HomeMy WebLinkAbout25990-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: 2-26676 Date: 09/10/99
THIS CERTIFIES that the building ACCESSORY
Location of Property: 8555 MAIN BAYVIEW RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 78 Block 9 Lot 48
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 14, 1977 pursuant to which
Building Permit No. 25990-Z dated SEPTEMBER 9, 1999
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 ACCESSORY STORAGE BUILDING AS APPLIED FOR "AS BUILT" & AS PER ZBA #2341
DATED 10/13/77.
The certificate is issued to PAUL & JEANNE HUNTER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
zd�� ) - _ 4
uilaing Inspector
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 25990 Z Date SEPTEMBER 9, 1999
Permission is hereby granted to:
PAUL & JEANNE HUNTER
8555 MAIN BAYVIEW RD
SOUTHOLD,NY 11971
for
CONSTRUCT ACCESSORY STORAGE BUILDING AS APPLIED FOR "AS BUILT" &
AS PER ZBA #2341 DATED 10/13/77 .
at premises located at 8555 MAIN BAYVIEW RD SOUTHOLD
County Tax Map No. 473889 Section 078 Block 0009 Lot No. 048
pursuant to application dated SEPTEMBER 14 1977 and approved by the
Building Inspector.
Fee $ 35. 00
A r ed S 'gnature
ORIGINAL
Rev. 2/19/98
Form No. 6
ClActie.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT /
TOWN HALL
765-1502
J
0 APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
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.
r 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-O 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'.'pre-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,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . .. . . . . • 0. . ..1.� . .. . .. . . . . . .. . . . . . . . . .
New Construction. .. . . . . . . ... GGOldd Or Pre-existing Building. . . . . . .
Location of Property. . .T.;> ?5. . . . . mo- kr1. . .���.u� .
House No. S eet Hamlet
Onwer or Owners of Property.. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . .rl/ . . . .Block. . . . . . . . . . . . . .Lot. . . . . . L.iQ . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot:. . . . . . . . . . . . . . . . . . . . .
Permit No. . . __ : . . . .Date Of Permit. . .. ., . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . .
HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . ._-t . . . . .
Fee Submitted: $. . . . . . �-5..-. . . . . . . . . . . . . .
Com. 5697 . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . .
APPLICANT
C-0
FORM NO. 3 _
Al
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
A
TOWN CLERK'S OFFICE
4.
SOUTHOLD, N. Y.
NOTICE OF DISAPPROVAL
,. 47., J7
kujile No. ..................................................................Date ..................................................... , 19.......
za `t
:icor - . ......
l .
�� .�.
..................................................... ..........................
PLEASE TAKE NOTIC that your applicat' dated ................................y.L.....•.. 19........
for Permit to construct p .............�.......
........... ........n..... ....� �t the remises located at ..��/
^. =
/ Y
....... s...� vv..e�,�:`:`.�.....� r.'��.::........... Street .i v
Map .................l1 ....... .... Block ...............• ...................... Lot ....�.<.............................n.../... is
disapproved on the following grounds .....
L.....^1....C�..a.A.?.....I . lu..Q.e............................................
.....................................
.................................�.............................................. ................................................................................
dJ, j•t ,/l ..-q;4�_ .. ......../"]) T ' ( ' ... R.... ..:......� ..................................................................... '
Building Inspector
l �
a �
i
BOARD OF HEALTH
1.... �) - '-',■y lyy� T FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
l � � TOW
F SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
�L - BUTLDI DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
Tri1, C.'c tl T HALL SEPTIC FORM
. . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971 _
TEL: 765-1802 NOTIFY:
I
pp CALL
Examined..... 1 J........, 19.Ff. ec®® qq MAIL TO: . . . . . . . . . . . . . . . . . .
Approved...3/1........, 1-#�. Permit No. Z.tJ./.Q�. .................................
Disapproveda/c .................................. .................................
......................................................
(Build ng�I
APPLICATION FOR BUILDING
ERMIT
22 qq C'
Date. . . .. J . . . . . . . . , 19!.
INSTRUCTIONS
a. This application most be completely filled in by typewriter or in ink and submitted to the Building Inspector
3'sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan slowing 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 o
this application.
c. Tree work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Susi
permit shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in chole or in part for airy purpose whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS IEREW MASE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or denolition, 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 inspections.
(Signature of applicant, or nave, iif'a'corporation)
(Mailing address of app cant) SOIA6W
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil,
................aujoa.S......------........,.t,..........I.I......�.r. ...............................................
Name of owner of premises ......wr-(Lm•l�G•••• •• ,•1 .-(,..t4L, . ........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.....:...................................................
(Name and title of corporate officer)
BuildersLicense No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Location of land on which proposed work will be done....................... ..... .....
......... s..... _n...B.. .. .�. 1...0...................?.c. . 1.��...............
House N;mber St Hamlet
)Ha6mlet
Canty Tax Map No. 1000 Section ......(Cl....... Block ................ Lot: ....•3 ........
Subdivision ...................................... Filed Map No. ............... lot ...............
(Name)
2. 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 ..... t1'.1•+1..,t,:,)(,.<t..�l..l.l... LlS-,C-ftb .tiQ f�..'c14C ,.
3. N.aLure of work (check wthidi applicable): Nw Wilding .......... Addition .......... Alteration ..........
Repair ............ Removal ............. Demolition ............ Other Work ..................................
(Description)
4. Estimated Cost ......................... fee ..............................................
,oto be paid on filing this application)
5. If dwelling, rudber of dwelling units ............ Number of dwelling units on each floor ................
If garage, amber of 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 ......................... Ndnber of Stories ......................
Dimensions of sale structure with alterations or additions: Front ............... Rear ...............
Depth .................... height .................... Ndnber of Stories ...............
8. Dimensions of entire new construction: Front ....... 1
....... Fear ...�5 f........ Depth ��.........
Ikigilt ......... ........... N,Qber of Stories .1h,/T!...............
9. Size of lot: Front .................... Rear .................... Depth ....................
10. Date of Purchase ..................... Nae of Former Owner ........................................
11. Zane or use district in whidh premises are situated ..............................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ........................
13. Will lot be regraded .................... Will excess fill be removed from premises: YES NO
14. Nares of Owner of premises ........................... Address .............................. Phone No. .........
Nameof Architect .................................... Address .............................. Phone No.
Name of Contractor ................................... Address ...............................Phone Pio.
15. Is Lhis property within 300 feet of a tidal wetland? * YES .......... NO ..........
*IF YES, SWITIFD IOldl 11d1SI S P1041T MAY RE W411RIM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, wihether existing or proposed, and indicate all set-back dimensions
from property lines. Give street and blocdk auber or description according to deed, and show street nares and indicate
whether interior or comer lot.
See Z6
Sum OF N3i YORK,
... 35h
. ..... SS
k CC
........... ......r.,.. .......................being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named,
QIeis Lhe ................. .......... .....................................................................
(Contract r . agent corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed Lhe said work add to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and
Lhat the work will be performed in the mamer set forth in the application filed therewith.
Sworn Lo before me this QQ
�3C454....day o ' .. ... .... 19..[.qq/.
Notary Public .... . ..................... ........
ROBERT I.SC R. (Signature of Applicant
Mowry Public.Stat of sw York
�Nw 01 SC47 I ouMy
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