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Home My WebLink About9660-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date August 6 85 THIS CERTIFIES that the building addition. Location of Property ....2.?;Q ..... West Drive Southold Ho.se ,vo. ' ................. 'S't/e3i ....................... County Tax Map No. 1000 Section .... .5.9. ..... Block ....... 5. ....... Lot .....29.2 Subdivision ................ .~. ............. Filed Map No...~ ..... Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... A.]p?.~.~...6 ........ ,19~8.. pursuant to which Building Permit No. 966©Z dated ...... k.p?j_.~...6 .............. 197.~.., 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 ......... .... 4 .a¢.~..o.~..qv~. 9..a...~.~.e.-~..a.m~!~. ¢~e.!$.~.n.~: ................................. The certificate is issued to DANIEL C. VASSALLO of the aforesaid building. Suffolk County Department of Health Approval ............... .~[.g;. ....................... UNDERWRITERS CERTIFICATE NO ..................... ~393~.~./4. ..................... Building Inspector Rev. 1/81 , Y; (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9660 Z Permission is hereby granted to: pursuant to application dated ............................ ..... ,/.~ ~: ¥('......_.......,...~.,. 1~.,.,...... and approved by the Building Inspector. Fee $.../.~' .................. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with 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 featu res, 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, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5, Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings end "pre-existing" land uses: 1, Accurate survey of p~operty 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. XXX Fees: 1- Certificate of occupancy . $5.00 2. Certificate of occupancv on pre-ex[sting dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property 210 We, st Dr~,ve .... S..gp~.b,o$¢ .... House No. Street Ham/et Owner or Owners of Property ' , County Tax Map No. 1000 Section ..... 5. .9 ........ Block ....... 5, ....... Lot....2.9,:; ,2 ....... Subdivision ................................. Filed Map No ........... Lot No .............. Pe ........... Date of Permit ~6~78 Applicant ........ rmit No 9660Z ,4 ................................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... XX ................. '"' Fee Submitted $., ..~...~.. ~.r~)~' Construction on above described building and ~it meets all ?p_/~idable codes and regulationsI C,O~_ I'~)~ I ~3~ Applicant .... .~{....~-~. ·.. C.~.~./. .~....~..... :.....~...*.~. ....... I ...... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS I $ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 J.Iy ,I, A..c.,,o.~o.o./..N3935 THIS CE~IFIES THAT ~y t~ ~t~ ~u~t ~ ~ ~ ~ int~ ~ t~ ~t ~ ~ t~ ~ ~ ~ ~ t~m~ o~ John Nlcholas~ West ~r., Southold, L.I. in the following location; [] Basement ~ Ist II. [] 2nd FI. Section Block Lot was examined on July ~. 1978 and found to be in compliance with the requlrements of thls Board. SERVICE DISCONNECT S E R V I C OTHER AFPARATUS: Goodale Elec. RRI Box 1Sa Hattltuck, N.Y. LIc.7~3E This cerlificote must not be altered in any mannerr return to the office of the Board if incorrect. may be identified by their credentials. COPy ~ARTMEHT. ~THIS COPY OF CERTIFICATE~.MpST~ NOTBE ALI~. IH~AHy. ~ ~ __ APPROVED ~6,S _hlC)TED~ NOTIFY BUILDING D~PARTJ~ENT ~T 76~-26~ 9AM 1. ~EFOR~ ~AC~F~LL[~O FOUNDA- TiON 3. ~FORE COVE,~[~'~*= '~-~S OF ANY 4, RNAL WHeN 20~ CO~PLETED NOT RESPONSibLE OR CONSTRUCTiO~ E~OAS 5. ALL COHST~UCTiO~ REQUIREk~EHT~ '~ -'.Y. STATE TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ................................. ~N~TRUCT~ON$ 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 ofproperty must be drawn on the diagram which is part of this application.~k~ 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 port 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 pursu&nt to the~"~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances 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-co admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applic~'~t:i .............. ~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~ ..... m.c ........................................................................................................................................... L Name of owner of premises &. ~. e..s.....:::../ ............................................................................ .......... If applicant is a corporate, 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 ............................................... 1. Location of land on which proposed work will be done. Mop No.: ........................................ Lot No ....................... Street and Number ......... w'~ 2.~. ............................................................................................ ~2r ,' 7 z~ ~k J (~ ~.)~/../--'Z4c:t .~.~. ............ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ..~.~.~.:f~ .........~..~..'h~.X. ........ ~...~.~Z,..'..!.~ .............. i ....................................................... b. Intended use and occupancy ..~..~.~;.~. ....... ..~..4.~.Z~..~ ....... ..~../.~ ............. .~..~.r:~.,~..,~....~.~.~ .~.(;£~.7~........: ........ New Building~ Add ton .. .Jz~...... Ateraton ............ 3. Nature of work (check which applicable): ....... / Repair .................. Removal ................................. Demolition ~ ...... Other Work ................................................ . /-- ,.~/i~___~ (Description) 4. Estimated Cost ....... .~..).....f..Z(... ~ .~. ............. Fee ....... l .................................................................................. : (to be paid on filing this application) ~.. l ......... Numb,:er 5. If dwelling, number of dwelling units .......... of dwelling units on each floor ............................ If garage, number of cars .....~. ................................................ [ ................................................................................... 6. If business, commerc a or 'nixed occupancy, specify naturb and extent of each type of use ............................ D mens ans of e× st ng s ructu es, ony Front ........ .......... Rear ........ ............... mpth Height .....'.~...~.. ............ Number of Stories ......~.- ..................... i ................ ~"~"7 ................................... ]~."7 .............. Dimensions of same structure with alterations or additions: F]ront .......... ~..i ...................... Rear .....~. ..................... Depth .......... .'.~..~. .............. Height ............................ Numberi of Stories ...~-.. ........................... 8. Dimensions of entire new construction: Front .......... ..t'f....r.2..,i ................ Rear ......... ..4:../Z.f. ......... Depth ...../,.~...f. .......... Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front .......... [..~..7. ...................................... Rear ................ !..~..'Z .................. Depth ../..~.~...~. ..................... 10. Date of Purchase ........................................................ Name df Former Owner .,~.~..o. ............................................ 11. Zone or use district in which premises are situated ....t~ff.~.~t .~7. ............................................................................... 12. Does proposed construction violate any zoning law, ordinancel or regulation: .... ~ ............................................... 13. Will lot be regraded ........,'2g. .............. Will excess fill be removed from premises: ( ) Yes ( 6'f'No 14. Name of Owner of premises, r:.e/~,~./..~.$ ............................... Address .~..{.~......kC:~..f...~t;.~.~. Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ...~.C..'~.......~.....~.../.'./~r.,.: .~..-~- .......... Address ...-.~..7..~...~.,iix~.~.c. Phone No ....................... PLOT DIAGRAM Locate clearly and d~sbnctly all buddtngs, whether ex~st~ng or iproposed and tnd~cate all set-back d~mens~ons from property lines. Gwe street and block number or descnpbon accqrdmg to deed, and show street names and red,cate whether interior or corner Iol. STATE OF NEW YORK, lc ¢ COUNTY OF ................................ ; '~"~ ............... ~'~.'.~...':.~..~......~.....~.~..'.'./.~.Z'.:'~...'~ ................................... being duly sworn, deposes and says that he is the applicon, (Name of individual signing contract) above named. He is the ..~.~:~.c .............................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to m~ke and 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. Sw°r~Z~re me this~ ~ ............... day of ....................... , 19 . Coun~ (Signature of applicant)