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Home My WebLink About22184-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23152 Date AUGUST 9, 1994 THIS CERTIFIES that the building ACCESSORY Location of Property 863S NORTH BAYVIEW ROAD SOuT~OLD, NY House No. Street Hamlet. County Tax Map No. 1000 Section 79 Block 5 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 27, 1994 .pursuant to which Building Permit No. 22184-Z dated J~LY 14, 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 ACCESSORY S~D IN '£~ REAR YARD AS APPLIED FOR. The certificate is issued to GADDENZIO BOCCOLICH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A Building Inspector // FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT i'OWN HALL SOUTHOLD, N.Y. 22184 Z BUILDINO PEI~MIT (THIS PERM)T MUS'[ I~E KEPT ON THE PREMISES UN'IlL FULL COMPLETION OF THE WORK AUTHORIZED} oo, .............. ............................ Permission Is hereby granted to: ....... ..~.~..~.~ ...... ~.~.~.....C..~..~.,~ ........ ~..~...¢.... ........ ~.~ ....... ~.~..~,.'~.~. /,~ ,~,p; ~ ,o ...... ~.~.~....~ ......... ~~.~......,,~'./.~ ....... ~ ......... ...... ~ ........ ~ ....... ~ ............. ~.~.....~.z~. ......... ...~,,,.~.: ....................... .......................................................................... ~.~.~: ...................................................... CouniyTax Map No. 1000 Section ...... .~.Z ............ Block .......... l~..,.,.~.. ..... Lot No .......... ~. .......... Building Inspector. ~ ~.....~.~. ....... Rev. 6/30/80 Form No. 6 ~~ TOI~ OF SOUTtIOLD BUILDING DEPARTMENT TO~ t~LL 765-1802 ~PLICATION 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 lihes, 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. Co~ercial 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 requirementsl 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, Swiping pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existin~ Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. T~mporary Certificate of Occupancy - Residential $15.00, Co~ercial ~15.00 Date ...~.~4~-..~.. ~??..~ ............... ~New Construction Old Or Pr existing B ildi · -..---.... e- u nm................. :¢.../. .... .Location of Property .......... ~ ....... · ....~9~'~.~.~. /p/ House No. Street Hamlet Onwer or Owners of Property .... ~....~.....'~......-~.. ~C~O&~f~ · ction .... ~.~ ..... Block .... ~ ......... Lot.. Subdivision .................................... Filed Map ............ Lot ..................... Permit No..~.~.~.Date Of Pe~it .............. Applicant ............................. Health Dept. Approval ...................... Underwriters Approval Planning Board Approval ........................ {equest for: Temporary Certificate ........... Final Certicate...~..~ .... ~ee Submitted: $ .... .~..'.~.. ................. OU~DATION ( 1 st) OUI~DATIO~'! ( 2nd ) ~.0UGH FRAME & .?LUMBING :I~SU~ATION PER N. Y. STATE E~EROY CODE FINAL ADDITIONA'L COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~.~,BG. [ ] FOUNDATION ..ZND [ ! I~JJCATION [ ] FRAMING REMARKS:,~ I BLDG. [)(4 'L Disapproved a/c ............................... ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 APPLICATION FOR BUILDING' PERM IT BO,~D oF ~la^~.r~ ......... 3 SETS OF Pt..x:~s .......... survey ................... Cll~C~ ......... ., CALL ............... NAIL TO: IN STRUCTIONS a. This apt;lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 st?eets ~r areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli- :ation. 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 i~sued a Building Permit to the applicant. Such permit hall 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 hall 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 luilding 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. 7he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. (Signaturp of applicant, or name, if a corporation) (Mailing address of applicant) ;tare whether applicant is owner, lessee, agent, architect, engineer, generai contractor electr~c~i~,~4~i&%~$~' or builder.~ ' h APPenDS'NOTED applicant is a corporation, signature of duly authorized officer. "' - NOTIFY BUILDING DEPARTMENT AT 765-1802.9 AM TO 4 PM FOR ~E .............................................. FOLLOWING INSPE~IONS: (Name and fitl~ ofco~orate officer) 1. FOUNDATIO~. ~0 REQUIRED : FOR ~URED~NCR~ Builder's License No .......................... 2. ROUGH - FRAMING & PLUMBING ~. INSU~TION Pl~mbet'sL]censeNo ......................... 4, FINAL - CQ~STRUCTION'MUST- BE COMP~E~FoR C.O, ]ectncmn s License No ....................... ALL CONSTRUCTION SHALL ME~ ~HE REQUIREMENTS OF THE N.Y. Other Trade's License No ...................... STATE CONSTRUCTION '& ENERGY CODES. NOT RESPONSIBLE FOR Location o~land on which proposed work will bc done ............... ....,,.,.......,...................D~IGN OR ~NSTRU~ION ERRORS House Number Street Hamlet P. County Tax MapNo. I 000 Section ...:. 7.~ ........ Block ...~.. ........ i... Lot ................ Subdivision Filed Map No. Lot ............... (Name) State existing use ~nd occupancy of premises and intended use and occupancy of proposed construction: b. Intended Use and occupancy ~', ". ~ ~ - · 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... , ..... Repair .............. Rem?val .............. Demolition .... ; ......... Other Work ........ . ~: "::'- '?;(Description) 4. Estimated Cost. "; ......... ~.-~.. ...... Fee "'; , (to be paid on filing this application) 5.. If dwelling number of dwellingi Units Number of dwelling units on ' ............... each floor If garage number of cars , ................ 6 If business commercial or mixeld occupancy ........................................... · ' specify nature and extent of each type of use 7 Ditnensions of existing structhr~s if any: FrOnt Rear ' . . ' ' H.eight .. ........... NmO ~er of atones ............... Depth D~nenmons of same structure with alterations or additions Front ......... T~ ................ Depth ' ~ Height .................. ear ................. ' Number of Stories 8 Dimensions of entire new construction: Front Height Nun~ber of Stories .............. : Rear ........... Depth 9. Size of lot: Front ~ · ......... ~ 'i ........ ;.. Rear ...................... Depth 10. Date of Purchase .......... ~ .... · ........... . · .. . . , · ....' ......... Name of Former Owner ,, ' ........ ! 1. Zone or use d~stnct in winch Promises are situated.. ' .............. ': ....... 12. Does proposed Construction viol~tte any zoning law, ordinance or regulation: .... ' ...... 13. Willlot be regraded . ~ .......................... 14 N f O ......... I ................... Will excess fill be removed from premises: Yes ' No · amc o wner of premises ...! ................ Add Name of Architect .......... i .... ' ress ................... Phone No ......... '. ............. Address ................... Phone No .............. , .. Name of Contractor ....... ~' ' ~'~ ....... Address ............. Phone No... 15.' I.s this property within O~ ~ ~ tidal wetland? *Yes'. .... '.'.. ' ............ · *If yes, Southold own Trustees Permit may be required· ' ..-. i PLOT DIAGRAM Locate clearly and distinctly all Ibuildmgs, 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, Ct'ORtK/'~ /1/ . ~ (Name of individual sfgnin'g contract) .... above named. ' ~ ·.. being duly sworn, deposes and says that he is the applicant ie is the. 2 ........... . ..... . ........................... ' (Co i~ te offi ) ...... ' ............ ~ ntractor, agent, cor ora cer, etc. )f said owner or owners, and is duly a.uthonzed to perform or bare performed the said work and to make and file this 'pplication; that all statements contain4d in this application are t'rue to the best of his knowledge and belief; and that the .~ork will be performed in the manner selt forth in the application filed therewith. ' ;worn to before me this ,'.' ..... ~~_ :"' 'day~o.,' .~/~'.... :, 19.?~ 'otary Pu~/~. County · NOteW Publlo, Stere of New YOrk . ~.~ No. 4879505 ! ~' ./- .... '/ .............. Qualified in Suffolk County I . Commission Expires Decembm'8, ,,..~z/'