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Home My WebLink About20180-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27019 Date: 04/04/00 THIS CERTIFIES that the building ALTERATION Location of Property: 1275 BUNGALOW LANE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 3 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 1, 1991 pursuant to which Building Permit No. 20180-Z dated OCTOBER 3, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued is BATHROOM ON SECOND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate ie issued to LOUIS O. & PATRICIA GIGLIOLI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-059430 04/09/98 PLUMBERS CERTIFICATION DATED 02/02/00 FRANK MEYER A o zed Signature Rev. 1/81 I~. 0 POEM NO. 1! 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 2 0 1 8 0 Z Date 19.l. Permission is hereb granted i ~~.r.....~~.... ~ of premises located at ...........,~.E..r .............s!~,',~~.~~~.."..~ ~`f.~' 4~:....................................... .........................................................~.~.i~;~c~~?G„ County Tax Map No. 1000 Section ......,lv.Z..-°°,'~..a...... Block Lot No.....~.~~ pursuant to application doted .....~~.~'......1 19.~f and approved by the Building Inspector. v-~ Fee $..:"l..t~.`j(.~.. ~ :........................t........y e?:........ ilding or Rev. 6/30/80 rorm ivo. o ~ I ~ ~ ~ ly~~ TOWN OF SOUTHOLD ~ i X ~~-~-v--~ BUILDING DEPARTMENT ~ ~ I ` ~ J TOWN HALL ~ 765-1802 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 farm). 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 $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 - .25~. 4. Updated Certificate of Occupancy - $50.00 5. Tem orar Certificate of Occu anc Residential 15.00, ommercial $15.00 P Y P Y- $ C / Date New Construction...,...... Old Or Pre-existing Building Location of Property... ~iZ 75.... ??.~~~:~Gf?`~.... l~~l~G...........:~/f.~7,~rG-~ C House No. Street Hamlet Onwer ar Owners of Property........./.1.4f:l3..:! ~i~,Tic.r:~'~d?.....~.-'.G,.F~.~.<f?`:`:5 County Tax Map No 1000, Section....`~:.J .....Block......-,-~ .......Lot.......1 Subdivision ....................................Filed Map ............Lot.. Permit No ."~tl~~U..~f.....Date Of Permit.. ~.GJ~3/~/. ...Applicant.li~~l.1.`~..0~°. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Cer at Fee Submitted: $ C~~.. 5696 C D z2'o~7Qt q APPLI T 4 TEL. 765-1802 ~pS~FF~~CpG TOWN OF SOUTHOLD ~~'c. OFFICE OF BUILDING INSPECTOR c ~ ~ ~ P.O. BOX 728 u' ~ a C TOWN HALL .YO~~O~ SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date rv~cry ? 2-60L) Building Permit No. ~ 2= Owner (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. . (plumber's s~gnature) Sw,.,o~r,qn to before me this `.I:.~' day of ~ X00, No ar"y Public Notary Public, q ~U ~ County E11ZA9E1H:lOHtdSON~PATRICK yo ~gx57~SSui(oikCouMY Canvttission ~ 4Y189d' ~Q . $070445 THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Hare APRIL 09,1998 15734698198 H 059430 Application No. on fele THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above appHca[ton number is in the premises of LOUTS GIGLIOLI, 1275 BUNGALOW LANE, MATTITUCK, NY irz the foddowing location • ? Basement ? Ist Fd. ®2nd FL. Section Brock Lot was examined on MA~2CH 30, 199$ and found to be in compliance with the National l;Zectrieal Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. KW. AMT. K.W. AMT. N.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'Pi. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS NO. OF FEET AMT WAiiS SERVICE DISCONNECT NO. OF S E R V I C E METER AMT. AMP. TYPE E9UIP. 7 0 2W I 0 3W 3 9 3W 3 0 4W NO.OPERCOCOND. OF CCWCO~ND. NO. OF HI-LFG pF~HI~LEG NO. OF NEUIRAlS A. W. G. OF NEUTRAL OTHER APPARATUS: BATHROOM ADDITIONAL-I, "NO VISUAL DEFECTS, "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition Taas found. LOUIS 0. GIGLIOLI ~ ~O1wJL 63 2ND STREET BROOKLYN, NY, '11231 GENERAL MANAGER Per 1 ~ This certificate must not be altered in any manner; return fo the office of the Board if incorrect. Inspecfors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-1$02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSU ION [ ]FRAMING [ FINAL [ }FIREPLACE & CHIMNEY REMARKS: DATE q INSPECTOR '1ELD I;;.`•,.c .iJ:i ~~Jn:.. I~ :;v:Ki•tENT~ t, m ~ H ? ~ 'OUI7DATI0"I ( 1st ) I y 'OUNDATIO;J ( 2nd ) ~ -I - C I o TOUGH FRAME & PLUMBING H Z. ~ m an :NSULATI0;1 PER N. Y, y STATE EPlERGY CODE I T ' r l~ ~ . m ` ~ ~ 9c ~ y • FI;lAL I . I V TTIOPI L CO EP;TS x c_ C~ . w • rl ~ 3~ ~c~~~ ~1 • • ~ x ro H 7] ' 9 H r.. O V~ T m a r H T m .9 H • a l 765-1802 BUILDING DEPT. INS~EC7'1®N [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE S CHIMNEY REMARKS: ~ ~ r~ DATE l 1 INSPECTOR WpLTEP HEPZFELD 1180)-18381 LARRY B. REIGN HERZFELD S.ZL ~ V 8' N, FR C. HOWARD b EDINBVRDH WILLIAM H. CO% HERBERT PUBIN EDWARD P. SPEIflgN ROBERTq BERNgflD LINDA GENEPO $NLAflEN BERNARD J. WALD DAVID B. HAMM IVAN LAWNER CLIFFORD 8. AARON MICXAEL HOENIG XENNETX M OpEEHFIELD ATTORNEY 5 AT LAW MgRC G FOSENPEpG SNgPON HYMAN EOWAAD L 01PN8gUM JEPOME R HELLEPBTEIN PERPY L MINTZ CHARLES E. O'BRYAN IAN CEREBNEY JONATHAN HERLPNOS QO WALL STREET MqP%D. ROSENZWEIG MICHELLE PUSSO THEODOPE NESS MARVIN E POLLOCN PATPICIA 21NC%E EPIC B BETTELHEIM FRED W PgU3%OLB III WILL1gM B RANDOLPX MIR1pM S%OLNI% DONALD D CASALE JOHNA SCHULT2 JONNM SCHWAPT2 NEW YORK, N. Y_ 10005 LESLIET WILLIAMS LINDA M. BPOWN ELLIH M. MULNOLLANO 0. THOMAS SCHWEIZER DONNA S. FRIEOMAN MAUREEN OOEpNER FOGEL LEONARD M POLISAR HOWARD L WE%LEfl ISAAC D SEPILZINGER EMNANUEL 6 NTIAMOAH BEYMOUP %AGAN HAROLD) Mc HAY TELEPH ON E: 1212) 344-6500 MICXAELS OgLWB SANORAE POTTEP MARTIN B. FRIEOLANDEP CARP STEWPRi SELAREN TELEFAX'(212)34A-3333 JPNET O'CONNOP CORNELL JOSEPNB pO3ENBERG MARTIN L. LIGHT EUGENEP FEIT CABLE" PIEROWAL NEW YORK NOPEENM GIVBTI PLAN D. STEWAgT DANIEL V. OSOVB%I WILLIAM C GUIDA yV. U. 1. 6615A1 EDWARD V. BCNWENDEMANN MARTIN J. MOS%OWITZ JEFFREY L CHABE CARL T GRpb50 NANCY HEPBHEY LORD LLOYD A. SAPpO TERRY MYERS PETER J HUPBHAN STEVEN A.STEIOERWALD MICHAEL L. STONBEPG HARRY P~ BPAUNSTEIN SHIRA p. SCHEINDLIN PAMELA L. M1LEINBEPG ROGER E.PPENTZEN JEFFPET GOL%IN COUNSEL ~ ~ y ~~L~Cf _ 1 ~~j SAMUEL RABIN LOTS M BflENNER 6 ~.l BENJAMIN b HLAPPEP EMANUEL P OOLD GERAPD C FALCON JOMNJ OPISCOLL GISELLA LEVI CPROTI ALLEN MUPPAY MYERS MARTIN A. ROEDEp JVOY B. BROWNBTEIN p CXARLESA CRUM September 30, 1991 SPECIAL COUNSEL pAPON D.TWEPBNI VIA FEDERAL EXPRESS Town of Southold Building Department Town Hall Main Road Southold, New York 11971 Attn: Gary Fish Dear Mr. Fish: Pursuant to our conversation enclosed please find a copy of the application for a building permit, three copies of the plans and specifications, one copy of the survey and a check in the amount not to exceed $300.00 If the foregoing is satisfactory please issue the building permit together with the certificate of existing. If an inspection is required please call. Very truly yours, HERZFELD & RUBTN, P.C. ° ~j Ma (~rc G~.~Rosenberg%`"`~ MGR/os encl. _ix.v.. a ~"Y . « n ! yy f 1 5(~ ~~IX~~FY~ 1)(~)l t(1~~ _ i 1i ~ .v.... _ t~ >a SA~ ~ b:,~ ~ ~ ~,n ~j HERZFELD & RUBTN ~ H `=}~ry~ri. ;7;;~ i, E~~I~„gf~JjRL3BIN~;~. HANLON, HERZFELD &RUBTN 1925 CENTURY Ppg1t EAST ;~BOI'BRICNELL AVENUE 10 PPR30NAGE ROAD LOB gNGELE9. CPLIFORNIA 9003) MIgMI. FLORIDA 33131 EOIBON. NEW JERSEY 03B3T TELEPHONE 12131553-0451 TELEPHONE (305)301-7998 TELEPHONE 1908)349-9880 Form No. 6 TOWN OF SOU1'fIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION POR CERTIrICATE OF OCCUPANCY This application must be filled in by typewriter OP, ink and submitted to the building inspector with the following: for new building or new use: I. 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. :3. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date :;ew Construction........... Old Or Pre-existing Building ' Location of Property House No. Street Hamlet Unwer or Owners of Property County Tax Map No 1000, Section ..............Block................Lot...................... Subdivision....... .............................Filed Map............Lot...................... i'ermit No ................Date Of Permit................Applicant............................. !iealth Dept. Approval ..........................Underwriters Approval......................... !'fanning Board Approval Request For: Temporary Certificate........... Final Certicate........... !'ee Submitted: $ .........APPLICANT y7~ l.S G~ G ~2/3 ~~~as~~ BO.1RD OF HEALTH FORMN0.1 J SETS OF PL1:iS .......,s.. TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT C1ICCt : TOWN HALL SEPTIC FOR:t . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Uo<IFY; ~~jj CALL xamincd ~ 19 rte, G NAIL TO . PProved ~a,(~ 19 Permit No. r.7 v~.L! ~ . . isapproveda/c 4•`~'• F~~..... uil o Inspector) APPLICATION FOR BUILDING PERMIT Date 19.. . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 [s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. c. The w. covered by this application may not be commenced before issuance of Building Permit. d. Upon _yproval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit all 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 all 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 iilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ie applicant agrees to comply with all applicable laws, ordinances, buil g code, h usin ode, and regulations, and to mil authorized inspectors on premises and in building for necessary insp tuns. ~ " " (Sim ature of a~p~ 'cant,~or~~ ~ if a~tion)... . ~ z-¢'e~d - ~~r~ rn • .cY?~? ..~~['1.641eE 11 - (Mailing address of applilcant) ~~p~((~~~~yn/Y~p~/~ ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or~buS~derkj. ~ODO,~ .....~w.n.?.r.~ . . ime of owner of premises ,~r~~l./. F..CJ. ~~~~~,P`~~, ! C~ , , , , , , , , , , , , , , (as on the tax roll or lot t decd) applicant is a corporation, signature of duly authorized officer. (N'ame and title of corporate officer) Builder's License No . Plumber's License No . . Electrician's License No. . t:.c, . ,.u . . Location of land on which proposed work will be done, House Number Stre P Hamlet i~ County "Pax Map No. 1000 Section B!eck , , Lot , . Subdivision Filed ~4ap No. Lot............... (Narnc) State existing use and occupancy of premises and intt nd~d use and occupancy of proposed cryonstrur,tiur.: K ~7i~C~ a :risting use and occupancy v ~1~5~"~l'..f~lfl'~1.~~. ~~G~~~,~ E--; ~`%x' f~` ~..~~'',I';";~:`.`~ ...!~J. . +i~ - ar_,a, ` , ` ^ndcd use and occupancy ...1.1,G(tt ~4f.....~1~1( . ~~Jl/r).~-:-....^.. ,t~L~.~~.k, C;'~;~;7'/. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . ~... _ Repair .............. Removal .............. Demolition ... Other Work ............. : (Description) 4. Estimated Cost ....... ~.~..~5, ....................... Fee ................................... (to be paid on filing this application) 5. If dwelhng, number of dwelling units ............ Number of dwelling units on each floor ................ · If garage, number of cars ...... ,... 6 Ifb or m' i ...... . ..................................................... · umness, COmmercial ~xed occupancy, specify nature and extent of each type of use . ~.~....: ......... 7 Dim sio isti if F t ~.~'~.r o~. Rea~. ~.~q c~.~ ~pth · en nsot ex ngstructures, any' ron ~.. . . Height ............... Number of Stones ........................................................ Dimensions of same structure withI alterations or additions: Front .'~ Q/*~. · .~. ·.. Rear .................. Depth ...................... ! Height ...................... Number of Stories ...................... 8. Dimensions of entire new constru4tion: Front ....... ~ .q~gZ~. '(~4r ............... Depth ............... Height ........ N ' ' ....... um ~b,er of Stones ............ 10. Date of Purchase ............. ! ................ Name of Former Owner ............ · ................. 11. Zone or use district in which premises are situated ..................................................... 12. e · · i . . Do s proposed construction violat~ ~}ny zoning law, ordtnance or regulation: .................................. 13. ~ill lot ?~regrad? ...... >. ~.~:,...> ...... ;.. Will e~x~;e, ss, fil]~ bt~ r,en~ovcd from premises: Yes [4. ~ameoluwnerolpremjses ~..~,;t·qy'?f~4'k'rt3Pt, Carwet4a,td..,~ee 7/orreo'~ Zt ~,:. ott ~ ~ r-. , ~ v, s ,,amc of, ~Arch)te~t ... O¢ o.a. lcJ...F~.~.I~.' .' ...... Address .~...vO. ¢ff.5/~-~/e. gtq . Phone Nok2,/Aj.45:* marne olcon[ractor ;. . . ^a~,~, ~r/~er~ r~( ~o ¥ ..... · ..... 5. Is this property within 300 feet of a tidal wetland? *Yes. Trustees Permit may be required· · If yes, Southold To~n ....... No ......... PLOT DIAGRAM Locate clearly and distinctly all b~ildings, whether existing or proposed, and, indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or comer lot. 'ATE OF NEW YORK, )u rry OF. S.S, . .. v,e.a .... -...... ............... Dye namcd. ! (ContractOr, agent, corporate oqficer, etc.) xa/cl..,~m~~, and is duly au!thonzed to perform or have performed the said work and to make and file tlds '4ication; that all statements containe4 ~ this application are true to the best of his knowledge and belief; and that thc rk wilt be perfo~ed in the manner self forth in the application filed therewith. orn to before me this i ................... dayof ......... ~7 ..... 19. ~~~1"~ iil~ tn New Y~ , , ...........