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Home My WebLink About8635-zNO. 4, TOWN OF $OUTHOLD BUilt, lNG DEP~ Town Clerk', Southold, N. Y. Certificete Of Occupancy No. ZS0.~0 ...... Date ................ D. eo.. 2.~..., 19.77. THIS C]~9.TIFIES that the building located at .. ~ 0~e.~.~..C.~ ............... Street Map No..Vlst& ~l.t~lock No ........... Lot No..2 ..... Cu~o~I~ ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............J~ue...~0, 19..~ pursuant to which Building Permit No.. 8~1~. dated .............J..u~.V...~.Q., 19.7.6.., was issued, and conforms to all of the reqt~e- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Prt.v.~t& .one. £s~].I~..Owe. ~., &n~ .................................... The certificate is issued to.. J~ssph .l~n~__so ........ ~m~ .......................... ~owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Deo.. 22 .. ¶ ~.. b~-R ,..~llla ..... UNDERWRITER.S CERTIFICATE No. N~I~0~0 ..... J~m~. 9... ~9~. ................ HOUSE NUMBER ....... 79~.... Street..C~ler~ .¢~; ....... .~utchogt~ ............. · ~UTNOLD, ~. Y. BUILDING PERIvflT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 8635 Z Date ........................ ,T: .............. Permission is hereby granted to: 'Jlndm,~a~. buildin~ A~C Joseph ~usso Southold Build New One family dwelling Glezm ¢ ova'l; Coutcho&n~e pursuant to application dated ........................ .~.~.,~.~......~..0. ............ , 19.~..6...., and approved by the Building In~oector. 6.10 Building nspector ( :LEVAT ON CE3 TIIE C, TE Tlds secti n wi~ pre .id-~ detailed :nstructions to communi~/ officials, surveyors, professional engi- .eels u timt ,~key can complete tke Certifi alton ~orm. A cmnmunity building )r th, p :trait .fficiats 'is a t ertifier of iu 'orml don on this NFIP for n. If. lhe uget t or Art a and l'ost-f eqt ival,mt off ici he 1~ ,td~ng in ;titution has determined that tl e builcing is in a Special dlood ttazard [RM ating Ol new emergency program ~atin! is to oe used, this ccrtifi[ ation form or d do m~entalion inust be submRted witlt tim ,asuranee app dcation Th.' fo~m ~ oDsis S of ,!u :e sec ire's: Set tim 1 , eals ;ith ~ c~ rtific:ttion of infort alien to detcrmi~ . elig~bilily !t ~d shoul:l be 'omplel3d t y th~ loc tl c mira nity bet :nit o 'ftc al >r a ret, ;ter~ d prol'.'ssion, cngi4eer, ar~ hi~ect c r sul ~yor. Se~ dot, 11 is fo Ele , i.,n Ce 'tif~catiou wi. ;h t ms~ be ccrtif re.t ;te~ xl trof~;io~ u c ~gine, r, trci~it~ ct, sm ye5 or. l'hts s tnt tit3 pt' mit ffic al, 2rovk ;d th~ d tta ~ .~d las bcea cert re& ;te ,xl ~rofe ;ira il; ,isted :b,~ve ail l tl~. permit of:icial i pk ed by. con au~ Cry buildi g as[eclor. l by a local .omlmu,ity ) rmit o' :ici~ i, [ on may b~ compl( ted a idea col ~- c J o other~ ,ise vail, late i ~y one ~f t] [e mercl~ tmn: cribing the Jta or i: col t- Se, rim, II dea w h c~rtific a t .gis crc I ell~ ~t~.ii' arch co~ mu nit ~ per d, ,flicial, p sio tals iisi xl ab vc . nd Iht.pc tiun of f oou ~roo e(l buildings l'his terrific,~ lion mu ~t be ompleted hy ecl, Thi: se don mty be col~ 4eted or oil erwise x did~ ~;d by: local >v de,l the d .ia u:.ed has bee~ certified by t ae of ti .' tel ~ ,tercd I roil .- m t official i mmcty trana:ril .~g the data. If, ilc loc~ I con nul ion at he b perm! of the p o 'ftc al corn tote:. Section II, ~g( sh)uld bt :om deled ri,id tl · III, the c~rtl '[er's na ae a · I other info :- 3 local comrn mily pe mit fficial :hou d BUtLOIN( OWN[. ~'S NAME ADDRESS Enter thc name and. complete mailing address of the owner of the building'being certified. Enter th~ property location or legal description of the buiMing being certified. !!LEV1 £LtGIBILITY CERTIFI(;A¥1ON (Completed by Local Community Permit Official or a Registered Professional Engineer. Architect, or Surveyor) ordinance, fhe certifier may rely on corcmumty records. The lowest floor {including basemenl) will he at an elevation ct It, NGVD. Failure to construct the building at this elevation may place the building in violation of YI:'S NO The bugdlm descr bed above has been constructed in compliance With the community's flood plain management E3 ~ ordinance t~sed on elevation data and visual inspection or other reasonable means· ~f NO is checked, attach copy of variance issued by the community. YES NO The Mobile Home located at the address described above has been tied down {anchored) in compliance with the [] community's flood plain management crdlnance, or in compile!me with the NFIP Specifications, {Community Permit Olficlal or Registered Professional Engineer, Architect, or Surveyor) TITLE .,~L:&,Jt 8 ~ ~ul L011~- ..~'/~ f~(~ · ~ i T~TY ~2~ (~J ~' ~ ¢ ~' ~'3 STATE ~£'¥ ZIP SIGNATURE -~F¢>~ ~A.~ DATE ~//'~'~'~ PHONE SECTION 1. This section is used for certification by the Ice'al community'; permit official, re~istere~ professional engineer, architect or sur{,eyor, and is completed as follows: Enter the Commutfity Identification Number, the Msp Panel Number (if available) upon which the property is located and the letter suffix of the map. An example would be 290230-0010-B. Enter tile date of the map. If Emergency Program, enter the date of the Flood Hazard Boundary Map (FHBM). If Regular Program, enter the date of the community's initial Flood Insurance Rate Map (FIP, M). Enter the FIRM Zone shown on the FIRM at the property location. Enter the date of construction of the building described above. Building is: · 1. New/Emergency Program Construction - For the purpose of determining insurance rates, buildings for which the start of construction or substantial improvement commenced after September 30, 1982 are New/Emergency buildings. 2. Pre-FIRM Regular - buildings for which the start of constructioh or substantial improvement was on or before December 31, 1974, or the effective date of tt]e initial Flood Insur~tnce Rate Map (date printed on community FIRM), whichever is later. 3. Post-FIRM Regular - buildings for which the start of construction or substantial improvement . commenced after December 31, 1974 or the effective date of the initial Flo. od Insurance Rate Map (date printed on community FIRM), whichever is later. ' e · ' Re: 6 SO 10T The attached annroval was issued subTect to the ~.o+-~'~o~ ~ont~*~d. . ~.~,~ below ~ ~ .,~ ~ ·,. , .our approval s~p. Would ;~u please t~e the ~ozlo,.~n~ concision approval oH the f~al C of 0 as this ~ii ensure that ~ future ~ll"be made aw~e of the nitrmbe problem. mPrivate well with ~gh ni~r~es - see Hsaith Department note on f~za! survey"~ "~hmxk you~ ~obert A. Villa) P. E, TOWN OF SOUTHOLD .r BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ,..~...: ...................... ]9 ........ ......................... :'..::::~: .......... : .......... . _ . APPLICATION FOR BUILDING PERMIT ......................... INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building Inspector, with 3 set~ 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 ar public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 issue 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 hove been granted by the Building Inspector. APPLICATION I$ HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os 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 buildings for necessaw inspections. .......................... ~.... r~'~t ...... '~'~'~'~ ...... : '-"-'~ .......... "~/: ............. (Signature of applicant, or name, if aJcorpor~ion) ...... !.9..~?.. .... :: ..... ,... :.~:~.~,...... .... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... 13.~.~.~.~.:~ ~ .............. Name of owner of premises .~-e.b.¢.~7)r>.......~.~..¢~...~ .................................................................................................. f app ican~,~s a corporate, signature of dul~thorized o~. '~'"~'~;~ a~d title of corporate officer) Builder's License No ..................................................... , · Plumbers bcense No. ElectrlciQns License No ..................... Other Trode's License No ............................................... ' s,,~ ~,~ ,,~,, ............... ~.~......~..u~ ............................... ...... ~:,~.~.:~.~ .............. Municipoli~ 2. Stere existing use end occupency o¢ premises ~nd in~ended use end occupency o~ proposed construction: o. Exisiting use and occupancy ............................................................................................................................... b. Intended use and occupancy ......... ~\1~.~: .................... ~ .......... [..~.. ...................................................... / 3. Nature of work (check which applicable): New Building.. ..... Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior, .................... Other Work .................................................... (Description) 4. Fstimoted Cost ........ .~.9....~.:~..~.......~-. ................. Fee .~..i.~.....~..~....... ................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .~.)..~...,L.'.~.........Number of dwelling units on each floor ............................ If garage, number of cars .......... r~......; .......................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................Depth .................... kJeight ..... ~"~ ....... Number of Stories ....~~'. ............................................................... Dimensions~:~of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... ..L~.f~..,.(,~ ........... Rear .......~...(9.1..~..,.N. ....... Depth ...,,~V,.(,~'....~..L.I... Height ..... ,'.,.~.. ........ Number of Stories .......... t .......................................................................................... ~ ............. 9. Size of lot: Front ............ j..~D.kq .................................. Rear ..... ~..~,,,~ ........................... Depth ,.~..~.~ ................... 10. Date of Purchase .......... L~....~.~ ................................. Name of Former Owner ....z; .................................................. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... j~.....0. ....................................... 13. Will lot be regraded , ........................... Will excess fill be removed from premises: ( ) Yes ( I~No 14. Nome of Owner of premises~.~.~..J~...k,l.~.-~...g..-- -- ......... Address ~....b'..~..~/J~N....['~hone No ....................... Name of Architect .............................................................. Address ................................Phonle,~N~ .............. .~ ..... No, ne of Contractor ...~....~.~.19.-.~ ..... .~..?..~..L...~.....~Address 12..)~.......(~J....~...~... Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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. STA'rE OF NEW~ Y~:~,I ~<;,,,~,,~: / I,, [ S S COUNTY OF ...... .~:,~'M:t-...~....~..c',.J.~.'..f ,'' · ......................... J~..~..~¢....,~..~.....~..~...~..~..~.~.....~.~.. ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. - He is the I::~ ~..-.~...,~ ~-...~.....~...~. .................................................................................... (~,.ontr::t:~-4~e~t, corporate officer, ~ of said owner or owners, and is duly authorized to perform or have performed the said work and to make end file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor 'the work will be performed in the manner set forth in the application filed therewith. ............ ........... %, Notary Publ c,. ................... .~...~.~...L~..... County ........... ~....,~"~-,'"~.......~./~..~. ~- .,,~-~'"", ........... ~ · , ~ ~ ~'~ ///7 /'(-~ - (SignatLTre of applicant) ~~ i~EVILLE NOTARY pIIBLIC, State of New No. 52-8125850, SuJfolk Cou.~ Term Expires March 30, t9~ ~ffolk County Dei~rtment of Health Services Pot Approv&! of Construction ~(Mly Southold, N,,Yo XX97X for th~s residence w~l! confom to the 8tand- ~91 ic~nt s 0 ~ O~ LOT '7_ ~ ~- ~VI~ ~LU~" ~u~olk Cmmty D~l~r~nt of I~mlth ~.~es _ H~ l~fo No. The uter supply nad Storage d~sposal syfJtegLs for this residence w~:L1 coufom to the stand* aLMS of ~he Suffolk County Dept, of Health Services. CtllCklBroBE High Nitrates %1~'at er not to be used for p~eparation,~ ~,,, of b~by formula ar consump~ ~ tion by infsnts under 6 months of age. 'o