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HomeMy WebLinkAbout14972-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16357 Date October 30, 1987 THIS CERTIFIES that the building CONSTRUCT ADDITION Location of Property 829 R.O.W. North Bayview Road Southold, N.Y. House No. Street Hamlet 078 08 012 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Hay 20, 1986 . pursuant to which Building Permit No. 14972 Z dated J u n e 10, 1986 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 ......... ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ROBERT D. & MADALINE D. WENDELL ..................... ?o¥.'o;, ' oT r Yr Jr x .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N835362 UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 ~'ORll NO. ~ TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERg~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) o. 1497 Z County Tax Map No. ]000 Section ....... ..C),..-~...~,. ..... Block ...... .l~..~. ........ Lot No ...... ,(~11..~,~ ..... pursuant to application dated ......... '~.....~......~....C~..-- ............. , 19.~J..(~., and approved by the Building Inspector. Fee $. ~.~.",~..: .............. 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 m amammmaa 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:Coperty 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~ C. Fees: ~ d i t~{ ~o,n.s $~ 1. Certificate of occupanc~ uw~$ZS'T. Q0, Accessory fSI0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3, Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacan~c Land C.O. $ 20.00 S.uvd tea c.o. S 50.00 Date ...... ....... NewCons t~uc t, ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ~.~...../.~.'..~..~.~.~.~.~..6~,..~.~..,..~..~'.~..~..~./.~..~ ..................... House No. Street Ha~21et Owner or Owners of Property .~.L)~P,_~t~..__)'p,..(2-d~d..~/~JLdg~.l i~y'l ~ .p.'..~qJ~,z~ d~. ( ...... County Tax IVlap No. ~ 000 Section .... 7.~ ....... Block ....... ~.. .... Lot .... '~..~;'~, ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ate of Permit .......... Applicant . : ......... Health Dept Approval Labor Dept Approval ~ Underwriters Approval Planning Board Approval ~ Request for Temporary Certificate ...... '7. ........ Final Certificate ..;..~.~. ............. Fee Submitted $. ~.. ~":~)O .................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 "L THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES ~AT Doaglas Wen~ll, ~r~ ~ o~f ~ ~ayview~ad, ~o~oZd, ~ in t~ follou4ng Iocation~ ~ Basen,ent ~ Ist ~, ~ 2,td Fl. Section Bilk ~t ~e~ber 17~ 1957 FIXTURE FIXTURES OUTLETS 7 9 7 DRYERS RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FUTURE APPLIANCE PEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET SERVICE I)I~CONNECT S E NO OF CC, COND R V I C OTHER APPARATUS= Trac~ l~ghting: 20 f~et 8-Lites C~odale ~lec~rical Cong. 7355 14a~* Road ~ag~iguck~ i~Y 11952 This certificate must not be altered in any manner; return to the office of the'Boara if ~£c#783 COPY, FOR~BUILDING, DEPARTMENT. THIS COPY, OF CER, TIFICATE,· ,, , MUST, :, .NOT BE ALTERED N ANY MANNER, OF BUI'f. DIN(; INSPECTOR P.O. BOX 728 TOWN HALL SOU I'IIOI,D, N.Y. 11971 October 21, 1987 TEL. 765-1802 R~ Douglas Wendell 829 North Bayview Rd. Southold, New York 11971 are unable t;o complete your Certificate O_~'~/~,~nc¥ bcc~ use .of Lhe following reasons, An ;~.Dpl. Jc:atiott for Certificate of Occupancy / / :1~) llwt~:rwrit-.crs Certificate on file, t~.. Thc / / ~lr~ Health Dept. Approval on file. ~ii ~o i5. na'l in~;pcct.ion has been made, P]~:,t~,;(' contact: ()ur office on this matter. you for your cooperation,' Ihl J. ] d J.n~[ Depl:, l'Jo Plumbe~ Solder Certificate on file. ( all permits involving plumbing being issued ,lfter April 1,1984 ) FIELD INSFECTtON FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined . .~etM6~../..O. .... , 19~. ~. ^pp,oved ..~' :.q .... ,19e.¢ Pc=it No..~.¢?.7. ~..+-- Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date a. Tkis 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 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. 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 necessa~.Jaas~ect~.j // / y . / ~ (Signature of applicant, or nmne, if a corporation) ..~zq t~,~ ~' 94. ...... . . ..~. . .%o.~. . . ~.v~. . .. . :~. ~. x. .~ .... . ....... State whether appJicant is owner, lessee, agent, architect, engineer, gene~amla~olatr~gactoaUr,dre~eScStri%iranlP~l~baenru)or builder. ·.. ©~,~ .~./.~,<,'..~./" ....................................................... Name of owner of premises..~..,: .~. o.~..~:,... O..~ ~...~. ........................................ (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 .................................................. ~ .... . .¢%..%. ~.~.~....¢&...., ......... .~.~.&,~.g..-. ............................... House Number Street Hamlet O [[ ~ County Tax Map No. i000 Section .0.2 .cg...O..P ....... mock ...O.g...o..O ........ rot...O...~.,.o?..o. ...... 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 ................................................ b. Intended use and occupancy ~6-w~ e~ -- 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition ............ i. · Other Work ............... ~/' - o~/ ~ (Description) 4. Estimated Cost..~ ................................ Fee ................................ (to be p~id on filing this application) 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 n~ture and extent of each typ6 of use ..................... . . . 7. Dimensions of existing structures, ~f any: Front.. ~ .......... Rear ...Yg...i ...... Depth .......... Height ~.~... · .~5/~A~..~.... Number of Stories ....... ~ .......... , ....... i ............... t ............ Dimensions of s~me structure with alterations or additions: Front ...? ........ :'.... Rear ...~. ............. Depth .... ~.C. ............... Height . ...~...or.,~-.. ............. Number of Stories ... ~ ............. 8. Dimensions of entire new construction: Front ............... Rear ......... i ...... Depth ............... Height .............. ~ Number of Stories ............................ 9. Size oflot: Front ...(?.~. ................ Rear. l°~t . .. Depth ...~-2~../'. . . 10 Date of Purchase ~%.~ Name o£Former Owner 11. Zone or use district m which premises are situated ....................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~.q~).: ................. 13. Will lot be regraded ..... ~.~:' 2". ............. Will excess fill be removedi from premises: Yes 14. Name of Owner of premises ....... e~ .o~...~,.~.. Address ................ ...Phone No ............... Name of Architect ........................... Address ................ !... Phone No ................ Name of Contractor .......................... Address .......... ~.. &..,... Phone N¢.~ ............... 15. Is this property located withinl00 feet of a tidal wetland. Yes. ..... ~_~ ..... · 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE.,~OF NEW YORK, S.S COUI~J~OF ................. ~, / ....... being (Nameq~f individual signing contract) above named. duly sworn, deposes and says that he is the applicant He is the ............................................................. , ............................ (Contractor, agent, corporate officer, etc.l of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application;that all statements contained in this application are true to the best of hi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ 0 day of 19 $otaryPublic, · .......................... ...... County ~. ~i N0~r~t ~U~.Wn#IllN g~ ~E~ ~ i (Signature of applicant) go. 470'/878, Suffolk Com'~l,,,-? , 'Term Ex~lres M~.T?30, lg-'t'lTt NO?E ,, .... -- ~,~m"~PROVED r ' ~:' ir ~ pLUMBING ', ' ~:,,:: , · ' ,, ~'~ . r' AEL CONSTRUCT ON SHALL MEET ' " 'r ; j THE REQUIREMENTS OF THEN'Y ' ~ . ". ~ES~NSIBLE ~R '0 4,. O0