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Home My WebLink About8566-zFORM NO. 4 TOWN OF $OUTHOLD EUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUpANGgf No Z-24746 Date NOVEMBER 15, 1996 THIS CERTIFIES that the buildin~ Location of Property 135 BAYBERRY ROAD House No. County Tax Map No. 1000 Section 76 subdivision ADDITION SO~THOLD, N.Y. Street Hamlet Block i Lot 6 Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 1976 pursuant to which Building Permit No. B566-Z dated MAY 5, 1976 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DE~K ADDITION TO EXISTING ONE FAMILY DW~LLING The certificate is issued to DOROTHY MIHALKO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/~A Rev. 1/81 / //il~ng Inspector TOWH OF SOU?HOLD BUILDIHG DIPARTMIHT TOWH CLERK'S OFFICE SOUTHOLD, ~. Y. BUILDIHG PEI~IT (THIS PER~IT ,~UST BE KEPT O1%1 THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8566 Z Permission is hereby granted to: ~4~,, ..~;~ ~$ e.~... &lz,~4,~'e .................................... ................. ~oGth~....~.-~-. ............................. ~o ...~..~.&c~e~ ~n~...s~m~e~-~ ...................................................................................... at premises located at ~i;~...~l..,~,~-....Me,~.t...C~e.~.J~.~Zl~J.o~. ....................................... ........................................... .w./.15......~.1~ .~.r. r~...~1 .......... $...~.~.$)~.o. ~.A .....~:I..,..~;.,. ............................... pursuant to application dated .................... ¥/~.Xr ........ ~'. .................. , 19.~..~..., and approved by the Building Impector. 10.00 Fee $ ........................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with tile following: for new building or new use: l. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Itealth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less titan 2/10 of 1% lead. 5. Commercial bnildiqg, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsfble for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or bnildings and "pre-existing" land uses: 1. 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 signed 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 l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimmiug pool $25.00, Accessory bnilding $25.00, Additions to accessory building $25.00. Businesses $50~00. 2. Certificate of Occupancy on Pre-existing Buildint - $100.00 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5o Temporary Certificate of Occupancy - Residential $15.00, Commercial $]5.00 Date ..... ~.£ ........................... New Construction ........... Old Or Pre-existing Building .... ~ Location of Property..Z3.~] ..... ~ .~C q.~ . ~0~,~ ...... ~'~ ~ ~.~ /~ ..................... Nouse No. ~ ~-~ Street Hamlet Onwer or Owners of Property .......................... . . ........ .. . . .... .. . County Tax Map No 1000, Section.9.7~.?~...B]ock.7.~.'. .......... Lot..Vf.7.k .............. Subdivision. ~ . [~ ~.~ ............. Filed Map ............ Lot.. ...... .................... tleaIth Dept. Approval .......................... Hnderwr~ters ~pproval Fianaing Board Approval ........................ Request .[or: Temporary Certificate ........... Final Certicate ........... ubm t ed, ................... ............. APPLICANT BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS. DATE .INSPECTOR / .? FOR~W NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .............. J ..... 19,Z..~.' Disapproved a/c ...... (Bu~ld~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 part for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Buffding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, 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 oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or"n~rme, if a corporation) ~' ~-/ (Address of applicantF / Builder's License No ........ .L~-.....-~....~..~'.Y.Z?.L.....: ............... Plumber's License No ................................................. Electrician's License No ............................................. State whe~er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~....~~......~..~..~ ........................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Other Trade's License No ............................................... ,~ / _,~,,-~ ,4 //] ~-,, r(/, ~' ( Municipality State existing use and occupancy of pre~qises and intended use and occupancy of proposed construction: n ~~ ~ b. Intended use and occupancy ................................... ~....~. .......... .~,~, .......... : .................................................... Repair .................. Removal .................. Demolition: .................... Other Work ..~._~.~...'¢.t.~ ............ ..~ //~ ------'-- ~ (Description) 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 garqge, 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 ................. ~.~ ............ Rear .......... (.~..~. ........... Depth /~' Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ ,0. o,. ....................................................... ........................................................ 11. Zone or u~e district in which premises are ..... z..~ ...... ~.z:_.: ..................... Z~T) ....................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... X.H...M ......................... ; .............. 13. Will bt be regraded . ............ ~.~...~ Will (xce~ ill[ be removed from pre~:~ ) Yes ( ) No 14. Name of Owner of premises ..~.~.~~... Address ...~.~ ....... Phone No ........; .............. Name of Architect .............................................................. Address ................................ Phone No ......... ............... Name of Contractor ~ k Address Phone No. 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 interior or comer lot. cq/ E r~F ~'~ COUNYY OF . ~..~.~ /1C' .................. being duly sworn, deposes and soys that he is tne~apphcam ['~;;;";T'i'~;'i above named. ~Je is the ..................................................... ~.~4..%~. ....................................................................................................... (Contractor, age,t, corporate officer, etc.) of said awner 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 applicotion are true to the best of his knowledge and belief; and that the work will be performed in the manner set foffh in the application filed therewith. Sworn to before me this ..... .....o, .................. .......... - ... ........................... ~'~'~' (Signature of applicant) ~ Term Expires Marc~ 30,