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Home My WebLink About17534-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall SouthoLd, N.Y. CERTIFICATE OF OCCUPANCY No Z17422 Date OCTOBER 18t 1988 THIS CERTIFIES that the buildin~ Location of Propert~ 365 BAYER ROAD House No. County Tax Map No. 1000 Section 139 ACCESSORY MATTITUCK Street Hamlet Block 03 Lot i1 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 12, 1988 pursuant to which Building Permit No. 17534Z dated OCT. 14~ 1988 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. The certificate is issued to JAMES S. & JOSEPHINE SELLARS (owner, XK~) of the aforesaid building. S[~FOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 TO~VN 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) g!7534 Z Dote ..¢(.~../../...~'... ..................................... , 19.~.~:~ County TOX Mop No. 1000 Section ........ ./..'~...~.. .... Block .... ~ .......... Lot No....//.... ............... pursuant to application doted ........ ../.,,O...~....~ ......................... , 10.,~....~. and approved by the Building Inspector. Fee $.~ .......... Rev. 6/30/80 FORM NO. 6 TOWN OF BOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ~]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ I00.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $'50.00 Date .......................... NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ' House No. Street Nan;let Owner or Owners of Property ...5,~.; .'-'-'-'-'-'-'-'-'~,~. ~. ~..-~,~... .: ,,.~:./~..~. .... ~.:.[_/<..../..~.c.~. ......~:.. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and~ meets ~l!cable codes and regulations. Appl cant ..........~~- . .'~,~,/~,, ......................... . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ,.,,m ;,,, :,/; > : . . . : . . . _,. ^ppro,,ed ............... , l~ . Pe~,t ~o. ./.~. .~.. . . Disapproved a/c ..................................... ~ APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL MAIL TO: BLDG. DEPT. TOWN OF $OtJ1140L~ Date ................... 19... INSTRUCTIONS , ~sets of plans, accurate plot plan to scale. Fee according to schedu e ;" b PI t I ~ ' ' ' ~ " ' :~* ~"::" ? ' ~ ' . o p ~ showm, locanon of lot and of bmldm.s on premmes relahonsh~p to a4i,gkn~ag p~ga~r pubhc streets or areas, and gxvmg a detmled descnptmn of layout of property must be drawn o~ cation. ~ c. The work covered by t~s application may not be commenced before issuance d. Upon approval of this application, the Building Inspector wQl issued a Build~[[[188~~. S.~h~mit shall be kept on the premises available for ~spection throu~out the work. e. No build~g shall be occupied or used in whole or zn part for any purpose shall have been granted by the Build~g Inspector. .PLICATION IS HEREBY MADE to the Building Dep.men, for the ,ssuan~,~~~it pu.uant to the Building Zone Ordnance of the Town of Southold, Suffolk County, New York, ~ff oth~~~ or Regulations, for the construction of bufld~gs, a~ditions or alterations, or for rem~r demolition~a~ ~ere~ deschbbd. The applicant agrees to comply with all applicable laws, ordinances, bulldog code, housi~~ns, and to admit authored ~spectom on premises and ~ bulldog for necessa~ inspections. (Signature ot apphcant, or name, r t (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~ .~. . /.~ ............... .. (as on the tax roll or latest deed) - Ifapplicantisacorporation, signature ofduly authorized officer. 0CC~?~(~ 0~ IS,UN V FUL THOUT CERT F[C ', E OF OCCUPANCY Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ' ................................ .... ).;..r. ~.~.~ .~.~..~ .v..~.. d. ................................... .ff..~..,~ ~ ........... House Number" Street Hamlet ........ County Tax Map No, 1000 Section {'~.~ Block '-~ Lot /[ Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intemlcd use and occupancy of proposed construction: a. Existing use and occupancy .... .9~..~...'~. /..~./ . ~. & ............ b. Intended use and occupancy ...... -- .......... ~, ' " ~ ........................ 9' 3. Nature of work (check wllich applicable): New Building .......... Additioln .......... Alteration Repair .............. Removal .............. Demolition ....... i ...... Other Work ...... 4 Estimate'd Cost 1.7,~f ~..~.°~' ' i (Description) · ' " ........................ Fee (t~ be paid on filing this application) 5 Ifd lli b fd lli it N · b fd 11' gi its hr We rig, Bum er o We ng un s ................ unl er o we In tln on eec eof If garage, number of cars ........................... , ........... 6Ifbi Ii d ......... ' ify d of h typ f ...... · usiness, comlnerc a or m xe occupancy, spec nature an extent eec e o use ................. 7 Di i f iti t~ utes, if F .... · mensons o ex s n stnlct any: rent ............... Rear .... ! .......... Depth ............. H igl Nub of St ri " e it ............... m er o es ......................... ..................... Di io f vith It tie r additions: F ' ' ........ mens ns o same structure x a era nso rent .................. Rear ................ D pth H igl t be:r of St ' ' e ...................... e 1 ............. Num eries .............. 8 Di ensi of ntire'nex ti F '' .'.. ' ...... IAi .... ~..) '' ' . in ons e v construc on: rent .... t-2 ...... Rear ............. Depth . . .......... Height ...~/,/,'Z.~. ....... N. umber of Stories .... 9 Size of lot' Front /.,.0~..t . ',- ' ' ' ';h',i z ...... i ......... / . .............. l~ear.../.w~. ..... : f ~ '" 10. Date ofmurcliase ...~,'~, . t O£~,~ - ,,~. ......... D~,epth, h~.'. .O"~ .,,~, ................. 11 " ....... - ',U ," ' ~ '."'" '~ ............ r~ame m l"ormer Owner ,,d~ff~4,Ct~-~...~ .~..b'.~. ..... ·z~one or use OlS[rlC£ In WlUCll premises are situated .................. i. · ~ .... .... ~2. ,D,,.°..es.P,r.°p°sedc.°nstructionviolatea~nyzoninglaw, ordinance or r;~l'ati0n. 1. i ..... .i'i .......... - ' 1o. Will lei oe re~raoed /~tJ'7 ,,, ~ ..................... , · .-. · ...... ' ' ' ' 'iq '~ ...... excess fill be removed from premises' Ye ~'~. rqameo~Uwnerofpr, emises ~;~=t~..~.~... ~ ~,, ,.~ ..... ~., ~ · Name of Archlto-*; --- ........ ~,~ ~..,~.;.. ,~uuress :...~.t4,~/~:,.,.~.; v~r,/~ plione .No ~.qp.-://,j.~..7... -, - ' ; .FY" .,.,...: Phone'N ............. ' rqame o~. ~:ontracto~~..~?~.~. Address ~/.4//~.1{~ .~.,../~,~';/~. Phone No 15.Is thins property located within 300 feet of ' ' -.,~.-~----~v *-,,-',- -2-' ~L~'~i''' · If yes, Southold Town Trustees Permit may be requirhd. 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 comer lot. , ! STATE OF NEW YORK, COUNTY OF ................. S.S . 0[,ow o 4. iFINAL . CON~M~T ~BE CO~PL~E FOR C.O, A~ CO~T~c~N THE REQUIR~EN~ STATE CO~S~U~O~ C~ON ERROR~ · . . .' ................... be' ! ~'"~"" ~. '' · · (Name of Individual signing contract) m g d u IY sw ° m ',.~ e~ ~,.s-e s~s~l~~ ~,i~t~ applicant itc is the r ,,,~ . , .... (Contractor, agent corporate officer o~l;~l ~ '"" ta, dllJJ of said owner or owners, ~d is duly authorized to perform or have performed {he~lyioa3~-h~ apphcatmn; that all statements contained m this apphcation are tree to t ~e best oflfis knowled e a Jif m~e. and file ttus work will be perfonned in the manner set forth in the application filed th ....... i*h g behef, and that the Swum to before me this ............. .4 ........ or ..................... ~[[~ g, ~E ~[ ........ · .... N~A~ PUBLIC, ~ of ~ew Yo~ ~ , ' ' N0. 4707878 Suffolk Cou~o (Signature of applic~t) let= ~ ~s Bi*ch ~0, 19 ,./