HomeMy WebLinkAbout27908-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29419 Date: 05/07/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 10425 MAIN BAYVIEW RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 1 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 16, 2001 pursuant to which
Building Permit No. 27908-Z dated NOVEMBER 16, 2001
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 NEW ACCESSORY GARAGE WITH NON-HABITABLE SECOND FLOOR IN REQUIRED
REAR YARD AS APPLIED FOR.
The certificate is issued to MIKE & IRENE VENETIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 05/02/03
PLUMBERS CERTIFICATION DATED N/A
"�4f ze,4
thori ed Signature
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. 27908 Z Date NOVEMBER 16, 2001
Permission is hereby granted to:
MIKE & IRENE VENETIS
48-07 HOLLIS COURT BLVD
FRESH MEADOWS,NY 11365
for
DEMOLITION OF AN EXISTING ACCESSORY GARAGE AND CONSTRUCTION OF A
NEW ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR
at premises located at 10425 MAIN BAYVIEW RD SOUTHOLD
County Tax Map No. 473889 Section 088 Block 0001 Lot No. 004
pursuant to application dated NOVEMBER 16, 2001 and approved by the
Building Inspector.
Fee $ 565 . 70
,Vek), aaAO VC7-—5&Ct.'P�0
Authorized Signature
COPY
Rev. 2/19/98
�i I *-0
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL o
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, Commercial $15.00
Date. �— a 03
New Construction: 1 Old orPre-existingBuilding: (check one)
Location of Property: v u,�.o tis k�,I c
House No. 1 I Street I / Hamlet
Owner or Owners of Property: I l� P_ T_ re --I
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: �_ (check one)
Fee Submitted: $
7 z.-t UL;w
(0 3 8 0 Appli��cant Signature
co�.aG'flq
BUILDING PERMIT EXAMINER CHECK LIST
DATE REVIEWED: -/ 6/01
.DATE SUBMIT TED: /y0/01
APPLICANT NAME: UctitTs ,
SCTM# DISTRICT: 1.000 'SECTION: �g BLOCK: LOT:
tU
STREET: ZS 111 �IP1u) CITY: o O _SUBDIV.NAME:
PROJECT DESCRIPTION: Qin
ARCHITECT/ENGINEER:`—UrH I L L FAST TRACK?
SINGLE&SEPARATE CERTIFICATION-REQUIRED? NOTES:
LATS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JANAM 100-25.Merger.(A nonconforming at any time after 7/1/83)
ZONING DISTRICT: A-C- CONFORMING?
REQ.LOT SIZE:!ACT. LOT SIZE: REQ. LOT COV5:�16 0 ACT. LOT COV.
REQ.FRONT o PROP. FRONT REQ SIDE v ACT. SIDE
REQ.REAR o PROP. REAR
WATER FRONT? 00 DESCRIPTION:
PANEL #: FLOOD ZONE: x ,
AGENCY PERMITS REQUIRED FOR REVIEW
APP OV S REQUIRED:
SUFFOLK COUNTY HEALTH DEPT: YES o I O ED#): DTE: / / .PERMIT#:R10-
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES N
SOUTHOLD TOWN TRUSTEES: YES or O
TOWN ZONING BOARD APPROVAL: YES or
TOWN PLAN. BOARD APPROVAL: YES or
TOWN HISTORICAL PRE (SPLIA):- ,YES or
NYS ENERGY: YES OR NO : '1 1
EGRESS (18 H min.?4 sq total) VENT(SQ. FT. x 4%)
BUILDING PERMITS OPEN/EXP D: BP -Z/C/0
.HAVE PRE CO'S Y OR N BP -Z/C/0 Z,;23161
O
NOTES-:
FEE STRUCTURE: FOUNDATION: SF TT� (�
FIRST FLOOR : / Octf SF
SECOND FLR : /,00 S SF O OTAL
TOTAL: a 0 / 6 SF FEE FEE FEE
'OT( ;/,C2/,g SF)-(_f&ge SF)=_ rte' SFX$ •-,'d_=$ +$
r J
suawNo uEIrr.
INSPECTION
[ ]
FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU ION
I 1 FwuNlnG INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
LZ
DATE Z7 4 .3 INSPECTOR
l
BUILDING DEPT.
-.,,JNSPECTION
[ OUNDATION iST [ ] ROUGH PLBQ.
[ ] FOUNDATION 2ND [ ] INSULATION
[ 1 FRA11111NQ I 1 FINAL
[ ] FIREPLACE & CHIMNEY
10,
REMARKS: b9D/li00,
►iS,r�
S
DATE NSPECTO
BUILDING DEPT.
"PECTION
[ FOUNDATION 1ST [ ] ROUGH PLBO.
[ ] FOUNDATION 2ND [ ] INSULATION
1 FRAMING [ 1 FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: .
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DATE INSPECTOR
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TOWN OF SOUTI:IOLD BUILDING PERMIT APPLZATIJN CHECKLIS]
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: 765-1802 Survey_
PERMIT Nog?- C Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined ,2061 Contact:
Approved 20ja _ Mail to:
Disapproved a/c
Phone:
Buil
D
D ����
B APPLICATION FOR BUILDING PERMIT
eu D�oERX Date 20_
INSTRUCTIONS
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 a Certificate of Occupanc
is issued 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 applicable laws, ordinances,building code,housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
\c (Signature of applicant or name,if a oorporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or.builder
C�>Wtser
Name of owner of premises I M t L K`e- V e N C-T IS
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
No Ge,f p
(Name and title of corporate officer)
Builders License No. /II/A — S Ls�P
Plumbers License No.
Electricians License No. fetrot� - h!o CK-sz�a Rf Tker T/o« Y,
Other Trade's License No.
1. Location of land on w,/ 46±7h�ch proposed work will be done: < ,
5b S,Kcods L Arc, �t— Alowj ±t ✓f6w ( Jk[obs Cd-rr+e Sourft C� ...0 I`L
House Number Street I Hamlet
County Tax Map No. 1000 Section)D oo Block O $ S Lot
Subdivision Filed Map No. Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy STr«c t'o�E V kr s to,�'Xu
b. Intended use and occupancy 5 Y1 uK e /
Nature of work (check which applicable): New Building _ Addition Addition Alteration
Repair Removal Demolition ✓ Other Work
(Description)
Estimated Cost 2- Ff oao - Fee
¢�t�5 (to be paid on filing this application)
If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars 2, b3e E j
If business, commercial or mixed occupancy, specify nature and extent of each type of use. 'YK t 0 K'e, ..tors
Dimensions of existing structures, if any: Front r Z Rear ( g Depth Z�
Height 13E 7:t Number of Stories 1
Dimensions of same structure with alterations or additions: Front Z 8 Rear i;'8
t
Depth Height( - To MED PTNumber fStories
D F hMA RkFfCK�£3'l0" oU
Dimensions of entire new construction: Front �� Rear Z 1d ____Depth 3C
Height A--6o, e- Number of Stories I
�. Size of lot: Front 612-.7A Rear '35 q-5 Depth I S%•Of
.0. Date of Purchase Name of Former OwnerT(fyr'tot-s 1= ) JtIWNEcA- Ned-Ley
1. Zone or use district in which premises are situated A I C_
2. Does proposed construction violate any zoning law, ordinance or regulation: Iy o
3. Will lot be re-graded N(O Will excess fill be removed from premises: YES NO
4. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
5. Is this property within 100 feet of a tidal wetland? *YES NO
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines.
7. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
;TATE OF NEW YORK)
SS:
;OUNTY OF )
being duly sworn, 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.)
If said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
hat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
ierformed in the manner set forth in the application filed therewith.
;worn to before me this
�—day of 2496V az6 20-0/
�1 rotary Public Signature of Applicant
EIEEEN S. SANTO"
NOTARY No.i ,Sw.07a rte'Ymk
Cemmiru'aJi iWRIn / I
SURVEY SHOWING GARAGE
AT BAYVIEW
T 0 WN OF S 0 UTHOLD
SUFFOLK COUNTY, NEW YORK
1000-88-01 -04 /
SCALE: 1 "=40'
SEPT 23, 2002
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N.Y.S. LIC. ND. 49618
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ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION `p f� {1,i5'ry ` N '`f��J 0 FA X;(631) 765-1797
OF SECTION 7209 DF THE NEV YORK STATE EDUCATION LAV.
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS
HEREON ARE ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 1230 ELER STREET
SAID MAP WHOSE SIGNATURE ASPPEEARS HEREt ssED SEAL OF THE suavcrOz SDUTHDLD, N.Y. 11971 102— f73m]
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UNDEftG1fIEUiI7LDERS TIFICAE
DATE
B.P. �✓��'�'�
FEE BY: � OCCUPANCY uj
NOTIFY BUILDING DEPARTMENT AT Y OR
`w '765-1802 9 AM TO 4 PM FOR THE USE IS UNLAWFUL 0� IVOT FRXEM w.j
FOLLOWING INSPECTIONS: IT�: "' ER '
- TWO OUT CERTIFICATE WG URTfL SURVEY
1
'FOR PO REDCONCRE EREDUIREO OF OCCUPANCY F FOUNDATION LOCATION �
2. ROUGH - FRAMING & PLUMBING HAS BEEN APPROVED. -i W
3. INSULATION
I �`� 1 4 FINALB - CONSTRUCTION MUST
l ; I TE FOR C.O.
ALL CONSTRUCTION SHALL MEET
' r + THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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