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FORM NO. 4
a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 2-24675 Date OCTOBER 1, 1996
THIS CERTIFIES that the building AGRICULTURAL
Location of Property 1100 COUNTY ROAD #48 MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 122 Block 1 Lot 2.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 31, 1994 pursuant to which
Building Permit No. 22342-2 dated SEPTEMBER 19, 1994
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 AGRICULTURAL BUILDING AS APPLIED FOR.
The certificate is issued to PAUL & MAUREEN GRIPPA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - SEPT. 27, 1996
PLUMBERS CERTIFICATION DATED ~j N/A
a
p din Inspector
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)
®
N 22342 Z Date 19. 6• • • •
o
Permission Is hereby grantteyd~'o:
//acs..a~~.. & ......~....lf
to .....1.
009
.........e........
~.........'...l~l~.... Q
at premises located at........ Imp..... ~ N
?f!`~.fi..z ....h
County Tax Map No. 1000 Section ......~aO?`....... Block Lot No.
and approved by the
pursuant to application dated 19.9.
,
Building Inspector.
C40
Fee $..dr..0......
.
Building In ector
Rev. 6/30/80
r•
R TMN OF SOUTHOLD
BUILDING DL?ARTMN'
TOWN HALL P, iY,ll
165-1302
SFP 271996
APPLICATION FOR CERTIFICATE 07 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:
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 325.00, Additions to dwelling $25.00,
alterations to dwelling $25.00, Swimming pool 525.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildina - $100.00
3. Copy of Certificate of Occupancy - .25¢"
4. Updated Certificate of Occupancy - 550.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ~GV. /-7~
New Construction Old Or Pre-existi Buildi g a~.....
Location of Property.......... J . //miloZ -lO. .
House No. Street Hamlet
Onwer or Owners of Pro eft
~
County Tax Map No 1000, Section...' ? Block Lot..... P(.:
.
Subdivision........//.// Filed Map Lot......................
Permit No...ZDate Of Permit. ~f..Applicant./bl!N......
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval-.
Request tor: Temporary Certificate........... mal Carticate.......
Fee Submitted: 5.~1
~f~u Y A I
O VAPPLICANT
c ~ x(615
O~~g0fF0~,~-~O
Gyp
H Z
Town Hall, 53095 Main Road p Fax (516) 765-1823
P. 0. Box 91971 Telephone (516) 765-1802
Southold, New York 1
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 12, 1996
Mr. Paul Crippa
1100 County Rd. #48
Mattituck, N.Y. 11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
ffi An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
ffi 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 # 22342Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
DA-A
i:ONMENTS
JNDATIONI (1st) - - y
111DATI011 (2nd)
2
1GH FRAME & -
. I H
[*7
MATI0N PER N. Y. II y
STATE ENERGY
II
CODE
a
^
F I: f A L IX_~ _C\1
ADDIT 0NAL COMMENTS: m
r x
• C%L~ f~ Vim A
x
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r
• - a
M
;,.2'`".wX•Leh..s.wn*"iw. ca.•r ~:'y P+. t .
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9~
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Town Hall, 53095 Main Road p ® Fax (516) 765-1823
Telephone (516) 765-1802
P. 0. Box New York 9 11971
Southold, N
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 12, 1996
Mr. Paul Grippa
1100 County Rd. #48
Mattituck, N.Y. 11952
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. (Enclosed)
No Underwriters Certificate on file.
The check is a/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 # 223422
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE ?//0 INSPECTOR
3
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL
[ ] FO AT 2ND [ ] INSU ION
[ MIND [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS: G 9A e~l
DATE /~~/Zzx~~~INSPECTOR
a_
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8052794
F BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date AUGUST 08,1995 Application No. on file 87389595/95 H 046456
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
PAUL GRTPPA, 1100 ~CPCOUNTY ROAD
~I#48, MATTITUCK, N.Y.
in thefolimcing location- U 1' 0ase gent (n Ist Fl. n 2nd Fl. OUT Section Block Lot
was examined on and found to be in compliance with the National Electrical Code.
'FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT, K W. AMT, K.W. AMi. K.W. AMi. K.W. AMi. H P.
60 82 54 52 8 1 4.5 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. On H. P, GAS H. P. AMT. NO. A. W. G. AMT. AMP AMT AMPS. TRANS. pMi H P SYSTEMS AMi WATTS
NO. OF FEET
1 E' 1 30
SERVICE DISCONNECT OF S E R V I C E
PMT. AMP. TYPE METER =102W11 e AW. G. A. W G
EQUIP, ER N OF CC. COND. NOOF HI LEG NO.OF NEUTRALS OF NEUTRAL
1 200 CB 2/0 1 2/0
OTHER APPARATUS:
G. F. C. SE-9
SMOKE DETECTOR:-1
PAUL GRTPPA
1100 COUNTY ROAD #48
MATTITUCK, NY, 11952 GENERAL MANAGER
Per
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.
COPY FORSUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY,MANNER.
_ BOARD OF HEALrH
a~ FORM NO.1 /-9 SETS OF PL.1,;S
TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT I/ CIIECI: _
WnA ,
o#~ TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOT, FY
CALL giV~
Exam d9 MAIL T0:
`
n 1,
Approved 19' Prmit No. 7`Z
Disapproved a/c _ .
(Building Inspector)
P CATION FOR BUILDING PERMIT y
Date . L!~ a 19 R
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.
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 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 issued 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 for necessalr'~yinspections.
' (Signature of applicant, o`r~n~ame, if a corporation)
& ailing
iling address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
CtOn 2l-
Name of owner of premises OG ld _e.4~!(,`°/ , •
(as on the tax roll or laftest deed)
If applicant is a corporation, signature of duly 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 .
1. Location of land on which proposed work will be done . .
//o a 4ac~!2fy ~~~c~c/{ /l ySo2!d cf
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot...................
Subdivision . Filed Map No. Lot .
(Name)
2_ State existing use and occupancy of promises and intended use and accupanc roposed construction:
a. Existing use and occupancy ~ . , , . 4'... .
b. Intended use and occupancy ...~Ctv~ O Ce.... S .
v .`A
3. Nature of work (check which applicable): New Building Addition Alteration
Repair • Removal . . Demolition Other Work
(Description)
4. Estimated Cost a0 Z21~ Fee Q.
,'z
1109
y•,
5. If dwelling, number of dwelling u (to be paid on filing this application)
g. nits • 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 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 Rear • Depth
Height Number of Stories , . • • • • .
9. Size of lot: Front . Rear . Depth l . . . . . . . . .
10, Date of Purchaseb, la , , , , , Name of Former Owner . °d w! ~!!s . .
11, Zone or use district in which pre , • • . .
raises are situated . .
.
12. Does proposed construction violate any zoning law, ordinance or regulation: .
13, Will lot be regraded • Will excess fill be re oved from premises: Yes No
14. Name of Owner of premises
.ae~ilD~lyla~u,Ee.~ ~rddress //ooCou,~¢vrld°`~l,P Phone No.
Name of Architect
Address Phone No............... .
15. Is thisslproppertSouthold withn T ...i Address Phone No
00 feet o of a tidal wetland? *Yes No...Y.....
Name ofConyes,own 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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF &S
2uvP~.7-7F-~~ R being duly sworn, deposes and says that he is the applicant
Name of individual si ni g contract)
above named.
~Iie is the ......o 64"`?
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dulylauthorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
,Sworn to before me this
. / ter` ...--.dav of u r 19 .g '
Notary Public, o U„roe„( County J
LINDA
York
J.COflPER~~vr.
Notary Public,~ State of N c r `
No. 4822563, Suffolk r. (ignature of applicant)
Term Expires December 31,1a_..Q
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765-1802 9 AM TO A' PM FOR THE I°.e.90 91,00 1, a4wew 1141111411w1144 w Iawm~ /1 v nn 1i1a 111w1wna.
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