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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22186 Date MARCH 9, 1993
THIS CERTIFIES that the building REPAIR
Location of Property 320 BUNNY LANE NEW SUFFOLK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block 6 Lot 28.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 1 1993 _pursuant to which
Building Permit No. 21254-Z dated MARCH 3, 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 REPAIR 16'x16' DECK ADDITION ON EXISTING ONE FAMILY DWELLING
The certificate is issued to MICHELE YOZZO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
yBuilaing Inspector
Rev. 1/81
FORK NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NW9 21254 Z Date .:P/3 19.9..3
Permission is hereby granted to
to f . . t`
rn.......
at premises located at ....c s~tl~l7
f.~....~- ...t
f
.
County Tax Map No. 1000 Section 147....... Block & Lot No.... - i
f pursuant to application dated cv../ 19...r~.., and approved by the
Building Inspector.
Fee S•••/u1,~j.
f
i WI
dr
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT IJ~U
TOWN HALL
1993
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 requirements.
33. 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
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 .0 G~ 7.°j
.
New Construction........... Old Or Pre-existing Building..X
Location of Property:..~ZQ BANNY. L.ANE............... N.EW.SDF.F.OLK.......
House No. Street Hamlet
Onwer or owners of Property..... LOXG.ISLAND.SAV.IN&S..BANK
County Tax Map No 1000, Section ...U 7 Block 6.......... Lot..2.8.2
Subdivision..NFX M FF U . ........................Filed Map..X......... Lot.X.....................
Permit No~.... Date Of Permit. v',/......Applicant..BA~RS.M•..G~~.KQQGY:..R:A:
Health Dept. Approval ..........................Underwriters Approval Planning Board Approval
e~.~aa+z..
Request for: Temporary Certificate........... Final Cert c X.`Y;/? I
It
Z
Fee Submitted:
Q,~c:4 Go~C7
`Q a I PLICA T
11_. L17 I::~': •..1J:i ~~U Crfi•1 L N Tf 1~Y
-a o
H
FOUNDATION (1st) VI y
FOUNDATION (2nd)
;OUCH FRAME &
.PLUMBING
H
INSULATION PER N. Y. 'V
STATE ENERGY
CODs
FILIAL
ADDITIONAL COMMENTS:
M
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H
JAMES M. GILHOOLY, R.A. [L[EUTEM 0)[FUR ~]vMMOML
ARCHITECT
390 Plandome Road
MANHASSET, NEW YORK 11030 DATE
(516) 365.4177 l ATTENTION
TO "rowQ ter- ~QVT~sa~ ne ~ZC>
~VI L' I _jGT p l~'r M 1~1 T
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~rc~x.~'-rNc7c.~ I-~?~'- l (r-1~7 I
~r641 76-~'* - IOC)
> WE ARE SENDING YOU "Attached ? Under separate cover via the following items:
? Shop drawings ? Prints ? Plans ? Samples ? Specifications
? Copy of letter ? Change order ?
COPIES DATE NO. DESCRIPTION
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THESE ARE TRANSMITTED as checked below:
? For approval ? Approved as submitted ? Resubmit copies for approval
? For your use ? Approved as noted ? Submit copies for distribution
> ? As requested ? Returned for corrections ? Return corrected prints
? For review and comment ?
i ? FOR BIDS DUE 19 ? PRINTS RETURNED AFTER LOAN TO US
REMARKS
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COPY TO
> 40%Pre-consumer content •tort, POST-consumer convent SIGNED:rI`-~`'e~~~
VPOWtl1d0.2 ®IZ, CMm, AY¢ ON/1 if eaOosures are not as noted, kindly notify us-at once.
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BOARD OF HEALTH
FORMNO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
11993 BUILDING DEPARTMENT CIICCF
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765.1802 t.07I FY ;
Examined 19 ~3 MAIL
MAIL T0:
Approved c' 1911? Permit No. a/oZ5 _ .
Disapproved a/c .
- ....fem..' '
(B ilding ctor)
APPLICATION FOR BUILDING PERMIT
Y .
Date ....................L2..
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 street
..)r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl
ration.
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,
;hall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issua f a Building Permit pursuant to th(
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, ther applicable Laws, Ordinances o:
2egulations, for the construction of buildings, additions or alterations, or fo em I or demolition, as herein described
fhe applicant agrees to comply with all applicable laws, ordinances, building de sing code, and regulations, and tc
admit authorized inspectors on premises and in building for necessary inspections.
(Signat~t;edo an ?r p8W~ if a corporation)
MANNA.. r.P11.N`llltt...1103.0............
(Mailing address of applicant)
State whether applicant is owner, lessee, agen( architect ngineer, general contractor, electrician, plumber or builder.
JAMES M...AJ.LIiOULYt,R; A..................................................
Jame of owner of premises LONG; ISLAND SAVINGS, BANK
(as on the tax roll or latest deed)
f applicant is a corporation, signature of duly authorized officer.
CARL THOMAS,, PROPERTY MANAGER
(Name and title of corporate officer)
Builder's License No
Plumber's License No • • •
T
Electrician's License No. u' r
Other Trade's License No . . .
Location of land on which proposed work will be done .
320 :,BUNNY LANE.......... NEW SUFFOLK
Ilouse Number Street Hamlet
County Tax Map No. 1000 Section , ,117 Block 6........... Lot , , 282
Subdivision NFW. UFF V Filed Ma No. X K
(Name] P Lot .
State existing use and occupancy of premises and intended use and occupancy Of proposed construction:
a. Existing use and occupancy.....1,FAM.I.LT. DETACHED.
.
. FRA k QWF~.4IN6
.
b. Intended use and occupancy ,FAMILY DWELL iNG WITH ,REAR DECK„
. 1
'3. Nature of work (check which appli"cable): New Building Addition . Alteration
Repair , Rempval Demolition `
* MAINTAIN EXISTIING REAR DECK Other Work..X.:`.... o*q)
$1, 600.00 (Descripti
4. Estimated Cost .$.5.0..00
(to be paid on filing this application)
5. If dwelling, number of dwellin (units Number of dwelling units on each floor ..1
If garage, number of cars . Nl...
6, If business, commercial or mixed occupancy, specify nature and extent of each type of use NIA ,
7, Dimensions of existing structure'is, irfof any: Stories •.Front... .
~~rrRea
Depth .
Height Numbe.....I .1. t;.I.QRY. A~l~
Dimensions of same structure with alterations or additions: Front .16: X16 : DECK . AT'Rea AR' ' • , • • ' • • ' ' •
Depth Height , Number of Stories . .
8. Dimensions of entire new construction: Front , ear • • . . • . . ' . . . .
Height . Number of Stories • . . . • • . . ' ' • ' ' ' . • Depth .
9. Size of lot: Front ..10,0 . Rear .1.QQ'. .
10. Date of Purchase Depth ...199,.,9,
Name of Former Owner •
11. Zone or use district in which preen' Ises ern, situated . , , . • . • • • , • . ' ' ' ' ' ' '
12. Does proposed construction violate any zoning law, ordinance or regulation: . NQ .
13. Will lot be regraded Nja
p W ` .$Arr~~ ll excess fill be removed frott~,gr~~p+;e
14. Name of Owner of remises DNr•JSW0V N$,' tthess ?01 Q40 AQURY R40. CSI c~tid 1Vo (51f )547;2kt2,
Name of Architect JAMES. M.. WHOOl.Y,., R,A,• 4 , . , , Address39A..49NQQMR RDt .MANN tb No. (~w. 4 ~'i .
Name of Contractor . Address . , , , , , Phone No..... , .
13. Is this property within 300 feet of a tidal wetland? *yes,, " " " '
*If yes, Southold Town Trustees Peralit tally be required. " Nc.X
PLOT DIAGRAM
Locate clearly and distinctly all buildings,'twhether existing or proposed, and, indicate all setback dimensions 4n
property lines. Give street and block number or description according to deed, and show street names and indicate when#i.
interior or corner lot.
9
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TATE OF NEW YORK, S.S
ouNTY on JAMES,~I. G~LHOOi;Y,, ,R•~A• •
being duly sworn, deposes and snys,that he is the applicant
(Name of individual signing'contract)i
)ove named.
ols tile . .9RQHkTTC.T
(Contractor, agent; corporate officer, etc.)
`said owner or owners, and is duly authorized to or hao ve
perform performed the said work and to make and file this
~phcation; that all statements contained in this application are true to the best of his knowledgc'und belief; and that the
aEk will be performed in the manner set forth in the application tiled thebcwith.
vorn to before me this
. .............~i n .day of , . I~w,l . 19
?'tary Public, ~/ltli.....
TYRONE unty
gENl5 T TYRONE McGF ~Yurk '
Notary Public, State Of New,
N
ouslifiea in Nassau Counw ...(Signature of applican d)
Commission Expires April 19
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
REMARKS:
DATE INSPECTOR
!DYED AS NOTED
P R AS NOTE ~Y1 B.P.# 2 S~ 1. A CONSTRUCTION WORK PERMIT SHALL BE OBTAINED
DATE` B.P.#c1
FEE: BY: 13 PRIOR TO START OF ANY WORK.
NOTIFY DEPARTpp 785-1802 9 AM TO 4 PM 1 Di DEPART AT 2. CONTRACTOR SHALL HAVE ON FILE WITH THE AM TO 4 PM OR THE BUILDING DEPARTMENT ALL NECESSARY CERTIFICATES V
FOLLOWING INSPECTIONS: INSPECTIONS: OF INSURANCE.
1. FOUNDATION' - TNIC R I()N - TNIOREOUIRED 3. ALL MATERIALS, ASSEMBLIES, CONSTRUCTION AND
FOR POURF D CONCRETE K DCONCREI'E EQUIPMENT SHALL CONFORM TO N.Y.S. BUILDING
2 ROUGH - FRAMING & PL FRAMING & PLUMBING CODES. TN 4. CONTRACTOR SHALL INSPECT THE SITE AND SHALL
3 INSULATION 4. FINAL - CONSTRUCTI( CONSTRUCTION MLIST VERIFY ALL EXISTING CONDITIONS AND DIMENSIONS
~T BE COMPLETE FOR C.U. LET[ FOR C.O. •PRIOR TO SIGNING OF CONTRACT. ANY DISCREPANCIES
ALL CONSTRUCTION A! RUCTION SHALL MEET SHALL BE REPORTED TO THE ARCHITECT OF RECORD
jclL~-rI -IG1 THE REQUIREMENTS OF IEMENTS OF THE N.Y. PRIOR TO COMMENCEMENT OF THE WORK, OR THE
C ~1~L-N F.JG STATE CONSTRUCTION & STRUCTION & ENERGY CONTRACTOR WILL BE RESPONSIBLE FOR SAME. )T RESPONSIBLE FOR 5. ALL WORK SHALL CONFORM TO THE NEW YORK STATE
'V5441-ir-W ~.JQ CODES. NOT RESPONSIB (2pI LiI N U DESIGN OR CONSTRUCTION 'ONSTRUCTION ERRORS BUILDING LAWS.
6. CONSTRUCTION SHALL BE PERFORMED IN A MANNER THAT
WILL PROTECT THE WORKMEN, THE PUBLIC, AND
` j ' Ili II ADJOINING PROPERTY OWNERS FROM INJURY.
5 7. ALL SURFACES SHALL BE PATCHED AND REPAIRED AS
REQUIRED WHERE THE WORK HAS CAUSED DAMAGE.
8. ALL PLUMBING WORK SHALL CONFORM TO THE N.Y.S.
c,Caj BBL i/F pn 'a I'C 8 -4a l j ~l PeG~ PLUMBING CODE. 9. ALL PLUMBING WORK SHALL BE DONE BY A LICENSED
PLUMBER.
u+'~ til 10. ALL ELECTRICAL WORK SHALL BE DONE BY A LICENSED
L~J ~t k~ ELECTRICIAN.
~ I$~"6" I j ~;rilY 9 a_Ef"OIj ~ta~oq-a a~~•~ 'c+T 11. CONTRACTOR SHALL OBTAIN ALL CERTIFICATES OF
aaY- v&'6 Nero N ~ob~l c 6-kj'EG COMPLETION FOR ALL WORK PERFORMED.
P° am I,~'en 12. TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE PLANS HAVE BEEN PREPARED IN COMPLIANCE WITH
THE NEW YORK STATE ENERGY CONSERVATION CODE.
13. ARCHITECT HAS NOT BEEN RETAINED FOR SUPERVISION
OF CONSTRUCTION.
14. AT LEAST ONE SINGLE STATION SMOKE DETECTING ALARM
DEVICE, INSTALLED IN CONFORMITY WITH SECTION 1060.10, SHALL BE PROVIDED ADJACENT TO SLEEPING
SPACES ON EACH FLOOR LEVEL AND SHALL BE LOCATED
ON OR NEAR THE CEILING.
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