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Home My WebLink About19415-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z20038 Date_ JUNE 26~ 1991 THIS CERTIFIES that the building. ADDITION Location of Property. 7635 BAYVIEWRD. EOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 __Block__O? Lot 30.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 19, 1990 ..__pursuant to which Building Permit No. 19415Z dated SEPT. 25~ 1990 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 SCREENED PORCH ADDITION AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUN~ DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 WESLEY & AGNES DICESINSON ........ ~N/A N/A B~u~Inspector NO TO~'N OF SOUTHOLD IUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. (THIS PERMIT Mg$~;~,~P~I' ON THE PREMISES UNTIL FULL COMPLETION ~ THE WORK AUTHORIZED) ~ 41 5 Z Dote ... ~ Permission is hereby granted to:_ ~ ~ / ,. ......... at pre..m.i;~ i°coted at ...... .~..'.'~..;......~....~.....~.~ .................................... County Tax Map No. 1000 Section .......... ..~...~... .... Block ....... ~ ........ Lot No ....... ..'~.....~/..../..... pursuant to application dated ....~.../.../..~.. ..................................... , 19.~....~.~ ond approved by the Building Inspector. Rev. 6/30/80 2 0199i EiLDG. DE~T. TOWN OF APPLTCATION FOR CERTIFICATE 0F OCCUPANCY TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 ~ccurate 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 archiuect or engineer responsible for the building. 6. Submif 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: io 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. Fees i. Certificate of Occupancy - New dwellin§ $25.00, Additions to dwellin§ $25.00, Alterations to dwelling $25.00, Swimmin§ pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-e×isting Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0 Date ....... Jung .3 ,. 2~.R1 .................... few Construction ........... Old Or Pre-existing Building..X .............. ,ocation of Property...7f>~5-Ba.y. view. ~d .......................... $o~kholP ................. . House No. Street Hamlet nwer or Owners of Property.. ~sl~ .and. ~gge~. ~iCgi~gO ................................. ounty Tax Map No 1000, Section .... 28 ~^ ? ~ ' ........ Block$~.~-. .......... Lot .... 1 .................. ubdivision .................................... Filed Map ............ Lot ...................... ermlt No.[~.~J~..~. ..... Date Of Permit..~Qr~.Q ..... cant... Appli P~9~ .................... ~alth Dept. Approval.a~A ..................... Underwriters Approval .... ~/.~:.i~.~ ............ [anning Board Approval ........................ aquest for: Temporary Certificate ........... Final Certicate .... ~ ..... ~ ~03-5'~- APPLICANT ' FOUNDATION (1st) FOUNDATIO~'~ 2. (2nd) ROUGH FRAME & -PLUMBING INSULATION ?ER N. STATE ENERGY CODE FilIAL ADDITIO~A'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION []FRAMING []FINAL ] ROUGH PLBG. 2ND [ ] INSULATION -o TOWN OF SOUTHOLD ~ ] FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 BOARD OF HEALTH . . 3 SETS OF PLANS ''~"~-~' SURVEY ......... '.---- ' . Approved 19... Permit No ............ Disapproved a/c ................................. ................................. APPLICATION'/FOR BL41'LDING PERM IT INSTRUCTIONS NOTIFY~ CALL ..................... blAIL TO: Date ' ....Aug....22., 199. Q. a. Tiffs application must be completely filled in by typewriter or in ink And submitted to the Building Ihspector, with 3 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 streetg or areas, and giving a detailed description of lhyout of property must be drawn on the diagram which is part of this appli- cation. e. 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 throuv, hout the work. e. No building shall be occupied or used in whole or ~n 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 ~:emoval or demolition, as herein described. The applicant agrees to comply with all applica6~e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. '(S~ature o~/hpplicant, or name, if a 768G -Bayv-i/ew· R~d ~ · Sou~ho.l<% · · N-Y. -~ t 9-7.1. · · (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nameofownerofpremise~Dickinson Wesle.y R & WF (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... x..x.x.x.x.x..x.x.x...~..O_~...~...t~.' ' ' XXXXXXXXX Plumber s L,cense No ......................... Electrician's License No..x.x.x.x.x..x.x.x.x. ........... Other Trade's L cenco N~' xxxxxxxxxx 1. Location of land on wliich proposed work will be done: 7635 Bayview Road ...... · ,, Southold llouse Number Street. ' ........................ · ....... Ha~nlet " County Tax Map No. 1000 Section 78 ...... ~ BlOck 9 .30..1 Subdivision ..................................... Eilcd Map No. (Name) .............. Lot ............... 2. State existing use and occupancy of premises and intended use and Occupancy of proposed construction: A. Existing use and occupancy..11>~t%~..home ....... B. Inten ed use and occupancy ...................................... ' 3. Nature of work (check which ap.~licable): New ~,ila;,,~ .......... Rl~moval Demolition Swim~om Repot ....... Tennis Court ......... Accessory Building 4. Estimated Cost ..$1500.. 5. If dwelling, number of dwelling units ............ ..........~/'z--F(n~e ....... Other Work; ...... , . . .... (to be paid on fi ng this application) Number of dwelling units on each floor ................ If garage, number 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.. ~D..fL ....... Rear , iD..IS ....... Depth 3-_2.~f b? ...... Height ............... Number of Storiex .... 2 ................................................. Dimensions of same structure with alterations or additions: Front . a.o .¢ha~go ..... Rear . 'no' 'ohang.s. · ·. Depth ...3.6..fig .............. Height ...~.o. ch.a.~9o ......... Number of Stories.. no. .eha~',9@ ....... 8. Dimensions of entire ne~v construction: Front .... O_.~ .:f:~ .....Rear .. ~: ~..3g ....... Depth ...1.0 · f~ ..... llei~ht .1-1 f.~, Number of Stories ,l ' 9. Size of lot: Front . .105..f.~, ......... .... Rear... ,1:0.4. fa ............ Depth .... 2 R0...3t · f.b ..... 10. Date of Purchase . .. 8/2.6. ..................... Name of Former Owner ..; .Rayraand. D.i.okin,s.on .... I 1. Zone or use district in which premises are situated .... l:oai0ei%t,.J.~,l ................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .n. 9 ........................... 13. Will lot be regraded ...np ........................ Wiil excess fill be removed from premises: Yes .... No. 14. NameofOwnerofpremises W. R. Dickinson Address76,35 Bayy. iew Rd. PhoneNo..7.6.~.5.75.Z .... Name of Architect.....n.°ne... . . .. Address . Phone No ................. · Address Phone No Name of Contractor ... ow.rm,; ..................................................... 15.Is this property located within 300 feet of a-tidal wetland? *YES .... NO.>;.. · If yes Southold Town Trustees Permit may be required. · 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE\V YORK, S.S COUNTY OF ................ '. (Name of individual signing contract) above neared. being duly sxvorn, deposes and says that he is the applicant He is the ........................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file this application: that all statements contained in this application are true to tim best of bis knowledge and belief; and that the work will be performed in the manner set forth in the applicatioo filed therewith. Sworn to before me this ............ /ff .......... day of ..... , ot=ry, b,,s ......... ounty HELE~ K. DE ¥OE I~ffARY PUBL C, Sta~e of New York No. 470787S, Suffolk County./ 'lerm £xpire$ March 30~ (Signature of applicant)