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Home My WebLink About15261-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .Zl487.0 ...... Date ....~e~t. 1.2. .................. 19.8.6. THIS CERTIFIES that the buridmg .... .B.e.c.k. ........................... Location of Property ...... 36.89..S.T.I,L,L,W~T. ,E,R ~V.E .... .C.U.T.C..H.O.G.U.E. .......... House No Street Hamlet County Tax Map No. 1000 Section 137 .Block 01 .Lot 013 Subdxvtsmn ....................... Fried Map No ...... Lot No ........... conforms substantially to the Apphcatton for Bufldlng Permit heretofore ~ed in tlus office dated $.ept....9 ........ 19.8.6 pursuant to winch Bmldxng Permit No. 152617. dated ... Sapt. 2.1 ........... 19 8.6., was issued, and conforms to all of the reqmrements of the applicable prows~ons of the law The occupancy for wIuch tins certificate is ~ssued is ........ Deck addition to an existing one family dwelling. The certificate ~s ~ssued to DANTE & FLORENCE COLOMBO (owner, of the aforesaid building. Suffolk County Department of Health Approval . .N./.A. ......................... UNDERWRITERS CERTIFICATE NO ............................................... Rev 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEP~,~IT (THIS PERMIT MUST BE KEPT ON THE pIREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 15261 Z County Tax Map No 1000 Section ~., 57. , . Block ...... ..~....J. ...... Lot No .... .~...!..~ · · . pursuant to clppJlcCltlon dated . c,~.~O-~(~.~ c~ ..... 19 .~(o, 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 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor w~th the following; for new buddings 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- t~ons, a certificate of Code comphance from the Architect or Engineer responmble for the building. 5, Submit Planning Board approval of completed rote plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-exmting" land uses: 1. Accurate survey of p:Coperty 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 ~nspect~on of bu dd~ngs or premmes, or other pertinent mforma- t~on required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5 00 2. Certificate of occupancy on pre-exmt~ng dwelling $15.00 3. Copy of certificate of occupancy $1.00 ~/?/~/. -~- / /~ 4.Vacant Land C.O. $5.00 $15.00 Date ........................ 5.Updated C.O. / NewConstruc%1on...~... Old or Pre-ex|st|ng Building ........... Vacant Land ............ House No. Street Owner or Owners of Prope y d. County Tax Map No. 1000 Section ............... Block ...~. ........ Lot ....... Subd~vimon ............................. Fded Map No ........... Lot No ............. Permit No .......... Date of Permit .......... Apphcant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ....................... Planning Board Approval ...................... Request for Tempora~ Certificate .................... F~nal Certificate ....................... Fee Submitted $ ,.~'O ~.~ Construction on above described budding and permit meets all applicable codes and regulations. Apphcant ................................................... R~v 10 10-78 ~IELD INS?ECTION COMMENTS FOUNDATION (lst) FOUNDATION (2nd) BOUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ADDITIOSAL xammed ~pproved )ssapproved a/c ........ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ToWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 .~..~. !!.., 19 ~' Permit No. ) '~' .~.~. ! .~. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Rece:l. ved ........... ~'19.. a Ttus apphcatmn must be completely filled m by typewriter or ~n ink and submitted to the Buil&ng Inspector, with · ts of plans, accurate plot plan to scale Fee according to schedule b Plot plan showing locatmn of lot and of buildings on premises, relatmnsinp to adjoining premtses or pubhc stree : areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of th~s app! mon c The work covered by tins application may not be commenced before ~ssuance of Bmldmg Permit. d Upon approval of this apphcatlon, the Braiding Inspector wdl ~ssued a Budding Permit to the apphcant. Such perm ~all be kept on the premises available for inspection throughout the work e. No bmlding shall be occupied or used in whole or m part for any purpose whatever until a Cerhficate of Occupanc ~all have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to tl mld~ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances, egulatlons, for the constructmn of buildings, addltmns or alterations, or for removal or demolitmn, as hereto describe, he applicant agrees to comply with all apphcable laws, ordinances, bmldmg code, housing code, and regulations, and lm~t authorized inspectors on premises and m building for necessary inspections. - '/ (S~gnature of appli~ne, ff aj;orpor, i~tion) (ma±l±ng address of ~?ppl±cant) rate whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electncmfi, plumber or bmlde lame ofownerofpremises .....~,~.A/7--~' ~. 74~5>,~°.~/(/C~ (as on the tax roll or latest deed) ! apphcant Is a corporation, s~gnature of duly authorized officer (Name and title of corporate officer) Builder's Lmense No. Plumber's License No Electrician's License No Other Trade's Lmense No ................. Location of land on which proposed work wdl be done ..... }louse Number Street ~le County Tax Map No. lOOOSect~on ./~ ..... Block. ~ / ..... Lot Subd~v~smn ..... (~a~;l ....... Fried Map No Lot ....... State emstmg use and occupancy of pr~ise$ and intended use anq occup~y of proposed cogstmctmn a Ex,sting use and occupancy .~.}~~¢ ~~~ .......... b Intended u~ ~d o~u-anc, r/ ~/~ ~h~fl 3. Nature of work (check which applicable): New Building ......... Ad&tic ...... Alteratlo~.j ,~ . · Repmr .. Removal ...... Demolition ......... Other Work.. ¢~-.'w~q~cz:~. Cit' q~.~L'~) ~ ~_~..~ ~ (Description) 4 Estunated s- Fee ' . .............. (to be 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, commercml or mixed occupancy, specify nature and extent of each type of use ............... 7. Dmlenslons of exmtmg structures, if any Front ......... Rear .............. Depth .......... Height .......... Number of Stones ...................................... Dunenmons of same structure with alterations or additions. Front ............. Rear .............. Depth ...... Height .............. Number of Stories ................... 8. Dunenmons of entire new construction Front ....... Rear ............... Depth ............ Height . . . Number of Stones ....................................... 9 Size of lot Front ........ Rear ................. Depth ................... 10. Date of Purchase ............... Name of Former Owner ...................... 1 1 Zone or use district in which premises are situated ................................. 12. Does proposed construction violate any zoning law, ordinance or regulation' . ........................... 13. Will lot be regraded ................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ............... Address .................. Phone No .......... Nmne of Archflect ............. Address ............... Phone No ....... Name of Contractor ................. Address ................. Phone No .......... 15. Is this property located withinl00 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 exmtmg or proposed, and, lndwate ail set-back dnnenmons from property lines Give street and block number or description according to deed, and show street names and indicate whether interior or coroer lot. STATE OF NEW YORK, S.S COUNTY OF ............ (Name of individual signing contract) above named. being duty sworn, deposes and says that he is the applicant He is the ......................................................................... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is duly anthonzed to perform or have performed the said work and to make and file tb~s application; that all statements contmned in this apphcahon are true to the best of his knowledge and belief; and that the work wgl be performed in the manner set forth in the apphcation filed therewith. Sworn to before me this ........... 7. ..... of. ....... S~a~,_L~_~'~i. (S~gnature of applicant)