HomeMy WebLinkAbout16969-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17129 Date JULY 28, 1988
THIS CERTIFIES that the buildin~ ADDITION
Location of Propert~ 8495 PECONIC BAY BLVD.
House No. Street
County Tax Map No. 1000 Section 126 Block 04
Subdivision Filed Map No.
LAUREL
Hamlet
Lot 13
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 21, 1988 pursuant to which
Building Permit No. 16969Z dated MAY 12, 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 screened in porch addition to existing one family dwelling.
The certificate is issued to
MICHAEL & MARY FLL~N CIRRITO
(owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF NF2%LTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
~f~Bui~ld~nspector
Rev. 1/81
FOBI~ NO. 0
TOWH 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)
No_ 16969 z
Permission is hereby granted to: ~ , ~
......................... 7 ...... /7)'": .......... ::~""~' ...... ~ ' ''//'' ' ' '/
....~....-. ........ ~.....~/'~......,~:~.~ .......................................................................
at premises located at ...~:.7...~..~......~.-~,mc~.~.......,z.~.~ ....... ..............................
County Tax Map No. 1000 Section ........ ./....~...~., ..... Block ......... ..~....~...... Lot No ...........-,/...,.'~,. .....
pursuant to application dated ...... ~./...~.. ..................................... , 19.~..~.., and approved by the
Building Inspector.
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUP
[Nc, OW.
Instructions
A. This application must be filled in typewriter OR ink, and submitted I~=====a~ to the Building Inspec-
tor 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 p~operty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
~ 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
I. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.O0 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
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 ..........................
NewC°ns~'ruc ti°n ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .... .c~.~.?..~. ..... ~.O¢~,~,~. ~ /'~/..c~.~.~;;. ~....~..?.~./
Ho,, Vo. r , ......... ! .........
Owner or Owners of Property . .~.r.~?.~.. ~.......~... ~..~.~!~..~....~.~.F?~.~-.t...~. .........
County Tax Mep No. tO00 Sectioo ............... Block ... ~ ........ lot ...............
Subdivision Filed Map NO Lot NO
Permit NO. J/-~. ate of Permit ,~;'. /?,. Applicant/"~,. . ~_~.. .r~,,
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 . .,.~/~..
OU~JDATION ( Is
DUNDATION (2nd)
DUGH FRAME &
.PLUMBING
~SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
765.1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING ~]~NAL
765-~.802
BUILDING DEPT.
INSPECTION
' ]~FOUNDATION IST [ ] ROUGH PLBG.
J FOUNDATION 2ND [ ] INSULATION
FRAMING
FINAL
REMARKS:
O1
b
WHITE & GIRRITO
ATTORNEYS AT LAW
May 12, 1988
Town of Southold
Building Department
Town Hall
Route 25
Southold, New York
11971
Attention: Thomas Fischer
Re:
8495 Peconic Bay Blvd.
Laurel, New York
Permit # 16969
Dear Mr. Fischer:
As per our telephone conversation of this date
forwarding a check for $50.00 to cover the cost of the
application fee for our enclosed deck.
I am
As we now intend to do our own work, please submit the
application fn our names as the homeowners. No charges wfll be
made in the previous plans submitted.
Thank you so very much for your kind and considerate
attention to this matter.
MARY ELLEN CIRRITO
MEC/jc
Enc.
J ' faetlltl~ for this loe~f, toa have
~ tnspeet~ by this departmen~ ~ 1
~. ~'IO'~"W -- /00.0 0 /
~ ~A~ ,~'~[.~--~ ,~ ~/ -~'~ ~,",~ t, ~/.~' - ....
/
For Individual
usine ertifi ate .,
I ~HEREBY CERT..~FY th~at I am conducting or transacting business under the name or designation
County Ot State Ot New York.
I F~RT~ER CERTIF~ that I am the saee~ssor sn interest ~o
IN WITNESS WHEREOF, I have this
and signed this certi~cate.
dar of MAR 1 9 1982 z9 , made
STATE OF NEW yORK { ss.:
couNvy
Onthls ; f~,aayof ~
to mo Rno~n and known to mo to be tho indivldnal
certi~cate, and he thereupon
JUDITH KERN
NOTARY PUI~LIC, ~ate c4 New ¥o~k
No. 30-4679885
Qualified in Nassau County
Certificate Filed in Suffolk County
CommJss~o~ Expires March 30, 19_~'"~
19~, be£ore me personally appeared
described in and who executed the £oregolng
duly acknowledged to me that he executed the same.
VICTOR LESSARD
EXECUTIVE ADMINISTRATOR
(516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF $OUTHOLD
Town Hall, 53095 Main Road
P.O. BOX 1179
Southold, New York 11971
March 21, 1988
Mr. Milton Connor
165 Lincoln Ave.
Deer Park, N.Y.
11729
Re: CIRRITO BUILDING PERMIT
Dear Mr. Connor:
In order to process
more structural details.
to be more than a deck.
this application, we will need
Proposed construction appears
Construction shall meet requirements of New York State
Uniform Fire Prevention and Building Code.
Truly yours,
SOUTHOLD TOWN BUILDING DEPT.
TF:gar
Thomas Fisher
Building Inspector
~!~ROVED AS NOTED ,
NOTIFY BUILDING OEPART~IENT A1
765-1~2 9 AM ~ 4 ~ FOR ~E
FOLLOWING ~SPE~IONS:
FOR ~UREO CONCR~
2. ROUGH - FeA~NG a ~BING
3. INSULATION
4. FINAL . CONS~U~ON MUST
CO P ET FO'C.O.
THE REQUIREMENTS OF THE~,Y.
STATE CONSTRUCTION & ENERG"r~
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
SKYLIGHT.S. I
~ ,_" r'.. "',
12-0
,/
EX/STING HOUSE,
- ~ BATH
~ AREA
SHOWER
DRES
AREA
J- 4'-6" -
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1803
Disapproved
a/c
/(Build/~/g Inspector)'
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
CHECK ..........
§EPTIC FORM .............
NOTIFY
CALL ................
MAIL T~
· row. OF ou ot,
Date ................... 19...
INSTI(UCTIONS
a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
se{s 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 Buildh~g 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..c=ode, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspectionsLL
(Si~nafure of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
(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 HUST BJg~SUFFOLK COUNTY
Builder's License No..,~".P'-~-:~ ............
Plumber's License No .........................
LICENSED
Electrician's License No .......................
Other Trade's License No ......................
1. Location ofland on which proposed work will be done~ .................................................
· .s ..... 7
House Number Street
County Tax Map No. I000 Section .... .7.~ ./~.gBloek .... .~..~. ......... Lot....~....~..~.. .......
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .. }.
-- ~ , .' ' };d ~,~,; ~;{~:i:':~;q~h ~ ...............
b. Intended use and occupancy ./.
.... y. q.-- ..........
3. Nature of work (check which applicable): New Building .......... Addition ....... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
~, I (Descrip.tion)
~. Estimated Cost .... ' ................ Fee .......................
i (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 mixedi occupancy, specify nature and eXt6nt of each type of use
7. Dimensions of existing structure~, if any: Front ............... ~Rear .............. Depth ...............
Height ............... Number of Stories .................. ~ .....................................
' ' ' "' .... '~' ~ Rea
Dtmenmons of same structure w~tl4 tllteratmns or addlt~ons: Front . .... ........... r ................
Depth .................... i · H~eight .. · ~ Number of Stories
"8. D~menslons ofenbre neW k'pnst ctlq~: Front .......... . ......P&ar ............... Depth ...............
Height ...'~. i ........ :NumberOf Stories ....................
9. S~zeoflot: Front ..... :. ~ 4 :' Rear
10. Date of Purchase .., ' ....... '; 1" ................. Name of Former Owner .............................
11 Zon edi i i h'chp ' ' it ted
· e or us str ct n w i remlses are s ua ...........................................
12. Does proposed construction viol~ .te any zoning law~ ordinance or regulation: ................................
13. Will lot be regraded ......... , ....... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ................ Address ................... Phone No.O~./~. .-..:~..~.'Z../~:/~..
Nmne of Architect .......................... Address ................... Phone No ................
Nmne of Contractor ~.9'~1~..,.~r'69 .'45.. ~ ............ Address .... : .............. Phone No&~.'2..n-,S.O.7[;~ ....
15. Is this property located ,,ithin 300 feet of a tidal wetland? *Yes ..... No .....
· It! yes, Southold Town Trm~tees 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 umber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF..
.......... ... Z't.~..~./.~-O.,'~.... ~----~ Z'.'?.~...O~.. ....... being duly sworn, deposes and says that lie is the applicant
(Name of individual signifig contract)
above named.
He is the ....................... , ..................................................................
: (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dulyl 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 ket forth in the application filed therewith·
H£LEN lC DE VOE
Sworn 1o before me th~s ,
' _, &/ ' "~ ~t~- ,J~ TARY PUltLIC, State of New York
_ ~----..,a.C~ i ~ /
..... ~ .day of ..... ~ , 19
Notary Public/:T ........... ~ ....... County
, ~ . , k-...---C.--"~'(Signature of applicant)