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Home My WebLink About10384-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building InspeCtor Town Hail Southold, N.Y. Certificate Of Occupancy shed addition THIS CERTIFIES that the building .. · Location of Property . 645 Baxhome Road Mattituck Hottse No. Street Hamlet County Tax Map No. I000 Section ....0~.~ ..... Block 05 .... Lot 024 Subdiwsion ...... .~i]~lO.v~ .t?giJ~ .......... Filed Map No. ~.6..5.2 .... Lot No, 22 conforms substantially to the Application for Building Permit heretofore f'ded in this office dated October 3,6 19 7.8. pursuant to which Building Permit No. 10384 g dated ........ ~.u. qu..a~..3.1. ......... 19.7.,9., was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which th~s certificate is issued is ......... a shed addS tion to private one-family ~w.e. lling.. The certificate is issued to ...... INCENT & LOUISE TIRELLI (owner, of the aforesaid building. Suffolk County Department of Health Approval ,.. ~I/.R. ................................... N/R UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10384 Z Permission is hereby granted to: , _~ ~ , ~ ............ ../.~~~...~_ ~.~) <: ~ .E~,.~.~...Z~...~ ....... ================================= B~ilding Inspector 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 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: 1. 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 occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Bate ...... ./.L:, 7. ..... New Building .... //', .... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~ ?J. ~ ........... 4~..-] .... ~ ?.-.~.C. .... b. ............. 5p.u. ( .~...D. ,, House No. Street Hamlet Owner or Owners of Property . [/~.w. ~t.~: .~.~- .... ?..L.~. ,.,.1.~, .~ .... .~I):{.L[ ~ .................. County Tax Map No. 1000 Section .. ~..~?. Block . .'J.'.~ ........... Lot ..... ~ .~. ...... Subdivision,..g~. I .1./.o..~y. ....J~O ~ .~.~. ........ Filed Map No..~.~..~.~.~TT...Lot No .... .~.. ~ .... PermitNo./,0. -~Z. DateofPermit ~/31/~;.Applicant L~ e ~'T ~ ~)~-¢_}) , Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... .~..u.-~ ............... Construction on above described building and permit meets all ap_plic'able codes and regulations. ~ "~-( ~lC~'-~ Applicant ...~,~....~, J,~,'~ .... fl. ................. Ai.~ DITIc._~I~JAL TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 April 16, 1984 TEL. 765-1802 Re: District 1000, Section 056, Block 05, Lot 024 Property owned by Vincent Tirelli To Whom It May Concern: Please be advised that there is presently one Certificate of Occupancy for the above mentioned property, for a private one-family dwelling built pursuant to Building Permit 8487Z. TWO additional Building Permits were issued on August 31, 1979. B.P. 10383Z permitted construction of an inground swimming pool with fence enclosure; B.P. ~0384Z permitted construction of a shed addi- tion to the private one-family dwelling. Certificates of Occupancy has not yet been issued, but both constructions have been inspected arid approved by the Building Inspector, and the C.Oo's should be issued shortly. Sincerely Victor Lessard Executive Administrator VL:ec FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1803 ..... ....... Disapproved a/c ...................... ~ ....... ;~ - (~ing Inspector) Date .................. , INSTRUCTIONS a. 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 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 issuance of Building Permit. d. Upon approvtd 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 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, htusing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary insj0ectioft~. ...... I/.~...~.../..~..- ..................... (Signature of applicant, or name, if a corporation) .................. , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .O..~..~:.5 P: ................................................................................ Name of owner of premises ...~.t,.~..~; ~..~..?....L.....??.~.~./.}..~'. ....................................... (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 No .......... .~..%?~...~..~ Plumber's License No ......................... Electrician's LicenseNo ....................... Other Trade's License No ..................... Location of land on which proposed work will be done .................................................. · ..... .... ........... ..... ................... House Number Street Hamlet County Tax Map No. 1000 Sectio,qn .... .~.. ar~ Block ~ c~ .7. Subdivision ..... ~/(lc['.~, .~. ...................... Filed Map No...~..~..~...t~. .... Lot.. ~..1~.. ....... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............. ./..~../' ............................................ b. Intended use and occupancy ........... .~..~..M~..~..: .~: ...... ~'~¢;~ ~ ~r{] ~:./~ ~d 3. Nature of work (check which appl!cable): New Building .......... Addition .......... Alteration ........ Repair .............. Removal .............. Demolition .............. Other Work ............... ---- i I ~)f (Description) 4. Estimated Cost ...... .~. ~ 19.! ....................... Fee ...................................... i (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height .i .............. Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ..................... ~ Height ...................... Number of Stories ...................... 8. Dimensions of entire new construdtion: Front ............... R~ar ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. ~Date of Purchase ............ : ................ Name of Former Owner ............................. 11.~ Zoae or use district in which premises are situated ................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded .......... , .................. Will excess fill be removed from premise~:~ 14. Name of Owner of premises .................... Address ................... Phone No./.~. ~.J~T'..,,~../z~.~ Name of Architect ........... i ................ Address ................... Phone No ................ Name of Contractor .......... . ................ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block n ~mber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YQ4~K, - ~, - .......... '../f * ~'f//.~/. ~&~..~** 2f...~. ~~.... being duly sworn, deposes ~d says that he is the ~pplicant (Name of individual si~i~g contract) above named. He is fl~e ...................... . ...................................................... (Contractor, agent, co, orate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements cont~ned ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this Nota~ 'No. 52-q52~76 - S,*ffolk Count~ Commissim~ Expires March 30, (Signature of applicant) 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.~,.~,:- ' ! ~. N..57ol4,5o,,W, BAY t-tO N'IfE P-.D, 'r.z 6"NVAT'E. IZ MAIN --''''/' '- ._.SCALE / MAP> OF LOT NO. 22 PIAP OF WI LLOW POI N T- SU F F. A~SI4Al',d 0 MAQLIE TOWN OF...,QUTHuL,L), N.Y. GUA~AN TE'.ED TO: ~oODE~!CK VAN ~UYL