HomeMy WebLinkAbout18701-z
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19728 DATE: February 13, 1991
THIS CERTIFIES that the building ALTERATIONS
Location of Property 2260 GREAT PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 145 Block 4 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 14, 1989 pursuant to which
Building Permit No. 18701-Z dated DECEMBER 20, 1989
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 ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ANTHONY J. & MARIA MERCORELLA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-158431 - OCTOBER 31, 1990
PLUMBERS CERTIFICATION DATED FEBRUARY 9 1991 - ROBERT 0`BRIEN
~2/
Building Inspector
Rev. 1/81
so>Rac xa ~
TowN o~ souTHOLa
BIitLA1NG aEPARTMENT
TOWN HALL,
SOUTHOLD, N. Y,
BUILbING PERMIT
(THIS PERMIT MUST $E KEPT ON THE PREMISES UNTIL FULL
CQMpLET1ON OF THE WORK AUTHORlZED3
18701,
N~ Z gate .../.,r`.t~~ a .,~Z..
Permission is hereby pra ed to:• ~
.....~ti y-.~......./..~~377
at premises located ct .,.~.,~,.~.0 ~~t;~i~~ ~ ~_.,..•.....,,p.....,~~~.~,,,y,,.
Ccwnty Tax Map No. 1000 Section .,....1~... flock ..........~.....~Lot No.....,T
pursuant to appifcatian doted ..,,1~~.~~.~ 29.(,f..7., and approved by the
Quilding Inspector.
Fee $
r..
$uff Inspect
Rev. 6130/80
Form No. 6 a ~...,,~~.J~!;:~~ }lq
~
TOWN OF SOUTHOLD J~ ~ 8 I~~~ tG' 3
BUILDING DEPARTMENT !
TOWN HALL ~~,e~ J
s~.nG. "s~rsr: .m~~-.n~
765-1802 YClWrq e~~ ~rau~~;,~~[ ~ ~
,~.~,w.~.,,..
APPLICATION FOR CERTIFICATE OF 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 $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
S. Temporary Certificate of Occupancy - Residential $15.00, CommerciGal $15.00
Date ~~a/j///l~:G ~j./IIJ ~7 y~
New Construction........... Old Or re-existin~jB~uild' p
Location of Property...~.'1'.bd.. ~~CC3/?/G'i~!F~".~~Yj~:...~'~QIJ.l(~4~1,... /~/.~~.•...rrQ~B'
House No. Street Hamlet
Onwer or Owners of Property. ~N r"/.`~!d!Q~ J' . ~ ~!g'~.!"~.. /j/j~'~Go!~EG G,g _
County Tax Map No 1000, Section... .J ~~....Block....~..........Lot
Subdivision. .........................Filed Map............Lot..
~ Z ...............LG
Permit NcS. .......Date Of Permit..".J .°'tb/.~~ ...Applicant!/7:~`~!v~ ~ ~:~~6
Health Dept. Approval ..........................Underwriters Approval..
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...~......
Fee Submitted: $
eon 19~a`G LICANT
' ,c''d~F{]~~~ TEL.7G5-18f??
icy s To~~rr or souruoY.n
,~'~;~"'na~'~~.~y q.~ ~ct- OPl'ICG OC BUILDING INSI'P:CTOR
v ~ ';9;;'~,i~l ~ TOiVNliALL
'~"Ory, ~ O~ SOtJTI101.D, N.Y. 1 1971
~,'~tya~ : r~ .
October 2, 1990
ANTHONY & MARIA MERCORELLA
2260 PECONIC BAY BLVD.
LAUREL, NEW YORK 11948
'to S9hcm This, May Concern,
47e arc unable r.o complete your Certificate
of Occunancy because of the fo11o~•~ing reasons.
/~~1n application for Certificate of Occupancy
/~s not on fi7.c. iENCLOSED)
1o tJnderc•~rit-crs C~:rtificate on file. i
/ ( ~'he rhec:}: i:; (*i€#~t~~r`tt~i/not on file.)
/ / No tlcal.L'h Dept. 1lpproval on file.
D:o final insi~ect:ion hay been made.
Plea:;r.. contact: our office on this matter.
Thank you for your cooperation.
I;u.ildir,q Pcr;ni.t-. t! 1 8 7 0 1 Z
Duilc3inc Dept.
"'k/_ Slo I'lumbrr Solder Certificate on file.
( al.l per;aits ~.t;volv.i.ng plumbing briny
.issued aLi.Cr April 1,1964 )
TEL. 765-1802
oc~~FFQL~'~~l~i TO'S°JN OF SOYJ'T330b,D
" ~`c OFFICE OF BUILDIIIG INSPECTOR e-~
d - P.O. BOX 728 ~~S' l,~ ~ i
j~~r! ! r,~, ; .
a , ~`~s~, r=n 14 s L=j~,~..,_e~~.
v' ~ TOWN HALL r ~:m~.~
vO~~c?s ~ SOUTHOLD, N.Y. 11971 t~~ ~ ~ ~~B ~ ~
4j ~ ~
C E R T I E' I C A T I O N
Date ~ ~ l
Building Permit No. /~$'~S °J'F>~~ ~8'`j39
owne r ~f,Q, ~°~~251Ll /ZOZCa~fZLL/f
(please print)
Plumber ,QoGf~~T~'r~/~.~' ~~i~f'
(please print)
I certify that the solder used in the water supply system
contains less than 2J10 of to lead.
l~t i
(plumber's siynatu e)
Sworn to befor^ me this
~~day of ~ 'f
,,a,~r ~ otary Public
Notary Public` /~~-J l County I 'tiAURAHILL
U NOTARY PUBLIC, State of NY
No. 4935372, Su(falk Coi:,-
i Term Expires June 27, 19fr1-'
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~~`
7J.1ri1U7 BUREAU OF ELECTRICITY ~'''
65 JOHN STREET, NEW YORK, NEW YORK 10038
Date ')<-'1"(,~t13P;1t :fi,1r19C1 Application No. on file fi(;Cst~f);y$`',41$~) AY 1j$iu'i;l
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced 6y the applicant named on the obove opplication numher in the premises of
nra~rfailnv l~><:ernrfrr.llra, f~GL:rI»s1~ f+n~r ~~,~Tr1.. p,82, llnkfR.~;~L,, luau.
in the ollowin location; ~ Bnaement t3U 1~
f q ® lat Fl. ^ 2nd F'1. .Section Bloek Lot
was examined on 1)1]•f,~O})f~;fl 't ~' ~ .I `d `I Il and found to be in eoneplimECe with the requirements of this Baard.
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT RUORESCENi OTHER bNi N W qMT K W ~ qMT. K.W AML. K.W. AMT. H P
1 i K I s1 f. 7'7 ~t i 1, .'I ~'
DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDERS SPECIAL REC'PT TIME CIOCK$ BELL UNIT NEATER$ MULTI.OUTLET DIMMERS
AMi K. W. Oll H. P GAS M. P. PMT. NO A. W. G AMi AMP qMT. AMPS TRANS. AMT. H, p SYSTEMS
NO.OF FEET AMT. WAnS
) 1i 1.
SERVICE DISCONNECT
AMT AMP TYPE NO.OF
METER
EQUIP. 5 E R V I C E
I A' 1W I ~ JW 3,9' EW 3,e' 4W NO. OF CC COND A. W G. NO Of HI-LEG A W G~ NO OF NFUTRAlS A. W G'
PER .6' OF CC. COND OF HbLEG Of NEUTRAL
7 1(111 t'H i X I, ;'. / i> { ,> j ~
h'R<a6:T k/H-'I
G.N'.f f:-7
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t.>lfrrt~;11, ~tv, i t arts
This certificate must not be altered in
~" l
ft, <~, ~:,h~~r, ~~~~
GENERAL MANAGER
return to the office of the Board if incorrect.
~ ~t „
er
be identified by their credentials.
CDPY FQR BUILDING DEPARTMENT. THIS C®FY DF CERTIFICATE MUST NDT BE ALTERED IN ANY MANNER.
~nl rss-isoZ
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST 1~1 IROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL ,n,f
REMAR S: 0, c~--
DATE l INSPECTOR
765-1802
l BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ROUGH PLBG. ,('~7~~~-~'
FOUNDATION 2ND [ ]INSULATION V~
[ ]FRAMING [ ] FI AL
REMARKS:
DATE ~ CI INSPECTOR
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G BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[~MING [ ]FINAL
REMARKS: -G-,~'~'-'~e.~''~ - r~'~-
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31 ' f°~~ " NOi't¢ ti SURANCE' C4~PAN
~ Ttt4~ IN ~~ROt1RK'E
r ~ a "5 30 JOSEP.I'I ~
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~ ~~"~~L1ERK~S ppFl+iS A
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1 " FX~ '{"',";';~;M;
~~='~ry~~,~L~7I1I\/J("~ BOARD OF HEALTH
~;-,~_;-=,L~m„L ~Ll~J~L"=ate 3 S£TS OF PLr1NS ~•.~s .
~i~„ FORM N0.1 SURVEY ...L?•.~........
j 4~ TOWN OF SOUTHOLD CHECK ~ J g•S~.. ~y, ;
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
BLDG. DEPT. $OUTHOLD, N.Y. 11971 NOTIFY ; ~ ~SBS
TOVJNOFSOUTHOU] TEL.:705.1802 CALL .~lT:l.l: •
MAIL T0:
Examined 19 S~>t~. C,}~. cr':I~~.cnt2~I:ca.~, ..~~77.•.....
Approved 19~ Permit No.. ~ ~ ~ 111 ~ U ~ ~~.r~.CX .
Disapproved a/c ~uRc~AS~ /~~~1
/ ` s/
( ~il~n specYOr)
APPLICA ION R BUILDING PERMIT
Date 15 .
. ~ INSTRUCTIONS
~
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ~
' 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 [Iris 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 iemoval 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 necessary inspec ons.
(Signature of x pp ~ ant, or name, if a corporation)
• (Mailing address of applicant
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . J 1~i11~ ..:-I: rk' ~~~il~.... Y.''.~ ~45' S°~ :~.C, ~L?`~ .
(as on the tax roll or latest deed)
ICapplican[ is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . • .
Plumber's License No. ~1~'~T D,'~~/E~ ,,LL
Electrician's License No. . ~,~"'i~.s ./W :Mv~.RAti/ ~A' 3(Q~3
Other Trade's License No . i~~~~n~~
1. Location of land o[n~whfi~ch proposed yw~ork will be ore; 2 ~ ~,.ut79~e'
Eiouse Number Street. Hamlet
County Tax Map No. 1000 Section ...~.~`S,.. ~ • • • • • . Block Lot . , 7`.......... , ,
Subdivision Filed slap No. Lot .
(Namej .
State existing use and occupancy oC premisesandDintende/~d,use and occupancy of proposed construction:
a. Existing use and occupancy l • • • U~ .
b. Intended use and occupancy . • • • • . .
3. Nature of work (check which appl}
cable): New l;uilding Addition Alteration .4~ .
Repair Removal Demolition ..............S~n~~h.... , .
Tennis Court Adcessory Huilding. .Pefice r or
4. Estimated Cost ~?°.c? . Fee .(.~y1%Q.
; .
If dwelling number of dwcllin urj (to be paid on'tiling this application]
g its Number of dwelling units on each (loot
If garage, number of cars ,~,/~k .
6. If business, commezcia! or mixed occ panty, specify nett c and extent of each tXX.P~,,c of use ./.X~~,~`/.'.. .
7. Dimensions of existing structures,l,if any; Front . , . Rear .....`lr.(....... Depth . .
Height .,l.~........ Number of Stories .......!r . .
Dimensions of same structure with alterations or additions: Front Rear . .
Depth I. Height Number of Stories
8. Dimensions of entire new canstntction; Front Rear Depth ,
Height Number of Stories . .
9. Slze of tot: Front Rear ....~~.r~`' Depth . .
10. Date of Purchase ' Name of Former Qwner .
. .
1 1. done or use district in which premises are situated . .
12. Does proposed construction violate any zoning law, ordinance or regulation : ;
13. \Vill lot be regraded ® . • • Nill'Cxcess Cill be removed from, premises: ,Yes
Nof"'.
14. Name of Owner of premises ...............Address ...................Phone No............... . .
Name of Architect ........Address ...................Phone No:.
Name of Contractor . ~ ~ ~ .Address ......Phone No. , .
IS.Is this property locaged within 100 feet of a tidal wetland? *YLrS.v ~NO....
*If yes, Southold Town!Trustees Permit may be required. '
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate al! set-back dimensions from
property lines. Give street and block riumber or description according to deed, and show street names and indicate whether -
interior or corner lot.
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STATE OF NEw YORK,
COUNTY OF . I S.S
• • • • • • • • • • • • •~n • • • • • . • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual si ing contract)
about named.
•
ficisthe ! .
.t.
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Cilc this
application; that ail statements contained in this application are trot to the best of his knowledge and belief; and that the
work will be performed in the manni'r set forth in the application Glcd thcrowitlt. • ~
Swom to before me this ~ ~
Notary Public, `t,-..~•~:~!~- , . • County ~ ~ , 0 /
MDR R47
78t
8;~t• DE VOE
StateotNewYorti (Signature•ofapplicant)
Terra Ezpiros Mgrchf30 19
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