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Home My WebLink About21484-zFOPS4 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22409 Date JUNE 21~ 1993 THIS CERTIFIES that the buildin~ Location of Property 1345 BRIDLE LANE House No. County Tax Map No. 1000 Section 102 Subdivision ADDITION Street Block 8 Filed Map No. CUTCHOGUE ~ N.Y. Hamlet Lot 21 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 4~ 1993 pursuant to which Building Permit No. 21484-Z dated JIVNE 15~ 1993 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 APPLIED FOR The certificate is issued to THOMAS A. & CHRISTINE A. FALCO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A /~uildi~g Inspector Rev. 1/81 FOEM NO.3 TOWN OF $OUTHOLD BUtI.DtNG DEPARTMENT TOWN HALL SOUTHOLO, N.Y. NO_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ...... ~;.'~/..~ ..................................... 21484 Z / at premls at ........................ __..~,' ,4;~, ............................................................. Counlyfax Map No. 1000 Section ,,,,~.~..~......'~... ....... Block .......... ~ ..........Lot No ......... ~. ,~.. .......... j2ursuant to application dated ...... ~.i.'?..~.:~.....;,. .............................. 19 ,/.,¢4¢.... ........ Building Inspector. Fee S....¢/,~.~... and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN,HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 requirement.~. B.~ For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and i 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... !. :.R .3.. ................... .. . New'Construction ........... Old Or Pre-existing Building ................. - House No. Street ......... '~{g~''''~' ....... Onwer or Owners of Prop.erty .............. j .......... ~ ~ : ~-O County Tax Map No 1000, Section..o.....I O ~.....Block ....... ~. ........ Lot... ~ ~ Subdivision .................................... Filed Map ............ Lot .................. .. . . Permit No..~.l.~.~..~ ..... Date Of Permit...~.' ~/*5~'~'3 .Applicant..~.hO~ /Or' '~.~.0 . Health Dept. Approval ........................ .. Underwriters Approval ......................... Planning Board. Approval ..................... . Request for: Temporary Certificate ........... Final Certicate....~.. ..... Fee Submitted: $ ..... .~....~.~. ................. %;zrtb ....... : ........... yiELD FOUND~TiON ( ls t) FOUNDATION (2nd) ROUGH FRAME & ·PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~ 15. ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ .~"F*~AL REMARKS: ~ DATE INSPECTOR T/tle No, 07- 105- 047 ~ FORM NO. 1 : ~ , TOWN OF SOUTHOLD BUILDING DEPARTMENT ~' JU!'~J" [ TOWN HALL ' '," SOUTHOLD, N,Y. 11971 Disapproved a/c ' APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH /'SURV£Y .......... ../CHEc~ . .,. Date . . .~..: ............. INSTRUCTIONS ' a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 st?eets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. e. 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 building for necessary insp, tions. -- (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (L .......... ' .......... ' Name of owner of premises . ..~..~. O..'C'(~. ~ .~. .... .~..:.. ~.O~.\ .C-...O ....... .C.,. ~.~! ..~..'~3...ex...~.'....Ecs...~.c,-..,O (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 License No. Other Trade's License No ..................... Location of land on which proposed work will be done ............................................. ! .s. ......... c . '.d.I. .e._. ...... n i . . : ...... .c,. . o. . .... House Number Street Hamlet o,,n, Ta Map o.,O0OSect,on ......... Block .... f. ....... :... Subdivision ........ . ............................. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constructioh: a. Existing use and occupancy .... 0 ........................... e..9., g .................... b. Intended use and occupancy ....... k( ' 'ppli bi ) Additio ..'.~.. .3. Nature of wot check which a ca e · New Building .......... n .... Alteration ]Repair .............. Re/noval .............. Demolition .... : ......... Other Work ............... is-0o (D ripfi ) i i .... esc on 4 Estim d Co · ate st ... · · · - t~ ........................... Fee ........ ~ (to be paid on filing this application) I 5. If dwelling, number of dwelling units ..... Number of dwelling units on each floor .... If garage, number of cars .. [ ............. 6. If business, commercial or mi>~'ed occupancy, specify nature and extent of.each type of use ..................... 7. Dimensions of existing structulres' if any: Front ............... Rear .............. De th ........ lteight ............... Ntlmber of Stories ..... ]. . P .... D~mens~ons of same structure ~,vith alterations or additions Front ...... Rea'r ..... i;i~ii~i'i .... epth . . ~.. '.' ' ' ' k' ' .' ........ i ' ' ' Height ...... ;,.,.,,,: ......... ... Number of Stories. ' 8. ~m~ens~ons ot entire new construction. Front, oc ~ r~ ,O Ct r .......... ~' r ......... ~ .............. ; .,ear ...-~,. ........ Depth ./.~. ....... Height ............... Nu,?nb%of Stories ........ 9 Sizeoflot Front /.d'°Z~iT~ Rear '*S,~"P. .............................. [~l ............ · ,5-0 ~ 5~o 5 ........................ ' Depth , , I0. '.%0'%i ..... ~..°t.ff. .'~. ........ Name of F. orgnerO,wnqr .T.~.qO.c.e....4....~.c~ ?~g,'x . 1 1. restrict in which pre~nises are situated, l~..e ~ { o~e~.~../r.,_{ .... : ..... 12. Does proposed construction violate any zonin~ law ordi~,'~,',-2',-;'-~' ,' .' ;" ........ t~! ~ ...................... 14. · ...... - .................... wm excess fill be removed from premises: Yes : .N~]o. Name of Owner of premises . 'l .................. Address ................... Phone No ............ ' Name of Architect ......... ~ .................. Address ................... Phone No ............... Name of Contractor ........... Address ........... Phoneme . 15. I.s thzs property within[300 feet of a tidal wetland9 *Ye~ ' i; ./ ............. *If yes, SoutholdlTown Trustees Permit may be required. . PLOT DIAGRAM 'i Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. rATE OF NEW~,Yog~ , S S ' ....... .w? ' ' ....... ,' '~' '% '% · .' being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ......... ,: is the ..... . ................. I ................................. . (C P ffi ) .................. ' ontractor, agent, cur orate o cer, etc. said owner or owners, and is do/; authorized to perform or have performed the said work and to make and file this ,plication; that all statements conta'ined in this'application are true to the best of his knowledge and belief; and that the ,)rk will be performed in the manne~ set forth in the application filed therewith. ' '~orn to before me this ... :'.\ ~(~.~. ...... '...day of i . . .~....'--.~-~, ....... ~tary Public, , .,~:']~ ' ' ' ~ ........ x' County ' Nota~ Public, State of New York blo.,4692622- Suffolk County ?,~ (Signature of applicant) Commission Expires Nov. 30,