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Home My WebLink About14216-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13797 Date August 23 19~. THIS CERTIFIES that the build~g deck. Location of Property 2605 North Bayview Rd. Southold House No. Street Ham/et County Tax Map No. 1000 Section .... .7.9. ..... Block 2 .Lot 10 Subdivision X ...Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... A.u.g.u.s.t...2.2 .......19.8. 5. pursuant to which Building Permit No ....... 1..4.2.1.6. Z. ........ dated ........ .A.u.c/u..s .t..2.2. ......... 19.8.5., 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 ......... The certificate is issued to ...... .W..A~.D..E..MA..R., .&. AN.N.b...t9~..S .S.N.E.R' ........... (owner, X~iD(?lF~X of the aforesaid building. Suffolk County Department of Health Approval ................. .N./.A. ..................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TIlE WORK AUTHORIZED) 14216 Z ot premises located at .................................................................................... .~ .................................... County Tax Map No. 1000 Section ........................ Block ¢~ Lot No. /O pursuant to application dated ............... i..?.Z.....~,...~T.. ...................... , 19....?..,~--ond approved by the Building Inspector. Fee ~ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Soutbold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ia ~ 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. Commemial 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. 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 3. Copy of certificate of occupancy $1.00 4oVacant Land C.O. $5.00 $15.00 Date ......... NewBu dn ~ r eex' 'n ' ' g .......... ... OI9~o Pr - ~st~ g Build ............ Vacant Lar,~65 ............. Location of Property. ~ ./~..~.)/.. ,~)../~. ....... , ........... ~/~ ~~ Owner or Owners of Property ~S~~ ....... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./Z/'~/~/ Date of Permit .~J?..~/~..¢'Applicant ~..~.~.~..~. ~. C~'~I~ .J~/ Health Dept Approval ~ Labor Dept Approval ~-- Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.........~'~' O .0 . . . .VL~...~,~.~. "~ ~-~ ........ Construction on above described bu ilding and permi/m/e/~all. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 )isapproved 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 s~ts of plans, accurate plot plan,to scale. Fee according to schedule. b. Plot plan showing locatmn of lot and of buildings on premises, relationship to adjoining premises or public streets ar areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. c. The work covered by this application may not be commenced before issuance of Building Permit; "::~'e d. Upon approval of this application, the Building Inspector will issued a Building Permit to the appficant. *~ucn permit shall be kept on the premises available for inspection throughout the work. h e. No building shall be occupied or used in whole or in part for any purpose whatever until ~t Certificate of Occupancy all 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 ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or !egulations, for the construction of buildings, additions or alterations, or.~for removal or demolition, as herein described. he applicant agr. ees to comply with all applicable laws, ordinances,~~bui~flirlg~code, h~ing code, and,6~gul~t~ns, and to mit authorized mspectors on premises and in building for necessary ' ' ~~.~/~g(' i~hatu/d of ar>~li~"~__ oCn~lne, ff 0~corgti~ration) "'" ...... ih ili g addr'es '( f applicant) irate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed wor~ withe done ....... D .......... ~n,¥ ............. :fl ............ ......... ............ ............................ Stree~ Hamlet House Number County Tax Map No. 1000 Section .... .... 7~... .. Block ...... .~ ........ Lot..f.~ .............. 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 '~x~.~ ~ ~ ............ :...~ ..... ~ .......... ~ .......... b In tended use and occupancy ~ e ~ Z ~ ~...~ [~?~~~ ~~ 3. Nature of work (check which a ,plicable): New Building ..... '. · .. · 'A ldition... X... · · Alteration .......... Repair .............. Re~noval .............. Demolition .......... .xOther Work .............. 4. Est~nated Cos . .! .......................... Fee .................................... q' (to be paid on filing this application) 5. If dweBing, number of dwelling units ............... Number of d~ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature~d extent 7. Dimensions of existing structuges, ifany: Front ........ ,~..~ .... Rea: Height ............... Num. ber of Stories .../~...~.~ ........... Dimensions of same structure with alterations or additions: Front .. D pth ..... ~ .......... ~... Height ....................... l "8. Dimensions of ~htire new construction: Front..·~. ~.'.. . Rear Height ,~. . · Numb_~r of 10. Dati of Purchase ...~.~'~. .................. N'ameofForme 11. Zone or.use district in which p!emises are situated ................. 12. Does proposed construction violate any zoning law, ordinance or regula' 13. Will lot be re~raded .... ./~/~. .... rA .~t~ ........ Will excess fill, 14. NameofOwnerofpremise~.~'~'t~7~.~.~,~ddress .~,~ Name of Architect ............................ Address .................... Phone No ................ Name of Contractor ........................... Address ................. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propo~ property l~nes. Give street and bloci: number or description according to dee. interior orcorner lot. STATE OF NEW YOR_K~., COU. J~TY OF. ~..&'. ~.-.~·~..z/~' ~'~ . ~'~'. '.~'. '.~k~/~ .......... being duly (Name of individual si~ing contract) above named. ............ .......................... (Contractor, agent, corporate o: of said owner or owners, ~d is duly autho~zed to perform or have perfo~ application; that all statements contained h this application are true to the work will be perfo~ed in the m~er set forth in the application filed there~ Sworn to before me this ........... ~ ...... day ~f .~.~'. ..... 19 Nota~ Publi~~~. ~_~ounty , N0tASV ~6~0. gA~ 0~ N~ V08[ ' '~ ' i Oualifl~ in S~f~k Coramlsslon Exol?e March~, elling units on each floor ................ !fea of u .e ...... ......... ........... Stories..,' ....... .... ~ ........ Depth .../ ............ ....... Depth . ./.'~2~?.2.'v~./.F~., ...... ' Owner .............................t ion: ................................ ~e removed,fr~ premises: Yes No ~[, ~/[ ~t/.~,~Pl] on e No ................ yom, deposes and says that he is the applicant ricer etc ) med the said work and to make and rile this best of his knowledge and belief; and that the ~ith. el, and. indicate all set-back dimensions from and show street names and indicate whether