HomeMy WebLinkAbout13935-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No z17229
Date AUGUST 25, 1988
THIS CERTIFIES that the building
Location of Propert~ 180 KERWIN BLVD.
House No.
County Tax Map No. 1000 Section 053
POOL, FENCE AND DECK
GREENPORT
Street
Block 02
Hamlet
Lot 23
Lot No.159-160
Subdivision PECONIC BAY ESTATESFiled Map No. 1124
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 1985 pursuant to which
Building Permit No. 13935Z dated MAY 9, 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 INGROUND POOL~ FENCE, DECK TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to RAYMOND AND ANNA CIACIA
(owner, X/f~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N836126 OCTOBER 6, 1987
PLUMBERS CERTIFICATION DATED N/A
Bu~il~tngInspector
Rev. 1/81
~OR~ NO. 0
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
13935 Z
Permission is hereby gronted to:
..... /...~..q.~/fi.~~......~...~ ..........
.... ~:.~...~..t. ....... ~...~.:.....u..t~.{. ........
~, ~ .~,¢ ',.,,, I , ,~
.................................. ......
· t ,~ ~. .I V
0,,,rem,,, ,~o,ed ot .~ .~..?... ~ ~ ~.~..-. C~ ..~... ...........
Co~n~ Tox Mop No. ~ooo Sec. on ...... .9.ff..~ ..... B~o~k ...... ~.~. ....... Lot No. ~..~.~
pursuant ,o application dated ........ ..~.....~...'~.. ......................... , 19~b''........,-- and approved by the
Building Inspector.
Fee $,,.,,.~,...t,.~ .....
Building Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD I! !~A Ill
Building Department ['~i I ~
Town Hall i~\~i
Southold, N.Y. 11971 ' ~J [~L ....
APPLICATION FOR CERTIFICATE OF OCCUPANC
Instructions
A. This application mu~ be filled in Wpewriter OR ink, and submi~ed ~ ~ to the Building In~ec-
tor with the following; for new buildings or new use:
1. Final ~wey of properW with accurate location of all buildings, prope~y lines, ~reets, and unu~al
na~ral or topographic fea~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 Unde~riters. ~
4. Commercial buildings, Industrial buildings, Multiple Res{dences a~d similar buildings and in~alla-
tions, a ce~ificate 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 u~s, or buildings and "pr~exi~ing"
land uses:
1. Accurate ~ey of p~pe~y showing all properW lines, ~reets, buildings and anu~al na~ral or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safeW inspection of buildings or premises, or other pe~inent informa-
tion required to prepare a ce~ificam.
C. Fees: Add~c~oas $25,00 ~O0~S ~25.00k[~[~A~[0N ~25.00
1. Ce~{f[cateefeccupancy kew D~e[[[~ $25.G0, Accesso~7,,,~O.O0 ~s~ess
2. Ce~ificate of occupancy on pre-existing dwelling ~ 50.00
3. Copy of certificate of occupancy $ 5.00. ove~ 5 yea~s ~]0.00
c.c. 0.00 ... ......
New C o~ ~ ~ ~ ~ c ~ ~ o~ O~d or Pre-existing Building Vacant Land
location of Proper~ . . [~q ..... t ......................
Hou~ No. Street ~ Hamlet
Owner or Owners of Property
CounW Tax Map No. 1000 Section ............. Block ............. Lot ..... .......
Subdivision ................................. Filed Map No . ~J.~.~[ .Lot No.
~armit ~.., ,,,~ ~ata ~f ~armit · . ,Agplicant
~aaltk ~ept, Approval ........................ Eab~r ~apt, Approval .......
~qu~t far q~mparar~ Car~ificam ..................... Final Cartificat~ .....................,
Construction on above described building and permit meets all applicable codes and regulations.
Applicant .. .
FOUNDATION
(1st)
COMMENTS
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
~gDE
FINAL
ADDITIONAL COMMENTS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~/~000708 BUREAU OF ELECTRICITY
mg 85 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
on2y the electrical equtpn~ent as described below ~nd introduced by the applicant nar~ed on the above application number in the premises of
Raymond Ciacia,~ 180 Keratin Boulevard~ Greenpor~ N.Y
the followlng h,cotion~ [] Basement [] Ist FI. [] £nd Fl. Outside Section Block Lot
in
t~s examined om September 22 ~ ~ 87 and fourtd to be in cotnpllance with the reqtdrement s Qf this Board.
FIXTURE FIXTURES RANGES
OUTLETS SWITCHES
DRYERS
,FurNAcE MOTORS FUTURE APPLIANCE ~.m:m:ue#: TIMECLOCKS
[JNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT
OTHER APPARATUS:
1.-C. F. C. I.
S E R V ,I C E
NO, O E COND' OF CC. COND~ OF HI-LEG OF NEUTRAL
_(S_W~_I~,_~NG~PpO_~)_ This certificate covers compliance at the date of inspection only.
. Because of unusual environments iC is advisable to have frequent teat a~d/or repairs
made by a qualified person.
Sal Prato Electrician
Wiggins Lame,
Greenport, N.Y~ 1194~
This certificate must not ,be altered in any manner; return to the off~ce of the Board
Lic. 1049~
Inspectors may be
tUl LDING TH!S MANNER.
7G5-~.802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING [~FINAL /c~
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [,~NAL
RmARKS. ~ ~ ~
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received ........... ,19...
Date ................... 19...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
~ts of plans, accurate plot plan to scale. Fee according to schedule·
b. Plot plan showing location of lot and of buildhags on premises, relationship to adjoining premises or public streets
r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
ation.
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
~tall 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 purpgse whatever until a Certificate of Occupancy
~ta!l have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Petxnit pursuant to the
~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws~ Ordinances or
[egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
dmit authorized inspectors on premises and in building for necess3gy~inspections. ~
' ,' r (Sighature of applicant, Qr name, if ~ corporgtion) .
(Mailing address of applicant)
gtate whether applicant is owner, lessee,' agent,' architect, engineer, general contractor, electric[an, plumber or builder.
lame of owner of premises ..... f~. 4~~...~:~Q. · .~ .......................................
(as on the tax roll or latest deed)
if applicant is a corporation, signature of duly authorized officer·
...... (Name and title of corpor'ai~ ~ffic~r)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No.. '.~.';~..~.~...~
Location of land on which proposed work will be done...~t~.~. ~...~ .~.....~...~-~A~..~ ......
· ?. .......... .................. x.,./,. .............
House Number Street H~mlet
County Tax Map No. 1000 Section ,~'~'~ Block
Subdivision..P,.~.d~q~.. ~... ~ ...... Filed Map No. //.1..t/. ........ Lot.'~.].5.-~..--../.~...
(N~me)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy...~j~. ~~...~.~. &~ .~.~.~ ~,~_- :t---- -- ~--~ ...................
b. Intended use and occuPancy ." ~...~x'-~. ~. ,~-~-~. ~. ~'~'~O~ .............................
3. Nature of work (check which applicable): New Building .......... ddition .......... Alteration ..........
Repair . ~!.,~..~ ~ ........ Re ......... Demolition ......... Other Work ~ .~..~. Y'
(Deseription)/->-~
4. Estimated Cost...,fp.t~,o. ~ ~ ..................... Fee .....................................
~ *' (to be paid on filing this application)
5. If dwelling, number of dwelling units ........ } ..... Number of dwelling units 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 existing structul'es, if any: Front .......... Rear ........... Depth...~? .........
Height ..... ].~. ~ ...... Number of Stories ... ].]~.,~w. ................................................
Dimensions of same structure ith alterations or additions: Front ..... :>, ~,;,~ ........ Rear . " '
Depth ' Height Number of Stories
8 Dimensions of entire new construction: Front Rear Depth
Height ............... Number of Stones .......................................................
9. Size of lot: Front ......... ]l~. ......... Rear .... ~. ............... Depth .../.~.~. ...............
10. Date of Purchase ...... /~b'~. ................. Name of Former Owner ...~ .............
11. Zone or use district in which pFemises are situated .... ~ ...............................................
12. Does,proposed ¢onstructton wolate any zoning law, ordinance or regulation: ................ /. ..............
13. Will l~t be regraded . . . i .......... Will excess fill be removed from prem'~e's Yes No
N~e of Architect ......... ~ ........... Address ................... Phone No ................
N~e of Contractor: ....... ~ .................. Address ................. Phone No ................
Lo~t~ ~l~aly ad distinctly ~1 bufld~s, wh~th~r ~xistin~ or proposed, ~d, indi~at~ ~1 s~t-bac~/d~ensions i~om
prop~rW lin~s, GN~ str~t and block number or d~s~ption ac~ord~ to d~ed, ~d show 'street n~s and' i~di~at~
*/
/ /
COUNTY OF ...... a.a . k d /
above named. . ~ i /
, , . .........
: , , . ] . . (Contractor, agen{i eor~brate officer, etq.) ,
of said owner or owners, ~d is d~ly authorized to p~rform or ha?~ p~rfo~d th~ said work and to m~e ~d fil~ this
application; that ~1 statements co~tain~d ~ this application ar~ tru~ to the best of his ~owl~d~ and belief; and that
work w~l b~ p~rfo~d in th~ m~n~r s~t. forth in th~ application fil~d therewith.
Sworn to before me this
,
............... .... ..... __ ..........
,. NOTARY PU~IC, State ~'0~. (Signature of applicant)
No, 470~878,
AP~-OL-~D AS NOTED
7654802 9 AM TO 4 PM z~
FOLL~¢,/I~!G tNSPECTIONS, r~
1. FOUNmATlmN _ TWO ~EOUI~D
Ff)q P~u~rfD CONCRETE
2.R~UG~4 . FqAM~NG <~. PLUMBING
3.
THE ="~ .... :'"-x"~S C>F T''=
, COMES ~,~'r .RESPONC~~ r~ FOR
DESIGN ~-' CONSTRtJCTION ERRORS.
TE-LEPHO~E GREENPOrT 7-1055 ESTIMATES GIVEN
BOAT BUILDING
REPAIRING
RAY'S BOAT SHOP
- Raymond Ciacia, Prop. -
sPaRS MARINE ENGINES
RIGG1NG LISTINGS PAINTS
Route 25, Main Ro~d, grecnport, L. h, N. Y.