The URL can be used to link to this page

Home My WebLink About19043-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22444 Date JULY 8, 1993 THIS CERTIFIES that the building. ADDITION Location of Property 6560 NORTH BAYVIEW ROAD House No. Street County Tax Map No. 1000 Section 79 Block 7 Subdivision Filed Map No. SOUTHOLD~ N.Y. Hamlet Lot 2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 1990 pursuant to which Building Permit No. 19043-Z dated MAY 24r 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 APPLIED FOR 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 FRANCIS M. & NANCY T. FUSCO /~ildi~g Inspector Rev. 1/81 ~vOF.~ NO. ~ TO~N O~ BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM '~9043 Z Permission is hereby granted to: .... .~~.~.......~..~.:....~.~..~...~..~ .... ~ ...... .... ...~.....~,~.~.~...~.~,.....~.~.~ ........................... ~ ...................................................... ~oun~Tox ~o~ ~o. I000 S~c~ion~ .... ~ .......... ~l~k .......... 0 ~. ........Lot No .....~ ............. ~uildlng Fee $..~.~...~..o Rev. 6/30/80 Ae Be 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: 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. 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 - $100.00 3. 'Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 /4.. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ Date ..;..,~.~,~?.'.~.~. ........ New Construction.~.~i...;.. Old Or Pre-existing Location' of Prope t · ~..~.97. ........ D.'J~..~'V.I.~(~ House No. Street Hamlet 0nwer or Owners of p y .................. County Tax Map No 1000, Section,............,~ Block ...... 2 ....... · LOt...,~. Subdivision ............................... Filed Map ............. Lot ..... Permit No .......... Date Of Permit ........... A~licant Health Dept Approval Underwriters ' ....................... Approval ..... Pi lng d App 1 ' Request for: Temporary Certificate ........... Final Certicate ....... · ?ce Submitted: - .. · .................. ...... Ai~PLICANT 9' 165.~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION 2ND [ LATION FRAMING [ ~ FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~JLATiON []FRAMING [ ~/FIFINAL ~,_.-- INSPECTOR ~ --~ faeilitto9 for this location FQRM NO. 1 TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN HALl. ~0UTIIOLD. N.Y. 11971 TEL.: 7G5-180~ (Building inspector) APPLICATION FOR I~UILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS SURVEY ..................... CllECK s E~T:c '~U, '~ ................ NOT~ FY ~ HAIL TO: , INSTRUCTIONS . a. TRis application must be completely filled in by typewriter or in ink and submitted to the Building/~ector, with 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which i~pari of this appLi- cation. c..T, he work covered by this application may not be commenced '~ - ' - -- ' ~ d. oetore tssuance or.t~uilding Permit. - Upon approval of this application, the Building Inspector will/!;sued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection througJlout the work. e. No building shall be occupied or used in whole or in part for any purpose, whatever until a Cer~ifitmt, of Occupancy shall have been granted by the Building Inspector. ' APPLICATION IS HEREBY MADE to thc Building Department fbr the issmlnce of a, Building Permit pursuant to the Building Zone Ordinance of the Town of SouthoId, SufFolk County, New York, and other applicable La~. Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, a~ herein described. The applicant agrees to comply with all applicable laws. ordinances, buiIding code, housing code, and re~tions, and to admit authorized inspector~ on premises and in building for ne~cessary inspections. · L~lgnature et applicant, or name. if a ~ra~'l~n')' (Mailing address of applicant) State whe'ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .~~t.~:.. ,~ame oc o,vu= oCptemises..0~.~.'...~.. ¢....~..0~....~....7..,. ~ ........... (as on thc tax roll or latest deed) ....... If applicant is a corporation, signature of duly authorized officer. Plumber's License No ........ ' ................. Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done: [louse Number .... Hamlet ........ C°nn'yT=,',ap o:,0o0 t,on ...... ..... ""7' .<. k,C.~,ct2.&.~ .~O.~.~:O. .... ' ..... ' :' Subdivision .. · ......... Eilcd Map No. h"' {Name) .............. Lot ............... Slale existing usc and occupancy of prcmiscs and intended u · . . sc and occupanc o£ · - · · . , Y proposed construct on: ~ *-~ '. o==c, !.. b. Intended Use ~.a o=up=~r ...~.C.~ ....... ~ ............... : .... ............................ 3. Nature of work (check which applicable): Ne~v Building ......... * Addition . ....... . . ,'dleranon ........... Repair ............ R~mov:ll .............. Demolition ' ' ' pool. Tennis Cou'~ ~ ' ... ............ Swxmmlng ............ £st=ated Cost. ....................... e ................................. I (to be paid on l~]ing this application) $, If dwelling, number of d~velling u~its ,,,,,,,,,,,,,,.' Number of dwelling units on each floor If garnet number of cars ! - 6. If business, commercial or mixed OCCupancy, specify nature and extent of each c of usc . .., .... ~ ty, p ............. 7 Dimcnsionsofexistingstructurcs iifany: Front ' .Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear ' Dypth '. .................... ~ Height ..................... Numbcr,,o[ Stones .................. 10.9'8'Hei=htDtmensmns Rf}ntire ne'v c°nstmdti°n:siZeDate, oflot:of P'archase' ' ~:Fr°nt ........ .... ..... LJ.OJ~ .~ i' /.O~.. ,Nm"~' puer~i ...... o,./.~ .Z.'?t.'lL~'...at°nes"" ,~ -~..-Fr°nt;'" ............ .~q.Q t jJ~Rear....,~..~.. 'l~,L~Name" .... of Former~Rear~' '" ....................... ;'~Owner .......................... ........ Depth .. C~Depth...~-i~ ~ .......... 11 Zone or Use district in which Premises are situated 12. Does proposed Construction any zoning law, ordinance or regulation: . .J~..~ ............... Will lot be regraded ....... Will-"c ........ · ,*.,m,o,lr~,~,-..~.,,~;~,.~ ' ' -''"''' '--....., - 14. Name of Owner of premises tc:J~4arfl, J.Q/:~. p-~. ELJ~.~..C)Address .A.J.. t~ g.L/l/~./14 J?.~. Phone No. Name'of Architect : ...... Address Phone No Name of Contractor ...... ; · · · ................... Address ................. Phone No ..... 15.Is th~s property located within lO0 feet o~.'a .tidal wetland,* *YES .... NO.~.~'' · If yes, Southold Town Trumtees 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 NEW YORK ' COUNTY OF ' S.S ............................... (Name of individual signitJg' ................... contract) being duly sworn, deposes and says that he is the applicant above named· (Contractor agent corporate officer etc) ' of said owner or owhers, 'and is dulyi authorized to pe,rform or bare performed the said work and to make and file this applicat on: that all statements contai}md in tiffs application are true to the best ofhis knowledge and belief;and that the Work will be perfommd in ~tt~e re=ncr :set forth in the application filed therewith. Swam to before me this ' ,.,,,~ (Signature of applicant)