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Home My WebLink About15436-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA/~CY No Z17094 Date 0ULY 18e 1988 THIS CERTIFIES that the building. ADDITION & RENOVATION Location of Propert~ 495 ELIZABETH LANE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 5 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 21, 1986 pursuant to which Building Permit No. 15436Z dated OCTOBER 29e 19~6 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 ADDITION & RENOVATION TO EXISTING ONE-FAMILY DWELLING. The certificate is issued to LESLIE & JOSEPHINE GAZZOLA (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N021057 PLUMBERS CERTIFICATION DATED THOMAS A. TAGGART 4/29/88 Building Inspector Rev. 1/81 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING P ERJ~,~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Z Date ...{:~. ................................. , Permission is hereby granted to: ............ · ................. et premises located at ....~.,~..~ ........ ~.~ ..~.~1~.__: ......... ~ ........................ County Tax Map No. 1000 Section ....... ..~..']..~ ....... Block ...... .~,~. ....... Lot No ....... ,~....~,..; ........ pursuant to application doted .... c~.~.~.....~.l ............... , 19.~....Lf~., and approved by the Building Inspector. Fee $..~....'...../.... ..... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCC Instructions A. This application must be filled in Wpewriter OR ink, and submitted I~--~-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 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: t. 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, 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. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelllng,$25.G0, Accessory',~10.00 Buslness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... NewConstruc~ion...,... OIdorPre-exis~ti~gSuilding ...,..L~.. Vacant Land ............. Location of Property .~. ~...'.'~....~..~",'. ~' . ,~., .~..~ · · .... Owner or Owners of Property ...... ~ . . .~. ~~.~?..~...~..~..~.'~.~---'-/('-)~ County Tax JVlap No. 1000 Section .... /.~'~..... Block ....... ~.~..: .... L~'.....--.~ Subdivision ......... z ................. , .... / .Filed Map No ....... /J?..Lo,t No/'-h ............. Permit No./.~'-/~..4 ~,, Date of Perm tz/~/~'~./..~;~..~o~lican, ~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ......... ~equest for Temporary Cerlificate ..................... Final Certificate ....................... Fee Submitted $ .......... C~nstruction on above described building and per~m.e~et%all ap'~ble codey/and regulations. ......... 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST r ] ROUGH PLBG. FOUNDATION 2ND [ ]~NSULATION / FRAMING [~ FINAL REMARKS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit NO. I~q %('0 --C~-- Owner LC~C ~ "~'~)~q;{o o.. ~:~,~ZOI C_~ (pleas~print) (pieage print) ~ O I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ....... ( ~l~be ~' s~ature) Sworn to before me this /~ , ~~~~ .~. ~,~,,~ //.; .o.r~u~_~c u~o~o'u THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ES JOHN STREET. NEW YORK, I~aY~l~/1 ~.~)~?3E g f12~ (}57 JUI,Y O~ 19~ ~ppl~e~tlon Mo. on,lc THIS CE~IFIES THAT .... jL..t~__u~tMM~the~t~numMrint~s LKShTE ,AZZO[,~, EI, IZAB~;T~ I,~N~:~ ~oW~HOLI), N.Y. ~ exami~ on and found to be in complJaflce with the requJret.enfs of th~ ~. RXTUIIES 10 ).'~ URVI~I~a(~NNECT S E n V I C E NY. 11971 ~' '- ~]e BUll_mI4& DEPARTM~rr. THIS COPY OF CERTIFICATE'MI.~T HOT BE ALTERED IN ANY MN44ER __~ ~OUNDATION ( 1 s t ) ~OUNDATION (2nd) ~OUGH FRAME & FLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINA~ ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. "iN SPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG~ FOUNDATION 2ND [ ] INSULATION [ '~FRAMING [ ]FINAL INSPECTOR ,~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ O,~~UGH PLBG. FOUNDATION ZND ~i~SU~TION FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [~ROUGH PLBG. FOUNDATION 2ND [ ] INsULATioN FRAMING [ ] FINAL INSPECTO~~ 765-1802 UILDING DEPT. SPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~F ~FOUNDATION 2ND [ ] INSULATION MING [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL INSPECTO~--~ 7GS-3,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ~ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ]FRAMING [ ]FINAL ,REMARKS, O ~ DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL COUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .C~.~..,~.c~., 19~.~. Approved .~..~-...0~2~-.....~..~.., 19~..~. Permit No..]..~..cl..~.~...~ Disapproved a/c ..................................... Received ........... ,19... (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 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 throu~daout 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 Build~l~g In~p:~ctor. APPLICATION IS HEREBY MADE to the B~iildiri~ 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 bufldi~gs,.additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicabl$ laws, ordinances, building/f?de, daousi~ltpco~ and regulations, and to admit authorized inspectors on premises and in building for necessary inspect~)0~. ~] a~ur'e/ff~ f applic ant, or n hie, if a corpora tion) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................................... '~:'5 ........ Name of owner of premises .~. ~--~/i ~- C (X.~. Z q)l C.~ -,.' '...'.. ;'~. ....... (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 prop~seil work will be done .................................................. House Number ,. Street Hamlet County Tax Map No. 100O Section .............. Block .... ~}'5'. ........... Lot ..... .~. ........... 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..~6'X..h~, o~..~.. ~O~/rx ~.':..~..¢0~.q~Z¢,/ ............................. b. Intended use and occupancy..~..-~---~ ~i .Y.~-..W~. %.v¥.~..~3.~.. %.,O,.O,~g 9.vl .a~ ............................. 3. Nature of work (check which applicable): New Building .......... Addition ..... Alteration .......... Repair .............. Removal .............. Demolition ........... :... Other Work ............... [ (Description) 4. Estimated Cost ...... °. · · .'Y. ! ....... Fee .......... , .......................... (to be Paid on filing this application) 5. If dwelling number of dwelling units .. :.l~. ~ ~ ...... Number of dwelling unitis on each floor ............... If garage, number of cars .... ~,)O.kk~- ............................... i ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .... ~/*q ............. 7. Dimensions of existing structures, if any Front ~.~. ~ ...... Rear .... ~.t. ..... Depth ... o~.~.' ....... Height .... 1 ~.t ........ Number of Stories ........ 0 hJ .~ ............................................ Dimensions of same structure with alterations or additions: Front ..... '$'~'..~. · I. Rear .,~,~,. t.. Depth ..... oT~ .............. Height ..... /.~ .............. Number ofiStories ..... 0/4 ~.. ............ 8. Dimensions of entire new construction Front ~. ~. Rear ~q'~ ~l D~nth ~.~' ! Height .../~.~ ......... Number of Stories ......... D~.~'~ ............. i ............................ 9. Size of lot: Front ]~l, CO. Rear ].50 b~nth A~',5' ef~/~';l ,F 10. Date of Purchase ... Se ¢~,~b.~V.. lq&.% ....... Name of,Fo.rm~r Owner .:~.u.i. tU 5...~J~.'O,~:~ ....... 11. Zoneorusedistrictinwhichpremisesaresituated [c ~ ,, .I~ 12. Does proposed constructmn wolate any zomng law, ord~nance or regulation: ..]~.C) .......................... 13. Will lot be regraded .... ~.O .................... Will excess fill be removed from premises: ~ No 14. Name of Owner of premises . . .Cw.~'Z.~[.~.~.~... Address ............... l .... Phone No ................ Name of Architect ........................... Address ............... .... Phone No ................ Name of Contractor .......................... Address ............... i .... Phone No ............... 15. Is this property located withinl.00 feet of a tidal wetland? * Yes ..... No .~... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, in, [icate all set-back dimensions from property lines. Give street and block number or description according to deed, and sho~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF..: .............. ...~,..Q~o,.4~,o.~q. ql~q~, .................. being duly sworn, deposes and'says that he is the applicant (Name of individual signing contract) above named. He is the '-J(Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sfiid work and to make and file this application; that ali statements'contained in this application are true to the best of hislknowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. I Sworn to before me this. ............. ~.,~ ....... ,.day of ........ .(~.~.: ........ , 19~"J~J. ! _ ,, Notary Public ...... ~' . .t~.'. //.~.J-:. ', .f~, .~.2 C~~~ · - .... ~ ItROIIf. DEV0[ ' / // (Signatu-'l~ofappli~anti NO 4707878, 8uffelk County ' ' Iem~ ihplres Ms,ch 30,10~./~