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Home My WebLink About13092-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15361 March 18, 1987 No .................. Date ................................. REPLACE EXISTING PORCH THIS CERTIFIES that the building ................................................ 4075 Bayview Road Southold, New York' Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ... 0..7.8 ...... Block ...2. ........... Lot .... } .8 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 27, 1984 13092Z ........................ pursuant to which Building Permit No ...................... May 27, 1987 dated ............................. 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 ......... REPLACE EXISTING PORCH ON EXISTING ONE FAMILY DWELLING. EVELYN SWISKEY The certificate is issued to ..................... [o~;n'e'r,'/~'gr~'Y~ft .................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. tq / A N/A PLUMBERS CERTIFICATION DATED: /,,Building Inspector Rev. 1/81 FO~.,M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo BUILDING I~ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13092 Z Permission is hereby granted to: ...... .c..~,..%~..~.k.~ ............. .....-..F.:.~.?.~. ............. ~.~ ...................... .~:~-~....M~.....~.~.~.~..~ ....... c~, ~ .~ · 0~ . ~ ..... ,~.....~....~ ........... ~...~ ........ ~....~.~.~ ......... ~..~..~,~. ~ ~.~..~..~~.~...~.....~...~.., ............................................. at premises I~ated at ...~.~ ...... ):.,~.~.~.L~)..Z~.-..~.~~ ......... County Tax Map No. 1000 Section ..... ..~...~....~.. ........ Block ....... ~ ..........Lot No ....... J...<.~ ............ ................. ~. ............. .~t. pursuant to application dated . ..~..~ . []. .., 19 ., ond approved by the Building Inspector. Building Ins~ctor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, .This application m.ust bo filled in tv?writer OR ink, and submitted ~a a~a~=a to the Building In,pec- ker with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buitdlngs, property lines, streets, and unusual natural or topographic features, 2. Fine approval of Health Dept. of water supply an.d. sewerage dispos~l-(S-B form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Coalmercial buildings, Industrial buildings, Multiple Residences and similar buildings and in,ella. tions, a certificate of Code compliance from the Architect or Engineer responsible for the buildin0. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957)0 Non-conforming uses, or buildings and "pre-existing" 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 coda or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: ' 1. Certificate of occupancy 2. Certificate 0f occupancy on pro-existing dwelling $ 5 0.0 0 3, Copy of certificate of occupancy $ 5.'00, ove~ 5 ye~cs $10.00 4.Vacant Land C.O. $ 20.00 5.Uodatod C.O. $ 50.00 Date .......................... 6. ~lteration NewtOns true,ion ...... Old orPre-exlsting Building ~ ........ Vacant Land ............. Location of Property House ~o. Ham Owner or Owner~ of ~roporW ..... ' ........................... CounW Ta~ Ma~ ~o. 1000 Section ............... ~lock ............... lot ................ ' ' ' Filed Map No Lot No Subdivision ..... 0o ................. ,o,0 ........ o,..o.o. , ,,.o.o ....... Health Dept Approval Labor Dopt Approval . . Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate Final Certificate Fee Submitted $ ............................. Construction on above described building end permit meets all applicable codes and regulations. Appli cant ..... __ · ....... ,- .... .~ .\... ...... 0 ............ It~, 10.10.78 c o FIELD I ~IS['ECTION ?OU~IDA'i'IOlt (1st) FOUNDAT!OU 2. (2nd) ROUGU FRAHE & ?LUMBING ~NSULATION ?ER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: NOTIFY BIJILDING BEPARTMENT AT. 765-1802 9 AM TO 4 PM FOR THE FOLLOWING ~N'qTFCTIONS: ~. FOUN~A?[ON -'TWO FOR P~UR'}I'~ CONCRFTF 2. ROUGH FRAMINC: P P~ ;MBING 4. F[NA - ¢-~ "; ~ ~ "~qN MtJST BE C~ml.. 'TF tzar C 0 ALL CONCrE~;~-qON S,,At_L MEET THE RFO! STATE CONSTRUCTION & ENERGY CODES. NOT . RESPONSIBLE , FOR DESIGN OR CONSTRUCTION ERRORS. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P,O. BOX 728 TOWN IIALL SOUTtIOLD, N.Y. i 1971 TEL. 765-I 802 This is to advise you that the job under building permit no. 13092Z. issued to Evelyn swiskey. on 5_~.~./84 for Assition is completed and a final inspection has ( ) has not ( x ) been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check fatS25.00 payable to the Town of Southold. Please indicate to Whom tile Certificate of Occnpancy is tO be mailed, and arrange with this office for an inspection date Occupancy or use i.~ unlawfnl without a Certificate of Occupancy. Please help ns to clear np this matter so that legal action does not have to be taken. Thank you for yonr prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gnr oriel. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Permit No. l .?.~.').(~ 0..~ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Dat~ .~..9 .... 19~..ff 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 perry, it 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 hi building for necessary inspections. -- -- ~- ,~,~4;(Sigitature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~,Lt..,e. ! .~.g] .... 5 14ey " (as on the tax roll or latest deed) If applicant is. a corporation, signature of duly authorized officer. ~ and ~rate officer) ~' Builder's License No....0 ~~ ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No .......... : ........... 1. Location of land on which proposed work will be done .................................................. ................... ............ .3..o?. ................ .... House Number Street Hamlet County Tax Map No. 1000 Section ...... .Q~..~, .~ ...... Block ........ ~ ....... Lot I X~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .. h .07..3..~ .......................... ' ............................... b. Intended use and occupancy ...h0?..~..'~.....~t....~...?. 3. Nature of work (check which applicable): New Building ..... ' .....'Addition .......... Alteration .......... Repair .............. Remgval ....... Demolition .............. Other Work ' ~7 . 6~-L~ortl~escription) ...... .i ' (to be paid on filing this applic i 5. If dwelling, number of dwellinglunits .. ~ I.f~ Number of dwelling units on each floor.. If garage number of cars ' 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height Nun~ber of Stories Dimensions of same structure with alterations or additions: Front ............... Rear ................. Depth ................... ~.. Height ............. i ......... Number ~)f Stories ....... 8. Dimensions of entire new constrUction: Front . . :P-~6' Rear . .re .......... Depth ............ Height Number of Stories 9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... i .................. Name of Former Owner ............................. 11 Zone 0 district in .... · r use which premises are s~tuated ....................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ i!~.. · ... ·....,... ... Will excess fill be reg~oved from premises: Y~.~es No 14. Name of Owner of premises . A~ddress .~ .... Phone No. b... ,¢. ?..~.~ Name of Architect ........................... Address ................... Phone No ................ Name 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 lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, CO'UNTY OF ..... .................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signi ng contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dui ' authorized to perform or have performed the said work and to make and file this application; that all statements cont~ .ined 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 .......... ..~.7....~-..; ..dayofi. Notary Public ....... ~.!. NOTARY PUBLIC, S{aN of New (Signature of applicant)