HomeMy WebLinkAbout20319-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
8outhold, N.Y.
CERTIFICATE OF OCCUPANCY
Ne: Z-26388
Date: 04/20/99
THIS CERTIFIES that the building ALTERATION
Location of property: 1515 YOUNGS AVE SOUTHOLD
(HOUSE NO.) (STREET) (PL%MLET)
County Tax Map No. 473889 Section 60 Block 1 Lot 6
subdivision Filed Map No. -- Lot NO. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 3, 1991 pursuant to which
Building Permit No. 20319-Z dated DECEMBER 9t 1991
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 ALTER ~WTSTING OFFICE BUILDING AS APPLIED FOR.
The certificate is issued to ROMANELLI REALTY, INC.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
H058924 03/04/98
04/06/99 NORTH FORK PLUMS.& SAINT.
Building I~ec~or
1~0~ NO. ~
TOWN OF $OUT~OLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PEItMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES uNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Ne_ 20:31 9 Z
Permission is hereby granted to:
...... .~..a...t..~...~.~: .....................................
...:~:..~.~.....~:..~. ~....u...~...v..~. ....... . -,
.................. .......
County Tax Map No. I000 Section ....~.I~D. .......... Block ..... ..~.~ .......... Lot No.......~..~,~..,.....;..
pursuant to application dated ....~'~~.....~... ................... , 19..~...!., and approved by the
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR 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 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-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 w~iting 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.O0
3. Copy of Certificate of Occupancy - = .25~,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential~5.~0, Commercial $15.00
/ ~,a,:~ ...~/.f...~~/q .............................
~ecatien of ~roperty . ./.~/~. . ~. ~ ~. . .~. .°.~. ..... Z~.~. ?~ ~ .............................
House No. Street Hamlet
0nwer or Owners of Property.. ~ .~2~0..~./././' .~..~.~../.~.~
' .... iiii'ii" "'ii i.g..i ..... iiii'"
co=y T,= ~p ~o 10o0, sectfon..~.O. ........ Bloc~....~..~.. . .'~ ..........
Subdivision ... Filed Map Lot .......
Permit No~.~.~../.7. ..... Date Of Permit ................ Applicant .............................
Health Dept Approval · Underwriters Approval .......
Planning Board Approval ...................... % ' ~
Request for: Temporary Certifi. icate ......... i.'Final Certicate.
Fee Submitted. $... ~...~..~'.< V: ............
&~.~..5 ~, t~ '7 ' · ...........
co ~ ~¢5~ .... ~.~i~ ............
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
DATE
owner: (please print)
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of
1% lead.
Sworn to before me this
...~..~/a ry Public, SO ~ \______~.~ County
~/ / Term ~pires May 31. ~,~
THE NEW YORK BOARD OF FIRE UNDERWRITERS
8G69984 BUREAU OF ELECTRICITY
V 40 FULTON STREET, NEW YORK, NY 10038
Date ~i~RCH 04,1998 Application No. onfile 15543498/98 H 058924
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
BURT'S RELIABLE INC., ~515 YOUNGS AVENUE, SOUTHOLD, NY
in the following location; [] Basement ~ 1st Fl. [] 2nd Fl. Section Block Lot
was examined on FEBRU/~Y 23 ~ 1998 and found to be in compliance with the National Electrical Code.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS
AMT, K.W, OIL H.P. GAS H.P. AMT. NO. A.W.G.
SERVICE DISCONNECT NO. oPi . s
AMT AMP TYPE ~VI(~[~pR. ~ 2W I ~ 3W 3, 3W 3, 4W NO O~EC~C~COND
OTHER APPARATUS:
RANGES
SPECIAL REC'P
AMT. AMP. i
TIME CLOCKS
AMT. AMPS.
V
BELL UNIT HEATERS MULTI-OUTLET
SYSTEMS
TRANS. NO. OF FEET
I C E
EXHAUST FANS
AMT. H.P.
DIMMERS
AMT. WAITS
AWG
OF CC ~:~ND. NO OF Hr-LEG
EXIT SIGNS-2
1515 ¥OUNGS AVENUE
SOUTHOLD, GENERAL MANAGER
11
Per
Thlscerflficate mustnotbeaNeredlnany m~nn~r~re~~rn~~~h~~~~~e~f~heB~~rd~f~nc~rrect~~n$pect~rSmayb~ld~nt~fiedbyth~Ir~r~d~nt~~IS~
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE.MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1195099
BUREAU OF ELECTRICITY
~' 815 JOHN STREET. NEW YORK, NEW YORK 10038
Date
THIS CERTIFIES THAT
in the followlng location: ~ Basement ~ Ist FI. ~ 2~d ~3. 0 [)~ Section Bilk Lot
AU(; U F~ I' 30
FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES
FLUORESCENT
OTHER
DRYERS
OTHER APPARATUS:
E R V I
?'i'-'LD -"~'":'~- ' '
FOU~;DATION
FOUNDATION (2nd)
2.
ROUGH FRAME &
'PLUMBING
INSULATION FER N.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMME~;TS
o~
6.' Ifgar~ge, numberofcars ....... ' ............ Numbcrofdwelling units on each floo~ ...............
If business, Commercial or mixed occupancy, specify nature and ex*~, Ac , . .
~tmensions of Same structure with alterations or additions. Frm ' ~'~ '~[1~ ............ , ' ·
9. Size of lot: Front J~,2~, '&} ...... ~. ~ ...... ' ..............
.............. Depth
10. Date of Purchase Or.~ %5~ ....
II. 5one or use district m which premises are situated..~m~Xr~ ........................
12. '''
roes proposed Construction violate any zo ~ no D'" ~' ................. ~ ...........................
13. ~ d~, ormnance or regulation: .~0 .......................... ' ' '
Will lot be regraded Mc ....
N~e of Contractor ~ .Omp~ ........ Address .~Q ~qr~3' 5~5 ..... Phone No.
15. Is this property ~it~n' ~b¢' ~k~' LTL' 2'.L' 5ddre~s - '& ................ Phon No ...
· If yes, Southold Town Trustees Permit may be requirg~j · · i~o .........
.... PLOT DIAG ~M
Locate clearly and distinctly ~I buildings, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from
prope~y Hnes. Give street ~d block number or desc~ption accord~g to deed, and show street names and indicate whether
~ntefiororcomerlot. ~ ~ ~ ~ i. l ,
FATE OF NEWq~.K~f-'_ [ I ~ S S
oua r¥ oF .... .
N '.' '.' ~ .... t ..................... being duly sworn, deposes and says
6 ameo[md wdua signing contract)
'OVC ~3nlcd.
(Co ag fi ................................
ntractor, ent, corporate of cer, etc.)
said owner or owners, and is duly authorized to perform or have perforated the saki Xvork ~IId tO make and file this
qicalion: that all statements contained in thk application are true to the best of his
"- wdl be perfo~ed in the m~nerset [orttl itl the applicadon ~Icd d~erewith, knowledge and belief;
om to before me ¢~i! ............ and that the
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
January 24,
1996
Romanelli Realty Inc.
Box 544
88 E. Hoffman Avenue
Lindenhurst, NY 11757
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
xx
No Underwriters Certificate on file.
The check is not on file. $50.00
No Health Department Approval on file.
Ne final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 20319-Z
Please contact our office on this matter.
cooperation.
Thank you for
$OUTHOLD TOWN BUILDING DEPT.
DEPARTMENT OF HEALTH SERVICES
COUNTY OF SUFFOLK
ROB='RT J. GAFFNIEY
SUFFOLK COUNTY EXI:'Cl. JTIVE
April 27, 1993
Cashin Associates, P.C.
1200 Veterans Memorial Hwy.
Hauppauge, NY 11788
Attn: Gary Matz
Re:
Bert's Reliable Fuel Oil
SCDHS JOB No. H~9~-337R1
SCDHS ID Nco 10-0029
Gentlemen:
Enclosed please find plans submitted to this office for the above
referenced project. These plans have been found to meet the
standards of Article 12 of the Suffolk County Sanitary Code and
have therefore been approved for construction as noted.
Contact Mr. John Gladysz of this office at 854-2524, at least
48 hours prior to starting construction, to arrange the re.quired
inspections. Toxic or hazardous materials may not be put ~nto
the storage facility until this Department gives final
installation approval and issues a permit to operate.
If you should have any questions in this matter, feel free to
contact me at (5~6)854-2540.
Very truly yours,
Public Health Engineer
er,-.c ·
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG,
[ ] FOUNDATION2ND [ ] I~ATION
[ ] FRAMING [ ~J' FINAL
[ ] FIREPLACE & CHIMNEY
BOARD OF HEALTH .........
3 SETS OF PLANS
...................
CU E< ....................
SEPTIC r o t(:t ..............
/ HAIL TO:
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN FIALL
SOUTFIOLD, N.Y. 11971
TEL.: 765.1802
'\pPr°ved '~'~' · .~...~. ·., 19 .°l). Permit No. om' o ~1c~"7C.
Disapproved a/c , ~
................ , .........
APPLICATION 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
ets of plans, aceurgte 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
tr a,reas, and oiv' ~,
:ation. o mo a detailed description of layout of property must be drawn on the diagram which is part of this appli-
c. The work covered by tkis application may not be cbmmenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector w~ill issued a Building Permit to the applicant. Such permit
hall be kept on the prentises available for inspection throughout the work·
e. No building shall be occupied or used in whole or in part fdr any until a Certificate of Occupancy
!:all have been granted by the Building Inspector.
APPLICATION IS HEREBY IvlADE to the Building Department for
3uilding Zone Ordinance of the Town of Southold, Suffolk County, N
{egulations. for the construction of buildings, addit ons or alterations
'he app cant agrees to comply w th ail applicable aws, ordinances, bi
dmit authorized inspectors on premises and fin building for necessary/ns
Permit pursuant to the
Ordinances or
ition, as herein described.
e, and regulations, and to
or name, if a corporation)
(Mailing address
;tatI whether applicant is owner, lessee, agent, architeC't, engineer, general contractor, electrician, plumber or builder.
..... ........................................................ . ........................
~ame of owner of prmnises . ~Q .~a\\ \ ~ 0, ~0~ ~ '~
(as on, the t~ roll or latest deed)
t' applicant is a corporation, signature of duly authorized ffficer~~ ~PPR0~ED ~S
...................... ' ................ FEE:.~_~ .'~ m,. g ~ .
(Name and title of corporate officer) -
8U~LO~F~G OEPA~WME~rr
Builder's License No. ~ ~ 7BS-L~02 9 AM TO 4 PM gO~
Plu ~ber's License No ........ ; ................ FOri POO~E~ CO~CSgTF
Electrician's License No..~ 0.~%~. ~. gt . a. msu~,no~
4, FNAt ,~ ' - . ' '
Other Trade's License No ...................... gE co~Pt,~r~ FO~ C,O
ALL COfgSTRUcTIoP, t SHALL
Location of land on which proposed work will be clone. T~-I~ RFQU
......................... ~- ~ ~m~m..0~. 'fl~-. ~.~...
.................................... ?'9,
llouseNumber Street --~>"'~% ~ g~;v~::,-' .... 7,'
ConnW Tax Map No. I000 Section .. ' ........ Block O[, OO Lot DOG, OO '
SubdMsion Filed Map No.
(Name) .............. Lot ................
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~om~g(CX~k ~ . ,.
b. Intended use and occupancy ~ ,~ '~
3. z lc). e ui~ m .. Addition .......... Alteration .
! ........ · ............. Other Work ..........
E tim ted C ~. ~F~',OOO I00 (Description)
4. s a ost . ' ' ~ ..... I ........................... Fee ...........
5. If dwelling, number of dwelli4g units.. ~,~ ~ ..... (to be paid on filing this application)
. I~garage, numberofcars ...~.. . .. "' Numbcrofdwellingunitsoneachfloor ....
' '' ' ' " Y: "~3 .......... Rear .~$:.Q'.'... Ocpt]~'.g47Q'.' .....
· · ·: ...... ~u:moer of Stories .. ~.q~ ......... . . . ...
Dimensions of same st~ctur~ Cvith alterations or a ditio . . ' ............................
De th 0 ~ ~ ns. Front Mo C~ ' '
~'P '. '~'''~ ...... I'' IIeight ..~ ~,, .......... ~ ..... Re~r.~q.~:~ ......
8. w construct,on: Front· .~0 C~ - rms. ~ .~... ~ .......
~m~cnsmns of entire'ne ' · ' ............... Number of Sro
' ~... ~ear De
Height .............. ,. Nu~ her of Stories ...... , ....
9. Size of lot: F?ont .. ]p~ r ~'~.~ ..... Rear IGD~ ~ .............. ~. ·; ...........
10. Date of Purchase ~c.~ 1~ ................. De-th
I1. Z . . '.''". .... !' ................. Nameo F .... " "' '~' ...............
~one or usc d:smct m whmh prem scs arc situat,~ ~m~,~ O~er Owner ..................
13. Will lot be reerade
14. N~e of Owner of premises ~&~&~' ~; ..... .. Wall e~¥ fil~e r~moveq f~o~ premises: . Yes
N~e of Contractor .k~ Sw~ ............. ~ress .,q .~0ynX.?~ .... Phone No. q3~.~ ~qS~ .
15. Is th~s nra-arc,, .14~L'.' ~ ', ............. Aaaress . . nh ~ xr ......
· If yes, SouthoZd ~o n zda3 weCZand? *Yes ........ ~ ~' ' ....
~ w Trusceos Permmc may be required. N
.-. , PLOT DIAG~I
Locate clearly and distinctly ~l] b tidings, whether existing
propegy Hnes Give street ~d bl~- L ..... or proposed, ~d, indicate gl set-back d~ensions from
interior or co~er lot, ~ .umoer or aescfiptlon accord~g ~o deed, and show street names and indicate whether
TATE OF NEW,:YZZ~K.~"C~ I~ ~
(Name oJindividual signing contract)
~ovc Hflnled. '
being duly sworn, deposes and says
' is the !
(Contractor agent corporate officer ) ....................
, , ,
said owner or Owners, and is duly at thorizcd to perform or have performed the said Work ~nd to make and file this
plication; that all statements containe~ in this a~plication arc true to thc best of his knowledge and belief; and that the
~rk will be performed in the manner set forth in the applicatiou filed therewith.
om to before me this
·
......... ·
· ..~- .~M .... County
CLAIRE L. GLEW.
Not~ry PubllOo State of NeW York .
No. 4879505 i
Qualified In Suffolk County
{~m~l~lon Explre~ December18, 19 '--.
(Signature of applicant)
'.