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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-22107 Date JANUARY 14, 1993
THIS CERTIFIES that the building ADDITIONS
Location of Property 175 FIRST STREET LAUREL, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 126 Block 10 Lot 9.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 31, 1992 pursuant to which
Building Permit No. 20930-Z dated SEPTEMBER 1, 1992
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 ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to VINCENT & MAUREEN PAPA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-259915 - DECEMBER 10, 1992
PLUMBERS CERTIFICATION DATED N/A
-/,Building Inspector
Rev. 1/81
i
FORM NO. a
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)
N°°-N° 209302 Date
Permission is hereby granted to:
~J...../~.... ...y~..
c 7OiT~a
to ...~'C2n/sT(Zu GT ..........ems! r! ?~~~.1..ne......f....!,-r--
.
7a ......~9 ..f a.v ~(Gc
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at premises located at ........................~7~/..SST...............................................................
,~~G~.......:~~%.....................................
..vl. /SET....1',........~
q
4 County Tax Map No. 1000 Section 1 p61........ Block ......la......... Lot No.
I pursuant to application dated 0 19.L and approved by the
l
Building Inspector.
1 Fee
.....JIUIng/
Ins
pector
Rev. 6/30/80
i
jr Form No. 6 MQNc(
TOWN OF SOUTHOLD,.;
BUILDING DEPARTMENT
TOWN HALL
765-1802 JAN 3
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the bpi"1i~ng
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 2110 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.'
3: 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
..°?/..L...7.~
few Construction........... Old Or Pre-exist' Building
[.acation of Property: ......................±,e Oki Q-
House N,o.n \ treetp Hamlet
)nwer or Owners of Property.. Y.,\Q,~r~PN„VJ11C2}1"X
:ounty Tax Map No 1000, Section..... ).(o Block......1. U `l
Lot.....
:ubdivi•sion
.File~/d Map............ Lot. M
'ermit No. a0_1? Date Of Permit.....././ /JR..Applicant.,.~eL,,\J~
:calth Dept. Approval ..........................Underwriters Approval.........................
Tanning Board Approval
equest for: Temperar Certificate........... Final Certicate. Y
ee Submitted: $,,,J.O~ '
.e,H~394 ..../h. .
C~
~ ~ IO^ APPLICANT '
INSPECTORS
Victor Lessard .
,r eoUFFD(,Y
Principal Building Inspector SCOTT L. HARRIS Supervisor
Curtis Horton ti
.
Senior Building Inspector y Southold Town Hall
Thomas Fisher > F T P.O. Box 1179, 53095 Main Road
Building Inspector Gary Fish ''i7D j 4 ~~"rte - Southold, 6New ) 765-1823
o 971 Fax Building Inspector v Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
JANUARY 8, 1993
FRED MILNER
870 BRAY AVENUE
R ° NY °119§2 -
RE: VINCENT & MAUREEN PAPA
To Whom This May Concern:
We are unable to complete your Certificate of occupancy
because of the following reasons:
XX_K An application for Certificate of occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
Z11g The check is not on file.) $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 20930-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
CC: VINCENT s MAUREEN PAPA
e
THE NEW YORK BOARD OF FIRE UNDERWRITERS lnhr;
1L750N3 BUREAU OF ELECTRICITY
88 JOHN STREET, NEW YORK, NEW YORK 10038
Date irmsN6N$ 10,9997 Application No. on file 78928492/92 N 259915
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the alums application number }n the premises of
VLNCIINP PAPA, 175 131' STRP:f;Tj 6AURELt N.Y,f
in thefollowing location; [N Basement L11J`.C
1st Fl. ? 2nd Ill. Section Block f1i Lot
wasexarninedon nE•,CI4Pdm 07'199,' andfound to be in compliance with the requirements of this Rdard.
FIXTURE FIXTURES RANGES COOKING DECKS'_' OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K W AMi. K.W AMT K.W AMT. H P.
u
3
I
DRYERS ti FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIMECLOCKS BELL UNIT HEATERS MSYSTEUTLET DIMMERS
AMT. K. W. OIL H P. GAS H. P. AMT NO. A. W. G AMT. AMP. AMT AMPS. TRANS. AMT H P NO. OF FEET AMT. WATTS
SERVICE DISCONNECT no. Of S E R V 1 C E
AMT. AMP. METER
TYPE L A, tW 9 SW 3 03W 3,e' 4W NO. OF CC COND. A. W G NO. OF HIAEG A HI G' NO Of NEUTRALS A W' G'
EQUIP. PER .9' OF CC.COND. OF HI 0 OF NEUTRAL
OTHER APPARATUS!
i~SQTORSt1-1.,0 I9.{?, ~
().C. I:'xtmzic rue, LtC.~3023R
1. BOX 518
LAUREL, NY, 119413 GENERAL MANAGER
9.1 l i
Per L.t
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING [ FINAL
REMARKS:
DATE T INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST. [ j ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE Q INSPECTOR
I
765-1802
BUILDING DEPT.
INSPECTION
[ ] F NDATION 1ST [ ) ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[
[ ] FRAMING [ ] FINAL
REMARKS:
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL /
REMARKS: -r 9 G~J
DATE INSPECTOR
I
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
LATION
[ ] FOUNDATION 2ND [ /FINAL
FRAMING REMARKS:
DATE INSPECTOR .t,~f
D "i;:s. 11DA ~:(i9LNiS
M OUNDATION _ (15t) a
I a O"
OUNDATION (2nd) d
OUCH FRAME & (Vii
-PLUMBING I f
0 u H
m y
:ISULATION PER N. Y.
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STATE ENERGY
t
CODE I x
. ~,i .Ins H
FINAL
ADDITIONAL COMM S: x
• .
b
H
A W
' H
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H
BOARD OF HEALTH
~t11YY ~j`q FORM NO.I e/3 SETS OF PLANS
t'lJ ~7 If 79 /S R V E Y . 92 i TOWN OF SOUTHOLD CIIECF . .
'BUILDING DEPARTMENT SEPTIC CORM
TOWN HALL
Q SOUTH OLp Lu.Y_ 2127
.~O
E/~..... TEL.: 765-1802 CA
Examined 19 9Y
qq MAIL TO:
Approved 19/.4: Permit No.AnY0
Disapproved a/c
vino Inspector)
APPLICATION FOR BUILDING PERMIT p
Date
INSTRUCTIONS
a. This application must be completely filled in by typewri ter or in ink and submitted to the Building Inspector, with
sets of plats, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoinin" premises or public strce:
or areas, and giving a detailed description of layout of property must be drawn on the diaram which is part of this appl
cation.
c. The work covered by this application may not be commenced before issuance of Building
-d- Upon approval of this application, the Building Inspector will issued a Building Permit to he applicant. Such perm: 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 Occupant.
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 alte*ations, or for removal or demolition, as herein described
Tile applicant agrees to comply with all applicable laws, ordinances, building code, housinl- code, and regulations, and tc
admit authorized inspectors on premises and in building for necessa sPe irons.
(Signature of apphean , or name, if 1d • ...bi 110
A-.--...........
17 % (M i rig address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . YJ J7(t4. ,':f; , ,1'. ctumw.....1aQo .
(as on the tax roil or latest deed)WROVM WOM ,
If applicant is a corporation, signature of duly authorized officer. DATE' ~B.P-5....,~_-
RTMENT AT
NOTIFY BUILDING DE0A
(Name and title of corporate officer) 765-1802 8 AM 4 PM FOR THE
Builder s License No_ Efs/q r FOLLOWING INSPECTIONS:
' ' ' ' ' 1. FOUNDATION TWO REQUIRED
Plumber's License No. FOR POURED CONCRETE
( 2. ROUGH - FRAMING #1 pWMBING
Electrician's License No.~,• 8. INSULATION
4, FINAL - CONSTRUCTION MUST
Other Trade's License No. BE COMPLETE FOR C.O.
• ' • • • • • • ALL CONSTRUCTION SHALL MEET
1. Location of land on which proposed work will be done; THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
~.~LAJ CODES. NOT RESPONSIBLE FOR',
ElouseNumbcr vt pRCONSTIUCTIONERRORS
Street.// Hamlet
County Tax Map No. 1000 Section Block , , , h
Lot. a ,
Subdivision Filed Map No. • . • '
_ (Name) Lot
State existing use and occupancy of premises and intended use and occupancy of proposed, construction:
A. Existing use and occupancy..... TQP :\TN
B. Intended use and op~Cupancy.. .Ll' `fit\t
i
3. Nature of work (check which applicable): New Building Addition. l • • • . • • Alteration
Repair RpmoLal Demolition 4..'...3wi nning pool.......... .
Tennis Court accessory Building Fence .......Other Work:,
4. Estimated Cost Fee .
(tn be paid on filing jhis application)
S. If dwelling, number of dwelling units Number of dwelling units on each floor , , , , , , , , ,
If garnet, number of cars . 1 . • .
6. If bus' ess, commercial or mixed, occupancy, specify nature and extent of each type of use .
` 7. Dp, nsions of existing structures, if any: Front . , . Rear ....a?:....... Depth 8 ,
Hei=lit .....(5.... Number of Stories . f, S~ar. .
Dimensions of s~a~PttcI structure with alterations or additions: Frotht .9.) . Rear . d t : ;
De th ..`:IJ . Height Number of Stories . /
for
8. Dimensions of entire new construction: Front Rear Depth
Heiglit .......V Number of Stories . i
9. Size of lot: Front . . ,~4......... Rear......SO Depth ~i°~ a•
10. Dale of Purchase , ......0.&IQ . . .Name of Foti~tcr Owner ...I A9VVA~, i pea ric
11. Zone or use district in which premises are situated ....Re~ldei .
12. Does proposed construction vi, .S any zoning law, ordinance or regulation: • • • • • • • • • . • • • • +
13: Will lot be regraded ~.S Will excess fill be removed from premises: Yes Lc
14. Name of Owner of premises $9tpa>.... Address • ft0e-r...... Phone No. aAB: d )QH.... .
Name of Architect , Address . Phone No. .
Name of Contractor tl NIAX Address . ~ . PVe.c.. . Phone No. Q0.' tl
IS-La tb.is property located within 300 feet of a Vidal wetland? *YES ....HO.jS.
*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 dimcnsior;
property lines. Give street and block number or description according to deed, and show street names and'indicate
interior or comer lot.
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,
STATE, L,NF}V~ us, t~'Kl J
COUNT F 'S
. ~'c=oft`nc iduah signi . ` ` ` • • • . • • • being duly sworn, deposes and says, that he is the applican
(N5 $ig contract)
licis't'lic Al .fttll`latak?~-
Contr .
( actor, agent, corporate officer, etc.)
of
§aiil Towner or 6wncrs,'and is duly authorized to perform or have performed the said work and to make and file the
application; that all statements con 13 tied in this application are true to the best of his knowledge and belief; and that th
work will be performed in the manner,setTorjth in the application filed therewith.
Swom to before me this MRANIE V. BROWN
/ Nalary PuN No. Oats 1 Newyork
...............day of 19 NoIn 2
~•/Qualified in Si1871UNoAt Cou~py
J U1" 1` i~ IC.. ( Comm Od. t9, is~
Notary Public , I V• y County .
U ` ' I (Signature of applicant
UNDERWRITERS REQUIRED CERTIFICATE
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"'SUFFOLK COUNTY, N.Y.
- b14 / yl ,T• • 8700 - 126 10 09 • e N 09
~"s R~ Ii,6AA~ NO APB i, SCALE 1"* 40 LID V. 14, 1986
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4 FIL[D TN( ptl/FOt.II COUNTY CLEAR OFFIC[ NRI. „M f AS Y no. 9
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