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Home My WebLink About13314-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z.1.4. gtJ 9 .......... Date ... 9.c.~.ql~.r..6., .................. 19 .8.6. THIS CERTIFIES that the building .......... A.d. d..~.¢.i.o.n. ............................. Location of Property 8.4.5.. ~.~.Z. 1...C ?.e.q k,. D v i v'e B o u t h o 1 d ~ N.Y.' House No. Street Ham/et County Tax Map No. 1000 Section . .1.3. ~ ....... Block ..... 3. ......... Lot ..... 2..6 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · J..u .ly..2. .0 ~ ........... , 19 .8.4. pursuant to Milch Building Permit No .... ! .3 .3.1. 4. .Z ........... dated ... J u 1 y...30 ............... 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 existing one family dwelling The certificate is issued to Paul & Helen Forestieri (owner, ~O>OX of the aforesaid building. Suffolk County Department of Health Approval .......... N.../~ ............................. UNDERWRITERS CERTIFICATE NO ............................................. N7.67715 . Rev. 1/81 FOR3~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13314 Z Permission is hereby granted to: , . , .... .~.~.~.....~.~........~...~.~... ....... ..~~ ...... ~.:..~.:....!./.~...~. ........ _ ~t pmm~se$ Ioeoted ~t ............................................................................................................................ pursuont to application doted ......... ~ ....... ...~.....~.. ......... Building Inspector. ~ ...........~ .... ' 39~...~., ond oppro~ed by the Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - i~802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BI.DG. TOWN OF SOUTHOLO ktstr~ctio/'~$ A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate Iocatioo of all buildings, property lines, streets, and unusual natural or topographic feature~ 2. Final approval of Hea~th Dept. of water' supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrica[ installation from Board of Fire Underwriters. 4. Commercial buildings, IndustriaJ 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 p~perty shelving all propertv 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 mfety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certific~cte. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre*existing dwMIing 3 Copy of certificate of occupancy $1,O0 4.Vacant Land C.O. $5.00 New Building . ,~, f.~ ~ld or Pre-existing Building ............ Vacant Land ............. L°cati°n °f Pr°perty ~'~/'~' ' '~' ' '~' ' '~' ff ~/'~' ' ' ' fi '~' 'Hou~ No. Street .... '~-?'~'''~"~'~'~'~''~' .... (/,~..[~,...((ZT. Hem/et / h '+ ' , .............. Owner or Owners of Preperty v~'.O, ....... t-/ ..... ''...~)..~. ....... .~ ....... County Tax Map No. lOOOSection . L~. ~ ........ Block . .~, ........... Lot..~, .~. .......... $15.00 Date .......................... Subdivision .................................. Filed [~ap No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Heatth Dept. Approval ........................ Labor Dept Approval ........................ Underwriters Approval ......................... PlannMg Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building ~ permi~ meets, all applicable codes aqd regulations. Rev. 10-10-78 R c.. 3093'7 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY STREET, NEW YORK. NEW ~ORK 10038 o.,~ N 7 7715 THIS CERTIFIE~ THAT FIXTURE OUTLETS SWtlCHES 8 8 FIXTURES NCANDESCENT FLUORESCENT 8 OVENS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET NO, OF CC, COND, PER .8' OF CC. COND. NO OF HI-LEG OF HI,LEG MO OF NEUTRALS OF NEUTRAL OTHER APPARATUS: I~G.F.C.I. l-f~ke Detecto/' p~ul Fore~tieri ~4~ Mill Creek ~U~l~ld, N.Y. 11~1 GENERAL ~ANAGER Per ' This eerfifieot~ mos~ not b~ o~t~r~d in any monnor~ return to ~he office of the Board if-incurred InspectOrs may b~ identified 7~-Z~2 BUILDINGDEPT, INSPECTION F~ELD~NSPECTION COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~DE ' FINAL ADDITIONAL COMMENTS: "FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..~..~43.., 19~.~. Approved ...i~...,19~. q. Permit No.]..~..~./. .~..'.~. Disapproved a/c ..................................... ....... .............. [~ l~ltralk'* ~,t~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely tilled 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 Departme~nt 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit anthorized inspectors on premises and in building for necessary~,~_.~_._~~4~ (Signature of applicant, orname, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. (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 .... ~.~.['~..~). l~ ........ Plumber's License No ......................... Electrician's License No .............. r ......... Other Trade's License No ............ ~. ......... 1. Location of land on which proposed work will be done .................................................. ' :7. $ ~. ¥. . . ~ /. .Z. /,. . . . .c. .~ : ~. - . . . . ) ,ff ............... e ?. . e. g ..... ./ ~ ........... House Number Street Hamlet County Tax, Map, No. 1000, Section t .... [.~.~.. ....... Block ....... 3 ......... Lot ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and ~ccupancy ~f premises anddntended use and ?ccupancy ~f pr~p~sed c~nstru~ti~n: a. Existing use and occupancy .... /~.~. P{ {,1.~. ...... b. Intended use and occupancy ......... ~ ........ r ................................. 3. Nature of work (check ' ' ' which applicable): New Building ..... '. ....'Addition ..... Alteration .......... Repair ............. RemoVal .............. Demolition .............. Other Work ............... i (Description) 4. Estimated Cost . .~....,...,i ..,.. ............. Fee ...................................... ; ~' (to be paid on filing this application) 5. If' dwelling, num~ber of dwelling ~nits .... {. ........... Number of dwelling units on each floor ................ If garage, number of cars 6. If business, comm. ercial or mixed occupancy, spec/fy natture and extent of each typic of use .......... 7. Dimensions of existing structured, if any} Front., ,.8.e2 ..... Rear $ o . . Depth .3.o.. Height ............... Number of Stories .... ~. .................................................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... !.. Height .... /.~. C.~. ............ Number of Stories ..... 8.Height'DimenSi°ns. .............. of entire new construction:~,~mber of StoriesFr°nt"' .~.~/o~.: i:, Re ra~..~X./O.., i [. Depth ]~[::: [:: [ .... .... ?.' [' .fr 10. Date of Purchase ...... ~.~.C,~.. [.~..~.~ ......... Name of Former Owner .............. .... "j "" 1 1, Zone or use district in which premises are situated ................................. 12. Does proposed construction violgte any zoning law, ordinance or regulation: .. ~(,~. ........................ 13. Will l?t be regraded ...... ,~. ,J .... ;~ ...... .~_...q.. Will excess fill be removed from premises:~"~ 14. Name of Owner of premises ~.O.~...E~. ~X ~{[~ .~Address ................... Phone No..~. .~-.. Name of Architect .......... ,J ................. Address ................... Phone No ................ Name of Contractor I Address Phone No PLOT DIAGRAM LOcate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from prope~y lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. ,S.S ............................ ~ .................... being duly .§worn, deposes and says that he is the applicant (Name of individual sig~ lng contract) above' named. 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 i that all statements conthined in this application am 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. Sworn to before me this ..................... dayo ..... ........... 19, ~ / - , ~ ~.q /~? . / Notary Public, ..... v~-~' ' 'i ' ~' 'u' ' ~)'/~'~' 'd~' C°unty .(~ ~aT^~ ?omc, stm o~ }t~: ¥0r~ [.fi --t~.--M.z/..~.~.. ~..wx. ;;d'; .............. ' ~0. 4107878, Sutf01~ C0t~t~ -- t/ (S~gnature of. applicant) i