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Home My WebLink About17359-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17308 Date SEPTEMBER 15~ 1988 THIS CERTIFIES that the building Location of Property 195 House No. County Tax Map No. 1000 Section ALTERATIONS BECKWITH AVENUE SOUTHOLD Street Hamlet 61 Block 1 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 15~ 1988 pursuant to which Building Permit No. 17359Z dated AUGUST 25~ 1988 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 ALTERATIONS TO EXISTING PORCHES OF EXISTING ONE FAMILY DWELLING. The certificate is issued to THEODORE BUCCI (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Bui~ldi~ngInspector Rev. 1/81 FOR~[ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017359 Z Permission is hereb~granted to: ~. ~ , _ / ./~ / .. / ~... ~--.,~--~.~ .~~....~.~....~.~.....~ ~, ~...~.~.~z .............................................. ....... ...... ~ ~,~i,~, ~,ed ~, ...Z~.~.....~~~....~, ........................................... County Tax Map No. 1000 Section .......... .~.../......, Block ............ ~ ......Lot No ......... ~.....~'~... pursuant to application dated ........................ ~ .......................... , 19- and approved by the Building Inspector. Fee ...~..?~. Rev. ,5/30/80 FORM NO. 6 " TO, N OF SOUT,O, IltYl Building Department Town Hall III111 Southold, N.Y. 11971 ' 765 - 802 I APPLICATION FOR CERTIFICATE OF Instructions A. :This application must be filled in typewriter OR ink, and submitted ~ ~m.m...aam to the Building Inmec- tot with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,$25.Q0, Accessory,~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... .~./~ ................. NewtOns truction ...... Old or Pre-existing Building ...... · .~.... Vacant Land ............. Location of Property ............................ House No, Street Ham/et Owner or Owners of Property .............................. County Tax Map No. 1000Section........6/...... Block '. ..... .// ..... · Lot......'~...~,.. ..... Subdivision ................................. ----Filed Map No ........... Lot No ............. . Permit No...~] ~, .~'..~-Oate of Permit..~. ~Applicant Health Dept. Approval ..................... · · . Labor Dept. Approval ........................ Underwriters Approval ...................... · · Planning Board Approval Request for Temporary Cer]:ificate ..................... Final Certificate ........ ~ .......... Fee Submitted $ .... ?~.. ~ .~-~ .......... o.-/... Construction on above described building and permit meets all applicable codes and regulations. C'-Q'~:~'~--17~'~3~% Oj'~, Applicant ..... ~"~~.....~. ~ .. . ....... R~. 10-10-78 ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION ZND [ ] FRAMING REMARKS: ROUGH PLBG. ]/J~SULATION [~/j FINAL FOUNDAtiON (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD gUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY _ TEL.: 765-1802 CALL ..................... ~.-~/., ~.~" F'~ MAIL TO: Examined dT./.~..~. ...... , 19~ · · / ~' ;~ ~ ,, , USE . - ..AgP. klCATION ~OR BUILDING PER~IT W IHOUT CERTtFICAIE, Date ................... 19... OF OCCUPANCY INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shah be.kept on the premises available for inspection throb~mut the work. e.. ~1o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate 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, New York, and other applicable Laws. Ordinances or Regulations, for the construction of buildings, ad, ditions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (S~gnature ol applicant, or name, if a corporanon) (Mailing address of applicant) 'State whether applicant is owner, lessee, agent, architect, engineer ge~/~al c~elec'trician, plumber or builder. ......... ./T.-Z4~..~...~.~ ..... . .q~...,e-.~ ~...]. ~...~. ..... ~.g.R.0~.~.~.~. N..~. P~_..._. z... Name of owner of premises ....................................... ,~. ~.~_.87.. ~~ ...... , (as on the tax roll ~ ~ O~PART~Y AT If applicant is a corporation, signature of duly authorized officer. .766-1~ 9 AM ~ 4 ~ FOR THE FOLLOWING INSPE~IONS: I. FOUNDAT~N - ~ RE~IRED (Name and title of co,orate officer) ' 4. FIN~ ~N~RU~N MUST Plumber's License No ......................... ~E ~ffi~ C.O. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ~'. ................................. ' ................ ......... ................. ........ House Number Street Hamlet co~,tv ,~ ~p ~o. ~000 s~io~ .... b./ .......... mo~k ...... ~ ........... lot ..... ~ ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State ex/sting use and occupancy of premises and intended use and occupancy of proposed constrtiction: a. Existing use and occupancy ..................................................................... b. lntendeduseandoccupancy .........~''''........." ................. . ... ......... 3. Nature of work (check which applicable): New Building .... ' .. Addition .. . Alteration .......... Repair .............. Rerqoval .............. Demolition .............. Other V/ork ............... ' .~. ~.A .q? ' (Description) 4. Estimate'd Cost ...... .......................... Fee ...................................... i (to be paid on filing this applica'tion) 5. If dwelling, number of dwellin~ 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 Dimensions of existing structures if any: Front "'Rear Depth Height ,.. ............ Nm~ber of StoNes ........................................................ Dimensions of s~ ~m,c~ with alterations or additions: Front ......... Rear ................ Depth ' Height Number of StoNes 8. Dimens, io~g,of~entire, new construction Front ' ' Rear Depth Height ~ .,,~-. Nu er o e .............................................. 9, Size o ':'F?ont } .... Rear ...................... Depth .......... 10, Date of Purchase ., , ' ' ......... ........................... Name of Former Owner ............................. ! 1, Zone or use district in which pr'emises are situated 12. D°es proposed construction vidlate any zoning law, ordinance or regulation: ................................ 13.. Wiil lot be regrad~d ... ' ........ Will excess fill be removed from premises: Yes No 14, Name of Ownm: of premises ~ .. Address . Phone No. Name of Architect ......... ; ................. Address ................... Phone No ................ Name of Contractor Address Phone No ' 15.Is this property located within 300 feet of a tidal wetland? tYES .... NO .... *If yes, Southold Tow~ Trustees Permit may be required. ... i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or descript~ln according to deed, and show street names and indicate whether interior or corner lot. duly sworn, deposes and says that he is the applicant tie is the ...................... 1 ................................................................... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 ............. (47: ....... day orI ................ 3/ Notary Public, ..~ ~: tt/~,v~-,-_ County NOTAB'Y PUBLIC, State of New Y*tk ............. I . No. 4707878.'S~olkCo~ty ~ (Signature of applicant) ~ mrm Expires M~irch 30,1tl: ,./