HomeMy WebLinkAbout17309-Z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219160 Date JUNE 21, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 620 LAKE DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block O1 Lot 22
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 1, 1988 pursuant to which
Building Permit No. 173092 dated AUGUST 9, 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 EXISTING ONE FAMILY DWELLING.
The certificate is issued to JAMES ~ BARBARA GENOVESE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N056881 FEB. 6, 1989
PLUMBERS CERTIFICATION DATED HARDY PLUMBING JUNE 4, 1990
ti
Building Inspector
Rev. 1/81
~ TONN OF SOUTUOLD tl _...~~1.
IS 111 I
~ IIUILDZt1C DEPART2tC17T [~i~Cy
s
~ ~ f 1 ; ~ AUG 161989 t,...t
TONit IIALL
SOUTIIOLD, 2fEU YORK 11971
SLOG. DEPT.
~ 7 6 5 - 18 0 2 TOWN Of: SOUTHOL0
APPLICATION FOR CERTIFICATE OF OCCIIPAt7CY '
NEN COSSTnUCTION ...(,(,OLD OR PRE-EBISTZ27C IIUILDING..._._YACAti'D LA27D._..,)....
Location of Property... ~",J...:....Y.`:i~~'..~`-=~-__..., ~OU~T'(`fpL,I~.N~/
DOUSE 270. j~STREET llAnL`E,T f
Ovncr or Ovncrs of Prapcrty,~./~~-S~. r.;V.~~i3Att~1~....~,~J~.I.J.y~..S~.C.._...
County Taz Hap No. 1000 Section Block ._.r... Lot'...
S~ibdivi~ion Filed Map ......,.Lot......-,..
Pcrait 2io. 1.~~ D ~.Datc of Permit .._....._.ApPlicaot
ISealth Dept. Approval UndcrvriCCrs Approval........._....
?lannin~ Board Approval
Reque~C for Temporary Ce~jrt/i''ficaCC Final Certificate
°cc Suboitted: $.....P.":'`?. 0~~,.,,.
APPLICAt7
3953
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lD/14fas
POB,M NO. f
rowN of souTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°_ 017309 Z Date .......~.r..~9 19.8
Permission is hereby granted to:
~ .~d~t.~...~............~~...-?~.~
to . ~
~......~~/~/...~I~
ct premises located at ....~..~~..Q...... t.(..41G....~.1~~
County Tox Map No. 1000 Section Block Lot No.......~.~'.......
pursuant to application dated .......~.~f 19.f1..~ and approved by the
Building Inspector.
Fee S.•~P.
' Y
~uildi Inspector
Rev. 6/30/80
_ _
t,
THE NEW YORK BOARD OF FIRE UNDERWRITERS 11i' vACr, i
'I l'IC1C1? 08
ee BUREAU OF ELECTRICITY
F'b:HRIIAkY 06 ) q~y OHN STRE6Tr+NEW Y011MS4~NggW YppppK 8q038
ft17 ~56RQ~8~) N U56R#i1
Dote Application No. on file
THIS CERTIFIES THAT
only the slectried equipment a okecribed 6skro and introduced 6y the appNcant named on the show application number irs the promises of
JAMh:S (;h;NOVitiSP:, 6'1Q I,QA~[(,M: I)RIYFI. SOIJ'i'iiC)LD. N,Y.
in thejolloTCinR loEwttRr~flIAIYS!' 7yFet~~~ ~ Ixt Fl. ? Ynd Fl. .Section Block Lot
u~ss examined on endfound to 6e in carnpliance uitk the reyuirementx of this Board.
NXTWE XTURES RANGES COOKING D[CKS OVENS DISX WASNBtS EXNAUST FANS
OUTLETS ANS fYVRQISS INCANDESCEM ~ FLUg1ESCEM OTNRn AMT. K. W. AMT. K. W. AMT. K.W. AMt. K. W. AMT. N. P.
1I. 9 5
DRYERS FURNAC! MOTORS NTUtl ANUANC! RtIOMf SMOAI RRCR iIAAE t10CK5 RLIt UNIT MATERS /AULT40YTtlT DIMMERS
AMT. K. W. Oil N. P. OAS N. I. AMT. NO. A. W. G. AMT. AW. AMT. AMTS. TRANS. AMT. N. I. ~
~T AML WATTS
sRRVIa oBCONNECT No. a S E R V 1 C E
AMT. AAN. TYPE ~ i / PN 1 / 3W J / xW S / IW NO.O~CC. COND. OF CC ~ OMD. NO.OF NIdE6 Of ~ NO.OF NFUTtAIb Oj EUfGMAI
OTNlR AlMRATUS:
6.N'.G.i:-t
SAiIYA'1'C)R M: C. PRA'I,Y)
K . ft . NOX "~U$ -p~~
(:Nl•:Y:N)'CJR't'; NY. llti94 1J
I,T.CM;NtiN, NQ. 1.Od4 M, Psr
This artilicah must not ba altered in ally manner; rNurn to fM office of tM fbard if incorrM. Inspectors be identified by }Mir cndeMials.
COPY FOR bWLDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT bE ALTERED D! ANY MANMER.
z,_
- r:E1.7~.~-lsoz
~G`~ 1=CJ;<~;
~ D, TO;«•N OBI' St~iJT$~~.Z3:
~ l~ ~
i ~ ,c . OFFICE OI•' B,UILDI39~ I`ISPfiL-T;OR
"Olf~~ fit- SOUTIiE)LD,,1.Y.1.1971 ~2Q~
'rQ. za ~b
TOWNLOf SOU~TF•IOLD
C E R T I F I C: A T I O. 17
Date JUNE 4, 1990
Building Permit No. 17309
Owner MR. JAMES GENOVESE
(please print)
P1cYr',n= HARDY PL. & HTG. NORTH, INC.
(please orint)
I certify that the solder used .n the water supply system
contains less than 2!10 of 18 lead.
(plumber's signs ure)
Sworn to bef a me this
~daY o ,~cR,_
19 llotar~ lie ~J
Nota:'~ I'vh_ic, County
ppp14.11NE FWNIIOM
~yy q,~ ~ d 111s~!
? 30
765-1802
BUILDING DEPT.
INSPECTION
[ ~ UNDATION 1ST [ ] ROUGH PLBG.
1-fJC fC((~
OUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE ! B'~ INSPECTOR ~~ae~~7 "
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST f ROUGH PLBG.
()FOUNDATION 2ND [ ]INSULATION
[ FRAMING [ ]FINAL
REMARKS: ~~1-t.`~,~,~~
17 J ~ ~ 165-1802
BUILDING DEPT.
INSPECTIQN
[ ]FOUNDATION 1ST [d] ROUGH PLBG.
] F UNDATION 2ND [ ]INSULATION
FRAMING [ )FINAL
REMARKS:
DATE ~ INSPECTOR
~ ~3~~
765.1802
BUILDING DEPT.
INSPECTION
[ )FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [INSULATION
[ ]FRAMING /7 [ )FINAL
REMARKS: L~'-r~.c.~.Qa,r;~ ~r ~~2
DATE ~ I 3 ~ a~ INSPECTOR
~ 7~®9
rss-iso2
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ) ROUGH PLBG,
[ ] FOUNDATION 2ND [ ] IyBULATION
[ ]FRAMING [/)/FINAL
REMARKS:
DATE a?/ ~ INSPECTOR
Y1r:LD -:~:c~:~~:J IIUr,:n j~ .;C.`{MENT°
-v
1.~ ? ~
H
FOUNDATION 1st
FOUNDATION 2nd _ m
2.
ROUGH FRAME - o
/ ~ T
PLUMBING
Nc
3. ~ ~
m
rh
IIISULATIOPI PER N. Y. y
STATE ENERGY
CODE _1
x
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r
4. \ y
FI;JAL 3 p ~ R, ~
S 31 `~0 ? C~ ~ ~ E
ADDITIO AL COMMEPITS: _
~a~.
x
M 4`v~
~ \
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N
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x
m
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D ~ Qom/ BOARD OF HEALTH
U 3 SETS OF PLANS
FORM N0.1 SURVEY
TOWN OF SOUTHOLD CHECK .~r'.I~S~ . .
BUILDING DEPARTMENT SEPTIC FORM
BLDG. DEPT. TOWN HALL
TOWN OFSOUTHOLD SOUTHOLD,N.Y.11971 NOTIFY
c TEL.: 765-1802 CALL
Examined 19x.8 MAIL T0:
Approved 19~~Permit No. ~.7`309~ .
Disapproved a/c
~
/ . ~ Buil~g In~tor)
APPLICATION FOR BUILDING PERMIT
Date ...................15...
INSTRUCTIONS
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 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
s ll 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
`sh Il 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, hou code, and regulations, and to
admit authorized inspectors on premises and in building for necessa in ections. )
( ~grlature oi,a plic fi(', 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 premi~
.~~...-f!./~a?~..!Yl.:. ~:4~~ .
fj (as on the tax of r latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate offic/er~) ` ~
Builder's License No. ..~(J.7J7,~?-? ..~-~!?w.~IC~{~(JLv ~ ~ ~6(
Plumber's License No.......~S.g3.':e '
Electrician's License No. . {'~7.'.t'!-v.. !-:~~.C~~ G
Other Trade's License No.
~,xh-k-.~0/J... ~3~.~q.-}}T
1. Location of land on w}tich proposed work will be done . .
House Number StreQet Hamlet
County Tax Map No. 1000 Section Block Lot .:~a.~ .
Subdivision Filed htap No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy L.~.~ D L:~. C 1/
b. Intended use and occupancy ~ ~~C J
3. Nature of work (check which applicable): New Building Addition Alteration .
Repair Removal , Demolition Other Work,,
4. Estimated Cost r1. ~~4r'. ~ Fee ,
(to be paid on filing this applicationl_
5. If dwelling, number of dwelling units ~ Number of dwelling units on each floor ~ , , , , , ,
If garage, number of cars c'E .
6, If business, commercial or mixed occupancy, specify nature and extent of each type of use /~/.Q.... , . , , , , • , ,
7, Dimensions of existing structures, if any: Front ...(D.~.~.. Rear ~ ~t Q.:... Depth . ,rte, , , , .
Height Number of Stories .
Rear . .
Dimensions of same structure with alterations or additions: Front ~ ~ ~~r, pr......
Depth ......Height Number of Stories . , .
8. Dimensions of entire ndw construction: Front e~j .vr..'f Rear . ~ Depth ~-.g. ~ .
Height ...............Number of Stories SiY.+.
• ~Rf: r ~ .
9. Size of lot: Front ....I ~ ~ Rear ~D. C?.~. (J.... Depth W~-y.. lge. .
10. Date of Purchase . X25 ~ S,
l r1.7r....... , Name of Former Ownerj.•iA~'!~, J:~.~:A~ . ~1j~~E~~'~\. .
1 I. Zone or use district in which premises are situated . • .
12. Does proposed constructior~'vi late any zoning law, ordinance or regulation: . /1[ Jp .
13. Will loge rear de N ~ ......Will excess fill be removed from premises: Yes No
14. Name' t~tJrie~~f f~~~ 't'f.:~.'-~a~?-S.L.'... Address6~O~PxE:a?-,ScurEl4f~Phone No.7(oS:.:.l/9fo.. .
Name of Architect h~~~'~n:.......... Address ...................Phone NoZ4 ~'..3.~P.a .
Name of Contractor ,lIgIIC~ .~Y4~~11~S.E...... Address .G2?:C? ~.4KC y?/1.,,$Qt!7~LOf~e No. ].f4s
15.Is this property located vithin 300 feet of a tidal wetland? *YES...~^O'~..
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly 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. ~
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STATE OF NE1V YORK, S.S
~OUNTY OF .
• • • • • • • • • • • • • • • • - • . • . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
bove named.
le is the
(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 his knowledge and belief; and that the
ork will be performed in the manner set forth in the application filed therewith.
vom to before me this
...........r..........day oof/..(~. ..........,19~~
Mary Public, ....t...?t. ; 14/. ~ County ,
1
NOTARY K81s~to
ot~New Yarn '
1:'~'. ~
:A'J .
Na 47619')8, SuNdk CwMY (Signature of applicant)
Tam 6cpires Much 30,19,__a.,r