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Home My WebLink About15574-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...cJ.a.r .ag-.o..a..d..d~_.%~ .o.n..%o. e.xj:.s..~.i.n.~..d.w?.l. 1..i.ng.:. Location of Property .... 22.fi15 .......... S. 9.u.n.c}y.i.e.w..A. yg.n.u.e. .......... S. 9.u.e.h.q .1 .d ..... House No. Street Hamlet County Tax Map No. 1000 Section ..... .1.3.5....Block ........ 1. ...... Lot ..... .2.5 .......... X X X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 15, 1986 15574g ....................... pnrsuant to which Building Permit No ...................... dated....................,.......Dec'ember 16, 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 ......... Garage addition to existing one-family dwelling. SALVATORE C. RIZZO The certificate is issued to ..................... io~n.e.r~;/f~,~VXt~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .................. N./.A .................... N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FO~ NO. 2 TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEI~IIT Q'HIS PERMIT MUST DE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHOP, IZED) N~ 15574~ Z Permission is hereby granted to: ................. .............. at premises located at .~.~.~..~..~.~..~.....~J ..................... County Tax Map No. 1000 Section ...... .'/....~....~.. ..... Block ........ ..~....J ....... Lot No...,~J~...~....~..:J.. pursuant tO opplication doted ~.~..C~,.~....J...:~.. ........... , 19~..~)., and approved by the Building Inspector. Fee $..~..:...~. 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 I ~ 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. Find{ 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-'~xisting" land uses: 1. Accurate survey of pL'Operty showing all propertv 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. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50,00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $~0.00 4.Vacant Land C.O. $ 20.00 .UD ated c.o. $ o.oo Oate ........ New C ohs truct ion..~... OJd or Pre-existing Building ............ Vacant Land ............. Location of Property ............................................ House ~o, Street Ham/et o, .............................. County Tax Map No. 1000 Section .. Subdivision ................................. Filed Map No ........... Lot No .............. No' ~.i ~"~ q~-- f Perm,t]./. ~ .... Applicant .~..*.~...~.% ..../~/....~..~..~..~.... Permit .......... uate Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ...... .~. ................ Planning Board Approval ..... ~ ............... Request for Tempor~Certificate ..................... Final Certificate ..... , .[~... ............. Fee Submitted $~...~. ~..,~..~1~ ......... Construction on above described bu{[ding ts all applicable codes and regu lations. Rev. 10-10-70 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~/FRAMING [ ] FINAL REMARKS: ~ OUI~DATION {1st) OUNDATION ( 2nd ) OUGH FRAME & FLUMBING iNSULATION FER N. STATE ENERGY CODE FINAL · ADDITIONA'L COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .1~.~ .'-1 ¢., 19 ~.[0 Approved<~..~.... J. (e., 19 ~ .lo. Permit No..I.~'..~. ~ .~..~. Received ........... ,19... Disapproved a/c ..................................... (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 throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever untied 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 Cmmty, 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.~g.~. . '~' --~ if a corporation) ........ (mail{ng ~d~r~ of applic ) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. 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 ofland on which proposed work will be done. ~.~.~..~ ......... House Number Street Hamlet County Tax Map No. I000 Section ....... ./?..S. ~ .... Block ...... /. ........... Lot....~..~.~..~.."~...~.%?... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 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 .~ ~~ i i i 3. Nature of work (check which applicable): New Building .......... Addition. ~ Alteration !. Repair ..............Removal .............. Demolition ..........i.. Other Work ............... Fee ..... (Desc ption) 4. Estimated Cost ..... . .......................... . ........................... (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 cars ....... /. ..................................... : ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... 7. Damens~ons of ex~st~ng structures, afany: Front...~..~. ........ Rear . ~..~.... ...... 'l~;t't~ i[ i~i .~[ ....... Hight /.~. ! N mb fSt i ~. ~ e .......... u er o or es ................ i .......... ,. · ~?i ..... Rear ............... Dimensions of same structure with alterations or additions: Front ..... ~ ...... Depth . ,~. ~.e. ............... Height ......... ? ............ Number of Stories...f. .......... r ...... 8. Dimensions of entire new construction: Front . .../~. ....... Rear . . ./~../...i ...... Depth ...~..g~. ....... Height ............... Number of Stories .......................... ;..i ........................... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ....... ; . ..¢Name 9.f Former Owner ~ 11. Zone or use district in which premises are situated ~ i ~.~.~,/~. 2~ ~. 12. Does proposed construction violate any zoning law, ordinance or regulation: .~.4~ .......................... '13. Will lotberegraded ,~,~.~.._. .... ,~.~ ............. Will excessfillberemovedifrompremises: T;s.....~ 14. Name of Owner of premises ~; .~..Z.2~. Address .............. I... Phone No ........ · Name of Architect ........................... Address ................ i... Phone No ......... ....... Name of Contractor ~,. 7'~ R.~ ............... Address ~.~. ~;~J ~ ~. ~*~...Phone N~ .. ....... ' · Zf yes, SouthoZd To~. Trustees Permit may be required. PLOT DIAG~ Locate clearly ~d distinctly ~l build~gs, whether existing or proposed, an&indicate ~l set-back d~ensions from property ~nes. Give street ~d block number or description according to deed, ~d sho~ street n~es and indicate whether interior or corner lot. STATEOF SS COUNTYrDF, ~. ~ .'~Y~.,..'-Y. .... ' · · .~~. · .~ ................... being duly (Name of individuaFsi~ning contract) above named. sworn, deposes and says that he is the applicant He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the smd 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 ......... .~..~.7 .......... day of~v~: .............. , 19~. ?. ' Notary Public, .~../~..~.. ~... ...... County ~0~a~. R~,dmg t[~ ow %[0 .... ~ ~ : ' ' ....... ~isSio~°~g~/j¢ / ?~ i (Signature of applic~t) eom ~:! ¢'- .,,'-,.,: ,. , ',,.: :..,,t,,~ ~. ,J., ,~ /"t4 ? ,~ ,-., ,4 .~ ~_ ..~ ~ 7-z,~z ~ ,' '"_'_'. :\ ._,?..Zz¢'_ ' A ._1 OR C.-- /L ,9 I I I ' I r5 ,' e) A OCCUPANCY OR J t ' I H 't / / 9 7/ ~_jLJ