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Home My WebLink About15309-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... Z14960 Date October 6, ........ 19.8.6. THIS CERTIFIES that the building C a r p o r t a d d i t i o n Location of Property .q.q2.9.5. Y..°r3.h. Bayvie~ Road Southold, N.Y. House No. ' ............... 'S't/ebi ....................... h3rhiel County Tax Map No. 1000 Section . .0.7. 9. ....... Block ...0.5. .......... Lot 2 0.5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated S.c.p.t.e.m.b..e r..1.8. ~ ....... 19 .8.6. pursuant to which Building Permit No..1.5..3.0.9.Z. ............. dated .. ~ e p.t.e, r01~ .e ?.. ~ ?., ........... 19 .8.6., 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 ......... Carport addition to existing accessory building. The certificate is issued to .... ~..a.m.e.s...~ ?atricia Boyle ......... ..................... of the aforesaid building. Suffolk County Department of Health Approval ...... .~./.fi. ................................ UNDERWRITERS CERTIFICATE NO .............. .~/.fi. ................................ Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PER~IT Ct'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15309 Z Permission is hereby gronted to: ...... ............. ..~...o..~.~.~....~.~q~.....~ ............... ...~.~......~.:~.,...u.~.~.4... ,o .~.x........~.~....~..~.~....~..~.~ ....................... at premises located at .L.~.....~...?..~........./~...:....f-Z-~-..~..~..~.-.'~ ...................................................... County Tox Map No. 1000 Section .... ..C~....~....~. ........ Block ....... C~..~'. ...... Lot No...~.....?...Z...~ ........ pursuant to application dated ..'~...~....~...~.. ............. 19.~..J~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ --.~.--.- 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 p~'operty 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 safety 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 $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 g/~, 5. Updated C.O. $15.00 Date ................... NewCons truc tion...X... Old or Pre-existing Building , ..~. ....... Vacant Land ............. Location of Property .l~.~.,°:~. ~"/' ~4 Fi~ ~.d~ j.~ ..~.,/.~,, . House No. Street Hamlet Owner or Owners of Property .~.'~.~..~'. ~..,~...~7 ?.~.~..~}¢j~ .~..0.'~!~ County Tax Map No. 1000 Section ............... Block .............. Lot .... ' ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and pelmit meets a applicable codes and regulations App cant .~.~' ~ . . . ' . Rev. 10-10-78 g 30q q 7 ,FIE~ INSFECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL COMMENTS ADDITIONAL 'COMMENTS: 0 $, 69°t3'00'' E. ,ce/ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 TEl.,: 765-1803 Examined .~ .~. ~., 19 d~ ' Approve ...-'~..., 19~., Permit No. [ Disapproved a/c ..................................... (Building Inspector) APPLICATION 'FOR BUILDING PERM IT INSTRUCTIONS Date .... ' ........... 19 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 loca.tion 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 whk,h is part of this appli- cation. . c. The work covered by this application may not be commenced before issuance of Buildh~g Permit. d. Upon approval of this application, the Building Iqspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available, fgr inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until ~t 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. Tl~e 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 necessary inlpections. ,~ ¢ignature of applicant, or name, if a corporation) ::e.. ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ........ , ....... . .......... : .................................................... Name of owner of premises T4~t'l ~,J .~' .~. · ~./J7 .T'R ~d/.'4~. ~/~.~ g~.~ (a~s on tl~e 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 ..... ~... Plumber's License No .......................... Electrician's License No ....................... Other Trade's License NO ...................... 1. Location of land on which proposed work will be donel ................................................. ................. ./4.. , ................................... ttouse Number Street ~ Hamlet County Tax Map No. 100o Sect!on ....~).7.~ .......... Block ....6-ff. ............ Lot...,~..O.r ./. ......... 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 .... ~,4'~ y... ~4.... ~.~. .......... x' ..../~ ....,..~.~-~ .... ~. .....~. ....... b. Intended use and oacupancy ...... '~.~/~'/'/fi..~....(.ff~(&yT.~..o'7,7..P.)...2~.',.~./..~.....~...j~..~: 3. Nature 6f work (check which applicable): New Building ' ... Repair . Removal Demolition ~./. 9.O : 4. Estimated Cost ......................... .... .. Fez 5. If dwelling, number of dwelling units ............... Number of If garage number of cars I~)/,J ~' 6.If business, commercial or mixed occupancy, specify n~ture and exte 7. Dimensions of existing structures, if any: Front.. J.~... ..... ~.. R Height ' 1~ ..... Number 0fStories I . DnnenmOns of same structure with alterations or additions: Front . Depth .... ~1,,,.3.t ............ Height ..... I.¥! ............ ",8. Dimensions of entire new construction: Front ...fl`Clx..r..' ..... ! /. q t Number of Stories / Height .. ............................ 9. Sizeoflot: Front ...................... Rear ............ I0. Date of purchase .../.~/,~O.f. ~.O ............. ' Name of For 11. Zone or:use district in which premises are situated. ............. 12. Does proposed construction violate any zoning law, ordinance or reg 13. Will lot be regraded ..... ./~..c.~. ............... ..... Will excess 14. Name of Owner of premises .................... Address ... Name of Architect ........................... Address ... Name of Contractor .......................... Address ... 15. Is thi~ property located within 300 feet of a tidal *If yes, Southold Town Trustees Permit mav be required PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or pro] property lines. Give street and block number or description according to'( interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................ :being dui (Name of individual signing contract) above named. He is the .................................................. (Contractor, agent, corporat~ of said owner or owners, and is duly authorized to perform or have pe ditionI ..... Alteration ... i~.. Other Work .~A~ ~.0~ .... (Description) (to b~ paid on filing this application) dwelling umts on each floor ............... ~t of each type of use .................... ,ar . [ ~. 'I ........ Depth ....~,l ~,3 ...... ,~, .......,.. ..... ~ear.. ~.-r .......... · Number 6f Stories .... ~t ............... J.i .... pth ~./ ~ ar ..,~.~. .... De . r ....... .......... i Depth ............ J' ...... ncr Owner i" ~' ~9..~] .9..QF./7~.t~ ....... latlon: ...,/~..~. ..................... ill be removed from premises Yes ' Phone No ' Phone No ........ : ..... Phone No ............... ~tland? *Yes ..... No ..... ~osed. and. indicate all set-back dimensions fi-or ced, and shbw street names and indicate whethe sworn, deposes and says that he is the applican officer, etc.) formed the,' said work and to make and file tbi application; that all stateinents cOntained in this application are true to the best of liis knowledge and belief, and that th, work will be performed in the manner set forth in the application filed th ~.rewith. Sworn to before me this ............ /.(. .... dayof ..~ ...... 197.~. :'. ' .... . . County