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19689-z
~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20615 Date MARCH 31, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 645 GLEN COURT CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 83 Block 1 Lot 7 Subdivision Filed Map No. I,ot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 25, 1991 pursuant to which Building Permit No. 19689-Z dated MARCH 4, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANTONIO & NANCY VANGI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. PENDING - MARCH 30, 1992 PLUMBERS CERTIFICATION DATED FEB.13, 1992-MATTITUCK PLUMBING & HEATING uilding Inspector Rev. 1/81 i l08M NO f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAIL SOUTHOLD, N. Y. I BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 1 4 6~~ Z Date ...............1..............., 1 ~..6.1..~ Permission is hereby granted to~: ~ .,lt ....................l..rd'/.~ ~ .........,rd,..~1.......,Q.~ ....1....~f...r~.'..,~ ................................Pd~~~.~a~G/ ..~F~~_~'.~..1.. ~f 1~ at premises located at .....................(~...y..v,/2.........~~..,,~n~X~......1.......nl.`.~......1...... County Tax Map No. 1000 Section .Q.~ Block Lot No. pursuant to application dated 19.~~...~ and approved by the Bulidingrylnspector. L Fee S..d.4~.~~.~...~-J Building Inspector Rev. 6/30/80 Form No. 6 ~ ! ',.~~c'~-~=elckcr~ ~ * , . ~ 'C.-cam TOWN OF SOUTHOLD ! ~ ~ L ' BUILDING DEPARTMENT # TOWN HALL -~i,,-'~~1~~ 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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: 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 17 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 - $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 2/~3~~~. Z New Construction........... Old Or Pre-existing B-u}ilding..~. Location of Property....~.~.5.....~~~E:JIB..~.~1.`'4d .............~~~7P~.4-~.~................. House No. Street Hamlet / d ~7~ , Onwer or Owners of Property...~~'!V.R.:~"JF?.~`.`~!'..~lf~~~J./ . County Tax Map No 1000, Section.....~3.....Block.........~.......Lot.....~ J f Subdivision.. ~l ! 5~'?9-..~~.':`l.~T~ ...............Filed Niap.. S~ ~C~ ..Lot....... II cc ''7 / ~ Permit No...A%6~1.Z..DatenOf Permit.!-r!.?~ .~L~.....Applicant.:~~.~.~C~~rr~uC?F~ Health Dept. Approval....!v/!nn?.~~ ...............Underwriters Approval...~~................. Planning Board Approval...~~l.T , / Request far: Temporary^~Certificate........... Final Certicate...(.~..... Fee Submitted: $.....4:.5 : Uv c.~,p,~,, 4 ^3s~?.s . CO ~ d~ ~ APPLICANT TEL. 765-1802 oS~FFOU, coo, TOSVN Or SOYJTDOb,D ' ' ~c OFFICE OF IIUILDIPIG INSPECTOR ' ~ P.O. BOX 728 E ~;Y~' TOWN HALL y0~~%`c' SOUTHOLD, N.Y. 11971 . C E R T I F I C A T I O N Date Building P°e~rmit No. 1 ! Cry 1f Owner ~ ~ArJGr (pllease pr~ilnt) / I/ I Plur..ber/!/a'I'~,~~~~ I'~m6i:,w'rl7`ca+:.~~o~P. (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1; lead. ~r (plumb r' re Sworn to before me this , /rPT~~day of `~i~aJ/~.' 19 9Z- -cam Notary Pu Notary Public, `x-/~~r'/f-/~COUnty mI1FIfaACkfON ~i ~ Nw Yak OwNrd 6 8ullok County Twm Feb. ~a, i~a I~~g9 ~ Co ~ oG tS ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1>A~r, 1. $0;;{1,'/;;& BUREAU OF ELECTRLCITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date APR71: tAJr1y92 Application No. anJile 02Q~4FSei2lg2 1{ 0t74~5 THIS CERTIFIES THAT only the electrical equipment as deacrihed below acrd introduced 6y the applicant named on the ohooe application numher in the premises of rt[t. VAIJG;C f ~irFS (1C,i;N C'$'. l C!J'1'C1f(J rl[!° 1 Al,'C, in lhefollowing location; iz Basement 1st F'I. ® 2nd F1. ~~~1 Section Block Lot was examined on M~i.KCi'1 26t~~4~h arulfoundtu 6e in cmnpliance with the requirements q(this board. FI%TURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING OECKS OYENS DISHWASHERS EXHAUST FANS q CUTLETS INCANDESCENT fIUORESCENi OTHER AMT. N W AMi K W PMi KW AML K W AMT. M P ' g ' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. Oll H P GAS H. P. AMi NO A. W G AMi, qMP AMi. AMPS TRANS. AMT H P SYSTEMS AMi. WAiiS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V 1 C E AMi. AMP, rypE METER L.e 4W 1 A 3W ~ 9' 3W 3,0' 4W NO. Of CC COND A W. G. NO OF HbLFG A NO OF NEUTRALS A. G EQUIP. PER b OF CC COND. OF HbLEG Of NEUTRAL OTHER APPARATUS: "NO VICRAI, Dt5F1('1'Sr "Atl e1r:GrY~{rttl Burve~ rLa;i ilaen m~<te of: trite ex1~a;~ud • etsctxlcal e<1u:(pntetu. ~in L'tka! pr.sml Bea tndf,c.ute~(, " "No ohvioua LtDeat.lr~farto~ry i!onriit.ion +as f'ouTld. r1N. VArJGI G/~~~~~ 6/F'.i Gt,liif C7'. C ll't'QFIOCUK 1 iVV~ 11.939 GENERAL MANAGER Per r/ " 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 FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. " ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS pncs 1 P 1001071 BUREAU OF ELEGTRICfTY 83 JOHN STREET. NEW YORK. NEW YORK 10038 n is Dare FEBRUARY 03 t 1992 Appliration A'o• on file 02594992/92 N 222993 ( THIS CERTIFIEiS THAT only the eleetrirsl equipment as described 6abso and introduced by the applicant named on the abode application number in the pramKNS of RNTDNIO VANGI, 645 GLEN COUAT, CUTCHOOU6, N. Y. ~I in tkefollotainR Glcstion: ? Baeemen[ ~ let FL ? Ynd F7. q~ .Section Block Lut - uwa examined on JANUARY 27,1992 andfound to be in comp/ianrr with the reyuirernenta of thin Board. FlXTURE KE?TACIK SWIT07K RXTURES RANGES COOKING DKKS OVENS DISN WASNlRS EXNAUST FANS OUTLETS INCANDFXENT FIUOREXENt OTHEN Anti. K W. Anti. K W. A.Nf. [ W. Anti. K. W. Anti. N. P ¦ DRYERS FURNACE MOTORS FUTURE AFFDANC! iEEDERS SPECIAL RK'?T TIME Cltxl($ BEII UNIT NEATER$ MULTI-0UTIET DUAMERS AMf. K. W Oll N. P GAS N P Anti. NO. A W. G. AMf. qMP. Anti. AMPa. TRANS, Anti N P SYSTEMS Anti. WATIE NO.OF FflT SERVK3 DISCONNECT NO.OF 5 E R V I C E - Anti. AMI. il'PE ~ N 11 ]W 1 / ]W ] / 3W ] I /W OFFR RCDND. OF CC. COND. ~ NI-lE0 a ~H ~IEG NO. OF NEUiRAIS OF NEUfORAI oTNER AFFARArus: ' D6E'ECT3 Rl1dVBD A3 P1Et 10-22-91-1 • 3SRVTCE ffiI'1'Rl91CE CONDUIR OII<II.Y-1 . F d & 8 CONlR1UC'l~t LIC. #578-)9 G~ j~ POZ 215 90UTkiDID F NY, 11971 aEneta AIANA9i1 I1 C~ Psr This certiFicaN must n0f be shared in any monner; return to the offiu of the Board if incorrect. Inspectors moy be identified by ihsjr credenKals. UI DEPARTMENT. THIS C CERTIFICATE MUST NOT BE ALTERED iN MA i i~ i ~a' ~~~au~ I dui ~ ~ I I c ~ I I` i~ i~ - ~ rs~-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ]FOUNDATION 2ND [)INSULATION [ ]FRAMING [ FINAL REMARKS: ® Cv DATE ~ INSPECTOR J ; -1cLD i::SP?C;iu:: ~ ~~llbir. ~I i:ONMENTS •o m 1 . 3 ~l H H FOUNDATION _ (1st) N ' c~ m FOUNDATION (2nd) - 2. z 0 P,OUGH FRAME ~ PLUMBING y~ H 3. m~ m33 I1dSULATION PER N. Y. y STATE ENERGY CODE x A R9 ~ 4 . FIidAL ~ z ADDITIONAL COMMENTS: ~ ~n~ r~\ V V x m 9 • r H • Z d ' [+f ^o H 'tt cam..-~ / BOr1RD OF HEALTH 3 SETS OF PLANS d:~'• f y,~ FORM NO. 1 $UR V EY ~ • • • • • • . . 4S ~'L~ TOWN OFSOUTHOLD ClIL•Ch ~.Cb. BUILDING DEPARTMENT SEPTIC FORr1~............ BLDG TOWN HALL - OP pUTHOLD $DUTHOI„D._ lu.Y_ t1R7 t t10F I FY 5 d ~ ~It:.3~ TEL.:7GS~1II02 CALL ...9 19 MAIL T0: Examined Approved ~.CJ~l1.l,... 19~~ Pcttrtit No. ~sCl.l~ . Duapprovcd a/c • (Building [nspcctor) APPLICATION FOR BUILDING PERMIT ~ q Date . IS9/ INSTRUCTIONS a. Tltis application must be completely GIled in by typewriter of in ink and submitted to the But7d'atg Inspector, will • sets of plans, aeettrate plot plan to seek. Fee actirotding to schedule. b. Plot plan sho~vin~ location of lot and oC buildings on premises, relationship to adjoining premises or public stye: or areas, and giving a detailed description of layout of property must be drawn on the diagram whidtispart of this apF cation. e. 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 pert. shall be kept on the premises available for inspection throu~}tout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant 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 t` Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Rc_ulations, for the construction oC buildings, additions or alterations, or for removal or demolition, as herein desctibcc The applirsnt agrees to comply with all applicable laws, ordinances, building code, housing code, aad regulations, and [ admit authorized inspectors on premises and in building for necessary i s ignature of applicant, or name, if a corporltlon)~ • (ttaiting address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ....................~!ln~P~...............~./................................................ Name of owner of premises . ~i•rJ ~ /_V_i1`")C ~ _ . Y• :4'Jf'.T . • • ~ • ~ ~ • (as on the tax roll of latest deed) . lCapplicant is a corporation, signature of duly authorized officer. (A'ame and title of corporate officer) • Builder's Liccnsc No..._ _l~ v7 ~ _ _ Z...... . Plumber's License No . Electrician's Liccnsc No . Otltcr Trade i Liccnsc No . • Location of land on which proposed work will be done; I[ouse Number • ~ Street Hamlet • • • • • • County Tax \tapNo//. 10//00 S¢ction ~ 3• • • • • Bluck • , , , , • • • Lot 7 ' _ Subdivision ,t~,/ S h4 ..I~Lu FF F.i1cd tllap No. , ,~~1? ~ , , , , , Lot • (}.lantc) . State cx[sting use and occupancy of premises and in trndrd /u/sgey+uyd ocyeu~a\ncy of propose) constmetion: A. Existing use and occupancy......~~~..•'.•'•.•"•~/,C ..l::v.~~~~t`'~.g..... II,,,, . 8. Intended use and occupancy.:. .~•e•••'•`r`~~[c4f '"""~`1'~g • '~i . 3. Nature oC work (check which apQlicable): New Ouilding Addition . ......rt~f~~t~ ~ty Re air' Demolition ,Swimnrng o~ Tennis Court~...•.... RFmoval P o • • • Qccessor~ Building.......... Fence 2 ..Other W 4. Estimated Cost ~~f .~?C? : ~ . ~ v+,~r k........... . Fee (tn be oaid on filing this avplicauon~ 5, IC da•ctling, number of dwelling units , , , , , , , Number of dwelling units on each (loot , , ICgara^c,numbcrofcars _ 6. If business, commercial or mired occupancy, specify nature and extent of each ty(:c of use . 7. Dintcnsions oC existing structure if any: Front • •7~~.. ~ ~ ~ ~ • • Hciclu ~ ~ Rear L...... Depth l........ . - .NumpcrofStorics, ,r~~~;-;, ~ Dimensions of same structure wi !t alterations or additions: Front Rcar . • ~ ~ • Depth .....v. ~ . Flcight .....7.2':........ . Dirncnsions of entire new constriction: Front ...7, • • ~ ~ ' ' " • • Nwnbcr of Stories . Height 2~ . ~ Rcar .....7. Z..... Depth . . Num~er of Stories . , ~2 9. Size of let. Front .....1.'4~? P.car ......./,O ~...........DcP~.. 10. Date of Purchase , • ~ , Namc of Pot7rtcr Owner 11. Zone or use district in which pre{rtises aresituated • .~r• : 9Q ocs proposed construction viols c any zoning Iaw, ordinance or regulation: • , !Z7.4 . 13, Hill lot be regraded /•`3 ~ , ~ , , , , , , ~yill excess fill be removed from premises: Yes 14. Name of Owner of prcmis~s u;o UA,wS t_ , • . ' ' ' Name of Architect . , Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Pltonc No.............. . ~ • .Address .Phone No. . Name of Contractor ~/~?S~i2F/~r/leCri • • • • • , pddress ~i4°.3/.~f!~?~[C,/~, phone No.:~`~.~":.56 3d ' 15_Ls this property located vithin~300 feet of a tidal wetland? -YES....NO.x.. *If yes, Southold Town~Trustees Permit may be required. PLOT DIACRAivl Locate clearly and distinctly all ~,bulldings, whether existing or proposed, and, indicate all set-back dims..^sior:: is property lines. Give street and block dumber or description according to deed, and show street names and indicate w::.::, interior or corner lot. • i~/~ . ~i I I I„ ' ~i STATG O F \ ENV YO R I:, COUNTY OF $•S ~'~-?A?'~i~??~',GiC Cam' . , • • • • • • • • • being duly sworn, deposes and says that he is the applicc: (1\amc oCindividual signing contract) about named. Fie is the ........•~~ll.~~i<in..-.:.I (Contractor, agent, corporate officer, ctc.)• • • • • • • • • • • ~ • • • ~ • ~ • ~ ~ of said owner or owners, and is duly) authorized to perform or have pcr(ormetl the said work and to make application; that all statements contai4ted in lhis application arc true to the best of his knowledge and belief; and Utat ttl.;. work will be pcrl'otntcd in flit manner set Corth in the application filed thcrewitlt. Swom to bciorc me this day of.l....~~"..... 19~/, n _ Notary Public. ,~~,M,2~~~-~,-, ..~..~./i~FC--~....County NEIEN K. DE VOE ++~r®®--•• TermExpirastMaSrch80,NewYotk . ;4~~.~.~ ~y No.4711187R,Su11olkCounty ~ ' . I (Si;namreoCapplican' I I I e l -ZQ- O Y Ott MI i 4' (y'~ - ~ Ip~ 6"~-----..~ - 6_ O„-___ - T- \ O~ b r+'r--r, - G + ~o,O~~ ~ah u i I ~A a~+ ~Q Ir.. V 4 - ' stl~l~ al _ . _ J I ''d T I ~,y`, C'/a~\ftaw ri'~ c RP.~\r~4 k+~ t ~ _ jjff { 5 ~ ~ T~ I ~_,^2,X tC1 ~:S LG~~O: C~i..1~Cb21oG~4,.y C.,, ~ i } ,~r , i ~ ~ " ~ 14°coe.ic. I ~W', , I ^ $ I Fa¢ Ij I ~ - , _ y s r:. .i n.:;+ ~ w~V. 1. ~ a 4 lip k ~ ""I'-" -r' w.-.- : ~ - - ~ _ ; 1 ~ ~SrL. l_catL.`( Cui..s f4 ~ ~ ' I ' ~ ~"a ._--n-.-' G ~ xm~ ~ - i~ e d I ~ ~ [ , t4 1 XZ o \h\fl24t~iV\ \LaSU S's , ..I.. ^.wr t_. f~ I, C SJ~ n i fff~~~ ~ GM~~~~l~5ou~f.~e.!.t M+arSYwW.!$ 2 e']I-" ~ , ~ ,..~/~Q~~ _ I t ~ ~I `i y~ _ ~ ~ I I ~nll S ' t17..5'C~::An~ct~Le,R:~.S3~d4'~S L'~C~~Lni, ~ ' ~i ~ ~ f~'' +A a ~r ~ 'Q I I ERS CI~u~'y,;F~ 11 ~ ~ -art-r- I, x t9 ~ ,i 5s a ~ ~ _ ~ ~ ~ + ulr,E ~ ~ AEQ ' I i + ~ L~3~ 2xan Gas ~r<x2 ~ r' d' r5 1, t . ~ ~ ~ 4~ I ~ f , 41 -13-10 ~ ~ ~"i ~I ~ a ....I PoN~C~ J 4 zu'xaaxLx'ezcsf~L) I t= ,r ~ I I~ r ~~n - j ~ 1 ~ ~ I _ _ _;f~.. I I ~ ~ 'T C o W C..,., S L,A L'a. ~ ~ ' ~ r i, ~I ~ y` r~+ ~ IJ ~ - j~4~'- ~uti~c~.x~c~vA_c-~p ~ - ~'~k~ ~ ~ ` mz ~ ~ C r ~ ~i I ~ ~ ~ I ~~I~ ~ I ki ''w r J ' ~ - i-= ~ ~~~I~1; ~~~~~t_~~ ~ ~ ~ ~ ~ is ail ~ _ _ - ~ I -.-.-.-..__r.-____-_._ ~ e rs o.+ e IO ' ~ I - - - I APPRpVED AS NOTED ~ ;u 1 to I Cc uC.Y~gT'FC+a. ` I - FEE: BY: ~ i ` ~ ` d ~ NOTIFY RUILOlNG DEPARTMENT A ~ i ' r 3-0 . a-o.,---~ Z• e> 5=_._..~. p„ 14.'J ---~~rs~=rtsmrs~M~fb-n9oNt foR~HE 'M v ` ' ~ ~ ~ FOLL(7WSIVG INSPECTIONS: ~ ~ i ~ -~Fbil7 cis E UIRED I~~ ' , I~t 2 RO,UGFI - ~ n. \ a 1 I'„ i. _ 13 _A' _ _.____.T.r. -T..-:., _~!!i 61,_ O Z7_ ~ M Fi 4 U~AT O RO~ ~RUCT ON MUST ~ al F' ' 9E (COMPLETE FOR C.O. 1 ~ "~~1 ~ ~ ~ ALL 6"ONSTRUCTION SN~ALL MEET ' . ~ ~I y ~ ~ . _ '!'HE RIEQUIREMENT5 OF THE-N.`? = ~ ~ . ;STATE.: CONSTRUCTION & ~ ~ ~ ' r' ~ ~ ENERGY GOOF_55. NOT RESPONSIBLE FOR ~ ~ ' ~ OESIGtlV OR CONSTRUCTION E(iROR:i ' ~~y, rrul i _ ~ _ ~ , ~ ~ - r j~'~li ,ia ~ , ~e ~gp9vrL,BkhV~Ptl ~~u tlu:w:aE~; , - ~ C CdAfE4t,.PJ I - 1 ~ ~r.~.: ~F X[ ( ~ - - ~ i ~Z 6'4' - / _ 1 I V - 4 - I f Y J ~ Y~ ~ ~ I ~ ~ a(-/ ~:Y ~ V 1 ~ a9J/ ~ r~ \ _ L/ ~ ..~P: o ~ - L..~~ ;a i ~ y _ cc o5.c 5~ I ~ .2 ~ Z,~ z. ^ves~ z-z°6 s~oe ~ 4„ i /~ipY'i ~ ,~Y3°4±c~=~~?.~ Sn"~C' J I ~,b' 1~ 6~X ¢a ¢ a-r.1 L... ~ PAS , . Q' ~ © -i ~ ~+N I lt1q~K=l rl.C~nT ~CT: Go, / x ~ ti I ~ ~ 2 6 - o _ a - I ~ / ~ ~ I ` L~ ~JLEGP~~~-G `~~T --I~ II j ,I ~o I ~ - - ~ I j - ~ ~~-o' - - _ J ' . . ,