The URL can be used to link to this page

Home My WebLink About12904-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southo|d, N.Y. Certificate Of Occupancy No. Z12B14 Date Sept. 27 1984 THIS CERTIFIES that the building . .A..d.d.i.t.i..o.n..%o...A.c.c. lf :..B.l.d. 9: ................... Location of Property . .5 .7.1. Q .............. .I.n.d. ~..ap..N..e .c.k..L..a .n.e. ...... P.e..c .o.n.i.c. ......... House No. Street Hamlet County Tax Map No. 1000 Section ...0.9.8. ...... Block ...0 .5 ........... Lot ...0 ~.~.: 3. ......... Subdivision....Aja. d.r. ~.w..H.a..h.n ............... Filed Map No...8.7 ..... Lot No. 3 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~eb.. ....... ],6 .... ,198..4. pursuant to which Building Permit No..1.2.9.0.4..Z .............. dated ...... N/a~ql3 ..... 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 to Accy. Building The certificate is issued to . PETER D. PIZZARELLI .................... ?eYre'r, ~'~;;,,i.,h/ ..................... of the aforesaid building. Suffolk County Department of Health Approval .... .N./..A .................................. UNDERWRITERS CERTIFICATE NO ............ .N./..A .................................. Rev. 1/81 Building Inspector T(:~VN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BI: KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1290~ Z Date ..~ ....... ~. .......................... , 19..~....~ Permission is hereby granted tn. · ~ ~ ..... .~.~.~....~.....q.:. ................................... ~o ..... ~~.~, ,~......~.&.~..~. ~.~.....~.~....~....~..~...,...~.. ............. '"'~'~~0' ':~ ................................. ~ ~'"' /~ ; ................................. ,~ ~-""~ ~ ......................... ~ ; ........................ - · et prem,ses located at ...~...~.~/ ....... ~.~.....~.~.,..~..~.~...~J.~e.,~....L¢. ........... ..~ ...... County Tax Map No. 1000 Section ...~...0~. 3 ........... Block ........ .~'~.. ......... Lot No ....... ~..~..~.i.~.. ....... pursuant to application dated .~.~..~...~...~ ................... , 19~.~.., and approv~ by the Building Inspector. Fee ~ ........................ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall · ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitte~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 elecGrical 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. B. 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. 1. Certificate of occupancy $5,00 / 2. Certificate of occupancy on pre-existing dwelling / land use 3. Copy of certificate of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant l~nd/C.O.~ $ 5...00. New Builqting .... , ......... Old or Pre-existing Building ............ Vacant Land . Owner or Owners of Prope~ .... ~ ...... / ...................... County Tax MapNo. 1000 Section ,,, .. , ..,. Block ~. ~,.. · ,. Lot. ~ealth Dept. ~pproval ................... · .... labor De~t. Approval ........................ Approval Planning Board' Approval Unde~riters ........................ . ..................... Request for Tempora~ Certificate ..................... Final Certificate ...................... . Fee Submitted $ ............................. ~ ~[~ Applicant ..... ~.~ ~~..' FIELD I~SPECTION FOUNDATION FOUNDATION 2. (~st) ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY QODE FINAL COMMENTS ADDITIONAL COMMENTS: Examined .~.ad<..~,.x..k,p... Approved .~..a~,~X..kW... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., ., 19~.tl. Permit No. ! .~.5.~.c.[.-~... Received ......... ,19. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 issued 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 applicant agrees to comply with all applicable laws ordinances, buff,ding code, ho~using code, and regulations, and to admit authorized inspectors on premises and in building for necessary in:~,~ K ,-r ~g,a.,e,~ ' -- ''' iSignatur~'"-" ~ ~'~; ~p~'p~!~l. le', ~! 'c~;~a~io'~) .... (Mailing address of applican%) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ .......... Name of owner of premises ............... ~'..~..~ ................................................... (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...>7.7./..o. ' &:?/< .... ........ ........................................ I. r~,~. . {,,.~.[,,. . House Number Street Hamlet County Tax Map No. 1000 Section ..... O...~..~. ...... Block Subdivision .... .~.../~2./~. ~..~.~. .... ~ ........ Filed Map No.. ''~'7 ......... Lot ..... .-~. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~. ~.~7. ~*.r'- ~--~ ,o '~'''' .c~... ~..~'-..,,~....'~..~,..~....~.~¢..~t/f. ~.~ ......... b. Intended use and occupancy .... .-~..L q.~.C Nature of work (check which al ,plicable): New Building .......... Addition . Repair .............. Rem.)val .............. Demolition ......... ....... Alteration .......... ·.. Other Work ............... (Description) 4. Estimated Cost .... i Fee (to be paid on filing this application) 5. I f dwelling, number of dwelhnglunlts ............... 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 e~i~ing structures, if any: Front ..... 2'.O. ....... Rear ...2-.. 0 ........ Depth .... 2,,..O. ....... Iteight $' t~. I. Number of Stories . ./ .............. ._ Dimensions.of same struc.ture With alterations or additio~a.~s: Front .... ~..O. ........ Rear .... ~.. O. ....... Depth .... T.O. ?rtl(~. I .g ....~.. Height ....... ¢..T'~T .......... Number of Stories .... / . . , : . ~ 0t ....... i ...... 8. D~menslons of en1~re new construction: Front Y.q ..... Rear . / .... Depth . ./.~. .......... Hmght ..... ~V.I ....... Number of Stones ........................................................ 9. Size of lot: Front ....... 4~:~. ~ ......... Rear ...................... D~eoth ..................... 10. !)ate of Purchase ...... /. q.7..ff.~ ................ Nan~ of Former Owner 2~'L~..~.PS.'.~.... t~.Y{ft:] ...... 11. Zone or use district in which premises are situated ...... ~.-. ~t .......................... ; ................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ....~.O. ......................... 13. Will lot be regraded ...... ..~A~. .........~ .......... Will excess fill be remo~d, from premises: Yes 14. Name of Owner of premises . ~*'~.7~.~./~ ~. t~'~/l:f~-. ~./'Jrddress t".O.I.~.0]::. './.~./.~. ff..~..q .g//.q>hone No. '/~'~. Name of Architect ......... !.. ~7'....~ ~,......... Address, . ..~..~ . . ,_ ....... Phone No. Name of Contractor ........ i'....~../~t.~. '"'" .. Address ........ "~ Phone No ...... i i~. PLOT DIAGRAM Locate clearly and distinctly ali 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 YORK, , COUNTY OF..~.~?.d.¢.~,......,' S.S ................ : ~. .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named· He is the ' ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. S.?orn to before me this //~ .day Of. .t~....~ 19 .~..s~ Notary Public, . ................ CounW MARY DIANA rOSTER ................ NOTARY PUBLIC Stats of New York/ / /~ (Signature of applicant) No. 52,465§242, Suffolk County_ Commission Exp