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Home My WebLink About24045-zFORM NO. 4 TOWN OF $OUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No E-25321 Date OCTOBER 21~ 1997 THIS CERTIFIES that the building. ADDITION Location of Property 1210 ARSHAMOMAQUE AVENUE House No. Street County Tax Map No. 1000 Section 66 Block 2 Subdivision Filed Map No. SOUTHOLD r N.Y. Hamlet Lot 28 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 2~ 1997 pursuant to which Building Permit No. 24045-Z dated APRIL 15, 1997 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS A~PLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N. CHARLES & SYLVIA DeLUCA N/A N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PER~IT MUST BE KEPT ON THE PP, EAAISES UNTIL FULL CO~PL~ION OF THE WORK AUTHORIZED) N? 3t0t5 Z Permission is hereby granted to: ~/,t~......~~..~..,~.. ........ ,o......~~;;;;~;;;;..i~~..~ ........ ~ ......... ~;.~.~..";..~Z:.~.~;.~;~.~..?/~.~¥~?~....~~..~.~..~..~~.~'''"~ .......... C,~n~ To, Mop No. ,000 Sec,ion ..... ~.~,. ......... Block ..... ~.~ ........ Lo,,o....~ .......... Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTME~Ff TOWN FALL 765-I802 APPLICATION FOR CERTIFICATE OF OCCUPAANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: I. Final su~ey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water ~upply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Unde~rriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board .Approval of completed site plan requirements. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: i. Accurate survey of property showing all property li~es, streets, huitding and unusual natural or topographic features. 2. k properly completed application and a consent to inspect sig~ed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw~n~m~ug pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - · .25¢. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 , .tC K Date ......................................... New ConstructiofrT. .......... .Old Or Pre-existing Building ....... Location of Property .... ...... .~,r.>~.%~0.~.~iv.C~. .............. ~ ...... Stree~ House No. Hamlet Onwer or Owners of Property...~....<k~.~....-~...%~t~.~.%,..~.~..~.~.'~'~..C~--.... County Tax Map NO i000, Section .... .~.~. .Bloc~.-- 0 ~- ~1~ ~ Subdivision .................................... Filed Map ............ Lot ...................... Fe=it of .... Applicant ............................. Health Dept. Approval ......................... Underwriters Approval. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicata ........... APPLICANT TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-i802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: I. Final survey of .property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of cdmpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: 1. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall stage the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-~xistin~ Buildim~ - $100.00 3. Copy of Certificate of Occupancy - ~ .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 · Date ........ y ............................ __ ~ ..... .................. ....... County T~ ~p No i000, Section..~.~ ......... Block ..... ~ ..... Lot Subdivision. ~7~ ~ ~...~!~..~ ......... F~ed ~p ............ Lot ...................... Pe~it ..... Date Of ~ ~ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Fee Submitted: $ ................ Temporary Certificate ........... Final Certicats ........... APPLICANT JJ~, I L': 765-180;2 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPI.ACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION ~]'/FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAI~IIING [ t~FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~_~2/~_~ ~.~,~ INSPECTOR VAN TUY'--. P. ~:. r - APR 2 Igg? FORM NO. l TOWN OF SOIITIIOI,I) lllJ ll,bIN(; I)F, PA RTHF, NT TOWN ltAl,l, SOUI'IIOI,I), N.Y. 1197 I TEl.: 765~ 1802 IW~AIH) OF III~.AI.'I'I! ............... SlJRVF, Y ........................ CHF. CK ......................... .~EPT I C FORH ................... ~'IOT I FY '. CAI,I ................... HAll, TO: .................... APr'r.] CAT I ON FOR BN I I.D 1 NC, I'F. RMI T 1NSTRUCTIONS Dmte ................ ,19 .... n. '11~i~ nl~fllcnl:ic.~ ~m,-,t t~. c<:~letely Filial in by fyl~,~rlter or in ink mxl md~nitt~l to I.he lksildin~ In~l~elm' w ~lr~ts or mens, ~ 8ivi~ ~ ~tnil~l ~cripti~ or ln~lt o[ ~'o~rty n,mt 1~ drmm m the din~r~ ~dch i~ l~r~ or [~,rmlt ~nll t~ kept ~ tt~ pr~ ~nilnbte for insl~cti~ thr~.~tt the x~)rk. A~.I{~'I'I(~ IS I~ilW FW~ to tlm ~ilding l~rtn~nt For Ih~ i~mm~e or n ~[ldlrtg Po~it ~zrmm,t to the lt]i hli~ 7xwm Onlhw~e o[ th~ q~ off ~ll~ld, ~]FFolk g~mty, ~¢ Yotl% nfxl other n~licnble t~n, O~ti~mm~, or ~bneril~l. 'llm appllcm*t ngr~. Io c~)ly with nil n~)llcnble l~u, ordltm~men, I~lilding c~lel I.~mlng c~le, taxi (l~ql 1 ins mklrog, or nppl iem,!) (l~-,.r, nt.I {itle oF corlxWal, e of fleer) ~il(k.r.~ l.leen.~e I~ .......................... Phmimr.~ l.ieen.~e No Electr{eiou~ l.lcen~ ~ Oiler Trm~', I.icm~ ~} ..................... ...... I~.t.~ ............. ~c~ ~.~%~.~ ............................. 5.~ ..... ~ ........................... ~,,~..~..., ..~>ss~.~...~m~ ~ ........ ~,~, ~,,p ~, ................ ,~ ............... (~) n. Exi~th~1 u~ a~l ~mmqxm~y ............................................................................. / I~i~H ......................... li~lt~ of lil(;i ilia ...................... I1. Z~,~ or u~ di~tric[ iH ~lil:lt [.a,i~a Lire situatc~l ............................................................. lq,lYf D IA(}IIAH HELENE O. HORNr= Notary Public, State of New York No. 49513~4 Qualified in Suffolk County Commission Expire!~ May 22, 19 ,,// (Liil~ll;llulu o1: Appl icanl.) ...... ~......,~.....,,,,, ,,~ ..(~...~ ..... ,,,.e~...