The URL can be used to link to this page

Home My WebLink About14184-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18125 Date JUNE 19~ 1989 THIS CERTIFIES that the building. Location of Property 450 RAMBr~ ROAD House No. County Tax Map No. 1000 Section 88 Subdivision TERRY WATERS ONE FAMILY DWELLING SOUTEOLD f NEW YORK Street Hamlet Block 5 Lot 23 Filed Map No. 2901 Lot No. 30 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 22f 1985 pursuant to which Building Permit No. 14184-Z dated AUGUST 2~ 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 ONE FAMILY DW~3J,INGWITH ATTACHED GARAGE The certificate is issued to CHA~T~R CICCOTTO (owner) of the aforesaid building. SU~'~'OLKCOUNTY DEPARTMENT OF HEALTH APPROVAL 85-SO-115-OCT. 22~ 1987 UNDERWRITERS CERTIFICATE NO. N-830771-SEPTEMBER 4~ 1987 PLUMBERS CERTIFICATION DATED AUG. 31~ 1987 - HENRY J. SMITH & SON~ INC. Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_° 14184 Z Permission is hereby granted to: ~. ,- .,~ .......... ..7.~.~.~ ~.~/., ./~.z..~c ..... ~.'.....~?~/~...~ .................... ....... ,~.~.~./.../.o.z/D...........~.. .............. LZ.q.~.. ,o ........ ~.~..~,..~.~.~ ...... ~.~.~.....~.,...~,.......~.z.z..~...~ ...... .................................. .~Z/.~c ~ ~. ~. . . . . . ~ .~ o. ZZ~ ................................................................../ o, ,,,,,., ,~a,,d at ......... ~. .0. ........ ~..~-..~, ......../.~..: ...................................... ........................................................................................................ ~.oz~..o.~....-...~..~./...... ...... ~z~ ....... ~.~.~.~. ................. .. .~.... ........................................ ~z ......... 3. ................. Ca,,n,'y Tax Mop No. 1000 ~.~t,on ...C2..~.. ......... ,,o~k ....Q....?.. ...... Lo,- No....~..~.~.. ....... ,,u,uon,- to o,,,,,,,:a,,on da,~ ........ .~..~.~......,~ ................ . ",£~.%nd o,,,,ro,.~ b,. t",e Building Inspector. Building Inspector Rev. 6130180 'IELD INSPECT-iON ~ COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF $OUTNOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposel--(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. §. 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 unusum 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 screw 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 3. Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 $15.00 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property..~/~.--~-(-~ ............... .~.~. ~./.~ .r~. ~...~..~.. ....................... House No. Street HarP/et Owner or Owners of Property ......................................... County Tax Map No. 1000 Section .............. ~ Block .............. .~.~f Lot .... ........... Subdivision. '.~.~,_J-.£.L~....~..~,.~.~.~.~,~ ........... Filed Map No, .~.~.~/.L~. !...Lot No...~. ;;~ ....... Permit No. ,/.~'.))c.~.~.. Date ofPermit . .~.%~/~.~ff.Applicant .~)~.~).~../~j..........,.......... Health Dept. Approval ........................ Labor Dept. Approval ........................ v~ Planning Board Approval Underwriters Approval .............................................. Request for Temporary Certificate ............... Final Certificate ...... Fee Submitted $ ..~..6.,'~..~.. .................. Construction on above described building and permit meets all applicable codes arid regulations. Applicant..~...~ .................... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~'tg l~,~TJOHN STREET, NEW YORK NEW YORK 10038 Date Application No. on/lie 36521~/85 N THIS CERTIFIES THAT o~y the el¢ctrlcal equipment ~ ~scrlb~ below a~ interlaced by t~ ~p~ang ~m~ o~ the a~e application number in the premises of Charles ~iocoggo, W/~ o~ ~l~ ~a~450(~yview ~)Sou~ol~, ~ ~s exatnl,e~ orr ~ ~ ~ ~7 and found to be i. ,'o,tpllance ~*ith tbe requlretr~ent.~ of this Board* FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES ~[UO~S£~ 36 39 35 36 DRYERS FURNACE MOTORS TIME CLOCKS UNIT HEATERS J MULTI.OUTLET DI~ER$ SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V t C OF NEUTRAL ~lee~rio zoo~ h~a=er: 1-1-Okw., 3-~ oOkW., 3-1.5kw., Charles ~3h16-79th Avenue This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be cOPY FOR j~U~L~I~O ~P~RT~aT. Tm~ COPY their credentlals. N ANY MANNER. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date AuKus% 31, 1987 Building Permit No. //~/ ?q'~ Plumber (please print) H~nr~ J. Smi%h & Son~ Inc. (please print) I certify that the solder used in the water supply system contains less Lhan 2/10 of 1% lead. / /(plumbe3's signature) Sworn to before me this 31s%day of Augus% , 19 87 Notary Public, Suffolk County Notary Public #4844893 BE~NADE~IE t. IAPL}N NOTARY PIJfltlC. State of New Yo~k BUILDING DEPT. INSPECTION' [ ] FOUNDATION ZST' [ ] ROUGH pLBG. ~] FOUNDATION 2ND [ ] INSULATION, [ ] FRAMING [ ] FINAL REMARKS: a DATE ::~t ~\ INSPECTOR ~ 76S-1802 ~ BulLDIN(a DEPT. INSPECTION ~(~ FOUNDATION 'tsT, [] ROUGH PLB(a. I' ] I~OUNDATION ZND J- ] INSULATI°N [ ]FRAMING [ ]FINAL, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 , Examined i9.~.. .~'' .-~ Approved Pe,,it No./. Disapproved a/c ....... ~ .................... ~ · ./. · / (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19.. , a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 i 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 ~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 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. iThe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ....... ©.. F. ~.. d... C..,. 9: .......... (Signature of applicant, or name, if a corporation) .. s. y . . Cd.o n , .t . . 4 , . . g r. . . j.q.7. : .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~Name of owner of premises . .. [~.) ~ (as on the tax roll or latest deed) ~tf applicant is a corporation, signature of duly authorized officer. '. ,, (Name and title of corporate officer) Builder's License No ......... ./~.[ ............. Plumber's License No. /~L. i [ Electrician's License No ....................... I Other Trade's License No ...................... i. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ... k .o~'. ........... Block .... .~. ........... Lot .... ~..~ ........... Subdivision..'.~.'.~C.O,J... ~.~(.~.~,mr.21 ................ Filed Map No...~.~../7). }. ..... Lot....'~.Q ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~r.~kC.O~;l )[7 ........................ >7:.?74,,.~?,:~~ ..................... b. Intended use and occupancy ... 3. Nature of work.~(check which applicable): New Building .... .. Ad iition .......... Alteration .......... Repair .C~.J*~[ ~,.~ ..]~,, Rem6val ....... Demolition ............... Other Work ..... _ ~ , ..... (Description) ~' ~' (to be paid on filing this application) If dwelling number of dw~liing iunits .. ] Number of dw ling units on each floor ..... If garage number of cars .: .... If business, commercial.or mixed occupancy, specify nature and extent c f each type of use Dimensions of existing structurss, if any: Front ............... Rear .............. Depth ............... tteight ............... Number of Stories ....................................................... Dimensions of same structure ~ith alterations or additions Front ...... Rear .................. Depth ................... I · · Height .......... ..../ ........ N amber of Stories ........ i~ ~ ~ ...... 8. Dimensions of entire new construction: Front ..... .~.~ ..... Rear ~?ight ....... /. ....... Su/mber of Stories ........ ]. i . .~ ..................... . .................. Size of lot Front ..... fO.o., i ........... Rear ..... 2~i~ ............. Depth .../.~: .3.~../ .......... Date of Purchase .......... i .................. Name of Former Owner ............ I' .............. Zone or use district in which prbmises are situated .. ................................... i ................. Does proposed congtruction violate any zoning law, ordinance or regulati ~n: ..... O.q ....... J .............. Will lot be regraded ......... (LC,dol ................... . Will excess~b~_filltol ~ re~:~oved from premises:. . .Yes Name of Owner of premises . .~ .... T~9 ..... Address ........ 7.q.../~Te~.. Phone I~o ......... Name of Architect ......... I., ................ Address j~-(o.c.%~. ?lc..it?o?.. Phone No. *ari ?3 ........ S ............... Name of Contractor eC '. C~ t. l~g-.(. .... Address .~q ~ ~i. ~.. ?v.'; ~.0.. Phone o. 7b.:C.:l.a~t .~. ..... 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly al1 buildings, whether existing or propose property lines. Give street and block number or description according to dee~ interior or corner lot. 17z, STATE OF NEW YORK, COUNTY OF.. ......... (Name of individual si above named. ......... being duly s S.S ning contract) He is the ......... ~ (Contractor, agent, corporate c of said owner or owners, and is dhly authorized to perform or have perfc . application; that all statements contained in this application are true to th, w rk will be performed m the manner set forth in the application filed there Sworn to before me this Notary Public, . .............. · d, and. indicate ail set- and show street name )ack dimensions from [ and indicate whether ,om, deposes and says 'ficer, etc.) rmed the said work ant best of his knowledge ~ith. Ihat he is the applicant to make and file this .nd belief; and that.the (Signature of applicant) SUFFOLK CO, HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAG~ DISPOSAL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. ~A~ SERVICES. ~S~ ~ UTHOLD, NY11971 7~ SERVICES -- FOR APPROVAL Of DATE: AP~OVED: )iNGLE FAMILY ~F~OgK CO. TAA MAP ~SIGNATION: DEED: L. ~/~ P. j "TEST HOLEI STAMpIi · t H[/~LTH ~RV CES pool.~ , SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ' SLNCJ_E FAMJLY DWELLING ONLY DATEOCT 2~ lgB?H.S. REF. The sewage di!;nosa) and water supply facilities for this location h~ve been inspected by this Depa~ment a~d/~ other ~i~ and. f~nd Chief ~ Bureau RO~)ERICK VAN TUYL, P.C. LICENSED LANDSURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT.~OYAL H.S. NO. ~'""~)'1,1-''~'' 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. (s) APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES - FOR APPROVAL OF! CONSTRUCTION ONLY DATE: H.S. REF. NO. ~--:Z',',',',',',',',','~-Jl~ APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST· SECT. BLOCK PCL. OWNERS ADDRESS: DEED: L. TEST HOLE SEAL SOLDER USED 1N WAT]ZR SUPPLY sYSTEM. CANNOT EXCEED £/10oj 1% LEAD. ,'_ , ~ , . ' ' ~ coPP - ~b~r~boh~ p~M n CONTE~r~PA~Y o~ WPes ~ c~TIFI~ , : .- . ~/ FOLLOWING I, FoUNPATION - TWO REqUIREE~ [:OR pOURED cONCaETE ~, ROUGH - E~AMING 3, 4, FINAL - CON'STRUCTION BE ~O~APLETE FOR C, ALL CONSTRUCTION SI-TALL THE REQUIREMENTS OF TR~ STATE CoNSTRU~[O~ COD[:S,, NOT DESIGN OR coNSTRU~JO~' Road t /%, ~ I Phone 477-0400 ~ ,'Main Ro:/d !