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Home My WebLink About18902-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18933 Date MARCH 29, 1990 THIS CERTIFIES that the building ACCESSORY Location of Propert~ 5420 MAIN BAYVIEW RD. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 04 Lot 35 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19~ 1990 pursuant to which Building Permit No. 18902Z dated MARCH 21~ 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 ACCESSORY SHED 8'X10' IN REAR YARD. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A GEORGE F. & EILEEN A. MOORE Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18934 Date MARCH 29r 1990 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 542OMAIN BAYVIEW RD. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 04 Lot 35 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19, 1990 pursuant to which Building Permit No. 18902Z dated MARCH 21, 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 ACCESSORY SHED 10'X16' IN REAR YARD. The certificate is issued to GEORGE F. & EILEEN A. MOORE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ~uilding Inspector NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18935 Date MARCH 30¢ 1990 THIS CERTIFIES that the building. ACCESSORY Location of Property 5420 MAIN BAYVIEW RD. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 04 Lot 35 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19, 1990 pursuant to which Building Permit No. 18902Z dated MARCH 21, 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 ACCESSORY SHED 8~X8' IN REAR YARD. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A GEORGE F. & EILEEN A. MOORE ~/'u~J~Inspector Rev. 1/81 FORB[ NO. ,s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_o 18902 Z County Tax Map No. 1000 Section ........ ,J~... ........ Block ...... ~ ............ Lot No..,,~,,, ,~.... .......... pursuant to application dated ......... ~... ................................... , 19.~....~.., and approved by the Building Inspector. Fee $....~..~ Rev. 6/30/80 TOWN OF SOUTUOLD BUILDING DEPARTNCNT TOWN HALL SOUTHOLD, NEW YORK 765 -- 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LANB ........ HOUSE NO. ~3CREET ' HAMLET ' ~ount¥ T~ ~ No. ,ooo Section .'D%. ~lo~ ....~.. ~ot' ..'.~..%.. Subdivision ....................... Filed Map ........ Lot .......... ~eal~h Dept. Approval .................. Underwriters Approval Planning ~oard Approval Request for Temporary Certificate ....... Final CertificaEe ..... Fee Submitted. $ rev' ]0/14188 De FORM NO. TOWN OF SOUTIIOLD BUILDING DEPARTI~ENT TONR 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS This appllaatlon must b~ filed in typew-clter OR ink and submitted to the Building Inspector with the foll~wing; for new buildings or new use: ]o Final survey of property with accurate locatlon of all buildings, property lines, streets, and unusual[natural or topographic features. 2o Final approval of He~lth Dept. of water supply and sewerage-disposal(S-9 form)° 3. Approval of clectrzc~l installatlon £rom Board of Firn Underwriters. 4. Sworn statement fromiplumber certifying that solder used in system contains less' than 2/10 of I% lead2 . 5. Commercial buildingsi industrial buildings, multiple residences and similar. buildings amd installations, a certificate of end, compliance from the Architect. or Engineer responsible for the building. 6. Submit Planning Boar~ Approval of completed site plan requirements. For existing buildings IPrior to April 9, 1957~ non-conforming uses, or buildings and "pre-existing" land,uses: ]. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly cnmpletedlapplicatiou, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, · ~f a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3, Date of any housing ~ode or safety inspection of buildings or premises, nr other pertinent informatiofl required to prepare a certificate. For Vacant Land Certificate of Occupancy: [. An application for v~cant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lbt prior to April 9, ]957 shall also accompany the application. If!a Certificate of Occupaucy is denied, the Building Inspector ~hall state the reasgns therefor in writing to the applicant. FEES: ~. CERTIFICATE OF O~CUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accepsory buildings, $25.00 - Businesses $50.00. 2. Certificate of O~cupancy on pre-existing dwelling - $I00.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $]0.00 ~. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 Residential ~. Temporary Certiflicate of Occupancy -$]5.00 Commercial er. 10/14/88 · OU~D=TIO~! (1St) FOU!;DATIO:! 2. (2nd) EOUGH FRAME & .PLUMBING II~SULATION FERN. Y. STATE ENERGY CODE Fi::AL ADDIi NA'L COMMEI,~TS: FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 BOARD OF HEALTH 3 SETS OF PLANS SURVEY CHECK SEPTic . .. I , BI·DG, D~P'¥. ) TOW,N~ SOU%H~!;D TEL.: 765.1802 ... ................................ ~uildj~[nspecto~) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS NOT~FY' CALL * MAIL TO: a. Tlfis application must be complete y filled in by typewriter or in ink and submitted to the Building l~spec-tor, with sets of plans, accurate plot plan to scale. Fee according to schedule. , b. Plot pl,,;a~,, showing location of lot and of buildings on premises relationshi · ' · o ~r areas, and ,.tying a deta/led description of layout ,.r .... , . . p to adjoimn~ premises or public streets cation. ~ ~- v-*ver~y must ~e drawn on the diagram which is par~ of rids appl/- ¢. The work covered by tkis application may not be commenced before issuance of Bui/ding 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 throu2-~aout 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 applicab'~e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspcc ql~qn pr~mises a~d in building for necessary inspections. , ~ '~ ' . - . ~_,,(~S~n,a.!.u_re. ot arl;[phcant,,~or~na,m.e' ifasorpor.~ri~n')' ' ' · . (Mailing add'~ess of applicant) ......... State wh~ther ~'~6'lJ~hnt '!s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. --', . :; ,. ~- (as on the tax roll or latest deed) If applicant is a corpori]¢~io~i signature of duly authorized officer. (Name;aBd;title,o f'eorporate officer) · , . Budder s L~cense No .... Plumber's License No ......................... Electrician's License No ....................... Other Trad¢'s License No ...................... 1. Location of land on winch proposed work will be done; ' tlouse Numberk5 ' ~' ' Street, '-~':" ~'~-~ ....... \ ....... Hamlet ........... ..-x. % . County Tax Map No. 1000 Section ........... Block ................ Lot. Subdivision ................... Eiled Map No. (Name) ............. Lot ....... 4. 2. State existing use and occupancy of premises and intended usc and Occnpancy of proposed constrnction: b. Intended Use and occupancy ....... J ................. 3 N f k( h pp ' ) ildi Additi Alters n ............. · ature o wot check whic a lcahle: New Bu ng ......... on ........ Repair .............. R.'Emo_,y, al~ ..... :..- Demoli_~tion .., ............ Swlraraing pool .............. Tenn£s Court: ....... ;,,~. (~es,sory Build~_ng~. ~ ..... Fence ....... Other ~ll~. IJ.{~ ..... Estimated ..:-dr-d ........ Fee ..... ' "' I (to be paid on filing this application) $ 'Ifdwelling number of dwelling hnits ............... Number of dwclling units on each floor ................. 6.: If business, commercia or mixed occupancy, specit,y nature and extent of each type of, use ................ at/., Dimensions ot,_existing structure~, if any: Front..,..[.Ch ....... Rcar. .;..~.(~ ....... Depth .... Height .... ~ ......... Number of Stones ...... ~ ........... ~ ........ Dimensi6ns of same structure ,vith alterations or additions: Front . .~t~ ............. Rear ............. Depth .................... i.. Height ..... ~ ............... Number of Stories ................. 8. Dimensions of entire new construction: Front . t)~ .......... Rear ............... Depth .......... Height Number of Stories ' · ........... 9 Size of lot: Front , Rear ........ Depth .... · 10 Date of Purchase ' Name of Former Owner · 1 I. Zone or use district in which pr~mises are situated ........................................... i i ...... 12. Does proposed construction violate any zoning law, ordinance or regulation: 4~ ............................ 13. Will lot be regraded ./~1~. .... ! ................... Will excess fill be removed from premises: . Yes .... N~. 14. NameofOwner ofp~'emises ..i ............. ' ....Address ................... PhoneNo ...... Name of Architect ~{/l ....... i ................. Address ................... Phone No. ~. 15.Is this property located within l OD feet of a tidal wetland? mYES.. ~If yes, Southold Town Trustees Permit may be required. i PLOT DIAGRAM ' r ,~+~ ,,~.h, ~,,,~ ,~,l,,,,~,, ~li ~,,,ila~,,o~ whether existing, or ~ronosed, and indicate all set-back dLmensmns frpm ...... ~,,.,~,:, ............ J -1 ...... ~' ~ - * ' .... ate whether property lines. Give street and block, number or description according to deed, and show street names and mmc interior or corner lot. STATE OF NEW YORK, COUNTY OF ................ APPROVED AS NOTED DATE: , , B.R # .... FEE:: BY: NOTIFY BUILDING DEPARTMENT AT 76S~1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I, FOUNDATION TWO REQUIRED FOR POURED CONCRETE. 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MuST SE COMPLETE FOR C,O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROBS S.S ...................... being duly sworn, deposes and says that he is the applicant above named· : (Contractor; agent, corporate Officer, etc.) of said owner or owners, and is dhly authorized to perform or have performed the said work and to make and file this application; that all statements cofitained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manoer set forth inthe application l~lcd therewith. Sworn to before me this tELEN IL DE VOE NOTARY PUBLIC, State of New Yodt No. 4707878, Suffotl[ Calmly.,, Term Exiires March 30,19 74 ... County (Signature of apphcantl