 .Lot 22.1
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
March 9, 1986 pursuant to which Building Permit No. 14661Z
dated ...l~.a.r.c.h..1.7.,..1.9.8.6 ............ 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 .........
.... gr~php.u~.e ..................................................................
The certificate is issued to WALTER & LINELL GAIPA
..................... ?oYnbgT~~xxx'~ ..................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. N799609 March 23, 1987
PLUMBERS CERTIFICATION DATED: N/A
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLk-1'ION OF THE WORK AUTHORIZED)
N.o 1~661 Z
Permission is hereby granted to:
...~.~...x.......=...~.%.. ............................................
.,..~...~.~.~...~.:..'rl.:..J.L~.~..fl...
to ..... ~ ........... ,~ ........
at pre,,,i~e~ Io~te~ ~,....~'..~.~ ....... ~.¥..~.~.,....~,.....~.~.~.~ ............
County Tax Map No. 1000 Section ...... ..(~.....~..] ........ Block ........ ,~..,.~m'.. ..... Lot No.....'~..,~....L.I .........
~ursuo., ,o opp,co,~on doted ......~...o~....cJh.~! .................... , ~9.~.~., and opprov~d by ,he
Building Inspector,
Building Inspector
Rev. 6/30/80
TOWN OF $OUTHOLD
Building Department [l'\\
Town Hall [ ~ ~ ........... * ;'
Southold, N.Y. 11971 Tr~\?' ;~ .....
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY ~, ~ 7
Instructions
This application must bo filled in Wpewritor O~ ink, and submi~ed ~ ~ to th~ ~u[Idln~ In~ec-
tot with tho following; for new buildin0s or n~w us~:
1. Final su~eg of pro~ertg with accurate Iocadon of all buildinfls, pmportg lin,s, streots, and unumal
natural or topographic
2. Final approval of Hoalth Dept. of water su~plg and sewerage dis~osal-{S-0 form or oqua0.
3. Approval of eloctrical installation from goard of Fifo Hnde~riter~.
4. Commercial buildings, Industrial buildings, Multiple ~es[doncos and similar buildings and
tion% a cortif[cato of Codo complianco from tho ~rchiteet or fincneor rosponsible for the
5. Submit Planning Boaffi 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 p]Coperty 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~ $25.00, 'Accessory ,,$ t0.00 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.Oo $ 50.00 Date .... ~..~... //~?..~. ....
NewConstruction ..... Old or Pre-existing Building ............ Vacant Land .............
House No.
Owner or Owners of Property ................ ~./~..~. ........................
County Tax Map No. 1000 Section .... ~..~. / ...... Block .... ~.~ ....... Lot .... C~.~.o. Z/. ....
Subdivision ................................. Filed Map No ........... Lot No ..............
-- /x~8~L~/¢~ ¢~ ;~ -- /
U nde~riters Approval ~ .'::~ ~ ~.' .Pla~Board Approval .~/~ ...............
Request for Temporary Certificate ..................... Final Certificate ... ~ ...............
Fee Submitted $ .................... ..,/~ .....
Construction on above described building ~: ~Tplicable codes and regulations'//
Rev 10 10 78
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765CERTiFiCATE- 1802 OF
APPLICATION
FOR
OCCUPANC~.
This application must be filled in typewriter OR ink, and submi~ed ~ to the Building Inmec-
tor with the following; for new buildings or new use:
1, Final su~ey of property with accurate location of all buildings, pmpe~y lines, streets, and unu~al
natural or topographic fea~res.
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 Unde~riters.
4, Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and in~alla-
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:
1, Accurate survey of p~Operty 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 code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00
1, Certificate of occupancy New Dwelling. S25.0.0, Accessory.,~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 $10.)00/
5.Updated C.O. $ 50.00 Date .......................
NewCOns truction ...... Old or Pre-existing Building ........... . Vacant Land .............
Location of Property..L.~'-'~.... ~ .~.~...~... X?.¢~..'.... ~. ~.~.~. ...............
Owner or Ownars of Property . .~..~.~...'~'...~.~..~...~..~.4 .~?. ........................
County Tax Map No 1000Section /~,,~'~? b.'.~.. Z~-~ ]
............. Block .......... Lot .............
.Filed Map No ........... Lot No ..............
Permit 'N°./~*./.: .~.:: ';;t:':;A,/,,~ ;:r'r~ ,~ '~2~:: .Applicant .............. ,,,~ .................
Health
Dept.
Approval
.... t.~l.~ .............. Labor Dept. Approval · . [~.. ...............
Unde~riters Approval .... ~ .Planning Board Approval)/~.~/~. ................
Request for Temporary Certificate ..................... Final Certificate .. ~ ...............
Fee Submitted $ .............................
building and per~e) all_a~pp~l~le codes and regulations.
Construction
above
described
Rev. 10-10-78
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
March 17, 1987
Walter Gaipa
Box 247
EAST MARION,
Dear Mr. Gaipa:
I went to do the C.O. FOR B.P. #1466tZ which
you brought in yesterday.
I noticed on the original Building Permit that
Victor had written that it would require 2 C.O.'s.
Please fill out the second application which I
am enclosing and return it along with another
check for $10.00. Thank you.
Yours truly,
Secretary
FIELD INSFECTION
FOUNDATION (1st)
FOUNDATION (2nd)
COMMENTS
ROUGH FRAME &
FLUMBING
INSULATION FER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
Z/
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[,,~~MFOUNDATION 2ND [ ] INSULATION
lNG [ ] FINAL
REMARKS:
DATE
iNSP£CTO~~'/,~
765-1802
BUILDING DEPT,
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS'-
DATE ~./ INSPECTOR
//
7GS.'180~
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING
[ ] FINAL
1'6S.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[] FOUNDATION ZND [] INSULATION
[ ]FRAMING [ ]FINAL
'
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~ 85 JOHN STREET. NEW YORK. NEW YORK 10038
March 23~ 1987 459098/87
THIS CERTIFIES THAT
only the electric~J equi~ent ~ ~s~rlbe~elo~ a~ int~dq~d ~y ~pp~nt ~q~ o~ tb~ a~ve application number in the premises of
FIXTURE t FIXTURES
OUTLETS ECEPTACLES SWITCHES NCANDESCENT FLUORESCENT
7 3 6 6 1
DRYERS FURNACE MOTORS
RANGES OVENS DISH WASHERS EXHAUST FANS
TIME CLOCKS JNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SRRVIC~ DISCONNECT
S E
NO OF CC COND
OTHER APPARATUS~
3-G. F. C. I
Electric Room }Iea.1;ers; l-l.5~v~ 1-1.0kw
R V I C
3/0
E
OF NEUTRAL
3/0
Mark ~{ap~
19 Woodcock Izine
East llampton, N.Y. 1].937
Lie. 2678E
Per_ il
~ BUiLDiNG DEPARTMENT. TH S CO~ OF CERTIFICATE MU~T,HOT BE ALTERED N ANY
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
NUR'$EI~V
4X'¢
Post
J
~, bv
AX~
..~
0
' ',,A/A R E HO Ll~'3 ~:
0.04 5PD/ ¢-O.E OF ~LD6. AR~A
0. o4 ~ I~o0 ~0 ~PD
~00 ~AL. ~l~ WALL AREA
NOTES:
I. SUFFOLK C.O TAX MAP
BIS'[. lO00 SECT. 031BL.O
~'. AREA:
3-0 = PiPE
SITE PLAN
PREPARED FOR
WAL'TE
AT EAST
TOWN OF
SUFFOLK
R GAtPA &
MARION
SOUTHOLD
COUNTY, NEW
LINELL
YORK
GAIPA'-;
NOTE: "PfJF~dANT TO PART 621, UNIFORM ~:)C[DURES ACT, I ,~/ALTER GAIPA _ ~RESY CERTIFY THAT T. HERE
'~LL NOT BE ANY INDUSTRIAL OR 0t'RE~R WASTE: DISCHARGE' FRO,M ~E ~UILDt~ ON THESE PREMISS
SIGNATURE
DATE ~]~ , '
Examined..~ov~.& .).-I . .
Approved .~odl,~ .~.l..
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
., 19~¢. Permit No..I.q.~..~.)..~..
Disapproved a/c ..................................... ~
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ~ March 9, 1986
· , :~[hJ[Zl~2,~ ~ INSTRUCTIONS
a. This application must be cqn~t~e*~t~. ~J~l.e~?.c(~.i~ bY Wpe~riter or in ink and submitted to the Building Inspect°r, with 3
sets of plans, accurate plot plan to$~. ~rO~$.to schedule.
b Plot ~lan showing locati~ 6[-l'ot~ of bhitd~gs on premises, relationship to adjoining premises or public streets
or areas, andgivhg a det~led ~cr~r l~??t of property must be drawn on the diagram which is pa~ of this appli-
cation. ~-" ~ -. ~'~ ~ ~.
c. The work covered~b~U~g~n ~y not be commenced before issuance of Building Permit.
d. Upon approval Of~s hp~li~B~i~g, ~hd Building Inspector will issued a Build~g Pemit to the appUcant. Such pemit
shall be kept on the premises available for inspection throu~out the work.
e. No build~g shall be occupied or used in whole or in part for any purpose whatever until a Ce~ificate of Occup~cy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a Building Pemit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other a~plicable Laws, Ordnances or
Regulations, for the construction of build,as, additions or alterations, or f~r removal or d~olition, as here~ described.
The applicant agrees to comply with all applicable laws, ordinances, bufld~g code, housing/code, and regulations, and to
admit autEorized inspectors on premises and in bulldog for necessa~ inspe~s~/_ ~ ff ,
(Sig~l~ if a corporation)
P. 0. Box 2~7 ~sg Marion, N. Y. 11939
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
OWner
Name of owner of premises ....W.a.13.e.r..a.n.d..L.i.n.~.l.1..G~. ~.p.a .......................
(as on the tax roil 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 ...................... - ~
Location of land on which proposed work will be done ..................................... . .' ...........
~-~0 Rocky Point Rd. E~st Marion, N. Y.
House Number Street Hamlet
County Tax Map No. 1000 Section ....... .~.1 ..... ~ ....Block ..... 99.2 .......... Lot. 22.1
Subdivision ..................................... Filed Map No ............... Lot ............... (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction: vacant land
a. Existing use and occupancy . ~~
b. Intended use and occupancy N~ation with storag, e building , greenhouse, fenci ~g
and sign
-8.
10.
11.
12.
13.
14.
Nature of work (check which applicable): New Building ....X.X.X. i.. Addition .......... Alteration : .........
Repair .............. Removal .............. D~molition ......... ~.. Other Work ............ i...
i (Description)
Estimated Cost $15,000.00 ' F 'e $25'°°.
- (to be paid on filing this application)
If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ........ i ....'...
If garage, number of cars ............................................ i ...........................
If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use ................
Dimensions of existing structures, if any: Front....n.o.n.e ........ Rear ... ~. 'D~;t'h i ..............
Height ............... Number of Stories ............................ i ...........................
Dimensions of same structure with alteration~ or additions: Front ............ !. :... Rear ..................
Depth ...................... Height ............. Number of Stories
· · ; · 0' 0' ...... 6' .........
Dimensions ~z entire new construction: Front ... ~ ........... Rear ..... 3 .. i. . Depth . .5. ...........
6
Height .. . } Number of Stories .... o.n.e.. .
' 10 ' ' .............. ' .......... ¢ ..............
Size of lot: Front . 0 Rear 75 De,,t~
Date of Purchase ' ' ' '2'/2'~/8'6 ' ' ~J ....]~ ',-' ..... 2 ..... I v '~le'~lSe'~f 'M~/rkl~I .......
.............. ; ............ [ ......... ~ame o[ o r .; .............
Zone or use district in which premises are situated ?.esi~enr~aiJA~%rus~~£az ...........
Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ....n.o. .....................
Will lot be regraded ........ .n.q ................. Will excess fill be removed ?om premises: xx~l No
47~-0462
Name of Owner of premises .... Walqe~..& L. Qa~t~aAddress I~.~eview Ter. iE.. ~0l~No ................
Name of Architect .......... ~.a. nle..~ Ab. qv.q ....Address ................... Phone No
Name of Contractor...... . ..........same as a.b. qxe' .... Address .................. .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.
see attached
STATE OF NEW YORK, S.S
APP~OVE.~ AS NO'lrFa~
D~TE: : _
~OTI~' B~LD{NG DE?A~ITMEhIT
7~5-1802 ~ A~ TO
FOLLOWING INS, ECIIONS.
FO~ ~OU[~ED CONC[~'rt '
',3, iNSU~ATION :
(~E cOMPLETE FO~ C
~ODES. ~NOT [~SFONSflM.E FOR
application; that all statements contained in this application are true to the best of hlslknowledge
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
COUNTY OF .................
.......... A ..... ,j, :. ,;.., ........................ being duly sworn, depos ~s a.n'/~d~, ~.~.~l~,.~.[tLh~ Hs~the applicant
u~ame o~inaiviauai signing contract) .:~ ~. i~ /~'"
above named. 1[~/ ~ [ ~ ~
He is the ....................... 11~%... ~i I i [
(Contractor, agent, corporate officer, etc.) ~ ~):~'~ ((~ { ~[~[
of said owner or owners, ~d is duly autho~zed to perform or have perfomed the sdi~~a iile'~his
and belief; and that the
(Signature of applicant)
, , . ~/~
., ,
765-180~ ~ ',,~ -rO '....
~Hnu,~,, : ~ ~M ~R THE 'U ~ ,~ ,
ONS:
2 ROUG~ "' ~G ~ mH,..~ ~ ' ~ ,
3, INSU~,, - ...... mING
4 FNAr ~ 'u~ ~n ..... [
ALL CON~T~ ~'... /
~ATE CO~ST~ 'nON ~ ~N~V '
~: ' ~ ~ = ~ ~ , ~ ' ~ r
,,' ~ "~ :, .~ , , ~ ......... .,~,, ..... r-- ~ ~,,
'