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Home My WebLink About16077-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17097 Date JULY 19, 1988 THIS CERTIFIES that the buildin~ Location of Property 1360 House No. County Tax Map No. 1000 Section Subdivision ADDITION TRUMAN'S PATH EAST MARION Street Hamlet 31 Block 12 Lot I1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 22, 1987 pursuant to which Building Permit No. 16077Z dated JUNE 15, 1987 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 DECK ADDITION TO AN EXISTING ONE-FAMILY DWELLING. The certificate is issued to DAVID & MARY GIUGLtANOTTI (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 I~OB~ NO. B TOWN OF $OUTHOLD BUILDING DEPAltTMI~NT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 16077 Permission is hereby gronted to: .~.~.~...~.~...L:..~ ...~.~......~ ............. !~...~ ............. County Tax Map No. 1000 Section ..... ..~....~...I ........ Block ........ ]...~... ........ Lot No ......).1 ................ pursuant to application dated ...... ......~.~..~...~.. ................. , 19..~..'J.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 BLDG. DE~T. TOWN OF SpUll~OLD,' ~,, APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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 property showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occDpancy 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of Occupancy New Dwelling $25.00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3, Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ~'~/~ 5.Updated C.O. $ 50.00 Date ................ New Cons 15ruc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. House No, Street Ham/et Owner or Owners of Property .~A-,~ -- ..~}, .~.,.~..~/.,.~.x.r.:. County Tax Map No. 1000 Section O J' ! Block / L. Lot .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.. ;i~. :.l.r..Z-Date of Permit · ,~.~./?/,~.~.Applicant., .~?. ,~.,. ,~/, .~. ,/~ ,z~..~. . .~..' ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ,,, ~ ............... Fee Submitted $ c~'~,~~' Construction on above described building and permit meets all applicable codes and regulations. App,,can, " ' ............. Rev, 10-10~78 1~77 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~SULATION [ ] FRAMING [/] FINAL ~ REMARKS: ~ DATE INSPECTOR OUNDATIO:; ( 1 s t OUNDATION OUGH FRAME & PLUMBING i~';SULATION PER N. Y. STATE ENERGY CODE FINR/ · ADDITIO~IA'L COMMENTS 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 BOARD OF HEALTH 3 SETS OF PLANS SURVEY .. SEPTIC FORM ............. .......... ............... TEL.: 765-1802 Examined .fl ~ ./..~'~..., 19 3). ...~ ~ ./.~."7..., 19~..'/. Permit No./. .~.O..'].~..~... Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS NOTIFY CALL ................ MAIL TO: Date ...... · .~. ~L.¢..., 19 .P-/~. 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) ..... ....... (Mailing addre~ pp ' ) ,~ ,_ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,' plu~mber or (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S ~IUST BE SUFFOLK COUNTY LICENSED Builder's License No ..... ~ ............. Plumber's License No ......................... Electrician's License No ........................ Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. .... ./..3. (.? ............ ......................... .e-r....,?.-.? ..... House Number Street Hamlet County Tax Map No. 1000 Section ...... .'~.../ ......... Block ..../..L7 ........... Lot .... /../ ............. Snbdivision -- Filed MapNo ...... ~ ....... Lot ..... ~. ......... (Name) State existing use and occnpancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....ff.4., t..W4C .¢%...~..,q-.e~....~.~.'r.~ t../~...C{.W.t./~..~ 'f'',.a ~''rq ./~..~.: . .~..c? .~.ff. ~.~.~..d.~./.~. b. Intended use and occupa.ncy .ff./&..( .~.~..~. · .o.~..e:...ffJ~.m.: ./~.. ~. ~.t .fi( .~. ~....~/?i~ .~i'.~,.e.~.. ?. c.c. ¥ ~.~-_-_~..O.,.~./.~... 3. Nature of work (check which apphcable) New Building .......... Addition Alteration Repair .............. Removal ......... Demolition .............. Other Work.· .~).e.e..~'r'. ...... ~ ' ~ (Descrigtion) 4 Estimated Cost '7 73:. 00~ ............. , ................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ......... Number of dwelling units on each floor ................ If garage, number of cars .... i ' '~/l .............................................................. 6. If business, commercial or m/xed occupancy, specify nature and extent of each type of use ..; .~ ..'~. ........... 7. Dimensions of existing structures if any: Front ...... /.{..~ .... Rear .... /.~..~.-'('. ..... Depth..' ~i~'~ ..... Iteight ..... ~'~. ...... Number of Stories ..... .a?..~.'. ....................... 'i ..................... Dimensions'of ~ame struc)mre" . .............. with alterations or additions: Front 2Ltc g~ -/d.~.~. Rear .................. Depth Height Number of Stories Dimensions of entire new construction: Front..........~ec~/~ x/.~. ~(.. Rear ............... Depth .... ........ .. . Height ..... ~. g.*{.~.... Number of Stories ......................................................... Size of lot: Front ...... ,~. .............. Rear ....... ,5". ....., ........ Dept ........... ~ ........ Zone or use district in which premises are situated /~. 2o r~. Does proposed construction viq:late any zoning law, ordinance or regulation: ~t o Will 10t be regraded ............................ Will excess fill be removed from premises: ~ Yes Name of Owner of premises .~.~ .. t...~.~ ~ .(.-~?),~4 .,y.~ ~ AddressO~.d.~.. a.~ff/,%f~..~ ~,o .~./ ..... Phone No?.7.~.'.~fi.~. .,~.~./o.... Name of Architect ...... ~..~,. i ...... .~. .......... Address ..... ./~. t.,~.~, t.~..,~...,~.. Phone No ............... Name of Contractor .... '~'?' ' i .................. Address .... : .............. Phone~ ............... 15. 'Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... N~ ..... *If yes, Southold Town TrUstees Permit maybe required. i PLOT DIAGRAM Locate clearly and distinctly al! 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. 12. 13. 14. STATE OF NEW YORK, COUNTY OF ................. S.S · ' ................ .' ·;: ..... . 'i'. .................... being duly sworn, deposes and says that he is the applicant (Name of ind]wdual mginng contract) above named. He is the ..................... .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is drily authorized to perform or have performed the said work and to make and file this application; that ail 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. Sworn to before me this .............. ~. ~ ...... day of ..... .~. 04-,p ........... 19 .~'~. NotaryPablic, ...~..~.~..,¥~ ............. nty HELEN K. DE ~ PLIBLIG, ~e of ~w ~ (Signature of applicant) No. 4~78, S~olk T~m Ex~r~ Msrch 30,