HomeMy WebLinkAbout21376-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22347 Date MAY 20, 1993
THIS CERTIFIES that the building ADDITION
Location of Property 4450 NORTH BAYVIEW ROAD
House No. Street
County Tax Map No. 1000 Section 79 Block 2
Subdivision Filed Map No.
SOUTHOLD, N.Y.
Hamlet
Lot 4.4
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 27, 1993 pursuant to which
Buildinq Permit No. 21376-Z dated APRIL 29~ 1993
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 D~ELLING 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
GARY HUBBARD & ANO.
//~ui~ding fnspector
Rev. 1/81
FOI~I NO. ~'
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)
2;137S Z ~,,te ....~!~ ................................... , ~.~
Permission is hereby gront,ed//to: //~/
..~..~....~. ..:~..[:..,...2/..7~,.Z ...............
....... .....
o, pre~,s~,o¢o,,~ ~....~.......~..~~..~.'-~.......~.~ .......................
............................................................ ~;~.~ .................................................................
co~.~ ~ ~,~ ~o. ~0~ Se~,o. ........... ~.~ ..... ~ ...... ~ .......... ~o, ~o ....... ~..~ .....
pU~uont to oppilcation dot~ .... ~.~..~ .................................... , I~, and opprov~ ~ the
Buiidln~ Inspector.
Fee $.....~.~...
~ B~"¥'"n~tor
Rev. 6/30/80
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
HAY 12, 1993
C~4~J{YHUBBARI)
17 COPo~M SY~Tf~ZEYT{3%FN RO/~I)
COR.~2~I, NY 11727
RE: PRiR~IISES @ 4450 BAYVIEW ROAD NORTH, SOUTHOLD
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XXX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is ~not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
N~ Plumber Solder Certificate on file.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 21376-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
UND~TIO~!
~0UGH FRAME &
-PLUMBING
.f~SULATION PER N. Y.
STATE EHERGY
CODE
ADDITIONA'L COMMEHTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I~LJLATION
[ ] FRAMING [ ~ FINAL
DATE
765-~802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] I~ULATION
FRAMING [c"~FINAL
Examined .
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved ......... , 19~.. Permit No. ,~./'{..~..Z~..!
Disappr°ved~[~D ~ ~[~ .......... ; .............
....
N~I~ BUILDING 5~PART~T Al''' :"
7654802 9~M ~ 4 PM FOR T~
~LLOWING APPLICATION FO R BUILDING PERM IT
INSPECTIONS:
FOUNDATION ~ ~O REQUIREb
FOR POURED CONCRETE
2. ROUGH . FRAM}NG ~ PLU~NG
3. INSULATION INSTRUCTIONS
4. FINAL CONSTRLJCTJON MUST
BOARD OF HEALTR .........
3 SETS OF PLANS ..........
SURVEY -. .. .
SEPTIC FORH ..............
CALU .%3. b 3.7. .......
MAIL TO:
rote .... l []l) ...........
a. ~l~i[~kEa]~[q~d~Oae completely filled in by WpewHter or in ink and submitted to the Bulldog Inspector, with 3
sets ~tafi~&~I~ p~[~TFee according to schedule ~ ·
b*~4~ . , ' . · .
aha o~ buildings on premises, relationship to adjoining premises or pnb~c streets
or ar~dc~~.e~[~ of layout of property must be~ drawn on the diagram which is pa~ of this app~-
catio~O ES, ~p~L~lB~ 'FOR
c?~h%%~~~ion may not be commenced ~e~ore issuanc~ of Budding Permit,
d, O~,,,,,, approval ofd~pplication~.~ the Building Inspector will issued, a Bu~d~g Pemfit to the appEcant. Such pe~[t'
sh~l be kept~u~'e~v'aname ~or ~spection throughout the work.
e. ~~ ~' 9cf~[used in whole or in prat for any purpose whatever until a Ce~ificate of Occup~cy
shall h&~b~e~g~~fl~. Iffi~ector.
~ t~-]UUW~ AM ~ 4 PM FOR TH~ '
A~~I$~$~ MADE to the Bulldog Dep~ment for the issuance of a Building Pemit pursuant to the
Buildidg ~gHO~a~hhce 6P~OSouthold, Suffolk County, New York, ~d other app~cable ~ws, Ord~ces or
Re~ulatid~:~t-~PcGfi~ of bufld~gs, additions or alterations, or for removal or demolition, as here~ described.
The a~p~i3~re~,~6'i~t6m~C~pp~cable laws, ordinances, bufldhg code, housing code, and, regulations, and to
admit ~u~fl~e~ect~ on premises and ~ build~g for necessary inspections.~j
8C [;OMPLEI'E FOR C,O. · ............ M.~.~ .~-~. ~.~.~ ...............
AL~LONGTRUCr~O~ SHALL ME~T (Signature o[ app~¢ant, or name, ff a corporation)
THE .RFQUIREM~NTS OF THE ~.Y~
eODES~ NOT R[SPONSIBLE FOR (Mail~g addresser applicant)
DESIGN OR CONSTRUC'fl~N ERRORS
State whether ~pp]Jcant is owncL lessee, a~e~t, a~chJtcct, c~BmceL [eaem[ co~tmctoL eicctricJa~, p]umbc~ o~ buflden
......................................................................................
........................................................
Nme of owner of premises . .~C]"
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
?
Builder's License No ..........................
Plumber's License No ........................ 4'
El icfi Lice N -
ectr art's nsc o .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
....
House Number '" Street Hamlet
County Tax Map No. lO00 Section ...~."]~. .......... Block' . 2 ............ Lot .... .~ ..............
Subdivision ..................................... Filed M&p No ............... Lot ...............
(Name)
L Stateexistinguseand~ccupancy~fpremisesandintendeduseand~ccupancy~fpr~p~sedc~nstructi~n:
a. Existing use and occupancy ,,1
i .......................... ~ · .;:.:;, ,.. -~. .
b. Intended use and occupancy \
3. Nature of work (check which applicable): N~w Building .......... Addition .......... Alterat/.on ~ .........
' '
Repair .............. Removal ..i ..... .. ....... Demohtion ............ Other Work . .. . .....
~ : '.J' , (Descr/ption)
4 Estimated Cost? ~'~'Q~' '~" ';~. '~. ~ Fee
i fi (to be paid on filing this application)
5. !~f dwelling, nu.mber~of dwelling uni~. ..... 1~! .......... Number of dwelling units on each floor .... / ............
1I garage, hum ocr el cars ........ o~. .....1 ................
6. If business, co.mmercial or mixed oc¢¢panc~, spec.ify,nature and extent of each,type of use ........ ' '..'
7. Dimensions of existing structures, iffin,, Fr~ont ~.Q ,~___ pt% ~. ., ~'~ ......
height .. ! .-t .......... Number Of Stories . ) ..... ' ' ' '
Dimensions of same structure with aiieratiohs or aaditio-~. v.~2[ ' ' ') {)] .... .~ .... ,'~'~} ...........
,, ~.epth...~.L ................ .He~ght.j ....}~i .............. Numb~erofStm'ies:'.. .1. ... ~ ...
~ .ulmensions or entire new constructi6n. Front '5¢. ,', "-,'~ --, '.- ' - ~ ' '~ ' ' ~ ' '
,, ,,, , · , ........... r~ear . ..~.~, .... '.'. '.- .... ~,eptn ...1.~ .......
height ..'4 ............ ~NumberofStortes '1 ~., .......... ,-'~ ...- .......
9 Size of lot' Front '~..~.~.. ' i "~' ' '~xa ................... ,,,:, · .. · ' ' '
.... .. -, · .. , . ~ear. .~ . . r~,,th
10 DateofPurchase /')~l)~.~ L il . '~;-'-~ ';~" ..... '~ .... ['~!,~" 'q~".x~".:':'_ ...........
· ' ' ' ..... 1 ' ' ,"' ' '*' ,,~nume OI rormer owner . .x4....-~..~ l.x..x.x~,>.~.% .........
11. Zone or use district in which premisqs are situated..~ .~ ..................... . .....3. .....................
12. Does proposed construction violate ~ny I. .
zoning law, ordinance or regulation: . .~..~ ..............
13. Will lot be regraded ............ i.. ' · ' ............
14. Name of Owner of premises· ho,..c.~ .~.~x~b~ .~.' i~."'Address" Will excessn ~11 be~,~h~,~remoyed fr~ premises:~ ~ ,YesH ~ No
Nme of Architect ........... ~. r .... 2 ...... ...~., · ·. ~ ........... ~.~ ~ .~ ......
.... ~ ....... Address .Qgf¢~ .~'~5)}~. Phone No ................
N~e of Contractor ~.~.. '
....... ~ ........ Address ..... ~%.. ........ Phone No... ~g~[..
15. Is this property within 300 l~feet Of a tidal wetland? *Yes ........ No. ~ ....... ' .....
· If yes, Southold Tow~ Trust~es Permit may be required,
· .. ~ PLOT DIAG~
Locate clearly ~d distinctly M1 bulldogs, whether existing or proposed, and. indicate M1 set-back d~ensions from
prope~y Hnes. Give street ~d block number ox description accord~g to deed, and show street nines and indicate whether
ot.
,
~TATE OF NF~,~Y
:OUN YOF o.o : . · -- _..__
.... ........ s'' ' ' ' ' '.'';: "'.".' i i p and says that he is theepplicant
(~ame of individual mgnmg contr0ct)
~bove named. . ; ' . - ,
leis the ................... ~)...~..~... ~.
~ (,Contractor, agent, corporate officer, etc.)
.f said owner or owners, and is duly huthorlzed to'perform or have performed the said work and to make and file this
pplication; that ail statements contained in Ibis application are true to the best of his knowledge and belief; and that the
· ' in the application filed therewith.
zork will be performed m the manner ~et fort)~
worn to before me this
............ ..~-.;..( ..... daycof~..' i .,~A2~. ?..t.[. ....
~o ''-~/"~~ ' .County
tary Pubhc .....
CLAIRE ~ GLEW ~
';' Notary Pu.b. ~, State of New YOlk ' .
NO, 4879505 ,,q A'. · · · · x.,, -/:.-[ · · · ...............
', Qualified in Suffolk CounW C~-ff(' { I (Signature of applicant)
· ~ Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~PPLICATION FOR CERTIFICATE OF OCCUPANCY
~his 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-&isposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
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:
1. 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 si~ned 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 - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New' Construction ........... Old Or Pre-existing B¥ilding.
Location of Property..~~sO ~.~M~'~
House No. Street Hamlet
Onwer or Owners of Pro eft
County Tax Map No 1000, Section .......... Block .................
Subdivision .................................. Filed Map ............ Lot .......... ~. ......
Health Dept, Approval .......................... IJnderwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ............................ ~ .~.~
, i .....................................