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Home My WebLink About22201-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 8outhold, N.Y. CERTIFICATE OF O(::CUF, AI~C~i~ No Z-23150 Date AUGUST 9, 1994 THIS CERTIFIES that the buildin~ Location of Property 815 STEI~LING ROAD House No. County Tax Map No. 1000 Section 104 Subdivision ADDITION UuTCHO~UE, N.Y. Street Hamlet Block I Lot 28 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated J~LY 1, 1994 .pursuant to which Building Permit No. 22201-Z dated JULY 22, 1994 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 OWE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 WILLIAM & ANN PISA RELLI N/A N/A N/A FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N-° 22201 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ................................ ~ .......................... Permission Is hereby granted to: ...................................... ..~ ............ ~ ............ ~ ....... to.....~.~..~..~.~.c~... ...... ~....~.~..~/..< ......... ,~..~.~.::~....z...o.~..,..~,,, ...~ ............ ~...'~..,..~.~.~ ......... ~.~../.~ ........ ~~.~. ....................... ............................................... ~.~ ./...¢~..~..F..~ ........... ~.~...~ ................................. Oo,,~,ToxMapNo. ~000 Seo,o~....../....O..~ ..... ~,oo~ ........ ,,/. .............. ~ot No. .. .2.... .2.. ................ pursuanttO applloation dated .................. ..'~......~....g..~....../. ........... 1 9...~....(:/.. ..... and approved bythe Building inspector. Fee $..,,~,,,,-~.,,...,,~',, ..... ..... .................... ~;]i~'~'A~' ~;;'~'~;;~;;;/ ..... 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 accur&te 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 Upre-existing" land uses: 1. Accurate s~rvey 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling~ Alterations to dwelling $25.00, Swimming pool $23.00, Accessory buildi~.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Euildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ...... ~.. Old Or Pre-existing Building ................. Location of Property .... ~./.~.~ ................ .~.~..~-~..~..~./.-~..~.~ .~.~., ......... ~ .~?.?.~..~.?..~ ..... House No. Street Hamlet Onwer or Owners of Property. ~.~. ~..~./.~.~./~ ./~. .... .~../?.?. ~.~Z~f. ......................... County Tax Map No 1000, Section..//..~. ....... Block../. ............ Lot...~..~. ............... Subdivision.. ................. Filed ~..~f~ C~././~ .... ~ ..~ .... ~o~ .... ~ .............. Permit No..~. ~../...~..Date Of Permit..?.~..~..~ f'.~.... ·Applicant. ~.~..~./..~../~....~./..~,. Health Dept. Approval.' ......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ........................... ~,q~ o co ~o7.~)3 0 ................................ '" " ' ~ ......... t~utcot~c co~srtwcrtot~ smcz ~s~ CO'fC~'4~,O~ - L_ TOWN OF SOUTHOLD " E uO~M£~/r..~ . , ........ ... ,.% · ' CODE ADDTTIONAL COM~IEHTS · 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION ZND [ ] I~U~TION/ ] FRAMING [d~Jr FINAL EMAR · ~ DATE ~//~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUN_DATION :)ND [ ] INSULATION [~F~MING [ ] FINAL BUILDING DEPT. NSPECTION [~/]/FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS DATE INSPECTOR i BUILDING DEPARTMENT TOWN HALL TOW~LnD~G~ i $OUTHOLD, N.Y. 11971 TOWN(~'~'T~OLD ~_j ¢C/' TEL.: 765-1802 Examined 2~-- 19 ( ,,in~a..J..a4.¥.ZZ.,~ ... Approved.· ~..2..~·.., 19 ?.~Permit No...~..~.?..1~. t. '~ Disapproved a/c ' APP.,CATION FOR BUILDING'PERMIT B~ARD OF HEALTH ......... 3 SETS OF PLANS SURVEY CHECK ................. SEPTIC FORH ....... '"'" INSTRUCTIONS 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 sh~wing location of lot and of buildings on premises, relationship to adjoining premises or public st?eets ~r 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 permit 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 Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 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 admit authorized inspectors on premises and in b~ilding for necessary ins~/~.~M~.~ .'gSf/~./ff/'~/' '.v.'r. . .-,-~.. -.c..r...¢¢~.... - ...... -- (Signatur9 of applicant, or name, if a corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder. .............. O~£../¢. ......... ' ............................................................. Name of owner of premises .................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.' ................... Plumber's License No ......................... Electrician's Licensc No ...... : .............. :. Other Trade's License No ...................... OOOUPABO¥ OR USE UN }?FUL WITHOUT CEgEIFIOATE OF OOOU?A:CY '. 1. Location of land on which proposed work will be done ................................. : ................ · ....... J'. .......... ................ : ....... . House Nmnber Street Hamlet Cotmty Tax Map No. 1000 Section-...: ~/..t~..~. ........ Block ' Subdivision...~.4~,~[~... J~..~..~. .............. Filed Map No ............. Lot./..~.~ ........ (Name) 2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .......................................... b. Intended use and occupancy ............. ~ ~ .'h. .3. Nature of work (check which al~plicable, ........ ' :' - - ~ Repair ............. Removal .............. Demolition ..... : .... ih' ..... Ot eiWork .......... . o~,. escr on 4. Estimated Cost · · · Fee .~. ~'. : 2 (to be paid on filing this appli6ation) 5. If dwelling, number of dwelling Umts Number f dwelhng units on each fl'oor: ... ..... Ifgarage, numberofcars J Z'. '" ....... 6. If business, c°mmercialormixedoccupaney, specify.!~.tureandextentof,eachtypeofuse .:..~2~.. 7. Dimensions of existing structurels if any' Front ~f~ r,~ ~ .... g""~/>.7 ~. .% ..... ;~ ......... "~"[ ............... rqumber of Stories t' 7.7_.., · · · ~Dimensions of_~a_m.e s_tructure with alterations or additions. Front C5..~'_'~' . ~,~ Dimensions of entire new construction. Front ~.'~/O ,t ,, ., .-., .q .~ . .~ · ..~ ,/ .... 10. ~ate orrurcnase ..... *.. I. ~t;~.7 ............ ,~Name of Former Owner ./~..T. .~g/_.q r ....... 11. ~one or use district in which premises are situated., fZ.~-~/~.co/~'/~F ..... : ...... 12. Does proposed construction v. ml~te any zomng law, ordinance or regulation: .~ .(~. ........................ 13. Will 16t be regraded .... //~. '~), ] ......... ,.> ..... ~.~, Will excess fill be removed from nremises: Yes mame otcontractor .... .... ,4G..%,t.. Address ',- -- ' ' · .... 15. J..s tn~.s property w~_th~.n ~00 feet of a t~.da.t wetland? ~Yes ........ No.."'"' .... · *If yes, Southold ~own Trustees Permit may be required. ' ~ .... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block nu ber or descnphon according to deed, and show street names and indicate whether interior or corner lot. [35 APPROVED AS IIOTED NOTIFY BUILDING DEPA~,'/')~/IENT AT 765-1802 9 AM TO 4 F/~ FOR THE. FOLLOWING INSPECTIONS: I. FOUNDA¥tON TWO STATE OF NEW YORK. S' S ......... "~ff~z/'~ff4//". '.~(~' '//"~' '~'~' ............... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. J ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly~aut~ofized to perfom or have perfomed the said work and to m~e ~d file this application; that all Statements contained h this·application are true to the best of his knowledge and belief; and that the work w~l' be perfomed in the manner set forth in the application filed therewith. ' Sworn to before me this ~ NO~ARY~[I~'~, ' (Signature of a licit