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Home My WebLink About8794-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. CERTIFICATE OF OCuuFANCY No Z-24490 Date JULY 11~ 1996 THIS CERTIFIES that the building. ADDITION Location of Property 350 LAKESIDE DR. House No. County Tax Map No. 1000 Section 90 Block 3 Subdivision Filed Map No. SOUT~OLD, NEW YORK Street Lot Lot No. Hamlet 16 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16, 1976 .pursuant to which Building Permit No. 8794-Z dated AUGUST 16, 1976 was issued, and conforms to all of the requirements of~ the applicable provisions of the law. The occupancy for which this clertificate is issued is ADDITION TO EXISTING ONE FAMILY DW~T.T.ING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8794 Z Date .......................... -~g;~S~.....1.6 ....... , ] 9...~6 Permission is hereby granted to: $ovthold premises located at ...]ao.~..~.~.....C~ek'1.a~....ti~c,,~..~.~,2,k ............................................................... ................................................. ~L.~,~,.n.~..~.a. ~....2L~.?.~. ....... ..~..o.~?.~ ............................. ~u/suant to application dated ............................ ~,- ..... .~.~ ........... , 19..,.~'.., and approved by the B~il'ding Inspector. Building Inspector This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. Final survey of property with accurate location of all buildings, property lines, streets, and unusual naturai or topographic features. 2. Finat Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwrzters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buzldings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect si~ned by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupan~M-'~--~hdweliing $25.00, Additions to dwelling $25.00, Alterations to dwell~g $25.0~ Swimming pool $25.00, Accessory building $25.00, Additions to accessory ~i-iding $25.00. Businesses $50.00. 2. Certifimate of Occupancy on Pre-existing Building - $1OO.Op 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $1D.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Cpmmercial $15.00 Date .......~ ~. 7 ....................... New Construe=ion ........... Old Or Pr~-existing Building...- ......... House No. Street ~ Ha~et Onwer or Owaers of Property ...................................................... County Tax ~p No 1000, Section ...... Bloc .Lot.. Subd tvts~ca .................................... Filed Map ............ ilo c ...................... Health Dept. Approval .......................... Underwriters Approval~ ......................... Planning Board Approval ........................ . Request for: Temporary Certificate ........... Final Certicate ........... - *SUFiVEY.,,~ . ~.. FOR TH~OMA$ *d,~ ~ ~ . ELIZABETH.. :LOT-~UMBER 79 OF, ~. ~ . · ,.; ~E[~R. BEACH PA~K -, ' * . , . · ~TOWN OF SOUTHOLD -'. ~, -.~,., ,- ~ ' * , ' ~ ~ ~ RIV~RNEAD SAVt~S BANK SEPT. "" ~ ~ ' ~ SURV~E~ ~.Y,S.~I~.I~ Disapproved a/c ............................................. APPLICATION FOR BUILDING I~J~IT 'iNSTRUCTIONS Date ................................................ , 19 ..... a. This aPPlication must be completely filled in by typewriter oe in ink and submitted in triplicate to the Building Inspector, with 3 sete of plans, accurate plat plan to scale. Fee according to schedule. b. P at plan showing location of lot and of buildings on premises, relationship to adjoining premises or .p~. lic st, ree.t.s areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is port of this appl cahon.r~., 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 issue 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 port 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 Ordnance of the Town of Southold, Suffolk County, New York, and ~her appllc.able Laws, O. rdinanc.,es arC, Regulations, for the construction of buildings, additions or a!terations, or for rem. ay.al or demol, lt,on, .as he.rel.n descn .bed. zt The applicant agrees to comply with all aPPlicable laws, ordinances, bull.ding c..oae, hOusing coae, aha regulat,ons, and to admit authorized inspectors on premises and in buildings for necessary ,nspechons. Edward Villians Contraeting Ine ......... ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. b~ilder . . . Peter Echo . Name of owner OT premises ................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) E. ~illians Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .C..e...d:.a...r......]~....a..e.~..?.j~.~...~.. Lot No...~..~. .................. Street and Number .... ..C..q.~'...~.;[~lI, L~'J,.~..]~l[S.~....,.~lx~d ............................................................... Municipolity 2. State existing use and occuponcy of premises and intended use and occuponcy of proposed construction: a. Exisiting use and occupancy ......... ~.V..?..]....~.~[ ................................................................................................... sane vitX an additios b. Intended use and occuponcy ................................................................................................................................ 3; Nature of work (check which applicable): New Building.. ................. Addition ~ Alteration~ .......... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) .-: 4. Estimated Cost ....................... ?.. .................................. Fee ..... .l:.~.e.~ ......................................................................... (to be paid on filing this application) 5. i~f dwelling, number of dwelling units ...... ..O...~.. ............... 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... .th~$ .................. Rear ......... ~ ................ Depth ....~.~. ............... Height .................... Number of Stories .....one ......................................................................................................... 9. Size of lot: Front ....... 1...1.~. .......................................... Rear .......... ~2.6 ........................... Depth ...1.7.0.../...221.,.8~+. 10. Date of :~urchase 4:.; ................................................... Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated .!:A.a...~,;LSt~ ................................................................................ ]2. Does proposed construction violate any zoning Iow, ordinance or regulation: ....... ~.n¢} .......................................... .: 13. Will lot be'regraded . ........ .~...o. .............. Will excess fill be removed from premises: ( ) Yes ( ~ No · 14. Name of Owner of premises ..?..e..~.e...r....g...e.~..o. .......................... Address ..J~g~.l~gl~4~, .......... Phone No ....................... , Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor .~..d'...~'.....~..l...]:..]r.~l...a~....~ ............................... Address ....... .~...O..~..~.~...°..]r..~.. ..... Phone No ....................... · PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicafe all set-bc~k 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. see at~ached plan STATE OF NEV~!l~.¥1gli~]ll [ c c COUNTY OF ................................ ~' ' ~llen Wil-liam~ ................................................................................................. being duly sworn, deposes and soys that he is the appJicana (Name of individual signing contract) above named. He is the age~l;'~ of b~-,ilcilr.~. ......................................................... ........................................ (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 ~'his 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 .................... 1..$ day of ......................... Aag~l~...., ~....26 //,~,~ ./2 / /'//,~, ~ Notary Public,. ........ : .............. .~....'~....f..O....1~.. ........... County ..~..~..,...~...~ .................................... (Signature of applicant)