HomeMy WebLinkAbout30120-Z FORM NO. 4
.TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
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"No: Z-30141 Date: 04/16/04
THIS CERTIFIES that the building ADDITION,
Location of Property; 7380 NORTH BAYVIEW RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County.Tax Map No. 473889 Section 79. Block Lot 10
t
Subdivision. Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit. heretofore
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filed in this office dated FEBRUARY 25, 2004 pursuant to which
Building Permit No. 30120-Z dated FEBRUARY 26, 2004
'r 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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR. CONSTRUCTION CERTIFIED BY JOSEPH FISCHETTI, PE ON 2/25/04.
The certificate is issued to PATRICIA M SCHAUBECK & ANO.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A.
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized Si ture
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
i
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Ii
! PRMIT` I1TOa 30120 Z Date FEBRUARY 26, 2004
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Permission is hereby granted to :
PATRICIA M SCHAUBECK
PO BOX 604
SOUTHOLD,NY 11971
for
CONSTRUCTION OF AN AS BUILT DECK ADDITION TO AN EXISTING SINGLE
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a
FAMILY DWELLING AS APPLIED FOR
at premises located at 7380 NORTH BAYVIEW RD SOUTHOLD
County Tax Map No. 473889 Section 079 Block 0007 Lot No. 010
pursuant to application dated FEBRUARY 25, 2004 and approved by the
Building Inspector to expire on AUGUST 26, 2005 .
Fee $ 300 . 00
Authorized Signature
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ORIGINAL
Rev, 5/8/02
Forin No.6
TOWN OF SOUPHOLD "
BUILDING DEPARTMENT _ -
TOWN HALL
765-1802 20 1;
APPLICATION FOR CERTIFICATE OF OCCUPANCYr
SQwj� '45Sd
This application mustbe filled in by typewriter or ink and submitted to the Building Department -fi7re"'1'n"Y`1owm"g;
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 ofelectrical`installation from Board of Fire Underwriters.
4. S;-ono ,:• '.,r i+,!.I r!,+ •ri o,:Aler ce-ifying that the solder used in system contains less than 2/10 of 1°l0 lead.
5 t'o.u n ,; a i , I,I n .•o a.!r-a: b,,ilding,•Multiple residences and similar buildings and installations,a certificate
,r
l'( tit;.- ( Ili ore•r!.•r! orengineer responsible for the building.
6. Submit Ptanhing.Board Approval of completed site plan requirements.
B. For exititin;;buildings (prior to 'opril 9. 1957)non-conforming uses,or buildings and 0°pre-existing"land uses:
1. 1 property lines,streets,building and unusual natural or topographic
features.
2. Apropprly,compl4ed,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 X25.0
9,,,Additions to dwelling$25.00,Alterations to dwelling$25100,
Swimimng,pool$25.00,Accessory building 25.00,Additions to accessory building$25.00,Businesses $50.00.
2. Certificate of Occupancy o _re-existing Building- $100.00
3. Copy of Certificate of Occ pancy-$.25
4. Updated Certificate of Occupancy $50.00
5. Temporary Certificate of-Occupancy-Residential$15.00, Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: / (check one)
Location gfProperty: 73 [7 /1/0 &yV«/ 1L,pUp� y�7 fi47I 77foC6J
House No. Street Hamlet
Owner or Owners of Property: �U,6�7
Suffolk County Tax Map No 1000, Sectio Block 7 Lot
✓ /Rxx°73 ,�/
Subdivision (�-ydWw Aq3 Filed Map. �p (� � Lot: 3
Permit No. Date of Permit. Applicant: VY/W
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
A ' licam Signature
Applicant/ Date. r
Owners Natne:P a Reviewed:
Architect/ Date
Engineer: <f, Submitted: -,21,Ae- T
SCTM 9:
District. l 000 Section: 7�— Block: Lot / 0
Project St ,, f� Subdivision
Location: �� /�/'C%.. .,I �JJ. „ !G&�_ � Name:
Single S separate Required /
certification'. (Yes/No)
Req. Req.
Zoning rtis(ml jWsize: QY^O Aciaaf:r L. 1 [W.coverage 1'ro,3uscd WI
Rey - Rcq. Req f ,,,
(1'ronlYazd Proposed: (Side Yard �ProPosed; " !Rear Yard • Proposed,OLI (
Project Description: pe s 2t�D 4
AGENC ANERMITS Permit
4 REQUIRED FOR REVIEW N.A.. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees _
Town Zoning Board approval:
` Town Planning Board approval t /
Flood Plane Elevation???
FIood Zone:
Notest
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PROFESSIONAL ENGINEER
1125 HOBARTROAD/PO Box 615, SOUTHOLD. NEW YORK 11971
ELB31-765,957 FAY.631-614351E , e-mail: joseph@FmcXetli=m
Date: February 25,2004
Reference: 7380 North Bayview Road lMcKiemen
Building Inspector
Town of Southold
Main Road
`Southold,NY 11971
Dear Sir,
This is regard to the above referenced property,I certify that the deck has been constructed in
accordance **ith.New York State Building Codes. j
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET--/
VILLAGE DIST. SUB. LOTS
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FORMER OWNER ` rF1
N E ACR. i
y
tier ? 2 g
W iTYPE OF BUILDING
tE$. e,2SEAS. VL. `' FARM COMM. CB, MICS Ivikn Valut �r
LAND IMP. _TOTAL ATE REMARKS ` ' r `,°
rte.- ,-. _ ' ..a
jj'" �-.jq *`_
:
N 99
i
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illable FRONTAGE ON WATER
- i
/oodlarnl FRONTAGE ON ROAD
j
leadowkw,d DEPTH
Ouse Plot' BULKHEAD
Aal
COLOR �4�s3z f TRIM
_ -
M
Av ISL 1
x
7., — 7 -
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s
Extension
- _ I
Extension
Foundation ro he
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Porch / 6 Basement Floors ( jy K. —I
-
Porch ` Ext. Walls Interior Finish SLR.
_ �` _. .. _ - �iC Ian t �at•r. �, t fPtlifj�--
Breez�ewaY.
T Place �c' Heat R• -
Gara a / Type Roof Rooms lst Floor B BR.
Recreation Room lRooms 2nd Floor I FIN. B
O t6 Dormer �Drivewoy
Total
M-1802
0
BUILDING DEPT.
INSPECTION
[ j FOUNDATION IST [ XFIKAL
BG.
j } FOUNDATION 2ND jN
l [ } FRAMING [
F `
[ ) FIREPLACE & CHIMNEY
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� REMARKS:
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47
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j DAT INSPECT
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765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
} [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
REMARKS
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DATE / INSPECT
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST) H
w =---------------------- ----------
FOUNDATION(2ND)
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ROUGH FRAMING&
PLUMBING f� H
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INSULATION PER N.Y. H
STATE ENERGY CODE "
FINAL
ADDITIONAL COMMENTS
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ITOWN OF SOUTHOLD BUILDING PERMIT APPLWAtTON CHECKLIST
IBUILDINGDFAART M ENT Do you have or need the following,before applying?
TOWN HALL 0' Board of Health
'SOUTHOLD,N 11971 3 sets of Building Plans
TEL: (631)765-1802 Planning Board approval
;FAX: (631) 765-9502 Survey-
www. northforkneeSouthold/ PERMIT NO. Check
Septic Form.
N.Y.S.D.EC.
J Trustees
Examined 20� Contact:
ApprovedW6 '20 Mail to:
':Disapproved a/c
Phone:
Expiration
Building Inspector
APPLICATION FOR BUILDING PERMIT
' f �
Date 20
INSTRUCTIONS
a. This apphcation'MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
wets of plans,accurat fot 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 She 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 pemut 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
'iaddition six months.Thereafter, a new permit shall be required.
f [ APPLICATION IS HEREBY MADE to the Building Department for the issuance of 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,housin ode, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signator of applicant or name,if a corporation)
Ox
('— Mailingzaddress of applicant)
(State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises ' (JWAIdr-4 ;11^14q &V
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized office
(Name and title of corporate officer)
guilders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which,proposed work will be done:
0
7 3 Alo IWYV/0 4'
House Number Street Hamlet
County Tax Map No. 1000 Section Blo k 7 Lot` /P
Subdivision //gP1 Filed Map No. � Lot 41
(Name) 6 7/
2. State-existing useand occupancy of premises and intended use and occupancy of proposed cogstruction.
a. Existing use and occupancy LV-6-(c G/frt!/C /CG /Vcwcel — .
b, Intended use and occupancy §17166C /www/Gy APES/s? ,cc' As 1 --/Yzx (baa l �
3. Nature of work(check which applicable): New Building Addition i/ Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost 3 t 09 i Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units / Number of dwelling units on each floor
If garage, number of cars /
li 6. If business, commercial or mixed occupancy, sp?c\fy nature and extent of each type of use. ^—
7. Dimensions of existing structures,if any: Front �' Rear Depth
Height Number of Stories /
Dimensions of same structure with alterations or additions: Front AOl1!!oX loin Rear®/!�P/40X 66
Depth kwm( -�9 Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
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9. Size of lot: FrontAll/tpx /0t9 Rear 17 °ft X /00Depth ��f�'� G 4
10. Date of Purchase /yNE"d01f9�6 Name of Former Owner /kom//✓S
11. Zone or use district in which premises are situated
\
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO /
13. Will lot be re-graded?YES_NO /Will excess fill be removed from premises? YES NO
14.Names of Owner of remises c E7, Address/;�i /o, , iyv<F Phone No. �6 S 0??f6.
Name of Gaj /os Address A,& Sowt Phone No 16S ` 7 Y
Name of Contractor Address Phone.No.
,15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO V
* 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.
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 )
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.)
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 manner set forth in the application filed therewith.
Swom to b re me this J�
_ day of �1,`, 20 OZ
Notary Public �! 91'gnature tof Applicant
LYNDA M
NOTARY BORN
NoPUBLIC State of New York
.01130602p832
Oualified in Suffolk Cou
Term Expires A9amh 8. topnty 7
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NOTE
f O A9 N
SUED/ MAP F/LED 1N THE i
OFT!/ECLERKOFSUFMLK 4MM
JUNE 4,1971 AS RLEM25599
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REVISIONS YOUNG & YOUNG
4000STRANDER AVENUE, RIVERHEAD, NEW 7
4 ALDEN W.YOUNG HOWA
PROFESSIONAL ENGINEER AND LAND
LANG SURVEYOR,N.Y.S. LIG. NO,12845 N.Y.S.
UNAUTHgRIZED ALTERATION OR ADDITION TO SURVEY FOR. �/��yp p Q /� (� �c Q /� y/
j THIS SURVEY IS A VIOLATION OF-SEOTION GEORGE C,,B/fyU Y 8 8FATRJCE 4. OEHVRf
I' LLAAW9 OF THE NEW YORK STATE•EOUCATION LOTNO. 9, "LEEWARD ACRES AT BAY
i.. COPIES OF THIS SURVEY MAP NOT BEARING
THE LANO.SURV£YORS INKED SEAL OR
EMBOSSED SEAL MALL NOT BE CONSIDERED
TO BE A VAUO TRUE COPY. AT 8AYVIEW GUAR ,{SIT T
cUARANTEEs INDICATED HEREON SHALL RUN G E4L
ONLY TO -HE PERSON FOR WHOM THE
TOWN OF S041MOLD car
p�p, r APPROVED AS NOTED
I DATE: B.P.✓< 3p/ ab
Tz FEE: 30-0. BY:�
NOTIFY BUILDING DEPARTMENT AT "
- QX f2 P.3aL-jF.w;� 765-1802 8 A TO 4 P FOR THE
J 4,u4' FOLLOWING INSPECTIONS:
( 45>< 1. FOUNDATION - TWO REQUIRED
�' FOR POURED CONCRETE
2. ROUGH - FRAMING 8 PLUMBING
_ 3. INSULATION
i 1 zX co CC,A r-Loot2 J Q "r bT�d usr t
It" CCS. (ai L CONSTRUCTION SHALL MEET THE
ry�y.�,.� REQUIREMENTS OF TNF CODES OF NEW +
i I Q VT q„I'jf Q,' ,y,• I"V 'I ^' YORK STATE. NOT RESPONSIBLE FOR - F
" f V pI DESIGN OR CONSTRUCTION ERRORS.
� I 1--_— _ . L.. � � 1!D" PDUKc`PSr� <dh6Crtr't�',T•� P �'•3 ,
3'.0
---��1 OCCUPANCY OR :A
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
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DATE I12-70-n�
" 1INl� 1isl+ I � IIJG-r� 1�`� P�7J �-T ��K
DRAWING NUMBER
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