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Home My WebLink About22199-zPO~ HO. z~ TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23122 Date JULY 27, 1994 THIS CERTIFIES that the building ADDITION Location of Propert~ 10003 NORTH BAYVIEW ROAD House No. Street County Tax Map No. 1000 Section 79 Block 5 Subdivision Filed Map No. SOUTHOLD, NY Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in thie office dated JUNE 24, 1994 pursBant to which Building Permit No. 22199-Z dated JULY 21, 1994 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 AN "AS BUILT" DECK ADDITION TO A ONE FAMILY DW~T~.INGAS APPLIED FOR. The certificate is issued to ALFRED & CAROL WEIL of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED (owner's) N/& ~lding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 22199 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: .K..~.. ........... , .......................................................... £~:...~ ........ z~ .................................. ~ ...... to.....~..~.~ ................................. ~ ......... za~.,.~ .............. ./..~ ........ ~.. ...... ......... ..:..,.?~ .......... :~.,.:..?. ......... .~....~./..z..,..>.~ ........... ~.<. ......... ~..z..~. .......... <~t premises ~oc<~te~ ut .................... ...................... -.,.~-~.>..~,,/,~..~ ............................................. CounlyTax Map No. 1000 Section ....~..~... ............. Block ....... ...~....'~,,. ......... Lot No. ,,,../...~... ................ pursua,, ,0 ap~,,c~t,o~ d~,ed ........... ~ .......................... r., 19.....~...~...., and approved bythe Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. 2. Final Approval from 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 '!pre-existing" land uses: 1. Accurate survey of property showing ail 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 I. 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 Date ....~. ~. ~.~, .~. ......................... New Construction ..... ~.... Old Or Pre-existing Location of Proper ry... ~9)~ 0.5 ..... I.~..~.~.~ ~,.~...~:.. ~ ~ ~a; ~..~.. ~.~.~ 0. ~... Hous No. Street Hamlet Onwar or Owners of Property ...... ~.~...~..~.~ ........................................ County Tax Map No 1000, Section .... .~.~ ...... Block ...... ~ ....... Lot .... (.] ................ Subdivision ................................... · Filed Map ........ .... Lot ...................... Permit No Date Of Permit Applicaht · Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval.......... ............. . Request for: Fee Submitted: $ .... ~..~.~.~... 5 Temporary Certificate ........... Final Certicate ........... APPLICANT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING _ [ ] FINAL ~ DATE INSP ~' Approved ............... ;19¢/Pennit No. ~.4/.~...~-... Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEP/~RTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1802 (~ilfiff~'inspector) " APPLICATION FOR BUILDING PERMIT BOARD OF' HEAL'I'll / URVEY .................. .~,'CIIE CK ................... --SEPTIC F'ORH ............ · ~:0711:¥: . ..... HAZL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter erin ink and submitted to the Building Inspector, with 3 Sets of plans, accurate plot plan to scale. Fee according to scheduh. 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 apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectms on premises and in building for necessary inspections.. _ ' ..... .................... (Signature of applicant, or name, if a corporation) .... · (Mailing address of applican{) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. .... ........... ........................................ Name of owner of premises. · .'...C.~..C.Q .~.....~....~..~.. ......... ' '. ''i'" ........ (as on the tax roll or latest deed) ' ' If applicant is a corporation, signature of duly authorized officer. (N d titl ) .... "' amc an e of corporate officer .Builder's License No ........................ Plumber's License No ......................... Electrician's License No ....................... Otb T d 'sL'er N ra e Icense o ...................... 1. Location of land on which proposed work ~l.'~?z done ............................ lo, 5 ..................... Street ............ . " "ft;;il;;Q' .................. ' Cotmty Tax Map No. 1000 Section .. ...... S.h ....... Block ....... 5 ......... Lot ...... l--~- ......... Subdivision M ..................................... Filed ap No. (Name) .............. Lot ............... 2. Sthte existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... 6.~..C~COkt~f'~.~..~..Q ¢ ~ .... T" 4':f--' :,0' ,',.' ',. :' ...................... b. Intended use and occupancy ............... . ~ .."0,. ~ , ,:.. :..:: ~ .................... 3. e of work (check wh~c phcable): New Building ........ Addition ...... :.,-; ~1 .. Kepmr .............. Re oval .............. Demolition .............. Other Work ...... i ..... 4. Estimated Cost ...~...~ ~-Q.0..O,~ '~ ' (Description) t ........................ Fee . ' 5. If dwelling, number of dwelling Units ............... Number of dwelling units on each ~663~7''~ '1~ · If garage number of cars 6. If business, commercial or m x~d ..... ' .......~ ............................................... w .pancy, speedy =trite and extent of each type of use .............. 7. Imenszons ut exzstmg structures, if any: Front ............... Rear s,os amestructu or additions: Front't i'. '';'l~'dr' ........ ' ........ Depth ................... · ....... e ............... Dimensions of entire new consi ' i. ~. Height ...................... Number of Stories ...................... 8. ruction: Front ........... Rear ......... Depth ............. 9. . ............... Nu er of Stori es " 'o ~ot: ..................... Front ...................... Rear ...................... ' Depth . 10. Date of Purchase ........ ] .................. Name of Former Owner . ' .......... I I. Zone or use district in which p cruises are situated ......... ' .................. 12. Does proposed Construction v ate any zoning law, ordinance or regulation: ......... ' .... 13. Will lot be regraded ........ ... · ............ premises .. '... ' ................ Will excess fill be removed from premises: Yes .No 14. Name of Owner of · · Address ................... Phone No.. .. Name of Architect ~ ............ . .......... ......... ,' ................. Address ................... Phone No. . . Name of Contractor ...... ; .., . . ............ .................. Address ................... Phone No .............. 15. Is this property within :300 feet of a tidal wetland? *Yes ........ No ..... ' · If .yes, Southold %own Trustees Permit may be required. '''' ... ~ PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property Lines. Give street and block Inumber or description according to deed, and show street names and indicate whether interior or comer lot. -~5i"ATFE OF NEW YOJ'(I~ ~ .... ' .?aUNTy OF ..... 5;~!~----O[(r-r' . a~ ' ........... .... . (Name ofindividuaI signin contracti .......... being duly sworn, deposes and says that he is the applicant ~bove named. l}e is the . .~..~.lg.~tPt', (Contractor agent ............................. corporate officer etc ) ...... f said owner or owners, and is duly mthbrized to perform or have performed the'said work and to make and file this pplication; that all statements contain ;d in this application are true zo the belt of his knowledge and belief; and that the 'ork will be performed in the manner sgt. forth in the applicaticn flied therewith. worn to before me this ,. [ · .............. ?o. t ......... NOTARy PUBLIC, l~at~ of N,Y, ' ' ~ ' ' ............. NO. 4725089, 8uff01k ~ (Signature of applicant) z4o,o