HomeMy WebLinkAbout30196-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of tke Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30118
Date: 04/06/04
THIS CERTIFIES that the bu/lding ADDITION
~ocation of Property: 7980 NORTH BAYVIEW RD
HOUSE NO.
County T~ucMap No. 473889 Section 79
Subdivision
SO~THOLD
(~REET) (HAMLET)
~lock 7 Lot 52
Filed Map No. Lot No.
conforms substantially mo the Application for Buildin9 Permit heretofore
filed in ~his office dated MARCH 24, 2004 pursuant to which
Building Permit No. 30196-Z dated MARCH 25, 2004
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/RAMP ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOE
& AS PER CERTIFICATION OF LAWRENCE M. TUTHILL, P.E. DATED APRIL 5, 2004.
The certificate is issued to STEPHEN & pAMELA SCHIDER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTS~ DEPARTMENT OF ltEALT~ APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'rmu
Rev. 1/81
N/a
N/A
N/A
/Authormzed SignOre
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
30196 z Date MARCH 25, 2004
Permission is
hereby granted to:
STEPHEN & PAMELA SCHIDER
7980 NORTH BAYVIEW RD
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN AS BUILT DECK/RAMP ADDITION AS APPLIED FOR.
ADDITIONAL CERTIFICATION MAY BE REQUIRED.
at premises located at 7980 NORTH BAYVIEW RD SOUTHOLD
County Tax Map No. 473889 Section 079 Block 0007 Lot No. 052
pursuant to application dated MARCH 24, 2004 and approved by the
Building Inspector to expire on SEPTEMBER 25, 2005.
Fee $ 300.00 ///
U'
Rev. 5/8/02
ORIGINAL
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERIII~ICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Dep~;d~~
A. For new building or new use:
1. Final survey of property with accurate Iocation of all buildings, property lines, streets, and unnsual natural or
topographic features.
2. Final Approval from Health Dept of water supply and sewerage-dispesal (S-9 form).
3. ~pp~:Qyal of~ctrical installation from Board of Fire'Underwriters.
4. S~6m S~ateme~t from phffaber certifying that the solder used in ~ys~em contains less than 2/10 of 1% lead.
5. Co~,ergi~l b~ding, indus(rial building, multiple resld~.e~fes and similar buildings and installations, a certificate
nf Codec Cqmp~c~ from architect or engineer responsible for the building.
6. S~tbmii l?l~g Board Approval of campleted site plan requiren~nts.
B. For e.xis0~'ng bu,ddmgs (prior to April 9, 1957) non-conformmg uses, or buildings and pre-ex~sting land uses.
1. Accurate survey ofpmperty showing all property lines, streets, building and unnsual natural or topographic
features,
2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is
dC~, 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 d~velling $25.00, Alterations to dwelling $25/?)0,
Swimming pool $25.0C 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
New Construction:
Location of ]Property:
Date. ([ lo'l
/
Old or Pre-existing Building: [~. (check one)
House No. Street H~et
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No. ~O t ~ &
Health Dept. Approval:
O?cl Block 000
Filed Map. Lot:
Date ofPerm/t ~-~-Oq Applicant:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~ ~
Fhial Certificate:
(check one)
Applicant Signature
'~ WN QF ~OUTNOLD ~
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P.O. BOX 162
GREENPORT, N.Y. 11944
(631~ 477-I652
April 5, 2004
Michael J. Verity,
Southold Town Building
Southold, NY 11971
Department Head
Department
Re:
Residence
7890 North Bayview Road
Southold, NY
To Whom It May Concern:
I have inspected the deck and ramp ~ the rear
of the above mentioned premises and found thatthhe
construction of the deck and ramp are built in
accordance with the regulations of the New York
State Building Code and Southold Town Building Code.
Si~merely,
rence M. thlll, P.E.
Form No. 6
TOWN OF SOUTiiOLD
BUILDING DEPARTMENT
TOWN BALL
765-1802
T~s apphcafio~ mst be fi~ ~ by ~e~ter or i~ ~d sub~tted to the Bol~g
A. For new building or new use:
1. Final survey of property with accuram iocation of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Appr0val from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. A~pproval of electrical installa~/.on from Board of Fire Undervaiters.
4. Sworn Statfmen~ from plumber certifying that the solder used in system conta/ns less than 2/t0 of 1% leact.
5. Comm.er¢i~l. buiMing, industr/a[ building~ muitipte residences arid similar buildings and inst~lafions, a cenificate
of Cod} C:6mpliance from architect or engkieer r,~sppnsible for the building.
6. Submit Plarming Board Approval of completed site plan requ/rements.
New Construction:
Location of Property:
Owner or Owners of Property: ~5[~¢'Q.
Suffolk County Tax Map No 1000, Section
B. For existing bnildin~s (pr~0r to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate smwey of proper~y showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly c0mpleted application mad consent to inspect signed by the applicant If a Certificate of Occupancy is
denied, tl~e Building Inspector shall state the reasonS therefor in wr/ting to the applicant.
C. Fees ~
1. ~ertif~cate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Sw/mming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses ~;50.00.
2. CertWmate of Occupancy on Pre-existing Building - $I00.00
3. Copy of Certificate ofOcanpaucy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certi~cate of Occupancy - Residential $15.00, Commercial $t5.00
.
Old or Pre-existing Building: v tcheck one)
House No. Street - Hamlet
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: ~5{ ~, {~Vrv~
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate:
(check one)
Applicant Signature
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2NO [ ]/I~ULATION
[ ] FRAMING ~/~FINAL
[ ] FIREpLA/~E &.CHIMNEY [ ] FI,RE SAFETY INSPECTION
REMARKS. ~=~
DATE
FO~A~ON (1S~ ~ ~
ROUG~ F~G &
PL~G
~S~ATION P~ N. Y.
, .
'~ ~D~ON~ COUNTS
TOV¢2 BUILDING;PERMIT APPLICATION CHF~GKLIST
Do you have or need'the following~ befgre apptying?
TOWN I[tAI3% Board of Health
SOIJTttOLD~ NY 11971 3 sets of Building ?tans
Plarming Board avprova~
FAX: (63t) 765-9502 SuweY
www. n~orthf6~ck:net/Southold/ PERMIT NO. ~Ol ~ 6 ~ Check
-~ Sep/io-'Form
"--~- N.Y.S.D.E.C.
.20
Trustees
Contact:
Disapproved a/c
Building Ihspector
Date C3 , 20 O q
INSTRUCTIONS
a. This application M~ST 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. Plol plan showing location of lot and of buildings on premises, relationship to adjdining prermses 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
~ssues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
~ssuance 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 pemzit 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 o'r demolition as herein described. The
agrees to comply with al/applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on pr~ses and in bu/ld/ng for necessary inspections.
(Signature of applicant or name_ if a corporation
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
ameofownerofpremises Tam c aJ
(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 Licanse No.
Plumbers License No.
Electricians License No.
Other Trade's Licer~se No.
1, Loctkfi~on of land on which. ~proposed work will be done:
-] flO No.
Hous~ ~umb~r Street
Hamlet
¢ounty'Tax Map No. 1000 Section O 7fl Block 0 7
Subdivision Filed Map No.
(Name)
Lot
Lot
State ex~stmg nse and opcupancypfpr~mtses and intended use and occupancy of proposed constrac~,~a.
a. Existing use anil o ccupanc~
b. Intcmded use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost Fee
I~' dwelling, number of dwelling units
If garage, number of cars
Addition
Other Work
Alterafign
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
If bugtness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing sn'ucmres;ifany: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
3. Dimensions of entire new construction: Front
Height Number of Stories
9. Sizeoflot: Front Rear
Rear Depth
0. Date of PmZchase
Name of Former Owner
1. Zone or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation? YES NO__
×
3. Will lot be re-graded? YES__ NO ~ Will excess fill be removed from premises? YES__ NO ~
14. Names of Owner of premtses
Name of Architect
Name of Contractor
Address Phone No.
Address Phone No
Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES __
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PEPdMITS MAY BE REQUI~,~ED.
9*
b. Is this property within 300 feet of a tidal wetland. YES__ NO ¢//
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide 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)
SS:
COUNTY OF ~
]4 v~ q~JF£~ ~-[ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S ~He is the ~/~ FIC(~ ~
(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
in the application filed therewith.
before me this
,¢-/¢~ day o£ "¢~rp ~_
Signature of Applicant