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Home My WebLink About10362-z l~OP,~l NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO£D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP~EMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 10362 Z Permission is hereby gr~nted to: ........................................... ..~ ........ .~ ........ >..;~ ................ ~ ....... ~.--;..~...:...~ ......................... of premises located (it .C/,/~.,....~..~.~.~/~,,.~ ....... ~.~,~f. .............. ?..~ .... ..~ .............. ~..: ............. .~.~ ....... I .......... BUildingpUrsuant I`°applicati°nn:pector. dated ..~.-./..7// ................ ,19..7.~., and approved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate 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 responsib]e for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property line¢, 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. Fees: 1, Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3, Copy of certificate of occupancy $1.00 $5.00 Date. New Building .... /~ ...... Old or Pre-existing Building(X): ....... ~ fVacant Land ............ Hou~ No. ~ Ztreet ~ Hamlet CountV Tax Map No. 1000 Section .~ ....... Block . .~ ......... Lot...~.~ ....... Unde~riters Approva ................... nn ng Board Approval .................. ~ , . ~ Request for Temporary Certificate ..................... Final Certificate .., ~ ......... * Fee Submitted $ ................. Const?ction on above described building anc~mit'mee~s all am~4~ble~codes and regulations. Appicant.:., .._ :.. ...... .. ~ .................... ,.v.,o.,o.78 ,' 0.O, lO O, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEw YORK 10038 only the e~ctr~al~quiR~nt .~ ~r[bed bel~l[~roduc~ by the~oDlicant ~am~d~n the ~e ppplicatlon aumber in the premises of in the following location; ~ Basement ~ 1st FI ~ 2nd FI, Section Block Lot ~.~ ~.m~.od ,m ~pt~r ~9 ~ 1~0 and found to be in compliance with the requirements of tkis Board, OUTLETSFIXTURE SWITCHES FIXTURES COOKING DECKS OVENS DISH EXHAUST FANS FLUORESCEHT DRYERS OTHER APPARATUS. 1-4.SKW ~oW.~. 1-20~~ I~ea'c SYSTEMS E R V I C E NO O~E~C~COND OF;~GCC COND F NO ~NO NO OF Hi LEG 0~ W G AWG OF NEUTEAL 1/0 Ruland glec. Co. P. O,. Boxi43 £'~'~t~ituck, N.Y. 11952 Th,s cerhficate must not be altered in an return to the office Inspecto Per 11 COPY I IN ANY MANNER. TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buddings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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 peoperty 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 certifmate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. L-~-t .... f P,~,t, . . .~: ........................................ ~- · -~.~ ............. House No. ~ Steer ~ /~ Ham/et ow, , or o, ./.. ........ County Tax Map No. 1000Section O~ Block .~. Lot Subdivision. ~Z/~.~ ............... Filed Map No, .Z~(~..Lot No...~/ ........ ,earth ~.,~. *,,~o~..~::.~.?.~ ......... ,~o~ D.,~. *,,,o,a~ ........................ U,~,~e,, **,,o,.~E 5~¢)~ ............. *~a,,~, ~oa,~ *,,,o~ ...................... Request for Temporary Certihcate, / .Final Certificate Fee Submitted $ ¢~ ....................... Construction on above described building anc~pe~mit meets all a, pplicj~b, Je codes and regulations. Applicant ........... ,./; ......... FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. · 7] : oRm¥ Cerhflcate Of Occupancy No. 7'107c)/~ Date December 11, 1980 THIS CERTIFIES that the building ................................................ D~y Home L-~ne and Mid Way, £outhold Location of Property ......................... ~r'e~;t' .................. /:/,~r~ie~' House No. 04 020 County Tax Map No. 1000 Section 088 .Block ............... Lot Subdivision...B~.:Fi .l.:l.a.v.o.i? .................. Filed Map No... ?.?.1..0.Lot No...? .1 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...~.~1. ~.%lp.~...1.7 ........ , 19..7?pursuant to which Building Permit No. 10'562 7 dated .. )~.~ .uD.'b .~.0 ............... 19.7..9, 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 ......... Private One-Family Dwelling Roland V. and Dorothy A. Phillips The certificate is issued to ..................... [o~n.e.r, Jr~~: ..................... of the aforesaid building. Suffolk County Department of Health Approval .9.-. 59nq9... .~.o.b.e.r.t.A... y.~l..a... UNDERWRITERS CERTIFICATE NO. ~ Buildifig Inspector Rev 4/79 TEL. 765-1802 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 November 28, 1978 Mr. Roland V. Phillips c/o Mrs. Jean Bransfield 19 Dorothy Drive Syosset, New York 11791 Re: Lot 31, Bay Ha~en, Map # 2910 Suffolk Coauty Tax Map # 1000-88-4-20 Southold, N.Y. Dear Mr. Phillips, This is a corner lot, you have two front yards which require 50' set back. If there are dwellings within 300' of your lot, with less than 50' set back, you may use their average as your set back. Referring to your rpoposed plot plan. The houses on Bay Haven Lane set 35 to 40 feet back, so you may need to set back 37 + feet instead of 35. On Midway, 39 feet would be OK or you' may--be allowed 35 which I think the house to the west might be. If on your final request, we find you cannot meet the Code, I feel sure our Board of Appeals would grant you a variance as the proposed plot plan. I see little problems with your proposed plot plan. GHF/p s truly, GEORGE H. FISHER Sr. Building Inspector F'i ~,.J A L~ Al) D IT~ObJ A L A FO~ Hi), ! TOWN OF SOUTHO/D TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .............. , Z7 ........... .............. . ............ ............... .... 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 buddings on premises, relationship to adjoining premises or public streets or 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 wdl issue o 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 have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe'rmit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regu arians, for the construction of buildings, addm~ns or alterations, or for removal or demolition, as herein described The applicant agrees to comply with all applicable I~ws, ordinances, build ng code, housing code, and regulations, and to admit authorized inspectors on premises and in buil~tings 'foE-nec~a-~/ i~s~pectio~s, '" (Sigffatar~ Of applicant, o~al~e, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, arch~litect, engMeer, general contractor, electrician, plumber builder. or Roland V & Dorothy Ao. P~h~i.l,~$~ Name of owner of premises if applicant is a corporate, signature of duly authorized officer. ii~iame and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ...': ............................................ Electrician's License No. ~. ......................................... Other Trade's License No ............................................... Location of land on which proposed work will be done. M~p No .......... ..2.9_1_0 ..................... Lot No ....... ~.1. .............. Street end Number ....... ?.?..~..n..?.~....o..f....?..~.?....H..?.:,r.~.n...?~.n.?...~....~ ....................................................................... "~:;~C~ Municipality State existing use and occupancy of premises and rater, dod use and occupancy of proposed construction: a Exisiting use and occupancy Vacant ..................... b Intended use and occupancy ............ ?..e...~..i.~.n.?~.....~. ....................................................... 3, Nature of work (check which :pplicable): New Building ....... X. ........ Addihon .................. Alteration ................ Repair Removal Demolition .................... Other Work ................................................... .................. ' ................. ~ (Description) 4. Estimated Cost $ 4.0.~. 00C ..... Fee~......?.~..,...~... .................................................................. .......................... (to be paid on filing thru application) 5. f dwelling, number of dwelJi g units ..9~...~.~' ...... Number of dwelling units on each floor ............................ If garage, number of cars , t.~/o 9Ar ....................................................................... 6. If business, commercial or mixed occupancy, specif/y nature and ~xtent of each type of use ..... ~/.~- ................. 7. D~menslons of existing structu(es, If any. Front ..........?./..fi.. ........... Rear ................................ Depth .................... Height ........................ Number of Stories ........................ ' .......................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ........................... Depth ................................ Height ............................ Numb r of Stories ............~ ........... Depth 21 t 571 Rear 8. Dimensions of entire new construction: Front ....................................................................................... Height 25' Numberl of Stories '~ ............................................... 1 ~. De t ~ ......... J...5 ................. 1 ~ 2~ 2~ O. Size of lot; Front 2.5 Rear ................................. P 10. Date of Purchase ~eb, 4! ,~.~.~' Nome of Former Owner , .~.$.3..~;~.~,.~.1~1..3~1~ .................... , Residence ..................... 11. Zone or use district in which 'premises are situated .................................... 12. Does proposed construction v[olate any zoning law, ordinance or regulation: ....... .~ ............................................ 13. Will Jot be regraded ...~....~..e..~].~ ........ Will excess fill be removed fro~#/p:~mises: (x) Yes ( ) No , · Roland V & Dorgth ArPhi.l.~l~oss c/.g....u...r.~..t. '~Y~hone No. g21'46~3 .. eofOwnerof rem,ses ................ , ................ '~. ............ B oss~ ~,~ ............... 14. Nam P ., 7' m ....... R.~. Phillips Address ........ .e...[,..e. .......... Phone No ....................... iNome at ,~rcmtec~ .............. T .............................................. · , ........................... Addres ................................ Phone No ....................... Nome of Contractor ..........i ......... PLOT DIAGRAM te clearl and distinctly alii buildings, whether existing or proposed, and ndicate oil set-b~ck dimensions from I_~oco,:__~ ~iYv~ ~ n block number or description according to deed, and show street names and indicate Droper~y ,,,~= ...... freer a d . ~hether interior or corner lot, ~ 4'6 STATE OF NEW Y/O~K, .,.~ .~./ ]( c ~ COuNw T ~ ~_ ~/ , I/ _./.~~.. being above named, i duly sworn, deposes and says that he is the apphcor He is the ....................... ~ .......................... -. - ' ...... (Contractor, agent, corporate oft car, etc.] of ..;aid owner or owners, end is duly authorized to perform or have performed the said work and to make and fi this opplicahon; that all stotemehts contained in this application are true to the best of his knowledge and belief; or that the work will be performed in the manner set forth in the applicatlon filed therewith. Sworn to before me this /~ f'~ /~ Natal' public, · ......................... ,,uu.,~ ..... ~ ...... (Signature of c~pllcant) ~/ ELIZREIETH ANN NEVILL[ / ' NOTARY PUBLIC, State of N~w Yo~kf ~o> ~z~