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Home My WebLink About12932-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13006 Date Nov. 21 19 84 THIS CERTIFIES that the building ..... A.c..c.e.s.s.o..ry. ................................ Location of Property . .~7~.0 ................. p.e. 1..m.a.r, .D..r., ......... .........,....Laurel House No. Street /-/am/et County Tax Map No. 1000 Section . .1. 2. .5 ....... Block .... .0 .4 .........Lot . .0.1..8 ............ Subdivision .......... X. .................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... M.~r~l% ... ~_.4 ..... 19 .8.4. pursuant to which Building Permit No ....... 3:. 2. .9.3.2. Z. ........ dated ......... ~l~.qh ..... ~..4 ...... 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 ......... Accessory Patio With Roof The certificate is issued to LOUIS CAVALIERE (ownor, I~ ~/'tb~) ...................... of the aforesaid building, Suffolk County Department of Health Approval .... Iq/A lq/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FOB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12932 Z Permission is hereby granted to: ,-~ . ..~.~¥:~,~i~. ~.~ . ~~..~.....~'.. .. ~~.....~~ : ~Q ..... ..: . ..... ........ ............ ...... .............. .~~...~......~~ ........... ~ .......... ; ........... ~-~ ............. ~... County Tax Map No. 1000 Section ...Z..~.....~...'~... ..... Block .......... .~... ....... Lot No. / ~ pursuant to application dated ........ ~~.......J....L/. ............ , '9..~..LJ., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted~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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing ail 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/ land use 3. Copy of certificate of occupancy $I.00 --?re-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..~..~'..~...~. ......... ~..~.-.~.~?."~..~... ~....~. ............. .~'.~..~'..'~..~.~ ........ House No. Street Ham/et Owner or Owners of Property ...~.~. ~ ./?...~.~.1 .~....~.~.~.~-.....~..,~../~./~..~.././-~ ./?.~- ................. County Tax Map No. 1000 Section ....~¢<~.4¥. ..... Block ...~. .......... Lot.../~..o~. .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./..~. ??..2: ~ Date of Permit ./~...~.,~'. c..~../z/~'A~p~plicant .................................. ,ealth Dept Approval ........................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ . ..~. ,..4:/~'.. ..................... Construction on above described building a.~_ rmit meets all applicable cod.es and regulations. · Applicant .¢..'7~....4~...~.... L,,~¢'. ~. ~ ..................... Rev. 10-10-78 ~ 0 FIEI~D IN;~PECTI N 1. FOUNDATION [ 1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE Yt FINAL COMMENTS ADDITIONAL,COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL,: 765-1803 ~pproved .~..)9.ckqc.~.~· (.~/ ....19~. t;. Permit No.;..~'.q..~..~...~ 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 ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is pa~ of this appli- ation. 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 hail 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 hall have been granted by the B~ilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the milding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or t. egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· "he applicant agrees to comply with all applicable laws, ordinances, building :code, housing code, and regulations, and to dmit auth°rized inspect°rs °n premises and in building f°r necesl]7, i~~:... ~~.~ ........ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. qaine of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly aut,horized officer. (Name and title of corporate officer) Builder's License No...~,.~7~...~. ................ Phunber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · ..J. ........... ................ ........... House Number Street Hamlet County Tax Map No. 1000 Section ..... J. ,~..'~..T ..... Block ........ .q ........ Lot .... ./.~ ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~..~.~/..~. ......................................................... b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ........... Alteration .......... ' W k Repair ......... Removal .............. Demolition ............ ;.. Other or .............. 4. Estimate est ...................................... ......................... (to be Eaid on filing this application) 5. If dwelling, number of dwelling units ............ Number of dwelling unit~ on each floor ................ If garage, number of cars ............................................ i ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each typp of use ..................... 7. Dimensions of existing structures, ifany: Front ............... Rear ....... ; ...... Depth ............... Height ............... Number of Stories ............................ i ........................... Dimensions of same structure with alterations 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 ...................... 0. Date of Purchase ............................. Name of Former Owner ............................. I. Zone or use district in which premises are situated ......................... ............................ 2. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 3. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 4. Name of Owner of premises .................... Address ............... : ....Phone No. "J..q~.'.~40.3 ...... Name of Architect ..: ........................ Address ............... , ....Phone No ................ Nmne of Contractor .......................... Address ............... i ....Phone No ................ "' ' PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from ,roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. .TATE OF NEW YORK, S,S ~OUNTY OF ................. (Name of individual signing contract) bore named. ·. being duly sworn, deposes and says that he is the applicant le is the . .: ................................................................................... i (Contractor, agent, corporate officer, et~.) f said owfier or owners, and is duly authorized to perform or have performed tho said work and to make and file this pplicationl that all statements contained in this application are true to the best of his knowledge and belief; and that the ,ork will b~ performed in the manner set forth in the application filed therewith. .worn to bqfore me this ·..~t~t...C/9;.. ...... day of ..................... , 19 lotary Publ?., ............. · ...,~ ............. County ,~ NOTAi~Y PUBI lC, Slate of New Yorli. ' No. 4707878, SL~ifolk, Oountyoc?'z'', Ter £x,o~res ~rc 1 ~O~ l~? ' (Signature of applicant)