HomeMy WebLinkAbout28373-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29481 Date: 06/02/03
THIS CERTIFIES that the building ADDITION
Location of Property: 2555 NORTH BAYVIEW RD EXT SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 79 Block 6 Lot 4 .1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 2002 pursuant to which
Building Permit No. 28373-Z dated MAY 9, 2002
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 SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ROBERT A DEVITO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Q `
t
u ori-11
r' ed Sie ature
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: Z-29482 Date: 06/02/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2555 NORTH BAYVIEW RD EXT SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 79 Block 6 Lot 4.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 2002 pursuant to which
Building Permit No. 28373-Z dated MAY 9, 2002
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 12 .3 ' X 10 .3 ' WOOD STORAGE SHED AS APPLIED FOR.
The certificate is issued to ROBERT A DEVITO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Aut r' ed ignature
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: Z-29483 Date: 06/02/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2555 NORTH BAYVIEW RD EXT SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 79 Block 6 Lot 4.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 2002 pursuant to which
Building Permit No_ 28373-Z dated MAY 9, 2002
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 23 .4 ' X 12 .3 ' WOOD STORAGE SHED AS APPLIED FOR.
The certificate is issued to ROBERT A DEVITO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ N/A
PLUMBERS CERTIFICATION DATED N/A
Auth i ed ignature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 28373 Z Date MAY 9, 2002
Permission is hereby granted to :
ROBERT A DEVITO
PATCHOGUE,NY 11772
for
CONSTRUCTION OF AN ACCESSORY SHED AND A REAR DECK ADDITION AS
APPLIED FOR. 2 C.O. S REQUIRED
at premises located at 2555 NORTH BAYVIEW RD EXT SOUTHOLD
County Tax Map No. 473889 Section 079 Block 0006 Lot No. 004 . 001
pursuant to application dated MAY 8, 2002 and approved by the
Building Inspector.
Fee $ 225 . 00
C ?/ 'N�
Author zed Signa
COPY
Rev. 2/19/98
Form No.6 / -
TOWN OF SOUTHOLD
BUILDING DEPARTMENT �- APR
TOWN HALL 5493
765-1802 C,
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
I. 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 sirrlar 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.
B. For existing buildings(prior to April 9, 1957) non-conforming uses, or buildings and"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and 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.
C. Fees
I. 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- $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15y.(000D n'I
�J Date. f fr C ,3f (D3
New Construction: DEC rOld or Pre-existing Building: (check one)
�
Location of Property: 5� J 7 Fj 1A,,te S dI ( kit�l
House No. Street y� Hamlet
Owner or Owners of Property: VQ-060U`T p�F�� l I(l
Suffolk County Tax Map No 1000, Section A- 3 g D Block Lot
Subdivision Filed Map. Lot: ,
Perm t No. 271 iD� / l ' '2- Date of Petmit.�A4A'_ Z-V02- Applicant:4tjg. tt V r P0
Health Dept. Approval: Underwriters Approval: U.J
Planning Board Approval:
Request for: Temporary Certificate_ Final Certificate: ) (check one)
Fee Subm tted: $ o� LT-V_
Robert A. Devito
Applicant Signature
6,4,c, & `1
CO -?- a27ggl
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT APIA 2
TOWN HALL 4
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY -„
This application must be filled in by typewriter or ink and subm tted to the Building Department with the following:
A. 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and 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.
C. Fees
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- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
�) Date. ftpyuc 23i D3
New Construction: 7IACZzCY SHEAld or Pre-existing Building: ��J (check one)
Location of Property: -2-055-
l 5 J 51 tem-
House No. nn Street y, Hamlet
Owner or Owners of Property: AA
-060`x- - �F l)
Suffolk County Tax Map No 1000, Section '1 -7 3 B�Block Lot ` q
Subdivision Filed Map. _Lot:
Permit No. 'd� 73 Date of Permit. 14 UVL Applicant: tV
Health Dept. Approval: K Underwriters Approval: (() ;)
Planning Board Approval:
Request for: Temporary Certificate _ _Final Certificate: (check one)
Fee Submitted:
Robert A. Devito_.
Applicant Signature
co �a9 LIZ
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT X34
APR 2 Jr y�,,�
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY '
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and 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.
C. Fees
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- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Corrunercial $15.00
�) Date. WC �/?�
( D3
New Construction: ACC7 Sold or Pre-existing Building: DD (check one)
Location of Property: 2.05 3 (� S Q,t,(P
House No. Street � Hamlet
Owner or Owners of Property: 1`o6ey`r A- �F u l 1yV //�
Suffolk County Tax Map No 1000, Section A / 3 2 9 Block 7 q — Lot l0 ` q ,
Subdivision Filed Map. Lot:
Permit No. 73 -___2- Date of Permitlt4 LdcJL Applicant: ✓etiz X✓ _ l�l� r ttV
Health Dept. Approval: 0 Underwriters Approval: XJ J
Planning Board Approval: J
Request for: Ternporary Certificate Final Certificate: (check one)
Fee Submitted .$
Robert A. Devito
.lpplicant Srgtrature
C0 � a94g3
765.1802
BUILDING DEPT.
INSPECTION
[ 1,4 FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
DATE U L INSPECTOR i " J
� 8 373
M-1802
BUILDING DEPT.
INSPECTION
1 [
vfOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[v<"FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE Oda i oma- INSPECTOR-�Y��
� 373z?-
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE ✓ INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU ON
[ ] FRAMING [ " INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
pO
DATE 1,7Y INSPECTOR
FIELD INSPECTION REPORT DATE CONE IENTS
FOUNDATION (IST)
H
x
-----------------------------------
�� t
FOUNDATION (2ND)
z
J
ROUGH FRAMING& H
PLUMMLNG
77A
X�
INSULATION PER N.Y. y
STATE ENERGY CODE
0
4
0
0-
FINAL ? 0
ADA NAL COMMENTS
0
PIT m
m
_ z
ro
z
o y
0
z
H
x
d
b
ti
t OWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 ,3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 ��QC� 2 Spey
PERMIT NOC (85-3 J� Check
Septic Form
N.Y.S.D.E.C.
e t Trustees
Examined c
J \ ,20 Z Contact:
Approved 20 Z Mail to:
Disapproved a
_ Phone:
Expiration 11 _ , 203
( pR Building Inspector
n, y 8 2W APPLICATION FOR BUILDING PERMIT p
Date v 200 Z
" r INSTRUCTIONS T
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector 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 streets or
areas, and waterways.
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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
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 applicable laws, ordinances, building code,housing code,and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
p ) {
td�t_ltlb
(Signature of applicant or name,if a corporation)
(Mailing address of applican �—
1 (772
State whether applicant i owner, ssee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises IC.0&a rAr- b EA o-b
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
Wo3-�s t-a e ,5Bu4DL�
House Number Stree Hamlet
4 - - �S1
County Tax Map No. 1000 Section 0 t 1 Block � "'`' Lot '0DY'``
Subdivision Filed Map No. Lot
(blame)
2. State existing use and occupancy of prsesd intended use and occupancy of proposed construction:
a. Existing use and occupancy Zia(e
b. Intended use and occupancy �2 SIcQPvtGC
3. Nature of work (check which applicable): New Building Addition 7Z Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost `Qi t)a'1)D Fee
(To be paid on filing thi$�application)
5. If dwelling, number of dwellingis PA Number of dwelling units on each floor
If garage, number of cars a/ &
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 00`A 41 Crl4a&�
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES_NOJ�—
13. Will lot be re-graded? YES_NO�LWill excess fill be removed from premises? YES NOEL
14. Names of Owner of premises 10-06,tt-Pr AE J IM Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is#his property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO�_
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16v-Pspvide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
STATE OF NEW YORK)
COUNTYI OF-,6gt
(Lor4- D l'o !TV being duly swom, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor,Agent, Corporate Officer,etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application:
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the mariner set forth in the application filed therewith.
Sworn t lz@Ifpre me this
Off
;aa—
Nftary
^�20Q�
Public II Signature of Applicant
LYNDA M. BOHN
NOTARY PUBLIC,State of New York
No.01806020932
Qualified in Suffolk County
Term Expires March 8,20
1! �zcr Ced�2 Pas t 011i-175 ,:7(4
to
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,
vv 0 270 S Ceele 1 PeA-#off
wife
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BUILDING PERMIT EXAMINER CHECK LIST
DATE ISSUED: /
_/02
_
` DATE REVIEWED: �/_a/02
APPLICANT: DATI SUBMITTED: x/ /02
SCTM#DISTRICT: 1,000, SECTION: (�, BLOCK: 6 ,, LOT:
STREET ADDRESS:�p 5 HCS�(�S LW CITY: ;�n,)-ttYjgQ SUBDIVISION:
y� T , D +� �CC�S
t-i
PROJECT DESCRIPTION: CCt��1� �g, �
ESTIMATED PROJECT COST: 0-� ARCHITECT/ ENGINEER: FAST TRACK? /w
SINGLE & SEPARATE CERTIFICATION-REQUIRED? /1/O NOTES:
LOTS 40,000SF-100-24.Lot reeognition.(CREATED before lune 30, 1953),UNDERSIZED LOTS FROM JAN.1997 100-25.Meiger.(A nonconforming at anytime after 7/1/83
ZONING DISTRICT: AC CONFORMING? YES
REQ. LOT SIZE: � ACT, LOT SIZE: #"f REQ. LOT COV. ACT. LOT COV.
REQ. FRONT Ate, PROP. FRONT---,,/ REQ SIDE <_ ACT. SIDE
REQ. REAR � PROP. REAR ✓ C4-
�J lr
WATER FRONT? NO DESCRIPTION: �—
PANEL #: I/,S FLOOD ZONE:_,
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES olgBED #):_DTE:—/ /_ PERMIT#:RI0-
TOWN SEPTIC RECEIPT: Y o�I
NEW YORK STATE DEC: ]PRE-DEC 9/1/75 YES
SOUTHOLD TOWN TRUSTEES: YES ono
TOWN ZONING BOARD APPROVAL: YES
o
TOWN PLAN. BOARD APPROVAL: YES o
TOWN HISTORICAL PRE (SPLIA): YES N
NYS ENERGY: YES OR NO : z'
EGRESS (I8 H min.? 4 sq total) /, VENT (SQ. FT. x 4%) LIGHT (SQ. FT. x 8%) "
BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z-_ K(,Z22HAVE PRE CO'S : Y OR N BP -Z/ C/o Z- ,
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
I. 5(f l a_SF)- (_SF)- SFX $ =S +$ +$ = $ 150
5�p
�s
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F-
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MAP No.0230 12n2100 i
Lxuaeead SIMON 0 adam to on ddarrt e d mkww Butt"7700 ... .. ..._.i
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�0{OTNaaw Now.r~a. SURVEY DATE: 02/28102 SCALE)"MW
CERTIFIED ONLY TO:
MMM A.DEMO DESTIN G.GRAF
NONiH fOIMt MNK _... .. .. _ LAND SURVEYOR
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NOTIFY BUILDING�DElN►RtMEltT AT
765-1802 ! AM TO 4 PM FOR TME
FOLLOWING INSPECTION&
1. FOUNDATION - TWO REQUIRED
FOR POURED CONI ETE
2 ROUGH - FRAMING A PLUMBING
& INSULATION
4 FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
UNDERWRITERS CERTIFICATE
REQUIRED
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
i'
2002 PRICE LIST
FORK LONG ISLAND
's Lane S Rt. 48, Peconic 11958 Riverhead, NY 110 1
31 ) 7653090 (631 )
7 55808 Fax
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Everything in this Catalog is Built in Peconic or Riverhead.
All of our double doors are T wide with 12" hook and eyes.
Extra Heavy Gauge Galvanized Hinges with Solid Brass Pin.
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If It's Built for the tyre.moi lien
it's Built by North F ;*k Wo® sign
and Long Is l dtfie '
In Our Peconic or Riverhead Factory!
JUN 13 2002 '� �e ( � Z;.
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