HomeMy WebLinkAbout18600-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 220132 Date AUGUST 7, 1991
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 640 CHESTNUT ROAD SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 03 Lot I6.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 23, 1989 pursuant to which
Building Permit No. 186002 dated OCTOBER 26 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____ONE FAMILY DWELLING, ATTACHED DECK AND 2 CAR GARAGE
The certificate is issued to SAL C. RIZZO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-91 JULY 29, 1991
UNDERWRITERS CERTIFICATE N0. N126274 APRIL 27 1990
PLUMBERS CERTIFICATION DATED PERFECTION PLUMBING MAY 17, 1991
Bu lding Inspector
Rev. 1/81
rosat xo. s
TQWN OP 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 ~ ~ 8 ~ ~ ~ Z Date ~...1'.i?...........c~:. ~t?........., 19.
Permission is hereby granted to:
.~~.x. ~
......................................................................1...........................p....................................................
at premises located at ...~..T..~.......~,r~-~:5~.'....~-~...........C~.~
E' ,..3
County Tox Map No. 1000 Section Block .....Q..~........gLot No. 'r~
pursuant to application doted ....5~..~~..-....!~.~~ 19~..t., and approved by the
Building Inspector.
Fee $....1. g..l....
uilding Inspector
Rev. 6/30/80
'Ir)T.uZ x'm:~IL ~~3 d
Form No. 6 i~, t!~ ~ ~
Q TOWN OP SOUTHOLD
A'r ~ ~ ~ BUILDING DEPARTMENT
HW TOWN HALL
765-1802
BLpG. pEPT.
TOWN OF 5OUTH0Lp
PLICATION POR 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 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 archi•-ect 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.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions Co 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, Commercial $15.00
s Date
]ew Construction..?.....//.. Old Or Pre-exi/s/ting Building../.~~./. ........r,.^...
.ccaticn of Propeity....lly~ .............C.~~.`rs~/~l/~,../.4~1........d.~UT~p~,~l-;J.............
House No. Street Hamlet
rower or Owners of Property...~~~ ...ccyy~.~~ L~ ~
ounty Tax Map No 1000, Section..r3.G.:~.....B1ock...~...........Lot..: .~rO."',......
ubdivisionl
............................../...../Fileed Map............Lot..P....................
ermit No. l.~~6b~,.....Date Of Permit..l~~LS~~G`.1....Applicant..~i9~,.4-. ~~~rz~...........
ealth Dept. Approval...y~:~ ...................Underwriters Approval. ~G~...................
lanning Board Approval., ~~;5
:quest for: Temporary Certificate........... Final Certicate.!%........
'e Submitted: J~,,,,,,,,,,,,,,,,,,,,,,
y~3s~
d ~Z ~ 073 ~ J~/~/ APPLICANT
18
THE NEW YORK BO/RRD OF FIRE ~i!"fN1TER5 PAre i
1~I(ll)iYQ BUREAU OF ELECTRICITY
B6 JOHN STREtT. NEW YORK, NEW YORK 100iE.~
Date ANC(11_ 2Y,1<ty(r ApplfcstionNo.onfile 66Ft(117bY1134 N 7/G`I'Yd
TNIS CERTIFIES THAT ~k:
~ only the efsctricd equipment a deacrilred helolo and introduced by the applicant aawted ou tM ahoee appNeat(on nurwltsr to tMrrewtiwa q/
SAI_ RtL~ri, Hk.O I:Hf:STNt)1 RUAU, PULL N'S, tiUl1THfILU, N.Y.
(.'AR/Alit(:/(lllT " -
in thsfdbleirtR brotion; ~ Basement Q Ixt Fl. ? Ynd FI. Section Bloek /ot
ores examined oa ANN C I. 1I I , i `BSI) end found to be in romplienee with the reyuiromentx of thu Board. -
tiX11N! AUK fWITCX6 _11X7UM6 RANOIf 0001(St9 WCIIS O DKII.___
-
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TEL. 765-1802
~o5~FF0~-~o~ ~ro~r~ or s~~rT~oa,~
, .~~.c OFFICE OF BUILDIPIG INSPECTOR
~ L ' „ P.O. BOX 728
~'E~` '~ry`1 ~ TOWN HALL
0~~~ ~~`r 50UTHOLD, N.Y. 11971 .
01~~
C E R T I F I C A T I O N
Date %/7~g~
Building//~~ Permit No. /~(,®fJ
Owner ~~¢G ~LLU
(please~p/rint)
P1usber~r~d7eo,a y~/v~i~iw~ `+~/J~tf~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead. ,
(plumber's signature)
Sworn to before me this
/7~day,of
~ ~f9-t~s~ELP~~
19_ZL_• Nr tart Public
tlotary Public, Q~ County LINDA J.COAPER
NNo8.~48225fi3. Suffolk County
Term Expires December 81,19~Y~
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tlnzrxr~ ~ TEL,~7G5-1802
Op~~FF.flt1f~OGy TOWN OF SOUTIIOLD
.~?r ~ OFFICE OP BUILDING INSPECTOR
`6~ P.O. BOX 728
~ ~ ~ TOIVN HALL
O~O! ~ ~a0<' SOUTfiOLp, N.Y. 11971
May ]0, 1991
SAVTATORE & FRANCES RIZZO
BOX 1614
SOUTHOLD, N.Y. 11971
To 4lhom This May Concern,
We are unable to complete your Certificate
oL~Occupancy because of the following reasons.
/J/ An application for Certificate of Occupancy
is not On file. ("ENCL05ED)
/ / No [Jnderwriters Certificate on file.
j~Tlic check is (o~~~~~~/not on file. } $25.00
No Ilcalth Dept. T.pproval on file.
No final ins.pecti.on has been made.
Please contact our office on this matter.
'Thank you for your cooperation.
Buildi.nq Permit i! 1 8 6 0 0 Z
Buildi.nc- Dept,
No Plumber F,o].der Certificate on file. ~ .
( all permits involving plumbing being
.icsucd after npril 1,19II4 )
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSU TION
FRAMING ( FINA4
REMARKS: . -
DATE ~ ~ INSPECTOR "
a
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INS TION
[ ]FRAMING [ FINAL
REMARKS:
~re..._.~„~"
~
DATE ~ INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ FRAMING [ ]FINAL
REMARKS: ~ L5.-f~,~~..~" ~~-~d~ ~ ; i""~
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UILDING DEPT.
INSPECTIQ~N
[ ]FOUNDATION '1ST [ ] lROUG PLBG.
[ ] FOUNDATION`~2ND [INSULATION
[ ]FRAMING ~ [ l FINAL
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REMARKS: ~•,~%t~.%~`tl.~'z-<~~~i~
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DATE l INSPECTOR
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( } ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: i
DATE I d?U INSPECTOR
1 ~~o~
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ] FRAMINfae [ ]FINAL
REMARKS: C~~
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DATE I / ~ INSPECTOR
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BOARD OF HEALTH
'FORMN0.1 3 SETS OF/PLANS -v.....
SURVEY
TOWN OFSOUTHOLD CHECK .?~G&.-
BUILDINGDEPARTMENT SEPTIC FORPf
• TOWN HALL ~7 ~f
SOUTHOLD, N.Y. 11971 NOCALL • • E =t•CI.7~
• TEL.: 7G5.1802
't~'~ MAIL T0:
Examined Q,~~G ~.14 „ 19 ~9.
Approved .c~(v., 19$q. Permit No. J. ~ ~ ~?4. ~
Disapproveda~c
. . a.~-.--..
D ~ ~ l5 Il V •15 ~ (Buildin; inspector)
APPLICATION FOR BUILDING PERMIT
Date ~/z;3 19~ .
BLDG. DEPr. INSTRUCTIONS
TOWN OF SOUTHOLD _
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 diagtam 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 hfADE to the Building Depaztment 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.
T}te 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 inspections.
>
.,..~~1~.~.i..~!..... ~'L}
(Signature of applicant, or n~rtYe, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, genera! contractor, electrician, plumber or builder.
Name of owner of premises cr?-~:.. ~ . f~~~'~~ .
as on [he tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST IIE S,UFPq K COUNTY LICENSED ~:0/vGG~E~'K f~D/t7('~'
Builder's License No. ...~o,r!~; .
Plumber's License No. ~~U ~?1.~~~~~' " '
~ Electrician's License No. ~r~.:~ .
Otltcr Trade's License No.d~.0,?; ,
1. Location of land on which proposed work will be done. ~C`~~T/~.U~ (C~ .
House Number Street Hamlet 3
County Tax hlap No. 1000 Section .....d Block .....3............ Lot . , , , ; ; , ,
Subdivision ..,l~P%o1/,G, /z, , , ,~I,~?S ~,[:~.5'~~~ Filed Map No. ,~/,D,/~/,~z:...... Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . .
b. Intended use and occupancy ~4r!~l~l!!'l.~ .
3. Nature of work (check which applicable): New Building Addition rUteration .
Repair Removal Demolition Other Work .
(Description)
4. Estimated Cost ~l.'s'./!z::•~!!±:l~.,.ltr:.~--~/
. Fee .
(to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
If garage,numbcrofcars
6. IC 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 .
Dintcnsions of same structure with alterations or additions: Front . Rear .
Depth ' .Height Number of Stories .
8. Dimensions of entire new construction: Front Rear ...............Depth .
- Height . Number of Stories t~. .
9. Size of lot: Front Rear ...:'Nf'S De,Pth .~/7. .
10. Date of Purchase . f~/.J~';„a Name of Former Owner >~f!~ . ~:E:n°:~f: . , ; ~ , .
1 1. Zone or use di..trict in which rc
12. Does ro osedcconstruction vo}attses are situatert .
P P to any zoning law, ordinance or regulation:.. ~~0.... , , r' . •
13. Brill lot be re raded , j , , , , , , , , , , , ,Will excess [ill be.removcd from premaes:
' r Y; d ...Address .~s.'./Ju1//..,7 ./Il ~ .Phone No-; y~ .i:~„J!'.~~~y, ,
"
14. Name of Owner of,premises.7a". 0 Address /.~f lyd+'?~`.'J~C%~~. Tk'/J.•Phone No, . ~ Yes I Np
Name of Architect aJal.. ~C~Y>>: ~ ~ d ~ , , , ,
Name of Contractor r;r~:4i.~~i-.4/~'rG.~'.'K:.~a~~~'y'.~tu , , , .Address ....:..............Phone No. lCJ'../lJ~l~ .
15. Is this property located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town 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
anterior or corner lot. ~ ,
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;TATS OF 1L-11' YORE, S.S
~Oli~TY OF
(lame of individual si nip ~ ~ ~ ~ ' ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
^ ng contract)
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Dove named. I
1ciSthe
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
~plication; that all statements contained in this application are true to the best of ltis knowledge and belief; and that the
ork will be performed in the manner set forth in the application tiled therewith.
worn to 6cforc me this I
.............a3 ....da°y~~ot....~~............, 19g`~.
otary Public, ....~R~P;~ ; , ,1;~•, I l1J,Q County ~
NELEN k DE VOH ~
NOTARY PUBIIC, State of,New York (Signature of applicant)
No. 4707878, SuffolkCouMy
Term Ezpires March 30,'19.....
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