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HomeMy WebLinkAbout15460-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15296 Date February 24, 1987 THIS CERTIFIES that the building Stainless Steel Chimney & Wood Stove Location of Property 480 North Bayview Road Southold, New Ydrk County Tax Map No. 1000 Section 078 .Block 9 .Lot 4 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated October 31, 1986 15460 - Z ..................... pursuant to which Building Permit No ...................... dated.....0 ...... c t o b e....r 3 .... I , ...I 98 .... 6 .. 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 ......... STAINLESS STEEL CHIMNEY S WOOD STOVE The certificate isissued to KAREL & LAURIE ZMRZLIK ..................... ?o',;.~;, Ye~ Y.,~lt,-~ ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO ......................................... PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15460 Z Permission is hereby granted,tp: ~ , / ~..~....~.c.,......~~~.. ...~.~.~ ...... ~..,.,~,'~,-,,:..~.....~....~ .......... ~~.~ ..........,,~.,..y..........!..,..~.~.~. ...... ~ ,~. ~'.~' ~..._. ............................................. ~ ............ .._. ........ :;. ........... ;, ....... ......... County Tax Mop No. 1000 Section ......(~....'~....~. ........ Block ...... .~.~ ........ Lot No ..... ..~...I ............. pursuon, ,o opplication doted ..... ~;~..~....~-&......~.l ................ , 19.~.~, and opproved by the Building Inspector. ~ing Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 BLDG, DEPT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pz'operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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- tion required to prepare a certificate. C. Fees: 1, Certificate of oc_cupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 ,.oo 5. Updated C.O. $15.00 Date ........... New C on s t r u c t i on ...... Old or Pre-existing Building Vacant Land Location of Property...~...~)..., .~.O. ?.f, .'~.., .~..~.....~I~...~. '/' .~ .~ ............. House No. Street Ham/er Owner or Owners of Property ~---'~". ,~ L-A~IJ~E 7-.~'~,~.-7--..L,t~--.. CounwTaxUapNo. 000Section .... p.7. ......B,ock .. Ct Lot Subdivision ................................. Filed Map No ........ ... Lot No ............. . Health Dept. Approval ........................ Labor Dept. Approval ....................... . Underwriters Approval ........................ Planning Board Approval .................. , .. . Request for Temporary Certificate ..................... Final Certificate ........... Fee Submitted $../.0. .......... ........... ~ ~-~ ~/~.O Construction on above described building and permit ~ets ~.p,p. '.~.-, codes and regulations, Applicant .... ~ ~ t. ................................ 10-10-78 R~c~ 3 i3ot/ 'OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7Lq-~iO2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PI. BG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~NAL DA~INSPECTOR~ SUFF, GO. HI~ALTH DL~T. APPROVAL I H.S. NO, , ZM~ZLIK ~, L. 6074 i ~ ~-f~ ~' ' ..~ ~_.~ .. . . .p. ~o~ I~'' ~' '" ' .... ~ , ,"' "~ F h ~ ~'[' 'f ~' ' ' *' " '-~ · "~"' ~i~ 'x~ t'x "~ " ,.... ~ ~ ~~. ~ ,:~. ~~ ,~ c~r~,~.~,. ,r. /~.;. ~, ~ ", i .~ 8UFIf' ~0' O~' OF HEAl'TH ~RVIGE8 8TA1T'M [NT Oil I NT[NT VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF $OUTHOLD DATE: MARCH 7, 1989 NAME: LAURIE B. & KAREL ZMRZLIK ADDRESS: 480 NORTH BAYVIEW ROAD, SOUTHOLD RE: BUILDINg PERMIT ~ 15460Z CHIMNEY & WOOD STOVE SEC. 078 BLOCK 09 LOT 41 This Building Permit has expired. You are now in violation of the Town of Southold Zoning Code. Please contact our office, this matter must be corrected. V, ictor G. Lessard Principal Inspector 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~::)..~....a~... ?~J.., 19 ~..~ Approved ~ .~..~...~.}.., 19~.G. Permit No. I.,~.q..G.O..~' Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 p_re.mises or public streets or areas and giving a detailed description of layout o'f property must be drawn on/h~'B[~ng~i~h is part of this appl~- cat~on c. The work covered by this application may not be commenced before issu~9~.of,~B~ilcl~lg"l~il~L ] ~'~4 d. Upon approval of this application, the Building Inspector will issued a .Bui2~,~ ~t~10itl~O~l~a~,~.¥1~ 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 purBo~ wh~e f Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the iS~thnce of ~' ~n~ruit pursuant to the Building Zone Ordinance of the Town of Southold, Suffblk County, New York, and other hpplicable Laws, Ordinances or Regulations, for the construction of buildings, addition~ or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code~Rd regulations, and to admit authorized inspectors on premises lind in bnilding for necessary inspections....~...~../.. (Signature of applica~, or flame, if a corporation) (Mailing address df applicant) State whether applicant is owner, lessee, agent, architect, engineer, geueral contractor, electrician, plumber or builder. Name of owner of premises . .~...~.~.~...~.,..~.. · .~. · · -~- · .... ~.~-~ ~ .......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plmnber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... 1. Location of land on which proposed work will be done .................................................. 4~)O ......... .I~.~..X~.. ~.h..~. ~-~. ................ ~?'~)~'Stde; ..~...~...'T~.....~.. ................... , ............. House Number Hamlet County Tax Map No. ,000 Section Block ~ Lot. ~ ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Namu) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~t~T~ h~ ............ b. Intended use and occupancy ~ I ~ ~ 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration ......... Repair .............. Removal Demolition ............ Other Work O~ ~~C~ SYI~L~ $'1~ C..~%~ ~ $~%~.~ 41~ ~O~]C) (Description) 4. ~P~etd~ost~'1~ .~...~...~...~ .1'~. ........... 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 .. ~..~T .... Depth...~.'7. ~ .... Height ....~,,~ ~ .... Number of Stories ........ I~14~ .......................................... Dimensions of same structure with alterations or additions: Front ..:. ~O- ~ ..... Rear .... ~./~e~-~... Depth ..... '~'7. · ~ ........ Height ...... ~,iao. ~ ....... Number of Stories ...... ~ .......... 8. Dimensions of entire new construction: Front .......... ..... Rear ............... Depth ............... Height ............... Number of Stories .......... :: ........................... ;~' ' '/' ' i'--' ' "' ' ' 9. Size of lot: Front ...... ~.l~t ~[. ~... Rear~...... ~{ae~a.'~7..~:~. .... D,ep~th~ :~.....~'~.~!~.~... · 10 ..... Date of Purchase .l~CILa~lla---.l~..~l~'~'~.~t~..NameofFormerOwner~._.:.. ,- .~ .- . ....... ..~l.rs~e~lq...:'~.t30~.~~ .. .... 1 1. Zone or use district in which premmes are sffuated ................. If~--'".~..t ~:l~. I Pk'l.~ ................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... ~..~ ................. 13. Willlotberegraded ......... ~.~O. ............. Willexcessfillberemovedfrompremises: Yes ~.~.~.. 14. Name of Owner of premises .~..~.~ ~, .7-41~.S~7~l~.l~,,Address ,~1 1~ I~ll~... Phone No. 7~I~. · .-. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... ; .............. Phone No. ~..~ .......... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..Y:. · If yes, Southold Town Trustees Permit maybe required. PLO~T 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. ~)l,ao'V~.~t~ ~0/ ~"~18'~ q / goV 41 OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIfiCATE OF OCCUPANCY STATE OF NEW YORK, S.S COUNTY OF ................. (Name of individual signing 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 duly authorized to perform or have performed the said work and to make and file this application: that all statements contained 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 flied therewith. Sworn to before me this ............ .~./ ......... dayof .......~. · ~. ........ 19~...