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Home My WebLink About11518-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... .Z,1.2.4..9,6 ....... Date .............. .M.a.y..3.0. ........... 19.8.4. THIS CERTIFIES that the building .... 9.n.c. 7 .f.a.m.i.t.y..d.w.e..1.1.i.n.q ..................... Location of Property ..... 3.4.0 .......... B r oW. ri.. $ .t T.e.e.t. ........... House No. ' ....... Street ..... Nam/et County Tax Map No. 1000 Section ....0.4..8 ..... Block .... .0.3. ........Lot . ;P/.q .0~32.-.~ .... conforms substantially to the Application for Building Permit heretofore fried in this office dated .... Oc.tp~.e .r..1.6. ..... , 191~. pursuafit to which Building Permit No .... 1.1.5..1.8.Z. ........... · dated ..... I~.e~b~r..~ .......... 19 .~.1, 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 .... . ..... ......... new. nne~-fzumily..dwel3~ing ............................................ PAUL & CHRISTINA DINIZIO The certificate is issued to ........................................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Hea]£h Approval .......................................... pending UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FOZ~ ~0. ~ 'TOWN O~ SOU 'HOLD BUILDING TOWN HALL ~ SOUTHOLD, N~ ~. BUILDING FE~IT~ (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S COMPLETION OF THE WORK AUTHORIZED) UNTIL E}ULL Perrhission' is hereby granted to: ~-~-.., ...... .............................. ~'..... ~...,.e~a~.~t.... '"'i ' .......... ~0 at premise~ located at .....~..../.~ ............ t ........... ~~.z~.....~.~.,z..~.~.~.~2~.~ ...... :~7 ............ :. ~.:...,,.,~.:7.....-..~...:...Z./ Cour~ty Tab/Map No. 1000 'Section ......~...., .... Block~ .~:~.~,,....:......; Lot No,~,/.~.. ...... ~.~...~z, ~ pt~rs~on, ~o application dated ./~..~..~'...~..L.....,;.......:..i....~...., ,S~.. ~.., and Opproved by the · i Baildlng Ir~spector. nspecto? 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 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. / Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 ot land u se'~'15'~/$5.00 Date.. New Building .......... Old or Pre-existing Building(Z)., ........ = ZVacant Land ........ 'ocationofProperty. .. . .'. .. .... """ " ...... '" ........ ' House No. Hamlet Count,/Tax Map No. 1000 Section ............... Block ............... Lot ..... ~ .......... Subdivision ................................. Filed Map No...; ....... Lot No .............. Perm,t ~,~o..l/. X./. :~ .~ Date of '~erm~t X~':."X-...rl..^pp,,c~nt ....,,~.,4... ~'.'¢.'.'~ .~ .......... Health Dept. Approval ....... /.; .~.,. abor Dept. Approval ........ .-. ............ ,. · Underwriters Approval .~,_.0,,.~,.~. ,.~,.~,.~, . ,~..t, ..... Plannin oar rovat .................. ~ ,., Request for Temporary Certificate ..................... Final Certificate ................. Fee Submitted S ............................. Construction on above described building and permi~,c]eets all app,~cab, le~codes and regulations. AI~p cant , .~...~...~.,'~"~ ' Rev. 10.10,78 FIELD INSPECTION~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL COMMENTS ~.__~ ADDITIONAL COMMENT~ TOWN OF SOU~OLD OFFICE OF BUILDING INSPECTOR · P.O. BOX 728 TOWN HALL SOUTHOLD. N.Y, 11971 TEL. 765-I 802 ~ .T,.~s 1~ cO aGVlse you ~hat the 4~x .,~ ....... rermlt No, Jl,~J ~ ,~ i~su=~ ~ '- < ~ u,,u~. ~ulialn~ --, ~6 - n -a~ (~ nas ~o;~ b~:~ d~ne. in opdep to complete ~ ~ oh_s file, it is necessapy ~- enclosed = ~ ~ .... g 2seres. Please fill out ~' ~ ~or,:(s) , re¢urn same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be mailed, and arrange with this office fop an inspection date. Thank you for your prompt attention. VL:ec Enclosures Very truly yours, Victor Lessard Adminis tr~ tot FORM NO, 3 TOWN OF SOUTItOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ~.~.c~...,,~/.~./~.O ........... .~/.~..~..~...~... ............... · .~. ~,~./~.~,,.,./. z.~. ;. PLEASE TAKE NOTICE that your application dated .... ~... Location of Property ,.. ~.~ ...... ~~~. ~'- ........... house No. ~treet County Vax Map No. 1000 Section.~ ....... Block . .~.~ ........ Lot ?~. ~ ~.. is retu[ned herewith and disapproved on the following grounds ~.~. ~,~..~ ~.. x.~... ~..~.. ~:~ ~...~ ......... RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~..~../..~' ..... ,19,~(~d'. ...... l ,Z.,'er,nit ......... "' ': .................... '," (Building Inspector) APPLICATION FOR BUILDING PERMIT AI~plication No././~.~/..~. ....... INSTRUCTIONS a. This application nmst be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi inspector, with 3 sets of plans, accarate 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 stre~ or areas, and giving a detaJled description of layout of property must be drawn oil the diagram which is part of this apg cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept on tile premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any pnrpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe Tl:e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections./~ //. /./ ////--YI/ . . .......... ...... . .......... (Signature of applicant, or n~me,-if a corporation) State whether applicant is owner, lessee, agent, arc~fitect, engiueer, general contractor, electrician, plumber or build N ue of owner ofpr,,,n,ses .'0;' ...... V.~..~ ..................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of coq~orate officer) Builder's License No .......................... Plumber's License No .... ~.. .~7 .(---~--Z... ............ El~ctrtman s Lmense No.. Other Trade's License No ................... -... 1. Location of land on which proposed work will be done .................. House Number Street ' H t County Tax blap No. ~000 Section ... ~.~.~. ........ Clock ..... 3 ........... Lot..~,.d .......... . . '(Naind)t, ' ............. , ......................... 2. State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy el~/y ~ D Ii Otb. Repair .............. Removal .............. ama don .............. er Work ............... (to be paid on filing this application) i. Ifdwelling, numberofdwellinglunits..~..:f~:::::I. Nuxnb~rofdweliingunits?n.e~c.hfl. oo~ ................ If garage, number of cars .................................................... i. If business, commercial or mixed occupancy, specify ~ature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .......... , ..... Rear .............. Depth ............... Height ............... Nun!bar of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth It 'gl N be fSt ' {. Dlnlenslons al elltlre new constB etlon Front .................................. Height ............... IskKab,~r oc~,,,Stories ........./ ........... ~ .......... ' ........ ,... ~,. ¥ .......... 1. Zone Or use district in which prGmises are situated.., i ............................... ~. ................. 2. Does proposed construction violate any zoning law, ordinance or regulation: ...,~..~ ........................... L Will lot be regraded ....... .., .............. Will excess fill be removed frgm premises: Yes Name of Architect ....... Name of Contractor ...... ................. -.. Address ................... Phone No ................ Address Phone No PLOT DIAGRAM Locate clearly and distinctly all buiklings, whether existing or proposed, and.indicate ~1 set-back dimensions from roperty li~)es. Give street and b ack'number or description according to deed, and show street names and indicate wh~ther :terior or corner lot. TATE OF N~E1,k~--~R,J~ .,? "S · ......~~--~ .......... being duly sworn, deposes and says that he is tile applicant ' (Nanie ofindivi~a~i~mg co~ract) ~ove named. e is the .................................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, m~d is dr)fy authorized to perform or have performed the said work and to m~e and file )plication; that all statements eon'rained in this application are true to the best of his knowledge and belief; and that the · ork will ~e performed in the man~er set forth in the application filed therewith. worn to before me this C ~'>Om ~Z~ 0 \ 22~.~2 6" 0 0 :';Il