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Home My WebLink About13775-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25838 Date: 07/23/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 800 BAYVIEW AVENUE GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 52 Block 5 Lot 44 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 14, 1985 pursuant to which Building Permit No. 13775-Z dated MARCH 22, 1985 of applic~-.~'~ was issued, and conforms to all of the requirements the provisions of the law. The occupancy for which this cer~s issued is ACCESSORY SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to ELEANOR A. BERG (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 I~ORM NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 13775 Z Permission is hereby ........................................................... ~./......~.~ ,o..~ ....... ~.~....~...'~..~...~.~.,.....~. ..... .............. .......................... '~i ............... ~"-"iii'P;/;~.'";~'"'! ........................................ i ............. i ...................................................... County,ITax Mop No. 1000 Sectk~...,0.~.....~:.. .......Block ....... ~ .........Lot No ...... ~...~... ........... ~ur~o., ,o opp,,c~,,on do,~ .....~.~..¥~..~....~..~. .................. , 19~..~...., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and sub~i~~bui±d~ng inspector with the following: for new building 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 frq~ Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Ppre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, A-Iterations to dwelling $25.00, Sw~,ming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - , .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..~.l~.'.~J.~..~. ........... .. · · New Construction ........... Old Or Pre-existing Building ................. Location of Property ......................................................................... House No. Street Hamlet ..... ..... ..... ....... ........... County Tax Map No i000, Section..~.~. ..... 1 ck ........... Lo ......... Subdivision ........................... ... ... . . . Filed Map ............ Lot ..................... . Permit No..J ~V.~.5 ..... Date Of Permit~]~. J.~5 .... Applicant..f/.}~ ~L~ Health Dept. Approval .................. ....... . Underwriters Approval.. ....................... Planning Board Approval .................. ... .. . Request for: Temporary Certificate ........... Final Certicate ........... FIELD INS~ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: %6L, FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ,-. Jl LJji '-I!1 II TOWN HALL \A I~ ~ ~'~,~ , I',~,~[ ' ~1 ~,.~l~.~[i. DEP~'. 12¥ amin ~rl ¥~ ~L&~% .~z_ lg~. ................................. ....... 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 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 necessary insl2,eeAions. (Mailing address of applicant) (Name and title of corporate officer) Builder's License No ..... i~.~.' ..~. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... State whether applican[ is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ' ......... Nmne of owner of premises .............. ~ .' .................. i ........... ~ ~,. =.~ .................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Al:, 7 ~ AS NOTED FEE:~ ~.. BY: ~, NO~I~q' m *[I ~ NG DEPARTMENT AT 765 1?'? 9 AM TO 4 P,M FOR THE 1. F~U" .x ION - TWO REQUIRED F~z ..... ~q CONCRETE 2. POt '' ' CRAMINE. ~ PLUMBING 4. F~F'~ ~Sr :' '.(';N MUST ~ut~-ALL C''''''';~''m~ON F'~ALL MEET 1. Lacation of land an which proposed work will be done .................. ?. ~ - ,~,~ ...... c .... y. ................. ~ .................................. C~'KK,'i '~T' ' REBPONSIBkE' ' FOR' House Number Street pEql~e~R CONSTRUCTION ER~O¢~ County Tax Map No. 1000 Section . ~..~ ........ Block .... ~. ......... Lot...~.~ ........... Subdivision ..................................... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of premise~d int~use and occupancy of proposed construction: a. Existing use and occupancy . . ~ J ................................... b Intended t se and occuvancv 3. Nature of work (check which applicable): New Building ....k~. ' .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... r~' ,-. (Description) 4. Estimatedl~ost [ /egO, (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number oY 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 .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth . Height C ., . Number of Stories .......... 8. Dunens~onso ent~renewconstructmn: Front ~, ~, ? ~. /4 Rear Height .. './. ~..'~.. ?. ..... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. I 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ; ....... ,~ .......... Will excess ffi/be removed from premises: Yes No 14. Nmne of Owner of premises .~: ~k6.~.4'.. f,~/,'~.~ .... Address .ffq'~.c..~.~5.~..b/..x'~..',, .~'.~..~.. Phone No. ~f.f: 9~. '...~. '?. ~ g: NameofArchitect . .~1 ~ t: ~ .~'~ .... ;t.'~...Address -*~..~.~..(~-,~...~./PhoneNo 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 yOR, I~, ,~ ~, S S COUNTY OF ~)~.c~.... ......... d '~- a.~x,' '~ -~' '~'~''~ '~ ......................... being (Name of individual signing contract) above named. 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 filed therewith. Sworn to before me this Lc eoo, ........... ·- ............. #O~a~v ~ ~ ~ I~ v~ (Signature of applicant) Term Expir~ M~r~ ~0, 1~,~~