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Home My WebLink About16308-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17884 Date MARCH 24, 1989 THIS CERTIFIES that the buildin~ ALTERATION Location of Property 530 KNOLL CIRCLE & 1090 BAYVIEW RD. House No. Street County Tax Map No. 1000 Section 37 Block 5 Subdivision GARDINERS BAY EST. Filed Map No. 255 EAST MARION Hamlet Lot 9 Lot No. 18 & 19 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15~ 1987 ..pursuant to which Building Permit No. 16308-Z dated AUGUST 2, 1987 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 ENCLOSED EXISTING BREEZEWAY & MAKE INTO KITCHEN AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED SCOTT R. WERNER & WAYNE A. GRIFFITHS H-004568-AUGUST 19, 1988 Rev. 1/81 Building Inspector ~OB~ NO. ~ TOWN OF $OUTHOLD BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 16508 z Permission is hereby granted(.~to: ~, ~, ..~.../~ ..*')' ~'~ ~'~' . ~. ....... ~..~.,...j.c.. ............................. x~o~ 1/.~.'7 o .... ........ ~./..J./..~2..o.. ....................... , .................................. I"'~' ........ ,"~T'"2';'"t~'"7 ;' ................ -' "7 ', '~J '" ~'"' '~' .' "'~' County Tax Map No. 1000 Section .... .O...~.~. ........ elc~k ...... .~...~.. ....... Lot No. O .~. pursuant to application dated ...... ...~.. ~..~..~.. .................. 19.~.3.., and approved by the Building Inspector. Building Ins~ctor Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 1197 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE .............. NE;'/ CONSTRUCTIOH ....... OLD OR PRE-EXISTING BUILDING. X.VACANT LAND ........ Location of Property.fP[~.~PPfY'.~Pf'J~..; ............. HOUSE NO. STREET HAHLET Ovhet or Ovners of Property.. ~ '-~.~..~.4-.. ~ . f~ ' ' [ounty ~ax ~ap ~o. 1000 Section . .. Block .... Lot ....... Permit No ....... Date of Permit ~3- .Applicant ~ '. ..... Health Dept. Approval '~ ~ ........ ~nderwrlters Approval~.qq~ Z Planning Board Approval ~ ............ × Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: rev. mo/14188 UNDATION ( 1st } UNDATION ( 2nd ) UGH FRAME & FLUMBING SULATION PER N. STATE ENERGY CODE Ye . ADDITIONAL COMMENTS: ,¥ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST ~- ] ROUGH PLBG, ] FOUNDATION 2ND [ ] INSULATION ]FRAMING ?~J/FINAL ~ // INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION FRAMING 2ND ~ ~ /~ULATION £/~ FINAL REMARKS: DATE INSPECTOR ~, ~/~ OCCUPANCY OR '//~"'¢'~ ~t~'~"[S tJNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY SUPPLY' SYST£M ;AN~rOT PLUMBER CER1 ~IC~ T~O~V ~T BEFORE ~CUPANCY for Water distributing system; piping shall be of types K or L ~ 0 0 '~._J .... ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT . . ~/. . . · FORM NO. 1 SURVEY . TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y. 1~I971 NOTIFY TEL.: 765-1803 CALL ................ MAlL TO: ~7z7 Date .................. , 19... 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 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 o]~ 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 building for nece~ions~,./~ ....... y. ./o. . (Mailing addrsss of applicant)-- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST B.E./.~UFFOLK COUNTY LICENSED Builder's License No ....... ~'r~"A(fff' ............. Plumber's License No ...................... Electrician's License No. ..~/~.. Other Trade's License No .... '.. ~f~ ............. 1. Lgcation ofland on which proposed work will be done ~/'~'2/-"~/~ ~/ ~f~f ..... ~;~; ~},}~: ........... :'' ':''' ~;r;;; ...... ~ .............. ~a':l;;'" ............ '~''; ..... County Vax Map No. 1000 Section ..... ~:Z ....... Block ~" Lot Subdivision ..................................... Filed Map No ............... L~t ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:~ a. Existing use and occupancy .~.~(~..~/] ~.~ ~q}~' ... ' ;~'~¢2~'~: ....... d " b. Intended use and occupancy ** 4 ~ . . . ........ 3. Nature of work (check which a~plicable): New Building ' Addition .......... Alteratiomv../~'.. ~.. .... Repair .............. Removal .............. Demolition .............. Other Work ............... (Descfiplion) 4. Estimated Cost .... :1.~.v..'~..i .......................... 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. Dimensions of existing structures, if any: Front. - ..... Rear .............. Depth. ~ ............. Height ............... Number of Stories ...... i. ............. · ..... Dimensions'of same structure rith alterations or additions~;/Ff6~t ................. Rear .................. Depth ........ 4. :~/ ....... Height ...................... Number of Stories ...................... Dimensions of entire new corn ruction: Front ....... ~ ..... Rear ............... Depth ............... Height ............... Nu] nber of Stories ........................................................ 9. Size of lot: Front ' ........... Rear ........ . .............. D th ..... ' 2~7~'/~ ....... ~.. ................. Name of Former Owner .~..~. ~.. ~.~. ~O' ] .............. 10. Date of Purchase .'~'-.~../.-. ................... 1 1. Zone or use district in which '~remlses' ' are situated' ........... . ......................................... 12. Does proposed construction vi01ate any zoning law, ordinance or regulation: ~.~ ........................... 13. Will lot be regraded ...~?...; .................... Will excess fill be removed from premises: . .Yes .~ ~o~ 14. Name of Owner of premises ~.~A.~,F.~..~r~"/..~./~./.~. Address .~. l~..~/~'>~.~.~... Phone No..~?.~;. & 7. ~.~.... amc of A ltect ......... I .................. Address .......... /t'~?*P' ' ' Phone No ................ Name of Contractor ........ ! .................. Address .... ; .............. Phone No ................ 15. Is this property located! within 300 feet of a tidal wetland? *Yes ..... No *If yes, Southold Town TrCstees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all s~t-back dimensions from '8. property lines. Give street and bloc~ interior or corner lot. number or description according to deed, and show street names and indicate whether COUNTY .~..~.~. ~'¥~.~....~. 7! .~..~..t~. ! .~.~.~. !i.~(~ ~ ................being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. lie is the ...~ .~.~ ......... ~.. ~ ................................................................. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly autho~zed to perform or have perfomed the said work and to m~e and file this application; that all statements contained h tbs application are true to the best of his knbwledge and belief; and that the work w~l be performed in the m~nbr set forth ~ the application filed therewith. Sworn to before me thi~// ~ ~ ~ , i ,, ¢? / ............ ~...~ ....... day o~ ......~.~ .... ,19.. / t Nota~ Publi~.~~... Couny A, .. / , ~ .... ~ ............ ~/''; ......... ?'~ .................. ~ ~_~..~ {/ (Signature of applicant)