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HomeMy WebLinkAbout14171-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Ne. Z14259 Date March 6 ................................................. , 19.86.. TH1S CERTIFIES that the building ..... 0..n .e..f.a..m .~ ~.y....d ?.e.~. ~ ~, .n.g... ................... Location of Property .... .29 ..... h.e...L.o.n.g..W.a.y. ....... East Marion House No. Street Ham/et County Tax Map No. 1000 Section . .q~ 9 ....... Block ..... .0.2 ........Lot .... 115 Subdivision. ,P.e.~l~..e..B.e..a.c.t! Farms Filed Map No. 626.6 .Lot No. 58 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ~T.u.~y..1.1 ........... 19 .8,5. pursuant to which Building Permit No. 14171 Z dated . .,J UJ-,Z .3Q .................. 19 .8.5., 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 ......... ..... One..f. ami2.y..dwe.Lling. ..................................................... The certificate is issued to ......... .Iv 9.u.5. s....S.a.C..i .n.a. .................................. (owner~l~R w~trml~l~ X of the aforesaid building. Suffolk County Department of Health Approval ........ 8. 5. T,S.O. U ] .0.0 ........................ UNDERWRITERS CERTIFICATE NO. .N 730990 PLUMBERS CERTIFICATE 1/27/86 Building Inspector Rev. 1/81 FOB~ NO. O TOWN OF SOU33'fOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14171 Z Permission is hereby granted to: ~ .- ~ ..... ~./..~...~.~./~.~.~..../~.. ..~ ........... ~~.~l/.~.....~.,...Y...........~7..~ ,~ ~- / ,o ........ ............................................................................................... ~.~.~....~.~.~v~. ............ o, ,,,m,,, ,~o,,d ~, ...... ~.~.....~...~..~. .............................................. .......................................................................................................... ~.~..~~..~..~ County Tax Map No. 1000 Section ...~..t~...~... ...... Block ....~.~. ........ Lot No..../../.;~)..'~.. ........ pursuant ,o application dated .... .~.~..~.. ...... ./....~.., ..................... , 19~ and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD Building D~partment Town Hall .... , ,~uthold;-~.y. 11971 APP~LiCA'rlON FOR CERTIFICATE'OF OCCUPANCY "I;~tructions A. This application must be filled in Wpewriter OR ink, ~ ~ubm'~tte~' -'~-~ ...... to the Building Inspec- ter with the following; foi' hey~ui~dings or new use 'l: Final ~ey of prope~ ~ith' accurate location of all buildings, prope~y~l~n~s, streets, and unumal natural or topographic fea~res. 2. F;nal approval of Health Dept. ~f water ~pp'Jy ~nd sewerage dispos~l-jS-~ form or equal). 3. ~pproval of electrical installation from Board of Fire Unde~riters. ~* Commercial buildings, Industrial buildings, Mult pie Res dences and simi ar buildings and installa- tJcns, a ce~ f cate of Code corw~) ante ~oc-~ ,tt~e Arch tect. or Engineer' responsible for the building. {, St~bmit Planning ~oard approvaJ'of completed s~te plan requirements where applicable. B, Fur existing buildings (prior to April i957). Non-conforming u~s, or buildings and "pre-existing" land i, Accurate m~ey of peppery showing all properW i~rus, ~reets, buildings and unumal natural or ~opographic features. . worn slatem~nt of owner or prewous own~r as to use, occupancy and cond~t~on of buildings. 3~ Date of any housing code or safew inspection of buildings or premises, or other pe~inent informa- '~ion required to prepare a ce~ificate. ~. C~ificate of occupancy $5.00 .-~ 2, C~ificate ..... of occupancy on pre,-existing dwelliq, g / ~ .Z C~py of certificate of occupsnCV $1.00 1 BLDG, TOWN OF ,SOUTHOLO N~w Bu;Iding .............. Old or Pre-existing Buildipq ............ Vacant Land ............. c,,,,w Bap No. ' 000 s,ctio, O ..... Ulo.k Lot.. Permit No ............ Dato of earn:it .......... ~pplicant .................................. Health ~2ept Approval Lubor Dept Approval Umte~,,r[ters Approval Planning Board Approval' R,~quesl lor Temporary Certificate ..................... Final Certificate ................ -C~n s ','uc lion or1 above described ,~~ huihLng an~ pertvut, meets all eflp~icable codes and regulations. Date land use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 FORM NO. 6 TOWN OF SOUTHOLD Building Depertment Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY OF SOUTHOLD Instructions This application must be filled in typewriter OR ink, and submitted t IJamlm~a 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 featu 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 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. 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land/C.O. $5.00 .~/..~./. Date ........................ New Building .... .'.~.. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~..~. -~'.~. .~.~. -~ Zo.~j~. (z)~.y .~..4~7~../~.~.~./.,4 House No. Street Ham/et / Owner or Owners of Property .. ~.~,~./.'~ .................................................. County Tax Map No. 1000 Section ... ,~..~.~. ;~..., Block . ~.2,0D Lot Subdivision..~'-.~.~./.~..~,,4~..~.<.z~. ~c. ..... Filed Map No. ~..~.~.( ..... Lot No...-~?. ........ Permit No. /.~'../.7/..~.. Date of Permit ........ Applicant .............. Health Dept Approval ~' Labor Dept Approval Underwriters Approval .~ ....................... Planning Board Approval .... , ................. Request for Temporary Certificate ..................... Final Certificate ...~.~., ................ Fee Submitted $ ~ ......................... Construction on above described building and permit meets all applicable codes and regulations. Applicant.. ~¢~..~ ........................... Re~. ~o-,o-~ ~ _qJ~ TO~LN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No.14171 Owner An~elo ~onforte -(please print) Plumber /,(//~//1~;~ ~, ,~/~/ · --(please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before ~e this Notary Public, .~ County N0.52-925,%2~ Su~oH~ Count~./~ (plumber' s signature) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 9 ,.t, :ranu~ .[4,J. 9,'~; ,~pplic.tlo, No. on~ile 3~4S~..9/~ N730990 THIS CERTIFIE~ THAT only the electrical equipment ~ ~scribed below and introduced by the applicant named on the above application number in the premises of ~4~, & ~rs, Lot~ Sa.ffina~ 2940 The Lon~ay~ E, in the following locatlon; >~ B.sement ~ 1st FL ~ 2nd FI. Section Block Lot was examined on ~lle ]~r ~ ~ ~ 9 ~ ~ andfou~d to be ia con~pliance with the requirements o~ this Board. FIXTURE FIXTURES ~ RANGES COOKING DECKS OVENS OUTLETS SWITCHES 24 37 ?9 24 DRYERS FURNACE MOTORS FUTURE APPLIANCE eeeueRS TIME CLOCKS DISH WASHERS EXHAUST FANS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E OTHER APPARATUS: Special Rc:c~pt,.~ 2..~20amp~ £~30amp~ G.P.C,X,- 1~ Smoke Detector-~ 1 · ~ack Lighting- 40'.~-0"-8 lites R ,V I C E OF CC COND. OF HI-LEG 4/0 NO O~NEUTRAL$ OF NEUTRAL 4/0 Gary S~rdi 4.i Lowell Ave. Holt~ville~ N.Y., .t174,P iic,~420E GEN$1~AL MANAGER certificate must not be altered in any manner~ return to the office of the Board if incorrect, inspectors may be identified by their' credentials · COPY FOR I UILDING DE '. THII ED t =R. FIELD INSPECTION '~ COMMENTS I. FOUNDATION (1st) FOUNDATION (2nd) ROUGU FRAME & PLUMBING o/1' /b'C II~SULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTo: TEL. 765-1 TOWN OF $OUTtlOLD ~ . OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of Lhe following reasons. /~/ An application for Certificate of Occupancy . is not on file. ~~ ~ ~~w~ No Underwriters Certificate on file. /~/ The check is(outdated~not on file.) /~/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ / ~ ~_ _~ _~ Z Building Dept. ***~ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION REMARKS: [ ] FRAMING [~'INAL \ 765-1~02 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING ~'~ FINAL ~/-~ .... ~'~'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 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 ~ets 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 br areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- bation. 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 hall 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 ~hall 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 Bttilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~he, gulations, for the constnmtion of buildings, additions or alterations, or for removal or demolition, as herein described. e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to tdmit authorized inspectors on premises and in building for necessary inspections.~ . ~... (Signature of applicant, or name, if a corporation) 211 woodycrest Dr. Holtsville N.Y. ........... 'ai Jids; i ..... ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder. Name of owner of premises ...... .M~',. Louis. ,Sa£i~ ................................................ [ (as on the tax roll or latest deed) if applicant is a corporation, signature of duly authorized officer. no (Name and title of corporate officer) Builder's License No .... ~..67.-.H.I. ............... /Plumber's License No...~.'.t~O~O°~' ~ ,~Electrician's License No..~. ~..~..-.~... ?. /.~.~ .... Other Trade's License No. (~\~5¢ ............. i. Location of land on which proposed work wiil be done. . . .E.a,.~.~. . .FI.~.rfi.~ .n: ................................. ...... a~,~.0 ................... y~e...Zp.n.g' .w.a~ ............. ~..e.~.b.z.e., .%e.a.e..h. ?.a.r..m.~.. ............. House Number Street Hamlet County Tax Map No. I000 Section . .~.°.°.972°.~ .27.1.1.5., Block .... 9.2. ........... Lot, .: .~:...1~.5 ........ Subdivision ..... ~e..~.~:.L.e...B.e.&.o.h...Fg.r.m..~ ........... Filed Map No...6.2.6..6 ........ Lot .... 5~ ......... (Name) 2;. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... y.a:.c.a..n)..3: .~.n.d. .................................................. b, Intended use and occupancy .... ?.q..cg.n.~.~.r..u.c.~' .%. p.~.e...~.~.m.~.~, y..~.w.e. ~?.~.n.~..fp.r..ypp.5;d..e.n.~.~%$ .... Rep 'r '- ,' ~ Rem'oval . , . Demon ' ~ r.~.,a., .,~ .... · .... , ........ hon ......... ~, .~-Other Work ............... 4. Estimat~Cost .... ~/9~ : .... ......................... Fee. f'. ~.~,. ~ ~ i ~ (to be pai~filing this application) 5. If dwelli//~, number of dwelling units... 9.n,e ......... Number of d~ If garage, number of cars .... i.°..n,e ............................ 6. If business, commercial or mixed occupancy, specify nature and extent ~ 7. D~rne stuns of existing structur~es, if any: Front.. nono ........ Rear Height ............... Nmnber of Stories .................... Dimensions of same structure With alterations or additions: Front ... Depth ............... ]... Height ................. r'"" 8. D~mensions. ofentire new construction Front .~.7. f.e.e..~ .... Rem ' Height 1.6 feet u,...n~,~fc+~.,~, one " * f-': ';" '-" ......... : ..... ?'6. fab- . 9. al e o 1o[ l~ronr ...... F, ear i 10..Date of Purchase .9/lJ../.8l~ .................... Name of Fo. rr~. e 11. Zone !or use district in which piemises are situated ....... elling units on each floor, one f each type of use .... r~Pa~ ............ .............. Depth ............... ............. Rear .................. ~umber of Stories ................. 57 ~ee't n,~,,,~ 37;'3'3 'f~e~' ' Owner ....&~ig~..q ,. ~.o.n.e..n.f.e.i.d. ,... ,t i.e.1, g r. q qn..e.4 ........ 12. Does proposed construction violate any zoning law, ordinance or regulal ion: ... no 13. Will lot be regraded ..... y.e.~ .......... ~ ......... Will excess fill )e remove~c[ from premises: . Ye~ ~ 14. NameofOwnerofpremises .Loui. s Safina Address 1707 3ummerfxel$~.~~ 386-2~J80 ~>' e c ' Homo" ;£~[n~9'~'.' ...................................................... Nam of Ar hltect ...~ .... ,~) .............. Address .... K .... Phone No. . Name of Con'--c'or ange±0 tvion:~or~e -,. '211 WSoayc/'~c"_. , '~-75-781'9 ...... ~a ~ ........ ............ Auoress ...'. '...I; ........... Phone l'~o ................ PLOT DIAGRAM 'i Locate cleariy and distinctly all buildings, whether existing or propo., property lines. Give street and block number or description according to dee{ interior or 'corner lot. ~, and. indicate all set-back dimensions from and show street names and indicate whether STATE OF NEW YORK, COUNTY OF .......... S.S ............. ,~,~ · · .,~ .......... being duly s ~orn, deposes and says that he is the applicant (Name of individual signing conlracu above named. He is the 0,.9 J~ .~. (Contractor, agent, corporate o ricer, etc.) of said owner or owners, and is dhly authorized to perform or have perfo ~ned the said work and to make and rile this application;that ail statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manqer set forth in the application filed there' vith. Sworn to before me this ./ ...................... day 6f. 1 Notary Public, . ....... ~01'~tRy PIIBIje Stat ................. '''' '' ' , 80f No. 52.9250625 Suff01k C0antv (Signature of applicant)