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Home My WebLink About14394-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. z14742 Date August 1, ...... 19.86. THIS CERTIFIES that the building "One family dwelling Location of Property /+20 The Crossway~ East Marion~ New .York County Tax Map No. 1000 Section 03 0 .Block 2 .Lot 1 0 6 M/o Pebble Beach Farms 6266 39 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 10, 85 14394z ..................... , 19... pursuant to which Building Permit No ...................... dated October 24, 85 ............................ 19..., 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 ......... One family dwelling The certificate is issued to Joseph P. & Barbara Carlozzi (owner, ~,~I~X X of the aforesaid building. Suffolk County Department of Health Approval 85 - 5 0 - 11 1 UNDERWRITERS CERTIFICATE NO. N 7 4 6 7 0 9 Plumbers Certification dated: August 1, 1986 .... Building Inspector Rev. 1/81 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y; BUILDIHG PEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 14394 Z Permission is hereby granted to.~____ ~ , ~ /.~ ....... . ,~,.././....~..~.z~~.....6~,¢~/o ~ z ../...~.. .~....z~rm'..... ..................................... .... ~~~.....~.,..~....zz.~¢ ,0 ...... &~c~2Z~.~.~..~ ....... ,~. ...... ~.~......~.~.~.~ ............. _J.. 0, ~,,~,,, ,~,,ed ~, ...~.~.....~.~.~.~.~..~.....~.~.~-:..~za~/~-'/ County Tax Map No. 1000 Section ..~...~ ........ Block ...C)..~... ......... Lot No../..~.~. ........... pursuant to application dated ..,~..r~..: ...... ~..~. ......................... , 19 .~¢>....Vand approved by the Building Inspector. Fee ~ ~"'~... ~'~-~~ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall [~outhold, N.Y. 11971 APPLICATION FOR CERTiFiCATE OF OCCUPANCY Instructions in duplicate A. This application must be filled in typewriter OR ink, and submitted V co ~he Building Inspec- tor with the following; for new buildings or new use: 1. Final survay of property with accurate location of all buildings, property fines, 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: 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, occupancv and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to preoare a certificate. Fees: 1. Certificate of occupancy $§.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date .......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. ,/ Location of Property ................ House No. Street x Ham/et County Tax Map No. 1000 Section .... ~2..~....O. ....Block .... ................ Subdivision .~..~'...v ........... Filed Map No..~..~..~.~.. J_ot No. Permit Date ................... Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Finat Certificate ....................... Fee Submitted $ .~..' ..0...c2 .................... Construction on above described building and p.c~mit meets/~ll apl~licable code%and regulations. Applicant " . Rev, 10-10-18 CoZ- Iq TqP~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P,O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.__ Owner ~C_~) ¼ (please print) Plumber ~O~q~ (please print) ~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this Notary Public,~.County -- ' (~umger' s signat~fre) BARBARA STE~WSKI N~aW ~bl~, State ~ New York No. 4~752 Qualifi~ in Suffo;k Coun~ ~ ~mmi;s~o, E~res March 30, 19~ Notary THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date A[)'~l~ ?,,[T~,[9~6 /Jppllcation]~o. onfile $79724/86 THIS CERTIFIES THAT N 746709 only the electrical equipment as described below and introduced by the applicattt named on the above application number irt the premises of Joseph Carlozzi~ Crossw~y(2nd o~ Rt,) (Pebbl~ Beach Dev)~ ~as't Marion, N.Y~ in the following Iocatiott; [~ Basement was examinod on April 21.~1986 FIXTURE OUTLETS RECEPTACLES SWITCHES 45 26 DRYERS FURNACE [] 1st Fl. ~ 2nd FI. Section Block and found to be in cotnpliance with the requiretnents of this Board. Lot FIXTURES RANGES OVENS EXHAUST FANS TIME CLOCK! UNIT HEATER.~ MULTI-OUTLE1 DIMMERS SYSTEMS NO. OF FEET FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT, OTHER APPARATUS: G.F.C.I.-1 Smoke Detectors~ S E NO, OF CC. COND, PER ,~ R OF CC. COND V I C NO OF HI-LEG OF HI-LEG OF NEUTRAL G ~ S ~lectric Box Southold~ N~Y~, GENRRAL MAN~GIER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ideni~[fied MANNERS. :OUND~TION (1st) :OUNDATION 2. (2nd) [~OUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: ',, ~~ ~. ,, 765-1802 BUILDING DEPT, INSPECTION,,. · ~ [ ] FOUNDATION 1ST [ ] FOUNDATION ZND [ ] INSULAT FRAMING ROUGH PLBG. ION [ ] FINAL REMARKS: DATE iNSPECTOR 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. \ / [ ] FOUNDATION 2ND [/~ INSULATION [ ] FRAMING [ ] 'FINAL REMARKS: INSPECTOR :: .- / ,:: y 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG., '~J~F~O'UNDATION 2ND I' ] INSULATION FRAMING FINAL REMARKS:, //~ ~'~ DATE / i NSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH pLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL / REMARKS:,,, 76S-1802 BUILDING DEPT. INSPECTION 0UNDATION 1ST [ ] ROUGH pLBG. [ ]'~OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL ,REMARKS: DATE, ! ~ INSPECTOR ,~/\ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 1985 i - eLOe. OEPT. I ' Or somom,,,,,,,, Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 'Jets 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- cafion. 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 construcfion of buildings, additions or alterations, or for removal or demolifion, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necesi~7, i~~..~_0..~7~:~ ................. ( S~.i~um t6 frtapplicant, or i~alh e,~ vc'~! if a corporation) .... (Mailing address of apph'chnt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ........................................ . .................................... - (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...[~q B..g~ ,9. ~-- ............ Plumber's License No. t~l~,O~o~J ~.~ o~ Electrician's License No. DtO [~4~otl/M ~,, ~,./ 1. Location of land on which proposed work will be done..~.~.~ ~..{'-~.....~..~.~..~.L. f ./1..~..t~. 5 ................. 9... ............... ......... House Number Street Hamlet County Tax Map No. 1000 Section ..... ~. ~. ........ Block .... ~ ............ Lot.../~ ~ ........... Z Subdivision ..................................... Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constmcfion: a. Existin~ usc and occupancy ..................................................................... b. Intended u~ and o~upancy .................................................................... 3. Nature of work (check which applicable): New Building ...[,~.'. .... Addition ! ......... Alteration .......... Repair .............. Removal .............. Demolition . ........ i .. Other Work .............. (D riptl ) e$c on 4 Estimated Cost Fee ~' (to ~e paid on filing this application) 5. If dwelling, number of dwelling units / ............... Number of dwelling uOits on each floor.. ! If garage number of cars ~ ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 Dimensions of isting structures if any: Front Rear ' Depth Height ............... Number of Stories .......................... i ............................. Dimensions of same structure with alterations or additions: Front i Rear Depth ...................... Height ...................... Number bf Stories ...................... 8 Dimensions of entire new construction: Front Rear " Depth ~eight ............... Number of Stories ......................... ; 9. Size of lot: Front.. .................. Rear ..................... ~ Depth ..... ................... lO. Date of Purchase .. '~/.t~ .................. ' Name of FormerOwner~r'..~/[FbZ~.s 11. Zone or use district in which premises are situated ........ ~ .............. i ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .. i~.0 .......................... 13. Will lot be regraded .......... ~ ............ ,~ ...... ~/~ll exc, css fill be rem.~J~d from premises: Yes 14. Name of Owner of premises ~a£~.~ .~. ~,~P./l.~../t..IZ~. ?A"fi~['[ss [¢...o...l~.q~..~. J, i~.~..~.... Phone No..'/~'.~': ?.log. Name of Architect .... .~ ...................... Address ............. i ..... Phone No. h,?'oo .... Name of Contractor.. [.5.o. ~. ].C~ .~..~. .......... Address ............. ~ ...... Phone No. '". ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. lndicate ail 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. Notary Public, HELEN tL DE NOTARY PUBLIC, ~de ot New Ne. 4707878, Suffolk Tm'm Expires l~mh STATE OF NEW YORK, '~--'S78-' ........................................ COUNTY OF ................. ................................................. being duly sworn, de )oses and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, et~.) of said owner or owners, and is duly authorized to perform or have performed th~ 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 manner set forth in the application filed therewith. Sworn to before me this ? RODERICK VAN .'.'~YL P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPR6VAL~ H, S. NO. ~ STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLI~.EO.yDF-JPT. OF~ HEAL];~iSERVICES. ~ 117 ~attituck,' N.Y. 11952 SUFFOLK COUNTY DEPT.' OF HEALTH SERVICES -- FOR APPROVAL OF co.s .uc o, o. v APP"OVED: I SINGLE FAMILY DWELLIN~ SUFFOLK CO', TAX MAP DESIGNATION: DIST. ~CT. ~OEK PCL OWNERS ADDRESS: ' - - _. ' .,x.1/Kt,%1 --- 5t 2EE. ~ DEED: L. ~/,k TEST HOLE STAMP SEAL FOUND TO BE ,SATISFACTORY.. / / ~:- ! ,, ' ~.r~.,,. &.,.C~. ~.. ! a"fof Wa~tewa[er :l~t~a-" ' ~e~ent ~ti~. .....J t / RODERICK VAN~.T..UYL P.C. ; LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. SUFFOLK COUNTY DEPT. OF HEALTH 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. APPLICANT SUFFOLK COUNTY DEPT· OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONlY DATE: H. S. REF. NO.: APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWN£RS ADDRESS: DEED: L. xJ/A P. TEST HOLE STAMP 21NGLE FAMILY ~.O~ ~F. NO. z~ ' ' . ' ' ' ' : ' , :" , ' '" ", CErTIfICATE__oF__OCCUPANCY, , , , , , ~' ,, : - ,, Ifcopp~r~tu~m~ ~q 9sed ,,, ,. : , ' , ,, ' ' ,- ': ]~ : '' ." , 765 :1802 9'A~TO~ p~FO~H~ ' ' ' ' ' ' ' ' ' ' .... :"' ~ ':' ~ LEO INS CTIONS: ~' , , .- ' FOUNDATIQN .~O REQUI~ED . ' : , , , , o ~az~N~ PE : ' : ':' ~' ' ' J FO~ pOU~ED CONCRETE ~ '. ,, , , ' ; ,' :: ' " :' , : ". ':, ' ~. ROUGH: ~MING, & PLUMBING, ' t]: :, :' ' ............ '": "'' ~' ' : ' 'a' ass "' "' ,.' ' ' : "" '", 4. FINAL- C~NSTP. UC~ON T ' ~ ' ~ ' ' ' HALE MEET ' ' '' ;ALL CONSTRUCT ON S ' ' ' '; ~HE REQUIREMENTS QF THE-N,.~; ' "- ' STATE CONSTRUCTION & ,ENERGY' ' , "' ' ' " ' ' ' ~ ' CODES NOT RESPONSIBLE FOR '' ' DESIGN OR cONST~UCTION E~RORS -,.'., ... . , : : : ,, :'. :,,:::, ,.", / ~75 Jr ~;,~