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Home My WebLink About13065-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date ............ 4~Z.2~ ............. 19.t4 THIS CERTIFIES that the building. AclO~-g~..r~. ~,.. Location of Property ... J-.0.3.5 .......... CalYe.a .~leck. Ret ................. $o~%hoJ-~.. House No. Street ~1 Hamlet County Tax Map No. 1000 Section ·0.63 ........ Block ....07 ......... Lot .... 0!~ .......... Subdivision .......... Y; .................... Filed Map No...3; ..... Lot No..Z ........... conforms substantially to the Application for Building Permit heretofore Fried in this office dated ·.. ~r. il ..... 16 ...... 19 B.4 pursuant to which Building Permit No, .13065Z ............. dated . . .Ap.r.&l....2.6. ............... 19 .8.4. , 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 ......... Addition & al%eration to existing o. ne .f. am.i.l~ dwelling MICHAEL DE CARLO The certificate is issued to ......................................................... (owner, le~ee'ol' of the aforesaid building, Suffolk County Department of Health Approval.... ........................... . .,.,.... . UNDERWRITERS CERTIFICATE NO N6 0 0 3 6 0 . Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDIHG DEPAP, TMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~3065 Z Permission is hereby granted to: ...... ......... ~/.,.....,~ ........ ...-/Z ....... .~....e..~.7~.o..4~.....-..:~..:..~.......//.~. £/ /~.....,2c~(..~..~.~,~ ......... &.~..~,az.(,.~...../,~.d.d~..2./~; ...... ~, ~ ...... ot ~,,m,ses ,ocateLt...,~./..e..~ ....... ~..(,~.......~...Z.....~ ........................... ............................................................................................................... ;:Te.~z~,~.-~...-.~...:9) County Tax Map No. lO00 Section .... ~.~..~, .......Block '"~"Z ......... Lot No...~..~-~ ....... pursuant to application dated .... ,d~./.~.~:~.. ......../....~... ............. . 1 .9~.../.., and approved by the Building Inspector. TO ,,::"'.'VF. EXCESS FILL , ,~'~ pKEN~ISES BY REG.u .IA, I. DRiV2'i',VxY COblt~AUCT~ON ~ CESSPOOL CONS I AUCTION ~ C~LLAA cONSTEUC-f ION ~ Rev. 6/30/80 FORM NO. 6 ',TOWN OF $OUTHOLD Building Depar'cmen'[ Town Hell $outhold, ' ........ APPLiCATiON FOR CERTIFICATE OF OCCUPANCY Instructions This appt cation must be filled (n typewriter OR ink, and subr~itted in duplicate to the Building Insoec- tot with the following; for new bui!dings or new use: 1. Final su,~zey of property with accurate location of all buildings, property lines, streets, and unusua natural or tooo?aoh[e features. 2. Finalapprova of Heaith Dept. of watersupp yandseweragedisposal_(S.9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Muitiple Residences and similar building~ 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 buildines and "pre-existing" land uses: 1. Accurate sup~ey of peoperty showing all property I~nes, 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. Data of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a ce~ificate. ,/ Fees: 1. Certificate of occupancy $$.00 2. CertificaTe of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ~.'~, ll;;:i~i Old or Pre-existing Building(%) . -.._---'= --= /Vacant Land .C Owner or Owners of Property .~-r.4.~$..~ '~, Subdivision ....................... ,Flied Map'No. ' m ......... · ....... Lot No. Health Dept. Approval ........................ Labor Dept. Approval ....... ' Undemzriters Approval , .............. ' .......... Planning Board Approval .................. Request for Temporary Certificate - ~ ~ ,..FinaICerdficate - Construction on above described building and permit'meets all apol~cab e__codes and reeulations. Rev. 10-10-78 Applicant l DUNDATION (1st) ~ -- DUNDATION ( 2nd) ....... OUGN FRAME ~ ~, i.L :_ ~ ..... PLUMBING --~ NSULATION PER N. Y. _ STATE ENERGY C,ODE ' 1 ! 2 R 3. IN 4 ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS, BUREAU OF ELECTRICITY 86 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the e]ectrlcal eq~ipn~ent ~ described beIo~ and i~tmd~¢ed 6y tl~ applier ~d o~ t~ ~b~e appl~c~tio~ ~umber i~ the pre~ise~ of in thefollowing location; ~ Basement ~ Ist Fl. ~ 2nd FI. , ~$l~ Section Block Lot was examined on ~kj.l ~ ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMN~ERS SYSTEMS NO, OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: 1-G. P. I. 3~4 Glen la'zve This certificate must not he altered in any manner; return fo the office of the Board if incorrect. Inspectors may be id COPY, FOR, ~UILDI~NG DEPARTMENT. THIS qNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~'~J~J~k~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK. NEW YORK 1003~ ,).~ ,~, .~',', :L~,~ .~,~.llc.tio.~o.o.,~,~ ~'~]:~S/~ N 653298 THIS CERTIFIES THAT ~kic~-v~l DiC~lo~ 103~ ~/~ C~..~vo~ Nec~ ~/., ~/0 Yo~s AVe, ~ ~o'~hol~ ~,Y. in the followir~g location; [] 1st FI. ~ 2nd Fl. Section Block Lot and found to be in co,npliance with the requirements of this Board. FIXTURE OUTLETS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDESCENT FLUORESCENT DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: E R V I C OF CC COND. AW, G OF HI-LEG NO OF NEUTRALS OF NEUTRAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be by their credentials. cOPY FOR B~UILDING DEPARTMENT. TH S COPY OFCERT FiC~T~ MU,~T NOT ~E l I~ ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Application No../. ?.~.J.o.~..'~ ....... Disapproved a/c ........ '_522 .....~ ...... "' 't3 ......,' ................................. .. , , ...... ' (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 Occupahcy 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, b.~lding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for neces~ ~2~ ~ - (Signaturqof applicant, or n~poration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.~x ¢,~.~-,~..... ...5't~¢~F.-~-~--/~.~ff~;'.. ~J-~' ~: ............................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.., ./../.~.'~....G: .7~.%.r-.v. , . Plumber's License No"5~&/b //e r~. Electrician's License No./~...~./~.~.Y.~. k...~-. *~. J.~..'. \ Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. 1o :' __ " ............ ..................... House Number Street Hamlet Cohnty Tax Map 'No. 1000 Section .. ?..&. ?. .......... Block . J~ ...... : ........ Lot. 3 7- Subdivision ................ (iq'a'r~)' ............... Filed Map No ............... Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~ff. ~/ ..... .077 . .(.Z .~ .~?..~'. ................................ b. Intended use and occupancy .... .gQ.'-/g. rJ72 .~. ....................................................... 3. Nature of work (check which apblicable): New Building .......... Addition .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... , (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling u_nits ............... Number of dwelling units 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. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. [~;~/. Number of Stories' Height ................................................................ Dimensions of same structure with alteratmns or additions: Front ................. Rear ................. Depth .................... '.. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............. Height ............... Number of Stories ....................................................... 9. Size of lot: Front ....................... Rear ...................... Depth ..................... 10. Date of Purchase ........... , .................. Name of Former Owner ............................ 1 1. Zone or use district in which prqmises are situated .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ......... ~ ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of p~r~em~ses ...! ................. Address ~ ................. Phone No ................ 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 NEW/~ORK~ ........ ~ .].~... J.e~.~.~ .....: .................. being duly sworn, deposes and says that he is the applicant (Na~e of individual ~ing contract) above named. He is the ' (Contractor, agent, co,orate officer, etc.) of said owner or owne~, ~d is dfly authorized to perfom or have perfo~ed the said work and to m~e ~d ldo ~is application; that all statements con~ained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this ' 19~