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Home My WebLink About15310-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy NO. Z14961 October 6, ... ......... ; ....... Date ................................. 1986 deck addition THIS CERTIFIES that the building ................................................ Location of Property 10205 North Bayvi~w Road Southold, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section . 079 Block 05 . .Lot 20.5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .S.e..p .t.e.m.b.e..p..1.8. ~ ...... 19 .8 .6. pursuant to which Building Permit No. ?.5.3. ! .0..g. ............ dated .S.e.p..%.e.m.b.e. ~...2.2. ,. ............ 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 ......... dock addition to .e.x.is, t..i.n~ one family dwelling The certificate is issued to James & Patricia Boyle (owner, of the aforesaid building. Suffolk County Department of Health Approval ....... N/A FOBI~ NO. 0 TOWH OF SOUTHOLD BOILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDii~IG PERM, IT (THIS PEP. MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 15310 Z Permission is hereby granted to: .... ~ ........ ~: ...................... ~.:....: ............. ; ........ ..L.o......g..~.~ ...... ~..:..,~....~/.../.~....,~. ~~....,~.:..~........LZ.~..~..~. ...... ~'"'"~ .................... .'"'¥" .................. ~o-'~ ........ 'il .""-"'.'"' ~, .z e. atp remises located at..~...D....-~....'E/~;~ ........ ...J~...~..?..-~. ...... ~ Y.~ ..~:~.... ....-~n~ ............................... pursuant to application dated ....~,~.~.~...~...~. ............. , 19.~...~.., and approved by the Building inspector. Fee $...,~....t..~... Building In.~ector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Ruilding Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~m Immmmmm 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 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 occupancy $5.00 2. Certificate of obcupancy on pre-existing dwelling $15 o 00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~,//?/.~. 5. Updated C.O. $15.00 Date ..................... NewCons truction../~,. Old or Pre-existing Building . .~... ........ Vacant Land ............. Location of Property /.d~..<~ ~..~ House No. Street Hamlet Owner or Owners of Property ..~'.0.. ,~.f,~ ~c~j0.~.J~,'c¢~ 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 ~ts all applicable codes and regulations. Applicant . . .... .'...~ ............................. Rev. 10-10-78 3o9q ') 6~1~'00'' £. 60. FIELD INSFECTiON 1. COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Appr~ved%?~..~..t~ 19~7{~. Permit No.]..~..~../.O. ..~. 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 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 appliz 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 permil 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 ~t Certificate of Occupancy shall have been granted by the Buildiug Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ 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 necessary insppctions. ~ /~ (~ature 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 . .~J~o.r.~.. 9:-...~.T.R[.c !'.~...~.w./v.L. ?. ......................................... (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... ~ ............ · · Plumber's License No ......................... Electrician's License No. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ./0.2, o.,$7 ................. .M. . .0. .0. .................... ftouse Number Street Hamlet County Tax Map No. 1000 Section .... .O.7..~. ....... Block .., ~ ........... Lot...~ .O.?. / ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed cons[ruct on: a. Existing use and occupancy ...~ {tO .Z~..)(..~..X'./.~.d-~...C.t.= ....... ,,5~rJwCrO.~ ~ C.. M~,~WC-. ~' . b. Intended use and occupancy ...... 3. 'Nature of Work (check which applicable): New Building ..... ' ..... Additie ......... Alteration ......... P, epair Removal ..... Demolition Other Work i~.~. q ~7 (Description) 4. Estimated Cost ..... ..~- .~..~. ...................... Fee .. 5. If dwelling, number of dwelling units ............. Number of dwelling units on each floor ............... If garage, number of cars ........................ ' .................. i ............................ 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 ..... i ........ Depth .............. Height ............... Number 6f Stories ............... , .......... 4., .......................... Dimensions of same structure with altm'~tlon~ or additions: Fronic .......... i ...... Rear ................. Depth ...................... Height ................ ...... Number Of Stories ..................... '- 8. Dimensions of entire new construction: Front .......... ' ..... Rear ...... i ........ Depth ............. Height ............... Nulnber of Stories .......................... i ........................... 9. Size of lot: Front ...................... Rear ..................... i Depth .................... 10. Date of Purchase ../.C) [~O/gc~ ............... Name of ~ormer Owner ]..0~.~../M ..~..O77/:f.~-f. ...... 1 I. Zone or use district in which premises are situated ....................... : ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..i~.(-~...' ................... 13. Will lot be regraded ..... .~.._O ............... ~ .m.,CVill excess fill be removed from premises' Yes ~ 14. Name of Owner of premises ~JJ~ ~..~..~. p. 8~TgtO&~0.~,~dress . M,. ~.~.f qt. ~.~. '~O... Ph'one No.' 7.6ff.. '/~..~. ~....~"~ Name of Architect ........................... Address ................. Phone No ............... Nmne of Contractor ................... i..:... Address .... : ........ , ..... Phone No ............. 15. Is this property located,within 300 feet of a tidal wetland? *Yes ..... No .~.. *If yes, Southold Town Trustees Permit may be required. .. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frm property lines. Give street and' block number or description a~cording to deed, and sh~w street names and indicate wheth~ interior or corner lot. STATE OF NEW YORK, S.S , i COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applican (Name of individual signing contract) above named. He is the ................................................. ...' ...................................... (Contractor, agent, corporate officer, etcD of said owner or owners, and is duly authorized to perform or have performed the isaid work and to make and file thi application; that all statements contained in this application are true to fhe best of his knowledge and belief; and that th~ work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................... y of ............ 19 .~..~ Notary Public,...~ff~...~.~ ................. Count.~ _.-, (S' f ppi' " Ignature o a mantJ