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Home My WebLink About10821-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17870 Date MARCH 22, 1989 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 480 NORTH BAYVIEW ROAD SOUTHOLD~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 9 Lot 41 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 8, 1980 pursuant to which Building Permit No. 10821-Z dated AUGUST 8~ 1980 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 ACCESSORY STORAGE BUILDING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HED2]TH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 LAURIE B. & KAREL ZMRZLIK · / yldi~g Inspector ~o~ ~o. ~ ~ SOUTHOL;D, N~ Y, BUILDING:- PERMit' (THIS PERA~IT MUST BE KEPT ON TH,E PREAAIS COMPLETION OF THE WORK AUTHORIZED) · N? 10821 Z Date UNTIL I~ULL Permission is hereby granted to: ... r,.~.~.~'.~.~......~./~....;~,.,,., ........ ,o ....e.~..,~.~.z~...~.~....~~....~,~.~.....~.~ .............. ....................................... ;:"~ ........ ~-~ .......... ~':::"~z;;"'~';~'"~:'~::' ~ at premises located at ...~.~ ...... ~ ...... /~.~Z~...~. -.~0~ ~ ' .~.~.~ ,, .~:~ ~ Coun~ Tax Map No. 1000 Section .. ~. Bilk ~ .......... ~.~t No ....... ~ ..... pursuant to apphcation~ dated ......................... ~,....., 19 and approv~ by the Building Inspector. . ~ Fe~ $.~. .................. : Rev. 6/30/80 Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DAr~. ~ar~ ~7.,- &9.&% - NEW CONSTRUCTION . MX OLD OR PRE-EXISTING BUILDING .... VACANT LAND.. Locat:on of Property... A~q......~o~h my~w. . .~°~s, So~o:s, ~.:. EOUSE NO. STREET HAMLET ' ~ & ~ . Owner or Owners of Property Laur e B. Karel Zmrzllk County Tax Map No. 1000 Section ..Q%~. Block ...9... Lot ..~ Subdivision ....................... Piled Map ........ Lot .......... Permit No...........10821g Date of Perm£t Aug:~', P~App[icaut Karel gmrzl±k Health Dept. Approval .................. Underwriters Approval Plannlng Board Approval Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $. /~, ~0 APPLICANT .... '.~....~...~. .............. ~x.. 3~s~,I rev. 10114./88 FIELD FOUN ROUGH PI INS[ S~ INSPECTION DKT~E COMMENTS IATION ( I st) )ATION (2nd) FRAME & ~UMBING ~ATION PER N.Y. ~ATE ENERGY CODE FINAL -- ADDITIONAL COMMENTS: ~'~' "~ ~C~IO~ 7209 O~ RODERICK VAN TUYL P, C. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, "11971 /g~(y ~ TEL.: 765-1802 Examined ........ ~... ,19ZO App,oved ?.. . ...... 10 0. Permit No.. t.0 Disapproved a/c ....... "...'~. .~-~ ................ / (Building Inspector) APPLICATION FOR BUILDING PERMIT Date Application No. / 0 ?d / 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 braidings 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 ~ssuance 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 have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pu,suant to the Building Zone Ordinance of the Town of Southold, Suffolk Cotinty, 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, houst~~ cod~c-~nd regulations, and to admit authorized inspectors on premises and An buddings for necessary inspections./') P. O, BOX 873~ .SOUTHOLD~ N~iD YORK 11971 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises LAURIE. .B....& . . .K/)~.L..Z.NRZ.L.I.K. ........................................... (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. · . ~.~.d--.~.ij~. Phnnbel's License No ................ Electrician's License No ................ Other Trade's License No ............... Location of land on which proposed work will be done ............................................ 480 NORTH BAYVIEW ROAD SOUTHOLD~ NEW YORK 11971 Ifouse Number Street Hamlet County Tax Map No 1000 Sectmn . . Q78. ........ Block ....... 9 .......... Lot .... .4.1. ............ Subdwis~on ..... Fded Map No .............. Lot ............... (Name) Si,itc ,'xh{lIli', tINe ,hid (}ct IlpdllCy O[ ])l'ellllSeS alia intended usc alit[ occtlpatlcy of proposed construction' R~.' S. I DE NT I4L . . .TOOl, STOlOX, q/~ .Sl[l~O 3. Natme of work (check which applicable) New Building . . . .X.X ..... Addition .......... Alteration ......... Repair ............. Removal ............. Demolition .............. Other Work ............ (Descript'mO 4. Estimated Cost ....... .~.7 9.0.. 9.0 ................... Fee ... $.19.,.09 ......................... (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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front... g.0. J: T ...... Rear . ¢0. YT, ...... Depth ... 27. YT, ..... Heigllt .... 2.3. ~ ........ Number of Stories .... .O.N~. ............................................... Dimensions of same structm'e with alterations or additions: Front ................. Rear ................ Deptli ................... ~... Height ..................... Number of Stories ................. 8. Dimensions of entire new construction: Front .... 13. FT ....... Rear .... B. F:i: .......Depth ... J-2. FT ..... Height 8 FT. ' . ............... Number of Stones ........................................................ 9. Size of lot: Front .... 1.5.6...2.1.! ............ Rear .... 1.6.3...2.7.' ............ Depth .. g9.6.,.17.' ............. 10. Date of Purchase . . . .I).E.C.~g.B.~.R..1.2.,..1.97.9 ......... Nan~e of Former Owner . . .Mt~K..I.E..8.T.LT.T.Z.E.R .............. 3, 1. Zone or use district in which premises are situated ..... ./7t...2.O. ~.~. .................................. 12. Does proposed construction vi$1ate any zoning law, ordinance m' regulation: .... .I'I9 .......................... 13. Will 16t be regraded ..... .b].O.i .................... Will excess fill be removed from premises: Yes No ~ 14. Name of Owner of premises J-g,IJK,I~B~o,~. V,A,RF~L... Address . ~.89. ~....B.a~/y.t.e.w..R.d.. Phone No. 76.57.16¢5 .... ~ Name of Architect ......... ' .................. '~'~"~J-~ Address ........................... Phone No ............... Nmne of Contractor .......................... Address .................. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lihes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. DIST, 1000~ SECT. 078 BLOCK 9~ LOT ti1 STATE Ot~ NF, W~,, ~ ~Y, ORK COUNTY O F .~.-'~-.~.-/I/-~.. ......... /~.~.~.}. · ~.~.~ ~.~ ....... bmng duly sworn, deposes and says that he is the applicant (Name ot ~ndtwdual signing contract) above named. lie is the .... (,Contractor, agent, corporate officer, etc.) ,f s:ud owner or owners, and is duly authorized to perform or have performed the said work and to m~e and file this ,~q,hcat~on. that all statements confalned h~ this application are true to the best of his knowledge and belief; and that the ,.~.o~ k wdl bo performed in the manner set forth in fhe application filed therewith.