HomeMy WebLinkAbout14059-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22320
Date MAY 12~ 1993
THIS CERTIFIES that the building_
Location of Property 970 WEST ROAD
House No.
County Tax Map No. 1000 Section 110
Subdivision
ADDITION
CUTCHOGUE~ N.Y.
Street Hamlet
Block 5 Lot 45
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 17, 1985 pursuant to which
Building Permit No. 14059-Z dated JUNE 19~ 1985
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 FOUNDATION~ DORMER ADDITIONS & 1st & 2nd STORY DECK ADDITIONS
TO EXISTING ONE F~MILY DWELLING AS APPLIED FOR.
LENNY& LEE INFRANCA
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-746043 - APRIL 23~ 1986
PLUMBERS CERTIFICATION DATED JULY 29~ 1992-PECONIC PLUMBING & HEAT.
~ ' //uil~ing Inspector
Rev. 1/81
I~OB~ NO. I~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 14059 Z
Permission is hereby granted to:
.... ~.~_...~..:~.......u~.?....
~....~.~%.~.~...~...~i..~..... ................................
at premises ,Loted at [....C]J...~L..~..:.......~.....~..-.~..-....~.'.., ........ ~~~ .........................
· iiii~2.~i"i. ...~..ii'ii"~i~iZ~ZZiii. . . .. ...................... ......................i'"ii... .........iYZZZ.... . ......Z'Z""iZii... ....
County Tax Mop No. 1000 Section ........ ~.]...~.. ....... Block ....... .C~..~.~... ..... Lot No ........~....~..~.Z .......
pursuant to applicotlon dated ....... ~...~..~. ..................... , 19.~.~..'~, and approved by the
Building Inspector.
ee :a..,m~ ..................
Building Inspector
Rev. 6/30/80
ROSENTHAL & BURCHERI
290 OLD COUNTRY ROAD
MINEOLA, NEW YORK 11501
(51 6) 739-3220
FAX
739-0938
June 30,
VIA FEDERAL EXPRESS
Mr. Gary Fish, Building Inspector
Town of Southold Building Department
Main Road Box 1179
Southold, New York 11791
Re: 970 West Road,
1993
Cutohogue, New York
Dear Mr. Fish:
Per our telephone conversation, enclosed please find the
original certificate of occupancy. You have indicated that you
would add that the decks are also covered by this certificate.
In light of the fact that a closing is imminent, kindly return
the new certificate of occupancy to me in the pre-paid federal
express envelope provided.
Thank you for your courteous assistance.
RCB/cmp
encl.
Very truly yours,
Russell C. Burcheri
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O.. BOX 728
TOWN HALL.
SOUTHOLD, N.Y. 1197I
TEL. 765-1802
C ERTI F ICAT I O~
Permit No.
(please prznt)
(please print)
I certify thag the solder used
contains less than 2/10 of 1% lead.
in the water supply system
Sworn to before m~ this
FIELD INSFECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
2.
~ROUGH FRAME &
FLUMBING
INSULATION FER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [,,-']~FINAL
DATE
765-1802
LDING DEPT.
NSPECTION
[ ]FOUNDATION 1ST []ROUGH PLBG.
[ ]FOUNDATION 2ND []INSULATION
[ ]FRAMING []FINAL
REMARKS:
{ yos~7~-
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING ~INAL
REMARKS:
'DATE
INSPECTOR
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined....~..~.~..., 19 ~.~.
Approved .'.. ~ ~.u~,. ¥ .ck.., 19~.~. Permit No..~..~.~ .~.o) ..~..
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received
.7.., ~9~..x-'
Date
......... ,19
INSTRUCTIONS
a. This application must be completely filled in by Wpewriter 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, housin~g..~ode, and regulations, and to
admit authorized inspectors on premises and in building for necessary~nspections. /(
· ....
(Signature~of applicant, or name, if a o porat' )
· ....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
... ........................................................................
Name of owner of premises ... 0. · · ~ .... ~.~.~...~ ..................................................
(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.. ~..c~ .~.].t..~91 } . .
Electrician's License No.
Other Trade's License No ......................
Location of land on which proposed work will be done:,..~..~..~.[ ..... ~ .4.,~ ...............................
.... ' .... ...........
County Tax Map No. 1000 Section ...-'''l.[..(~). .......... Block ................... ~J'O Lot .(.).~.'~. ...........
Subdivision ..................................... Filed Map No ............... Lot ................
(Name)
Slate existing use and occupancy of 17hemises and intended use and occupancy of proposedconstruction:
b. Intended use and occupancy .... v. r.. ~' .\~ ............. ...
3. Nature of work (check which applicable): New Building ..... ' ..... Addition ......... Alteration .......
Repair ....... Removal ....
................ Demolition ......... ,~.,-... Oflaerqg/ork ...... ' .........
4. Estimated Cost .................................... ~2..~.) 60 ~ Fee ....................................
-~-~' ,x (to be]paid on filing this application)
5. It' dwelling, number of dwelling units ............... Number of dwelling uni'ts on each floor ....... ~ ......
If garage number of cars
6. If business, commercial or mixed occupancy, specff ture and extent of each type of use .........
_ . /, ... ~,. '/f ..
7. Dimensions of ~r~ti~ng structures, if any: Front .... t~' ...... Rear . ~ ~. ~ ....... Depth .~.... ~...
Height ..... l'. V. '.. .... Number of Stories.../ ' ' '
Dimensions ~f same st~cture with alterations or ad( Ins: Front ...' .& .~..' .... i ..... Rear,., ~ ~. [.. ........
Depth .r-~ 0/.. ~ ./ ........ Height ... '.'~..~ ., · Numberer Stories ../. ~f..-~ .....
8. Dimensions of ?.n~r~ new construction: Front...~. ........ Rear ... ~ 'fYi ....... Depth .~a. ?/...~....
Height ..... ]~. ~ ..... Number of Stories ........................ ! ............................
9. Size of lot: Front ...................... Rear ...................... ]Depth .......... .... . ......
10. DateofPurchase ............................ ~NameoLFormerOwner ~.~.~.~.~.:~.~0o~.~......
11. Zone or use district in which premises are situated,.. ] .~..~. £~.q ~"~c~.. ~.... ~ ........
12. D.oes proposed construction wolate any zomng law, ordinance or regulation: .............................
13. Will lot be regraded ...... t · '.:~c.' ~-- ............. Will ex~ess fi, Il be r_gmov~d from premises: Yes
14. NameofOwnerofpremisesgr.~.~.,.t.'~..ff~-~e_% Address~q.)~e;~.~ .~ Ph~,~
Name of Architect .......................... Address ........ ~. .....~ .... Phone No ......... ~: .....
Name of Contractor ~.~--.~..T.~ .%.. ~./o t<'-[.l.k ~,. Address. ~ .~-.~.~.q <~tt.~. · Phone No,7.~.(/,,
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and~ i~ dicate 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,
COUNTY OF ............ ..... S.S
................................................. being duly sworn, dep )scs and says that he is the applicant
(Name of individual signing contract)
above named.
He is the .................... ~ ........................................ ~ ............................
(Contractor, agent, corporate officer, etc.!
of said owner or owners, and is duly authorized to perform or have performed the iaid work and to make arid file this
application; that all statements contained in this application are true to the best of hi~ 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
,
Notary Public, .... . · · · . County
NOTARY eugllC, State o~ New Yoi'~ .............
NO, 4707878, ,%Jl01k C0ulI[¥ .a (Signature of applicant)
TeFra Exp,res March 30, 19~if ~