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Home My WebLink About22800-zFOBM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFIC. ATE OF OCCUPANCY No Z-23713 Date JUNE 16, 1995 THIS CERTIFIES that the building Location of Property. 330 DAYTON ROAD House No. County Tax Map No. 1000 Section 71 Subdivision ADDITION SOUTHOLD, N · ¥. Street Hamlet Block O1 Lot 25 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JI~NE 1, 1995 pursuant to which Building Permit No. 22800-Z dated JUNE 5, 1995 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 SUN POR~HADDITION "AS BUILT" TO EXISTING ONE FAMILY DWELLING The certificate is issued to WILLIAM A. EIGHT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 ~ /~Bu i l'ding Inspector FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENI' TOWN HALL $OUI'HOLD, N.Y. N9 22800 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: , , · ..... ~.~ ....... ~...-z~...~....~ .................... to..,~.~ ................... ~ .............. ~,~....~ ........ ~.~ ............. .~J-.. .......... ,~.~../...v... ............. ~: ............ ~~......~.: ................................... ........................ ~ ....................................... :.!~/..~.,~'.~ ....................... ,, ......................................... Ooun~,~ax~a,, No. ,000 Sect,on....2l ............. ~,oo~ ...... ~./... ........... ,Let~o ...... ~ ......... pursuant to application dated .................... ~././(.. ............................ ../~.~ ........ Building Inspector. Fee $.... Z .~..~..,~ ..... and approved by the Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT //q~/ ~ ~ ~ ,~ :, ZOWN UALL / 765-1802 : 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: ~. Final survey of property with accurate location of all buildings, property lines, streets, and unnsual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. ,Approval of electric~ installation from Board of Fire Underwriters. Sworn statement from~plumber certifying that the solder used in system contairs less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buzldzn s and znstallations,\a certificate of Code Co- "' ~ ' ' g ~ ~p*mance zrom architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. F~r existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and .pre-exlst~ng" 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 ~. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 " 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00' New Construction .......... Old Or Pre-existing uilding .............. · B Location of Property. %~O ~ ~o~ RO~ ~o~oIR Street Hamlet Onwer or Owner Property..40. l . . k.. ................ ......... Block .............. Lot ..... ....... ................. .................................. ' ' · Map Lot Permit No ................ Date Of Permit ................ Applicant ..... . ............ Health Dept Approval ' ' ......................... Underwriters Approval ..................... Planning Board Approval ...................... ~eqaes~ fo=: Temporary Certificate ........... Final Certicate ........... ~ee S~bmitted: 7G5-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [~NAL REMARKS: DATE I N SPECTOR ~-~//~/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ....... (~. .., 19?f~.Permit No..'~"]-aP'Oh9 ~ Disapproved a/c ..................................... BOARD OF HEALTtl ........ · 3 SETS OF PLANS' . ....... -' SURVEY ................. ../ CIIECK SEPTIC FORN ..... tl o.'~ i FY; CALL ................. HAIL TO: . ( Bt, ild/uo ~fi sp e'c t or) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date a. This ap/~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2 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 sti'eet: 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 Renu atio.ns,' for* t&~ e~l~.st'~ction of buildings additions or alterations, or for removal or demolition, as herein described. The aplblicgnl agrees to comp y wi.th all applicable laws, ordinances, building code, housing code, and regulations, and to admit authoriz~drinspectorsOnpre~ises andin, building fornecessaryinsl~ctions..~ ...~(,..~... ' , ,. ' ',;/~6) .~l~ ~'! ...... ' ' ' ,~ ...... ' ......... .... . ;c ~:~ ;~; ' ' (Sig~jhture of applicant; or-q~e, h a corpor"ation! · ' ~.~,,~ ,., . 3 ~ ~ ~l,' ......... . ~' :~,,,, (Mailing address of applica~ht) State whether applic~d~'~i~ owner, lessee, a~, architect, .engineer, general contractor, electrician, plumber or builder. ;i, , ' . ............ (as on ~e tax roll or latest deed) If appilcant is a corporation, signature of duly authorized officer. (Name and titl6 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 ..... · ............................ : ................ ..... ............. House NumbJr ...... ~ ...............Stree~ ........ Y .... ( ....tl Hamlet CountyTax Map No. 1000 Section .... ' .............. Block ..... ] ~ ........ :... Lot....,<.'..'~... ......... Subdivision ........ . ...... ' ..................... '. Filed Map No ............... Lot ............... (Name) 2: State existing use and occupancy of premises and intended nsc and occupancy of proposed construction: a. Existing use and occupancy . .. ~..t~ .............................. b Intended use and occupancy ' '3. Nature of work (cheg.k wh,ch a,pplicable): New Building . · . . Addition . Alteration .. [ Demolition . .... i.. Other Work .... · (Description 4. Estimated Cost ' '; ................... Fee .......... i . (to be paid on filing this app cation 5. If dwelling tunberofdwe imlunits ' ,; ., ) '~-- ............. r~umeer of dwelling units on eac] floor ........ · If garage, number of cars .~M/L/7~,; ................ ' .......................................... 6. If business, commercial or mixed occupancy spec nature and extent of.each t e of 7. Dimensions of existing structur~s ifa],,,: Fr,~-t [ i~ ~yp, use .... . ............ lie ~t .... . ...... Nun ere or '' nn nsmns s ] structure w t alteratious or additions. Fr~,.,+ ' ' ......... ~ ............... ~eptn .... ~. ..... ;. · He, t ........ , ......... .., Number of Stori 8. Dimensions of entire new cons ction: Front ........... ' Rear .... De He it ..... Number of Stories . .. ' ........ 9. Size of lot: Front .... i . . ' .................... : .............................. ..... ~ ........ Rear .............. Depth ' i0. Date of Purchase ........ 11. Zone or use &strict m which preunses are situated.., ormer Owner ..................... : ....... ~ ~, ,,,rog ~aw, ornlnance or regulation, po 13. Willldtberegraded .. ; P,,/Q ....... ' ..................... NNmm~::~rWc~%:[p. ' ' '. ............. w',excessnboerenmvedfro premises: Yes ., .~ ' ' ' -;½, .' .............. Address ..... Phone "o ...... ptame el contractor .N/AX ~, ' ......... ~'~ ...... .'. 1.5. .s tnJ. s property wlthid 300 feet of' a tidal -,~"~- a'o .......... ~'"-' .......... · *If yes, Southold T?wn Trustees Permit may be requir;~[''"'' No..t~.O.... PLOT DIAGRAM Locate clearly mid distinctly all buildings, whether, existing .or proposed, mid. indicate al set-back dimensions from property lines. Give street and block nhmber or description according to deed, and show street nmnes and indicate whether hlterior or comer lot. . . $ I® '"5; AP O ,EDASNOTi D ' TIFY 8U~U)II~G DEPARTMENT AT FATE OF NEW YORK, OUNTY OF ................. S.Sj (Nature f individual signinXg )eve named. being duly sworn, deposes and says that he is tile applicant i (Contractor, agent, cor'porate officer, etc.) .......... said owner or owners, and is duly auiliorized to perform or have performed tile said work and to make and file this plication; that all statements contaimdl in this'application are true to tile best of his knowledge and belief;and that the )rk w~l be performed in the mauner set ~fortb in the application flied therewith. /om to before me this