HomeMy WebLinkAbout26075-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27017 Date: 04/04/00
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 550 WELLS AVE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 61 Block 3 Lot 8.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 30, 1999 pursuant to which
Building Permit No. 26075-Z dated OCTOBER 26, 1999
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 INSTALLATION OF TWO SKYLIGHTS & KITCHEN RENOVATIONS TO EXISTING
ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JOSEPH & ROSEMARIE CAGLIUSO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-066923 01/21/00
PLUMBERS CERTIFICATION DATED 03/16/00 JOSEPH CAGLIUSO
t rized`/Signature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 26075 Z Date OCTOBER 26 , 1999
Permission is hereby granted to:
JOSEPH & ROSEMARIE CAGLIUSO
550 WELLS AVE
SOUTHOLD,NY 11971
for
INSTALLATION OF 2 SKYLIGHTS AND KITCHEN RENOVATIONS AS APPLIED FOR
at premises located at 550 WELLS AVE SOUTHOLD
County Tax Map No. 473889 Section 061 Block 0003 Lot No. 008 . 001
pursuant to application dated AUGUST 30 1999 and approved by the
Building Inspector.
Fee $ 75 .00
Authorized Signature
ORIGINAL
Rev. 2/19/98
r� 7 %r .
f. } r !K CP_ E Form No. 6 R'
ilMin r� TOWN OF SOUTHOLD APR 3 M �� Y BUILDING DEPARTMENT
TOWN PALL
^ 1 765-1802
SUOIHOLD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OF, ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form) .
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25'C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . )QfR,l L . . . . �DC O.0. . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . .':. . . . . . . . . . .
Locationof Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Y!SC . ' OV . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. . . OS� .J1 � RaS�Mt4Rf� ,GJU$ O
County Tax Map No 1000, Section. . . . . . . . . .Block. . 003 . . . . . . .Lot. . .U.Q•t�• ;OU /
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . .I. . . . . . . . . . . . . . . . . .
aGU 7J� ?.Date Of Permit. .QGl: �4 l999 JO5£ �y C �iG�J uSU
PermitNo. . . . . . . . . . . . . . . . . . . . . . .Applicant. . . . . . . / • • • • -
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . ✓. . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary C;ertificate. . . . . . . . . . . Final Certicate. . . .f. . . . .
Fee Submitted: $, S UO
6),,k.• 5?6�3 (�>. '��� ,q�•r 'v•�•C . . . . . . . . . . . . . . . .
co 770/7 PLICC"T
�O�gF1FFOLKCo
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Town Hall, 53095 Main Road y Z Fax (516) 765-1823
P. O. Box 1179 • Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: 3
Building Permit No. �GoTsz�
Owner:
(please print)
Plumber: jo-. OrIY C1964i'u so
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plyumbers S4gn ure)
Sworn to before me this
—IP day of 1 ' IauiE-
Notary Public, County
holmPUBIC State of New 1Mtk
fedSCualiin Suffolk
Term Expires March a,2OL2
.T.D INSPECTII N REPORT DATE COMMENTS
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INDATION ( IST) ii II
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [�R H PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ �RAMING [ ] FINAL
[ ] FIREPLACE/�& CHIMNEY
REMARKS: A� -,t-- -
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DATE INSPECTOR 1
,7660
T65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ) ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPI.ACE & C,HIIMjNEY
REMARKS,: L/L 7
DATE 0-0 INSPECTOR
BP la-
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THE NEW YORK BOARD OF FIRE UNDERWRITERS
6a7
BUREAU OF ELECTRICITY D
40 FULTON STREET, NEW YORK, NY 10036 e
TA-r]Tt.TRY `11 .2000 1391469S/TSI H 066923 p
Dale Application No. on file P
THIS CERTIFIES THAT v
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of C
r,
J. CAOLIUSO. 550 DELLS RVENUE, SOUTHOLD, NY
FF*S.��1 G
in the following local B n C7 1st Fl. ❑ 2nd F'1. _AF Section Block Lot p
� v =AT fief, E
was examined on and found to be in compliance with the National Electrical Code. p
C
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUr.
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT, K.W. AMT. I K.W. AMT. K.W. AMT, K.W. AMT.
L
r
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTI. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS E
BELL SYSTEMS D
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
1 Ex! 1:'/ ' 1 2
0
E
SERVICE DISCONNECT NO.OF S E R V I C E E
METER C
AMT. AMP. TYPE EQUIP. 1 0 RW 1 0 3W 3 0 3W D 0 4W NO.O FCRCOCOND. OF CC COND. NO.OF HI-LEG OF HI LEG NO.Of NEUTRALS OF NEUTRAL L
L
r.
e
r.
OTHER APPARATUS: L
f
tADDLE FAVI F--_" F
F'ANELBOARDS: 1--6 CIR. 50 c
TItACIi LIGHTING; -I4
c
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JOSEFii .'i"-.OLIUSO
14?15 ^AST 16TH 2TPXET
B,rOOxn'N; NY, 11230 GENERAL MANAGER
1 1
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This certificate must not be altered In any manner; return to the office of the Board If incorrect. Inspectors may be identified by their credentials. f
COPY FOR BUILDING DEPARTMENT. THI UST NOT BE ALTERED IN ANY MANNER.
' BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY: t �m
CALL
Exaadnred.................. 19.... ....... MAIL TO: . . . . . . . . . . . . . . . . . . .
Approved..IP-4.(P ........ 19`j Permit No. c4 �S ............I....................
Disapproved a/c ..................................
.......................................... .... ......
Building Inspector)
ICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . .INSTRUCTIONS
7n- -, •; i?lD
is application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector
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 mist be drawn on the diagram which is part of
this application.
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 issue 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 tEIM MALE 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, ordinancesor
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, building code, housing code, and
reguP1tbV,g6q•admiiY,�rtlrpyized inspectors on premises and i building for n._essary inspections.
ON L E 4D CONTENT BEFORE rRJE K ooppw tubing is USW �5 ........... .
CERTIFICATE OF OCCUPANCY {Orwsterdistributing ior1ture 5 8 fIsTY 6n s>Ro if a corporation)
SOLDER USED IN WATER sgsteN PIPIns*M11 be �q o 1,y r� f r�c
SUPPLY SYS TEM CANNOT OftweS K or L only (Mailing addFess .. applicant)
EXCEED 2/70 OF I%LEA0.
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, phcnber or build_
..................................................................................•.....
Name of owner of premises ....� H OSEMA 1 C,9rLpuSQ•... ..............
�..........R...._...�1. .... ...APPROVED-AS NOTED..;�......
(as on the tax roll or latest deed) DATE: lU. B.P- 7 S 2F
If applicant is a corporation, signature of duly authorized officer. FEE
N J UNDO WRITERS MMICATE NOTIFY BUILDING DEPARTMENT AT
fl.......................................REQWRED ..
(Name and title ocorporate officer
f >, 785-1802 9 AM TO 4 PM FOR THE
OCCUPANCY OR FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
USE IS UNLAWFUL FOR POURED CONCRETE
Builders License No. ............. ..... 2. ROUGH - FRAMING & PLUMBING
Plumbers License No. ...........Y'.VI.THQ.UT CERTIFICATE 3. INSULATION
(�(O. �p 4 FINAL . CONSTRUCTION MUST
Electricians License No. .......OF.O-CGUFANCY BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
Other Trade's License No. .................... THE REQUIREMENTS OF THE N.Y.
I. Location of land on which proposed work will be done....................... STATE•C.RN&TBLICTION.&.ENERGY•--
35'p XA.XLLS QVCNJ , Sav-(HOLD ) &1E' W YOkIK J)§9 ES. NOT RESPONSIBLE FOR
(....GN OR•CONSTRUrTIQN•ERR0RS••-
House Number Street
� 2 gqHamlet
Canty Tax Map No. 1000 Section .....4.�........ Block ....3......... Lot ...17.T l........
Subdivision ...................................... Filed Map No. ............... lot ...............
(Name)
2• State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...........L. ... ylb! -'?rk J. ...........................
b. Intended use and occupancy ........`..I....................'..7..�.=a..... v...................
3. Nature of work (eeck which applicable): New Ikmilding .......... Addition .......... Alteration .. ...
Repair ............ Removal ............. Demolition ............ Other Work ..............................
(Description)
4. Estimated Cost ......................... fee ..............................................
(to be paid on filing this application)
5. If ckaelling, mummer of dwelling units ............ lhnber of dwelling units on each floor ................
Ifgarage, rxnler of cars ......................................
6. If Imsiness, co nercial or mixed occupancy, specify nature and extent of each type of use......................
7. Dhwnsions of existing structures, if any: Front................ Rear .. Depth
............. .................
Height ......................... Neer of Stories ......................
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth .................... height .................... Nmnber of Stories ...............
8. Dimrensions of entire new construction: Front ................ Rear ............... Depth ..............
Ilei0nt ......................... Nuuber ofIStories ..1....7...............
9. Size of lot: Front .... ............ iLeaz ..... Sc1..l........ Depth ....................
f pb 2 c
10. Date of Purchase ..9.�gI.I.g........ Nare of Fomer Owner ........................................
11. Zone or use district in width premises are situated ..............................................................
12. Does proposed construction violate any zoning law, ordinance or regulation:
..................
13. Will lot be regraded ....................
Will excess fill be removed from premises: YES NO
14. Names of Owner of premises ,ln ►.(...C�.�rllyst'7.,.. Address 4Y1 ...... Pham No. 7b. .y�-
Name of Architect .................................... Address .............................. Pham No.
Nine of Contractor ................................... Address ...............................Phone No. ...........
15. Is this property within 300 feet of a tidal wetland? * YES .......... NJ ....1i�...
*IF YES, SCIMUD TOM 1iQ7$IFSS M09T MAY BE MWIZZ.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setback dimensions
from property lines. Give street and block nuber or description according to deed, and show street names and indicate
whether interior or corner lot.
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CODNIY OF ...... .......... .. . ...*t 1'f K
(Hare of tm tviJua�i in� � ��Ls� pW V CD��k,e wt7+-( PLC -1- 3”Qs l� C A 6-'.4 c u'
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.... ,... f .�2,..,.,. . ..:beirng July sworn, deposes and says that he is the applicant
gn g
above cloned,
He is themwo-gn
......... ... .......................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed die said work and to nuke and file this
application; that all statements contained in this application are true to the lest of his knowledge and belief, and
that the work will be perforued in the earner set forth in the application filed therewith.
Swum to before me this Q
.......�'� �.....day o s� . .19.Q./...
Notary Public ... ....... ...::c.... .. .( /,{,{� .
ROBERT L S JR ( ignat of Applicant}
Notary Public,St a of NeW York
Qualified in ffotk County
No.O1S 7250
Term Expires May 31,
F4 fir-( - { J,''o o 5
REVISIONS BY
OCCUPANCY OR
USE IS UNLA . MPROYED AS NJ�TED
WITHOUT CiEF�iIFICATE en.3-I '.R• I1215
OF OCCUPANCY INDEPARTMENT AT
— —
.!_`T.._�._.I NGBINpIBGOwma FOLIAWINOINSPECTIONS: FOR THE
7 I EEdIG� L FOUNDATION - TWO REQUIRM
- ----- FORFOIRiEDOONCRETE
ROUGH FRAMING A PLUMBING
- pUTAABINO s R -
I,r ELLnu MGWAIX - - a I ' LAT CN
_ - -- • FINAL • CONSTRUCTION NWT
WjiTERlN1ER NEEO -ALL CONSTRUCTION SHALL MEET
/ECOMRLETE.FARG.O._...T._:._..
_
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION t ENERGY
-- -- - \ \ - ----- ---
—
ryPw
CODER. NOT RESPONSIBLERbPMrWOMrMM
rwaudUYE "
-_1DESIGN OR CONSTRUCTION ERRORS
ONEW
optPMONIMYB
ro
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PLUMBER CERTIFICATION
--�-- — E 3° ." ��
ON LEADCONTENTB
CERTIFICATE OF OCCUPANCY
SOLDER USED IN WATER
tppLy SYSTEM CANNOTNEW
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