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Home My WebLink About14101-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that tile building one-family dwelling Location of Property ....6.2.5 ............. C. o..r.e.y..C..~.e.e.k...L.a.n.e. ............ .~ ?.u.g.h..o.l.d .... House No. Street Ham/et County Tax Map No. 1000 Section .... .7.~ ...... Block 4 .Lot 25 Subdivision..C. qr..ey. Creek Estates .Filed Map No. 4923..Lot No. 21 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..3.u.n.e...2 ~ ........... , 19 .~.5. pursuant to which Building Permit No, ~ 41 01 Z dated ...... 4q .1 y..2. ............... 19 .~.5., 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 ......... ,Qr~ ~e r y.a.m.S.Z~..d, .~.e.Z.Z.~..n ~... The certificate is issued to FRANK & PHILOMENA NICOLICCHIA ..................... jo¥o' 'r: dda' 2d 6'aCi ..................... of the aforesaid building. Suffolk County Department of Health Approval 85 - S 0- $ 5 UNDERWRITERS CERTIFICATE NO .... N 748262 Building Inspector Rev. 1/81 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) 14101 Z Permission is hereby granted to: ....... ...q. ...... ~. ....... ../:~./~. Z~..e.... ~.. ........................... ,o ..~.~.~.~.~....~.... .:.~.L~ ~...:~..4..:...~.c,......~/:.:. .................. ...................... .~../.& ~.c~.~.~.~.~ ...... ...~.~. c.~_/./...cc :.4./.~ .............................. - C,~.~ ,~ ot ~re~i,. ,~o,ed at ........ d~dz. ............ Cz.~.. ................... ~......d,...~r ............................ ............................................................................................................. .~Ooz~..oP.:.zL..:...W..,. ...... c~,m To~ Mo, ,o. ~000 Se¢,,on .... .?..~ ............. ,~ .....G. ............... ~t Na ..... &5..: ......... pursuont to opplicotion doted ........................................................ , 19 ........ , ond opproved by the Building Inspector. Fee $ ..,~t..'~. .............. Building Inspector Rev. 6/30Z80 f3 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ I~am~mm to the Building Inspec- tor with the following; for new buildings or new use: I. 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 instaila- 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 property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occapancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. Fees: 1. Certificate of occupancy $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 $15.00 Date....~...~..~/. J. '.~..~ .~.' .~/ ...... New Building ~'~ Old or Pre-existing Building Vacant Land Location of Property ......................... .~.o...v~,..H,L..~?O?.~..~. , ~....~. ...... .~.~.o.~?..~t~' .... House No. b'treet Ham/et Owner or Owners of Property . .~.C..~..~..~..~...~..: ?.~..~,~.~. ~ .... .~.'% .~,?.~ .%~ .~..~. ~. ~ ........... County Tax Map No. 1000 Section"~.~ ............ Block ?. ?} .... ....... Lot...~.~ .......... Subdivision ................................. Filed Map No ........... Lot No. ~.. ! .......... Permit No ........... Date of Permit .......... Applicant .~ ................................. Health Dept. Approval ?..~.~..~.~...~..~ .~..~' ........ Labor Dept. Approval ........................ Underwriters Approval..~..'.~ ~ .~...~..~..~ ....... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. ~L.~..~....v~..~. ~...~...~.. ..... Lonstructionon above described building ar~l~ermit meets~a~-~plicab. Je codes and regulations. ~[~/~ -- Applicant ~.....~...~..~..~ ........................ ·: ........ Rev. 10-10-78 TOWN OF SOUT OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit NO. Owner (please p~iht) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. / (~lu~ber ' s s.i~ure ) Sworn to before me this ~ day of k~h~t~'. , Notary Public, ~\~ . Co~unty ' E. R, WRUCK NOTARY PUBLtC,'Stat~ of New York No. 02WR4765955, Suffolk County I'r ..... e m Expires ~r,~ Notary Public ~,g5o2~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY I 85 JOHN STREET, NEW YORK, NEW YORK 10038 oato H~y 7,1986 ~lpplicatlonNo. o,tfile 364539/85 THIS CERTIFIES THAT N748282 only the electrical equipment as described below and introduced by the applicant named on the above application number itt the premises of Ralph Attenito, Corey Creek Lane, (Mare) Bnyview Rd. ~ 8outheld~ N~Y. i~t the following location; [] Basement [] 1st Fl. ~ 2nd FI. Sec£1on Block Lot 2 ~. ~vas examlned on ME~ l , ~ 9 8 ~ and found to be in compliance witk the requiren~ents of thls Board. EIXTURE FIXTURES -- RANGES OVENS OUTLETS 37 50 DRYERS SWITCHES 43 37 FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCK~ SYSTEMS NO. OF E EXHAUST FANS DIMMERS SERVICE' DISCONNECT' S E R ND. OF CC, COND. A. WG, PER ~ OF CC COND. 1 -2/0 OTHER APPARATUS: Special Rec'pt,-2.-20amp.~ 1-~0amp, Panelboards;l-Z0(cir.) 100ampa~ ~.F.C.Io-1, $~oke Detect:or~l 2/O Sky E~ectric Corp~ ~ · R~.04/Le~.s Rd~ E. Quogue, N.Y.~ 11942 GENEI~A/ MANAGER This certificate must not be altered in any manner; return to the office of the Board ~f incorrect. Inspectors may be identified by their credentials. t COPY OF ~ ~IEL% INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. I{OUGH FI{AME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE o FINAL C'OMMENTS ADDITIONAL ,MMENTS: MUNICIPAL TESTING LABORATORY, INC. f~l:~].::CJt.:~ [' Ixl/] ......... j...... ...... E] 160 LAUMAN LANE - HICKSVILLE, NY 11801 [] 7520 N,W, 82ND ST, - MIAMI, FL 33166 (516) 938-7120 (305) 884-3427 L;I, l I:f.]q'l: t~,.IAL, t..:]AAY C , ~1 ..t [:, I L,. ( t.h*d .................................................................................................................................. "~u'.'rF ;, '~...1' "l;'q I A'I" N: ). "t~t' ,.~Al,.ll..fl,t~ .I, ,.~,}~ :...::: ............. . ........................................................................................... ~..,~?;d . ~ .J~ .,, . . .~.=..: .............................................................. .............. E!~ff!~LQT.(..~ .............. EgpNDm' :~:~:~.t!. ~ " " ..... ,:- ::. ~' ~ : C '}..: -P ............................ D~:U.....~' V~:~:F~.) ~f..~. ~.:!g~L&~:L:?~.!=..]]~i~.~~ ~ ~ ..... , .~.:::..~..~:.:. F: UUtqDA I I Oht ....... 'y ;.:' ' · . W . - (%-IVI[{R l'li:.!.ii ........................................................................................................................................ ~4VEliAG :. L[}C',Af LON LIt-- IE,St St')t.FI-H t~{'~i..L.., t]F t%!OR'Ti-~ WALl.... 13F: I:'OIlND~\]' [1JIxl IZ~"f,:~ I' l/.~';~L.i.., i]F F'i31..IND(.~T T.[il',t ,,.:;i..llllH NAL.L. fiF FDLINDAT.i:L/Ixt I~II::i;S i' IJAtM... OF. I;'OUi,IL)?~ f .[ NO r'E .' REPORT RELATES ONLY TO THE ITE~ OR EX6gT LQCATIDN TE3TEgl ~ND ~AN ONLY gE RE?ROgUCEP ZN FULL1 NITH LA~ORATOR¥ ?ERM[SSIDN, ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 TOWN OF 'SOU~F)OLD Examined . .~. ..... , 1.9 ~ Received ........... ,1 9 · . · Approvedlg. ............... , 19... Permit No../.~./.~..~.~ Disapproved a/c ...... !~::: ~. .......... .(f~ ....., ..... ~y 2~. ,~ v.g,~ .................. ........................ ,~d... ~~ ,,/ / (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 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~-l)uilding code, h~wdl3g code~ and regulations, and to admit authorized inspectors bn premises and in bu, it~ing f~r~'fi~'~!~ns.p..ectionh State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ ............................................... Name of owner of premises .. ff.¢. ! .~. ?...?J~..Q-..~...~....q. ~..~.*.}?.. I..~..A..-~.~..~. .... ' .......................... (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.. [~.~.'~.. ? ............ Electrician's License No..~...~.~.'~. ;-..~.. .......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...... .... .e..o. .............. !.,. ....... House Num her Street Hamlet County Tax Map No. 1000 Section 7.$.~.~...~. ·..;. bb... Block .................. Lot ................... ~ .~. ........... '5 ...... Subdivision .Q~.. ~.~. . .~.:.x~. k .~.'~..~¢.~.' ~ ..... Filed Map No..~..~'.Z~. Lot ............... (Name) 2. State existing use and occupancy of premises and intended use an~ occupancy of proposed construction: ....... .~..l~,,.rq ~.. ~L~X.........~_..~. ~ .~..~ .~. j~..~..-"', ,~--,d .................................. a, Existing use and occupancy b. Intended use and occupancy ........ ~..'.h..~....~.?..~....~ ?. ~...~): .~..~.. !~..~2.~ ..................... 3. Nature of work (check which fipplicable): New Building ...... ddition .......... Alteration ........ i · 4. ted .............. e ........ ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... Number of d' 'elling units on each floor ............. If guru. ge number of cars ... 7: .... '~' .................................................... 6. If business, commercial or mixed occupancy, specify nature and extent ff each type of use .................. 7 D .... ~ 'f pth · lmenslons of existing structu es, 1 any: Front ............... Rea .............. De ............... Height ............... Number of Stories ................... Dimensions of same structure ~vith alterations or additions: Front ................. Rear ................ Depth .................. i... Height .................... 8. Dimensions of entire new construction: Front . ~'b.~.~. ~.(...~... 'Rear antber of Stories .~.3....~ ...... .................... Depth . ~. f.~..e/..(_ ..... .eight ............... Number of Stories ................ .................. .~';: iii ........... 10. Date 'of Purchase ......... : ................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ...................................................... 12. Does,proposed construction viblate any zoning law, ordinance or regula :ion: ................................ 13. Will lot be regraded ...... ~ ................... Will excess fill be removed from premises: Y~s No 14. Name of Owner of premises .fi'~/~/l/,/g [~/,~(,,~}~.~,ddress .................... Phone No ............... Name of Architect ......... .............. Address ................... Phone No ................ Name of Cont~aotor~. i~.....&_C/-d:.. Address &~.: k ~.i/.¢ ... rhone No ............. i PLOT DIAGRAM .: Locat~ clearly and distinctly all buildings, whether existing or propos and, indicate ail set-back dimensions from property lines. Give street and block number or description according to dee and show street names and indicate whether interior or coruer lot. STATE OF NEW YORK, ~S.S COUNTY OF ................. ............................ , ..................... being duly (Name .... of ~ndlvldual s~gplng contract) above named. He is the ' ' (Contractor, agent, corporate of said owner or owners, and is duly authorized to perform or have perfo] application; that all statements contained m this application are true to the work will be performed in the mannler set forth in the application filed there~ Sworn to before me this ~OTAR¥ POlitiC,. State of ~bw ¥0rg .... NO. 4707878. Suffolk C0~uut~ 'orn, deposes and says that he is the applicant ricer, etc.) med the said work and to make and file this best of his knowledge and belief; and that the ~ith. r i i 105. cP. SUlr~O~ OOU~A~ ~r~aT,'~¢t,l DEPAR~MEN~ T, he se~a~ disposal and water faollities for this loeatlo~have been inspected bF this deportees% SedUces