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Home My WebLink About12358-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... Z. 1..5.8.0.8,.A. .... Date ..... May 28, 1987 THIS CERTIFIES that the building ..... d.e..c.k..a.d..d.i.t.i. 9.n' ?.9. ?.x.i.s.t..i.n.g...d.w.e.l. 1..i.n.g.... Location of Property ... 9. .1..6.0. ......... .G.r.~.a..~..P.e.c..o.n.~c...B.a~. Blvd. Laurel House rye, Street Hamlet County Tax Map No. ]000 Section .... ~..2.~ ..... Block 5 ..... Lot 10 Subdivision.. Ax;~;h~;c..D. 9W~.s. .............. Filed Map No .... 2. .~...Lot No .... .9 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated May 6, 1983 pursuant to which Building Permit No. 12358Z June 1, 1983 dated ............................. 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-family dwelling. The certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ............ N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 TO~, O' soU','.°~' i! .u,,m~o DE~'~'rMmy TOWN 'HALL $OUTHOLD, H. Y. BUILDIHG PEI~iT: (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S UNTIL ffrULL COMPLETION OF THE WORK AUTHORIZED) i! Permission is hereby granted to: Building Inspectoc Re~ 6/30~80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 76_5 - ].802 Instructions A. 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 w th accurate location of all buildings, property lines, streets, and unusual natural or topographm 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. §. Submit Planning Board approval of completed site plan requirements where applicable. B. 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 topogr;4~hic 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 requ ~,~ed to prepare a certificate. C, Fees: 1. Certificate of occupancy New °we].llng.$25.00, Aeceesory,,,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5;Updated C.O. $ 50.00 Date .......................... 6.Alteration $25.00 NewCons %ruc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. Locat on of Property ?./,~)...,/~,b'?~,tt??. ~/~,,,~. ~L../M0 House No. Street Ram/et Owner or Owners of Property ...... F/~/~,4~/~ .~../~?/~'/,Z~/~:'/~/__ / ................. .............................. ):... County Tax Map.No. 1000 Section..,. ,/~,. ,~,, .... ,. Block ......"~-. Lot ~/v~ ........................ Sub i is,on ............................. . .... ,ed Ma, ...... Lot No...?. ......... PermitNo. l~.~..~z Date of Perm t ~/¢J ' ' v/~'~' ...... ' .......... ,~pp cant ....... . , j. ........ .Z~... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted r. Construction on above described building and(15~rmi~ets~J~5~licable codes and regions. ~/~ ~,, ,-~,~r~c^ -- '2' ' ~ ....... ~'' ...................... ~,,.~*. ........ FIEL~ INSPECTION COMMENTS FOUNDATION [qst) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF Sow OLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-! 802 This is to advise you that the job under building permit no. 12358Z issued to J.. Marmarellis on 6Jl/~3 ___ for Addition is completed a final inspection has ( ) has not ( X ) been done. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear up thi~ matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly yours, Victor Lessard Executive Administrator VL:gar encl. Examined. (///..d'.'.'.~.~. .... ~. .... , 1 .9~.~.' Approved . .~O. d'd.~.'... ( .... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 Disapproved a/c ....... : ...... ~. ................... ............. .... , (Builtlin'g Inspector) APPLICATION FOR BUILDING PERMIT Date . ~tay. 6 ........... 198.3. 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 issuanceof Bmld~ng' ' Permit.' ' d. Upon approval of this application, the Building Inspector will issued a Building Permit to the apphcant. 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, 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 admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 217.30..2~rd...avenue ,. L ~I · C...~N. Y....111.0.5 .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises ...Johr[ .&. Norma. Marmar~.llis ........................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License'Nq:,..~..~.~ ................ Plumber's License No. ~.'~d . .~...:/ ......... Electrician's License No .... ~ ......... Other Trade's License No .......... ~ ..... 1. Location of land on which proposed work will be"d.o~e ........... i ...................................... · ...... .... ................................ House Number Street Hamlet County Tax Map No. 1000 Section ...... .~. ~.~. ..... Block ......... '.. 5 .... Lot. / b Subdivision....~.~.~. '(~qame) ' FiledMapNo....~...[ ........ Lot '''7' ...... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy b. Intended use and occupancy ........ .~Gt&,~.....~O. f. J...3~.& %f / ................................. 3. Nature of work (check which applicable): New Building .......... Addition ... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... - ~ . -4~ (Description) 4. Lstnnated Cost .............. Fee ~' (to be paid on filing this application) 5. If dwelli~ng, number o f dweiling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... . ..................................................... ; ............. 6. If business, commercial or mixea occupancy, specify nature and extent of each type of use ..................... 7. 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 ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height' . .............. Number of Stories ........................................................ 9. Size of lot: Front ........... : ........... Rear ...................... Depth. ..................... ' Vl 10. Date of Purchase ....... 3/'3'/'72 ............... Name of Former Owner . .o~O~' .... ~o~.~h ........... 11. Zone or use district in which' pr~mises are situated ........... 12. r)oes proposed construction violate any zoning law, ordinance or regulation: "'NO ........................... 13~ Will lot be regraded . .... ~,~,... ................... Will excess fill be remol~d from premises: Yes No 14. Name of Owner of premise~'." i Address ................... Phone No. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ......... ................. Address ................... Phone No ................ Locate clearly and distinctly all! property lines. Give street and block ~ interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and~ indicate all set-back dimensions from tumber or description according to deed, and show street names and indicate whether ////// 7. STATE OF NEW~,YO~RIC~ ~.z'.. 'S S COUNTY OF .... ' ...........~"-~¥.'c?.~(~....ff.~././~. ~'~-.~r. f.Q~'*--~.~./.~.' .~7.~/'".~7-..g.'.~.... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ....................... . .................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicat{on; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannei set forth in the application filed therewith. Sworn to before me this ............. ~...q~'.'..:..day eli; ......... Notary Public, A,~Y~-~.~,~.. l.~'.,.. ~--~'.- .~.~.. County mo. §2-0244963 Suffblk OountYr--z~ ~ ~ ....... '~ .................. ; ........ Commlss~o £ r · ~ xpi es March .30, ~9'~,-~ (Signature of applicant)