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Home My WebLink About16837-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16817 Date April 26, 1988 THIS CERTIFIES that the building A d d i t i o n Location of Property 1755 Albertson Lane, Greenport House No. Street Ham/et County Tax Map No. 1000 Section . .5..2 ........ Block .. 05 .Lot 59. 002 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 16, 1988 pursuant to which Building Permit No. 16837Z . dated March 18, 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 single family dwelling The certificate isissued to EMILIO AND SABINA SAGONICtt ~o~,,~e~~f*~ .............. of the aforesaid building. Suffolk County Department of Health Approval ....... N./..A ................................ N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUHBERS CERTIFICATION DATED: Rev. 1/81 FOB~ NO. J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N_O BUILDING PE~.IT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL co~P,~ON of ','..: WORK ^UT,-,O,~Z.~,:,~ Permission is he, reby gronted to:/ -- ./.£.~..o...~~....~.~ ...................... ~ , .... ~~.~...~ ........ ~.~.~ ,o ~......~/....,~ ~... ~~.~.. ..- ~~~ ,..~~ .... ...~.e~__ ~~ :~......~..~_.. ~ ......................................... ~, ~,,~ ,~,~ ~, ...... ~~~...~ ............................................................ co..w To~ ~, No. ,000 S.:,o. ..... ~A .......... ,~k ....... ~ ....... Lo~ No...~..~ ...... Building Inspector. Fee $.~~.. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings or new use; I. 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 cert{ficate 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: I. 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 anv housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. ,~ C. Fees: ' - 1~ 'n~/~'' ^~'~ ~~0-~0' 1. Certificate of occupancy ,ew owe il ~,,~zo.uu~/ ,,~,c~ce~s~s'~,,,~.j~_lu. u__~Business $50.00 2. Certificate of-occupancy on pre-existing dvv~flfi~J'~ $ 50.00 5.Updated C.O. t $ 50.00 Date ....'~ ........... Cons tructio~~ New ...... Old or Pre-existing Building ............ Vacant Land ............. ...... Location of Property . .J, :7.~'~, ..... ~ ~,~ /1) ~. ;~. ..... ,~, J~,~,,~.~..,~,..7~.,. Hoi~se No. ~¢) ~ ~ ~J j C ttEtreet ~ team/et Owner or Owners of Property . .'~./~,//-r'; ! .~... ~'..~.~..~..d./.~.. ~-~ ...... ~..~ ............... County Tax Map No. 1000 Section . .~'~.~ ....... Block ...(? ........... Lot .... ; Subdivision ................................ Filed Map No ........... Lot No ........... ,, , Permit No ........ Date of Permit ........ Applicant. ~,/, .C-/~_~ .~.: /'~Y~-f~ ./-~. 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 a and regulations. ' Applicant .... · .~, ,~../7~ ~P'~., ,? .......................... Rev. I0-10-78 C.o, ?OUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: G 76S-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [/.,,]/FINAL DATE INSPECTOR ~L/~, ~, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~ £/-~INAL BOARD OF HEALTH ...... 3 SETS OF~.PLANS ....... FORM NO. 1 SURVEY .........~.. TOWN OF SOUTHOLD CHECK d~.~.~¢l.~: BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL . , $OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-180~ CALL :'~'~"--'~- - .,.~.~ MAIL TO: Examined .......... , 19 .~..~ Approved...~././~. ......... 19 .ff.~. Permit No.Z~. .~. .~. ?. · Disapproved a/c ..................................... ................................. APPLICATION FOR BUILDING PERMIT Date .... ~lar. ch. 8., ....., 1988. INSTRUCTIONS h. 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 comr~ced before issuance of Building Permit. d. Upon approval of this application, the Building Insbector 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 p_art for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Building Departn~ent 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 herei.n~described. The applicant agrees to comply withjll applicable laws, ordinances, building code, housing code, and re~ul~,t~Yns, and to admit authorized inspectors on premises and in building for necessazy inspections- ./~ /~.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. agent Name of owner of premises . .E..m.~.i.q..S.aij. a.n..i .c.h..a~OCl. S.~bina..Sa, gan. ich ............................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done .................................................. iT.s. q.r.e.e.n, pg.r¢.,. New York .................................. l-louse Number Street Hamlet County Tax Map No. 1000 Section . . 9.5.2.-.QQ ......... Block . .QS... 9.0 ........... Lot.. QS.9...OQ2 ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 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 .... .~.eq~..~. ........................................................ 3. Nature o[ work (check which applicable): New Building ' ,~,~m~,~e.q . Alteration Repair .............. Removal .............. Demolition'. .......... ..,. Other Work ...... ....... i (Deseri¢ion) 4. Estimated Cost ...................................... 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 ........................................... i ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of exbting structures, if any: Front Rear ' Depth Height ............... Number of Stories ........................... i ...................... Dimensions of same structure with alterations or additions: Front ........... ~ ..... Rear .................. Depth ...................... Height ...................... Number o[Stories ...................... Dimensions of entire new const ction: Front ..... /.S.fe ..... Depth ............... Height ]~2.~['7.]qq./.,~t.~.~.-~.. Number of Stories ........................... ~ ............................ 9. Size oflot: Front ...................... Rear ...................... iDepth ...................... 10. Date of Purchase . .. 3/.:1,7/86 .................. Name of Former Owner george..L,. Ponny.,..3n¢ ..... 11. Zone or use district in which premises are situated g.~-P~es/ ............. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...p.o. .......................... 13. Will lot be regraded ........ B.q ................. Will excess fill be removed from premises: Yes No 14. Name of Owner 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? *Y~s ..... No .X.~.. *If yes~ Southold Town Trustees Permit maybe required. PLOT DIAGRAM : Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deeck and show street names and indicate whether STATE OF NEW YORK, COUNTY OF..S,U.F..F. 9 .L.K ........ S.S ..... ~ .i .c.h.a.~..l..ff....H..a~l..1 ........................... being duly sworn, deposes and says that (Name of individual signing contract) above named. he is the applicant He is the ...... a~ent .,. .................. (Contractor, agent, corporate officer, etc. of said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this application; that all statements contained in this application are true to the best of hi! knowledge and beliefl and that the work will be performed in the manner set forth in the application fi[ed therewith. Sworn to before me this ....... IB.'c.h ............. day of ........ MorcJa ....... ,19..8.8 Notary Public,____._ ._(~ ~__...(_ /t(~JL,I. ~ ...... ~llf f ol.k ~) ~ . . . County