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Home My WebLink About14367-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy 85 No. Z14044 Date December 2 .,19.. Deck THIS CERTIFIES that the building ................................................ Location of Property 1 ~ 50 Terry Lane Southold House No, Street Ham/et County Tax Map No. 1000 Section ,..6.4. ....... Block .... 3 .Lot 1 3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed' in this office dated ·. Q .c.~... q..6 ............ 19 .8.5. pursuant to which Building Permit No. I 4 3 6 7 Z dated ...9.c.~... q..6 ................. 19 .8.5., 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 ......... .. D.e.c.k.. ~.d.d. $.t Aqn...t.o..a.c..c.e.s.s. 77..~..u.~.~.d.~..nF.. .................................. The certificate is issued to JOHN AND PATRICIA DI CARLO ..................... io¥~'o;, '~¥~(~&~,~'~( .................... of the aforesaid building. Suffolk County Department of Health Approval .............. n./..a ......................... UNDERWRITERS CERTIFICATE NO ...................... n./..a ......................... Building Inspector Rev. 1/81 1~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PElt~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_° 14367, Z Date .............................................. , 19 ..... Permission is hereby granted to: ,o ......... .C.0.v...~.~.d .......... ..d.~. .......... ~....~.(fif.o.~ ....... .?.?. ......... ~.q~:.,..~.~.t. ...................... ...................... ot premises located at ................................ ~, .......... "~'~"/ .................................................................... County Tax Mop No. 1000 Section ~ Block .......... ..~ ......... Lot No. pursuant to application dated ........................................................ , 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 N0V 271985 Instructions This application must be filled in typewriter OR ink, and submitted m lammm~ 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 install+ 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. For existing buildings {prior to Apri{ 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pz~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 $15.00 Date , ......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. .. ...................... Location of Property . '/'/' ~'~'~' ' ' ' ~ ....... ; ....... ~ ......... Hamlet House No. -- Street Owner or Owners of Property ....~-CxL ~. ~.~-. ~...~. Lt~.~.~.~. ~.~ ,~,~.~', · .~-Jq'.~./.O .............. County Tax Map No. I000 Section .... .~' ....... Block .... ,~ ........ Lot.../.3 ......... Subdivision ................... Filed Map No ,, ~... ,Lot No .............. .............. - z Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... .~2~.; .............. Fee Submitted $ ..... ~ .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .... ~'~. ,,. ~, './~ ,~ ,~ ,~, Rev. 10-10-78 FIELD INSPECTION FO!~ ~_T ~_ON _ (1st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 September 3, 1985 TELEPHONE (516) 765-1892 Jo A. Lessard Contracting 610 Richmond Road Southold, New York 11971 Re: John Di Carlo Deck Construction Dear Mr. Lessard: As per your request for a determination on the need of a wetland permit, regarding the above referenced matter, please be advised that the Trustees have reviewed your plan on August 2~, 19~5 at a regular meeting of the Board and determined by resolution that no permit is needed subject to the following provisions: 1. Care shall be taken so as to preclude the entry of any construction material into adjacent waters. Imme~iakely following construction, all areas of exposed soil shall be properly protected with suitable erosion control deviCes and/or Vegetated to prevent entry of eroded soil into the nearby waters. 3. No lighting that will be adverse to neighboring properties shall be permitted. If you have any questions, or need additional information, please do not hesitate clalling this office at the number listed above. Very truly yours, . Henry P. ~Smlth, President Board of Town Trustees HPS:ip cc: Building Dept. Trustees file 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , ~OUTHOLD, N.Y. 11971 \ TEL.: 765-1803 ........ ^pproved ..... ....... 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, 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 necesT~7, in.p. ~..~...'~ ........ (Signature of applicant, or name, if a corporation) · <...g.:.. .... (Mailing address of al:~licant) ] JT~ ] State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. (9o0. ~' ....................... "'::o;;;','m;:,i ....................... i":': 0 O. '0 .... .0.. .... < .~. ~ .% . . ., .................................... (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 ...................... I. Location of land on which proposed work will be done .................................................. ...... ~.:.r.,~.Co,.~ ............. 5~..~. o/~ .. House Number Street Hamlet County Tax Map No. I000 Section ..... ~..~ ......... Block .... ~ ........... Lot ..... O ........... 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.~.CL...~_ / t:R.~J .... ~.ct t<2 .................................. b. Intended use and occupancy ...... .L3. ¢.¢ [~. ..................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ....... ~,?,~.'~).~. '. ...................... Fee ......................... ~i ~' (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units 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. 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 construction: Front ............... Rear ............... Depth ............... Height ............... Nlffnbor or ~todes ......................................................... 9. Size of lot: Front .......... I ............ Rear ...... ' ................ Depth, . .................... 10. Dare'of Purchase . .~F~ .~4,y.. J.~..~. ........ Name of Former Owner .~.*a.~ .a,-~ .~/~/.-e.;. ~.~ 11. Zone or use district in which premises are situated .................................................. 12. Does propos, ed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ i .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .i .................. Address ................... Phone No ................ Name of Architect ' Address Phone No Name of Contractor ' Address Phone No 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 coruer lot. STA'rE OF NEW Y~ORI~ ,~, S. S COUNTY ....... ~/~ ....... ~ ~ .~ ............. being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..... 0. ~.~f.( ...... ~ .................................................................... i (Contractor, agent, corporate officer, etc.). of said owner or ownem, ~d is dOly autho~zed to perform or have perfomed the said work and to m~e ~d file this application; that all statements centred h this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~aer set forth ~ the application filed iherewith. Sworu to before me thisJ.. .............. ...... -- ..... Nota~ Pub~ ....... .... ..... ~d~ ~ ~/X ~"'~ (Si~ature of applic~t) / 0~9. O0 Z .i