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Home My WebLink About15977-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bu~ldlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17320 Date SEPT. 19r 1988 THIS CERTIFIES that the building. ONE FAMILY DWELLING. Locatmon of Propert~ 565 STARS ROAD EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 031 Block 03 Lot 08 Subdivision STARS MANOR Fmled Map No. 3864 Lot No. 3 conforms substantially to the Application for Bumldmng Permit heretofore fmled mn thms off~ce dated APRIL 27t 1987 pursuant to which Building Permit No. 15977Z dated MAY 8, 1987 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certlflcate ms issued is ONE FAMILY DWELLING, REAR DECKANDATTACHED 2 CAR GARAGE. The certificate is issued to FINNEr DAi~T~ff. C. JR. & TINAMARIE (owner, X~) of the aforesaid bumlding. SUFFOLK COUNTY DEPARTMElqT OF HEkLTH APPROUAL 87-SO-58 9/9/88 UNDERWRITERS CERTIFICATE NO. PENDING 9/13/88 PLUMBERS CERTIFICATION DATED PECONIC PLUMBING & HEATING 4/8/88 Uldl~ng~Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING pERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15977 Z Permission is hereby granted to: ....... ...~.~...~....~.,...~...~.... ......... =ursuant to a~pllcation dated ......,L~..~.....~.~ ................... 19.~..~., and approved by the Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Depar:ment Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru application must be filled in typewriter OR ink, and submitted aa ~ 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 naturat 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 F~re Underwmter~ 4. Commercial buildings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5. Submit Planning Board approva~ of completed rote plan requirements where apphcabie. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all propertv lines, streets, buildings and unusual natural or topographm features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ddlngs. 3.Date of any housing code or safet'¢ inspectton of buddings or premises, or other per~ment ~nforma- tmn required to prepare a certificate. C, Fees: Addit£ons 525.00 POOLS $25.00ALTERATTON $25.00 1. Certificate of occupancy New Dwelling 525.(10, Accessor7 '5 [0.00 Bus£ness $50.00 2. Certificate of occupancy on pre-exmt~ng dwelling $ 50.00 3. Copy of cert~ficate of occupancy $ 5.00, over 5 years 5]0.00 4.Vacant Land C.O. $ 20.00 ~.. 5.Updated C.O. $ 50.00 Date ...../'~---.~ ..... -~-?--~'~' New Cons t mucb zon ...... Old or Pre-ex~stlm~ 8uddm~ ............ Vacant Land ............. ocat,on of operty ........................ .... ......./J.. ...... Hou~ No. Street /Yam/et Owner or Owners o,.rope~ ........ ~ .~cs~.z... ~..~.~. ~ ..... .t....~..~.~....~.~.~.~ County 'Fax Map No. 1000Section ............. Block ~ . .. Cot . . .~. ...... Subd,vmmn ........... .'¢7.~,.../~./~../~..~./~. ..... Fded Map No.. . Lot No ........... / Health De~t. Approval ....................... Labor Dept. Approval ........................ Underwmters Approval ................... PIanmng Board Approval .............. Request for Temporary Certificate ..................... Final Certffmate ....................... Fee Submitted $ ............................. Constructmn on above descmbed budding and permL~meets all apphcable~;od _ es and regulations. Apphcant ...... ; .............. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICrrY ~t~ Appl~a~ion ~o. on file THIS CE~IFIE$ THAT DAN F~NNE, in ~ f~wlng l~a~YE ~ examined on and found ~o be in compliance with the r~uimtnenls of th~ ~rd. FIXTURE RXTUI~S OVENS DiSH WASHIBS EXHAUST FANS OUTLETS SWITCHES 22 30 2.4 22 SIIIVIC~ DISCONNECT S E R V I C E $~IOI~E D~TEC~'OR :-1 Of CC, ¢(~D. ~/0 1 ),/0 (; & S CONTRAC'rO8 · qou'rHOhD, IVY, 11971 ~ii cer~ficu~ mu~t not I~ ul~r~:l in uny manner; refurn lo t}~ offi~ of ~ ~o~rd if incurred, tnsp~ors may b~ iSent{~ by t~ir c~enfiuis. COPY FQII BUILDII4G DEPARTItHT. THIS COPY OF CERTIFICATE MUST HOT BI ALTERED IH ANY MAIMER. TOWN OF $OUTttOLD OFFICE OF BUILDING INSPECTOR P O BOX 728 TOWN HALL SOU"f HOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. [~-~ Owner (please pr!nt) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ' ~l~er' s s~nature) Sworn to before me this Notary Publlc,~County Not ar~; P~bllc BARBARA STEPNOWSKI Notary Pub~tc, St~e of New York No 4844752 Ouahfled m Suffolk County Commission Exp~res~, ~ 765-1802 ~/~ BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ~OUGH PLBG. / FOUNDATION 2ND [r~ INSULATION FRAMING [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND [ [~FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [v~ FRAMING [ ]FINAL DATE BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMA/I~KS: DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. 7G~XS02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. {~'~OUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL 765-Z802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] FOUNDATION FRAMING ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL REM.ARKS: ~ , DATE INSPECTOR ~/--~. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~'~INAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING .~ ~. : ]/~FINA~ DATE OUNDATION (1st) OU~DATIO~U (2nd) OUGH FRAME ?LUMBING NSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 1) H~TING ~IP~ ~ ~ 7813.23 - 75% EFF. Examined.. Approved Disapproved a/c BOARD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY V TOWN OF SOUTHOLD CHECK -~J~ :~:~ '. BUILDING DEPARTMENT SEPTIC FORM . ~'~..~;~ TOWN HALL $OUTHOLD, N.Y, 11971 TEL., 765-1802 ,1992 ,198.? Permit No (Budding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS NOTIFY CA:: .q2 ~ 97.?.~ ...... MAlL TO: a. Tins application must be completely filled m by typewriter or m znk and submitted to the Buildmg Inspector, with 3 sets of plans, accurate plot plan to scale Fee accordmg to schedule. b. Plot plan showmg location of lot and of buddmgs on premises, relationship to adjommg premises or pubhc streets or areas, and glvmg a detmled description of layout of property must be drawn on the diagram which zs part of this appli- cation. c. The work covered by tins apphcatxon may not be commenced before issuance of Buddmg Permit. d. Upon approval of this apphcatlon, the Building Inspector will issued a Buddmg Permzt to the apphcant Such permzt shall be kept on the premxses avadable for mspection throughout the work. e. No buddmg shall be occupied or used m whole or in part for any purpose whatever untd a Cerhficate of Occupancy shah have been granted by the Bmldzng Inspector· APPLICATION IS HEREBY MADE to the Budding Department for the xssuance of a Bmldmg Permzt pursuant to the Bmldlng Zone Ordznance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructmn of bmldmgs, additions or alterations, or for removal or demohtmn, as hereto described. The applicant agrees to comply with all apphcable laws, ordmances, bufldmg code, housmg code, and regulahons, and to admzt authorized inspectors on premises and m buddmg for necessary insp/~ctions · ..... (Signature of applicant, or name, if a corporation) (Mailing address of apphcant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder. ...... N neofownerofpremlses ............. iiii ii iiiii i"'i' (as on the tafroll or latest deed) If applicant is a corporation, s:gnature of duly authorized officer (Name and t~tle of corporate officer) ALL CONTRACTOR'S I~UST BE SUFFOLK COUNTY LICENSED Builder's License No .......... Plumber's License No Electrician's License No . .. Other Trade's License No Locatmn of land on winch proposed work will be done House Number Street County Tax Map No 1000 Sectmn ~. / Block Hamlet 2 Subdivision . ... .... Fded Map No .. Lot . (Name) State ex~stlng use and occupancy of premises and intended use and occupancy of proposed construction a. Exmtmg use and occupancy b. Intended use and occupancy 3 Nature of work (check which apphcable) New Building ~,.. . Ad&t~on .... Alteration .. Repmr ..... Removal ......... Demohtmn .... Other Work ....... ~.~/~t~ ,~ (Descnptmn) 4 EstlmatedCost .O..O~., .00 ........ Fee. ~..'~..~..'.~.~ .............. (to be paid on filing this apphcation) 5. If dwelling, number of dwelling units . ~/. Number of dwelling umts on each floor .......... If garage, number of cars ..... :~-,. ............................ 6. If business, commercial or mzxed occupancy, specify nature and extent of each type of use ........ 7. Dunenmons of exmtzng structures, if any Front. .. Rear ......... Depth ......... Height Number of Stones ...................... Dnnenmons of same ~r, ucture w~th alteratmns or additions Front ........ Rear ..... Depth ........ ~-- - Height ..... / ~.,,; Numbe~orf~S, tones ....... 8. Dlmens~onsofenhrenewconstruchon Front .~'.~'.' '. Rear ...o..~ ...... Depth ..~--' ":'' ' Height .~,~a,e~'~X ./)'~'/./,/. Number of Stones ... 'iil/;zd>ii.i 9 Slzeoflot Front ./)--~, ~.'~ . Rear . Name of Former Owner .~'~ 10 Date of Purchase ..... 11 Zone or use dlstnct in wtuch premises are situated ............ 12 Does proposed construction violate any zoning law, ord~nanceorregulatlon . . .' ":'/5~.t~'.iiill i."" .''''"''" 13 Will lot be regraded ... .~/l'.~q ........ , . ., Will excess fill be removed from premises' Yes 14. Name of Owner of premises ,.5"d.~'¢.,"/5 . ~j~Z/. (4~ddress ........... Phone No ......... Name of Architect ....... Address ............ Phone No .......... Name of Contractor ................. Address ............... Phone No:.t. ........ ~5. thzs property located wzthin 300 feet of a tidal wetland? *Yes ..... No ..~' *If yes, Southold Town Trustees Permit maybe required. PLO"I' DIAGRAM Locate clearly and distinctly all buildings, whether exxstmg or proposed, and xndmate all set-back dm~enmons from ~roperty hnes Give street and block number or description according to deed, and show street names and ~ndicate whether ntenor or corner lot ]TATE OF NEW YORK, 2OUNTY OF. . . S S (Name of individual mgnmg contract) tbove named ·. being duly sworn, deposes and says that he zs the applicant te is the ..... (Contractor, agent, corporate officer, etc ) ff said owner or owners, and is duly authorized to perform or have performed the said work and to make and file flus pphcatlon, that ail statements contained m this application are true to the best of his knowledge and belief, and that the york will be performed in the manner set forth m the application filed therewith, ;worn to before me this ....... .~. ~....day of... ~ ........ 19.ff7 1otaryPubhc, ..~---Ah'~.. ~-~..~...'.~.. County .~...~~.~...~_..~... ( v~AN v) SINOLE F ~I?.VEYED IDrZ LICENSED LAND SURVEYORS GR EENilIORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H S NO. L Y DWEu I FROM D "' ~.G.. ONLy AT,; OF APPROVAL ~I'ATI~:NT OF INTF/,NT THE WATER SUreLY AND SEWAGE DISPOSAL SYSTEM~ FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF TIlE ~,IFFOLK.~.~CO..~DEP,~. OF HEALTH.,~SI[RVICES. AI~I~,.IC ANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES-FOR APPROVAL OF I co..T.UCT,O- DATE: ~ '7 SUffOLK CO. TAX MA~ DESIGNATION DIST· ~CT BL~K PCL 4 -t- xEs~ ~E ....... __~ ........ J The ~ewa~e di~_~,,, a~d waler supply ~tmn have ~'i~d by ~ ~aM/~ SUFFOLK CO. HEALTH DEPT. APPROVAL H S NO. ~7-50-58 STATEMENT iDF I~NTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICES. fsi _ APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES - FOR APPROYAL OF CONSTRUCTION ONLY DATE: H.S. REF NO APPROVED. SUFFOLK CO TAX MAP DESIGNATION DIST. ~ECT BLOCK PCL ~WNERS ADDRESS: DEED. U £~,r36 ' TEST HoLE " ' STAMP" ' .~ ~1~ I~ ~ , sOmE Su~PL~ S~S~EM C~NN ExcEED 2/Io of l% LEAD" L ~l F-~ _S~ bE- i C~05,S 55