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Home My WebLink About16039-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certi[icate O[ Occupancy No Z16525 Date December 22, 1987 THIS CERTIFIES that the butldmg ....A.4 d. ~ .~.~.qn..s ................................. LocatlonofProperty 9875 Main Bayview Rd. Southold House No Street Hamlet County Tax Map No, I000 Section . .0..8.8 .. Block . 0 ] .......... Lot ,0 2. ........... Subd[wmon ..................... Fried Map No ......... Lot No .............. conforms substantially to the Apphcat~on for Bur(ding Permit heretofore filed ]n fins office dated ·.. M.a.y. 1.3 .... ! .9.8.7 .. pursuant to wtuch Braiding Permit No 1 6 0.3.9.Z. ............ dated .J.u..n e..9: 1...9 8 7 . ...... was ~ssued, and conforms to aU of the reqmrements of the applicable prov~mons of the law The occupancy for wtuch tlus cemficate ~s ~ssued ~s ....... & deck additzon & a slzdzng door addztion to an exzsting one family dwelling. The cemficate reissued to ...MR, R· ~UOV% ............................. (owner, of the aforesazd building. Suffolk County Department of Health Approval .N./. A ................................ UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION BATEB: N/A Building Inspector Rev 1/81 FO~V NO. · TOWN OF $OUTHOLD 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~ 160~? z Perm,ss~on is hereby granted to: ...... ~.3..9.......~....~~....~....{...: ........ ro ..~......,n,...~...~.......~..:L.~ . ... ~.,,?. ~ ~,,...~~.....~...~.,......,e...~~ at premses located at ..~ .~...~..~. ....... :,c,....~.... ~ .~. ........ ~.._~. ~ ........................ ~ ..... co~v Ta~ Mop Uo. ~000 S~.on...m~.~.. Block ....... ..~...~ ...... tot Uo ...... ~....'~... pursuant to application dated ..... ...t..y..¥~.~ Building Inspector. .,~ Fee $.u~-~... .............. ~l-..~ .............19.~..-J.., and approved by the Building Inspector Rev 6/30/80 FORM NO. 6 ~ TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Th~s apphcat[on must be filled in typewmter OR ink, and submitted t I~mmmaa to the Budding Inspec- tor w~th the following; for new buddings or new use: 1. Final survey of property with accurate location of all buddings, property hnes, streets, and unusual natural or topographic features 2. F~nal approval of Health Dept of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electmcal mstatlatlon from Board of Fire Underwmters. 4 Commercml buildings, Industmal buddings, Multiple Residences and similar buildings and mstatla~ huns, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For exmt~ng buddings (prior to Aprd 1957), Non-conforming uses, or buildtngs and "pre-exmting" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topograph m features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of bu ddings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- t~on required to prepare a certificate. C. Fees' 1. Certificate of occupancy $5,00 2 Certificate of occupancy on pre-existing dwelhng $15.0 0 3. Copy of certlhcate of occupancy $1.00 4.Vacant Land C.O. $5.00 [. .~.Z 5.updated C.O. $15.00 Date ./.~. '~P. . .-. ....... NewCons truc~,zon ..... Old or Pre-existing Budding .......... Vacant Land ............. Location of Property ............... ~,-.,,~ ..... :~..~,¢ ~....,.. ~ ........................ House No, '~'~ Street Ham/et Owner or Owners of Property .............................................. County Tax Map No. 1000 Section .............. Block .............. Lot ~ ~' Subd~wmon ...................... Fded Map No ........ Lot No ........... Perm,t No./~.i ~ .~..YD ate of Perm,t ~ .'~..~ ~. ~Applican,. ~.~., .t~../'.~....L?..z~.~. Z.% ....... Health Dept. Approval ........ . .-'~../'"/ ..... Labor Dept. Approval ........................ Underwriters Approval ...................... Planmng Board Approval ..................... Request for Temporary Certificate ................... Final Certificate .... · .~.~. · .~ ............ Fee Submitted $ ......................... Construct,on on above descr,bed bu,ld,ng an~/~ a,~aT~des and regulat,ons. Apphcant ./__~-f. ..... ~/4 .f_,//.<~/~ ..................... Rev 10 10-78 c, d, TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of tho followinq reasons. /~ An application for Certificate of is not on file. ~c~,~- /-/ Occupancy No Underwriters Certmf~cate on file. The check is(outdated/not on f~lc.) fl~5~ No Health Dept. Approval on file. No final inspection has been made. Please contact our office on th~s matter. Thank you for your cooperatxon. ~-Buildxng Permit ~ / ~ ~ 3 ~ Z Building Dept. ***/~/ No Plumber Solder Certifmcate on f~le. ( all permits involving plumbing being issued after April 1,1984 ) OUNDATIO:~ (1st) OUNDATION (2nd) OUGH FRAME & ?LUMBING NSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]~~TION FRAMING [//]' ~INAL ~ Exammed 'K~/.d-r~-~ ¢1 Approved .'.~,4,a.,5~ ~ Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y. 11971 TEL.: 765-1802 ,191~ 7 Permit No. 1.4o t~1 '~ (Bulldmg Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19. INSTRUCTIONS a Ttus apphcahon must be completely filled m by Wpewnter or ~n ~nk and submitted to the Budding Inspector, gat sets of plans, accurate plot plan to scale Fee according to schedule· b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premxses or public stre or areas, and g~vmg a detailed descr~phon of layout of property must be drawn on the diagram whmh Is part of flus ap cation. c The work covered by tbas apphcatmn may not be commenced before xssuance of Budding Permit d Upon approval of th~s apphcat~on, the Budding Inspector will ~ssued a Bufldmg Permit to the apphcant Such pen shall be kept on the prenuses avmlable for mspectmn throughout the work e. No budding shall be occupied or used in whole or ~n part for any purpose whatever until a Certificate of Occupa~ shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MA~DE to the Budding Department for the issuance of a Bmld]ng Permit pursuant to Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of buddings, add~ttons or alterations, or for removal or demoht~on, as herein descrtb The applicant agrees to comply .with all apphcable laws, or&nances, budding code, houszg~g42ode, and regutatmns, and admit authorized inspectors on premises and m building for necessary mspec/hO~s / /~ .... //. 7. ...... [maz~zng address or appx±cgnt) State whether apphcant ~s owner, lessee, agent, arcImect, engineer, general contractor, electnclan, plumber or ] . .Co:v .gcr. . ..................... Name of owner of premzses /P~A~ ~t /~"~~a''Lg 7~ ........... (as on the tax roll or latest deed) If apphcant ~s a corporation, signature of duly authorized officer (Name and htle of corporate officer) Builder's Lmense No..~. 7 ~--~..r .~. Z Plumber's L~cense No Electnc~an's L~cense No Other Trade's License No Location of land on which proposed work wflI be done .. House Number County Vax Map No 1000 SectAon ¢~'~P . Block Hamlet 0/,o..o . .. .C, Subdivision (N'ame) ' Fded Map No .. Lot ...... 2. State ex~stlng use and occupancy of premises and intended use and occupancy of proposed construction a. Ex~stmg use and occupancy .......................... b. Intended use and occupancy .......... . '. ....................... 3. Nature of work (check which applicable). New Budding . .. Addition ......... Alteration Repmr ......... Removal ..... Demolition ........ Other W~rk. 4 Estzmated Cost . 2]-0~90~- O..0 .......... (Description) · Fee ...................... (to be paid on filing this application) Number of dwelling units on each floor ........... 5. If dwelhng, number of dwelling unxts ....... If garage, number of cars ........... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... 7. Dunensions ofexmtlng structures, if any Front .. ~.:~(:> ...... Rear . .~.~ ...... Depth .5 ~ ...... Height /..~ ~ .... Number of Stones .. ,~ ............... -- ...................... Dunenslons of same structure with alterations or additions Front . ,.~ to. ....... Rear .. ~. 9. ......... Depth zT~~- .......... Height . / 7 .t .......... Number of Stones...~,, ............... 8. Dimensions of entire new construction Front .... ~, ....... Rear ... ~,,'~.q~. ...... Depth .,r~ .O ... Height /f)~ C~I~' .... Number of Stones.. Cd ....................................... 9. S~zeoflot Front /(~.O.. . Rear... /.O.O .......... Depth ~/.~.. .......... I0. Date of Purchase .................. Name of Former Owner ....................... 11. Zone or use district in wluch premises are situated ...................................... 12 Does proposed construction violate any zonmg law, ordinance or regulation' .../,'(. (~) ................. 13. Will lot be regraded . · · /~O ........ , .... Will excess f'fll ~e removed from pre~mes Yes 14. Name of Owner of premises J~f'O/'~l~y~Tr- .'F'/-/(d &{-. S.~Address ~7 7[ /ff/~/,:~../,r'~'~'['No.7 ~.)~.23~'./..Pr&'~. Narae of Architect . · ......... l ............... Address ................. Phone No . ~ ....... Name of Contracto?~o~a~ ed~ ~ ...... Ad d re s st/r~,./)t~Ag'//.~(-/~. J.*/~;l~oe~n~P~;. '~,~..~c? ~o... 15. Is this property lo ~uu feet of a tidal wetland? * Yes ..... No ~ if yes, Southold Town Trustees Permit maybe required. PLOT DIAGRA~ Locate clearly and d~stinctly all buildings, whether existing or proposed, and. indicate all set-back dunensions fro~ property hnes Give street and block number or description accordmg to deed, and show street names and indicate whethc mtenor or comer lot. ](o O C. STATE OF NEW YORK, COUNTY OF S.S (Name of ~ndlvldual s~gmng contract) above named bemg duly sworn, deposes and says that he as the apphcar He is the .. (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is duly authorized to perform or have performed the smd work and to make and fie tb apphcatmn, that all statements contamed m this apphcatmn are true to the best of his knowledge and behef, and that th work wdl be performed in the manner set forth m the application filed therewith. Sworn to before me this ......... /'~.., ,dayof. ~]... O~CUP~Ney OR ' WITHOUT CERTIFICATE , OF OCCUPANCY ,, ,, ,, ~, 1\ OCCUPANCY OR USE IS UN~WFUL WITHOUT CERTIFICATE OF OCCUPANCY ~FP~OVED ~.~ NOTED NOTIFY BUILDING OEPARTMSNT AT 765-1802 9 A~ ro -' PM FOR THE FOLLOWING INSPECTIONS: ~NDATION TWO ~EQ~D FOR PO~ED COEICR~TE ROUGH FRAMING a PLUMBING