HomeMy WebLinkAbout22621-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-24120
Date JANUARY 18, 1996
THIS CERTIFIES that the building
Location of Propert~ 5225 PEQUASH AVE.
House No.
County Tax Map No. 1000 Section 110
Subdivision
ALTERATION
CUTCHOGUE, N.Y.
Street Hamlet
Block 4 Lot 7
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 27, 1995 pursuant to which
Building Permit No. 22621-Z dated I~%RCH 9, 1995
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 ALTERATION & ENTRY DECK ~2)DITION TO EXISTING ONE FAMILY
DWELLING ~ ~PLIED FOR.
The certificate is issued to
JO~/~N D'AGOSTINO & ~ D. GUARINO
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HE~-LTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-048281 - DECEMBER 29,
PLUMBERS CERTIFICATION DATED
Rev. 1/81
1995
BN/A
u~laing Inspecto~~
FORM NO.3
T O V."N OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
N~ 22G21 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission Is hereby gr.~'~'~ed,t9'. ,,/ .... / ,~ ,~ £ . ~,. z~ /
~'.~...'...~..~, ,¢.,~...~..'¢..'.m:../.. ~
,o.....~.~,'"'..~....~.....~z~~'~....~..~ ..................
...... X ............ :..;....~ ............... ;, ........... ~? .................. 7" ............................... ~-~
.... ~.~ ~£,:,~ ~,~..~..~. ~ .....................................
CounWTaxMopNo. 1000 Sectlon......,~....~...~... ..... Block ...... ~ ............ LotNo....~.... .....................
pursuant to app,lcat,o, dated ............... '.~...~.'~......~........~......~.. ........ 19....~...~and approved bythe
Bullding Inspector.
Fee ~., ,:Z..~..
Rev. 6/3,0/80
Building Inspec~
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 18, 1995
Mr. Jeff Hallock
P.O. Box 302
South Jamesport,
NY 11970
RE:
PREM:
John D'Agostino & Joe Guarino - SCTM%1000-110-4-7
5325 Pequash Avenue, Cutchogue NY
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22621-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
Form No. 6
TOWN OF SOUTtlOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
AP'PLICATION FOIl CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new nse:
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 build.lng, 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
I. 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 Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00
.... .......................
Construction Old Or P~e /'
New ' . .......... -existing Building .... ~ ...........
Location of Property...~.~..House No. ............ e~. ~XJ~Street .......... ~Hai~l t~ ..........
Onwer or Owners of Property..4~..~. ],~-f~%~../.~O.~...~<w~.ff.~.~. ...................
County Tax Map No 1000, Section .............. Block ....... ~ ........ Lot ......................
Subdivision .................................... F.ilad Nap ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
ltealtb Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approw~l ........................
Request for: Temporary Certificate ........... Final Certicate......~....
Fee Submitted: $ ...... ~ ................
0 ...... '
PROVIDE ,PENINGS FOR ! ~ ~,. ..........
EMERGEI~ ~y ESCAPE AS
REQUIREDY PART. 7]4 OF ~...~ / - _ ...... ., .
'"P1L'UMBER CERT1FICAT/O~
~N LEAD CONTENT BEF~Ot~
:ERTI?ICATE OF OCCUPAN~
SOLDER USED IN WATER
SUPPLY SYSTEM CANN02
EXCEED 2/10 of I% LEAD
If ~pper tubing is us~
FIELD INSPECTION REPORT DATE COI~ff4ENT$
II
FOUNDATION (]ST)
ADDITIONAL COMMENTS:
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
STOP WORK ORDER
TO:
Jeffrey Hallock, Builder A/C Joann D'Agostino
P.O. Box 302
Washington Avenue
South Jamesport, N.Y. 11970
YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT:
5325 PEQUASH AVENUE, CUTCHOGUE, N.Y.
TAX MAP NUMBER - 1000-110-4-7
Pursuant to section 100-281 of the Code of the Town of
Southold, New York, you are notified to immediately suspend all
work and building activities until this order has been rescinded
BASIS OF STOP WORK ORDER:
ARTICLE XXVIII-SECTION 100-281 OF THE TOWN OF SOUTHOLD
CODE - BUILDING WORK BEING DONE WITHOUT A PERMIT.
CONDITIONS UNDER WHICH WORK MAY BE RESUMED:
WHEN A BUILDING PERMIT IS ISSUED
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both.
DATED: 2/24/1995
(Cert. Mail)
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
STOP WORK ORDER
YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT:
TAX MAP ~OMBER~ .//~- .//~-- 4/- ~
Pursuant to section 100-281 of the Code of the Town of
Southold, New York, you are notified to immediately suspend all
work and building activities until this order has been rescinded
CONDITIONS UNDER WHICH WORK MAY BE RESUMED:
Failure to ~emedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both.
DATED:
PROVIDE
R£QUIR£D
N.Y. STATE I
CODE,
UMBER CERTIFICATION
~ERTI~ICATE OF OCCUPANCY
~[f ~per tubing is used
f6r water distributing
eys~em; p~ping sha~ be
of types ~,,or L only_
PLUMBING
ALL PLUmBiNG WASTE
TESTN~G ~EFO~ COVE~g~G
SOLDER USED IN WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 of 1% LEAD.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ! I~JL/ATION
[ ] FRAMING [,~'FINAL
FIREPLACE & CHIMNEY
REMARKS~ J/~ .~.~j
DATE .....
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
INSULATION
[ ] FIREPLACE & CHIMNEY
REMARKS= ~ ,, ~~, ~
DATE: ~j(~f~'-~ INSPECTOR-//~~~
765-~.8~2
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ~f~SULATION
FRAMING
FINAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~053~89 BUREAU OF ELECTRICITY
~- 85 JOHN STREET, NEW YORK. NEW YORK 10038
Dat~ D~CE'HB~R 29,i995 ~pplicationNo. onfile 87953395/95 H 048281
THIS CERTIFIES THAT PB~IT NO, 22621
o~y t~ electrical ~uipment ~ ~seribed below a~ int~uc~ by t~ ap~ica~t ~d on t~ a~e application number i~ t~ p~m~es of
JOE GUAVINO, 5325 PEQUASH AVENUE~ CUTCHOGUE~ N,Y,
in the foltowlng ti,cation; [] Bes.ment [] Ist Ft. [] 2nd FI. OUT Section Bilk
~s examined on DF~CE~ER 26 ~ 1995 and found to ~ in comFliance ~ith the Ndonal Electrical Cde.
Lot
FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
SWITCHES
OTHER
OTHER APPARATUS=
}{ITCH~N- 1
DINING ROOM- 1
LIVING ROOH ~ENOVATION-~I
G~F.C.I:-3
E R ~ V C E
No, O~E~C~.CO~O.
OF NEUTRAL
JEFF HALLOCK (BUILDER)
79 WASH, AV~NLIE
P.O. BOX 302 GENERAL MANAGER
8, JA~SPOR'£, NY, 11970 I1
Per. ',i .......
This certificate must not be altered in any manner; return to the office of the Board if inco~'rect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FEB 2718
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
ssTs or
SURVEY
SEPTIC FORM
BLDG, DEPT. ~ TEL.: 765-1802 ):(>TI FY:. , , , ~
Disapproved a/c .....................................
7/'-(Builainolnspector) /
· F/ICATION FOR BUILDING'PERMIT
INSTRUCTIONS
a. This application must be completely 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, r '
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public sfi-eets
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 i~sued 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, anted regulations, and to
admit authorized inspectors on premise,s and in building for necessary inspe~s~,/~~. '
- -' . (Signa~re ~'ft~pl'm na~, or name, if a corporation)
............. x' .3. . ¢... . . .
(Mailing address of applicant)
State whither applicant is owner, lessee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder.
Nameofownerofpremises . .~:~.~.. 3.~. 0.. .47.. P. xm.. . 0 .........................
(as on th~ tax roll orTatest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No...V~..~..~... [-{:.~ .........
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ..................................................
............... e. . ............. .........................
House Number Street
County Tax Map No. lOOOSection ...:ILO ........... Block ....~.. ' Lot...7 ..............
Subdivision ........ · ............................ '. Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed constructioni
a. Existing use and occupancy .. .~.
b. Intended use and occupancy
'
.3. Nature of work (check which applicable): New Building ....... ,~.ddition ........ Alteration . . ..
Pal b .... '
Re r .............. Rem val .............. Demolition .....
, .... : .......... Other W~rk..
' "' (Description)
4 Estimated Cost 10C20.0..I~)'.
· ' ........................... Fee ......................................
' (to be paid on filing this application)
5 Ifd Iii mb fd Iii gUnit ' N 'b fd
· we ng, nu ero we n s ............. um er o welling units on each floor .......
· If garage, number of ears ..... I ....... ' .........
6 If business commercial or mixed occupancy specify nature and extent of ........... ' ' '
' ' . . .each type of use
7 Dimensions or, existing structureis if any: Front ....................
Height ~. Num!~er of Stories '.'1 .............. Rear iii" .......... Depth ..............
Dimensions of shme structure Nth alterations or additions: Front 5...~x~x~ ........ Rear ......
Depth .... ~ ................ i He t ................ ,Number of Stories ......
8. Dimensions of entire new construction Front ,~e4~x,,e, t, ,, ' .....
He:~,, . ,, ~ _ . · ~ear ............... tjer.... .. . pth
. ~-[ ............... Pqumoer or'Stones .......................................... ' .............
9. Size oflot: Front ........... ! ...... '... Rear ............. ; .... i... D ..............
10. Date of Purchase .. · epth .................
N f Form O ' ' '
11 Zone .... ' 'h' ...~... ...... ~ ......... ameo er wner ...............oruseals .............
· trier in w ich pre~mses are situated .............. ' ........................ ' '
12 D d c tio let g 1 ar~ .m, O ...............
. ocs propose onstruc n rio eany zonin aw ordin ce orre-ulation.
13. Will 1Bt be regraded ...... t,~.O ...... i ........... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises . .~q-.~'~..~ .~e-.~ ...... Address ..: ............. Phone No..q(~.
Name of Architect .......... ,. .......
-~.~.,~ .~[,[ c~.~ ......... Address ................... Phone No ............ : ....
Name of Contractor . . ~. ........... Address .................. Phone ~ ......
15.' I.s this property within 300 feet of a tidal wetland? *Yes ........ No...¢~. .... ' .......
· If yes, Southold Tpwn Trustees Permit may, be required. '
PLOT DIAGRAM
Locate clearly and distinctly all buildings, Whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block nhmber or description according to deed, and show street names and indicate whether
interior or corner lot.
E AS NOT D .
765.-180l 9 AM TO 4
FOLLOWING INSPECTIONS:
I. FOUNDATION IWO REQUIRED
FOR POURED CONCRETE
2. ROUGH * FRAt¥]ING & PLUMBING
4. FIN/~L C{)NSTRUCTION MUST
SE COMPLETE FOR C,O.
AI;L CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUC?tON ERRORS
TATE OF NEW YORK, '
OUNTY OF .............. S'Sl
'' 'J¢'~" ~'['~P~''~' ' '"" being duly sworn, deposes and says that he ls the applicant
(Name of individual signing ~ontract)
)ore named.
e :s the ....
(Contractor, agent, corporate officer, etc.)
· said owner or owners, and is duly aqtt~orized to perform or have performed the said work and to make and file this
~plication; that all statements contained in this'application are t'rue to the best of his knowledge and belief; and that the
~rk will be performed in the manner setI forth in the applicatiBn filed therewith.
worn to before me this '
..............
( ~/,]/]_ // ,z, ', ...... : · p ....... ~:, . .,~ /
,ta..ubiic,. 5 ,
,. .
. (lu~ledk~ ..- ."-- c //Ti.d/' ..... '.''~-"'"~ .........
' . e,~m~rr~,~ls, lqq$ . . .. ~/ ~ ' (Signature .o~'applicant) .