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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-18000 Date MAY 4, 1989
THIS CERTIFIES that the building ADDITIONS
Location of Property 1315 SOUTH HARBOR ROAD SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 075 Block 04 Lot 08
Subdivision Filed Map No. Lot No.
conforms substantially to the Apphcaticn for Building Permit heretofore
filed in this office dated April 3, 1989 pursuant to which
Building Permit No. 18008-Z dated APRIZ 6, 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 DEQC & SHED ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to FRANK BOUNAIIITO
(owner}
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
sEOHas 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)
N ~ $ ~ 0 O Z Date 19.Q.~
Permission is hereby granted to:
.
.............a-:~:... ~ ~.9.~:y....... .
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ct premises located at .~..a~..........?!:h...:P.~-q-~-h, ~ ~~~4f~
~~........~r.1~........l~ou,..-ark..~-........................................................ .
County Tax Map No 1000 Sectil~,~.MQ~,SO.. Block ......~.~....~.7. Lot No .fig..
pursuant to cpplication dated ...'~.7~-!`"^.... ~ 19.3., and approved by the
Building Inspector. v
Fee ~ .
.
Building Inspector
Rev 6/30/80
TOWN OF SOUTIlOLD
i It
BUILDING DEPARTlIENT
TOWN HALL
SOUTHOLD NEW YORK 11971 Rl-~"~ UF'i
> iC.\~vN OF SO~~r,OLD
765 - 1802 „~M
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE `~/tJ..~....
NEW CONSTRIICTION .ILe.~.2OLD OR PRE-E%ISTI/N/G BU/ILDING..J. ...VACANT/LAND...._...
Location of Properllty.~rl~~,...,~av~/~ /7l~(ZY7pr~,~G ___.~UcJT~~O~~.._.
HOUSE N0. ST//Rff``JJEET HAMLET
Owner or Owners of Property. , ~ ~~....'~r'.~V~ ~ ~ V.~~.
County Taa Map No. 1000 Section ~ 7..d Block .b Lot p
Subdivision Filed Map//........Lot .r^.~........ I..{j
Permit No. I.Ua~~..Date of Permit 71P~:, ~.~?Applicant 11~5~ .~U~~S~n:.l! Jrn~
Health Dept. Approval Underwriters Approval.........._...
Planning Board Approval
Request for Temporary Certificate Final Certificate _..x ~
Fee Submitted: $ /
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1?PPROVEQ AS NOTED -
DATE: ~ ~ S.P. N '~($~,0
FEE• ~ BY•..Y:
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NOTIFY BUILDING DEPARTMENT AT
765.1802 9 AM TO 4 PM FOR THE ~
FOLLOWING iNSPECTIONS ~
1 FOUNDATION - TWO REQUIRED '
FOR POURED CONCRETE
2 RnUGH -FRAMING & PLUMBING OCCt1PlANCY OR
3 INSUlAT10N USE IS tll+<LAWfUI
IS 4 ~ IMAL CONSTRUCTION MUST
= F=~ i'C1(~.1rlETE FOR C O W{TROUT CERTIFICATE
All t.()NSTRUCTlON SMALL MEET OF OCCUPANCY
THE RFrlUIREMENTS OF THE N Y.
STAFF CONSTRUCTION & ENERGY
CODES NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS -
1~LD, iLS. c,,. i~;. ~~U;,Ta I~ OL't`Tt~ILNTD
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BOARD OF HEALTft
3 SETS OF PLANS
FORM NO.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC roRrl
' TOWN HALL
SOUTHOLD, N Y. 11971 NOTIFY ~,(y /7
TEL.. 765 1802 CALL a:~.`~ . .
Eramtne 1949. MAIL T0:
p ll ,pv 0O 22. f"~ l~ f
Approve ...1~ 19D~. Permt No ~ ~ . . ~ ~V`7_ ~ c G ~ _
~l f t ~ t i
DtsaPProved a/c 4
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1
BLDG. DEPT.
. , ti~t~, dL TOWN OF SOUTHULD
(Building Inspector)
APPLICATION FOR BUILDING PERMIT /
2 '
_ Date . a.r..,•'........, 19!~~
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submtttcd to the Budding Inspector, with _
sets of plans, accurate plot plan to scale. Fee accordtng to schedule.
b. Plot plan showtng location of lot and of butdings on premtses, relattonship to adlotmng prcmtses or public street
or areas, and gluing a detatled descrtptton of layout of property must be drawn on the dtagram which is part of this apph
capon.
c. The work covered by this application may not be commenced before issuance of Budding Permit
d. Upon approval of t}tts applicatton, the Butldtng Inspector wdl tssued a Budding Permt to the applicant. Such permt
ahall be kept on the premtses available for inspectton throu_lrout the work.
e. No budding shall be occupied or used to whole or to part for any purpose whatever until a Certificate of Occupant;
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bwldmg 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 alterations, or for removal or demolttton, as herein described
The applicant agrees to comply with all apphcatile laws, ordinances, building code, houstn~ code, an regulations, and t~_
admit authorized inspectors on premtses and in butldtng for necessary mspec o s • f
c:-
(Sig attire ot" applicant, or name, if a cor~ranon)
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, piumber or builder.
fti~:t~!L...........,G~
NameoCownerofpremtses...~2~r?~.....!-.'CC{hf`Ir•V~~.,,
(as on the tai roll or latest deed)
[f applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's Ltcense No. ~ ~ 3 . • • •
Plumber's License No .
Efectncian's Ltcense No . . .
Otfter Trade's Ltcense No . .
1. Location of land on which proposed work will be done . .
I ~ 1
.F~ ~,'J.......J.4%V.~.'^...::'J:tC.L(:Yl..~..~~....... .Sou.i n ~.Lf.'!
House Number Street Hamlet
County Ta>t blap No 1000 Section ~ Block ! Lo[ .
Subdivision Filed t,iap No Lot .
(Name)
State ensLng use and occupancy of premtses and intended use and occupancy of proposed constriction
a. Existing use and occupancy U NC . F~ nl,~ ~ v. ~4u~ r_ t ~u ~
II//
b. Intended use and occupancy ..~~.t:.(` K..'~~~~~ .
i~,
, ,a i
Y
3. Nature of work (check whuh applicable). New Budding Addrron ~ • rUterauon .
Repasr Removal Demolstson Other \Vork .
(Descnptson)
4. EsumatcdCost.~~~-,Ja'~"'' .............Fee..
t
(to be patd on Fling thss apphcatson)
5. If dwelling, number of dwelling unsts Number of dwelling units on each floor .
Ifgara;e,numbcrofcars
6. If business, commeresal or ms~ed occupancy, specsfy nature and cetent of each type of use .
7. Dsmenssons of e~csstsng structures, sf any Front .Rear Depth .
Hes^__ht Number of Stones .
psmenssons same structure wsth alteratsons or addstsons Front Rear .
Depth ,G+ Hesght . Number of Stones .
.3 r
Dsmenssons of enure new construction- Front Rear . , i . Q Depth .
Hesght ...............NumberofStones...........,.
-a,
9. Ssze of lot. Front ~r~.y Rear D pth 4,. r,.::........... .
10. Date of Purchase ............................Name of Former Owner . ~ n rte, ~.F; Y~ .
11. Zone or use drstrsct m whsch premsses are sstuated .
12. Does proposed construction vsolate any zonsng law, ordsnancc or regulatson• ~ .
13. ~VdI lot be regraded ~'i.~ . Wsll excess fill be removed from premsses: Yes N
14 Name of Owner of premsses ...................Address ...................Phone No.......... .
Name of Architect ,Address ...Phone No.............. ,
Name of Contractor . ~G . ~ ~ !,:.Address a. t;, ..Phone tvo.. .
15.Is this property located within X00 feet of a tidal wetland? *YESa/..NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and dsstinctly all buddings, whether existsng or proposed, and.sndscate all set-back dsmensrons fro
property fines. Gsve street and block number or descnptson according to deed, and show street names and indscate wheth
mtenor or comer lot
~ z
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STATE OF NEWK / S.S
COUNTY OF . k~0.
.N./?[~~- . [ f'~ being duly sworn, deposes and says that he ss the apphca
(Name o mdtvsdual ssgnmg contract)
above named.
ficsstEte
(Contractor, agent, corporate offscer, etcJ
of said owner or owners, and ss out rform or have performed the said work and to make and file t:
applscauon, that all statements contained m thss apphcatson arc true to the best of hss knowledge and belief, and that t
work wdl be performed m the manner set forth m the apphcatson filed thcrcws[h.
Swam to before me thss
. I: day of ,~~C-~.~-G 19~.
No[a ublsc, , .~fS~'~ .~ounty
EEItHH ANN NEVIIL~ ._.~~~1 ~x .
Note~vuel~.ste.otN.wyetlt (Ssgnature of applica
No. 62.8126860, Su!lolk
Term F.>tpiras Octo6or 81,1