HomeMy WebLinkAbout24435-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26287 Date: 02/16/99
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 2105 CALVES NECK RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 4 Lot 46.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 15, 1997 pursuant to which
Building Permit No. 24435-Z dated OCTOBER 28, 1997
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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to LUKE K & RITA LICALZI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-467153 10/02/98
PLUMBERS CERTIFICATION DATED 10/05/98 CUTCHOGUE EAST PLUMB&HEAT
Building Inspodtor
Rev. 1/81
i
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)
Date......OCTOBER 28 , 19...9
Z 7...
24435 .............................................
Permission is hereby granted to:
LUKE K & RITA LICALZI
..........................................................................................
19 PROSPECT AVE
................... ......................................................................
GARDEN CITY t NY. 1,1530
.. .................................
to......CONSTRUCT_.AN. ADDITION AND ALTERATION TO AN EXISTING S,I NGLE
FAMILY DWELLING AS APPLIED FOR
.......... .............................................................................
..................................................................................................................................................................
.......I........................ .........................I.........I....I..• ................. .,..........................................................
............................ . ............................................................................................................I............,.
at premises located at..................2105 CALVES NECK RD SOUTHOLD
.............................................................................................................
......................................T. .................................................................. .. .............................................
County Tax Map No. 473889 Section ....9��........... Block ......0004 Lot No. ,0............0.......1...
pursuant to application dated .....SEPTEMBER 15 19 97
and approved by the
Building Inspector.
Fee$.......38..;80...
............ ... .
r. .. .. .. ... ...............................
uilding Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 ' .�&D O� �d p
50t�
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR 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 1% 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:
X. 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 Building - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . `. . .°�.� f I . . . . . . . . .. . . . . . . . .
New Construction. . . . . . . . OldV r Pre-existing Building. . . . . Y� ./. . . . .
.d.l a. .. . . .... . .. .00 v-V- d..
Location of Property. ..
House No. Street Hamlet
1 ff
Onwer or Owners of Property.. . . . . .. .!f<ct�.. .C�cl.1. . .^:c�:!��:—. � .C. :►. . . . . . . . . . . . .. . . . . . . .
County Tax Map No 1000, Section. . .. . . . . .. . . . .Block. . . . . . . . . . . . . . . .Lot.. . . . . . . . . . . . . . . . . . . . . .
Subdivision. .nn. . ..L..L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . .
..
Permit No. . a.�T:� . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . ... . . . . . . . . . . . . .. . . . . . . . . . . .
Health Dept. Approval. . . . . . . . /V/-/ . . . . . . . . . . . .Underwriters Approval. . . . .Y . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . /� . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .�
q P y . . . .
a 6-
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . .
Q�t
_55 8 a .G!1 f . .�:. �`.-� . . . . . . . . . . . . . . . .
5 S
Cd � g6-2g? APPLICA�`IT
•
�ULAA'
TOOr S 1 I�n7LD TEL. 765-1802
C�� �, UT
tk,!��. :< OFFICE Or IIUILbi
NG INSPECTOR
,,, P•O. t30X 1179
TOWN HALL
SOUTHOLD. N.Y. 11971
C E R T I F I C A T
I rate
Building Permit No. 2 yy 35z
Owner' ��Ca 'Z �•
(please print)
Plumber AJ � I-SYho,.) C
1please
print)�—"-
I
certify that the solder used in the water su
contains less than 2/10 of 1% leadpplY system
o . .
it
I(
'(Plumber 's
signature)
'
Sworn to before me this
-__Z_,___d a y of o c,-r-
iIti�r
tiotarNotary�P. lic
I I ublic, StLFNL,C�- County
Z,
I
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE '
1001071 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date OCTOBER 02,1998 Application,No. on file 15812898/98 N 467153
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
DR LUXE LICALZI, 2105 CALUES NECK ROAD, SOUTHOLD, NY
in the following location; ® Basement ® lst Fl. ® 2nd FL OUT Section Block Lot
was examined on SEPTEMBER 29,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
62 51 50 62 1 9.5 1 1.2 4 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
2 F 2 -
SERVICE DISCONNECT NO.OF - S E R V I C E
METERNO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYP EQUIP. 1 0 2W 1 0 3W S 0 8W 3 0 aw PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
1 200 CE 1 X 1 4/0 1 2/0
OTHER APPARATUS:
RESIDENCE & POOL HOUSE-1
PADDLE FANS-5
5 TON AIR CONDITIONER-1
MOTORS:1-F H.P. ,1-5 H.P.
PANELBOARDS:1-14 CIR. 100,1-16 CIR. 100,1-1 CIR. 60
G.F.C.I:-15
L �
G & S CONTRACTOR LIC.#578-E GENERAL MANAGER
BOX 215 ANN
SOUTHOLD, NY, 11971 Per
This certificate must not be altered in any manner; return to the office of the Board if Incorrect. Inspectors may be idbliltified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Tss.isoz
suauiNa DE".
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ �INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE�� �� F INSPECTOR
suaoINa oewr.
INSPECTION
[ ] FOUNDATION IST [ ROUGH PLBG.
[ ] FOSMIDATION 2ND [ ] INSULATION
[ "'I-RAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMA,
DATE � 9 �� INSPECTOR__%
BUILDING DE".
NSPECTION
[ ] F UNDATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ j INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLA FIIMNEY
REMARKS:
DATE INSPECTO
B ILDING DEPT.
SPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: O
DATE INSPECTO
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & C111MN Y
REMARKS: ' /<�
DATE Z611 /9tINSPECT0
1_11,I.W'lWrit I I(111 ItPI'UIIT Ih' ,
P11111111AT11III
l U lulm'1'toll^^-w(1111))-- Yl
Il1)1►1:11 I'1l Alli: R ,
rl.ulrn 1 nc: j
7
------------------------- -�_....,..» �..,,•.... l.?��.. - -,�_-Cv _G —
111!i111.A'1'I(111 1'I:II 11• Y , _�� �
I:I 111 R -
_
------------------ _--- .. �_ ---- ----------- __________-_______-__---__---------------- ------.._ -_-_____-----_----_--_----_-_- _--__--_---
--_---_---•-. ------•------- -- --------- -_„Atm -1-------►I--------- -
t:J
F•
It
t
L'I
_ I
BOARD OF HEALTH . . . . . . . . . . . . . . .
✓
FORM NO. 1 3 SETS OF PLANS . .
TOWN OF SOUTHOLD 1URVEY . . . . . . . . ... . . . . . . . . . . . . . .
5 BUILDING DEPARTMENT w�CHECR . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
BLDG.DEPL SOUTHOLD, N.Y. 11971
F OUT TEL: 765-1802 NOTIFY: eau, �hPn►/K�csG
CALL . J.8) #7j+.-r 2-8 4 6
Examined.......��� 19 ' C/ MAIL TO: . . . . . . . . . . . . . . . .
Approved : . . .��.., 1947 Permit No. I� �.. C A�C ... t7hY1.. ...........
..... ... ..
Disapproved a/c .................................. .... .....
.....80C VO
.........................................................
T
(Buil.:ng.. ..nT,... ..
APPLICATION FOR BUILDING PERMIT
Date. . . . . . .Sept. .9. ., 19.97.
INSTRUCTIONS
ti
a. this application must be ccinpletely filled in by typewriter or in ink and submitted to the Building Inspector with
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
istreets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
c. The work covered by this application ray 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 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. The 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 nec sary inspections
t _
•(•- of X-1—aic•�. -;r ,.i'f a corporation)
7- Neponsit Ave. Ne nsit,N.Y. 11694
...............................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................................9rGhitect.............................................................
Name of owner of premises L1Xk4. .•..Tri.CA:.7j.,..V,I2...................................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
................ :A......................................
(Nave and title of corporate officer)
Builders License No. ......................... To be selected
it
Plumbers License No.
Electricians License No. .....................
Other Trade's License No. .................... n n
1. Location of land on which proposed work will be done....................................... ........
...............21-05.CPJ.Ye9;..WQ9k.BQAc1..........................�Pgtwm.........................................
House Number StreetHamlet
County Tax Map No. 1000 Section 70-4-.46....... Block 04.90......... Lot .AQ,Qql.....
Subdivision ..n.................................. 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 ...QiAgIV.ZWIAY.Fg91A=QP ..................:..........................
b. Intended use and occupancy ..SiAgIV.F:W1,.Y.FgQideWe..................:.:,i..:..........,.........
��N s
2084.23 TO5LY, ENQ
ITT
6?F YOUN+fs�S AV 6. Iz
' X440 E. AA'' �sz. 7
`Y Y
FEW --- t S-4
o : u` -- ---- _ MAP OF P POPERTY h
SP Jr 4--'SNC EQ FO� �..
r -U `� ``�
r � +
44G.IDEpT L4
LUVE F21TA Lt CALZI
k, r y' ,
AT fi
! �a _
.�,►- TOWN OF 5OUTI�iO tyY
ov
Alf
tic �`�j
All
SCALE-40
�, ,�, ��,� �� • �.,� �� � i r � � � t x�`� SCE �
• �,�, ff//// FE.
4.,
' 4, t� Stiff, CG TAX A'=14
b this wuvaY b a vtolatim ofrAicanon
flection 7208 of me Nsw York efN. � � � '� ' `
i
Cbpies w.tnta w _.. t
PIMP
n^BY map not bea
the fartd seal or �o
at+rveybfatnced �A' il ? �, �
arnbotaed 2001 Shap not bs consklersr' ,� F \y K�/ ` C!!��1 f�`s4 77� *•• ^�*/µt••t t��� y T •w •` ` r S
tabeavamhocopy V ' l� � \� 4f� +S.7t..JL.ttt'11 ✓i� _
y+
Dtuarardeos indicated horeon shaC ¢� .f�'^.,° ^ 33 A C,�i+1►L Y L 7. D
ardy to the Denson for whom the surveg. i FC b
i is prepared•and on his behalf to me �i4 "` ,,7 `
title Com an, r . .
P y gove:rtmentalagercy
J
tendin Ul f \/ r f i fjA' #/'lar l ZICk 7ry ]rN V F Y+, i a}
g st anon 1 s:sd hereon and w.. r
to the assigns s cf the lending insti / � \C S F a
_,.
{ t add Gua ntc a not trensfe at>N
tt
to additional al sus j.mions or subsequ>^S
r,
- ':'.. �...w,...........�..._...—_.�.�.�^tom�...._..�. _.��...—.".'_
.....6a¢o_.J•:�i..t. n Ei...: ... ._... r... w....a' •. :., •. _ ._ ...+.r...^�—w.�.�.l+,.y — .t+,w.