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Home My WebLink About17091-z - FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..2.:170,13........ Date ..June..?~~..1988 THIS CERTIFIES that the building ADDITION Location of Property 1645 ,East Gillette Drive East Marion, N.Y. House NO. ~ ~ ~ ~ ~ Sheet .....................Hamlet County Tax Map No. 1000 Section 3 $.......Block ....4..........Lot ...24........... . Subdivision ...............................Filed Map No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated June 3, 1988 17091 Z pursuant to which Building Permit No. . dated . , ,June 10', ] 988 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 . PORCH ENCLOSURE ADDITION TO EXISTING ONE FAMILY DWELLING' AS APPLISD~ FOB. The certificate is issued to , . , ,MAX & MARGOT PILOSSOF lowne~~~s~~'i)X $ . of the aforesaid building. Suffo]k County Department of Health Approval N/A UNDERWRTTERSCERTIFICATENO...?ENDING - June 20, 1988 PLUMllERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 soaas xo. a 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) NQ 017091 Z Date ......~.,1.~~ 19.~.ff Permission is hereby granted to: ' to r~......r~. ~ ct remis ated of .~6.f~~ ~~6""".`yr ...~f.~!..~. . . . . P . . . . . . . . . ~ . . ...~~.~i. ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~v. j........ . . . . . . ./p. . . . . . . . . . County Tox Map No. 1000 Section ........~A....... Block ..................~`.:.CLot No...........~~.L..,7...... pursuant to application dated ..........~~s.~,1 19.P7..~ and approved by the Building Inspector. OB Fee / ~a 1 . Build~~ g ~I ~ ~ ctor Rev. 6/30/80 i f/~~~ - FORM NO. 6 JUN 3I~H6 ~ TOWN OF SOUTHOLD Building Department ~i,._,e..,.,....,,~....s.,_w.~-_.~..~~- Town Hall s+t.ec~. L[:; r. Southold, N.Y. 11971 It)~i.~~~ p~„„,r~urt~lf~t_t5 765 -].802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted to the Building In~ec- torwith the following; for new buildings 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 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling, $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ 10.00 4.Vacant Land C.O. $ 20.00 5.Undated C.O. $ 50.00 Date NewConstruction,,,,,,pldorPre-existing Building Vacant Land Location of Property /~Kf..G%Q,yl.'...~'C~l~1lE.,J~jlil':...SST.../,i19,,~P,~o%f House No. Street Namlef Owner or Owners of Property ..M.A:~..?~..,/.~fR!Q.~°7...~~C~~so~,,,,,,,,,,,,,,,,,,,,,,,,,,, County Tax Map No. 1000 Section Block ....~f.......... Lot J~.......... . Subdivision ~U~ 9/YU ..........Filed Map No. ...°3......Lot No. . ~j.........~...R. a ~ ~ Permit No. ~ ~ Date of Permit i ..:...Applicant . Health Dept. Approval ........................Labor Dept. Approval . Underwriters Approval ........................Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ Construction on above described building and permit mee all applicable odes and regulations. Applicant .//f • Rev. 10-10-78 6Zae.3y•19Fj Co~.?701.`3 Y ~ . T<PS-1802 ~J~~ BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] tNS CATION [ ]FRAMING ~ FINAL REMARKS: ._____---~/G~~ ~r~ _ - - - DATE ~ INSPECTOR ~ - ~ c.~. s "~'~~~'THE NfW YOrRK (BOARD OF FIRE UNDERWRITERS 3 3.QDO74$ .BUREAU CF ELECTRICITY 83 JOHN STREET, NBW YORK, NEW YORK 16038 Date J1JJ,Y 3?,„3.9$8 APPlicationNo.onfile 55?4?988/88 M D2338~r TNIS CERTIFIES THAT only [he electrical equipment as descrihed 6elors and introduced 6y the appllcnst rwnsed on the otiose eppligtion numlter in the premises of MAR PIJrOSSOF, 3C+A5 BAST GTLLRT~~Tyyf`; ~RIYV', EAST MA1flOM, N.Y_ inYhefollominR klcotion• n g nt Ll Ist Fl. ? Pnd Fl. .Section Block Lot JIJIdF real e+amined un and found to be in rnmpliance mirk the requirements of this Buerd. ' q%TURE RXTURES RANGES COOIf1110 DICKS OV9K DISNW EXNAUST FANS ~*~S ? ACIK SYYI7CNK INGNDESCEM FLUORESCENT v AMT. K. W. NAT. K. W. AMT. K.W. AML. R.W. AMT. M. P. 3 DRYERS WRNACE MOTORS RITUR! AMDANCR IREOEES f~[CIAl REC7i TItAR GOOKS ~LL DNIT NEATEES MULT40UT11f DIMMERS AMi. K. W. ql N. P. GAS N. P. AMT. NO. A. W.O. AMT. AML. AMT. AMPS. lEAteS: AMT. N. P. ~ ~T AMT. WAITS SlRVKE gSCONNKi NO.OF S E R V 1 C E AMT. AAIP: TYPE ti~P, IAtW IFJW 3l JW JXAW ffR SCOND. qCC COND. rte. Oi N4LEG Op~XI ~IEG ND. Of NEUIRAIS a./EIIIOWVI .oTNEe ARARAitJS: SAC,YATOR.F. J>RATt7 ~ W3f>GTNS I,ANk: R.R. EQR 20R OYRAI MANAOH 6RF;RMYORT,. NY, 33.994 J3. I,iC.'P;MSlP NC}. iQt19P, Per This certificate must not be altered in ony manner; return to the offim of the Board if incorrM. Inspectors may. be ideMifiad by tMir crodantiols. COPY FOR BUILDING pEPARTMENT. TNIS COPY OF CERTIFIGTE ANKT NOT bE Alt y_ .~4ANY Ai41#IER. ~ .J.,d:fl: ' ; BOARD OF HEALTA . r 3 SETS OF PLANS r.,<. FORMN0.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL Examined . • .'~~v• • • • • 19 ~ ~ MAIL T0: Approved 19 Permit No.. ~.7U 9~ ~6 ~ I_G I~ ' ( r ' Disapproved a/c ?l ~ ~ JUN - 31988 ~I r TOWN~OF SOUTHOLD (Build' g Inspector) APPLICATION FOR BUILDING PERMIT Date 15 . INSTRUCTIONS x ~ . t."a.` w.~tt~~ ,t>~ ~ . Tlus application must be completely filled in by typewriter or in in"k acid"subr~1~l~ed,~q~~~}g~~$~,ut~~~)n~~Inector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule ti r ~ ~ ~ o tta~ ~f#~ ' b. Plot plan showing location of lot and of buildings on premises, re~a}fiions~kttp,oK ~~1nm~,~rem~seso public streets or areas, and giving a detailed description of layout of property must be gawp ori, the tagiam~~htc)ris ~ar~ of this appli- cation. ~ ~ ~ 4°'« ~ . c. The work covered by this application may not be commenced before issuance of $utldingEPertlrit~ ; d. Upon approval of this application, the Building Inspector will issued a Build}~~$ermrt to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. ,.s~= ,~;-;,,,,~~p e. No building shall be occupied or used in whole or in part for any purpose whatever until aC,'ertificate of Occupancy shall have been granted by the Building Inspector. ~ ~ ,i,. 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 insfl,~~}~tions. ` (Signature ot" applica t, or nam if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...........................................~G.......... ~J Name of owner of premises / ~ 1.~~J:.. r.... !.~QS:S~! ! . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . G.,! 1. Location of land on which proposed work will be done. ~ ; , , , , , ~G, ~~F M~?,~N....v7~ Ilouse Number ~ Street Hamlet County Tax Map No. 1000 Section Block Lot A~,7`........... . Subdivision ..M~'P /~'"~....~d~g Filed Map No. ~03a~", , , . Lot . (Name) 2. State existing use and occupancy of premises and inten,~d/ed use and occupancy of proposed construction: a. Existing use and occupancy ~~t... , • ~~~~L/ Af6 b. Intended use and occupancy (~~fnG1G,~f~:~ • • •C 3. Nature of work (check which applicable): New Building , , Addition' Alteration epair CRemoval DemolitioFee ~ Other Work . (Description) 4. Estimated Cost Fa . , , , , , J f~-I D•Q. . If ara e, number of cars g • • • t ~ be paid on Feting this application) If dwellin number of dwellin units .p , . Y; ,P y Number of dwellin U g g nits on each floor . 6. If business commercial or mixed occu anc s ecif nature and extent of each ;type of use . . . . 7. Dimensions of existing structures, ~f any: Front . Rear Depth . • , , , , , , , , , , , , , Height Number of Stories . Dimensions of same structure with alterations or additions: Front Rear , , • , , , , , , , , . • p gh De th Iiei t ~ ...Number of Stories . 8. Dimensions of entire new construction: Front . Rear..... Hei ht • g ...............Number of Stones..............:.,.........'......... Depth 9. Size of lot. Front Rear Depth . 10. Date of Purchase •••••••••••••••••••••........NameofFormerOwnerl 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 " " " " " " " " " " i excess i e remo, ' ' ' ' ' ' • • • • • • • • • ved from premises: Yes No 14. Name of Owner of premises . ............Address . Name of Architect Phone No . . ............Address .Phone No. . Name of Contractor .....Address ......Phone No. . . 15.Is this property located within 100 feet of a tidal iretland? *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 interior or corner lot. ' A//P/PROVEO AS NOTE~D~~, ~ ~ DATE B.P, q _L_L=.S aD ( _a , NOTIF 8 DING DEP RT E AT '~'d~'~Y~ `B~7 765-1802 Q',AM TO G PM F R THE ~g FOLLOWING INSPECTIONS: ~ i. FOUNDATION - TWO REQUIRED r FOR POURED CONCRETE M ~ ^"~a~~ 4. FINAL~~~ CONSTRUCTION MUST ALL CONSTRUCTWON SHALL MEET THE REQUIIIEMEIMTS OF THE N.Y. • STATE CONSTRUCTON AI ENI#RGY CODES. Nql' RESPON$t91,E fOR DESIt3N OR CONSTRUCTION ERROR8 STATE OF NEW YORK, COUNTY OF S.S ' ' ' ' ' ' ' ' ' ' ' ' ' ' r'' "G~v • • • • • • • • • • • • • • been dul sworn de bses and says that he is the applicant S Y p (Name of individual signing contract) above named. He is the . WZ'~;!i~ Q (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 this application; that all statements contained in this application are true to the best of leis 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 . . . 192. Notary Public, County CLAIRE L.OLEW, ......~p.,r~ ~l~¢4? ~Na~~MNwvYfMk ` • . QusllNed fn Sul/oNc ~ (Sig ture of applicant) ;,~~nnlalon EKplra 9~cember 8 18._.~