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Home My WebLink About15522-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... .Z.-.I.5.6..1.7 ..... Date April 9, I987 THIS CERTIFIES that the building DECK ADDITION L,~c~*~,~-,,¢P ....rt,, 885 Arshamomanue Avenue So N.Y. ............ v. uthold t~ ff ....................... . ............... House No. Street ........ County Tax Map No. 1000 Section ....0.6.6. ..... Block ....0.3 .......... Lot 04 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November 20, 1986 15522Z ...................... .. pursuant to which Building Permit No ...................... dated November 25, 1986 .............................. 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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to RALPH LEVY ..................... ioYn' ;, x ................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 l~OUTM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, 14. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15522, Z Permission is hereby granted to: .... ..e.~......¢ ...... ~.~.~ ...... ..z..~ ...... ~.....~.~.: .................. ...~.....~.:~.,....L~...t~./. ........... ~, ......... , ................. :'=x:""~'""~'~'"~ ............ ~ ..... ]..~ ....... ~.._.=~ ...... · ~ at prem,ses located at ..."~..~...~......~.~.~..~.......~.~ ......... County Tax Map No. 1000 Section ...... (:~.~..~. ..... Block ...... .~.~. ......Lot No .......0...~. .......... pursuant to opplicotio, dated ...... ~..~.....~..........~...O.. ............ , 19.2.~.., 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 BLDG. DEPT. TOWN OF SOUTHOLO APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submi~ed aa ~ 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. Approvat 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 unusuat 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 $25.00 -- BUSINESS $50.00 .A~CC_~S~SO~ 2. certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, ove~ 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... c~¢C~ NewC°nstruCti°n. .~... Old or Pre-ex{st~ng Bui}ding ............ Vacant Land .......... Location of Property .......... ~ ~ ~ ~ House No. Street Ham/et County Tax Map No. 1000 Section ~ Block ~ Lot. ~.~ Subdivision / D M -- ................................·Zed Map No ........... bot-~, , - ......... ....... . . q. .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... d $ /~.~. ---- Fee Submitte ........................ Construction on above described building and permit meets ¢11 applicable codes and regulations, App,cant ................................... Rev. 10-10,78 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,,']~NAL OUNDAT!ON (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE ADDITIONA'L COMMENTS EDWARD CIAGLO Custom Builder 3 WEST THOMAS ST. SHELTER ISLAND, N.Y. I1964 PHONE: (516) 749-0738 OR 749-0386 UILDINE} MATERIAL PRODUCTS SOLD TO Mr. Edward Williams November 12,1986 150 Seawood Drive, Southold, N.Y. 11971 Weather Strip one door $7.~ 00 5UR VEY OF PROPER'FY TolNN 'OF $OUTHOLD SUFFOLK OOUHTY h~£~V YORK 6urvcy Certified ~OU THOLD THE TIFL~ OA'rE5 SURVEYED: M4RCN 19, 198J Surveyed by SM/TH ~ dUNO ~2o MEOFO~O AVE. PATOHOOUE~ N.y Phone 47S..St92 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined ,~,~ .~. · ~.<J.., 19~.~' Approved .~.~ ..~., 19~.~.. Permit No../..~:.~..a..Z:..~: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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. (Sign~ur~f applicant, ,or~pe, ,if a corporation) /s 0 ~k,,~,~t oo. ~ -~.~.. (mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber orbUidel r. Name of owner of premises .... "-~/.~.~. ! .~.'~. .......... J" ' '~' ', s on he tax('a .... t' ..... ;o'li ;; i~t~;t' ~'l~d') ......................... If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... I.~../..~-. g...~7. · ./ ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ............. ...... House Number Street Hamlet County Tax Map No. 1000 Section .. ~ d Block .dp.. '-5 Lot ~ ~9 ~ Subdivision .... ~..~. !}~.~JOwl .......................... Filed Map No../..~.?..7-~: ...... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~...~-'-'-/J/.~z~/c/ .... dd-x~.~/,r/~-.~ [57. ................................... b. Intended use and occupancy ........ ~fl~ ..................................................... 3. Nature of work (check which applicable): New Building .......... Addition .., ........ AJterafion~q.. Repair .............. Removal .............. Demolition ........... i' ' · Other Work../~..~w. ..... .~/,~r...~.. (Description) 4. Estimated Cost ..................... Fee ...... (to be ~aid on filing this application) 5. If dwelling, number of dwelling units .............. Number of dwelling units on each floor ................ If garage, number of cars ........................................... 1 ............................ 6. If business, commercial or mixed occupancy, specify nature,and extent of each t3~p~ of use .................... . 7. Dimensions of existing structures, if any Front. ~..f[./.~...~ ..... Rear . .,~...~.,.~.t., ..... Depth·..3.B-'. ~ ....... · er of Stories ......................... ~ ..... Height ............... Numb ............. ? ...... a .... Dunenslons of same structure with alterations or adghtlons: Front ....... : ..... Rear ......... Depth ..... ~( ............. Height ..../.~.. ............... Number oflStories ... [ .................. 8. Dimensions of entire new construction: Front ... ~.~ ( ...... Rear . ~ .t Depth .. ~ ?. .......... Height .............. ?~] ' inber of Stories ............................ ! .............. 2, ............. 9. Size of lot: Front .~...J' ................. Rear .... ~ ..5".6.~. ......... Depth ~.~.~.., 10. Date of Purchase ............................. Name of Former Owner .............................. 11. Zone or use district in which premises are situated . .~. . 12. Does proposed constructlo~n vlolate any zoning law, ordinance or reaulation: .~.o ....................... 13. Will lot be regraded ...~. ~.. r~ .0 ._./~. · ~ ........ Will excess~fill be removed from ;famines: ~es' 14. Name of Owner of premises ./....c~ ...... ~. .... Address ............... ; .... Phone No ................ Name of Architect ........................... Address ............ ' .... Phone No ................ No. I5. Is this property locat~,d withinl.00 feet of a tidal wetl~d¢''~ · If yes, $outhold 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. STATE OF NEW YORK, S.S c°umTY_ *f9 V' '9': ': , ....... ~ .t~d. · ~ ............................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named· , (Contractor, agent, corporate officer, etc.) df 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ....................... day of ...................... 19'-.a v .~, ~, l.. ,,/. ,, ' Notary Public, . ../~/~n~-~ .c~. .................. Coun~ ~_. i ~. '