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Home My WebLink About15173-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17312 Date SEPTEMBER 15r 1988 THIS CERTIFIES that the bulldln~ Location of Propert~ 230 House No. County Tax Map No. 1000 Section Subdivision ADDITION I~INCENT STREET ORIENT Street Hamlet 25 Block 3 Lot 14 Flied Map No. Lot No. conforms substantially to the Application for Bulldlng Permit heretofore filed zn this offzce dated AUGUST 3, 1986 pursuant to which Building Permit No. 15173Z dated AUGUST 6r 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whmch this certificate ls issued is ADDITION TO AN EXISTING ACCESSORY BUILDING. The certzfmcate ~s mssued to MARIO & IRENE ANTONAZZI (owner, Y~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROV~tL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N841958 KING PLUMBING & HEATING INC. 9/12/88 Building ~nspector Rev. 1/81 FOF. M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N. Y. BUILDING PEP~,41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 15173 Z Dote .~..~.....~.. ........... Permission ~s hereby granted to' ~: --~-'.~-.~...~....~ ~...: ......... '~...~...~,.~...~:..w:.. ~?.~... at premises Iocot~g ot ..~.~.......~.~~....'.~w...~......"rm,~ .. ........ ..~a~,~ ...................... co~n~ to× Mop So ~000 sec~,, 0~-..~ ~k ....... D..~... Co~ ~o..1..~ pu~uont Budding Inspector Fee $.~..~ ~ Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD E~u llding Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewmter OR ink, and submitted m ~ to the Building Inspec- tot with the following; for new buildings or new use: 1. Final survey of property w~th accurate Iocatmn 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-g form or equal). 3. Approval of etectrmal installation from Board of Fire Underwmters. 4. Commerolal 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 Planmng Board approval of completed rote plan requirements where apphcabte. B. For exmting buildings (prior to Apml 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 mforma- t~on required to prepare a cert~fmate. C. Fees' Addztions $25.00 POOLS $25.00 ALTERATION $25.00 1. Cer~lficate of occupancy New Dwelling $25.00, Accessory,S10.00 Buszness $50.00 2. Certificate of occupancy on pre-exmtmg dwelling $ 50.00 3. Copy of certlficate of occupancy $ 5.00, over 5 years $]0.00 5,Updated C.O. $ 50.00 Date ............... NewConst, ruc~,zon..... .... OIdorPre-exlstmgBui[dmg ......... Vacant Land .. .......... . Location of Property .......................... ~'~fO ~.//,~..~.~... ~r~'7~ ~'7~ ..................... . .......... I-Iou~e No, Street Ham/er Owner or Owners of Property County Tax Map No. 1000 Section ~-5--~. Block ~ Lot., Subdwmlon ................................. Filed Map No .......... Lot No .............. , Permit No/~.~ ~ Date of Permit .... Health Dept. ApprovaJ ................. · ... ...LaborDept. Approval ...... ............. .. .. . Underwriters Approval ........................ Planmng Board Approval Fee Subm:, dS../, ............ B. .... Construction on above descmbed budding and p~m~t meets all applicable codes and regulations. ..... ............... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL 765-1802 CERTIFICATION Date ?//o~ ./j$ Building Permit No. Owner /~ ,~o ,~ ~0 ~ (please print) Plumber ~7 ~t ~ Z~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this I,~ day of 19~ · Notary Public, Notary (~mn%~wto~ ~lr~ ~m.., o., ~IELD I,,S~ ~C~ iON DATE FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING I~$ULATIO~ PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING . [ ] FINAL REMARKS: ,, ~ 765-1802 BUILDING DEPT, INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [- ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~INAL Exam,S. _ Ap prove~"'~ Dtsapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y 11971 TEL.: 765-1802 ., 19~g. · 19~.~ Penmt No l ~l'7.~ (Bmld~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ~19... Date .... y~./ , 19 ?.: a. Ttus apphcahon must be completely filled m by typewriter or m ~nk and submitted to the Buddmg Inspector, w~th sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing locatmn of lot and of buddings on premises, relationship to adjmmng premises or pubhc street or areas, and g~vmg a detmled description of layout of property must be drawn on the diagram which ~s part of thru apph cation. c. The work covered by tlus apphcahon may'not be commenced before msuance of Budding Permit d Upon approval of this apphcahon, the Building Inspector will issued a Bmldmg Permit to the applicant. Such perml shall be kept on the premises avadable for mspectmn throughout the work e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc: shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Buddmg Department for the issuance of a Bmldmg Permit pursuant to th. Bml&ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations, for the construction of buddmgs, addmons or alterahons, or for removal or demohtton, as herein described The apphcant agrees to comply with all apphcable laws, ordinances, buddmg code, housing code, and regulations, and tc admit authorized inspectors on premmes and m bmldmg for nece~ (Marling address of al~phcant) O 7~(~,..4"O State whether applicant Is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner ofpremmes ,/~/~/0 ~¢t4f/~-~/ ~ ~ (as on the tax roll or latest deed) If apphcant m a corporation, s~gnature of duly authorized officer (Name and title of corporate officer) Braider's L~cense No. Plumber's Lmense No Electrician's License No Other Trade's License No .. Location of land on which proposed work will be done o House Number Street County Tax Map No 1000 Section ~-,5'- Block ...~. Hamlet .. Lot. Subdivision ........ Filed Map No Lot (Nm~e) State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existmguseandoccupancy (.~.Ct./4,/~.~. C2Cc6~./.7,/~i!> ~.,.r~t~.~5.~¢z'~. .. b Intended use and occupancy t~.fo.',~ f~.- CIO:~/g/~-/~. 6 ~..~ .~-./O-,,t/~. '_~'O/~'M" ~.,q MO~.. . 3 Nature of ~vork (check which applicable) New Budding ..... Addition //'' Alteratmn Repmr Removal ..... Demohtion ........ Other Work ~ (Description) 4 Estimated Cost ~.ot>o ~ F (to be prod on filing th~s apphcatmn) - N f d I1 h do 5. If dwelling, number of dwelling units ............ umber o we mg umts on eac or . .. If garage, number of cars .............................................. 6 If business, commermal or mixed occupancy, specify nature and extent of each type of use . 7. Du'nenmons of existing structures, if any Front ./~'..~. . Rear . /.7. ~- ....... Depth ~'/. -'. .... Height . ./~. '* ..... Number of Stones Dunenmons of same structure with alteratmns or additions Front ~['~ ......... Rear . . .' ...... Depth .~l:~~. ...... Height ......... Number of Stonest '/' "'-;,'2*~'~t'" ' 8. D~menmons of entire new construction Front ,/,~ t. .. Rear ./.t~. ....... Depth ~ . ' .. · Height t'/.( .......... Number of Stones ~. 9 Slzeoflot Front ... ~,~'J~4~".. . Rear .~.~;i~'.'~.i'il.'..iii'D;Pih~.-.~.fi)'~2--- 10 Date of Purchase ..~..~../f.~.~.('.'~.~.~. . . Name of Former Owner /4/,4/1'~. ~.~F. '~./~.l.,~'.~'~.. I 1. Zone or use district in which premises are situated .... 12 Does proposed constru~l~n violate any zoning law, ordinance or regulaQon ........................... 13. Will lot be regraded ./M.~ ............. ,.. . Will excess,fill be renkoved from premmes' Yes 14. Name of Owner of premmes ~:fA/7'.~.~lq'Z~t'Address ~J'~"-~/~,~-,-~' ~'DT, ' Phone No~O/.) lt.~q Name of Architect ........ '. ......... Address r-,,.~.~.. .'-~'.'f'~'.."'/.."'.. Phone No ............ Name of Contractor .................... Address ............... Phone No. ,'Z~ ........ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ~f/.. · If yes, Southold Town Trustees Permmt maybe required. PLO~r DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dunenmons fro property lines. Gwe street and block number or descnptton according to deed, and show street names and indicate wheth interior or corner lot. STATE OF NEW YORK, S.S /-07' /~ COUNTY OF ........ .............. being duly sworn, deposes and says that he Is the apphca (Name of ~nd~v~dual mgnmg contract) above named He is the (Contractor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and file tl appbcatlon, that all statements contained m th~s apphcatmn are true to the best ofh~s knowledge and belief, and that t work wdl be performed in the manner set forth m the apphcatmn filed therewith Sworn to before me th~s ....... ~ of.. d~.~(~. 19 .. ...... ur'e ~f apphcal SHE£TNO ......... OF JOB NO .i