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Home My WebLink About14344-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... ~.? 3.~.q.6. ...... Date ......... .07.~.o..b.e?. ?..0 ............ 19...85 THIS CERTIFIES that the building deck add±~;5_ezz. Location of Property ....~.~.Q Delmar Dr. Laurel House No. Street Hamlet County Tax Map No. 1000 Section ..... .fl ?.~.,..Block ... z~ .Lot 24 Subdivision X ...Filed Map No, X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... O.c..~p.~.e.~...~ ......19 .~.5. pursuant to which Building Permit No ...... .~.~..3.t~,.~. ........ dated . ...O.~.~.qb..e?..~ .............. 19 ~. , 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 ......... ~.eck additi..o~ The certificate is issued to D~E~E & ~ .1~..~(., fi_lVil~IIL~TI (owner~ of the aforesaid building. Suffolk County Department of Health Approval ................ ~./.~ ....................... UNDERWRITERS CERTIFICATE NO ........................ ~./& ...................... Building Inspector Rev. 1/81 FORM NO. 0 TO~N 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) No 14344 Z Permission is hereby granted to: ~,~ ....h. ~.~.,:'~?J. .................... iiiiiiiii i iiiiiii i;.i ..iiiiiii' . i .......................... .~.,l.~c.~ .... ~.~... ........... ~) ........... / ..................... ,o ............ ~..,o.,...,~ .............. ~.~. ........ ~:~..o.,~ ........................................................ pursuant to application dated ........................... ~...~..Z~... .............. 19....~...~.~--and approved by the Building Inspector. Buiidlng Inspector Rev. 6/30/80 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) N9 14295 Z Permission is hereby granted to: County Tax Map No. 1000 Section ....... pursuant to application dated Building Inspector. Fee ~ ................ .~ ............ , 19.~.~.~'~ and approved by the Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ia ~ 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. 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. §. Submit Planning Board approval of completed site plan requirements where appl!cable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" I~qd uses: 1. Accurate survey of pZOperty 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 inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15 o 0 0 3, Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 9-~--~'~- /y 6~3J /?ate .......................... New Building ............. Old or Pre-existing Buildihg ......... ,J.. Vacant Land ............. Location of Property ............................. -. · · ~ ................. Hou~ No. Street Ham/et Owner or Owners of Property . .~..6~.. !~.., .~.~. ~.~.r2. t.~....~.~,D..~.....~..r...~. ,~ · ' ';' County Tax Map No. 1000 Section ....i.~l .... '.. Block ....?~/ ......... Lot. ~.~ .......... Subdivision .... ~ '.'..' ......................... Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... ~equest for Temporary Certificate ..................... Final Gertificate ....................... Fee Submitted$.....~.,. .................... Construction on above described building and permit meets all applicable codes and regulations. -~',b. ~o, ~o~'7 ~'7 ~ Applicant ...... ~1~.' ............... Rev. 10-10-78 FIELD INS~ECTION FOUNDATION Ilst) FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING COMMENTS INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~iELD INSPECTION COMMENTS ~OUNDATION (1st) 'OUNDATION (2nd) {OUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined .... / .~/.~. ....... ,19 ~..~ Approved ..... /~'.'/f ....... 1, .O{5.' .~Pe rmit No./.~- .~...~.?r..<~. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) ./4/~ ~ Date .................. ]9 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 necessar~nspectigns. ~ ~ . · .5~. 4~.: .~..'.d~ .~.~'. ............... (Signature of applicant, or name, if a corporation) ...~¢.~ ./.~...0."...~...c .m~.. ;,5:~....~.~.... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... r.a~.~.. ~'.,r.~.5;. ..... .~.~.....~<+~ ...... ~:,.~...~F ................................ Name of owner of premises ,c c, ,>-- '~ (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 .................................................. ..... .a.z.0 ................. ................ ............... House Number Street Hamlet County Tax Map No. 1000 Section fla9 7 Block ~ Lot ~ 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 ... ff. ( .... ~' ('~'~'¢'~ ......... ~*i '~1 '~'~ ............ 3. }.Nature~6[~]~rk (check :~hi~h ~pplicable): New Building ..... 'i.... 'Addition .......... Alterati ~o~ ......... : ,Repair .............. Reipoval ............. Demolition .............. Other Work. ~..~-'~..~. . . G~] ~ ~ ~ ~ ~ ' (Description) 4 'Est~ated Cost .k~:~2'~ ................. Fee ..................................... .~-. ~ ;.. ~ ; ' ~ ~ ' ~ ~' (to be paid on filing this application) 5. If~welling;~num.bero?~e~ngun~ts ............ ;. Number0fdwellingunitsoneachfloor ..... If garage number of c~s ' ' 6. If business, commercial or mixed occupancy, specify nature 'and extent of each type of use . ~ .................. 7 D~ensions of existing structures if any: Front Rear Depth Height ............... Number of Sto~es ........................................................ D~ensions of same structure With alterations or additions: Front Rear Depth .................... ~... HeiSt ....... ~ .~ .... ~ ....... Number of Stories ...................... '~.8. Dimensions of entire new cons~mction: Front /~0 .~ar ...: .......... - Depth .............. ~olght ......... Number ~e q*~fioo ................ 9. Sizeoflot: Front .......... ~ ............ Reg ...................... Depth ..................... 10. Dat~.ofPurchase ........ ..: ............ ....... Name of Fo~erOwner ............................ 11 'Zone' or use district in which p~emises are situated 12. Does proposed construction viglate a~y zoning law, ordinance or regulation: . .~O. ........................ 13. Will lot be regraded ........ ~ .- ...... , ............ Will excess fill be removed from premises: Yes No 14. NmeofOwnerofpremises ..[ .................. Address ..: ................ PhoneNo ................ Nme of ~chitect ......... ' .................. Address ................... Phone No ................ Nme of Contractor ~g~M~ ....... ~L~o ~[Address . ~ ~ ..... Phone No.. ~7~... PLOT DIAGRAM Locate cle~ly ~d distMcfly ~1 bufldMgs, whether existing or proposed, =d, indicate ~1 set-back d~ensions from prope~ Hnes. Give street ~d block number or description according to deed, ~d show street nines and indicate whether ~tefior or comer lot. . : ~ STATE OF NEW YORK, i S.S coyly oF ....... ..... I . (Name of~ndividual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the .................... ~ .................................................................... ~ (Contractor, agent, corporate officer, etc.) of s~,id owner or owners and is d,uly authorized to perform or have performed the said work and to make and file this pphcatlon; 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 ...... ........... ..... .... ~'FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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, 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 ~ 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, an~ to admit authorized inspectors on premises and in building for necessary inspectiom. J / /~ /" /~Signatt~re of appli~"~a_cp, rpo~ation)~ (Mailing address of applicant) State whether li nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... ........................................................................ Name of owner of premises .................. f. .... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder s Lice~ No ........................... . Plumber's ,Licens~No ......................... Electrician s Licens~kNo ....................... Other Trade's License~ ...................... 1. Location of land on which proposed work will be done ....... ~..~'../~//.....~..)..~....~..~.F~..(~ ........ ; ........ '. ........................ ......... ........ House Number Street / , I Hamlet County Ta~ Map No 1000 Section X .~...~. Block ¢ Lot ~CJ 2. State existing use andoccupancy of pr~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... -.~ ~'t~~ .................. ~' -~ b. Intended usc and occupancy ~ ~ ... ?~ ~,. ~;~,~,,;?:~r.~ ......... ..... :J : ....... ~ ' · '~' ~t.~ ~,~, ~ : '.-~ ....... 10. 12. dicable): New Building ..... '.' .... 'Addition .......... Alteratio~x .......... ,val .............. Demolition .............. Other Work.../0.C~.d/7'.... (Description) .v..O. ..................... Fee ................................... (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... If garage, number of cars .... i ................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same structure With alterations or additions: Front ................. Rear ................. Depth ................... ]... Height ...................... Number of Stories ..................... Dimensions of entire new cons~'ruction: Front ............... Rear ............... Depth .............. Size of lot: Front .......... i ............ Rear ...................... Depth ...................... Date of Purchase .......... l ................... Name of Former Owner ............................. Zone or use district in which p?emises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ : .................... Will excess fill be removed from premises: Yes No Name of Owner of premises ~..i .................. Address ................... Phone No ................ Name of Architect ........... l .................... Address ...................... Phone No. Name of Contractor ~/'_'~r.~ .F.~...~..~.~.~¢ .~c..~.... Address,~./e~. ~.~. ~'~..,~-d~,/f~fi. eS-~Phone No. 2~.~, .~.~i~.' PLOT DIAGRAM l,ocate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloct number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, I S.S COUNTY OF ................. ....... -.- .................... ' ..................... being duly sworn, deposes and says that he is the applicant ~.~ . (Name of individual signing contract) above named. Heis the .................... ! .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dhly 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 w~ll be performed in the manner set forth in the application filed therewith. Sy~orn to before me this ............. it .~..~-,...day ;f... ~..~.. .......... , 19 '.~..''~ Not-'try Public, ....... County .- - Lot REVISlON~ YOUNG & YOUNG 400 OSTRANDER AVENUE, RtVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUN(~ SURVEY FOR: PATRICK J. PINTO LOT NO. 42," LAUREL COUNTRY EST~j~~~ -AT GUA~ T