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Home My WebLink About14117-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14040 Date November 27 1985 THIS CERTIFIES that the building D e c k Location of Property 1150 Terry Lane Southold County Tax Map No. 1000 Section ... 9.6.6. ..... Block ... 9.3 .......... Lot ...~ .3 ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .O.u.l. ¥..2 .............. 198.5.. pursuant to which Building Permit No...1fi. 1. ] .7.Z ............. dated . . .J.u. 1. y..5 ................... 198.5. . , 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 ......... 2nd story deck addition to existing house The certiflcate is issued to ....... JOHN AND PATRICIA DI CARLO of the aforesaid building. Suffolk County Department of Health Approval Iq / A UNDERWRITERS CERTIFICATE NO ..... N / A Building Inspector Rev. 1/81 FORM NO. 0 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION Of: THE WORK AUTHORIZED) N~ 14117 Z Permission is hereby granted to: __ ~ ,~ .... ~.~..~....a~.~...L L.~.....~ ...................... at premises located at ..... /. .............. 2.. .~ .... ~ ............................................ County Tax Map ,o. 1000 Section ..... ...C~.....~....~ .... Block ....... ..~...~ ..... Lot No ....... !.....'~... ......... pursuant to application dated ............ ~..,. ................ , 19..~..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT, TOWN OF SOUI'HOLD Instructions A. 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 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. 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 "pm-existing" land uses: 1. Accurate survey of pa~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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 o.o. ..oo J Date ............. New Building ............. Old or Pre-existing Building ............ Vacant L,~nd ............. // ca ' P J 15'O e ~ r' ' 0 z~_ ~C Lo t,on of roperty/~o'u;; ~/~.'~'~ .... .X~...CO ................. ,-~0...,, ~ [.~. ............ Street Ham/et Owner or Owners of Property .' .~D.[..~.....~..~. ~ t¢;c';c~- ~'~'.C.a.y./.O... County Tax Map No. 1000 Section ....~-O.~. ....... Block ..... '.~.. ....... Lot ..... J..-~ ....... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo..l~/./.--~.~'. Date of Permit .Applicant .... t.~.~.,~-,. ,. .'. 0... Health Dept. Approval ..... ~ .................. Labor Dept. Approval ........................ Underwriters Approval .... 'Y~ .................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Subm tted ....... ~ ~ ................... Construction on above described building and permil;,meets all applicable~lodes and regulations. Applicant ~-,~ "..~, L~'..~'~ .~..~. ..................... FIELD ~INSU~CTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION FERN. Y. STATE ENERGY ~ODE FINAL COMMENTS ADDITIONAL COMMENTS: 'FORM NO. 1 BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Approved...'5~L~.~'.., 19Xf. Permit No.t~t.( 7. ~.. Disapproved a/c ..................................... APPLICATION FOR BUI LDINO PER~ IT INSTRUCTIONS BLOo. DEPT. TOWN OF SOUTHOLD Received ........... ,19... 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 g 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 So_uthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildh~gs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cod~e~ and regulations, and to admit authorized inspectors on premises and in building for necessary inspegtTpns.~ . //r },//~.. /./. ,v'..¢, 7a ...... . .............. (Signature of applicant, or na. me, if a~orporation) ~ .~o~'/~o/-~D/Ad. kr2 .......... i~l'aili~¢ ~ddres, of/apPlicant) / / P' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~.~.~. 6 .~. · · .t~. ?Q .... · .~.'~. ¢/~ - · ~/: ~. .......................... (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..~..~ .5~..S-.f... ~.~.~..~,.. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .............. ^ ................................... t, o .................... House Number / Street Hamlet 4.¢ County Tax Map No. 1000 Section ............. 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 .... b. Intended use and occupancy ..... /~..~'...~m~../~.....t/~. ?...~. ~./~..~..~. ~c< ........ Nature of work (check which a~plicable): New Building .......... ' on ..... Alteration .......... Repair . ~.~ .-..~. Removal .............. Demolition ............ ! Other or ............... 4. Estimated Cost ........................... Fee .~ 5. If dwelling, number of dweilin~ units .............. Number of d~ If garage, number of cars .... i ................................ 6. If business, commercial or mix{d occupancy, specify nature and extent 7. Dimensions of existing structures, if any: Front ............... Rea~ Height ............... Number of Stories .................... Dimensions of same structure with alterations or additions: Front .... Depth ................... I... Height ...................... I~ "' 8.'~-Dimensions of entire new constrUction: Front ............... Rear ~,,..,~.,~ .... (Description) ........... (to be paid on filing this application) elling units on each floor ................ each type of use ..................... Depth ............ Rear .................. umber of Stories ...................... ............... Depth ............... d, and, indicate all set-back dimensions from and show street names and indicate whether 'om, deposes and says that he is the applicant fleer, e.tc ) med the said work and to make and file this best of his knowledge and belief; and that the iith. (Signature of applicant) STATE OF NEW Y(~RJ~/z ~ S COUNT~'JDF... ?;~. ~'~. '.'/~...... ..... · ~../¢~---~C~. 2... { .~../..(/.t~/. ·O. ................. being duly (Name of individual sigping contract) above named. SHe is the ~ (Contractor, agent, corporate o: of said owner or owners, and is duly authorized to perform or have perle: application; that all statements contained in this application are true to the work will be performed in the man~er set forth in the application filed there, Sworn to before me this ........ i...'.....~7/1, ...... day ;f .... ~7~/~. ....... ..., 19~. ' .,~-' Notary Public,..~.~//..~... ..... ./.. .... ' ' PLOT DIAGRAM Locatei clearly and distinctly all buildings, whether existing or propos~ property lines. G~ve street and block number or descnptmn according to dee¢ interior or corner lot. He,bt ................ Number of Stories .............................................. 9. Size of lot: Front .......... ] ............ Rear ...................... Depth ................... 10. Date of Purchase .. ,~.~ .... /. ~.'-? ........ Name of Forme, Owner .~Z_/'~)..~t.. .4~.. ~/.o~. 11. Zone or use district in which p~'emises are situated ................. ~ ..... 12. Does broposed construction violate any zoning law, ordinance Or regular on: ................................ 13. W/il lot be regraded ........ I .................... Will excess fill 1,e removed from premises: Yes No 14. Name of Owner of premises . .i .............. .... Address .................... Phone No ................ Name of Architect ............................ Address ................... Phone No ................ Name of Contractor ........ i .................. Address ................... Phone No ................ .p