HomeMy WebLinkAbout33252-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32624
Date: 09/24/07
THIS CERTIFIES that the building
ALTERATION
Location of Property: 32245 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 97
(STREET)
Bl.ock 5
CUTCHOGUE
(HAMLET)
Lot 6
subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JULY 18, 2007 pursuant to which
Building Permit No. 33252-Z
dated
JULY 18, 2007
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 ALTERATION TO AN EXISTING FARM BUILDING AS APPLIED FOR.
The certificate is issued to ANTHONY & GAETANA IMBRIANO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMEHT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3043872
09/07/07
PLUMBERS CERTIFICATION DATED
N/A
~~
uthor~zed S~gnature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form).
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 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
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:
1. Accurate survey of property 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. If a Certificate of Occupancy is
denied; the Building Inspector shall state the reasons therefor in writing to the applicant.
.
C. Fees
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
r/Jtllo7
Date.
New Construction:
Old or Pre-existing Building:
(check one)
Location of Property: :;;2;< If 5" m 19/ H t2d
House No. Street
Owner or Owners of Property: IJ (1/7/101'1 Y TrnI3IZ //1 IV 0
Suffolk County Tax Map No 1000, Section 0'1 7 Block 5
C IATr' ff-oG l.te
Hamiet
Lot (6
Subdi viSlOn
Filed Map.
Lot:
Pennit No. -5 :SQl5,) COate of Permit. J0/y /'6, 07Applicant HNi/fcN.jL- I,.,6/ltf:}IVO
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
Fee Submitted: $
dS~
CJ.M:.7) f.15
cot.}~~;} y
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.
33252 Z
Date JULY
18, 2007
permission is hereby granted to:
ANTHONY IMBRIANO
136 CLEVELAND AVE
MASSAPEQUA,NY 11758
for :
CONSTRUCT ALTERATION TO EXISTING FARM BUILDING. THIS PERMIT
REPLACES BP 17383.
at premises located at
32245 MAIN RD
CUTCHOGUE
County Tax Map No. 473889 Section 097
Block 0005
Lot No. 006
pursuant to application dated JULY 18, 2007 and approved by the
Building Inspector to expire on JANUARY 18, 2009.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
17, -s--c,
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I Located at
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BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
DOROSKI ELEC. INC
P.O. BOX 781
CUTCHOGUE. NY 11935,
ANTHONY IMBERIANO
32245 MAIN RD.
CUTCHOGUE. NY 11935
32245 MAIN RD. CUTCHOGUE. NY 11935
3043872
Certificate Number:
3043872
Building Permit: BDC: n511
??~c:.,
J:">'~
Described as a occupancy. wherein the premises electrical system consisting of
electrical devices and wiring. described below. located in/on the premises at:
Block:
Lot:
First Floor, barn, Outside,
A visual inspection of the premises electrical system. limited to electrical devices and wiring to the extent detailed
herein.' was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York. Department of State Code Enforcement and Administration. or other
authority having jurisdiction. and found to be in compliance therewith on the 7th Day of September, 2007.
Name OTY Rate Ratin. Circuit ~
Miscellaneous
as built 2003
Appliances and Accessories
Time ClOck/Switch
Wiring and Devices
Outlet
Fixture
Outlet
Receptacle
Switch
Receptacle
Receptacle
Service
I Phase 3 W Service Rating 100 Amperes
Service Disconnect:
Meters: I
o
10 0
10 0
11 0
5 0
5 0
3 0
I 0
30a
Fixture
Incandescent
General Purpose
General Purpose
General Purpose
GFCI
Appliance
100
cb
An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the instdBlibn is believed to
be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system.
Continued on Next Page
of 2
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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I Located at
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BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the appl ication of
upon premises owned by
DOROSKI ELEC. INC
P.O. BOX 781
CUTCHOGUE, NY 11935,
ANTHONY IMBERIANO
32245 MAIN RD.
CUTCHOGUE, NY 11935
32245 MAIN RD. CUTCHOGUE, NY 11935
3043872
Certificate Number:
3043872
Block:
Lot:
Building Permit:
BDC:
ns11
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, barn, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 7th Day of September, 2007.
Name OTY Rate Rating Circuit ~
seal
2 of 2
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
ii!Iii!IE!Iii!Iii!Iii!IE!Iii!I
3:3 ?-s-~ :z...
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUC'nON
REMARKS:
r~
.
-
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
;r- >;. oJ 0
,
...
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cvJ.1~ ~d,
DATE
1-/9,-0 1
INSPECTOR~~
:-'l::LD I;;S~; 2:=::- .:..::.;:;
1.
Fd~NDATION (1st)
-----~
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
4.
FINAL
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(M 5<::.4'--:)
OCCUPANCY OR
USE IS UNIJ~VVFUL
;~f'T' lOUT c,..r'j"'I"Ii:ICAT-
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A'r IN ..J.'
""",9-1- 9 9 ~ r
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FEE: ,?8 BY: AT
NOTIFY G
786-1802 . AM 10 4' .. THE
FOLLOWING IlSflEC11ONS:
1 FQUNDA1tON - 1WO..,...m
. fORfIClUMO~'.
2. 1lOU8M. "'~.t1lT.' . ....MIQ
s. 1.1\JUlMIN
4. FINAL . cell 1Il1A.. II MUSt'
.~POIu. MIlT
~ nil .~ n.: ...~ l:::JEEpLIK?ED By:
nnU IILl 11..rr M 25 ...A:
CCl'. _ 1_.- ': ''/LL/.4/v1 . //V7IV1c:7A...15 :e t..S
a II~GII<< .L__n___.D... / /1 =- ..s::i ///./1
- -- L ~tVD ,----"UPt/FY/rt./G y,/'-"'-<-rIVN/'tV(
13~ Box 377y ~.1-7ESL/o/?7 ".<.J Y
/
2/'p ~ //g~7
..
OFFSETS FROM STRUCTURES
TO RELATIVE BOUNDRY LINES,
ON SURVEY, ARE FOR A
SPECIFIC USE ONLY, AND
SHOULD NOT BE USED FOR
CONSTRUCTION OF FENCES
OR OTHER STRUCTURES.
tIo./O,/99
FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD. N.Y. 11971
. TEL.: 765-1802
Examined .~(........., 19 tf8~"~J-')'J-
Approved. . ~ .. ... .~. . ., I9~Permit No. .~
Disapproved ale .....................................
BOARD OF HEALTH ............
3 SETS OF PLANS ............
SURVEY .....................
CHECK ......................
SEPTIC FORM ................
NOT IFY
CALL .....................
MA IL 'to: A. ; /
IV-d:/' /~ ~
/" .
....... .... ....... ..... .........~~~~~....
APPLICATION FOR BUILDING PERMIT
Date . 97"". / . . . . . . . . . . ., IifJ.Z!.
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 wiII 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, ~!!ditions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, bUilding code, housin~ code, and regulations, and to
admit authorized inspectors on premises and in building for nec~~~ns: . :!J.),:-:,;,. . . . . . . . . . . . . . . . . .
(Signatu;f of applicant, or name, if a corporatIon)
. /..Jf" q.u..-<1':'1.flc.,~ ;n-1-"4.).(J./4
................. .........:1......, .:f:..'iI-?<!-,....
'.... (Mailing address of applicant) . II 7..j~
State whether applicant is<9w~e9 lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~~~.~; ~~~~; ~~~~~~~:e~':::: !biI~:: :'iL t~:;~l;~~t:~ ~:::::::::::::::::
If applicant is a corporation, signature of duly authorized officer.
........................... ...................
(Name and title of corporate officer) ,
.../' ?
Builder's License No. .--rf1(.~~..... ,
Plumber's License No. ........................
Electrician's License No.
......................
Other Trade's License No. .....................
I. Location of land on which proposed work will be done. .:? :: . . . . . . . . . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '.
. .p.?-.~':fr.................. .?1.~:.. .kl:(................ .~C#~.
House Number Street Hamlet" #' .-:.~ .......
County Tax Map No. 1000 Section ........9.?..... Block ......... ~ . . . .. Lot......G...........
Subdivision. . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . Filcu ~Iap No. .............. Lot............
(Name) ...
2. :':~:,::;:::~::::,:':::,:,,:r ::;;:z::',,'m;.O'~:::::' 0: :::::.:'.' :::'.'::'.'::: . . . . . .. . . . .
b. Intended use and occupancy ...... .4:~....~ 4.. .~-2-f..~~.......................
/
3. Nature of work (check which applicable): New Building....... . .. Addition..... " ... Alteration .........
Repair . .~. . . . . . . . . Removal " . . . , . . . . . . .. DemolItion .............. Other Work. . . . . . . . . . . . . .
(Description)
4. Estimated Cost. . . .c...:r;m (J.... .. .... ..... ..... ..... Fee
.. ..........-.. ..- ...................
(to be paid on filing this application)
5. If dwelling, number of dwelling units. . . . . . . . . . . . . .. Number of dwelling units on each noor . . . . . . . . . . . . . . .
If garage, number of cars ............................................................;..........
6. If business. commercial or mixed occupancy, spccify nature and extent of each type of use. . . . .. . '" '" . " . . . .
7. Dimensions of existing stmctures, if any: Front. . . .I.?-. ~~ .'lr. . . . Rear . '(:~'. 1- .-.11: . . .. Depth... 3.Q. ..-::>. . . . .
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,
Dimensions of same structure with alterations or adcyt~J1s: Front ... :1'."t (1:1. P;. . . " Rear..... $."~.":1.~. . . . '
Depth...;S:: 1/;41.~.. .. .... '" Height. :.I.r. ~ ... . ... ..... Number of Stories.. . .t............... . .
8. Dimensions of entire new construction: Front. . . . . . . . . . . . . .. Rear............... Depth ...............
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size ofIot: Front. . . . . . . . . . . . . . . . . . . . " Rear...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
II. 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 ............................ Will excess fill be removed from premises: , Yes No
14. Name of Owner of premises. . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. ...............
Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. ...............
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. ...........;...
15.ls this property located within 300 feet of a tidal wetland? *YES....NO....
*If yes, Southold Town Trustees Permit may be required.
- PLOT DIAG RAM
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 comer lot.,
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STATE OF NEW YORK,
COUNTY OF . . . . . . . . . . . . . . . .. S.S
(Name of individual signing contract)
Jbove named.
........ ... .......... ............... ......... ....
being duly sworn, deposes and says that he is the applicant
fie is the
...... ..... ...... ................ ..... ....... ..... ......... ..... ...... ....................
(Contractor, agent. corporate officer, etc.)
)f said oIVner or owners, and is duly authorized to perform or have performed the said work and to make and file this
'pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
Nark will be performed in the manner set forth in the application filed therewith.
;worn to before me this
. ......... '" .. .J. .... . .day of. . ..... ~......., 19 r.T.
;olary Public. ..........~.;f'-. .[)t;.?I.~County
HElEN It DE VOE
II(JQRY PUBLIC, State of New Yodl
No. 47078.,8. Suffolk ~unty.rq
Term Expires March 30. 1 f
..~~...K...........
j/ (Signature of applicant)
"BIll NO. .
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD, N. Y.
BUILDING PERMIT
<THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~~5&-
N~ 011~ Z
Date ..9...~.I........................................, 19.t.:Q
Permission is hereby grant to:
~...~.~....~..~........
........;??...~f.(~......~~:.....~d.......
.......~cI{~...................................
to.~~..4~~.............~.......~j;.......~
..~~..........................................................................................................................
ot premises located at .....;?:?:..?.:.s(s::.....>.:p{{1.~~.:.........?f?~..............................................
..............................................~c/~~~...........................................................................
................................................................................................................................................................
County Tox Map No. 1000 Section ..........9...2....... Block ...........~.... Lot No. ......s!?..............
pursuant to opplication dated ........................................................, 19......... ond approved by the
Building Inspector.
S'"t' ~
Fee $.~..
~~~#~_m.....
Rev. 6/30/80