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Home My WebLink About20096-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20279 Date OCTOBER 16~ 1991 THIS CERTIFIES that the buildin~ Location of Property 1830 BRAY AVENUE' House No. County Tax Map No. 1000 Section 126 Subdivision ALTERATION LAUREL, N.Y. Street Block 7 Lot Filed Map No. Lot No. Hamlet 22 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13, 1991 pursuant to which Building Permit No. 20096-Z dated AUGUST 16, 1991 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 ENCLOSE EXISTING ACCESSORY SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COIFNTY DEPARTMENT OF HEALTH APPROYAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PLACID & ALETA MELISSARI N/A Rev. 1/81 -~ Building InSpector 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) Ne- 20096 Z Permission is hereby granted t~o:// .// _ , ~ ..................... .... ./..£~...o.......~.~.~.....~ ................. at premises I~ated at ..... .~.~~~.....~.~. ......................................................... ................................................. ~~ ............................................................................... County Tax Map No. 1000 Section ........ ./...~... Block ...... . .~.... .......... Lot No. pursuant to application dated '. ......... ..~./.../...~. ................................ 19....~/.., and Building Inspector. approved by the uil~l/in.~:~:tor ' Rev. 6/30/80 Form No. 6 ~PLICATION FOR CERTIFICATE 0F OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN t~LL 765-1802 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. 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 inspecg 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 I. 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 ever 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 Date ........ ~,~. /?././/./. f ~~ ~ ................. ~ew Construction ........... Old O~e-existin~ Building ............. ~... ~ ' Location of Property.../~..~.C~../..~%/...~..~ .~ ......... ..~.~ //~ Ho'use No. ~' ' J~rgg~ .... Hamle''''''''~- .......... Onwer or Owners of Property.~.~,~.~~..~?.~..~~ ................ County Tax Map No i000, Section .... /.~.'.~. .... Block ...... .~. ....... Lot ...... ].~....~. ......... PermitS u b d iv i s i°n..~.' .~.' .~.' i~.' ~.'I ij'i~'j~'~il' i i i' ' 'Filed~/~z/~ ~ ~~/Map ............ Lot .......... '~ ........... No../ a_ _ ___ . . r~. ~. ,/~/../. Ap p 1 ic antg/~.~f~.~.. ~.-7.... ~ .~.. Health Dept. Approval .......................... Underwriters Approval ......................... "l~nnzng Board Approval .................... ... . ?,eqeest for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $~, ~ ..... . .~.~...~..~%? ............... i .~~~ ~ .~.~. C 0 ~ O~ q 9 APPLICANT TOWN OF $OUTIIOLD OF[:ICE OF BUILDING IN~'PECYOR P.O. BOX 728 TOWN HALL , 'O S UTIIOLD, N.Y. 11971 OCTOBER I1, 1991 TEI~. 765-1802 PI~CID I~LISSARI ' 1830 BRAY A~NIIE LAUREL, NY 11948 To Whom This May Co,ncern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~/ An application for Certificate of Occupancy is not on file. (ENCLOSEB) /_--/ No Underwriters Certificate on file. /_~/ Thc~ check is(Y~/not on file.) $25.00 /--/ No Health Dept. Approval on file. /_--/ No final inspection has been made. Please co~tact our office on this matter. Thank you for your cooperation. Dui]ding Permit Buildimt Dept. ***/-_/ NO Plumt~er Solder Certificate on file. ( all permits involving plumbing being .issued after'April 1,19B4 ]65-1802 BUILDING DEPT. INSPECTION []FOUNDATION []FOUNDATION 2ND []FRAMING [ ] ROUGH PLBG. INSULATION, FOUNDATION ( ls t ) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL !!DATE ADDITIONAL COMMENTS: i · .~.SD'I$'IO'W. - I-.<0.0 ......... '--'89: ............................... Z-~ ........ BOAKD OF HEALTH FORM NO. 1 /~3 SETS OF PLANS BUILDING DEPAR, TMENT - ~., clll~ C K ......... TOWN HALL ~'SEPTIC FORi'l .... SOUTHOLD, N.Y. 11971 .~. h ~.~7 TEL.: 765-180;3 Examined ....... ., 19.~/._r Approved ...... 7.~2 ..... 19 ?/ermit No....~...d~.?.~.. ~ Disapproved a/c .................................... f .......... ~P~b ~.~0T~ ...... ~ ....... ~ .. _ /~ ~ 765-1802 9 AM ~ 4~M FOR T~PPLICATION FOR BU LD NG PERMIT FOLLOWING INSP~CTIONS: 1. FOUNDATION '~O REQUIRED D~te .......... , ........ ,19... FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING INSTRUCTIONS 3, INSULATION a. 4,~plica~l~y filled in by ~pewfiter or in ink and submitted to the Buildup Inspector, with 3 ets of pl~ff~[~O.to scale· Fee according to schedule. b.A~o~2~i~.~o~o~1~Tand of build~gs on premises, relationship to adjoining premises or pubic streets x* are~Oki~n~i~[~leO~e~p~ of layout of property must be drawn on the diagram which is pa~ of this appli- :ation~At~7 CO~STBUCTION & ENERGY , c. F[:~[~o~~lra~on may not be cbmmenced before issu~ce of Bu,ding Permit. d. °~:~~~e Building Inspector will issued a Building Pe~it to the applicant. Such pe~it h~l be ~t on the premis~vaflable for inspection throughout the work. e. ~'~~~d in whole or in p~t for any purpose whatever until a Certificate of Occup~cy hall hav~t:~e~a~a~t~k~h~ ~I~?tor. ~ ~,~9~the Budding Dep~ment for the issuance of a B~lding Pemit pursuant to the [~R~[~['~fiS~Routhold, Suffolk County, New York, ~d other app~cable ~ws, Ord~ces or ~p~d~gs, additions or alterations, or for removal or demolition, as here~ described. :o ~1~ ~¢~licable laws, ordinances, b~udmg code, housm code, and regulations, and to ~~0~¢ ~ build~g for necessa, inspections. lulldlng Z~n,~ {~n~ {egulatienh,~O~,me.~ BE COMPLETE FO. ALL CONSTRUCTION SHALL. MEET T~ ~mUmUENTS OF THE STATE CONSTRU~ION & ENERGY co~s..~ ~S~O~SJ~LE (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. o~,~(n pz/¢Cl/~ ~'-. /~z-/.ss 7~ ~' ( .... : ........................ Name of owner of premises .......................................................................... (as on the taxx roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. OOCOPN C¥ (Name and title o~,~.rp,ortate~o/~ficer) Builder'sLicense o ....... , .......... -./~7,,,' USE tS UN WFUL Electrician's License No ....................... Other Trade's License No ...................... Location of land on w~ propo~ed.work will be done: ~. ~. ~. ~ .................... House Number Street Hamlet co~t~ T~x ~ ~o. ~000 Sec.on ..... Z~l ....... ~o~k ..... 7 ........... ~o~...~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy 3. Nature of work (check which applicable): (~ ~w Building ...... Addition .. ~. Alteration . . Repair Removal Demolition Other Work , .' (Description) 4. Estimated Cost ...(~.O..O. ..... i ......... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling u~its ...... .~. ....... Number of dwelling units on each floor ................ If garage, number of cars 1. ] . ~6' I,,f.busin ' '"" 'I ................ ;'rYa'~ .... ~ ........... ' "~;e'" ;" ................. · .ess, co..mmercml or mixed occupancy, specify_na u. d exte t of each type'of ' t. oimenstonsotexistingstmcturesiifany: Front ...;1,/..t. ....... Rear ...~.l..f.' ...... 'Depth .................. .. ]<.~g. ........ Height ./2.." .......... Numb~er of Stories ..... I.. j~. .............. t .................... t' ........... Dimensions o,f,,satme structure wit~ alterations or additions Front ~/. ..... Rear ' ~ Depth .... /~ .............. i. Height ..... ./,2..t .......... i i i ~q'u~belof St;~;s'.'.[ .t.' i i. 8. Dimensions of entire new construbtion. Front ~,! r R~ ~ ~ ,, -- t ~- ! ' ' ' . · · .......... oar...,~t ........ tJepm . *a ..... ;. Height .../2 .......... Number of Stories .../. .......... } ............ ...... 9. Size of lot Front ' f'O' '°'~' .... i .......... Rear ... Aa. .o. .............. Depth .... 2'~' ~ ............ 10. Date of Purchase ...................... ............ i ........ ' ......... Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated ~..tT,~jD. ~.t)'~ L 13. Will lot be regraded .... Pg. ....I .................. Will excess fill be removed from premises: Yes 14. Name of Owner of premises .... i ................ Address ................... Phone No ................ Name of Architect ........... l ................ Address ................... Phone No ................ Name of Contractor .......... I ................ Address ................... Phone No ................ 15. Is this property within 3~0 feet of a tidal wetland? *Yes ........ No..~.~..... · If yes, Southold Town Trustees Permit may be required "'. I ' P~OT DIAGRAM Locate clearly and distinctly all ~uildings, whether e..xi~tiRg or proposed, and~ indicate all set-back dimensions from property lines. Give street and block ngmber or description ~c'cording to deed, and show street names and indicate whether interior or comer lot. :OUNVy .................. ~. · ~ ......... being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) ...... bove named· is the ........................... , .................................................. ~ (Contractor, agent, corporate officer, etc.) said owner or owners, ~d is duly ~uthorized to perform or have perfo~ed the said work and to m~e ~d file this pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the /ork will be perfomed in the m~ner s{ t forth in the application filed therewith. worn to before me~ .......... ~ ~bl o, State of ~ ~T0 ~ /z/, - NO. 4~7~U~ ' ~ ~ · ' ~ ................... ........................ Qualified In Surfak Cbunty ~-' (Signat~r~ of ~mmlssion Expires D~em~er 8, 19~