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FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ... Date ... Z-15898 July 1, 1987 .............. ............................. THIS CERTIFIES that the building...2nd Story on seasonal dwelling ............................................. Location of Property ,Private Road off Naugles Rd. Mattituck, N.Y. House No. Street * ' * ' * * * ' Hamlet County Tax Map No. 1000 Section , 0 9 9 . , . ,Block 5 ..........Lot ... 8 ............ Subdivision ...............................Filed Map No. ........Lot No. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 19, 1986 15378 Z pursuant to which Building Permit No . ............. I ....... dated 0 c t o b e r 8 , 19 8 6 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 ......... 2nd Story on existing seasonal dwelling as applied for ................................................................................ The certificate is issued to ....,VINCENT & MARIE STUPPIELLO ..................................................... (owner, F& a bX€eXaXil2X of the aforesaid building. Suffolk County Department of Health Approval ............. . N / A ........................ UNDERWRITERS CERTIFICATE NO.......................PENDING .......................... . PLUMBERS CERTIFICATION DATED: Rev. 1/81 N/A Building Inspector roans rro. a 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) W15378 Z Date ..0. ,...... '`.... ...g ................... 193.41 Permission is hereby gronte to: X19.....�?..�4S.A4hr,r....... Q .. r ................ r�.•�......�......!?.....C4-...1�t ....a, . ...................1.......n........................................y..............�...f................ at premises located at .Qt+Q...1 5J......:.{i 1. �A�•••••+• ►•+••• ••••* r" UUD ................ ................... ..................................................................................................................................•.............. ................................................................................................................................................................. County Tax Map No. 1000 Section ....0.9..C....... Block ......0 J ...... Lot No..... © ........... pursuant to application dated ....".. •••••.4•..1•.......•••••. 191..`P.., and approved by the Building Inspector. Fee $........ B4dlni spector 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 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=perty 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 required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 c3 5.Uodated C.O. $15.00 Date....../ .................... NewConstruction...... Old orPre-existing Building .... V�..... Vacant Land Location of Property....................... . .. .... ...... ...... House No. �) 1 Street Hamlet Owner or Owners of Property .... V.a rvt'`�an int . 41rL: Y?,jr�!�......... . . . . . . . . County Tax Map No. 1000 Section ...... q.?...... Block ... S......... Lot ... �........... Subdivision .................................Filen dap No. ..........-Cot - No. ............ . Permit No........... Date of Permit ..........Applicant .................................. Health Dept. Approval ........................Labor Dept. Approval ....................... . Underwriters Approval ........................Planning Board Approval ......... I ............ Request for Temporary Certificate .....................Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable (codes and regulations. j Applicant . 1,l �.4 ......................... Rw. 10-10-78 RX.5M I coy. 15,agj COPY FOf BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ; THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW4YR%5dW i � July 01 1987 yyy jj ///yyy Bate Application No. on file N 9 1 THIS CERTIFIES THAT 9 n plicant med on he above applicationumber in the premises of only the electrical equipment as described below and introduced by the o Ho NY Viudwit & Marie Stuppiello, Private BI'Cad off Nau�d�es RcY., Nattltuckr � in the following location; ❑ Basement 1� Ist Fl. 2nd FL .Section Block Lot was examined on Oudla; 22, 1967 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ECEPTACLES SWITCHES M OUTLETS INCANDESCENT FLUORESCENT vAv q AMT K W. AMT. I N W. AMT KW. AMT. K. W.. S DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT TRANS. HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS s AMT. K. W. OIL H. P GAS H P. AMT NO. A W. G. AMT AMP. AML AMPS AMT H. P AMT whirs SS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER EQUIP. q,, ]W q %3W 3 %3W 3%4W NO OF CC COND PER% AWG. OF CC.COND NO. OF HbLEG A. W' G OF HI-LEG NO OF NEUTRALS A �`' G. OF NEUTRAL OTHER APPARATUS: *Nq VISUAL DEEECTea nAN FLEcTR:LcAL SURVEY BAB suN MADE or TBBE EXwsED ELUcTRICAL kQUIPX&NT IN Thr HRi'NiSES INDICATEU. °' "NO OBVIOUS UNSATISFACTORY CONDITION WAS FOUND.n C "yAy Maria StUppiello 39 Garden Blvd., GENERAL MANAGER Hicksville, NY 11801 r 4C,V ll Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOf BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ; 7 7 ll� SEP 191986 TOWN OF 8OUTHOLD OFFICE, OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 January 13, 1987 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. ( )An application for Certificate of Occupancy is not on file. ( i"O)No Underwriters Certificate on file. ( )The check is 0 outdated/not on file.) ( )No stealth Department Approval on file. ( )No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit #j— z ' w 2 ( )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April 1, 1984) Mr. & Mrs. Vincent Stuppiello 39 Garden Boulevard Hicksville, New York 11801 r'IELD INSPEOTIUN JDATE 11 m ° R 3 --_ _ H �Ip 3 W FOUNDATION (13t) n a m� FOUNDATIONd (2nd) — 2. z o . ROUGH FRAME & PLUMBING N H 3. m m H INSULATION PER N. Y. STATE ENERGY CODE x b m 4.y Q F J - ' ;— �G2/Sp �ela.la .i FINAL o= � z ADDITIONAL COMMENTS: x 00<7®did ✓Czc x ro b ' H O 7 2 x m b ;• H v -o 765-1802 BUILDING DEPT. NSPECTION [ ] FOUNDATION IST [ , ROUGH PLBG. [ ] FOUNDATION 2ND [ , INSULATION [ , FRAMING [ , FINAL REMARKS: 9^,r ke DATE .INSPECTOR 765-1802 BUILDING DEPT. T:Fi-;]i4 iL�I:I C ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ) FINAL 41 DATE OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY DROVED AS NOTED D 4TE: _ I l5lo B.P 0 FEE.5.�,..� �_! BY: �^ NOTWY BUILDING DEPARTMENT AT Yt, g 1802 9 AM TO 4 PM FOR THE r (_141 OWING INSPECTIONS: f-009GAI(ION TWO REQUIRED POP w01J9E0 CONCRETE +1 $4006He, CRAMINti & PLUMBING 4 Q(m�9TwUCTION MUST ALL 1:0',YS r Ptut:!TKIN SHALL. MEET THE 11r;C].t NR,,':"FNIS OF THE N.Y STATE ' Uhd:xr�ld.3C *f C}N W ENERQy CURES N ")T �IFSPONSIBLE FOR hESIGN :�t !"t;'-.*iSMUCTION ERRORS, rr J`*FY., ,•A FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL COUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined 19?!0 Approved P. . !?.., 14! Permit No. Disapproved a/c ..................................... .................................... ..... (Building Inspector) t' 7�ki - ii SEP 191986 Received ........... 719... APPLICATION FOR BUILDING PERMIT Date ..... �/..... , 19r� 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 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 a plicant, or name, if a corporation) ......................... -1 .(!�P!. ...... (mailing aaal ess kdf applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................................................ Name of owner of premises .. . S1Vl ?�`� °f . .... ... -..... . ? .......................... . (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 . ......................... Plumber's License No . ........................ Electrician's License No . ...................... Other Trade's License No . ..................... 1. Location of land on which proposed work will be done. ....T. :. �:... ....... ............................................................................................. House Number Street Hamlet County Tax Map No. 1000 Section ......99 ......... Block .......,?` .......... Lot .... 6 ............. . 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 ............ 1.1 ............ 1�......................................... ................I ( applicable): g Addition . 3. Nature of work check which a licable :New Building ./Alteration Repair .............. Removal .............. Demolition ........... Other Work ............... .. Fee ......... (Description) 4. Estimated Cost ....... A. P. �............ . ........ ......................... . (10 be paid on filing this application) S. If dwelling, number of dwelling units ............ s on each floor ................ Ifgarage, number of cars . . ............................... . YP ........................... 6. If business, commercial or mixed occupancy, specify nature and extent ofleach t units ofuse .............. . ..... . 7. Dimensions of existing structures, if any: Front ............... Rear .. , . , , , , , , , , , , Depth ........ , , , , , , , Height ............... Number of Stories ....................... , . ........................... Dimensions of same structure with alterations or additions: Front ....... , , Rear .................. DepthHeight 8. Dimensions of entire new construction: Front ............... Rear , , • Stories ..................... . Rear .............. Number of r ...... Depth ............... Height ............... Number of Stories .......... . 9. Size of lot: Front ...................... ... Depth .. ' • ..' ...... ........................... 10. Date of Purchase ••••••••••••••••••.•.........Name ofFormer Owner 11. Zone or use district in which premises are situated ..................... . 12. Does proposed construction violate any zoning law, ordinance or regu.lation: . . . . . • 13. Will lot be regraded ...... " " p e " " " " " " ' ' ' ' ' ' ' ' ' ' • • • • • •from premises: Yes No 14. Name of Owner of premises .................... Address .... fill be removed, Phone No............... . Name of Architect ........................... Address ............ Phone No............... . Name of Contractor ...... , .. , . Address ............ Yes ... Phone No...... . 15. Is this property located withinlo0 feet of a tidal wetland? * ..... No * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 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. TATE OF NEW YOR S.S 'OUNTY OOF ` '' ...... • �l • : • • S% ,�1 � � � �� a u ....... being duly sworn deposes and says that he is the applicant (Name of individual signing contract), )ove named. eisthe .........................Q. W.ly.fE 12g4 ................... (Contractor, agent, corporate officer, etc.) F said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. morn to before me this ....... 9��v ..........day of ..0--vzo- �. ........ 19 A Aary Public, to . .......... County 2 �e� { � DAJ.COpPEff o G ........ Awlsosof Now / 8902 Q..h-m (Signature of applicant) n_. F ZU11C41 • FORM NO. 1't- �'"� -- ( TOWN OF SOUTHOLD..flw.-°c1Ghic.,,. "�%,t�d,� 'Y'"_�-�du� �. .� BUILDING DEPARTMENT ' �C� yr,�r%` dam. — �'�-�-1� TOWN CLERK'S OFFICE,, 7i ado, $ SOUTHOLD, N. Y.dG, , r p Ifs tin -arc% a �n5 -,,ems d � Examined .... ....�.Z........ 19.2L. Application No.� �. 7...( .................... PP .. J. Permit No. ? ........f ....... ../ ,1 Approved 19...... Disapproved a/c ..... ..................... ........................... .................................................................. ............................ ............................................f............................................. v- crr�-� �i�. (Buildin9Inspector) APPLICATION FOR BUILDING PERMIT Date........ ........ ......, 19.... . INSTRUCTIONS .•��z��� - J a. This application must be completely filled in by typewriter.or in ink and submitted in triplicate to the Bui.ldin!k 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 application.' 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 issue a Building Permit to the applicant. Such 'permito shall be kept on the premises available for inspection throughout the work. rt 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, Orances 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 ' ilding code, housing code, and regulations, an4 to + admit authorized inspectors on premises and in buildings for neces a inspections. I..... ..... ...... ....... ( g atur of plicant r name, if a corporation) .......... ................. dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................... ��-�. ..�' ....: ..�........... Name of owner of premises ...:...A,t��e�P.�'(....cf.S.f .....1.. 6�( .1 ................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . .................................................... Plumber's License No . ................................................ Electrician's License No . ............................................ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ......................................... Lot No.'........................ Streetand Number................................................................................................................................................... Municipality 2. State existing use and occupancy of prem' s and iwended a nd occupancy of proposed construction: a. Exisiting use and occupancy .........1.`�.4�.G/X1.7, .....�.................................................................... b. Intended use and occupancy .......... t ......to. 3. Nature of work (check which applicable): NewBuilding. Addition .... Alteration . Repair Removal .................:' Dem'olition.:.............:.... Other Work ................................................ .... '7 (Description) 4. Estimated Cost .....�Q!!� ...........................................Fee.......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ...............Number of dwelling units on each floor ............................ Ifgarage, number of cars............................................................................:................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........ ........... Rear ..............2......... Depth ....1 ........... Height.........h ...... Number of Stories................................................................................................................. Dimensions of s me structure with alterations or additions: Front ................. R....y.... Rear .��.�............... r/��� .......Number of Stories Depth ............. ............... Height .......... �....... ....................... 8. Dimensions of entire new construction: Front .................................... Rear .........�.......... Depth ... X.............. Height ............ Number of Stories• .................................................... 9. Size of lot: Front ........ j.... Rear .........A.4 ....................... JD�ept� Aw ...................... 10. Date of Purchase .... ..7/ .......................................Name of Former Owner ...1.!:��I!.................................. 11. Zone or use district in which premises are situated ............ ..••••......•.••.••...••............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: , lei........._............... ................. 1.3: Will lot, be, regraded ..:.:: Willl exc s^fil ,�be removed .from pre 'ses: (, Yes ( ) No �y 14. Name of Owner of premises .. / - j t ....�'... � `. Addres �.� ����f� Phoney No.. � .....':. 1... Name of Architect.............................................................. Address ................................ Phone No....................... Name of Contractor............................................................ Address ................................ Phone No. ................... PLOT DIAGRAM Locate clearly and.distinctly all 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. STATE OF NEW Yi COUNTY OF ..,. .... ................. f S.S .................................................................................... (Name of individual signing contract) above named. 0 ....being duly sworn, deposes and says that he is the applicant Heis 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; that all statements contained in this application are true to the best of his knowledge and belief; and than the work will be performed in the manner set forth in the ap, cation filed therewith. Sworn to before this Notary Public (..�..�... ...... !120atanty .........................V.................... ....... ..... ......................... (Signature of applicant) JUDITH T. BOKEN Notary Public, State of New York No.52-0344963 Suffolk County Commission Expires March 30, 1;1.�J' IV 'G%Gk Z)i{l�'i� 7/7� 7(77Z- � 17 CAr • r � 33 r I ' !! �/b Y �!•G� 7/ri G� q ,tee o P4�, _ :,, • [� --�/� /� � p�.y, � C. L Ll Ll c� / i ZI )� VE: a i, mm kc- »'i 1: s..' ZOIT; .11 'C� l ly ,pp -.,r at, b:-„•. e 2 22 22 25 2i i 27 2k 219 134 lop At's 6YE I A, R H N ------ - ------