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Home My WebLink About16191-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15957 Date July 17, 1987 THIS CERTIFIES that the building ....A.d.d.i..t .ip.q ................................... Location 8595 Peconic Bay Blvd Laurel of Property ............................... ' ................................ House No. Street Hamlet County Tax Map No. 1000 Section 12 6 . .Block 04 .Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J u n e 22, 198 7 pursuant to which Building Permit No. 16 19 1.Z dated . . . J..u.l.y.. 8..,..ltl. 8..7 ........... 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 ......... .... .D.e.c..k..a.d.d..i.t.i.qn...t.o..a..n..e.x.i..s.t.i.n.g. one family dwelling. The certificate is issued to DOMINICK & CAROLYN SENATORE (owner, of the aforesaid building. Suffolk County Department of Health Approval ....... N /A N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FORInt_ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CFHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 16~?~ z Permission is hereby granted to: .... ~.~.s....~~.~..~. ...~..~.L..~....~.:.~.., .............................. ........................... n ............................ at prem,ses located ~t ...... ~.~.~.....~ ........................ ....~.....~......~...~ ............... County Tax Mop No. 1000 Section .... /.....'~....~.. ....... Block ¢:~iJ~L Lot No. !.~'. Building Inspector. Fee ....~. ................. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted g ~ 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 p~operty 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 requ ired to prepare a certificate. C, Fees: Additions $25.00 1. Certificate of occupancy New Dwelling,S25,00, Accessory iS10.00 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 .......................... NewCons%puc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .%. ~).u[ _v~.. , ...... Q~ ....................... House No. /'tam/et Owner or Owners of Property .(.~.~.~rx~.,~..-~.~,~l:~'~¥[¥%~;%~..l~... ~.~TO.[~.'~. ............ County Tax Map No. 1000 Section ~. .... %.".~-.~3 ...... Block .... ~ ......... Lot ..... I..~. ........ Spbdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ~ 7 UND~TION UNDATtON (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: / ~+. ho. do~: bat ~o~l~e'.f~s SHOWN ~o "MnP oF ~. b,Do~N5, FI~' t'~ 3~ ~,~ ,~ ~.a~,.t~.~ VAN TU,L, DC. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN hAll N.Y. 11971 $OUtHOLD, TEL.: 765-1802 Examined ...~..~J~..~..., 19 ~.'~ Approved .....fl~ ~.., 19 ~..~. Permit No. I..~. I ~ 1..~ Disapproved a/c ..................................... NOTIFY CALL ............. MAIL 7~:' ~'~-~ /~- (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 tiffs 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 necessa,,ry inspections., . (Signa~re';f applicant, o; ~n'e~ ii ~ 'c;;~;~a'ti~) i [q.6 .... (Mailing address of applic/t'nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .(~.~[.[10,.e, dg,.. :fh~Q~)..0~,~...~..~.. ~ .D-O.~ ............................ (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 COlqTRACTOR'S MUST BE SUFFOLK COU}ITY LICENSED Builder's License No ......... ~ ......... Phimber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done...~.C[_..~/o~t .?. . ............... ................. ............................. House Number Street Hamlet County Tax Map No. 1000 Section ...... [~)-{P ........ Block .... ..t.~. ........... Lot...I.¢ ............. 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 ........ . . .[/.~'~JZ~,.. ! ..................................... b. Intended use and occupancy .............. 3. Nature of work (check which applicable): New Building ' Addition , .. Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cos .~.7 .~ ...................... Fee ~ (to 13:e paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor .... .: .......... If garage ~number of cars 6. If business, commercial or mixed 6ccupancy, specify nature and extent of each type' of use ' · 7 Di f if F D?pth mensions o existing structures, any: ront ......... ,.. , Rear .......... ~ ..... · ....... Num b~r of Stories Height ....................................................... ~. ............... Dimensions'of same structure with. alterations or additions: Front ................. Rear .................. Depth ....................... ; Height ...................... Number of Stories ...................... 8. Dimensions of entiie new construction: Front .......... ..... Rear ............... Depth ............... Height Number of Stories . 9 Size of lot: Front Rea~' '.'. .... Depth 10 Date of Purchase Name of Former Owner ' 11. Zone or use district in which premises are situated .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ [3. Will lot be regraded ...... ^ ....! .................. Will excess fill be removed from premises: Yes ~ No t4. Nmne of Owner of premises [2,'~ ~J~).~.t&~70X .~¢.... Address ~ ~f'~. ~q~t~.~n~... Phone No.. O~Q ~: Name of Architect . ............. Address ................... Phone No ................ Name of Contractor ........... ............... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .~... *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly ail 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. 3TATE OF NEW YORK, S.S 2OUNTY OF ................. .............................. ~ .................. being duly sworn, deposes and says that he is the.applicant (Name of individual signing contract) tbove named. is the ......................................................................................... I , (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplitation; that all statements contained in this application are true to the best of his knowledge and belief; and that the york w/Il be performed in the manner set forth in the application filed therewith. iworn to before me this ............. ~..~ ........ day 9f...~... ,.~ ....... , 19~. 4ota/y Public,..~.~..~fv...~k.J .~.'~ ...... Count.~~ i HELEN It DE VQE ' NOTARY PUBLIC, State of New York . No. 47078:~8, Suffolk (~unty~.~, [e~fA Expiresidarch 30, l,q /~ ! (Signature of applicant)