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Home My WebLink About10383-zFORM NO. 4 *[OWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N,Y. Certificate Of Occupancy No g I 2.4.36 Date ............................ 19.84. .................... ~pril 25 . THIS CERTIFIES that the btrit~mg .. ir~grq)¢r~cl .pQ.o.], .............................. Location of Property ...6. 4. :5 ............. .B.a.y.hp.m.e...R.o.a.d. .............. .M~t.~.i.t.u.c..k .... House Ire, Street Hamlet County Tax Map No. t000 Section ...0.5.6. ...... Block .... 0.5. ......... Lot 024 Subdivision ...... ~.. ?'..l.l. qw....Pp.J:.n..t ........... Filed Map No.. 3.6.5. .2..Lot No....2 .2 ......... conforms substantially to the Application for Building Permit heretofore fried in this office dated October 16 1978 pursuant to which Building Permit No. 10383 g dated ...... .~.u. qu..~.t..3. J.. ........... 19..7.9, was issued, and conforms to all of the requirements of the applicable prows~ons of the law. The occupancy for which this certificate is issued is ......... an inc~round swimmin~ pgp. l.: The certificate is issued to VINCENT & ~OUISE TIRELLI (owner, le~see-~ te~a.v} of the aforesmd building. Suffolk County Department of Health Approval ...... N./'.R. ................................ UNDERWRITERS CERTIFICATE NO...................N4122,2..5 ......................... ... Rev. 1/81 Building Inspector FOI~M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10383 Z Permission is hereby grante.d..to:.. ~?~. ~.~_,~_,r,..~ Building Inspector. ~ ,...Z~ ......... Buildin~ Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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: I. Accurate survey of peoperty 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 occupancv on pre-existing dwelling or land use $5,00 3. Copy of certificate of occupancy $1.00 Date .... ......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property , .~..~t.~,'~-. ........ .,~,,~.~/,...L~.~.~.,~;.., ,~,]P .......... House No. Street Hamlet Owner or Owners of Property . ~.i.~..~..~..~... ~ .... .L.o. ?. l. 5, .~ ...... J ~ ,~,~,~,/,/, ,' ................ County Tax Map No. 1000 Section ...... f .~.~ ...... Block .... .,~. ........ Lot.. Subdivision...[P. ~ .Ii .d..~.' .... /~.c!. ~,.~, ~- .Filed Map No. .~..b.a.s.L%...Lot No. Permit No ........... uate of Permit .......... Applicant ... i .4y, ,~.~ ;~, ,~, ~,., ,~,t,~,~,~/, ! ! ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~..~ .................... Co/,n~truction on above described building and per,~nit meets all applicable codes and regulations. ('~:~ (~('J('~ Applicant ~"z,,,~¢~,,~ ~. '~.'./~,.~X~' . . ............. 5 ....... ........ AiD DIT'iLDt,,JAL FOBM NO. 1 TOWN OF SOUTHO, LD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ,~/..,..,~,.~.'.,/.. ............... ~9.~...Z Application No../..~..~.~......~'...-~... ............ . ................. , I9..~.Z. Permit No..Z~.~.~..,....~.. ......... Approved Disapproved a~'c ................ ~ ................................. i~ .................. ,lBuilding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or, in ink and submitted in triplicate 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 ofproperty must be drawn on the diagram which is port 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 o 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, 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 necessary inspections. (Signature of applicant, or name, if (3 corporation) ~. (Address of applicant) _ _ / State whether applicant is owner, lessee, agent, architect, engineer, gene~t/ra~'lec(r~c~a~' ~"~ "~'/~ ~ ~ ;l~m~er~Or//~ / builder ................. ....................................................................................................................................................... L ' Name of owner p m see ...................................................................................................... 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 ............................................... Location of land on which proposed work will be done. Map No.: ..... ..~.~...~..~...~ ............... Lot No.......~..~..."'~T.. .......... Street and Number ..... ~....~...~.~.. ....... ..~.....~.....~. ........ ~...~...'~.....~. ........ ..~....~.. ................................... .~...~.~..~....¢../...~'........~' / Municipality State existing use and occupancy of premises and inte~nded use and occupancy of proposed construction: a. Exisiting use and occupancy ..... '.~...~.~.,~../..~..~....~..,!..,..I....~T..J...~ ............................................................................. ........ ,-- ~- ........................................................... u .....................Ir~ ......... ~ ................... property lines, Give street and block whether interior or corner lot, 3. Nature of work (check which qppllcable): New Building.. ................. Addition .................. Alteration ............. Repair Removal Demolltio~, .................... Other Work ~-~'c ! ~ ~. (Description) 4. Estimated Cost .~/....~...~...o. ............. .~..~...~...~....~.. .............. Fee .......................................................................................... ,2/-~o~) i/~o / ' (to be paid on filing this application) 5. If dwelling, number of dwellin[g units ...... .0....~.......~:.. ........ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. D mensions 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 ............. t .................. ! I 8. Dimensions of entire new construction: Front ..... /..~. .......................... Rear ....~ ................... Depth ..~....~. ................ Height .....~.~.....~..,t. Number bf Stories ...... / ............................................................................................................. 9. Size of lot: Front .............. t .~...O, ............................... Rear ......... /..~..?.. ...................... Depth ... /. . ~.. ...?. .................. 10. 'Date of Purchase ............ /..~...~...J ............................... Name of Former Owner ..~..~:~...~.../~./~;.~...~.,..~.....~.. ........... 11. Zone or usc"* district in which p,'remises ore situated ...... Z~C../I~. ................................................................................... 12. Does proposed construction via ate any zoning aw, ordinance or ragu arian: .... ..~...,.~. ........................................... 13. Will lot be regraded' ......~...~....i ........... Will excess fill be removed from premises: (~(') Yes ( ) No 14. Name of Owner of premises ....~l~...¢..~.~...?....?...~..e.u.~..~.c....l.'~'~.~..~.//'Address ~.(...~1./../.~..~..~...~..~ Phone Name of Architect ................. , ............................................. Address ................................ Phone No ....................... Name of Contractor ' ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locete clearly and distinctly alllbuildings, whether existing or proposed, and indicate oll set-back dimensions from number or description according to deed, and show street names and indicate STATE OF NEW~-YOR)~ ................. ~~...~.~.....~ ...... ~ ....................... be g duly sworn, deposes and says that he is the applicom (Name of nd v dual s gnlng contrac~ above named. He is the ...................................... ~ ................................................................................................................ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and fife this application; that all statements contained in this application are true to the'best of his knowledge and belief; and thaz the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this -- ~ ' i ~0~-~8~ a ~o~ .... (Signature of applicant) FOR~ NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL Oote ....... ~~.....;..Z...., File No ................................................................. ~..~-4~ .:.~.. ~..~..; ......... i~~~..x.~..~.~... ......................... ~ ~,~ ~ ~o.~?~~~ ......... ~ ~)ZT~~ ~ : ................................... ~~~..~ ............... ~ ~ , Mop ...~ ......... Block ......... Z: ................................ Lot .......... ~..-.-..~ ............................. is returned herewith and disapproved on the follow;ng grounds ~~-.~...~..: ....... ~~~~'_ ~~~.~~..z...~~~. ~~~~/..~~..~~...T.~,~.~. " '~ ~ ' ...... ; ............. r ................ . W, ' ~ ~ ,~ %lemorandum from.... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 / 994-¥579 J .~SYZ ~' ~.s7 ~4 50 w, F°. 5,2 BAY MOHE 6" VCA'r'EP-- MAIN 7.4 -' MA[..> OF c-u~,=.~.,~rs_~a to: LOT NO. 22 -. 'NAP OF WILLOW' P..ANT-..UFECO. I ,~P4o~z i A5 SURVEYED AT . 'TOWN OF ~_OW~HQ%D,, N.y.. I ~ODEBICKVAN TU'(L,RC LI__C,.LAND 5U I~VE ¥~-GI~EE'N PC~T) N.Y, I~E ~L J ISVF~ C"O. DEP'TOF HF_~,LTH 5E~?~F_j. '.- '.~5TAT, EME~T OFINI'EMI' t ~. ;- .;, -.,. z~;.,'i ;,~J,~i~l.~ .i .i.~,.~,:- '