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Home My WebLink About27841-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No, Z-29380 Date: 04/22/03 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 16750 MAIN RD EM/ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 23 Block ~ Lot 4.2 Subdivision Filed Map No. _ Lot No. _ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 26, 2001 pursuant to which Building Permit No. 27841-Z dated OCTOBER 29, 2001 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 INSTALLATION OF A HEATING SYSTEM IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ADOLFO G & FELICITA ALAYON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27841 Z Date OCTOBER 29, 2001 permission is hereby granted to: , . ADOL,fO G ALAYON l81 WHITE ROAD MINEOLA,NY l1501 for : INSTALLATION OF A HEATING SYSTEM AS APPLIED FOR at premises located at l6750 MAIN RD EM/ORIENT County Tax Map No. 473889 Section 023 Block 0002 Lot No. 004.002 pursuant to application dated FEBRUARY 26, 200l and approved by the Building Inspector. Fee $ 75.00 . . natu p ,. ,..A' '. - "- . COpy 1 Rev. 2/19/98 . . . .. , . Form No.6 ~ TOWN OF SOUTHOLD f7JB~q-'f BUILDING DEPARTMENT z.fY' TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be fllled in by tYl'ewriter or ink and submitted to the Building Department with the following: A. For new building or new use: I. Final su,,'ey of property with accurate loeation of all buildings. property lmes, streets. and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fomll. 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/ I 0 of 100 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certiflcate of Code Compliance from architect 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: I. Accurate surwy of propel1y showing all property lines, streets. building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. [f a Certiflcate of Occupancy is denied. the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I 8 ')('r1 l. Certiflcate of Occupancy - New dwelling $25.00. Additions to dwelling $25.00. Alterations to dwelling $25.~0, 2. Swinuwng pODl $25.00. Accessory building $25.00, Additions to accessory btlilding $25.00, Businesse6_$_~O:pO. Certiflcate of Occupancy on Pre-existing Building - $100.00 -- 3. Copy of Certiticate of Occupancy - $.25 4. Updated Certilicate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residemial $15.00. Commercial $15.00 Date. 41,8/ "" New Construction: Old or Pre-existing Building: ____ (check one) Location of Property: (~--lL .... tr I:::' 1"2"".....0 crol\e,.r M,}v"...:, HOllse No. Street Hamlet Owner or Owners of Pruperty: ,.!,l)o<",1'<;> G ~ F6L\ C ,'\A- ALA-'-t ,,_' -- Suffolk County Tax l\lap No !OOO. Section Block l.ot - Subdivision Filed Map. Lot: Pertnit No...2; ~ '-11...__ Date ofPemlit. Applicant: Health Dept. Apprln-a!: Underwriters Appro\'al: Planning Board ApPw\'al: __ Request for: Tempurary Certiticate Final CertifIcate: ~ (check one) Fee Sublwtted: $ ~S"~ C~ 2= d.Cf':l~ ~ 11~ c. 0:) /0) Applicant Signature A . . ~l . FTKtD ~PEgTIQ~_R!~Q!! ._=~~~--- ~~~~~~~~~=~~~=====~=~~~~~~~~=~~~~=~===~~~~-~===== t> . '(i .I~ ~,~:' " ..$>:] " H_ ~ATION ---1JST)__ , . .", e- . . ::;L. =4 ~AT!O!"=~~l~_~~ . . . ~o/ ~ . r==--.== ===~-~_==========~============t==~=~~========--====== ~ ";t- , :) ~ IlO1JGIl FRAME & . - €> .PLUMIIING ' , -...) \}", , ~l C, '"'-." - - = ~ - -- ~ Ui ~f DISUt.ATl:ON PER N. Y. H ,.ot . STAtt ENERGY ~ ;.- CODE / " \1:\ ? 'Y/~~ ~ ~ A~ ~./":) G~ . '.A-" ....,., .. / / .. // l "\\ ..... . .,." .~ ? --' . nNAL "): , ~ / fS : APDI.TIONAL COMHEllTS: c - '-,. <5: 0 , - ~ - .' . !; ~ . ~ . . ~ . WI' Ul' "(11.1 U1U1..U tlUU;UlNV i'bKMH APt'LiLA1'1UN CHECKUS _ JILDING DEPARTMENT .2~ . I' Do you have or need the following, before applying TOWN HALL " Board of Health SOUTHOLD, NY 11971 I 3 sets of Building Plans '':~ TEL: 765-1802 ------ :;) 1~L{ I Swvey PERMIT NO. Check . Septic Form N.Y.S.D.E.C. , 20--Pi Trustees Examined Contact: Approved , 20!!4- Mail to: Disapproved alc J. (l-p Phone: ;)1rI - ? 37 - cJoYr '1"77-- f-33 '1 I Building w.&!leelo. . f'eh11/f '~UA-dL APPLICATION FOR BUILDING PERMIT Date tf',;L. -~6 - Or .20_ INSTRUCTIONS a. This application MUST be completely filled in by iypewriter 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 oftot and of buildings ~n'premises, relationship to adjoining premises or public streets or areas, and waterways. C. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building rnspector will issue a Building Pennit to the applicant. Such a permit shall be kept on the premises available for inspection throughO!1tthe work. e. No building shall be occupied or used in whole or in part for any pW'pose what-so-ever until a Certificate of Occupan is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildip.g, 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'a:Iterations or for removal or demolition as herein described. The applicant agrees to coinply with all applicable laws, ordinanci~s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for nece~ary inspections.' UNDERWRITERS CERTlACATE OCCUPANCY OR " REQUIRED USE IS UNLAWFUL (Signature of applicant or name, if a corporation) WITHOUT CERTIACATE 16 'II! Hilo../ - j2Jo E Y1~NtJr--I OF OCCUPANCY. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder . Name of owner of premises Ira ED AS NOTED (as pn tax ro 11 or latest de . B.P. #. If applicant is a corporation, signature of duly authorized o.flicer .......7:L_BY:~ NOTIFY BUILDING DEPARTMENT AT 785-1802 9 AM TO 4 PM FOR THE (Name and title of corporate officer) FOLLOWING INSPECTIONS: 1. FOUNDATION. TWO REQUIRED FOR POURED CONCRETE Builders License No. 2. ROUGH. FRAMING & PLUMBING 3S-Sg--P 3. INSULATION Plumbe~s License No. 4. FINAL . CONSTRUCTION MUST BE COMPLETE FOR C.O. Electricians License No. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. Other Trade's License No. STATE CONSTRUCTION & ENE,RGY CODES. NOT RESPONSIBLE FOR I. ~. DESIGN OR CONSTRUCTION ERRORS f"\(f II..J 0 ;V . ' .... Htm,: ,._. ....r, , .:) ~3 ,\ County Tax Map No. 1000 Section ' Block I l/lf' /'d-',T r . ".' Lot Subdivision Filed Map No. - Lot (Name) " ,.)i.UI.I.<.....hl.,'H!Ug U.)C Q.UU u....l,;u!-'aucy OI premlS .' d,' ended us and ofcupancy of proposed constructien: 'd. Existing use and occupancy Nf,.. 1J.r-<. b. Intended use and occupancy giN ~~, I ~ UJI 0-/6 rvQ..-,J I\- C e....-- Alteration~ ; Nature of work (check which applicable): New Building Addition Repair Removal Demolition Other Work Ie cf66 --- (Description) f. Estimated Cost Fee (to be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars . '. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories . Size of lot: Front Rear Depth O. Date of Purchase Name of Former Owner 1. Zone or use district in which premises are situated 1. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re-graded Will excess fill be removed from premises: YES NO 4. Names of Owner of premises It. ItfAto~ ~ ,-ttr1l-IIr"""- Address It, 'ffS Mj-;;V ~hone No. Name of Architect Address Phone No Name of ConrractorB~'i1_&-Ih'rJ (/n ~ n~5Address Phone No. '7iDD-?:?' 70 o'f'-( 5. Is this property within 100 feet of a tidal wetland? *YES RO y~qU:J:JO 31XJ:1;7":' ..... ",-~~"'r.' .'~~ 'J 1..0' . i . IF YES, SOUTHOLD TOWN TRUSTEES PE~~.!:~~ 6, Provide survey, to scale, with accurate foundation pl~' ~~d.i;;~;~~JJJO!UJ;~\ ~I 7. If elevation at any point on property is at 10 feet or below, mus~;~;11~\1~0~~~j ~ on survey. TATE OF NEW YORK). ss. :OUNTYOF5ui~~' .. ,.. )>, :J,~ rF\ds--lO ." being duly sworn, deposes and says that (s)he is the applicant (HaUl" of IndiYiduarSignlrlg'contract) above named, i)He is the -C~CL.-P,2 '1'~0.- (Contractor, Agent, Corporate Officer, etc.) f said owner or o"''Ilers. and is duly authorized to perform or have performed the said work and to make and file this application; lat all. statements contained in this application are true to the best of his knowledge and belief; and that the work wiJI be erfonned in the manner set fonh in the application filed therewith. LYNDA M. BOHN NOTARY PUBtJC. State of N." YorIl No. 01 B06020932 Qualified In Suffolk ~ Term Expires March 8, >. >. .