Loading...
HomeMy WebLinkAbout17904-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219132 Date JUNE 11, 1990 THIS CERTIFIES that the building ADDITION AND ALTERATION Location of Property 95 BILLARD RD. & 895 PINE TREE RD. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 001 Lot 004 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 24, 1989 pursuant to which Building Permit No. 179042 dated MARCH 10, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the Iaw. The occupancy for which this certificate is issued is ALTERATION AND ADDITION, ATTACH GARAGE AS APPLIED FOR. The certificate is issued to PAUL LIBASSI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N085594 AUGUST 9, 1989 PLUMBERS CERTIFICATION DATED MATTITUCK PLUMBING & HEATING-9/21/89 ~G~-- ui ding Inspector Rev. 1/81 fbHM NO f 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°_ 017904 Z Date ...:3~/..o ~9.~~ Permission ~s reby grante to: ~o M ~v v. L D~. 2 s ~N C , ) ,~.~-0-~- ~1 i~9~1 ~a ct premises lototed at t~..~. ......K X9.,5..' .....`f..~' . County Tox Map No 1000 Section Block .......:l............ Lot No...,7"...... pursuant to application dated 19 and approved by the 6uddmg lI^nspector Fee y.-l. Q. uildi ( for Rev 6/30/80 t FORM NO. 6 • TOWN OF SOUTHOLD ~ ~ ~}i y ` Building Department „ir~~ Town Hall ~r' ` ~ _ 8 Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ ~y`pr--- 70WN OF SUUTHp~J Instrucrions A. This application must be filled in typewriter OR ink, and submitted ~r~ to the Building Inspec- torwith the following; for new buildings or new use• 1. Final survey of property with accurate location of all buildings, property Imes, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S•9 form or equal). 3 Approval of electrical installation from Board of Fire Underwriters 4 Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C Fees: Additions $25.00 , 1. Certificate of occupancy New Dwelling $25.00, Accessory x$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50 .00 3 Copy of certificate of occupancy $ 5.00, over 5 years $10 00 4.Vacant Land C.O. $ 20.00 y/q S.Undated C.O. $ 50.00 Date Z' ~ .1........ New Construction, Old orPre-existmgBuildmg v..... Vacan/t~Land Location of Property ! y ~.•L~7~ . lM......l.! ~ "f ~ N'° r! `'1 ~aP House No. ~ Street Hamlet Owner or Owners of Property ~ i4!~.L:.L ~ ~ Ia• S S. ~ . County Tax Map No. 1000 Section ...~.0.~...... Block Lot...:... Subdivision ..Q...Filed Map N~of. Lot No. . PermitNo.~1~R!}Z Date ofPermit~~94~.~.1 .Applicant t~-.QM.V,u ~~,11~.11r~i'1~-1 Health Dept Approval ' .Labor Dept. Approval ' Underwriters Approval .Planning Board Approval ~ . Request for Temporary Certificate Final Certificate . ~ ,pi0 Fee Submrtted $ Z y. , , , , , , Construction on above described building and permit//meets all p able codes and regulations Applicant • R~ ,c.,e ~a ~ 3 ~ ~ s y C4 '=-/9r32 G~rr (y0 t ? ~4 TEL.7G5-1802 ~oS~FFOLS~~o~ ~ro~rr o~ so~oL~ ~r L. ~c OFFICE OF BUILDIPIG INSPECTOR ~ t: P.O. IIOX 728 i Ems' f~~' T TOWN HALL ~O/~ ~ F ~'ti- SOUTHOLD, N.Y. 11971 ~ v. . /,fol ~ Y;t7 JUN - 8 C E R T I F I C A T I O N t Yr,,rF,~~..~..~~ Date Building Permit No. 1 1'y O ~ Z. Owner nj4 V4 L t?„q ~ ! 1 iplease print) Plumber ~ `~u ~ v ~ ~z~. Cv, p (rlease print) ( I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. - (plumber's si ure) Sworn to beforo me th~is~j,,~~ ~ / ru~FN i% f~day of S~____~ c < _~f." _..ES~'E' ~ n 19~ Notary lic notary Public, s~j'~-UGf~County ~ ~M~FS~ ,~Yodc ~~~~i~tloq~i County T~ ~Cprea Fab.16, i99b THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001093 BUREAU OF ELECTRICITY R~ AUGUST 09,19R9a JOHN STREET. NEW YORK, N~W 910$9$936 N 085594 Datr Applicotion No. on file THIS CERi1F1E3 THAT only the a4etrkal equipment a deecrihed 6dow and introduced by the applicont nerved on the ohoro sppliwtion number in the premieae of PAUL LIBASSI, C/0 BIhLARb & PINE TREE, CUTCHOGUE, N.Y. txen ,,----jj~~ GAR in tkefdbwinR ~JUL'Y ~ ~~ent Ll lxt FI. ? End Fl. - .Section Block Lot was examined on and found to he in rnmpliencr with the reyuirementA of [hie Boord. NXILM! RXTURES RANOB COOIIIIIti DECKS OVENS DISH WAfNYf EXNAYST ANS. ~T~E AQJS EWITCMES INCANDltCEm rIUpEEClNT OTHER AMT. W. AMi. K. W. NAT. K.W. AMT. W. AMT. N. 5 10 4 DRYBRS RBRiACE MOTORS RITURE ARNIA11Cl 1EEDERf ENCIAL RECRT TIME CIOCKf R!LL WR7INATERE tlIATI.WTIlT DIMMERS AML K. W. ql N, r. (iA5 N. 1. AMT. NO. A. W. a. AMT. AMI. NAT. AMrb. TEAKS. AMT. N. r. ~ a ~T AMT. WARE SERVIQ DISCONNECT NO.Oi S E R V 1 C E AMT. AMP. Tyre 1/ tw 1 / tW t / x\M ]/,W No.O~C tcOND. OF C Ca~ NO. Of NI-Lf0 Oi•~ a• N0. q NEIRRAtS a"~NbU~IN O71MR AMARATUG ELEC. ROOM HEATERS:1-2 K.W.,1-.5 K.W. G. F.C.I:-1 .Nip'( GARY DOROSRI LIC.~2991-E 420 NONSELL 1,N. CUTCHOGIIE, NY, 1.1935 TE~iERAI MANAOEl1 ; 1l - < Per /-iclfy - Thi! certiBcata most not be altered in ony manmr; rNOrn to tM office of the Board if intomct. Inspsdors moy he idenNtied bT 1Mir credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIPIGTE MUST NOT BE ALTERED IN ANY MMriER. i n -1ELD ILS:'~CTiU;! ~~UAiE j ~Oa~IMENT.". - _ 7 . ~ m _ L• H\ POUIJDATION (1s~ FOUNDATI0IJ (2~d) m 1 2, S • Zc / 0 ROUGH FRAME X / PLUMBINQ' S f ~ ~ ~ 3. y~ IIISULATIOPt PER N. Y. 0 STATE ENERGY D DLO CODE _ r~ 4 . O / ~ y~ t -GG .~-fit FI;JAL ADDITI01lAL COMMEPlTS: x m ' x ~v ~ H 37 • ? \ H H O m a ~ r H ~ W ~ O C+1 "o H , 50'-..~P- L, d-!i.~Wdhl -i4)- If ~ ~ ~ ~ k / i`~ .~0~ ~ N.26 ~t5'~O"C'.. !50 0 'lf R ~ ' d.{ . a 1 ~ ..J I i ~a No2roN ~ w s-u z9 ~ ti ~ ~ ~ i; 2 4 k D' Z of ry?;~ w , r e ~ ~i o a ~ i -sty . ~y/ a" cU ~ ~ .;n N ~ m .p ~ r v. T D I~ r, r~ S i t, +'2, ~ ~ ' d $.2.0' ~fD'j0"6. l$0.0 `tom P•^__._ JJJ 3 / ut ~ ' y 6 B l'L L A 2.0 ILOA~. -.P ~ ' ~G~ I Y ~ ~i~ (`_~oi ton SF Q h I~ A to . ~1~~~-'7 ~ 'SI . ' , ~~i C ' ~ , 1 r~ X1.4 ~ ' 7•" • V 11 Z. I~ V I ~ 1 rr ~r N ~t ~ ~ I y' .i. t• N.~a 1+ 1 ~ ~y /ri cii b Y~~~W~~i ~ I~, J 7 765_18!!2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL REMARKS: _.~LIG~ C DATE ~ ~ INSPECTOR _ 765-iS02 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST f l ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ] FINAL REMARKS: / . cr~- DATE ~ INSPECTORS 765-1802 BU{LDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ) ROUGH PLBG. FOUNDATION 2ND [ INSULATION [ ]FRAMING [ )FINAL ~R/EMARKS; X ~ DATE INSPECTOR ~7~© ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST (~OUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION C AMING [ ]FINAL REMARKS: c,~ r DATE ~ ~ INSPECTOR 17~© ~ 765-1802 BUILDING DEPT. I NSPECTI4N [ FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING- r }FINAL REMARKS: 62,ia~~ DATE INSPECTOR BOARD OF HEALTH 3 SETS OF PLANS FORM NO 1 SURVEY . TOWN OF SOUTHOLD CHECK • - - - • - BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 7~~ 7~ TEL.. 765-1802 CALL l-~MAIL TO: _ Examined ~ , 19~~ ~ ~ Lw I i~irr ~~~-~..:.,.~.~,..~.~ryj f . Approved . 3.~6 , 19~ Permit No ~ ~ g~~f ~ I 1 . ~ FEB 2 4 iSs89 Disapproved a/c - • . . TOWN OF SOUTIiOLD (Bu ma Spector) APPLICATION FOR BUILDING PERMIT r Date . L` ~L , 19- INSTRUCTIONS a This application must be completely filled m by typewriter or m ink and submitted to the Building Inspector, wig sets of plans, accurate plot plan to scale Fee according to schedule. b Plot plan showing location of lot and of buildings on premises, relatronship to adloinmg premises or public str or areas, and giving a detazled descnptron of layout of property must be drawn on the diagram which is part of this a= i catron. c. The work covered by this application may not be commenced before issuance of Building Permit d. Upon approval of this apphcatron, the Building Inspector will issued a Building Permit to the applicant Such peg shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupy shall have been granted by the Building Inspector APPLICATION I5 HEREBY MADE to the Building Depaztment for the issuance of a Biulding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the constructron of buildings, additrons or alterations, or for removal or demohtron, as herein descnl The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, any admit authorized inspectors on premzses and in building for necessarY~u~~pections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or bush fic o . e ~ d '-e t`. Name of owner of premises L ~ A S S t (as on the tax roll or latest deed) If applicant is or oration, signatu~ of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COIINTY LICENSED Builder's License No. !I'~j. 01~ ~ Plumber's License No & Electrician's License No Other Trade's License No 1. Location of land ~oJn which proposed work will be d~ojne /t. . . ! ~ ~ 1 LU.~ ~ 1~'l! lL O . G. 1.i "f C 4i-0 ~ •_t ` . . House Number Str/eet Hamlet County Tax Map No ]000 Section ~ G ~r Block . Lot . ~ . Subdivision Filed Map No Lot (Name) 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ~ ~'^f b. Intended use and occupancy ~ . ~ ~ 3 Nature of work (check which applicable) New Building Addition . Alteration Repair Removal . , . Demolition .Other Rork . (Descnplion 4 Estimated Cost . ~ ~ ° ! ~ Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units I ~ Number of dwelling units on each floor , ~ . If garage, number of cars . . 6 If business, commercial or mixed occupancy, specif nature and extent of each type of use . . ' 7 Dimensions of exi~tmg structures, if any Front 0."~ Rear ~ Depth . ~ ± Height Number of Stones . ~ . ~ . . Dunensidns of same structure with alterations or additions Front y= .Rear ~ ti ~ o. Depth .'?~~~a3 ~ Height . ~~.~i° .ti Number of Stones . 8. Dunensions of entire new construction Front ! f. Rear ..4 .'S ' Q. Depth Height 1'"~."?. t- Number of Stones 9. Size of lot Front ~~R R ~ Rear . T. Dep~} ~ ~ . . 10. Date of Purchase ..Name of Former Owner M[ ~ ` 4.# ! . 1 I Zone or use district m which premises are situated . 12 Does proposed construction violate any zoning law, ordinance or regulation• ~ . 13. Will lot be regraded V Will excess fill be removed from premises Yes LT 14 Name of Owner of premises L ~ f AddresslK.f ?t~o}+(, w1.7, , ,phone No.~i!'4'z.'. 1~!E.° Name of Architect Address Phone No. . Name of Contractor .I ~F~iSp)r.Q1.tl~e Address~!'.'.!L!~ s.~"T!b. PhongNo.~~S~Z~T~. 15. Is this property located within 30D feet of a tigidal wetland? *Yes Ca'd *If yes, Southold Town Trustees PermitPLO~ DIAGKAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions frc property fines Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. ~ttrtf /+'T't~l T e Ncs"p STATE OF NEW YORK, S S COUNTY OF . . . being duly sworn, deposes and says that he is the apphcai (Name of individual signing contract) above named ~c He is the . (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 file th application, that all statements contained m this application are true to the best of his knowledge and belief; and that t} work will be performed m the manner set forth in the application filed therewith. Sworn to before me this ~ day of . ~~/a~':..... 19 Notary Public, ~~G~r:~-' ~ 2: !~~-r...... County NELEN K QE VOE . . NpTARY PUBtlC, °tate of Hew York Na47678/8,SuNaikCauMyy4 (Signature of applican Tartu Lzpiras Merch 3D, F9-tea--//