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Home My WebLink About22999-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. C~RTIFICATE OF OOJumANCY No Z-24790 Date DECEMBER 5, 1996 THIS CERTIFIES that the building. ADDITION Location of Propert~ 6325 PECONIC BAY BLVD. LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 10 Lot 23.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 28r 1995 pursuant to which Building Permit No. 22999-Z dated SEPTEMBER 7, 1995 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 DW~J.T.ING AS APPLIED FOR. The certificate is issued to BETTY CUCCURULLO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. 1/81 FORM NO.:] TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. N? BUILDING PERI, IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN'IlL FULL COMPLE~ION OF THE WORK AUTHORIZEDI 22999 Z Date .......... ~..~. ................... CounN Tax Map No. ,000 Secflon,,.,Z.,.~.,~,,. ..... Block ......... .~.....~... ....... Lot No. ..,~.,.~....?...?... ...... pursuant to application dated ................. ~ ~..~.,~,~¢;~,,,,, 19.. ,~,..~and approved byihe Building Inspector. .... Rev. 6/30/80 ullding ~'" 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/t0 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 '~pre-existing" land uses: i. 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 Buildinm - $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 Date ..... · / ~ew Construction ........... Old Or Pre-existing Buitdin~..~..fl .... ~j~ tT Location of Property .... ~.~0o~..~ ...... f..~'~.~..~ .... ~ ........... House No. ~reet ~ t Hamlet County Tax Map No 1000, Section .... ~. ........ Block ................ Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No..a~.~.~.~...Date Of Per'it ................ Applicant.... .......................... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~.. ...... Fee Submitted: $. ~. .... ,- ... ~ ~/,~ ..... . .............. REPORT DAT~ COHMENT$ F lEI.~= I ,=~_PEC_ ~ON ~ = FO[INDAT ION (IS'I') FOUNDATION (2ND) ROIJGII FRAME & P[oUHBIN~ [NSUI.ATION PER N. Y. STATE ENERGY CODE il¸ ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ~JLATION [~"] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR Disapproved a/c ................... (,~ ~. --..5 ..... // (Buildino Inspector) t' - JI(PP~IcATIoN FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 BOAgD OF HEALTH 3 SKTS OF ?LANS CIIECK~ ................... SEPTIC F O R.~! CALL MAIL TO: Date ................... 19.. INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with: sets 6f 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 street 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 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 Occupanc~ 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 th- Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and t, admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 6325..P.~¢onic. BAY.. Bl.v.d,, L~ur e£.,.NY. 2.X948.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Owner Name of owner of premises . . . .B.e.t.t.y.. Cuccurul 1 o (as on the tax roll or latest deed) If applicant is a corporation, signature of duly auth~orized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................. 6325 Peconic Bay Boulevard Laurel House Number Street Hamlet County Tax Map No. 1000 Section .... .1.2.6.-.0.9 .......Block 10.00 Lot 23.001 Subdivision ..................................... Filed Ivlap No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... S. ~ .ng.l.o..¥iaim. J,~y..R.e.s..~ .d.o.n.q .e .................................... b. Intended use and occupancy Single Family Residence 3. Nature of work (check which applicable): New Building Addition ........ Alteration ......... Repair Removal ......... Demolition Other Work New Deck · (Description) 4. Estimated Cost..$.5. t 9.o.o... ............................ Fee ..................................... (to he paid on filing this application) 5. If dwelling, number of dwelling units . 9.n.e. ,...E.x.%~.t). :. Number o f dwelling units on each floo/ N/A · If garage, number of cars N/A · 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front... ~ O.' ......... Rear ....6.O.' ........ Depth ...6.0. '. ........ Height 1 6 ' . Number of Stories One Dimensions of same structure with alterations or additions: Front ..... 6.0. ~ ......... Rear ...... 6.Q '. ......... Depth .... 7. 5. ! ............... Height ....... t..6.' ............ Number of Stories ....... 9.n.e. .......... 8. Dimensions of' entire new construction: Front .... hI/k ....... Rear ... 29.'.-~ 2 ['. .... Depth . 2.9.: ~- 0:'. ...... Height . .1.',-r 6 Y. ....... Number of Stories .... ~[k ................................................ 9. Size of lot: Front ....1.3.9.:9.? ............ Rear .... 1.¢.6...9.3. ........... Depth .... 2,5. Q:.0.9. ........... I0. Date of Purchase Aprilt 1992 .................. · ......... Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated.. R-40 12. Does proposed construction violate any zoning law, ordinance or regulation: .... N.Q ....................... ~ 13. Will lot be regraded ...N.O. ....................... Will excess f'dl be removed from premises: Yes ~o i4. Name of Owner of premises . .~.e.~.g. 7..C.u. qc..u.r.u.:l:l. 9Address .6.3..2.5..P.a. 9 :.B.a.y...B.1.0Phone No..5.1.6. .2..9.8.-~4.~..By... Name of Architect ...... ~.a..r.lc..I~.c..K??. ......... Address 615 Knollwood Lnph~n~r~ 516 298-9651 Name of Contractor .?9..B.a.. p.e.~.e..r.m.i.n.e..d ...... Address ................... Matt,_tuck,NY rnone"- v4o." ' ........... , : ' ' i5. Is this property within 300 feet of a tidal wetland? *Yes ........ No..X. ...... ~ · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. On Separate Shee5 STATE OF NEW YORK, S.S COUNTY OF .S..u.f.f.q~..k ........ .......... ,..B.e. ~.ty..C.u..c.c.u.r.u..1.1p. .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. Owner te is the ......................................................................................... (Contractor, agent, corporate officer, etc.) ff said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this ............. ~ .... day of...~. ~.~. ~,' ....... 19 .?.'~ County No, 52-8125850, Suffolk, Term Expires October 31, (Signature of applicant; ITl F. UT ~4 ~W ~J IA I