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Home My WebLink About11153-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Halt Southold, N.Y. Certificate Of Occupancy No. Z .q .q.5.67. .......... Date ........ H..~?.c.h...2.4 ................ 19.8.3. THIS CERTIFIES that theao~ikhng' .. p.qo. 1. ......................................... Locat~on of Property 1150 Terry Lane Southold H3~s'e ~'o'. ....................... 'S'de3i ....................... h3/.bi County Tax Map No. 1000 Section 066 . .Block 03 .Lot 013 Subdivision .... X. ......................... Filed Map No..X ....... Lot No...X ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated Hay 6 19 .8.1. pursuant to which Building Permit No. 11153 Z dated .... ?la.y . ! 5 ................ 19.8.1., was issued, and conforms to all of the requirements of the applicable prowsions of the law. The occupancy for which this certificate is issued is ......... .... .~.q . $.ng. ro .u.n.d' .s. ¥.imm..$.ng. p..oQ.1. . ............................ The certificate is issued to JOHN DiCARLO (owner, I~,~ee ~r-terr~nt') of the aforesaid building Suffolk County Department of Health Approval ...n./..a .................................... UNDERWRITERS CERTIFICATE NO. N 523382 Rev 1/81 Building Inspector FOEM NO. 2 TOW~ OF S~OUTHe.~ BUILDING D~PART/~EN~ TOWN' HALL SOUTHoLD, N~ Y. N°. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON ~H.E PREMISES UNTIL ULL COMPLETIdN OF THE WORK AuTHORIzED) "~ ' 19.. 1153 Z Dot~ ..... ~, . ....................... , Permission rs hereby granted to .... ~z.....~.~.~.....~.~.~...,~. ................ ..... ,,~..¢...-..,.~ ..... ~~.~....-~ ~o ..,~a ~e .~....~:~..~.. ~.~.~.....~.~..~r~....~...,,~m~o,~ ....... .:~ ......... ~.;~...L~o.... ....... ......... ~...,....:~ ............. ~ ....................................... ~ co~ ,~ ~o~ ~o. ~000 s~ o~ ...d~ ......... ~o~ ~.~ ........... ~o~ ~..~ ............. Rev. 6/30/~ 80 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 ail 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 p~an requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existin¢" 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 / / Date., /~.~/.~.,/ ~ .. / f~ -- // I ~ Street~ Ham/et _. County Tax Map No. 1000 Section .............. Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval .,/~/.~..~-~'~.. ?'.~. ......... Planning Board Approval .................. ~,,, Request for Temporary Certificate ..................... Final Certificate ........ - ......... * Feo Submitted $ .~.: ........................ Construction on above described ' bu JJOing and permi~ee~JJ ~¢~es a nO regu ,atJons.'~ t uuoO THE NEW YORK BOARD OF FIRE UNDERWRITERS F~[ BUREAU OF ELECTRICITY ~ jl~%!~ .[J~ )gJj~, 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 THIS CERTIFIES THAT only the electrical equipment as ~scribed below and introduced by the applicant named on the able application number in the premises of in the following location; [~ Basement [] 1st FI. ~ 2nd FI. OCsti~J~(J~] ~ ~L Section Block Lot was ex~,~lrted on JL)fkt~ l~ ~ [~ ~, and found to be in cotnpliance with the requiretnents of this Board. FIXTURE OUTLETS rECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS LJNIT HEATERS MULTI-OUTLET SYSTEMS NO OT FEET DIMMERS SERVICE DISCONNECT S E R V I C NO OF CC COND A W O NO OF HI lEG A W G NO OF NEUTRALS A w O pER ~' OF CC COND OF HI LEG OF NEUTRAL APPARATUS. This certificate must not be altered In any manner; return to the office of the Board Inspectors be identihed by their credentials, FOUNDATION (~st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY OpSE FINAL ADDITIONAL COMMENTS: FO~ NO, ~- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. D~sapproved a/c ......................................................................... ,'. ................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Thts 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by th~s application may not be commenced before issuance of Building Permit. d Upon approval of this application, the Building Inspector w~ll 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 opphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. cor; i'; 'i ........ 34-50 Veterans Hwy, bohemia NY 11716 (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Contractor Name of owner of premises ........ .J...o.h..n....g.$.~.~r..~q ................................................................................................................. If apphcant is a corporate, signature of duly authorized officer. (Name and t~tle of corporate officer) Builder's License No ............ ~...~..]'. ...... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ......... ~ ......................Lot No ...... .]:..3. .............. Street and Number Wear ~ o¢ z,~ ZebCo, A~.~' ~ i3' 5/..0 -ro~,~ (~reel~ .~.~9~¥L:&q~ .. _~f~,//~) Municipality State ex,sting use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy Residt%.~..c.9. .............. ' .............. in,round vinyl lined swimmin~ p, ool b. Intended use and occupancy ......................................................... <- '3. Nature of work (check which japplicoble). New Building.. ................. ,Addition .................. Alteration ...~ ......... Repa!r .................. Removal ;' Demolition .................... C~th6r Work ................................................... (Description) 4. Estimated Cost ............ ~ 8. 0. .0. ;. .0. .0. .................................. Fee / ~:)~ ~ (to be paid on filing this application) 5. if dwelling, number of dwelling units ............................ Number of dwelling umts 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. Dimens,ons of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Numb'er of Stories ................................................................................................................. Dimensions of same structurel with alterations or add~tions: Front .................................... Rear ........................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new con§truction: Front ............ .1..6. .................... Rear ....... 3~ ................. Depth ........................ Height ................... Number~ of Stories .................................................................................................................... 9. Size of lot: Front ............. .Z.~.:.O...0. .............................. Rear ............ .Z.~5.,.0.9. .................. Depth ........ ,l.{~..,.flp .......... 10. Date of Purchase .................. ~ ...................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction viglate any zoning law, ordinance or regulation; .......... ,~,.o, .......................................... 13. Will lot be regraded ......~9. ................. Will excess fill be removed from premises: (×) Yes ( ) No 14. Name of Owner of premises ..... M..ff.o..h....g.$.g..~.~'..Z.9. .................... Address ...~P,~J~gX..D;¢ ........... Phone ,No. R;~=~fi~ ...... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. G~ve street and block number or description according to deed, and show street names and indicate whether interior or corner lot. See attatahed STA-[ E OF NEW YORK, ~ S S COUNTY OF ...... SuBsoil( ............ fi' ........................................... ,q~.%.~.~,o.~,,~,,,~,~,~,,,,t~.,~,.~.~,, .................. being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contracf) above nam'ed. Contr~o~r He is the ........................................ ~ ......................................................................................................................................... ~ (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statement~ c~tained in this application are true to the best of his knowledge and belief; and thor the work will be performed in th~manner set fo~h in the application filed therewith. Swom~$ore me this ~m,/ _ ~ ~ ~ o J o 04