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Home My WebLink About10849-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...q°.~.S.~.gU.C.T .4PP!~.z.q~. .~.q .q4 .e,4. qg. ................. Location of Property 560 Bayview Drive East Marion, New York h3~ h/o~ ........................................................ street County Tax Map No. 1000 Section . 0.3.7. ....... Block 05 .Lot 00I Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Apphcation for Building Permit heretofore filed in this office dated August 18, 1980 10849 Z ..................... pursuant to which Building Permit No ...................... dated .... Augus. ......... t 27, 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 ......... ADDITION TO GARAGE ATTACHED TO ONE FAMILY DWELLING The certificate is issued to LYNN M. SCHEBE ..................... io¥.'~;. '~,~,'0 ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ........... ~6.9.l.6J7 - May 14, 1985 ........ PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 N? BUILDING TOWN! HALL SOUTHO~D, N~ Y.~ BUILDING (THIS PERMIT MUST BE KEPT ON THE PRE~I~S UNTIL ,FULL COMPLETION OF THE WORK AUTHORIZED) ~ , 1084~ ~Z ~to ,,~.~.? .................. Permission is hereby gra?t~ed to:~/~/Z%~r'E',4,~ ~, Court Tax Ma No 1000 Sec~o, ~[~...~.. Block~;., ~,~ ........... Lot No..~.Z ........... '~ : ~ ' and 'approved by the pursuant to application~ dated .~..~; ...... ~..h...{ ...... , ] '., Buil~ding Inspector. Fee $/~ .......... '~. ........ Rev., 6/30/80 , , ~ "~ ~ · FORM NO. 6 TOWN OF $OUTHOLD Buildin§ Department Town Hall $outho~d, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICAT£ OF OGGUPAN¢ Instructions A This application must be filled in typewriter OR ink, and submitted I I to the Building Inspec- tor with the following; for new buildings or new use: I. 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-exi~ting" land uses: 1. Accurate survey of property 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- tlOn required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Certificate of occupancy New l)weJling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 ¥~ars $10.00 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $ 50. O0 Date .... ////~f.-../5,-'.../..~..~. .... New C on a t p u c t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~.-~..~....~..~',,~ .~',/.~.~<'....z~/-/?. ~ ....... ~/--.~.d?....../~.4¢.~'¢'p~, .... ,~.-. ~ .... House No. Street Hamlet Owner or Owners of Property ...... ,,~'. ,,1/~' .~.~ .... .~.,...,~..~-..,.~.~_, ............................. County Tax Map No. 1000 Section .... ~...7. ........ Block .... ~7-../ ....... Lot.././.~a~, .~%, .~. Z'/'. ~' Subdivision Permit No, ./.~,..~'..Y.~.~ Date of Permit~./~7./~?. .... Applicant .... Health Dept. Approval ........................ Labor Dept Approval ....................... . Underwrrters 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. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~9 85 JOHN STREET, NEW YORK, NE~¥V ~ORK 10038 ,.,~ ~,,,~.,o. ~o. o.~,~ ~/~ N 691617 i,~ the following Iocatlon; ~ Basetnent ~ 1st Fl. C 2nd Fl. Section Block Lot FIXTURE OUTLR'J$ FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS' E R V I C 2/0 AWG OF NEUTRAL Per_ /' i / / 11 ' r~ Th,s cerhficate must not be altered in any manner, return to th~ the Boar(imf ~s may beJdentified by their credentials. CO~YFORB~UILD NGDEPARTMI~NT'THI$COPYOF~qI~q-IFIC ~ ~: ~ OT ~E LLTERE,D IN ANY MANNER 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~ULATION / FRAMING [,/] FINAL REMARKS: FIL~D~ Z~'SPECTION DATE COMMENTS FOUNOAT~0N (lsd) FOUNDATION ( 2nO ) ROUGH ~E & PL~BING INS~ATION P~ STATE EN~GY C0~E ADDITIONAL COMMENTS: ,,-'~ FORM NO. 1 ~, TOWN OF SOUTHOLD "' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined/f/-~_~.~....~.~...., 19/~. , ', -~ Approve . ,.ff...dT. ..... l .PermitNo./P. .¢V. ' / Disapproved a/c ................. ~ ...... ~. ......... .,/// (Bui ding Inspector) APPLICATION FOR BUILDING PERMIT Application No.,/~J.~ .~.¢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 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 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 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 code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) I 1 5~~ & State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises LV0. ~ ................................ (as on the tax roll or latest deed) If applicant is a co~oration, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. TO Plumber's License No ......................... Electrician's License No. ?9....l~.....~.. ,~??...~ ..... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~. ................................................ .................... House Number Street Hamlet County Tax Map No. 1000 Section .. ~ ........... Block .... ~. .......... Lot...q~.l ............. Subdivision~.¢~?...~fi~. ~[~ ........... Filed Map No.. ~7.~ ....... Lot .I.l~. ~1~ ....... (N~e) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~..~.~..~~..~.~. ~ff~ ~ ~ b. Intended use and occupancy ................................................................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... R, epair .............. RemoVal .............. Demolition .............. Other Work ............... 4. E!timated Cost .............. : ........................ Fee ..................................... ; (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. D~menaions of existing stmctureg, if any Front... !?! ......... Rear ...I.~-! ........ Depth . .~.?.C.O..u ....... Height .. ! ~.~ .......... Number of Stories ... ~.~..~'. ....... Dimensions of same structure with alterations or additions: Front' i i i/I. } i '. i i i i i i i i i i 'l~;~r' ' ' ' i~'! ............. Depth . . . .?,..~.~ ............. i · Height .... ! .0 ~ ............... Number of Stories .... iR.g) ~.. ............ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ...........i .......... Rear ...................... Depth ...................... Date of Purchase ........... ~ ................. Name of Former Owner ............................. Zone or use district in which prexnises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded . I~.0 .' ..... Will excess fill be removed from premises: .__ Yes No amc of Owner of premises. ¥~).._. . .~. . Address .,. .. · .... e ....... _~: ...... t or ......... , ................. Address ................... Phone No ................ 10. 11. 12. 13. 14. 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 corner lot. STATE OF NEW YORK, ...... ~.*~ l~.~lO., l/~,...,~..A..~..~.~.q ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (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 applieation~ that all statements contained/n this 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 . ........................ day o~ .................... , Notary Public, .... 0^ , ~u~l#,~ ~n su,oll~l~e~M~ o . (Signature of applicant) Conlmls~lon Expires