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Home My WebLink About23838-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24835 Date JANUARY 10, 1997 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 1825 DEEP HOLE DIRGE House No. Street County Tax Map No. 1000 Section 115 Block 14 Subdivision Filed Map No. MATTITUCK, N.Y. Hamlet Lot 18 Lot No. conforms substantially to the Applic.ation for Building Permit heretofore filed in this office dated NOVEMBER 15, 1996 pursuant to which Building Permit No. 23838-Z dated DECEMBER 4, 1996 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 CA~PORT ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & CONCETTA VIVIANI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Inspector lrO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted t/~ ..~~..~/..~./..~?.~. ................... ...... ../..~~~.~.~.. ........ .... ............ ~ ............................. ~..~..j~..~'~~ ........ ~:~.5~.~..~ .......... pursuant to application dated .....................~..~..../....~... ........ , 19..?....~.., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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: 1. 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 completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural qr 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 state the reasons therefor in writing to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00~/Additions to dwellin~ $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-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ew Construction...~.. ..... Old Or Pr~-existing ~u±~ding .......... Loeation of Property .... . ... ii iiiii .......... ..... .. ... House No.~-~ Street Hamlet Onwer or Owners of Property.. . County Tax Map No 1000, Section..../.~ .~.. Block Subdivision .................................... Filed Map ............ Lot ...................... Permit No...~..~..~..~.~..~..Date Of Permit.../..~.'.~/~.~...Applicant ............................ Health Dept Approval ...... Underwriters Approval Planning Board Approval.... ................ .... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................ . ~[ ~~.[ ~ .~., ) ~ ~ . ~ ' ' APPLICANT ..... : ............. I"ll'.'l.I) IIl,'il'l::(~l I()1t I(I~,I'{)I(T 21tl)) Ir I I IAI, ,N G~ADY FRLt'f : tHRSON hL.T. ':aE~8-438-114% PHQN~ NFl · ' ti,-,,, ll 19'm~=, FJI' 'F,F'M F'¼ ~ F- FROI~ : ~dAE, ON ~ .... 9~38-.,.,]8-1145 PHONE NO. : ,,,~.. ~ ~996 t~4:12PIfl Pl H r ~[ 47 Fanning Road II ~ Riverhead, New York 11901 ',t ~ (516) 727-2444 We hereby submit specifications and estimates for [5 ' Signature Acceu. rance-- " 'oI ~'roposat - ~, .,o., ,,,..., ,.,,.,., ...... , Signature Signature 1 NS'I'RUCT 10N~ 3 ,qETS OF PLANS ............... ?,UP,¥E¥ ........................ GIIECK ......................... SF, PTI C FORH ................... if'IA 11, TO:./~. ................ Date ................ , 19 .... a. 'lllis qqflicatua nu~F Is, ¢:¢~l~lelely rilh~l in by ty~,~rtter or '~ seth of plans, accurate plot: plan tO scale. [r~ accotxllng Lo sch~lule. b. l'lok plna ¢~in8 I~atkm of lot aM of l~lldlt~s ~ preaises, telatio, ship to ml.iohTi.a prcaliaea or lddle th i s alii i cat tim. c. ']he ~)rk c~l 1~ t.hl, oH~lical:{o, v~y tg~t. APlLI(~'fI(~ I~ IEla~l~ }~I~ to tl~ l~fildlnl~ l~ffJrt~.[ For the ism~a~'e or a l~fildl.8 l'e~it l~ra~a.L to the I~Jihli.g 7.~ Orcli~.re of Lhe 'lDi of fxmtl~fld, PaJffolk (~nty, l~l~ulal, i~n, tar 1.1~ c~mtn~tim of I~fihli~;, mMiti¢~e or all:eral:J~, or For ~al or ~lRio., a~ herei. {b~crd~l. I1~ qph a t asr~rt Io co~¢y with all (i'tfi li.g ,~ldress of al)PI iea. I.) SI. ale Mr, ti}er ~q~pl icatll, is {~er~ les, r, ee, aid, enl.~ nrcl itee ', ap, meet, Rel~rnl eo. LrneLor, electric]a., l)lu~l~,r or I~uhl(,~ O~ ~.,~ ,,, ,~ o~.,.~..,~ .<~:c ~ ~.~..~...~.~.~. &...v.~.¢~: ~ ........................... If ala~l JC,'lnl. iS a corlx~ratJcah si§;;qtun? of d. ly ,'~ll.tK~rj?,¢~,l officer. aid tit le of corlx)nqte officer) l~,i lders i.{cenr, e I,b .... '././~. ¢.~../. ............. 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Yx~ i~r u~3e di~l'~icl: in ~{~:ln Dro~.l~e~ are s[l'u~ffc~l .............................................................. { PLOT .. ..... x..m~. Ol i~vitiual .iI~,~d.g co.I 0~1RE L GLEW ~rk (i~iR~al m eol: Apld i~:~c~l ) No*n~ Publ{o, State of New No. 4879505 Oualifmd in Sufto}k County ~ ~'~ Commission Expires Decembe~ 8~ ~ 9