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Home My WebLink About13299-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No ....... .g.1.2.6. 5..6 .... Date ................ .3.u.l.~..3.1 .........19.8.~ addition THIS CERTIFIES that the building ................................................ 805 Bayhaven Lane Southo id iocation of Property .~ .... : ........................ ._ ................................ 088 04 033 County Tax Map No, 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 2 7 19 8.4. pursuant to which Building Permit No .... 3.3 2 9 9.Z. dated ........... ?.u. 1..y..2.7. ........ 19 8 4. ,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 ......... deck addition to an existing dwelling. The certificate is issued to ................... MASON G. SMITH (owner, of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 I~OB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13299 Z Permission is hereby granted to: ........ ........... ..... ./.a~....~.~/w,~.z~... ~.~.-. ..... ~c~-~o.~.~.~. ~. :.~......z/..~ 7 / ~ ~o ....... ~~~ ....... ~.....~zz.Z~....z~......~Z~..~~ ...... ~....~ .................................................................................................................. z.. ................................................................................................................ ~~~...-~.~ ..~~~....~.~.~.~ ............................. ~...~..~% .................... co~.~ ~ ~p ~. ~0o s.¢,~o...~..~ ....... e~k .~. ......... ~, ~o..~.~ .......... ~,~., ,o ~,,~,,o~ ~,~ ...... ~z.~......~. ................ . ,,.~ ~,o~ ~, ,~e Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter OR ink, and submitted--i~:dul~,~t~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 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 safetv inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1, Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $I,00 land use --Pre-Existing C.0. $15.00 Vacant land C.O. $ 5.00 Date ........................ New Building ~ .~,/~ Old or Pre-existing Building Vacant Land . .,. Location of Property ....~...o..~.. ,,LTIE~ U¢,~ Z~h/z~__ ~? ~ HOU~ No, ~ StRet ~ -. Ham/et Owner or Owners of Property~)~'~.. .... . ~'~ 2J~ ~ ~. ~.. CounW Tax Map No. 1000 Section O ~ Block ~ Lot.. O S,b,~i~io~ ..... V. ~X~.~ .............. F~,~ ~,, ~o. ~77~ .... Lo~ ~o... ~.~ ....... Permit No. ]. ~ } Z Date of Permit .Applicant .~.~. ~ ~z / ~4 Health Dept. Approval ........................ Labor Dept. Approval ........................ .Y~.[C. Planning Approval Underwriters Approval ......................................... B(~ard' Request for Temporary Certificate ..................... Final Certificate ...... ~.. .............. Fee Submitted $ ,~. c~../.. . C~ ~ t '~)"~0,/~'~(O ......................... ~. ,~ ~(~v (~ '~ Construction on above described building and permit meets all applicabl~ code~and regulations. FIELD INSPBCTI~N COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: 'VACANT * BAY HAVEN LANE Ik'l 12 5,C~ ~ ................ VACANT" ' VACANT" 4 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT 'tOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. CZ..~,,/.~.. .... ,19... / (Building Inspector) APPLICATION FOR BUILDING PERMIT Received. InSTruCTioNs a. This application must be completely filled in by typewriter or in ink and submitted 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 issued a Building Permit to the applicant. Such permit shall be kept on the promises 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 cbmply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary it}?pections. ............ (Sig_sature of applicant, or name, if a corporation) · ' . ...... ~ ............ z; ................... f {Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. (as on the tax roll or latest deed) " If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No .... Electrician's License No ....... .~..~ ..... Other Trade's License No ...................... Locatiou of land on which proposed work will be done ....... House Number Street Hamlet County Tax Map No. 1000 Section .......... Block .............. Lot ............. SubdMsion .... · .~. · .~.d./.~..~('. ·~..~. .................Filed Map No. ?.'.~./.O ....... Lot...0f.~7(: ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed'0onstruction: b Intended use and occupancy ................. 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ......... ' '*eration ......... Repair ............ -- Remgval ....... ....... 'Demolition .............. Other Work .~.~ ?./.%- .... - 25-- (Description) 4 Estimated Cost ..... Fee .. ~*' (to be paid on filing this application) 5 If dwelling number of dwelling units ~ Number of dwelling untts ou each floor If garage, number of cars 6. If business, commercial or mixer[, occupancy, specify nature and extent of each type of use ................... 7 ..... if any: Front Rear Depth ·Dtmens]ons of extstmg structures ................. . ......................... Height: ............... Number of Stories ...... ~ ................................................ Dimensions o/f)s,a~me st~..c!u.r.e° ?it~.~itions: Front .... ............. Rear ............... 8. Ihmensions of entire new constrUction: Front ............... Rear .. ~ ........... Depth ........... Height Number of Stories 9 Size of lot: Front ' Rear ' Depth 10 Date of Purchase . c Name of Former Owner 11 Zone ...... ' situated · or use &strict m which pr¢~mses are ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... 13 Will Io~ be regraded ~ ~ Will excess fill be removed from 14. Name of Owner of premises ... Name of Architect ......... Name of Contractor ........ ,remises: Yes No ..: ............... Add,ss ................... Phone No ............... ................. Add,ss ................... Phone No ............... ................. Addmss ................... Phone No..' .............. PLOT DIAGRAM Locate clearly and distinctly al!' 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 whethe~ interior or corner lot. STATE OF NEW YORK, COUNTY OF ........... ...... S.S (Name &individual sigqing contract) above named. ........ being duly sworn, deposes and says that he is the applicant He is the ..................... [ .................................................................. , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements cont:ained in 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 of..; ...... Notary Public, ...... ~g.. . , ~tOI~RY PtlV,[~C, State o~ Ne~ Ymk ltO, ~707878, SuffOlk ~OU~lyo~/ ie~m [~plres Mo~ch 30. lO .~ (Signature 'of applicant)