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Home My WebLink About13758-z FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Ap This application must be filled in typewriter OR ink, and submitted mi - 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 disposal-(S-9 form or equal). 3. Approva~ 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" lapd uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural 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 safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Certificate of occupancy $25,00 -- BUSINESS 2~. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]_0/00 4.Vacant Land C.O. $ 20,00 5.Updated C.O. $ 50.00 Date ....~..~..~/..~.? ............ New C OhS %ruc t i on ...... Old_or Prl~-existing Building ............ Vacant Land ............. County Tax Map No. 1000 Section., ./. ,~. ,~... ...... BlOCk. ...... ~ ....... Lot ............... ~ .~. Subdivision ................................. Filed Map No ........... Lot No ............. Permit No./~?..5~. ~ 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 ~ Applicant .. ~ Rev, 10-10-78 ~.0-?:. 15C22 ] meet es and r.egulations, )h ~. l.em~ri~e L08 ~i~tge ~rescent Manhasset, N, Y, 11030 JOSEPH E. LE~RI~, III 108~ MA~4ASSET,~W Y(1RK February 26, 1987 Mr. Angelo Accardo Building Inspector Town of Southold RE: Wells Road Mattituck, New York Dear Mr. Accardo: Pursuant to your instructions, I have enclosed a copy of the New York Board of Underwriters electrical certificate and a new survey of the property which was performed by Sealand. The location of the plumbing fixtures are virtually identical to the original location, but the fixtures themselves have been replaced with new. If there is additional information you require, please let ~e know. Thank you. JEL:dj Enclosure ~ ~J~s~h E. Lemerise, III F1ELD,~INS~'"CTION FOUNDATION (1st), COMMENTS FOUNDATION (2nd) 2. PLUMBING INSULATION PER N. STATE ENERGY C~ODE 4. ~]/e,~£,~ ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728~ TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. /)An application for Certificate of Occupancy is not on file. /)No Underwriters Certificate on file. )The check is (*~/not on file.) )No Health Department Approval on file. )No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit #., [ _~_ 7 _.~--Z~- Z )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April I, 1984) SPECIFICATIONS FOR: DISTRICT 10OO SECTION 126.OO BLOCK 08.00 LOT 022.000 1. Footings shall be poured concrete with the top or upper surface no less thanX~2~inches below grade as a minimum and below the frost line. 2. The footings shall be no less than 16 inches wide and 8inches deep. 3. Appropriate steel reinforcement concrete, 4. Concrete blocks shall have the inches by 16 inches. shall be used when required in poured nominal dimensions of 8 inches by 8 shall be clean 5. The sand and gravel used in the mortar and concrete and free of all debris and foreign matter. 6. Only first quality mortar and portland cement shall be employed. 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION 7GS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION AST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING , REMARKS: [ ] FINAL BUILDING D£PT, INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. ~,%FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ ~ THE NEW YORK BOARD OF FIRE .UNDERWRITERS BUREAU OF ELECTRICITY E5 JOHN STREET, NEW YORK, NEW YORK 10038 THl~ CERTIFIES THAT o~ly the electrical equipment ~ ~scr~bed bel~ and int~uced by the ~i~nt ~med on the,~ve appli~atio~tam~r J~ the premises of in the followlng location: ~ Basement ~lst FI. F~brua~y 0*~, 1987 ~ 2nd FI. Section Block and found to be in co~ tpliance w th the reqt iretnents qf this Boord, FIXTURE i SWITCHES FIXTURES RANGES OVENS 'DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TItAEC!.OCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT S E R V I C OTHER APPARATUS: *lid VIS?AL ,D~ECTS~ 'A~ EL~C'£I~ICAL SUtWE¥ HA~ ~ ~E O~ T~g ~OSED ELEC%~IC~ EQU~T ~ T~ P~MISE8 ~DICATED,' '~O OBVIOUS U~A~i~F~OR~ CONDITION ~ FO~D,' lO~ Ktd&e G~Ca~ GENEEAL MANAGER Pe~ most ool be olfered in any manner~ ce~u~o to the offke of the 8oard if incorrect. ~nspectors moy be identified by their coPY FOa SU~LO~a~ VEe~aTaaaT. Ta~S CoPY OF CaaTi¢~CAT~ gU~ a~T S~ AL;~aaV ~ AaY ~. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ,' TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1803 ~xamined .~0~...~..I..~..., 19~.~.~. ~pproved ...~. 04yetiS. ! .~.~.., 19 .~.-(. Permit No. l )isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli. ation. ¢. 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 hail 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 milding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or leguiations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Itc applicant agre0s to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary~'!nspecti?n~ /~h._/Z~././a//~ ' (Mailing address of applicant) Rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. lameofownerofpremises ..~-.0..~.~.?/t ~-' L-e:-/,,,i ~t~ (as on the tax roll or latest deed) applicant is a corporation, signature of duiy 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.... ~../.. .~..~.~.4..~/~... .. . ~cation of land on which p~posed work will be ........................... T ......... ........................ ~o~ .,~.~ 7~/~uc~ ........... ........ ~tr et ......................................... House Number e Hamlet County Tax Map No. 1000 Section .. * · ..... Block ............. Lot. ~ ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~..~..~ J~..O.,'Y!.q~... t~t~"a'~o ~,47-~,~r~ . b. Intended use and occupancy o. .~. .~.'-'-~. . .[~. .,,q-.~. I.~. ~. . ~ t;P. ~'/':r~./.,O. .C-. '..O' a ~'~-- ¢.4 3., Natureof~ork (che6k th a hcable) New Building .......... Addition ........ Alteration ...... Repair ............. ~ Removal ..... . ........ Demolition .............. Other Work ......... . ..... ~ ,--,~, .,-~ ,,;,~,~' ~'ff / · . [ . (Description) .... i ......................... Fee ..................................... .... ,~4i (to be paid on f'fltng this application) 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............ Height ............... Number of Stories ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth .... ~ ' ................ i" Height ...................... Number of Stories ................ 8. Dimensions of entire new construction Front ..... .a/.,~ ...... Rear ....~./,~. ........ Depth .. N/t'}' .... Height .... ,~[.~. ......', Num, ber of Stories .... '~f/~.. ................................. 'z f :Fron .../P.~.'Oei Rear /O0oOt n,,nth I~'.~..i~'ii~ Si e o lot t .... ., .................................. ~ .......... Date of Purchase ..... ~./~...,~/~..I$. .............. Name of Former Owner . ~.q.~.t.~....~.~..~o. Zone or use district in which premises are situated ................................... R..~r! P?...~f.c. ~ .... Does proposed construction violate any zoning law, ordinance or regulation: .... .~.o. ....................... Will lot be regraded ...... /~/.O ................... Will excess fill be removed from premises: Name of Owner of premises .~.~.e'~.~ ~..,.~.~.~..e{t!s. ff. ~:Address/q ~ .~j&~..,~. ~.~., .c..o~..~... Phone No.~'/( Name of Architect .......... [ ................. Address ................... Phone No ............... Name of Contractor ......... ! ................. Address. ............... ;.. Phone No ............... I. 2. 3. 4. PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate ail set-beck dimensions fro ,ropel~y lines. Give street and block ~umber or description according to deed, and show street names and indicate wheth, nterior or corner lot. rAT~ OF NEW YORK, S.S OUNTY OF ................. R £ttq~eR'r$ ~ M ............................ : .................... being duly sworn, deposes and says that (Name of individual signing contract) ~ove named. e is the ...................... i ..................................................... agent corporate-'o~r otc ) s.aid .owner or owners, and is duly anthonzed to perform or have performed the said work and to ~phcat~on; that all statements contained m this application are true to the best of his knowledge and ork will be performed in the mannelr set forth in the application filed therewith. yom to before me this .... .... ..................... ,19 C otary Public. ..... ........ NOTARY a PU, I. IC, ,Stae of New York No 4707d,78,1SL,ffoJi/ CoLIoty ,- , Is the appltcan ake and file th lief; and that ti~ County ~;f appHian ~, ,-.--'~ BY: /,,/, r,_~- . NOTI~ BUILDING DEPARTMENT AT 765-1822 9 A,M ~O z PM FOR THE ~OLLOW,/~C FO~ .... R-'q CONCRetE 2. ROU~'-', - cqAM~N¢ ~, PLUMBING 4. Fib's'. - C~''; ' "* :%N MUST ALL CC',~q:'~ ~ ?'4 ~ 'S, LL MEET THE RE~~ ":~'~:h:-72 OF T%E N.Y. CODES. NOT RESPONS~FL: DESIGN OR CONSTRUCTION , / 12,G. 0 0 o~.0o ~l~" = l ' t DATE I I 012.000 /'0o 0 o~2, Oo 0 yv"= /~ N/F F¢ o N/F 2. R~$'-' .... '~' .... P' UMBING 3. IN~,' ~"" 4. FiNAl ..... ~ MUST ALL CO~* THE REQU'~: STATE CONq CODES. ~ .............. ~R A ~ ~A ~/~U~ DESIGN OR ~NSTR~C ~ ~ TOWN O¢ S~THOLD O~TA~RE $ JO£$PH ff. / £MKFtI$£ F¢ 0 MAP OF DESCRIBED' PROPER T SITUATED AT /ATTITUCK TOWN OF SOUTHOLD SUFFOLK CO., Al. ~ ARE/I: I~000 Sq. FT. (0.$~7'3 Acres} 160.00 ~b~O CERTIFIED TO: CHICAGO TITLE INSUt~ANCE COhIPANY FOR' dOSEPtt E LEMERISE Tn' 1 surveying & engineering p.c. west main street riverhead, new york 11901 (516)569-1717 danuary 22, 1987 dob Ne 83-308A 1000-I26-08-22 Scale: I"= 30' i