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HomeMy WebLinkAbout17418-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218063 Date MAY 30, 1989 THIS CERTIFIES that the building ADDITION Location of Property 210 SUMMIT ROAD SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 06 Lot 22 Subdivision Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 2, 1988 pursuant to which Building Permit No. 174182 dated SEPT. 14, 1988 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 ADDITION TO EXSITING ONE FAMILY DWELLING. The certificate is issued to JOHN & INCA DOHT (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N057229 FEB. 7 1989 PLUMBERS CERTIFICATION DATED N/A uilding Inspector Rev. 1/81 FOIBai NO. D TOWN OF SOUTHOLD fUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 01741 Z Date ......~..~:.~.~ ............................... 19..A...b Permission is hereby granted to:. ~°..:~~Ic... ~d9 ............................................... ro ..C~ljrl~.,/~1~%t'/...../1.!cep/~GGr.~..G.Qrj:.....~.~.~~%h`~.!?,~~....::....J~-.~F.-.rt,~.. .0~~-- .. .. at premises located at .....~..~o..... .. ... ~Gl:t ........................................................... Caunty Tax Map No. 1000 Sectionp'...,.;~..~.,~ ............. Block ..... pursuant to application dated ...A.~~ ................................ ~•~ ~9~z Building Inspector. Fee $..`~ ..D .~T............ Lot No....Z:.Z"'........... ...., 19 and approved by the ~_"'""'7""" ... .r ....... .... ............... ildi g Inspector Rev. 6/30/80 ~'° ~ e r ~ ~.,~,, FORM NO. 6 $' G +° TOWN OF SOUTHOLD S~ ii ~ JAN 2 3 Building Department (~ ~ 4.9~_, Town Hall `r 53teDG. ;~t~p~; Southold, N.Y. 11971 ~,.,...m,,.TCtvv~v erg ~our~aa~i 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted •6~~ 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 lines, streets, and ;snuwal 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, ar buildings and "pre-existing" land uses: 1. Accurate survey of pYt~perty 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, $25.0.0, Accessory ~$ 10.00 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 5. Undated C.O. $ 50.00 Date .,January.5:1989...,,.... NewConstruction„X,..OIdorPre-existing Building Vacant Land Location of Property .. , , , ,?10 Su[cunit Road - Southold ..................... Nause No. Street Hamlet Owner or Owners of Property ..... J41~. &, Inga, Doht, , , , , , , , , , , , , , ......................... County Tax Map No.f000 Section ..79........... Block ..6............ Lot...??........... Subdivision ......................,...........Filed Map No. ..........Lot No. ............ . Permit No. . ~1,7,4~$, , , Date of Permit 914(88, , ,applicant . , ,Ron Morizzo F3uilder Health Dept. Approval ........................Labor Dept. Approval ....................... . Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Certificate ...... X............... . Fee Submitted $ . ?5.00 . Construction on above described building and ermit meets all applicable codes and regulations. Applicant .,~~r:~:~'.l' l ...... ..................... . aa~. io-ioae ~ ~~ 37-35 r'IcLD I;:SPEC:iUi) ~ ~llATE ~ i;OMMENT° 1 ~t ~ ? c . r ~ - _ H H FOUNDATION ( ) _ c FOUNDATION (2nd) to C 2 . o 0 / ROUGH FRAME '& PLUMBING ~ ~~ ~ ~ x 3. ~ r~ IfdSULATIOPI PER N. Y. ~ STATE ENERGY CODE s a !a ..-~ y 4. FI1dAL CO ADDITIOtIAL COMMENTS: x . ~ x C 'v ~ H ~ 9 H H O 2 i ~• x ca a \ r H x d ca - . _ o a .~ ~"': t THE NEW YORK BOARD OF FIRE UNDERWRITERS ~Ai~°~ 1.000'177 BUREAU OF ELECTRICITY 88 JOHN STREET. NEW YORK, NEW YORK 10038 )rF.NRI)AkY O7.tyky F,0?.'i02fiy/R$ k 05`]::%ti Dote Application No. on file THIS CERTIFIES THAT aroiy the ekictrleal equipment w dwcrihed 6eloio and introduced 6y the epplicont named on the otiose oppliatlon numftsr in the promisee of Ji)FCN Oc)HT, ?,iq SUHM~i;9' RoA)). SC>il'i'NOLn, H.Y. to tM foilominR loco nn ~ /st Fl. ^ Ynd FI. Section Block Lot ~i~11JA>2Y ~°J~`~'>~ry meeesemined on and found to 6e in compliance with the reyuiroments ol'ehL Boord. R%TI1R6 COOKING DECKS OVENL DFSH WASHERS EXHAUST FANS R%TURE 110n fYY1TC11Et OuNETR INCMIDEECENI HUDMECEN7 OTHER NAT. K. W. AMT. K. W. NAI. K.W. AMT. K. W. AMT. N. P. 5 k 5 5 7 r• DRYERS RJRNAd MOTORS FUitME ARUANp REWES SFRGAt REC/T TIME t10CKS pll UNIT INATNE MULi4011i1ET gA1MER5 NAT. K. w. al N. P. DAs N. 1. AMT. NO. A, w. c. AMT. NM. AMT. AAVb. TRANS. AMT. M. r. SYEiWS NO. W RRT AMT. WATI6 SERVNB DISCONNECT NO.OF S E R V 1 C E AMT. AMP. TTPt ~ 1 / TM 1 / TY 7 / ]V/ ~ / KW ~' RR eCONO. Of CC COND. NO. OF N4D:G Oi MI ~1 G NO. Of NFYIIIAIS ~ ~~~t T•. ( j OTHER AF-AEAIUS: s ~~ YAtY), k, B[JkNS 275 'P(7fIFi NAkRQR LAND: _ Sf)11'I'NOh1), NY, 1 ty'lt, p~µ RIREIAOER 17 i, ll'8N515 Nt), "'%!S2 N, Per -~/'~- ~ This cerfificaN must not be a1Mnd in any manner; return to fM offin of the Roardif incorrect, Inspecforc may b i~nfiNed by tMir cndantiok. COPY FOR BUILDING DEPARTMENT. THIS COEx~QFERTIFIGTE MIST NOTE ALTERS IN ANY MANNER ~ ~~f/I~ 7-65-1802 BUILDING DEPT. IN~PEC7'ION [ ]FOUNDATION i5T ( ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ) FRAMING FINAL REMARKS: ~ _._._ /? ~lr~" rss.iso2 BUILDING DEPT, INSPE~TI4N [ ]FOUNDATION 1ST [ ] R UGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: L~~'i U~-- DATE INSPECTO ~.. ~~ //~ 7ss-iso2 BUILDING DEPT. f NSPECTf ~N [ ]FOUNDATION i5T [ ] ROUGH PLBG. (]FOUNDATION 2ND (]INSULATION [ MIND [ ]FINAL REMARKS: _~~~/ ~~` DATE ~~ ? INSPECTOR ~~~, r ~~~/~ rss-iso2 BUILDING DEPT. INSPECTION [FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL DATE ____~© ~ INSPECTOR --~ .:. , .. ~- _ C -i 4, t ,~ ~ B~l7_TE4Nl I~ ~ ~ , , In ~q~q i z?,',y v r ~: ~ I ' _ waco'nY~ " t , ' ~„ .. 5.60"OZ'gp"~, 1 %~' ~,~' r ~ ~ T n~r~b ~E ~ ~ ' ~ ~s ~t, e xi ~ ~ for dalwn , q }'~ 'r.~. ~ ~ ~' , r^ i m 1 r~ ~~ 1 ~ f 1 ~ r-r , , ~ fi ~ ~ ^~ I. ~ •t`~ ,.sly ~ 3~ "' ~ ~ m. , I 'a , j °~ _-'~_"___' ~ ~ ~,~ ~ 60 ~- ~ ~ C7~ trrCwtu~~~r"""ne'r ~ ~ ~ ~" !~~ ~E~ ~ ~ ~ ~~ ~~a ~ ~ ~~~ ~ •• N.60'OZ ffC~"W - !Z'S.0 71 r ,' ~,. •caul+~~'~Er+~va,rrRwwatw,w«~cro~~; -, ~ ~ ~ Krtrloabrt~mrnrlola'--- IO THIS SURVEY IS A VIOLATION OF ~ Q SECTION 7109 OF THE NEW YORK STAK•: •, Q ~~ ~ J.ac.k~nls , " foucnTloN uw;; ~~ n~ 'r` =, OOZES OF THIS SURVEY MAO N01; BFARRKl t I ~ N! LAND SURVIYOR'd INKED SIAI OR ~I ~ ~ ~ f' .MBOSSED SEAL SHALL NOT B! CONSIDERED ~ ~ ~ ~ ~ ~~~`~.1i'~~'J O !! A VAIID ~S N~OPY y4 'P': C,t t „~,• J ~ UARANTEES IN D HEREON SNALL RUN ' "~ ~ U! "y. ~,"may NLY TO TMI 0!R O !OR WHOM iH! dURV/>L /^~ C "' -.-.n-_~.~.....f..~ 5 PREPARED/ ANO ON NIS BFHAIF TO TH! ' EO ,` ] ~~~~~ r'1 tiff COMOANY, GOVERNMMTAL AGENCY rINR, (J ENDING INSTITUTION LISTED HEREON.'AND[h'{i O THE ASSIGNEES OF THE LENDING INSYtj~"?~L}~ ITLt CBRTI P. ~ ~ UTION,'CUARANTEES ARE NOT IRANSFERABLE'h ' O ADDITIONAL INSTITUTWNS OR SUBSEQUfNi ' _.., .- r -~p~.k v}h~»Y,»...~a,~iq Syp; (TAMIL' 1 ~-7 p • y i-~~ ~ I +~ al'~pF.l RI - i j1.~5 _,. " Surve c~a( t+tor 8T, 197& '~ " +~"~'~i'~Slr`~~'` ~ ~ "°`a, ~5 ~ ~ROyDERICK YAN TUYL. f C s r' r. ~ r•'"~;~ ~~ ~`' <<a ~; 7(iWVN CJ(= :_ICXJTI h:J[_L71 N.Y K-- C.n.M..~f~ ~il~ty~~if I i:a~~k~~a ~ {°p~~~k'L~''~'~~+'9~`~r " LIC. LAND ALRVEYOR6.ORE[N ~.Y>~~# ~'~t~~~l ~~~~~ 4 V A~' rjlq ~f ~TJ 'Ya~`I"~ 'F~ YII >vf~lL <~.7'nx N>-Y~, lam': r'<!lrnhialY:1.Y'sf;lcX~p,Srcf:07'9,~10~4/:Gr'~.n'!'2'?,-,;y~~'4;~@Y,;l:,~~o~n'~~'¢~'U~a:~~'',`'};>1 /n,~, ~Jy1,es. Th ~ Motif 210 Sumniif' ~o~p ~~~~~ ~y RON MORIZZO BUILDER, INC. Contractor -Home Improvements P.O. Box 789 SOUTHDLD, NEW YORK 11971 {516) 7 5-5772 „~- ~ - BonxD i } 3 SETS ~ J FORM N0.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ,/ 9/ y ~ MAIL Examined . T . • . • • • . ., l:V/ . d A ~~~ ~ ~ j p 19 PS!Permit No ~~4~ ~ ~ . pprove .... .. . ., .. . Disapproved a/c ..................................... ................................. ~~ ildi g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS OF HEALTH ...... OF PLANS ....... FORM .............~ TO :.............. Date ..August, 29 r ......, 19 . $$ 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 br 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 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 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 removal 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 inspections. Ron Morizzo Builder, Inc. .............................................. (Signature of applicant, or name, if a corporation) P.O. Box 789, Southold, N.Y. 11971 .............................................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor ................................................................................................ .................................................... Name of owner of premises ... , ,John & Inga Doht, (as on the tax roll or latest deed) If ap c is a c ration, signatur nfd~ul~y authorized officer. ...... ~... .. . ~` Gr~-~ . `......... . (Name and t' e rporate officer) ALL CONTRALTO MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ..6772-HI, , , , , , , , , , , , , , , , Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . .................... . 1. Location of land on which proposed work will be done . ................................................ . 210 Sutc¢nit Road, Southold ...............................................................................:............. House Number Street / Hamlet County Tax Map No. 1000 Section .....~~. ~......... 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 ... ...One,fam~~y, dwellzrig . ........................................... b. Intended use and occupancy .. One famil ............Y. dwellin .......~. .., ~~..~3h 4~5Rh . ', with aa,d'~Ytiori.,.. ......~:.:..:.....:........................... ;_ . , ~., ..~; , «.; ~ .: 3. Nature of work check which a 'licable): New Building .......... Addition ..X....:.. !Alt,~i'ati6n,;;~,:.'.'.,5,„...•.. . Repair ...... (....... Removal .............. Demolition .............. Other Work ............ ,~. ~ 1 i )~esc>n) ~ ~ ,l 4. Estimated Cost.....~.15~OOO00 ...................... Fee ................'_.~ ........ (to be paid on i`t'lli~fP1'~~"° 5. If dwelling, number of dwelling units ............... Number of dwelling units on ea h,.fl ..............: "`~ If garage, number of cars .....1 .................................................................. 6. If business, commercial or mixedoccupancy, specify nature and extent of each type of use .................... . 7. Dimensions of existing structures;, if any: Front ............... Rear .............. Depth .............. . Height ...............Num$erofStories........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear ........ , ........ . Depth .................... . .Height ...... , ............... Number of Stories ..................... . 8. Dimensions of entire new construction: Front ............... Rear ...............Depth .............. . Height ............... Numl)er of Stories ......................:................................ . 9. Size of lot: Front .......... Rear ...................... Depth ..................... . 10. Date of Purchase ............' . .................Name of Former Owner ............................ . 11. Zone or use district in which premises are situated ....................................... . ............ . 12. Does proposed construction violate any zoning law, ordinance or regulation : .... . .......................... . 13. Will lot be regraded ..... , ... J .. . ...............Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . JQl?ri. PPht.......... Address ..Southold, , , , , . , , ,phone No ............... . Name of Architect .. ... ... ~ ... .. ... ....Address ...................Phone No...... . Ron Mori~zo Builder, Inc. Address ,Southold , , , ,phone No. , 765-5'x'72:.... Name of Contractor ........... ............... . 15. Is this property located within 300 feet of a tigidal wetland? *Yes ..... No .X... *If yes, Southold Town Trustees PermitPLO~ DIAGKAMed. 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 interior or corner lot. ~~ STATE OF NE Y RK S,,S COli'NTY OF. g. ~ (Name o~dividua si ni ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant g contract) above named. He is the ...................... ', ......... ................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly~~a perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this _ ..............day of.~ ... ..........19~_ Qotar~Public, . , .... w•- .. .. ~ Count `,~ ~ ~,_ ~_ ~ , „_ /UyN NH111tLE (Signature of applicant)