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Home My WebLink About23293-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OC~umANCY No Z-25121 Date JULY 7, 1997 THIS CERTIFIES that the building Location of Property. 615 MARLENE LANE House No. County Tax Map No. 1000 Section 143 Subdivision ADDITION LAUREL, N.Y. Street Hamlet Block 3 Lot 26 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 11, 1996 pursuant to which Building Permit No. 23293-Z dated ~CH 12, 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 SUNROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ARTHUR W. & DORIS AIELLO N/A N/A · B~ld~ing Ins~tor. Rev. 1/81 FORM NO.~. TOWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 23293 Z Date ............ .U./~ ................................. Permission is hereby grantecJ to: . . ..... ~.~.....~...z..../:..~ ...................................... ,z/.,.~4.~,,,~ ........................................ .... ,x.,. ........ ~.,.-~. ......... ~Z:.....,. ....................................................................................... Coun~yTax Map No. 1000 Section ..Z.~,...-~. ............ Block .......... ..~..,~... ......... Lot No......~...~.. ................. pursuant to application dated ....... ~..~,,/~.~.....?../.. .................. 1 9...? .,~....., and approved by the Building Inspector, ee ~..,..¢,~ ................ 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 i% 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. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, i957) non-conforming uses, or buildings and '!pre-existing" land uses: 1. Accurate survey of property showing all 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 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, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinz - $i00.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $~5.00, Commercial $15.00 Date .... .~. ................... New Construction ........... Old Or Pre-existing Buildin~ .............. J.. Location o roper ..................... House No. Street Hamlet 0nwer or Owners of Property...~-~Or~-/.~~ .... ~Y. .................................. County Tax Map No 1000, Section..~ ........ Block... 3 ........... Lot..~. ............... Permit No. ..........~3..~. 3..~. ate Of Permit..3~.~./~.~ ..... Applicant ~./. '~. .......... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ..... ~..... Fee Submitted.' .......................... ": IFI~;III,^TION I'F.I~ i't, ¥. $'I'A'I'I~ COI)I~ Ir i' I1^ l, Al)l) I/1' I OItAI. (iOHItlI~.NT$: 7.5. 02 .I. d;~O3 SJ, DflqO~Id ~IWIOS Si',!OSV~[S ~tflO~l d~O9 S£gO_flO;~d ~V'IOS S5[OSV~S LIFIO~I ,8//_ ll-,Ol dE[OD S,lOflffO;qd ~d'¢IOS SXOS¥~tS ~IflO~I Z 'd~O3 S£3flqO~Id ~WIOS SNOSV~[S ~flO~i ~ ~ A ~¢ ~ Z Z 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN/SULATION [ ] FRAMING [ r/j FINAL [ ] FIREPLACE & CHIMNEY DATE .... INSPECTOR : T~?~I~[~SOLITH(}! *~ SOUTHOLD, N.Y. 11971 ..................... TEL.: 765-1802 Disapproved a/c ..................................... FORM TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN HALL . ~;p-aingrmspector) APPLICATION FOR BUILDING PERMIT BOARD OF IIEALTH ~ SETS OF PLANS ........ ~SURV'E Y ................. _.~CIIECK ................ SEPTIC 1~ ~ R,"I ............ HAIL ' INSTRUCTIONS ·, a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stl-eet or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appl~ cation. , c. ' The work covered by this application may not be commenced before issuance cf Building Permit. d. Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Such permi 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 Occupanm shall have been granted ~y the Building Inspector. APPLICATION IS HEREBY MADE to the Building Departmer~t for the issuance of a Building Permit pursuant to thc Building Zone Ordinance of the Town of Southolfl, Suffolk County, New York, and other applicable Laws, Ordinances 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 admitauth°rizedinspect°rs°npremisesandinbuilaingf°rnecessaryinsp~ct~52L___ ' ' :..'i' :..~i ~ ................. "~ ........ ' ........ (Signaturp of applicant, or name, if a corporation) . (Mailing address o f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general', contractor, electrician, plumber or builder. .. ( s on the tax roll or latest de,ed')'}~,~/?~ 2 _.. If applicant isa corporation, signature of duly autliorized officer. ' DA~t. ,~~."~ ~. a ·... .... t ............... .:'. ............. NOTII~y BUILDING DEPARTMENT ~,T .... '76B-'1802 ~ AM ~TO 4. P~ FOIl TIlE ; . FOLLOWING INSPECTIONS: <~ame and title of co*orate °~f~cer-C CUPANCYOC ~. POUND^TION . mO .EQU~RE" ........... UNLAWFUL .O..OU.EDCO"C"~*E ~uilder's L~ce.se No ...... USE IS ~...o.~.- ..~M,NG · P'.MS'"G Pl.mbcr'sLicens~No ....... ' ....... WITHOUT CERTIFICATE ~. ,..u~T, ON : · · · 4. FINAL - CONSTRUCTION MUST Ele tr, c,an s L,ce.se No ............. OF' 0 'COUPANC¥ .E COMPL.E.OB C:O. ALL.CONSTRUCTION SHALL MEET Other Trade's License No ...................... THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY 1. Location of land on wbich proposed work w I be done ........ CODES, NOT RESPONSIBLE FO_R House Number Strcet Hamlet County Tax Map No. 1000 Sectinn: ~ ~?J Block 4. . ............................ ~. ...... Lot .... ~9. c2 ..L). .... 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 ....... ~F/~..~. 2/~9~,c .~ · 3. Nature ofwo~k (check which a~plicable): New Building .......... Addition Alteration Repair .............. Removal ....... · ....... ............... Demolition -,.i . · ·..: ......... Other Workl ....... fir' (D ipti 4. Estimated Cost ..... -.- . escr on ~'' ................ I .................... Fee . 5. fdwelbng, number of dwelling units . / ... Number of dwelling units on each floor. I ' (to be paid on filing this application) . If garage, number of cars ~ .......... · ......... 6 Ifb i · "."~ ............. ." id upan~y fy' ' ' ' fe t tip of ' 7 Di us n;ss, cOmlx~ercla occ ,spec, nature and extent o ac~ ' e use ................... · ~H~nens ohs ofe sting structur0s,if any: Front ...... Rear ............. Depth ... 'ght N ~.b fSt i ''' : ...... i ............... n* er o or es ........ ' ........... si ofshm ith It ti dditi .......... ' ................................ ~J~men ons e structure w a era OhS or a ons: Front De th.. ' i ..... Rear.· ~..P . ' ................. ,..He,ght ......... · ....... ........... 8. ~JlnlenslOlls of ent;~,~ ne, ....... ~ .... · ~ ' ......... ; · · mumoer oi ~torles ....... height ..... ; Numb . ~ . · ....... ~xear ............. Depth ........... ....... mcr I ~tones ........... . . . . ...... S zeof ot: ront ' , Rear //?5 .... ' :' ate or ur hase ........... , ......... , ......... Nam of otmer ≠ .............. ' .; .... ' Zone or uke district in which prdmises are situated ocs proposed construchon vm ate any zoning law, ordinance or regulation: Will 16t be regraded ... . r ........................... fp ......................... Will excess fill be removed from premises: Yes Nc Name of Owner o remises .. ~ ........ ; ........ Address ................... Phone No ...... Nme of Architect .......... i ........ Name of Contractor·../.~.~. (.ZC [--~. ~. ~ )'~" Address ................... Phone No.. . · · · · .. .Address ................. Phone No ....... yes,'Southold own Trustees Permit may be required. ' ' 14. 15.' Locate clearly and distinctly -'dl property I/nas. Give street and block interior or corner lot. ~TATE OF NEW YORK 20 UN-F,y OF ' ~ k.. ,(Name of indi~idu~ignin~ contract) PLOT DIAGRAM i ' Ibuildings, ~'heth~r existing or proposed, and. indicate all set-back dimensions from ~umber or description according to deed, and show street names and indicate whether ·..;... ,being duly sworn, deposes and says that he is the applicant re is the ' '! " i ' (Contractor agent porate officer ) , , cor , etc. ,f .s,.a~d owner or owners, and is duly ~uthorized to perform or have performed tile said work and to make and file this :~ ~pucation; that all statements contained in this application are true to tile best of his knowledge and belief; and that t'he ork will be performed in the manner sat Yorth in the application filed therewith. .vo.rn to before ,ne this .. .............. .,tory Public.. .... ,~, ;.~.~ ,,, -,, .'.::,~' .: ~ .~ ..... County /')/ · I 1Nm~t Pu~, ttmeof rhNvY(N'k /f//~ / ~ No. O~C ~,4830282 ........ ~, Qualified I. ~ffolk Cou.ty ,.,~ ' ................ ~s August 31, 19~ · ~X..~mrnismon E~i~, (Signature of applicant)