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Home My WebLink About20070-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 2outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z20154 Date AUGUST 16, 1991 THIS CERTIFIES that the building Location of Propert~ 580 KOUROS ROAD House No. County Tax Map No. 1000 Section 117 Subdivision ADDITION NEW SUFFOLK Block 6 Filed Map No. Street Hamlet Lot 19.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 31, 1991 pursuant to which Building Permit No. 20070Z dated AUGUST 8, 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 DECK ADDITION AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 SALVATORE & ANGELINA CARIDI Building I~pector FO~,M NO. ~ TOW~ O~ $OU~OLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT cOMPLETION OF THE WORK AUTHORIZED) N~ 20070 Z Permission is hereby granted to:~ -- .......... .,.. ..... "*' . ' ........ Z~o ...... ;P ......................... ~"7 .............................................. at premises located at ....................... .~....~~:.....~.'~.~(. ................................................. County Tox Mop No. 1000 Section ..... .//....~.. ...... Block ........ .~... ......... Lot No.../....~./....Z. .... pursuont to application doted ....... ..~.../.....~..L. ................................. , 19...?Z, and approved by the Building inspector. Fee $.~.'..~..~ Rev. 6130/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN l~LL 765-1802 A2PLICATIoN FOR CERTIFICATE OFioccUPANCY \. This application mugt 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 ali 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 C~pliance from archizect or engineer responsible for the building. 6. Submi~ 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 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 $25~g0, Alterations to dwelliog $25.00, Swimming pool $25.00, Accessory building ~ 5.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Build5ng - $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 ......... ......................... ' ,' - 's'ing Builfling ................ House No. Street Hamle~ ' ewer or Owners of Property..~.~. ........ ..... ., .............. ,unty Tek Map No 1000, Section .... ~.?. ..... Block ....... ~.~. ..... Lot...;~ ...... ~bdivision ................ ''' · ................ Filed Map ............ Lot ........... :rmit No .... ate Of Permit ....... pplicant. . ... 'alth Dept Approval ' · ' ......... Underwriters Approval arming Board Approval quest for: Temporary Certificate .... ../...' ~ ....... Final Certicate.. e Submitted: $.. .,..~'~ .... ................ APPLICANT ........... ?'.hELD .... ,, r .... ~, {{Dh ~ r~ ~, OHO4 £/qT ~ FOUI~DATION FOUNDATION ROUGH FRAME & (1st) PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE FINAL ADDITIO~IA'L COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. REMARKS: FOUNDATION 2ND [ ] INSULATION FRAMING FORM NO. 1 TOWN OF SOUTHOLD JUt 3' I ~ ' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ......... 19 .~/../., , .... Disapproved a/c ..................................... APP~0~Eb AS NOTED ... ......... ~ ./ ~ 7~5-1802 9 AM ~ 4 PM FOR TH~ppLiCATiON FOR BUILDING PERMIT FOLLOWING INSPECTIONS: t. FOUNDATION 'IWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING INSTRUCTIONS 3. INSULATIO~ BOARD OF HEALTiI ......... 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC P 0 R,~! .............. ..... .7.4.d.. .~'... n ¢.g.~..q. .... H^IL TO: Date " 19. , a.4. ltlI[~tapp-lic~l~'~CWo~bS/l~tli~tely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of l~r~lCth~ ~ OlOn to scale. Fee according to schedule. b~. t-~l~t'l~lt{~ll~ l~h~td~n ~ and of build,As on premises, relationship to adjoining premises or pubic streets Br a~ a~~[~l~ ~i~ti~n of layout of property must be drawn on the diagram which is pa~ of this catio~ATE CONSTRUCTION & ENERGY cU ,:'~[}.~g},~gF~[~e~ion may not be commenced be'fore issu~ce of Bugding Permit. ~~~~, the Building Inspector will issued a BufldNg Pemit to the apphcant. 'Such pemit shal be kegt on.Ihe_prmi~S av~spection throughout the work. e. ~0 building shall b,~, occupied or used in whole or in p~t for any purpose whatever until a CeNificate of Occup~cy hall h~-~p~n ~[fl U~ ~y[?~7~~ e c t o r. AP~~I~ ~X~ the BulldOg Dep~ment for the issuance of a B~Iding Pemit pumuant to the Buildid~'~b~/~[~:Town of Southold, Suffolk County, New York, ~d other applicable ~ws Ord~ces or r~e ~p~n~tt~?,~lE~Svith ~n applicable ~aws, ordinances, b.~ding ~od~, ~o.si.g ~ode, ~d ~eg.~atio~, ~d to a,m, ,or ins ctio. . 4. FINAL OA'~NSTRUCTtON MUST ~ COMPLETE FOR C.O. ALL CONSTRUCTION SHAt. L MEET THE REQUIREMENTS OF THE N.Y. S'IATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State ~[8~'Oa~l~'8~Ce'Ig~lv~FJ[~J~ agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tw/t rolYor latest deed) If applicant isa corporation, ~ignature of duly authorized officer. .............................................. OCCuPgNoy OR (Name and title of corporate officer) .uitde,'s'.icen* No. ¢ .C. USE IS UNLA W?UL Plumber's License No ......................... [~¢ITt~OUT Electric'an s License No ....................... OFOCCUPANcy Other Trade's License No ...................... ' 1. Location of land on which proposed work will be done ......................... ; ....................... '. House Number Street Hamlet County Tax Map No. 1000 Section ...... /./...-). ...... Block ......... ~ ....... Lot ...... /. ~.0.ff ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . D/LJ~rr_ ....~./3~/~/~...k/ .~. LO b. Intended use and occupancy ....... ~-~..0...r'f2. ~- /-A).r..~..ITl ~..~.. ~.Q .~ 'O~-~'~.. 3. Nature of work (check which applicable): New Building .......... Addition ....../~.... ·Alteration' ~ ": '''~ ~'.: ........ Repair .............. Removal ............. Demolition .............. Other Work ............... / ~.> ~ . {~g ~ (~.escription) 4. Estimated Cost . . . . .~-~-....-:7::.... .'7. z~gfO...,,..~ ..e, .......Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Din~ensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories .. 2 ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ........... Depth ...................... Height ...................... Number of Stories ........... · 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ............. ' 9. Size of lot: Front ........... . ....... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner 1 1. Zone or use district in which premises are situated .................... ' ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ':., ........... :'i ............... 13. Will lot be regraded ............................ Will excess fill be removed'from premises: Yes No 14. Name of Owner of premises .................... Address ............. ; ..... Phone No .......... ',, ..... Name of Architect ........................... Address ......... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... *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 dhnensinns from property lines. Give street and block number or descr/ptinh according to deed, and show street names and indicate whether interior or corner lot. .TATE OF NEW YORK, OUNTY OF ............ S.S ..................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contracti .......... )Ore named. is the ' (Contractor, agent, corporate officer, etc.) said owner or. owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication; that all statemants contained in this application are true to the best of his knowledge and belief; and that the ork will be perfomed in the manner set forth in the application filed therewith. yom to before me this ~k~ PUBLIC, Sine ~ ~w Y~ ' No. 4707878, Buffolk ~ ............................ T~m hpir~ March 30,19~ (Signature o[ applicant)