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FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217527 Date NOVEMBER 18, 1988 THIS CERTIFIES that the building ADDITION Location of Property 4180 OAKLAWN AVE. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 09 Lot 44 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 29, 1988 pursuant to which Building Permit No. 172012 dated JULY 11, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ANTHONY & MARY ZORI (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A l/~-d~.~-.ol~l Quo Building tspector Rev. 1/81 eoaat< 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 o 017 2 01 Z Date 7.,~~` 19.c~f Permission is hereby gronte to: ice.......... at premises located at .....`.t.~~.s!J.........62'P7•f-~~.~ , ~(/~..~1~ ............................................`Y"' ...............................................................................................................p................................................ County Tax Map No. 1000 Section ...........~'tl....... Block ..............:1....,~^Lot No............ y"'..~':... pursuant to application dated .....~m./.a°?.9 19.GIZ~ and approved by the Building Inspector. o~ Fee $...4~ . 1.... uil i ctor Rav. 6/30/80 „i_~~..u~ ~ C~ ~1J[ FORM NO. 6 ¢ TOWN OF SOUTHOLD I ~ ~ ~ ~ Building Department Town Hall Southold, N.Y. 11971 BLDG. DEPT. 765 - 1802 TOWN OF SOUTHOtD APPLICATION FOR CERTIFICATE OF OCCUPA C Instructions A. This application must be filled in typewriter OR ink, and submitted ~ a.~.~ to the Building Inspec- torwith 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 $25.00, Accessory 10.00 Business $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 C.O. $ 20.00 5.Updated C.O. $ 50.00 Date Newtons truction„ • , , ,Old or Pre-existing Building , Vacant Land Location of Property .'y.~~ . ~~IC~RwN • ~T!'~rUU~ ~K~S.ord so u~c~ House No. Sheet ~ Hamlet Owner or Owners of Property . `}nl.nt~NZ /hvD ~l/fi2 j° 2, County Tax Map No. 1000 Section .......7~ Block Lot , 7. , . , , , , , , Subdivision .................................Filed Map No. ..........Lot No. . Permit No. , Date of Permit ..7.~(~J~ , .Applicant . tioVV:~ PLC . Health Dept. Approval ........................Labor Dept. Approval Underwriters Approval ........................Planning Board Approval Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ Construction on above described building and permit meets all applicable codes and regulations. Applicant . fr<~'u?'~, • • ~G!".` . Rev. 10~tOJ8 ~j I ~ i C.v. ~i~ya1 • r'1cLD I::Si ~O:.U:J ~IJATE ~ SOtKMENT° ~n `J 1. ~ N _ H FOUtJDATION (1st) FOUNDATIOIJ (2nd) __I _ - 2. I z 0 P,OUGH FRAME & O PLUMBING p ti H 3. M IIJSULATIOf1 PER N. Y. y STATE ENERGY ~ ~ CODE ~pr~ ~ ~ ) r o~ FI;JAL c~ N ~ O _~~~pp ADDITIOf]AL COMMENTS: x'1~ ro x ~ ro \ M \ a\ H M H O 2 A • r MaH\~\ - v ~l m v H ~ ev r ; ~ i I ~\k / ~ 3 ~ {//X~` ~ ~ Q / VVVj N ~ ~ ti ~ H / VO l J _ i » ~ N 3 / ~ ~ s ~~o o as ~ x ~a a x ~'Nw3 ~ / v' i z F0'~ ~ ~ ~ ~ ~ ~ o PN ~ N H 4~ ~ ~ ~ 6 U o ~ ~ d ~ ~ ~ Q U ;,a~~~c ~ {L e{{H ~0.p9_'#(S~9 I I®V~ q{p ~ws~~ ~ I n ~ ~A m ~ ~ ~ ~ r{{ J u ' ~ C7 y W Y U~~ a~ a m ' ~xW~° v~ o ~ ~ Wz,~~ ~ xa udi ~ ci a~Wmz ~ p~ OG~u 0. F- d yy dSNp ~ N vOZp zrr d ~ y iii dS ~ U ~ Z eyt3'+ G Qa vQ ®w~-°u~ac U L_....9' 'aPrM2 Wv:~U Jaa~p`) ~ QZQ? ~ o"~~pz~ 2 gZd~,y ''~f~O~Zu. lD J~~u u' Q W~f~O~ PIMd Q W tli ~>f. Q ti~ n W ~ ~ ~ y , h~ z~~ ~ rss-isoa BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ 7,]~INAL REMARKS:©~~ ,~9U ~ , ~J#~-- C~ , DATE t l g " INS C~'OR ~ ~~-u~~~°• BOARD OF HEALTH 3 SETS OF PLANS Gt•~•...... . g FORM NO. 1 ~~~I~~ SURVEY D:K,.......... TOWN OFSOUTHOLD CHECK .....IdQ BUILDING DEPARTMENT SEPTIC r• oart , , , , , , , , , QI.CG. Ot., t TOWN OF SOtJ'it)~iLl) TOWN HALL i vOUTHOLD, N.Y. 11971 NOTIFY _ TEL.: 765-1802 CALL .....7~5., S~~( ~y / cc Examined 19 P.~ MAIL T0: Approved 19~(~. Permit No.~~~.O~~ ' Disapproved a/c (ldin~ Spector) APPLICATION FOR BUILDING PERMIT Date 15 INSTRUCTIONS a. Tltis 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 wftole 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 witjt ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) z/l~0 ~RILc-Ft:ntnl ~'V~N~cr Jom~r2~-oN~ ~~y1~971 .......1 ' (Mailing address of applicant) , State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. (0 W nI Name of owner of premises ........A.rJ?.l"(°.^!-~.... mntD ...°'.~F~'~... ~:a2' ~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Game and title of corporate officer) Builder's License No. 6:w'.'t:°!?!. , Plumber's License No. . Electrician's License No. .....N~~ Other Trade's License No. fl . 1. Location of land on which proposed work will be done . . S'o~`iNa1--D house Number ~ Streets ~ ~ ~ " " " " " Hamlet : County Tax Map No. 1000 Section .....7 Q BIQck , Lot T ,T . , . Subdivision Filed Dlap No. Lot . (Name) ; State existing use anJ occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy a.4?~/.T.~.~"L . b. Intended use and occupancy ,S,Uiti D>rCl~ ir''-~• [ C Nature of work check which' • . • • • : • • • • • • ' applicable): New Building , , , , Addition • • • ' : Other,l ork "~`Y.J, l Re air P Removal . Demolition ~ ~ ~ ~ ~ • • ' L'OrrSTYLc/~7o,J 0~ Sum Y~~.IC. (Desdription) 4. Estimated Cost ........~.~J~ Fee . S. If dwelling (to be paid on filing this application) n s, number of dwelling units . Number of dwelling units on each floor . If garane, num bcr of cars . , 6. If business, conunercial or miffed occupancy, specify nature and extent of each type of use . 7, Dimensions of existing structu,res, if any: Front , , , , , , , , Rcar . , .Depth , , , , , , , , ...../y a mberofStorics.....~ ei Itt ' ' ' ' ' ' ' ~ with alterations or additions: Front /k ~/G} ~ • ' ' • ' ' ' ' ' ' ' ' Rear Di pensions of same ~ructure IIeight , , , , elf A , , , , , , , • , , , , , , Number of Stories N/A, , 8. D mensions of entue e~ constntction: Front ~ ' ' ' ' ' ' ' ' ' ' ' Height Rear Depth Nult~tber of Stories 9. Size of lot: Front Rear ,~5. ~ Depth lbo ~ . 10. Date of Purchase , . ,F~c~g~sK-, / 6 y • ~ • ~ ~ " • " • • • • • • • • . P ~•••••••......,.NameofF rmerOwner 1 1. Zone or use district in which "4 'Ftio.ee~tlc.~ 12. Does proposed construction viemises are situated , e~~!~~T?gz; , • 'plate any zoning law, ordinance or regulation: N. 9 . l3. Will lot be regraded • , . ' ' ' ' ' ' ' •j • • • • • • : • • • . • ....Will excess fill be removed from premises: Yes 14. Name of Owner of remises y-,!~ , 7.v21, . • , , , , , Address ~/!FO , ®!}e~~wnl, _ Phone No. 7,65; , P ~l9A.. Name,ofArchitect ,,,,,,,,,,,,,,,,,,,Address . ~ Name of Contractor ..................Phone No............... . P P Y ..............Address...................Phonc No......... IS.:Cs this ro ert looted within 100 feet of a tidal wetland? *YLiS....NO,X,.. *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 dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether in.erior or corner lot. II M VC 1 q=i,~tZo n• ~ _ 1 ' I I I I m- ~ i ~ ~ I ij _ ~ Y ~ W ~ ~ ~ i I T ~ N ° I I ~ ;h~ 4,ni-~ T N - I - J I I ~ ~ ~ ( I 1 9 I 1 I I I J --I---_"-" I I V --,sb Ik--- -~,o/,-----j ' I ct I I i ~ - ~ I I I ; , I '7 I I ~Y,' I w y, STATE OF NEW YORE, COUNTY OF $.S r (Name of indi4idual si,nii ' ' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant tg contract) above named. IIe is the (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 con[aijicd in this application are true to'thc best of his knowledge and belief; and that the work will be performed in the manner'sct forth in the application filed thcrowi[h. Sworn to before me this ~I ..............°l ~ day of .'i...0 , , 19 _ Notary Public, , , , G;~.. .County ~p NELENKUEVOE ~ ;C'.p?^2I ..00~.~ 718/B,Su~ttolkfpp ~ 0- ~ ~ • ~ ~ . • TennFxWresM>1rch30,1 (Signature of applicant) t, - i i