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Home My WebLink About13928-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) 13928 Z Permission is hereby gronted~to: .~.~...3~~...~.~.:.~? · ~.~C..~~.......~.., .................. ~...~~, ......... ~..~.~.~.~...~ ......... ,o ............................................................. .~ ..... ~ .......... ?.., ................. ............................................................................................ ~. ~ ,; ............ ; .......... ,., ........... at premises located at ..1....~....~...O.. ....... ~.~..~.....~ ..... ~.~.... ......... Count,/ fox Map No. 1000 Section .... /...?.,...~. ......... Block .......C~....~.. ........ Lot No.......~..:..!..~;;t ..... the Building Inspector. Bulling Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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. 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 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 $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .~.C~. Date. '... [.~,/. J~.~ ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property., House No. Street Ham/et Owner or Owners of Property ... ~O~f~ ~ L)..~P. ([ C~... ~.~L,.F. ~...L(~.C~././O ........... Countv Tax Map No. 1000 Section .... Subdivision . . ~,~,/~..bc.l.~,~,...~. ~. i~. ¢ ....... Filed Map No. ~.~,?...Lot No ..... ~ ........ PermitNo /3.~?~°~ ~O~, Date of Permit ~.',/~ ~/'~'"' Applicant. , .~,0./~/'). .~.! ........ ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificat ---- Final Certificate ................... Fee Submitted $... ~.' (/.~... ~..~..~..~. '.-}. / ....... Construc,tion ~,n above described building and per, mit meets all applicabl~,codes and regulations. ~j,~, o0,-~ G ~q Applicant .~ L~..~ '. .... ~QL-~ ................ Rev, 10-10-78 TO~N OF SOI3THOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date / ~//~/~0~ Building Permit o.159 g Owner ~'~t~ '~. L~-~fC-3f"[~i (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. /~( ~ 1 J~b~e r~,/s~ u r e ) Sworn to before me this /~ day of ~.~ , Notary Public,~ County tary Publ' R[GINA S. ~ATT[.I~VS NOTARy PUBLIC, St~te of New Yor~ No. 52-4636665, Suffolk Coun~ Commission Expires March 30, THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY ~ 8E JOHN STREET, NEW YORK, NEW YORK 10038 .ate O~toL~r 9, 1985 344317/85 ,,pplic.tion No. on fi,e N7!2092 THIS GERTIFIES THAT only the electrical equipment ~ described belo~ and i~troduc~ by t~ applicant ~med on the ~b~ application ~umber in the premises of in the followlng Iocation~ ~ Ba~me~t ~ 1st FI. ~ 2nd Fl. Section Block Lot was examined on ~:,~b[~ o ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES INCANDESCENT FLUORESCENT 19 2,5 19 19 DRYERS FURNACE MOTORS FUTURE APPLIANCE F~I:OI:RE TIME CLOCKS DISH WASHERS EXHAUST FANS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: i~G.Y.C.i. 1-~ke Detector S E R V I C E OF CC COND OF HI-LEG OF NEUTRAL NO. OF ~,EUTRAL$ Box 21§ ~outhold, N.Y. 11971 Lio. 578 . GENERAL MANAGE~' certificate must not be altered in any manner; return to the office of the Board if ;ncorrect Inspectors may be identified by their FI~LD ~NSYECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL EOUTHOLD, N.Y. 11971 TEL.: 765-1803 ~.pproved . . .~ ..~..(~.., 19 ?.~. Permit No..). ~.9..~.~..~ Disapproved a/c ..................................... ............................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG, DEP'[.. TOWN OF SOUTHOLD Received ........... ,~9.. · a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by tills application may not be commenced before issuance of Bi~ilding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit .hall 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 :hall 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 ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or legulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations and to mit authorized inspectors on premises and in building for necessary inspections. . ' (Signature of applicant, or name, if a corporation) omcq.. ,..,,?o.u..%.e. [a.q. )... (Mailing address of applicant) Rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................... ~ameofownerofpremises ...1.~.0,~C~.~\ ke~ ~\e--~lO ............... (as on the tax roll or latest deed) f appli/~ant is a corporation, signature of duly authorized officer. . ..... (Name and title of corporate officer) Builder's License No ....... ]..~.! ................ Plumber's License No .... /.'P.-.~..cO? .~Cr. ........... Electrician's License No...~ .~{. ................ Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number ~4'eet Hamlet County Tax Map No. 1000 Section .... [ O..~. ......... Block ....~. ............. Lot....~..' .J.~ .......... Subdivision .(,~ IT g~/~ ~.~C ~ (L.{.~..~.~.- .~ .~:~. ...... Filed Map No ............... Lot .... .~ .......... (Nmne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~J.Ck.C~O,.(h.~: ..................................................... b. Intended use and occupancy ..... .Q(~.¢~...%L[X'B [~..(h~k/d.~.~ t .[~ ................................. 3. Nature of work (check which applicable): New Building .... ~ .... Addition .......... Alteration .......... Repair ~, .:; .~.. :/:~,~... Ren~oval ............ Demolition .............. Other Work ............... ~ (Description) 4. Estimated Cost ........ ~'i LY.f.D..,. 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 .... i .................................................................... 6. If business, commercial or mixbd occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structm'es, ifany: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i... Height ...................... Number, qf Stories ...................... 8. Dimensions of entire new consiruction: Front ~oJ ' ~?~' R~r o~£ ~'If~" Depth . .~.~.?.J' ........ Height .... ~t¢. ~. ...... Number of Stories ........ ~ ...................................... t ....... 9. Sizeoflot: Front ..... ~.l.O.t.i ............ Rear ..... ~./9.t. ............ Depth ..... [.~?.:.g.§ ......... 10. Date of Purchase .......... i ................... Name of Former Owner ............................. I I. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction viOlate any zoning law, ordinance or regulation: .... 13. Will lot be regraded ........ O.@... ............... Will excess fill be removed from premises: Yes N~ 14. Name of Owner of premises O&~J~.l. J~,~"~-~.l~/].~ .... Address (~-.l~y~ ........ ~ .................... Phone No ................ Name of Architect .... : ~. ....... . .....Address ~ a . Name of Contractor~f.L/~ ~o.4~./ritz J) .~X.~.~.~.C~.. Address $~t~. ~9/..qt,aJ../'~... Phone No..~/~..~.cj/. PLOT DIAGRAM Locate clearly and distinctly ~fll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc number or description according to deed, and show street names and indicate whether interior or corner lot. STA'rE OF NEg( YORK, COUNTY OF. ~'Lt-~.g:~ ...... S. S ! .~.~.~.~..-r-AU. '~. .......................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the Cc>c ~o c0~ .~.~ .c~. , (Contractor, agent, corporate officer, etc.) owner of said or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application filed therewith. Sworn to before me this .......... .~. ....... :...day ~f .... . .~lA~...~. ......... , 19 o./ Notary Public, . .[~F.,... ]x.~ ..~:-.. ~J..¢-ff~.. County NOTA'RY PUBLIC, State of Ne~ York ................ ' No 4707878, Suffolk Cou~t,L (Signature of applicant) Term Exp,res March ~), 1~ P ¢0/ p 'J ' '' SURVEY FOR SUFFOLK CO[JN~TY rFP2R~P~'~T OF H~ALTH SERVICES DANIEL LETTERIELLO LOT 9 "GREENBRIAR ACRES" FOR /,PP~OV,~J, OF~ ~ CO;qS'I'RUC'r!ON ONLY ~ AT MATTITUCK DATE: A~IL 27,1984 - ~ I" 40~ ' ELF NO. SUFFOLK COUNTY; NEW YORK NO. 84-364 DATE~_~ ~'~~ . ~ U~UTHOR~ZED ALTERATION OR AODITION m ~lS GUARANTEED TO A~OVE~ - ~ , , ..... SURVEY ~ A VIOLATION OFSECTION 7209 OF THE HEW YORK STATE EDUCATION LAW USLIFE TI~E iNSURAN~ COMPANY OF NEW YORK SURVE~R'S INKED SEAL OR EMBOSSED SEAL SHALL ~GUARANT~ES INDICATED HEREON SHALL RUN ~LY HEALTH DEPARTMENT : -DATA FOR APPROVAL THE ~RSON FOR WHOM THE SU~EY I$ PREPAREO CO~STRUC A~O ~ HIS BEHALF TO THE TITLE COMPANY, GOV~N- ~ NEAREST WATEE~ MAI ~MI* ~ N SOURCE OF WATER: PRIVATE ~PUBLIC ~ ~E~TAC AGENCY AND LENDING INSTITUTION LISTED ~ S~F CO. TAX MA ;TI~0 SECTION log BLOCK ~ LOT ~.1~ HEREON~ AND TO THE ASSIGNEES OF THE LENDING P DI H~ERE ARE NO DWELLINGS WITHIN I00 FEET OF THIS PROPERTY INSTITUTI~, GUARANTEES ARE NOT TR~SFERABLE OTHER' THAN THOSE ~HOWN HEREON. ' TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT N THE WATER SUP~Y ~ ND SEWAGE DIS~AL SYSTEM FOR THIS RE~IOE~ OWNERS ~DISTANCES SHOWN HEREON FROM PROPERTyrLINE$ WILL CONFORM TO TH~ STANDARDS OF THE SUFFOLK COUNTY OEPARTMENT TOEXISTING STRUCTURES ARE FOR A SPECIFIC A~UC~, BUILDER INC. ' ' ~, PROPERTY LINES OR FOR THE ERECTION ~ FENCES r SOUTHOI~D NY ] , YOUNG YOUNG AVENuE , r~ ' , , ' ' U_ , ~ ' RIVERHEAD, NEW YORK NOTE:B ~ MONUMENT SUBDIVISION MAP~[LED IN THE OFFICE OF THE CLERK OF ALDEN W. YOUNG, PROFESSIONAL ENGINEER SUFFOLK COUNTY QN OCT. 7~ 1977 AS FILE NO. 6609 AND LAND SURVEYOR NY.S. UCENSE NO. 12845 - :' '~' ~ ~ ~ " ~, HOWARD W, YOUNG~ LAND SURVEYOR ~ ~'g~T~ OF W~L(W),SE~C ~AN~(ST)a CES~OCS(CP) SH~ HZeE~ N.Y, S, LICENSE NO. 45893 ~REr~OM FIELO OBSE~TIONS ~DOR ~ATA OBT~NED FR~ dTHERS' ' SUFFOLK CO. HEALTH DEPT. APPRovAL -- AND SEWA6E DIS~AL ~ATT'?UC~ S~F~K CO. DEPT. OF HEALTH ~RVtCES. ~C: SUFFOLK COUNTY DEPT. Of HEALTH O~ ~6T 10 I~ SERVICES -- FOR APPROVAL OF j CONSTRUCTION ONLY ~', H.DATE:s. ~FFOLK CO. TAX MAP DESIGNATION: ~ DIST. ~CT. BL~K ~L. t~ 'l~ 108 ~ q OWNERS AD~S: ,.~.~,~~~ i~ ~ , , , ,, have been TITL~ N0.Tt285-28~8 LICEN~D LAND SUR~YORS