HomeMy WebLinkAbout15537-zFORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.. Z15468 Date D. ece.m, ber 5., .......... 19 ~.{
Deck add±tion
THIS CERTIFIES that the building ............................................... :.
Location of Property ?.950 Sound Avenue · Mattituck, New York
House No. Street Hemle~
1/~2 01 17
County Tax Map No. 1000 Section ............ Block ............... Lot .................
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore f'ded in this office dated
November 12, .8. 6. p gp .1.55.3. 7 .Z
.................... ,19 ursuant to which Buildin ermlt No ................
dated I)ecember 3, 19 .8.6. ' ~ andconformstoalloftherequirements
........................... , was Issued,
of the applicable provisions of the law. The occupancy for which this certificate is issued i~ .........
.... D.~9.k' addXtion to ,ap, e.x.~?t,i,n,~ ,a. cc..e.s?o.r.¥, building .
The eerti£icat¢ is issued to ....... MICHAEL COMANDO & NANETTE TRUE
(owner, leV~ye~ t~t]~rY~b~ X
of the aforesaid building,
Suffolk County Department of Health Approval N/^ ..
UNDERWRITERS CERTIFICATE NO ................... .Iq/fi. ...........................
Rev. 1/81
/ Bt~rding inspector
FORM NO. ~
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)
N~ 15537~ Z
Permission is hereby gronted to:
at~...~.....~ ............
~.~....~.,.,/.,.....,.~.~ ........
...................................................................
at premises located at ...L..~...~..,~......~...~ ...............................................................
County Tox Map No. I000 Section, )....,/...~..'~.. ....... Block ...... ..~.J ........ Lot No ..... .)...'7. ..............
pursuant to application dated .... /..V...~~.....~....~=.. ........... , 19.~..(e., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
FO]I{~ NO. 2
TOWN OF $OUTHOLD
i~lJIt. DING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 15538, Z
Permission is hereby gronted to:
..~..~..~..~.L~~...~...... ..................
~~...~._....~.:....,.:.~..~.~ ......... .
,o
at premises located at ../..~...~..~"'~ ...............................
County Tax Mop No. 1000 Section ..... /,,,~,.,.,~,. ....... Block .... ..~....I ........... Lot No ...... .~..'7. ..............
pursuant to application dated ...~...~........~t..-...~, ........... , 19..~....(~., and approved by the
Building Inspector.
Fee $.~.:..~
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
$outhold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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 featu res. --
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.
B. Submit Planning Board approval of completed site plan requirements where applicable.
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 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.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
5. Updated CoO. $15.00
$15.00
Date.../'././~.. ~. '~'~' / ~ ...............
NewCons truc t;[on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ...................... ~ .......................
House No. A Street Ham/et
Owner or Owners of Property /~./. ,~...'~...~...~...~, ./~.. ,~, ~'~, ,/~'. .............
County Tax Map No. 1000 Section./.Y.~. ....... Block.. (J). L ........ Lot ....//....~. .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant/~./. ~./¢'../~..C~.~...C(~., .z?~. ~..~ ..........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .....................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant .~.~~ ............................
Rev. lO.10-7a
76S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND,[ ] INSULATION
ROUGH PLBG.
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION 2ND []INSULATION
FRAMING []FINAL
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
8OUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined ~..$.., 19~.(e..
Approve~..~. ·., 19~.b.. Per]nit No.l ~-..~..~?..~...
1,986
Received ........... ,19..
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .................. , 19...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 street
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 permi
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 th,
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
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, ordi~!ances, building code, housing code, and regulations, and
for necessary inspeetio s
admit authorized inspectors on premises and in building ....... :~ 'f~" ' ~'~ ~'
(Signature of applicant, or name, if a corporation)
.... ./r). ?x..~....-F.~.<..'~.. U.?.C ..............
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .../~../?. f.../¢-~... · .~.'.~ .~.. :../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.., ........................... , ..................
House Nmnber Street Hamlet
o .ty o.,000 .... ...... ........... / 7
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
occupanc~ ......... ~..~..../:.~-- .................... ; .....................
a.
Existing
use
and
.~...
b.
Intended
l
o
Natdre of work (check which applicable): New Building .......... A
Repair .............. Removal .............. Demolition
Estimated Cost .... .7...: ........................... Fee
...... Alteration .........
. Other Work..~7o5'.~. ..... .
........ (Description)
(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 bdsiness, commercial or mixed occupancy, specify nature and extent of each type of u~;e ....................
7 Dimensions of existing structures, if any: Front Rear ' Depth
Height Number of Stories 4 '
Dimensions of same structure with alterations or ad&tlons: Front ........... ~ ..... ~ Rear ..................
Depih ...................... Height ...................... Number et~ Storie~ .....................
8. Dimensions of entire new construction: Front ............... Rear ....... ~ ....... Depth ...............
Height Number of Stories '
9. Size!of. lot: Front ...................... Rear ...................... i Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
1 1. Zone or use district in which premises me situated ................................. -.
12. Doe~ proposed construction violate any zoning law, ordinance or regulation:
13. Will .lot be regraded ................... ......... Will excess fill be removed from premises: Yes No
14 Nam fO fpr i Adl Pho No
· e o wnero eib scs .................... rress .............. , ....ne ................
Name of Architect Address J Phone No
Name, of Contractor .......................... Address .............. ~... . Phone No. ...............
15. Is khts property located withinlo0 feet of a tidal wetland? *lYes ..... No&~-..
* If ~es, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Loca~¢ clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property Jines. Give street and block number or description according to deed, and show street names and indicate whethe~
interior or corner lot.
lq'
STATE OF NEW YORK,
GOUNTY OF ................. S.S
i ' ' being duly sworn/;;~]~g ia~ t~i ho isah~a~pl~l~t
(Name of individual signing contract) Foc. io~wN¢~
above named.
Hemtne ........................................................... ~x~.~, . .~, , ... .. ...........
(Contractor, agent, Corporate officer,~ta:}?
oI saln owner or owners and is duly autnorized to perlorm or have peffonned t~q,~al~-~.a~d,:,~a~ ~d file this
application that all statements contained ~ this application are true to the best ~,~i~¢'l~aa~¢h~li~;taa~t t~ie
work will be perfomed in the m~ner set forth in the application filed therewith.
Sworn to before me this 8~,~r~ GONa'r~t~C'rff~'~ ~' ~N~RGY
............... ( ~ ...... day of,. .... ~....
Nota, Public, ...~..Z..~.~<.".. County
,ttt.,. ..... ....................
~TARY PUBL C, ~e of New ~
~, 4707878, Suffolk Cou~ (Signature of applicant)
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD. N.Y. 11971
TEL.: 765-1802
Received ........... ~19...
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ................... 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, accurhte 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 c~e, and regulations, and to
admit authorized inspecto rs on premises and in building fo rnece ssary insp
....... ......f 'do;' ;ia'tidd ....
(Signature of applicant, or name, i a p ' )
....r ..............
....... [mai±ing'~fia~g~ of ~p~li~&~5 .......
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... ............................................................................
Nd,ne of owner of premises ~. ]..~.]?t..~?.~..~..O../~..~..~.. '.. N.~'..t~...Z~.~...7'~..~.~'. ................................
(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 ......................
Location of land on which proposed work will be done../57..3.'~.....,_~?..l/..~.....~....~.~..,,,"~-../~...b~.. ::...
House Number Street Hamlet
County Tax Map No. 1000 Section ... Z .~...~. ....... Block .... ~../ ......... Lot.. ?..2 ............
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 .................................
3. Nature of work (check which applicable): New Building .......... Addition...' ....... Altemti~... i .......
Repair .............. Removal .............. Demolition ............ :.. Other Work..~.~.. ~(.~'~.
(Description)
4. Estimated Cost .~.0..0 ................................ Fee ........... . ...........................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ................
If garage, number of c~s
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 ....... ~ .. Depth ...............
Height ............... Number of Stories ............................ ; ...........................
D~ensions of same structure with alterations or additions: Front ............ ; .... Rear ..................
Dep~ ...................... Height ...................... Number of Stories ......................
8'. Dimensions of entire new construction: Front ............... Rear ........ ~ Depth
Height ............... Number of Stories ...................... ~ .........................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Foyer Owner .., ...........
11 Zone or use district in whic remises 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 '~
14. Nme of Owner of premises .................... Address ................ ~... Phone No ................
N~e of Architect ........................... Address ................ ... Phone No ................
N~e of Contractor .......................... Address ................... Phone No ................
I5. 1s th~s property located w~th~nL00 feat
~ If yes, Southold To~ Trustees Permit may be required.
PLOT DIAG~
Lo~a~ d~uly ~d d~sfin~fly ~1 bulldogs, whether ~xisfing or proposed, and. ~nd~at~ ~1 s~-back d~nsions from
prope~y ~nes. Give street and block number or description accord~g to deed, and sho~ street names and indicate whether
inte~or or corner lot.
AJ OVEO NOTF. D
7~-180~ 9 A~ TO ~ ~ ~R THE
r:OLLOWING INS~C~ONS:
F~NDA'rlON TWO REQ~RED
STATE OF NEW YORK,. S.S FOR Pi)OREo CONC~E'I E
COU~Y OF ................. ' ' ~OUGH F~AMING ~
................................................. duly that ppnoant
(Name of individual signing contract) ~, ~l~ ~()~S'r~tJC'I'~O~ MUST
above named. AL~. t:0NST~tlCTiON S~ALL M~ET
He is the THF ~tltJ~NTS ~ rH~
........................................................ s~:er~s,~c,l~'~ '~ .....
(Contractor, agent, corporate officeG~.: t~t~T ~8~SlSt[ ~fl
of said owner or ownem, ~d is duly authorized to perform or have perfome~~[,:,a~ ~{his
application; thai ~1 statements contained ~ this application are true to the best of his ~owledge and belief; and that the
work will be perfomed in the m~ner set forth in the application filed therewith.
Sworn to before me this ,
........................ day of ..................... ,19..'.
(Signature of applicator)