HomeMy WebLinkAbout18640-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218573 Date NOV. 17, 1989
THIS CERTIFIES that the building ACCESSORY
Location of Property 1655 PARKWAY SOUTHOLD _
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 11 Lot 19
Subdivision SOUTHWOOD Filed Map No. 2141 Lot No. 28
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOV. 14, 1989 pursuant to which
Building Permit No. 186402 dated NOV. 14, 1989
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 ACCESSORY GARAGE.
The certificate is issued to MARION & LOUIS ZILLO
(owner, xxxxxxxxxxxxxxxx)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
`
Building Inspector
Rev. 1/81
rows xo. s
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)
~.864n
N Z Date . /l./~ 19...~>..
Permission is h eby nra,.nt~e to:
..a~.. ~.G...~~(.l~..T....~~..ll.....~1
......,~.~.~....s...~~-4
........`.'~~~~,~.......~1..%~~~...........119..
s z
to .~.~;~.....e,~~
at premises locoted at ....~fP...:.~~...v`..~......~~~~
Q,,~..G~Cr..C'~~~...........................................................
County Tax Map No. 1000 Section .........,.r...21........ Block ..........ll..... Lot No........~~
pursuant to application doted 19.CJJ.., and approved by the
Building Inspector.
Fee s.a,3.
Ate... ~c
Build for
Rev. 6/30/80
T047N OP SOUTIIOLD
BUILDING DEPARTMENT
TONN HALL
SOUTIIOLD, NE41 YORK 11971 ~j
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPAtlCY //'Q
DATE..I.~_/~~/~•/
NEH CONSTRUCTION ......./OLD OR PRE-E%ISTING BUILDING...._.VACANT LAND........
Location of Property..,~~~~,,,,,_,_____~,~~{~~/-}y..._.. .~~u/~~/~~
HOUSE NO.
/ STREET HAMLET
Owner or Owners of Propcrty..~/.~_dry/"/r-h. 1~--dL(ls ~/1_~,~ c~
County Taz Map No. 1000 Section ../o . Block ~f.... Lot'..%.....
~ll
Subdivision. J~uT~~~~~,,,,_,,,,, Filed Map .~~~~,.Lot...°.2~.,_,
Permit No. ........_.Date of Permit .._.......Applicant
Health Dept. Approval Underwriters Approval..._.._....._. 'i
Planning Board Approval
Request for Temporary Certificate
Final Certificate
Fee Submitted:
APPLICANTt_/_ ~;~c~i,(, . `~a L-~~Q/
(7
3 8~ aG
C 0 z r ~s" ?-3 '
~r/~ d/~y
'ev. 10/ 14/88
1
FORM N0. 6
TOWN OF SOUTIIOLD
BIIILDING DEPARTMENT
TOWN HALL
ii 765 - 1802 <
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
p, This application must be filed in typewriter OR ink and submitted Co the Building
Inspector with Che folloc~ing; for new buildings or new use:
1. Final survey of property with accurate Location of all buildings, property lines,
- streets, and unusual ~jatural or topographic features.
2. Final approval of 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 lumber certifying that solder used in system contains less
than 2/10 of 1Z lead.
5. Commercial buildings,'~,industrial buildings, multiple residences and similar,
buildings and installations, a certificate of code compliance from the Architect
or Engineer responsible for the building.
6. Submit Planning Board~ilApproval of completed site plan requirements.
B. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" land Vises:
I. Accurate survey of property showing all property lines, streets, buildings and
unusual natural or topographic features.
2. A properly completed pplication, a consent Co inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
' show single and separ~Ce ownership of the entire lot prior to April 9, 1957.
If a Certificate of Occcupancy is denied, the Building Inspector shall state the
reasons therefor in vFiting to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information'irequired to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1. An application for valicant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership ofi the entire lot prior to April 9, 1957 shall also accompany
the application. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
1. CERTIFICATE OF OCCUPANCY - New Duelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Acce~sory buildings, $25.00 - Businesses $50.00.
2. Certificate of Oacupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Cnrtificgte of Occupancy - $50.00
6. Temporary Certif}care of Occupancy - $25.00 Residential
$50.00 Commercial
I'
I
cv. 10/14/S$ i
~n n.vh{E~~mw«~. tea,: - FE 9,€~Fe gn+4rfF~+$ "3s!4n^'wew°.^z~;-wac. ~-gY'"Yn49lz+~,. m~~c~
, t .4~ € c k 'ba .'_1 1
~ IJ G' ~a~ 1 ~t^~
~ ~ - ~ y~
` i ` ~ .ih;. ~ ~ ~y r ~ W,~ ,5
1. U f `9. 4 , 1~L ~ .
C 5
. r
a ~ x I ~
} 1, i t T
xr ~ [t
. ~ (,k
~ ' ~
, S , t?~i J 4 ~S _
jR
f N-
..'S 4
~ ,
l *(m
it ~ 4 S 1.!".
3
~ 4
> 1 r PF"~' ~ i ~"isZ 5.' v
~ F ~ S - .~L
J tk~ i 1 ) li. t. J ~ 't 1• W..3 r ` N
+f ~i
.!~i _ ~ ~ ~~~k~ l' ~~t L 1
y Z 1 y rd' t, i, ~
eY
~ . x f:~L s -a f ~ ~
I ~ kA r t F~a ~'b
1 ~„VL. a~ E P 6 t.
~ ~ ~ ~ k
yam, ~H~dSAB.dLS ~fl e~ i a x ~~f,r°~.
• Phi' ~Y x?b~~\
(P( ~ f 1,+ac+++iWQ~ _ ~ ~Nl`. .t {'{i 644{~?4'~
~Ny ~ ~r r(r3 o ,^13}e ~ Mh7^T ~
t~ ~ m i j
}Q~~ fq .ryy~}~ d Y iy•~a+a~.~. F
• • ~ * ~'tMfR f 9 i 1 ~ f"' ~ }S i ~yt li7i~
' APL 3~ ~ 19~' t~' T
. ~ i "fib ~ ~i 'LrA3~
rAVl41.ANH'4COM Ql ~..g 1 : f'In~~D~ k-~~~^~~, x ~''y ~ y~^t^~''{s~`~4v
ti03~717JQ7 Ol tY'El£
.r ~ 1/ " ~f ' ~
fi !q 1aa~1'4
" s ~1 lc 5n 3~y~~t~ 1
~ ~ f" ~~~~fiV!!, 1.1ei'.xy,.
to <
r: ~ j" , ~ "
t ~ ~'y*
t t ~ r
u ~1 }j
q• .1. d+l did Q~f~§3 s.X
A S >M
. _ ~ 'd,^:. x6:' _ J. o ..._,e , r. v.w a.fc,~i.~dn .`x a-..ro_,n " ~~fAf' i~;~
,-a.Y4 tlY^L.~YSY-mss nl
~d. 1
~ ~
BOr1RD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORN
c TOWN HALL Q~~-~1--~_ ~
.,OUTHOLD, N.Y. 11971 NOTIFY
- TEL.: 765-1802 CALL . v~l~: ~.~.3`~ .
Examined .l/ 19~ MAIL T0: ~
Approved , 1901. Permit No.,l.4 ~
Disapproved a/c r~ L~'i V" ~ tJ \J 15
c%'.. ~ i AID
(Bt' ding Inspector) BL,D~. DEPT.
tOWN OF SOUIHOLD
APPL CATI N FOR BUILDING PERMIT
Date 15 .
- ~ 1F~/~~.3
INSTRUCTIONS ~1/
a. Tltis application must be completely filled in by typewriter or in ink and submitted to ~he Bui ding Inspector, w~~i't1h 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 streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of t]ris 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 Ceriiclcate 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, Nety 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 c,qq_~ y, wi~a ;~l,applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspect~9r~ oft ~~eifiisi's and in building for necessary inspections. yam, ~
.._..,........a... ip,'~t~.~..._„„.. I.QCl7S'..~~, l~f~/~l~1tj z.1~~
Y~ (Signature of applicant, or name, if a corporanon)
,,,yt t ...1.(a`~... l~~af'1~1J1~1...~Dv,r~tvl~.,.:~y.......
' Fitiry;,, (Mailing address of applicant)
State whether applicant is 'otdne'r,'less~e, agent, architect, engineer, general contractor, electrician, plumber or builder.
~Y" '
Name of owner of premise
(as on the tax roll or latest deed)
If applicant is a corp~ration,~signature o'f duly authorized officer.
........:y'.
(Name and title of ppc~~orporate officer)
Builder's License No. ...~Y.~I/.~~r'~
Plumbei s License No . .
Electrician's License No . .
Otter Trade's License No . .
1. Location of land on which proposed work will be done. ~ .
.1~.3 : ~ftRKGt1ll~.N...:..................~DU.77h~,~!~.. , .
House Number Street. • • ~ •
~y - Hamlet p
County Tax ~9ap No. 1000 Section .:/.P Block . •~j, , , , • , , , , , , , , , Lot . , ~ ( '
Subdivision ~lp(i1.7~1./,.c)D.Q~ Filed l,fap No. ..a~~~...... Lot o.C~
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .
b. Intended use and occupancy }'/.z'.~1/2Lf..~Ql:~.~ .
l
i
3. Nature of work check whit
p . • • . • • • Rh applicable): New Building Addition Alteration
Re air ~moval Demolition Other }Vork Q~«',~0~
(De~npt~~n~
4. Estimated Cost . ~I QQ/~ . Fee .
(to be paid on filing this application)
If garage, number of cars ~g units Number ofdwelling units on each floor , , , , , , , , , ,
6. if busrncss• commercoialdor mr~ed occupancy, specify nature and extent of each t c of use . .
7. Dimensrons of existtng structures, if any: Front , Yp ` ~ • ~ • ' ' ' ' ' ' ' ' ' ' ' ' '
Height Rear Depth..............
Nlrmber of Stories .
Dimensions of same structurel,with alterations or additions: Front Rcar .
Depth. .Ileight. ,Number of Stories.
8. Dimensions of entire new conl'struction: Front Rear ~J.......... Depth
Heig~~ a,~ : , , „ dumber of Stories ~ ~ ~ " " " " " "
9:~Size r Rcar .......................Depth......................
1Q~:.:I?,
t9„,~„
3,f 1'uz.Gltase.o-.,,...~-;~ i.~=,~ . ' .
r• ~ •••••••••••>...NameofFormcrOwner
•i~ i Ij
1 h • ~24'r~t°, t~ 1~Y~eQvn~vh clt remises are situated • ' ' • ~ • ~ ' • • ~ ~ ~ • •
1 't"""H"cres`pr'bptt)"con"structron violate any zoning law, ordinance or regulation: ~ •
13. Hill lot be regraded I, , , Nill excess fill,,(te remove from remises: Yes Nc
p Y
14. Name of Owner of remises ~ . • • .
Name of Architect ~uIS:~F~I/~j?,iQiJzItiAD Address 1G~;5: , f,1,QKt~1q;/,y~OUT?~`Qsj~ ne No..'7Gr5.-,~9,1c , , ,
.Address. .PhoneNo..
Name of Contractor . .Address . ,Phone No.. ,
IS.Is this property located with in 300 feet of a tidal wetland? *YLrS....NO..
*If yes, Southold To'w,n Trustees Permit may be required.
.PLOT DIAGRAM
Locate clearly and distinctly X11 buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and bloc~C number or description according to deed, and show street names and indicate whethe':
interior or corner lot.
~kl~,~~ ~~~~e ~j2~,c~1~ lglQ3.
P
UCIa~,J CY DATE: a~sA.RN~~'
U ~ U ~ UL ' ` NOTIFY BUILD Q DEPA NT AT
~~°HU~ C T~F~C 1765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION TWO REQUIRED
CU FOR POUREDCONGRETE
Eg i 2. ROUGH -FRAMING rA PLUMBING
3. INSULATION
'i 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY "
COOES. NOT RESPONSIBL'~ FOR
DLTSIGN OR CONSTRUCTION ERRORS
STATE OF NE}V YORK,
COUNTY OF . I,S.S
' ' ' ' ' ' ' ' ' ' ' ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' • • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(Aamc of individual signing contract)
above named.
H~ s the .......Mr. ~ Mr.~ ~ p ' -7
r
u s 7 o
~
'I (Contractor agent corporate officer, etc.) ~ • ~ ~ ~
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith. ;
Sworn to before me this
.......day of .....~//a!:..........., ]9~~•
Notary Public, , , , ~ , : , , , , , , County
NELEN K. OE YOE ' j G2C7-~:'c;':~... ~ • . .
NOTARY PU811C, State of New Yark (Signature of applicant)
' No. A707878, Suflalk County
Terra Ezgires March 30,19~~
!I