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Home My WebLink About11424-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy Z10783 Date . .~..oy.e.m. ~.e?..1..8 .................. 19.8.1. THIS CERTIFIES that the building ................................................ 41245 Hain Road Peconic, New York Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 86 .Block 1 ..... Lot 3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Oc%ober. 2 19 ?.1. pursuant 1142t~ Z ..................... , to which Building Permit No ...................... dated Oc bober 1 t~ 19 81 , 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 ......... Alteration and Addition to P~,tio Andrew Catalano & Wf. The certificate is issued to ........................................................... (owner~ ~K~a~ x of the aforesaid building. N/n Suffolk County Department of Health Approval .......................................... UNDERWRITERS.CERTIFICATE NO. N / R Building Inspector Rev, 1/81 hereby granted to: (THIS PERMIT MUST BE KEPT- ON :THE PPJ~MI~SES UNTIL FULL COMPLETION OF THEWORK AUTHORIZED): :~ !; ...... z tO .......... ~ .................................................................. -., ........i.. · ..... ......... t ....................... at ~remiSes located at ~ / ~ ~/-~' ~ ( ~ ,,~ / .~ ........ ............................. Coun~ ~aX Map No. lO00 Section .............. ; ......... oocg~,...~ ........... ~ LorN .............. pu~uant to application dated · ~ ~ ~194, by the .............................. ~ ...... t"'? .... ~ ~ , Building, . nspector. . FORM NO, $ 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 featu res. 2, Final approval of Health Dept. of water supply and sewerage disposai-(S-9 form or equal)· 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, ~ndustriel buiMings, 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 end "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lin~s, streets, buildings and unusum 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ...... ~. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property...../~i /' ' ' .~ ,/~,~.. ;~3 .~. ~ · .......................... House No, Street Hem/et Owner or Owners of Property .... ~'~'~.~....~.~.~.~.~.~.~.~.~...,. ~?~.~7~.. ...................... County Tax Map No. !.000 Section . .~.~ .......... Block .... 1 .......... Lot.. ,~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./..L .~..~'/X .~-. Date of Permit/¢~/,¢¢/'~, ,/.Applicant.. ~¢~,..~.~~~.. Health Dept Approval '-'- Labor Dept Approval -- ..~ Underwriters Approval ~ Planning Board Approval ~ ~,. Request for Temporary Cert ficate ............ Final Certificate ..... · .... - ....... · .,¢ Fee Submitted $... ~. ~..¢7.. ~. .................. ' ,n · \ ?/ ~(~ uonstruct~on on above described building and pe~rmit meets all applicable,codes and regulations AP P lie an t ~'.~.~. ,~.'¢%',...~ ~.~¢~f-~,, ............... Rev. 10-10-78 · F~EL~a~NSPECTION FOUNDATION (1st) FOUNDATION 2. (~nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY G,ODE FINAL DATE COMMENTS ADDITIONAL cOMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-t803 ................ , 19~ . Permit No ............ Disapproved a/c ....... ~ ~.~_~~.. ...... '. (BoJMing Inspector) ~ A?PLICATION FOR BUlkDING PERMIT INSTRUCTIONS Application No .............. a. This application mnst be completely filled in'by typewriter or in ink and submitted in triplicate to the Buildi 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 stre~ or areas, and giving a detailed description of layout of property must be drown on the dia~am which is part of this apF cation. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon apprcval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept on the premises available for inspection throughout the work. e. No building shah be occupied or use~ [n whole or in part for any purpose whatever until a Certificate of Occupan sh~l have been granted by the BuQding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Build[ng Pe~it pursuant to t Building Zone Ordinance of the Town ~f Southold, SuffOlk County, New York, and other applicable Laws, Ordinances Regulations, tbr the construction o~ btfildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, ~d admit authorized inspectors on premises and in buildings for necessa~ inspections. , ................ (Siguature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is o~vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, (as on the tax roll or latest deed) If applicant is a corporation, siguature of duly authorized officer. Broider s L~cense No .... /3. /. }./~') .x.7/ . . . ~. . / Plu uber s Linens.. No ......................... Electrician's License No.' ...................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done..../~.'~.]...~i ./.4~ .fi'..~..O].../. ;v..(,...c"~ .~...~. 0( f.. ~ .... . .,.C_ Y. . .............. . ,,. . /z ..... .c. .o. r? r. .<: . ................... House Nmnber Street Hamlet County Tax Map No. 1000 Section ............... Block ................ Lot .............. Subdivision ..................................... Filed Map No ............... Lot .............. (Name) State existing use and occupancy of premises and intended use and occupanc~y of proposed construction: a. Existing use and occupancy ...... .D. ~ .-~.. ~... ~ b. Intended use and occupancy ............. ~ ............................................ Natnre o.~work (check whicJ, applicable): Repair ~. ............ Removal ..... Estimated Cost .... fi?..~.'...~, ~" ...... ..... Demolition ............ Other Work .-~.~ ..... .~,q~ (Description) ........... Fee ................... ,.. .......... (to be paid on filing this application) If dwelling, nmnber of dwelling units ............... If garage, number of cars ...... ~ ...... If business, commercial or mixed Occupanc Dimensions of existing structures, if any: F Height . .............. Number of Stol Dimensions of same structure witli alteratk Depth ...................... ! Ileight Dimensions of entire new constrnCtion: Fr Nmnber of dwelling units on each floor ............... specify nature and extent of each type of use .................... rent ............... Rear .............. Depth .............. ns or additions: Front ................. Rear ................. .................... Number of Stories ..................... ,nt ............... Rear ............... Depth .............. Height ............... Numb¢r of Stcnes ....................................................... ). Size of lot: Front . .' .. ......... Rear Depth .~ ). Date 6fPurchase ........... i ............. Name of Fenner Owner .... .~t(-~7-...,9~q4o ...... I Zone or use district in which premises are tuated ' " > Does proposed construction violaie any ze aing law ordinance or regulation: 1. Will lot be regraded ......... ., ........ ~ ....... Will excess fill be remol~ed from prmnises: Yes No *. Natne of Owner of prem~ses~'M'~r,'7..ff_~ ~F-e~t,-/~e'~ddress a~,~-rt,~..~:~ ,~. ..... Phone No ................ Name of Architect ...... Name of Contractor ..... ..................... Address ................... Phone No ................ ................ Address ................... Phone No ................ PLOT DIAGRAM whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether Locate clearly and distinctly all buildings roperty hnes. Give street and block n'umber ~terior or corner lot. TATL OF NEW ¥(52RK, .. ~ ~ OUNTY OF~ ~'a (Nai'rr~ of indMdual signing cent )ove named. e is the ................. ~,- ~... being duly sworn, deposes and says that he is the applicant 'act) :Contractor, agent, corporate officer, et~.) /zed to perform or have performed tile said work and to m~e and file this this application are true to the best oftfis knowledge and belief; and that the h in the application filed tl;erewitb. said owner or owners, a/~d is du!y autho ;plication; that all statements cont'ained in 'ork will be performed in the mmmgr set for worn to before me this (Signature of applicant)