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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPAlIICY
No
Z-24333
Date
MAY 6, 1996
THIS CERTIFIES that the building
ADDITION
Location of Property
3415 NORTH BAYVIBW ROAD SOOTHOLD, IIBW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 71 Block 1 Lot 38
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 16, 1992
pursuant to which
Building Permit No. 20733-Z
dated
JUNE 18, 1992
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
2ND STORY DECK ADDITION TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to
EDWARD J. & MICHELE A. CANTLIN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NIA
UNDERWRITERS CERTIFICATE NO. NIA
PLUMBERS CERTIFICATION DATED NIA
Rev. 1/81
Inspector
I'ORM NO. .
T~N OFsOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~N<] 207aaZ
Date ...........¥t..................................., 19..9.~
Permission is hereby granted to: is
...;Ji.(1d... ..1l.~r3J..t.tt'!.t........ !1dç/.6Æ.... .:I:i!.ç, .
....LJ¿(),......(2d&.!!á:I.I!:J¡J......h&/..(~................
......;::;Qr&.í.tI.QJr<~.........1.I.: y :...... .1..(.9.. 2l......... .
to...r;,.~......~.......~...~......~...&......~...~.
./ .J/ ' ~/" f..A:L ' /
.~.,... ...........:~.............. ....·h~·~~·:;;;;...·..........·:¡;;·....·......·......·..·..·..............
at premIses ,;:2 at ....3..YI: ........~lfr.Æ....~T...~.....~...A..:........................................
....·......·........·..··....·í···..·....·..¡;:;.r1.~.ç;¿j·....··.. .......................). .....................................................
.............................l:..&1>..ið!..~~Q.......ç&.~r.~!.£....:.~.~.: ......................................................
Caunty Tax Mop No.' 1000 Section .......7/............ Block .......QL......... Lot No. .....¿l.............
pursuant to opplication doted ..........{¡/lIL/f'k..................., 19...9Kand approved by the
Building Inspector.
S'l) , it()
Fee $........................
·········~~i:-4"~t~~..·..............·......·
Rev. 6/30/80
/
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCy,=.,=,T_~OWN OF $OUTHOLD
BLDG. DEPT.
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.
B '4
For existing buildings (prior to April~9, 1957) non-conforming uses, or buildings and
Upre-existing" land uses:
i. 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. _Ce~i~9~_~_~_ccuap_~n_~y - New dwelling $25.00, ~dditio~~g~
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 Buildinz - $i00.00
3. Co~y of Certificate of Occupancy - $20~OO
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 Building .................
Location of Property ..................... ~ ...................... ~.~.~. ......................
House No. Street Hamlet
Onwer or Owners of Property ...... ~P.~. ~.~...~./~ g~]4~, z?~ . .~:~.~7%~ .....................
County Tax Map No i000, Section..~f:.?l .... Block .... 9/~q ...... Lot...~.~99 ...........
Subdivision Filed Map Lot .........
Permit No..~.'? ~. '~'~.........- z_ .Date Of Permit. . / .. .... Applicant . O~.?~. ~.. ~.~.~.~(.,~.l.c!~.... ~_
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval .
Request for: Temporary Certificate ........... Final Certicate....~. ......
Fee Submitted: $ ............................
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] I~LATION
FRAMING [~'] FINAL
[ ] FIREPLACE & CHIMN~EY
DATE~/~~
INSPECTO~~
IN N
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
/
[ ]FOUNDATION2ND [ ]?~SULATION
/
[ ]FRAMING [,/] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYo~k 11971
Fax (516) 765-1823
Telephone (516/765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 26, 1996
Mr. Edward Cantlin Jr.
1725 York Ave. - Apt. 5F
New York, NY 10128
Re: Building Permit #20733-Z - (2nd story deck add.)
Premises: 3415 North Bayview Road, Southold
Suff. Co. Tax Map ~1000-71-1-38
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of $outhold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
FOU~DATION ( ls t)
FOUNDATION (2nd)
ROUGH FRAHE &
.PLUMBING
I~SULATION PER N.
STATE ENERGY
CODE
FIliAL
'. ,: JUN I 15 on0 ,.,
oo~_ ~ ~,,, TOINN HALL
: ' ~'~ ' SOUTHOLD, N.Y. 11971
i~,, TO, i,,~, ,,, ,,' ..... "i TEL.:765-1803
....... .... .
Disapproved a/c .....................................
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
. (u/0il ~
Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
ClIECK ....................
SEPTIC FORH ..............
;J ;/"'-Y ....... ....
Date .................. ,19 ~...2~'
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
set~ 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 i~ bnilding for necessary ~nspections. ~ ,
.... Pze,.-/r. ....
- - (Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................................................... ,A.P.,P. qO. D..AS. PPT. O ......
'' , . --. .. _..~ _ DATE: ~ B.P. # ,~P.P./..P~z-
Name of owner or premises .../'~/?~..~..s2.3~..... ~....d~t~f~.../.~. ....... 1~.,5.~, ~ 0.. ~ .ffi,~
(as on the tax roll or latest ~ 8UILDI~ D~P~RT~E~--~I
If applicant is a corporation, signature of duly authorized officer.
ff (Name and title of co,orate officer) ........ ~P~ 0~
USE IS UNLA~FU[
~in~'~ u~.~ ~o ........ ~ ............. OF OCCUPANCY
~lectricJan's Lice.se No ..... ~ ~ ..............
Other TmdCs Licanse No .... ~ .............
T65-1B02 9 .'~,~TO 4 PM FOR THE
FOLLOWING INsPE~f(ONS:
I. FOUNDATION - TWO REQUIRED
FOR POUR~ CONCRETE
2, ROUGH - FRAMING & PLUMBING
3, INSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O,
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPO~N~i'BLE FOR
DESIGN OR CONSTRUCTION ERRORS
1. Location of land on which proposed work will be'done ..................................................
House Nmnber .. Street Hamlet
County Tax Map No. 1000 Section ......... 71 ...... Block ....... / .......... Lot...~. ............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
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
3. Nature of work (cheek which apPlicable): New Building .......... Addition ...... Alteration Z .........
Repair ............ RemOval .............. Demolition .............. Other Work.. ~J:'~.W-v ......
! (Description)
4 Estimated Cost . .~. Fee .........................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
· If garage, number of cars ..... i ..................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing tructureS,~fany: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories .................................
Dimension fs truct e with alt rati or additions: Font .......................
s o amc s ur e OhS r ................. Rear ..................
Depth .................... [. Height ...................... Number of Stories
8. Dimensions of entire new construction: Front ..... ./9.." ..... ,': z z.,' .
· Rear .. ~- ........... Depth .. t' ...........
Height ............... Number of Stories ........................................................
9. Size of lot: Front ........... ~ .......... Rear ...................... Depth ......................
10 Date of Purchase ~ · Name of Former Owner
11. Zone or use district in which premises are situated .... ,~.
12. Does proposed construction violgte any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ..... '. ~ .................. Will excess fill be removed from premises: Yes ;~2No
Name of Architect ........... ................ Address ................... Phone No ................
15. Is th:Lc property wJ_th±n 300 feet of a t:±dal wetland? ~Yes ........ No....,,~o .... ''';
~If yes, Sour:hold T~wn Trustees Perra~_t may be requ±red.
.. , 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 n~mber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK. 8.8
......... ~.F~. ~.:.t~4-~.! ....... ! ...... ........... being duly sworn, deposes and says that he is the a cant
{N~m~.. of individual signing contract) ppli
abe name, d ·
He is the
i (Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this
application; that all statements containbd ~ thi~ application are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~ner sot forth in the application flied therewith.
Sworn to before met~
~ $~,~ ~ (Signature of applicant)