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Home My WebLink About10567-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-2027B Date OCTOBER 16~ 1991. THIS CERTIFIES that the buildin~ Location of Property 215 EAST LANE House No. County Tax Map No. 1000 Section 31 ALTERATION EAST MARION, N.Y. Street Block 16 Lot H~let 2.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1991 pursuant to which Building Permit No. 19887-Z dated MAY 28, 1991 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 CONVERT ATTACHED GARAGE INTO HABITABLE SPACE AS APPLIED FOR. The certificate is issued to GEORGINE MATTEINI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N-206511 - OCTOBER 3, 1991 N/A .// 2uilding Inspector Rev. 1/81 FOF, DI NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPI_ETION OF THE WORK AUTt~IORIZED) Permission is hereby granted to: ....... ........... ..../z.7.......~.~z~,~.~...~,~-~-... ~.- ~o C~o.~5:z~d~.c~ ~..~~.~7..~//~....~ .......... ............... ~~.~'.....~~/~ .................... ~ ................................................... ~ ~rem~e, ,oc,,ed a~.Z.:.~.~:...Z--:.~~..? ...... ~*-:..~X~Z'-'~"'~ pursuant to application dated .~'~'/..~.¢~.V~;/.~-~'...~-~... ....... , 1~)., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY July 16, 1991 DATE ................. NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property ....... 215 East Lane, Eas% Marion HOUSE NO. STREET HAMLET Owner or Owners of Property ..... ~ Georgine Matteini County Tax Map No. 1000 Section 031 Block 16 Lot 2.3 Subdivision ....................... Filed Map ........ Log .......... 5/29/91 Permit No. 19887 Z .Date of Permit ...... Applicaat RoD Morizzo Builder Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate X Fee Submitted: $ 25.00 rev. FORM NO. 6 TOWN OF SOUTHOLD BHILDING DEPARTHENT TO~N HALL 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCy INSTRUCTIONS 'This application must be!filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: ]]. Final survey of property with accurate location of all buildings, property lines, stZeets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage-dlsposal($-9 form). 3. Approval of electricai installation from Board of Fire Underwriters. 4. Swbrn statement from plumber certifying that solder used in system contains less than 2/10 of ]Z lead.' 5. Commercial buildingm,:industzlal buildimgs, multiple residences and similar buildings and installgtions, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning BoardlApprovaI of completed site plan requirements. For existing buildings (~rlor to April 9, ]957~ non-conforming uses, or buildings and "pre-existing" land qses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or to~ographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in wr~iting to the applicant. 3. Da~e of any housing colde er safety inspection of buildings or premises, or other pertinent information ;required to prepare a certificate. For Vacant Land Certificalte of Occupancy: ]. An'~application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, ]957 shall also accompany the application. If a! Certificate of Occupancy is denied, the Building Inspector shall state the reason? therefor in writing to the applicant. FEES: ~.' CERTIFICATE OF OCCD~PANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Fool, $25.00. Accessory building $25.00 Addition to Accessbry buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. Copy of Certificat~ of Occupancy - $5.00 - over 5 years - $]0.00 Vacant Land Certi~.cate of Occupancy - $20.00 5.. Updated Certificat~ of Occupancy - $50.00 6. Temporary Certiflc;~te of Occupancy - $25.00 Residential $50.00 Commercial rev. 1~/14/88 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 topograph ic featu res. 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. B. 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 featu res. 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 ired 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 / ~ :/: Date·,. f. ............. New Building ............. Old or Pre-existing Building ............ Vacant ............. Location of Property/~o.u.F~2 ..... .~.--//~. ~..~.~. ................................. · Street Hamlet Owner or Owners of Property . · . ~ { ........................... t.(, - ' .p.. t County Tax Map No. 1000 Section .......... Block . . ' ' Lot. ~2 ............ Subdivision .............................. 'r .Filed Map Ng, .......... Lot No .............. -- l t¢. Permit No. J0~l ,~0.~... Date of Permit ~ ?~... Applicant Health Dept. Appro~l..[.q .~ .~. ?.T, .L3 ......... Labor Dept, Approval ........................ Underwriters Approval ,~L.~, ,~. ,~ ~ ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..,,..L~,. ............... Fee Submitted $ ............................. INSPECTION COMMEN%S __~ FOUNDATIOM (~sC) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7G5-1802 BUILDING 'D'EPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION AND IX] INSULATION FRAMING [ ] FINAL REMARKS: I ~'~'5 -. o5 .0~, 7.0 EkT, 4,~sz ,05'5 'ToT-',~,~_.. E~. T, L). Fi, "1' 0 7 ~: L ~;. T Cl. _ 4,a 4-J FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ....... INSTRUCTIONS a. This apphcation 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 th~s apphcation 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 ~nspechon 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 remov~al or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildin~ code,/l~ousing, code, and regulations, and to admit auth°rized inspect°rs °n premises and in buildings f°r necessary in~'c~as~ ~r~ ..~.. [~ .........(Signa~r~e of' · ,~. ~.,4S.~applic~nt, or na~/~6:~,, a ...... c~i~ora't' ' "ion/ .... . . Io..¢. . . . . ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber Name of owner of premises GL-. ~-,Q .~...C~. ~ .~-... ~.~.~.~_~.[.~. I ........................................... (as on the tax roll or latest deed) If apl~li, c,~ is~qorpor~ion, signature of-duly au~thorized officer. .. ....... (Name and tinge of corporate officer) Builder's License No ........................ Plumber's License No.6, ./~ ~[~(~.~. ~z..]~.._~/,/('.~, . Electrician's License No. ~...~'~t/~ .~.[~.~¢...74~(.C. Other Trade's License No ...................... 1. Locat~onoflandonwinchproposedworkwillbedmae...~./q'.~.'..~..L~(~. 0~ .~.../~...7-~..~...~?.~. ~..e. ~,~. ....... ~,~-.r..~w ............ C..~..Yz....~..~./,f. ..... ~o. House Number Street Hamlet County Tax Map No. 1000Section ~.-~.~.l ........... Block .J.~ ............. Lot ................... Subdivision .................................... Filed Map No ............... Lot ~. ~..~..fi': ./.~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building . .. Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Co t .. ~ ......................... F . . .~ ............................ (to be paid on ~ing this application) 5. If dwelhng, number of dwellingiunits ............... Number of dwelling units on each floor ...... ' .......... If garage, number of cars .... ~. ! ................................................................. 6. If business, commercial or mixe~d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurgs, ifany: Front ............... Rear .............. Depth ............... Heighg ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... I.. Height .... ............... Number. of Stories ....................... 8. Dimensionsgf.~ntire new construction: Front ..~-~a.~. .......... Rear ............... ~ Depth .t~.(~ ........... tteight ...].U(. .......... Number of Stories ..... / .................................. , ............... 9. Size of lot: Front .. ]~)0.~.... I ........... Rear .... [(2~. .............. Depth .~.O~. ................ 10. Date of Purchase ...- ....... i .................. Name of Former Owner . . Z,B:/5/~ 'fi---. ~ ................ 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: .. Iq..0 ........................... 13. Willlo~beregraded ...L{~.i ................... Will excess fill be removed from premises: Yes [No) 14. Name of Owner of premises~..~ ~/~.71-/~-4~/.{ ........ Address ~r?t~.~/~.M. 5. ~...... ,. Phone No ............. Name of Architect . ~ ............ Address 6LPr~F~/'{ G~ ~,/b], Phone No PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK. COUNTif OF . .~4~(M~.. ia'a ' (Name of individual sigaing contract) above named. , He is the ..................... i ...................................................... i ,k~° ,nt,ra~, agent, corporate officer,etc.) of said owner or owners, and is duiy authon-n-n-n-n-n-n-n-n-'~d [u~lSerform or have performed the said work and to make and file this apphcat~on, that all statements contained m th~s apphcat~on are true to the best of hm 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 ..... ~) .... ,...:~..~ayor...~ .............. , 1 .~. vqotary Pdblic, .... [~,~u^ ............ ~. ~owa[sff~; .............. x County ' . ..... NOTARy PUBLIC, State of Ne~w Yor~ .. No, 52'4~24771 , ',' · ' t '" Qaalrhed in Suffolk Counb/ (Signature of applicant) ~ SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISF~OSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. {si APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE: , H. S. REF. NO.:~~ A~OVED: DIST. SECT, BLOCK EL. OWNERS ADDRESS; ~TTr~NI TEST HOLEIi, ~AMP SUFFOLK CO. HEALTH DEPT. APPROVAL STATEMENT OF INTENT SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK ~O.,DEP~OF HEALTH SERVICES. SUFFOLK COUNTY DEPT. OF HEALTH H. S. REF. N A~ROVED: - · ' - ~ - SUFFOLK CQ TAX MAP D~SlGNATION: '. , DIST. SECT. BL~K ~L. h~ OWNERS ADDRE~: I DEED: L.~ -- TEST HOLE ~AMP t , ~. VAN T~ P.C., /~ 9~I- LA~ GREEN~T ' ~YORK APPROV~'D AS NOTED _ DXTE: .p. NOTIP'Z BUILDING DEPA,'~.~-MENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I, FOUNDATION ~ ~0 REQUIRED FOR POURED CONCRET~ 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL - CONSTRUCTION MUST B~ COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~ATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR D~SIGN OR CONSTRUCTION ERRORS, -TI Jl I ~Zl_ 1NIhlpo~'~