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Home My WebLink About10887-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southoid, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location of Property l:y[~tjs~7~oO...got'gh..0ak~t, ood. ll~.:l, ve_.) ......... l~a.tl~'ol.,..N. 7 .......... · 6'treet Hamlet County Tax Map No. 1000 Section ...1.~ ? ...... Block ...... 8. ........ Lot .... ~. ............ Subdivision[,auz'.el. Fa,~.k .................. Filed Map No. 2.1.2 .... Lot No. z~zt ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... g.e.¢ l~9~a.b.q~.. 2.3,., 190.0. pursuant to which Building Permit No .... 1. 9.8.8.7. .g ........... dated . .s.c.p.ke.m.b.e.r..2.6., ........... 190... , 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 ......... ..... ~.~.iva.t.e .One..F. am£1y. D~.elliag .......................................... The certificate is issued to .VioD. e the..Et, an.r~e s ch.=,tl$ ............................. (owner~ lesse~e~oa ~eoa~ZJ . _ of the aforesaid building· Suffolk County Department of Health Approval .... 1.0.-$.0.-.59.3./.3 ~/.SA. ll.o.b.(~ r ~..A. ~..V.~.I. 1. a. P UNDERWRITERS CERTIFICATE NO .... ~.51 ~ 3.?A ..................................... ....... . . . ~-.~ Building Inspector Rev. 1/81 BUILDING SOUTHOLD, BUILDING P,E~iT~' (THIS PER~IT MUST BE KEPT ON ~HE~ ~E~ISES~UNT. -- L ~ULL COMPLETION OF THE WORK AUTH~RIZE6~ "~,-"'~' 10887 ~°~ ... ...... .~.., ......... ,...~ ............. ............. , Permission is hereby graqted to: ~ RA~AZZO BLDG,,, C0~,~ ~/c Vt~e~e F~ce~chi~i ...................................... ~..v ....... ~'??'f'~ ........... 127 SWAN L~ BUILD A P~VATE ONE FA~LY [O ..~ ................................ ~ .................................................. ~""'~";'~ .................~[ ........................................ 790 N R~N O~OOD at premises Ioc~teo ~t ...~ ...................................... ;. ~,....".~;;..~....~..~ ............. ? ..................................... ....................................... ~ .................................. ~'"W~ ' ....................................... ~ ................................. t ................. ?'~"'?"'~ ................ ?'[ ....... : .............................. County Tox ~op ~o. 1~00 S*ction ...... ~.~ ......... , el~ek b,..}...~ ........... ~Cot ~o .......... ~ ............ pursuan'r to a--licationpp ~dat~d., ......... $e~.~.;~.~ : ..;,.' g,., 19 ~, and approved by the gUfldlng In,pector. . THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 100:38 ~- Mardn 11, 1981 104;/42 - 81 ~ ~ ~. 'THI~ GERTIFI~ THAT the following h, cat,on ~.sement ~ 1st FI. ~ 2nd FI. Sectiorz ~lock Lot was examined on ~J~'Cdl ~) ~ 19~)t and yound to be in ,'ompliance with the requlrements of this ltoard. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 20 21 DRYERS SYSTEMS NO OF FEET S E R V NO OF CC COND A W ~t.J0 OF PER ,6' OF CC COND I 2/0 ~¢Future gppl:tao~:e ~;2e~r/s: 1-2#14, ].-2~12, 1-2~10 ~;~c~l t~cep~:J~e/s; 1-ZO ;~s., 1-30 ~ps., 1-50 1-9.6 ~q. Elco. t~a~ %-2 1/2 'f'~. A/C C AWO OF HI-LEG NO OF NEUTRAtS AWG OF NEUTRAL G.O. Electr£c, 6 Poplar A,o'a,, Me~dfc~d~ N.Y~ 11763 , li~. 2677-g 11 This certificate must not be altered in any manner; return to the office of the Board If incorrect may be ~denhfied by COPY FOR B~ILDING DI~PAI~TMI~NT. THIS COPy OF IN ANY MANNER. FORM NO. 6 TOWN OF $OUTHOLD 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 foJlowlng; 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), Nomconforming 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 occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 V//~ Date....L~. ~-[...~...~7..?../ ...... New Building ............. Old or Pre-existing Budding ............ Vacant Land ............. Location of Property ~.. .~. . .~ .~, ~. ~e~O ~ . ~/'. ~ Owner or Owners of Property .. ~[.Q ~... ~.~.~.~.~ ....................... County Tax Map No. 1000Sect,on ...]~ ....... Block ~ ............. Lot.~ ............ Subdivision..~.~..~ ............ Filed MapNo..~[~,..LotNo..~ ........ Permit No./~.~.~ate of Permit .......... Applicant..~ ~... ~.~ Health Dept. Approval....t~ .~..~ ....... Labor Dept. Approval ..................... ~). Underwriters Approval ~ ~ ~ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ..... Fee Submitted $ . . .t ........................ Construction on above described building and ~er~eets a,pplicable codes and regulations~ .... .... .......... Rev. 10~10-78 FInD %NSPECTION COMMENTS FOUNDATION (2nd) ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~ / ~ FORM NO. 1 ~' TOWN OF SOUTHOLD ~/~ ~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 .~./ ' '" TEL,: 765-1803 ..~ 19Fa Examined ........ /.. .... , ... Approved ........ .,19 .mermitSo../ .rZ Disapproved a/c _ _', ~...~ ..... ;/ ..... ~.~.;.~ .... ~ · ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No...4.d) .~P.~..7 ...... 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 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 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, hojef~i~g code, and regulations, and to admit authorized inspectors on prelnises and in buildings for necessary insptc[i!~-. (Signature of applicant, or name, ii' aVcorp~tion) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer g~neral co~ electrician, plumber or builder. Name of owner of premises ) . . . M .[ .................................... (as on the tax roll or latest deed) If appl~ca~a,t.~a, aorl~r~tion, sjgjaature of duly authorized officer. (Name and title of co,orate officer) Builder's License No..7 ....................... Plumber's License No. '..~."..]~ ./~.~'~. ~..~ .~.kt.~'. Electrician's License No..C;.,.0:..~. ~C~.~i(,L. Other Trade's License No..m .................. ! 1. Locationoflandonwhichl~oposedworkwillbedone...~../.~....]~.O~...~.'.~C..~.t.O~..~t .... $~g~ .......... .......... House Number Hamlet ~Z~s~2.~ .~Y~ ................. Filed Map So. ~.{.'~ ....... Lot.~'~}}~}~' (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ~xistin~ us~ and occupancy .............................................................. b. Intended use and occupancy . .g~ ~.~a a.~( a.C ........ [..S~.7.'' '~~ ..... 3. Nature of work (cheek which applicable): New Building .......... Addition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ........................... Fee ..: .............................. ~t0 158 paid on fling this application) 5. If' dwelling, number of dwelli.n.g units ............... Number of dwelling units on each floor ................ If' garage, number of cars . . ~-~. 7.../..M.. ~.q2~t~/~< .M.'~.. ........................................... 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 ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ... Height ...... J 1 '"~ ~ ............ Num~ ¢?~r of Stories ........ .~ ....J ........ 8. Dimensions o£fintire new construction: Front . . PU..~. ......... Rear ...~T..~2'. ......... Depth . '.~.~ .......... ~eight ..l.~. ...... ~..,NumberofStories...:/....~..r ....................... aizeoflot:Front ...~.0 ................ Rear . . .~..O ................. Depth Date of Purchase . .~. .......................... Name of Former Owner .- ............................ Zone or use district in which premises are situated, r ................................................... Does proposed constrt~ion violate any zoning law, ordinance or regulation: . ~.l.O ........................... Will lot be regraded .~.~ ....... . ....... ~ .......... Will excess fill be removed from premises: Yes Name of Owner of premises ~ ~F~- ~(,/IZ0~ Address '- . Phone No Name of Architect . .,~ ........................ Address .......... ( ......... Phone No. Name of Contractor /~/t~.~... ~:~.. ~ ....... Address [2"7. btdt~r ~/rt~ 0tz~Phone No. .... vz. 10. 11. 12. 13. 14. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEVi~RK, ~ , ~' ' ~ ~ COUNTY 0~'~~'2~.' ~'~ ......... .......... (Name of individual signing contract) abow~ named. being duly sworn, deposes and says that he is the applicant He is the ..................... . ............./,-'~... ?..~..? ....................................................... k(Co~tracto~ agent, corporate officer, etc.) of said owner or owners, and is duly authoF~form or have performed the said work and to make and file this application; 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 manner set forth in the application filed therewith. Sworn to before me this N 'o~ .v. .................. NOTARY PUBLiC,State of New York e of applicant) No 52-8125850, Suffolk C0~_.~ ler'm Expires Match 30, 1~''~ Lot ,4' ?g¢ON lC TEST HOLE 0.0 SAND & GRAVEL this dc ~t,m~z~ t HEALTH DEPARTMEN1 DATA FOR APPROVAL TO CONSTRUCT t( N£AR£ST WATER IAIN ~--.,MI +- ~ISOURCE OF WATER PRIVA~FE~PUELI¢ ~ SUFF CO TAX MAP DIST J~._ $£¢ TION .~ BLOCK ~L_ LOT ~ TEL El = MONUMENT 3USDIVI$ION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON OCT.S, 1925 AS FILE N0.212. SURVEY FOR VIOLETTE FRANCESCHINI LOT 44, "LAUREL PARK" AT LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTRY, NEW YOHK MAR 4,198t DATE AUG 27,1980 SCALE I" = 40' NO 80-453 YOUNG A YOUNG ALDEN W YOLING~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N MS UCENSI:- NO 12845 HOWARD WYOUNG, LAND SURVEYOR NYS LICENSE NO 45893 400 OSTRANDER AVENUE RIVERHEAD~ NEW YORK 0 45 0 0 0.0 120 170 TEST HOLE SAND a GRAVEL SAND ~ coUN'I~' DEPAIgMENI' OF lilY, TIt HEALTH DEPARTMENT~DATA FOR APPROVAL TO CONSTRUCT ~ NEAREST WATER BLAIN ~-MI -+ ~SOURCE OF WATER PRIVATE ~_~PUBLIC ~ S~F CO TAX ~AP GIST ~ SECTION ~ akOCK L LOT 4 tTHiRE ARE ~ DWELLi~S WITHIN tO0 FEET OF THIS PROPERTY OTHE~ THAN THOSE SHOWN HEREON M=MONUMENT SUBDIVISION MAP FILEDINTHEOFFICEOFTHE CLENN OFSUFFOLK COUNTY ON OCR S, 19aS AS FILE NO. al2. SURVEY FOR VIOLETTE FRANCESCHINI LOT 44, "LAUREL PARK" AT LAUREL TOWN OF SOUTHOLD SUFFOLK COUNT,Y, NEW YORK q YOUNG a YOUNG ALDEN W YOUNG, PROFES%IONAL [NGINE ER AND LAND SURVEYOR N Y.S UCENSE NO HOWARD W YOUNG~ LAND SURVEYOR N,Y S LICENSE NO 4589.5 DATE AUG 27~1980 SCALE 1"=40' NO 80-453 ~DO OSTRANDER AVENUE RIVERHEAD, NEW YORK