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Home My WebLink About11833-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14932 October 1, ................. Date ................................. 19 86 THIS CERTIFIES that the building d e c k a d d i t i o n Location of Property .78.99..H. qr.t..o.n.s...Ay.e.n.u.~ S outhold, N.Y. - - House No. ' ....... Street Ham/et County Tax Map No. 1000 Section . .0.5. 4. ....... Block ...0.1. .......... Lot .... 0. 2. .9 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore Filed in this office dated J.u..ly..2.7. ~ ............ , 19 .8.2. pursuant to which Building Permit No...q. ] .8.3.3. Z. ............ dated ....A.u.g.u.s..t..2., ............... 19 .8.2. , 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 ......... deck addition to existing one famil.y dwelling The certificate is issued to Richard & Mar~ Lou Manfredi of the aforesaid building. Suffolk County Department of Health Approval N/A, UNDERWRITERS CERTIFICATE NO. N / A Rev. 1/81 BUIlDInG 11833 Z p~mlssio,n is hereby granted to: (THIS PERMITiMUST BE KEPTQN, HE cOMPLETION OF THE Wop, K ' io~te IFULL £ at'premises located at .. ............... , ......................................................... ~...~.~,~ .......... .;, ~.., ..~ Codnty Tbx Map No. · ~r~Uant to application dated ...... I~i[d hg I~nspector. Fee $.:~..~ ....... : ..... approved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 ---r ' 765 - 1802 APPLICATION FOR CERTIFICATE el= OCCUPANCY Instructions This application must be filied in typewriter OR ink, and submitted m ~ 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 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, 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .?..~ 09..[Jg.r.~.o.q~. h.a. qe. ................. ~. 9.u.t.h. 9.1.d.,' .~, ~ ............... House No, Street Hamlet ty Richard Manfredi & Mary Lou Manfredi Owner or Owners of Proper ............................................................ 054 01 O29 County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. 11833Z Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval ........................ Planning Board Approval ................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ .~,f~, .- .... .:?~ ........... , Construction on above described buildi eets~l pp~jca[~J~/c~h~s and regulations. ' Applican ......................... R~, 10-10-7B COMMENTS FIELD ~SPECTION 1. FOUNDATION (1st) FOUNDATION {2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~o_y.; -/oo, o FOoTiN~: , ?,OOL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH P~BG. FOUNDATION ~'ND [ ] INSULATION []FRAMING []FINAL REMARKS: Disapproved a/c ..L~ ........................... .~.~. .......................... ./ .......................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No ................. a. 'This application must be completely filled in-by t3~ewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 se~ of pierre, accurate pier plan to ~cale. Fee according to~¢~edule. b. Plot plan showing Iocatior~ of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and givJ~lg a detailed description of layout ofpragerty 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. UP°n approval of this application, the Building Impector will issue a Building Permit to the applicant. Such permit shall be kept on the' premises available for inspection thraughout the w~rk. e. No building shall be occupied or used in whole or in pert for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. B iAIdP~LI ~cATIO~N'!s HEREB. Y.,MA_DE to .the B..uil.d!ng_ D. ep.a...rt?ent.for, the .iss .uance of a Building Permit pursuant to the RU_~.a.;a~ti .~ g.r?nance, at .t. ne, ,o.wn..o~ ~x~mo.~.a., ~k .~.oumy, r~ew ;or,, and .other al~lic.able Laws, Ordinances or ~gu ar OhS, tar the construction or au~mmgs, addltione or alterations, or tar removal or dornolitm, a~ herein described. o~dem~PaPulitCh~:fe~Tn~p~:t~°rsmPo~lY~V~tmh ia41sacap~i~nab~li~nan:c~cneceess~31~rvllldlm~n~/e~tioooc~nn.s.houslng cede, and regulatio~s, and to 0 ......................... ................... ~';xx.4"~ (Signature ~ aloFt'ant, or n~me, If, a co~oratlon) " d~ .,.~-.~4)7a.~c~u~(/ '7~ ~r-- ~'/~TTD (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. A~enl: Name of owner.~f premises ............ E,f~Gi~ii'41L.liiG~-~'~cli .................................................. 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 .......... .N../..~ ............................ Other Trade's L!cense No ............llt~%. ........................... Subdivision Location of land on which proposed work will be done. Map No.: ............ ~.. ....................... Lot Ne ......................... Street and Number 7...~.~. ...... ~)~r;c)e~s...]~ll~....~)l~r.-~el,& ........................................................................... Municipall~ State existing use and occupancy of premises and intended use and occupancy of praposed constraction: a. Exisiting use and occupancy .............. ~6~a~ ...................................................................................... b. Intended use and occupancy ......... .~.~..~.~..~.~.~..~.~.~..C.~.a.~.r...e~.~..t~.~.e.~..~.....~..~.~..e.~.c.~ ........................... County-'T~-X-~p No. D~-st. 1000 Section . ~ Block ~)~- 0 ( Lot 3. Nature of work (check which applicable): New Building.. ................. Addition ......~ ........ Alteration ................. Repair .................. Removal .................. Demolitior. .................... Other Work ..................................................... · ~ (Description) 4. Estimated Cost ................ ,~SO~).l~lO .......................... Fee ..Te,~....~..~...~ ..................................................................... (to be Imid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars .................................................................... 5. If business, commercial or mixed occupancy, specify nature and extent of each t~/pe of use ............................ 7. Dimensiot~s of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ..... 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 .................................... Rear ............................ Depth ........................ Height Number of Stories ....................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law~ ordinance or regulation: ............. ~ ...................................... 13. Will lot be regroded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No · ~J~cbard [qanfred£ ,.. HorCons La. ] 4. Nome of Owner of premises .................................................... ~lmSS ................................ ~ No. ..................... Name of Architect ...............~.p~ ....................................... A~lre~ ................................ ~ No. ...................... Nome of Contractor .[I, ee~l~,~.£.ei~..~o~ ........................... A~lress .~.g.....2,~ ............. ~ No..~.. PLOT DIAGRAM RockE Po£nC Locate cleari.,/ and distinctly oll buildings; whether existing or proposed, end indicate oil set-back dimensions from property lines· Gwe street and block number or description according to deed, and show street names and indicate whether interior or corner lot. See At[ached Survey STATE OF NEW YORK, ! c ¢ .. ................ ..be,rig duly ~'orn. d~os~ and ~ that h~ is the above named. '-' - -- - (Contractor, agent, coqx~te office_r, etc.~ of smd owner or owners, and ~s duly authorized to perform or. ha~e performed the said work and to make and fde this application; that all statements contained Jn this application a.r?.true to the best of his knowledge and belief; end thor the work will be performed in the manner set forth in'tho al~li~6n flied therewith. Sworn to ~be.~ me this ..... Nato,,, JUDITH T, TERRY of appllcaf~)"~