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Home My WebLink About19471-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19468 Date OCTOBER 22~ 1990 THIS CERTIFIES that the buildin~ Location of Property 1090 BAYVIEW DRIVE House No. County Tax Map No. 1000 Section 37 Subdivision ADDITION Block 5 Filed Map No. EAST MARION, N.Y. Street Hamlet Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 17, 1990 pursuant to which Building Permit No. 19471-Z dated OCTOBER 17, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS BUILT The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A FRANK& CAMILLE PIROZZI Rev. 1/81 /~ ~uilding Inspector TO%VH OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 19471 Z Permission is hereby gra, nte~l,~l~: ~~_~_~~.......~...'..~/-~ ...,'~~.~,~ ....... ~...,. .................. ,o ~~~....~......:~~::...~..~~....~ ~./~...~~:~ ...... ~ ....... ~ .................................... ~ : ................ ~;~,,, ,~,t,, ,, ...z..~.~....~~...~:~ ....................................... .................................................... ~..~~ ................................................................... co..~ ~ ~o..o. ~ooo s.~.o. ....... ~.~ ...... ,~ ...... ~ ..... ~..o, ....~. ............... 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: ~. 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. 1. 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 Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5o Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... New Construction ........... Old Or Pre-existing Building ................. Location of Property. ~.~'.~ ~....~..~.~M.~/./..~/~C Zc .~.~..~..~../~.{~.~. House No. Street Hamlet On,er or O ners of .... ........... ......... County Tax Map No 1000, Section .... ~2 ....... Block ...... ~.3 ........ Lot....f ................. Subdivision..~*.'.~.~.~. ........... :..Filed Map ............ Lot ...................... Permit No ............... o Date Of Permit .............. . . Applicant ......................... .. .. Health Dept. Approval .......................... Underwriters Approval ....................... .. Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. Ek . qoq , .... ............... FOUI;DA~!ON (1st) FOUMDATION 2. ROUGH FRAME & -PLUMBING f2nd~ [~SULATION PER N. ST&TE ENERGY CODE FI~IAL ADDITIONR'L COMMENTS BLDG, DEPT. TOWN OF Sr,~UTI-"Ot D Examined ./.Off./.? ......... I:ORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORH ................ NOTIFY~ CALL MAIL TO' Approved ./.~//~.? ......... , I .9~..~. Permit No./~.~. ~./. ...... ..~ Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT Date .................. , 19... INSTRUCTIONS · a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Ihspector, with 3 ,kets 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 par~ 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, ad~ditions or alterations,~r for ~:emoval or dem~oJition as herein described. The applicant agrocl;.~o~,co, mply.~wit~h~,all applicable laws, ordinances, b~ding c~de, housirt~qJe, and regulations, and to admit authorized in'fbectors on premises and in building for neces~ec;)°~/~/ff55~~~~/.A~//~ ~ State wheth,.~r ~al~pl, i,cCht is 'owner, lessee, ,agent, architect, engineer, general contractor, electrician, plumber or builder. ~ ~P,~ ~O ~:r¢,! ..', ',.':~ -: (as on the tax roll or latest deed) If apphcant ~s ~tc~o~t~Mh~,~ m~n~ltUr~ of dnly authortzed officer. (Name and title of corporate officer) Builder's License No .... ~..Z4)..~..~.~.~.~.. ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work xvill be done; ". tlouse Number Street, Hmnlet ................ County Tax Map No. 1000 Section .~.2 Block d-- ~ , ................. ' ................. Lot .............. ,. ·. Subdivision O~O~,~ ~Y ~- '~ ~' Eiled Map No. (Name) .............. Lot ............... 2. St2te existing use and occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and occu.ancv B. Intended use and 3. Nature of work (check which applicable): New Building Addition Z~ Alteration R) ....... Swimming P~O!. }', ...... ~ .... mov~l .............. Demolition ........ Repa/rTennis ........ Court . {'.' '~; ~ · ACcessory' Building .......... Fe,ce ~ ~ ..... OCher Work~.\~-~...~ 4. Estimated Cost. .f~..!~f .......... Fee ~r~ ~ ... ' (to be paid on filing this application) 5. If dwelling, number or' dwelhng umts ............. Number of dwelling units on each floor ............... If garage number of cars ' " 6. If business, commercial or mixed ~ccupanc¥, specify nature and extent of each type of use .................... 7. Dimensions of existing structures,! if any: Front. ·, ............ Rear ............... laepta .............. Height ..... .. ........NumblerofStories ....................................................... Dimensions of same structure with alterations or additions: Front Rear · Depth Height Number of Stories 8. Dimensions of entire new constm'ction: Front ............... Rear ............... Depth .............. Height Num Der of Stories ' 9 Size of lot: Front i Rear Depth Date of Purchase I Name of Former Owner. . · Zone or use district in which premises are situated .................................................... Does proposed construction violale,any zoning law, ordinance or regulation: .... ~ ............... ..... Will lot be regraded ........ /~. ~ .............. . wilt excess fill be removed from premises: . Yes .... '14o ' . .' .... Address Phone No Name of Owner of premises .......... Name of Architect I Address Phone No · ....... Phone No ......... :o '~' .... Name of Contractor ......... i ....... i .. .......Address ...... ' ~' '. 15.Is thin property located with.tn 300 feet of a't~}.d~'l' wetland.* *¥115 .... · If yes, Southold Towul Trustees Permit may be required. i PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether ex,sting or proposed, and. re&cate all set-back dimenmons f om property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or comer lot. 10. Il. 12. 13. 14. DATE:~ B.R # ~ NOTIFY/flUILDING ~EPARTMENT ~ ~6~4~2 9 AM ~ 4 PM FOR ~E FOLLOWING INSPECTIONS: 1, FOUNDATION - ~0 REQUIHED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4, FINAL CONSTRUCTION MU~T BE COMPLETE FOR C,O. ALL CONSTRUCTION 8HA~ ME~ THE REQUIREMENT8 OF ~E N.Y, STATE CONSTRU~ON & ~EHGY CODES, N~ RES~NSlB~ ~ DESIGN OR C~S~U~ON EH~OHS STATE OF NEW YO~., ,. COUNTY OF ...... .~a.m\ )/--~ .... [ S.S ¢. w. [ ~ ~ ~ . C o being duly sworn, deposes ~d says that he is the applicant (Name of individual siglhmg contract) above named. , &~ is the ~ ~ ! (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly author zed to perform or have perfo~ed the said work and to m~e and file thi~ app cat on; that a I statements con,tamed n flus apphcatmn are true to the best of his knowledge and belief; and that the work w~l be perforated in the m~er set forth in the application filed therewith. Sworn to before me this , ............ .o ...... .... ...... Notaw Public .... ~.t~~{55~ · · · County ·