HomeMy WebLinkAbout17490-zFORM N0.4
TOWN OFSOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z, 1.829,1.... _ ... , . Date ...AUGUST 16 , 1989
.......................
d
THIS CERTIFIES that the building ......In,g,round, ,Pool, ,and, Fence
.................
Location of Property .... ~ 70 WOODSIDE LANE LAUREL
House No. ~~~~~~~•~~~~~~~Street .......................Nemlet
County Tax Map No. 1000 Section ... ~??......Block .. 05..........Lot .....~ ~......... .
Subdivision ...............................Filed Map No. ........Lot No. ............ .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
SEPT .. 29 ~ , 1988, pursuant to which Building Permit No. ... 17,4,9.Q~, , , , , , , , , , ,
dated .. , OCT.. 4.,:. 1988
. • • .......... was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for whiclt this certificate is issued is ........ .
INGROIIND POOL AND FENCE AS APPLIED FOR.
................................................................................
Tlie certificate is issued to . , ,LOUIS AND WANDA NARDOLILLO
(owner, %r%i~%aFr&
of the aforesaid building.
Suffolk County Department of Health Approval ...... N/A , , . _ , . , .
UNDERWRITERS CERTIFICATENO.... N042715 OCT. 28, 1988
..........................................
PLUMBERS CERTIFICATION DATED: N/A
twJ~ uildfn Ins r
/ g pecto
Rev. 7/81
FORM NO. D
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)
~ ~ 1.7 ~ ~ ~ Z Date ....~.4.r.L..~?~"~,r.....1 .................:-19.A.
Permission is hereby granted to: 1
...1~.:.~..~::. f1?:1::°...d.tX~c:,~ ..............
~..G~..... ~ :.... 1./. 9 ~ z.
(' _{~ ,
to \~~11^-RN!ckl..t~...4i:1....4M.~..~: r.^.~[~....... ~!~'..~... ~-~-.'.'F.~...... ~....G~
Q ....
at premises located at ..~..7.Q......4.M'r?'s~FG.... .:~.~.. ..... ...................... ............
County Tox Map No. 1000 Section ... /..rze7........... Block .......5?.5...... bLot No. ~..~ .................
pursuant to application doted .~/p~~-/itiY~4~.....~,.q........., 19.~n.., and approved by the
Building Inspector. V
Fee $..[.S.!!..:...
................
Inspector
Rev. 6/30/80
P~ ~'~
TOWN Op SOUTUOLD
BUILDING DEPARTHEttT
TOWt1 DALL
SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPAL;CY '
. DAT E ~f"C~...~~.. l~~P
NEW C02;STRUCTION ..~^! ~ -
-..OLD OR PRE-EgZSTIt2C BUILDTNG......VACAt2T LAND.,._~_..
Locatioa of Property. _,~,7D.... • ~Qp~s~~~ ~~- _
STRL•'ET NAMLET ~~~ ~~
Ovncr or Ovncrs of Property., ~(~ _~, "~2.- -' ,{' }~Y~Q /t~~~ ..
County Taz Hap No_ 1000 Section 5.~~,
IIlock .~~, Lot- _. ~,[-...
Subdivision..
..................... Filed Map ...._..Lot..........
PcrniC ;to. .........,Date of Pcr
m,i t n p p l i c a a t .,~1J.G{/S, ./Up~!/~~
Ucal[h Dept. Approval ~r ~' ~~
" '~ " " " --••••.. Undcruritcrs Approval. „ _„
.._....
Planning Board Approval
Request for Temporary CcrCiFicate .... ,
•.. Final Certificate ................
Fcc Submitted
APPL]
~ ,~~009
~~~/~y
~o ~j~~9i
°y• 10/14/88
FORM NO. 6
TOWN OF SOUTIIOLD
BIIILDING DEPARTTSENT ~~. ~ ~ ~`~~i•
TOWN IIALr_
765 - 1802
APPLICATION FOR, CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must be filed in typewriter OR ink and submitted to Chc Building
Inspector with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property Imes,
streets, and unusual natural or topographic features,
2. Final approval of.IIeal[h Dept- of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation From Board of Firc UndervriCers.
4. Sworn statement from plumber certifging that solder used in system contains less
than 2/10 of IZ 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 Approval of completed site plan requirements.
B• For existing buildings(Prior to April 9, 1957] nonconforming uses, or buildings
and "pre-existing" land uses:
1. Accurate survey of p=operty showing all property lines, streets, buildings and
unusual natural or topographic features.
2, A yroperly completed, application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separate ownership of the entire lot prior to April 9, 1957,
If a Certificate of Occupancy is denied, the Building Inspector shall state Che
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C- For Vacant Laad Certificate of Occupancy:
1. An application for vacant land Certificate of Occupancy shall be submitted,.
and a certified absC;act of title issued by a title company showing single and
separate ownership o£ 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 Dwelling $25.00, Additions to Dwelling $25,00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00,
2• Certificate of Occupancy 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
S. IIpdated Certificate of Occupancy $90.00
6• Temporary Certificate of Occupancy - $(.S,Op Residential
i $SD,00 Co~mnercial '
i
3O. 10/14/5$
=1cLD II:SPEC:iUtl ~ ~UAiE ~ i;0a`•tMENTD ,~
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II7SULATIOII PER N. Y.
STATE ENERGY
CODE
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ADDITIOPIAL COMMENTS: x
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G BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING
[~NAL
REMARKS:
DATE ~ INSPECTOR
w ~
THE NEW YORK BOARD OF FIRE UNDERWRITERS YAt;F: '
lool4R1.
BUREAU OF EI.ECTRK:ITY
;`~ ~' f)("T(>f1Y.R '3R 1~ JCAFINSTREET. NEW YORK. N5F25~1 RR810R038 N IlA.1, "I I K
Date ApplicotionNo.onfile 5ft5 8$8 AR
TN18 CERTIFIES THAT
only the e4etrlcal equipment as dsxeri6ed fNt101e and introduced 6y the applicant named on the eboce MPlicat7ola numher 1PE the premises of
Lt7Ut:S NANT)Ui~tiIL10, fiEk)t)3L(lF; GANY;, 1',AIIR~'t,. N. Y.
in the following loco ' e ^ Ixt FI. ^ Pnd F'l. Oill Sertion Block Lot
~~ ~. ~¢~
wax examined on andJound to 6e in compliance with the reyairementx of thu Board.
A%TUtl RXTYBB RA NBlf COOIIRl 6 aECKS OV ENS- DIfN W ASWK T FANS
~TInS AGE{ SWITCHES
INCANDESCENT PIUDKFSCFNT
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DRYlRS RIRNACE MOTORS NITURE ANUANgi RaEMf SiMWI REC/T TUNE CIOCIIf EELL UIRT IIEATMS A ~f ~ ENMMERS
AMT. K. W. ql k P. GAS N. 1. AMT. NO. A W. G. AMT . AMP. AMT. NAPb. TRANS. AMT. M. P. NO.OE lEET AMT. WATTS
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lBBgt~R~01S CONNECT NO.OE S ! R V 1 C E
AMT. AW. TYPE 11 tW 1/SW S/SW 3f ~W ~.alER%Cp!ID. GP CCOM4 NO.OF NI-IEG ~~~~~ NO.p NEUItADi OF ~PIWEUTGIIAL ~
VIPIM NrMnlln:
xISMaFiN1NG PC101,) 'I`h0.9 Cert7f'tcate
covers colDpl.iartr«a at the date of
inspection only. Hecau>te of unusual
environtncntg it i.>, advisable to
have frequent test'!»nd or repairs
made by a qu»lifi.ed pPTaon.
IJODY >sUM7I1L0
F'AT iIANF'
MA'C'CJTUC"K, NY, i1~f5'7.
Thit nrtificaM mlHt not be altered in
OEIIQAI
1 'I
t~1a;F;fiSF; HO. '331)0 F~ Psr
to Me office of file Board if
__ ~
DEPARTMENT. THIS COP1f OF CERTIPIGTE MUST NOT /E ALTERED INAtW MyRIHl.
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FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765.1802
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
CHECK ••••--•---
SEPTIC FORM .............:
NOTIFY
CALL ................
MAIL T0:
Examined . 4'S~.~^?~!-.. `~.' .., 19 ~.~~. ~~~ ~~~-
Approved .t?'4-~~^~...T.., 19 ~ ~. Permit No. ~ ~ ~. ~.~ .~L.. e'~'L ~
Disapproved a/c ..................................... D
................................... ............ SEP 2 91988
(Building Ins ector) BL>7G. DEPT.
p vn~san~ nr cni iron
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date .... //a.L ........, 19 P.4
a. This 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
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 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, additions 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 'nspec 'ons.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant) i t9f°~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................................................
Name of owner of premises ....... ~OGL(S......l .....~~ n ~Q ~.~~.r'. (.~ .......................... .
(as on the tax roll or latest deed)
If ap is s a corporation, at ofd ly authorized officer.
(Name and title of corpo to officer)
A L CONTRACTOR'S MUST~^~BE SUFFO~ COUNTY LICENSED
Builder's License No. ....'Z..y •~ • °..~~~....... .
Plumber's License No . ....................... .
Electrician's License No. /. ~d./~~~~'~...~.'~7:z''~~~eG
Other Trade's License No . .................... .
1. Location of land on which proposed work will be done. ...... ~t,1ll ~ !~Si fl~ ~~~
...............................
.. I ~a ..................!/ao~srr/.~... G:~~.........Lie.~t~?:..!~!-.y....:.............
House Number Street Hamlet /
County Tax Map No. 1000 Section ... ~°~.~ ........... Block ..:~........q. ,.,•.~. Lot ... [ .... /.......... .
Subdivision ... ~-/~L!l ~.~~/J ... ~~.~'~~i'-~.. Filed Map No. . ~~/~ • • • • . Lot .... !.~ ...... .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
g P Y .......... ~~~.rJ, ~?ll! ~~. cc.... .. {$~ i 3•i9<+ ...93 ...... .... .
a. Existin use and occu anc ~:*: ~ ~ a :t?:= =,,a1 ,.~;€.., . , . .
b. Intended use and occupancy ............ ~~~.~~~ ~ 7~..- `~'~ `a '~~dz-# ,
/~'L-mr Ct.~
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ......... .
Repair .............. Removal ..... , ........ Demolition ..............Other 1Vork .............. .
Q ' D ~~ (Description)
4. Estimated Cost.......:.. v ~ ........................ 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. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. .
Hunensions of same structure wilier of Stories ...................................................... . .
D~ , h alterations or additions: Front ................. Rear ................. .
Depth .................. ~.. ; .Height ...................... Number of Stories ..................... .
8. Dimensions of entire,new construetion: Front ............... Rear ...............Depth .............. .
Height .......... t. a ... Num>?er of Stories ....................................................... .
9. Size of lot: Front , ......... Rear ...................... Depth .............:....... .
10. Date of Purchase .............................Name of Former Owner ............................ .
11. Zone or use district in which premises are situated .................................................... .
12. Does proposed construction violate any zoning law, ordinance or regulation : ...............................
13. Will lot be regraded ........:...................Will exces fill be removed from premises: Yes No
14. Name of Owner of premises . ,/~1¢!enD,~ /!L O ....Address .. ~/.~/.?~~?<...... ,Phone No ............... .
Name of Architect ... ~ C~ .......... .Address ...... ........... .Phone No.............
..
Name of Contractor ... r ~~~ ~- Y ~`. ~.~~...... Address .. 1~~~~4-~1.~'. ,Phone No..~ . ~d
15.*Is this ro ert located within 300 feet of a tidal wetland? *Yes ..... No y?e...
P P Y
If yes, Southold Town Trustees Permit may be reqguired.
', PLOT DIAGKAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
Fr•~~ ~Fft~ ~~'ll2v~"1
STATE OF NEW ORK
COliNTY OF ... ~t I'6...
. ,~, ... e4.y.... !~. ~ . .
. .. f6K. !M ~...!q:.. ~EJ7
(Name of individual signing contract)
above named.
.. being duly sworn, deposes and says that he is the applicant
He is the ................1..~~!~!~';Cll„~.~............................................,..........
(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 th~ijs ~/
....... ~/~~ )...--...day of ........'. ._ .. ~ .., 19 .~.b
Notary Public, .. C ~C1~~Q.. ._.. .. .. County
I'
....... ................... . .......
(Signatur a plicant)