The URL can be used to link to this page

Home My WebLink About30710-Z FORM IIO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP2%I7CY No: Z-30550' Date: 11;•15;04 THIS CERTIFIES that the building ALTERATION Location of Property: 275 MAIN BAYVIEW RD SOUTHOLD (HOUSE 110. ) (STREET) i.H,AJTLET) County Tax Map No. 473889 Section 70 Block 5 Lot 53 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 14, 2004 pursuant to which Building Permit No. 30710-Z dated OCTOBER 19, 2004 was issued, and conforms to all of the requirements of the applicable pro-,isions of the law. The occupancy for which this certificate is issued is "AS BUILT" ALTERATION TO AN EXISTING PORCH ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. CONSTRUCTION CERTIFIED BY WARREN A SAMBACH PE. The certificate is issued to CHARLOTTE M SMITH i OF•IISER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL IS/A ELECTRICAL CERTIFICATE NO. 2028422 10/18/04 PLUMBERS CERTIFICATION DATED IT A A thori/i zz/e/d S gnature 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. 30710 Z Date OCTOBER 19 , 2004 Permission is hereby granted to : CHARLOTTE M SMITH BAYVIEW RD SOUTHOLD,NY 11971 for ALTERATION TO AN EXISTING PORCH "AS BUILT" AS APPLIED FOR at premises located at 275 MAIN BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0005 Lot No. 053 pursuant to application dated OCTOBER 14 , 2004 and approved by the Building Inspector to expire on APRIL 19 , 2006 . Fee $ 300 . 00 Authorized Signature ORIGINAL Rev. 5/0/02 Form No.6 TORN OF SOUTHOLD BUILDING DEPARTMENT 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 mater 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°o 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 sur•ev 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. ZLAT� New Construction: Old or Pre-existing Building: �—(check one) Location of Property: S %Q4/i� jt31f`(U/ECS.'/( Q,40 SoL4-1-Po I-D House No. Street Hamlet Owner or Owners of Property: (` . /7 WS1 Tr Clh /j/{ Z_- -.9 'f- Suffolk County Tax Map No 1000, Section it - Block �� Lot 4 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: JG( h LI-2 /y/<<�/Z Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ C6,c_ �/Applicant Si ture o rn�n�nrs�rsrru��l-�nrnrn�rt�s��l-�rr��n�n��nrnrnnr��.nrnnrs��n�nrs�rr�nrr��.nrs��n�r�r��nrs�n�n�l-�I-�rsr��.nsrr� o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAU OF ELECTRICITY f5 55 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 LORI SHELLEY LORI SHELLEY 5 5 5 C/O JOSEPH MCCARTHY P.O. BOX 3 S 470 MOCKINGBIRD LN. MARYLAND, NY 12116 5 5 SOUTHOLD, NY 11971 Located at 5 75 MAIN 84 2 IEW RD. SOUTHOLD, NY 11971 Application Number: 2Certificate Number: 2028422 5 Section: Block: Lot: Building Permit: BDC: X511 5 5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 First Floor, 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 S herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5 18th October, 2004. 5 5 Name QTY Rate Rating Circuit Type L5 5 Miscellaneous LJ 5 as built-1984 5 closed in screen porch 5 Wiring and Devices 5 5 Receptacle 4 0 General Purpose 5 5 Paddle Fan 1 0 c5 55 An as built inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is believed to 5 5 be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. IN 5 5 15 5 01 5 5 5 Sea/ S 5 5 I of I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 � rJ'arJ�rJ�r�rJ�rJ�rJ��PrPrn�P�PcP�PfJ�cPrJ�rJ�rJrlarlarJrJrJ'a�PrJ�rJ'ar1r.P�PrJ�cP cPrJ��P�PrJ�rl�cPr.I�rJ�rlar�cPrJ�rPrJ�r�cP�P�f'arJ�r�rJ�rJr.PcPcP o WARREN A.SAMBACH,SR. CONSULTING ENGINEERS PLANNERS Mr amen A .am ac ,SR PO Box 791 East Marion,NY 11939 November 4 2004 t Buildinu_ Department Town of Southold Town Hall 53095 Main Road Southold NY 11971 Re : Estate of Herbert Smith 275 Main Bayview Southold NY 11971 SCTM: 1000-70-05-53 BP#3071oZ To Whom it May Concern: Sita observation for the above reveals screened in porch screens were removed and a short wall and glass windows and door were installed. The installation of wall , door and glass windowns were installed. I hereby certify that its construction meets all New State code requirements at the time of construction. Sincerely, ff �� rL l tt�� . �Lt�4�-dL � •J)� Warren A, Sambat-h Sr . P.E. was: s ,E of raeiy r ApplicantJ Date Owners Name: Revie�med Architect/ Date Engineer. W Sr Submitted: SCTM H: _ Distrip: i o Section: moa: 7—_ t.ot — Projectn 7 Subdivision I.ocatioir. or 75 /✓fin_ �k v J, tiu S — Name:__— ` $in$le 8_ separate Required 7� certification: (Yes(NoJ_ Rcy_ C,[ lacy. J Zmsing bisviec� C� Jlgt size. 10- J� _nausl.3 7S I tLaeovaaeeakhoprucd Req RW ! r Req. - Jt'roor Yard Proposed �I [Side Yard �� / G7 Proposed:✓—J [Rur Yard protMietl' Project Description:. �GEI�C ERMITS Permit UQUIRED FOR REVIEW N.&- NO YES Number Suffolk Cotmty Health Dept. Now York State. D. E.C. Town Trustees Town Zoning Board approval: -7 Town Planning Board approval: _ Flood Plane Elevation M Flood Zone: ( a 171LLQ& JI 3a7io-2=� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE �� ° 7 INSPECTOR /?� ' v 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE �� INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS W FOUNDATION(IST) -- --- — y ------------------------------------ C FOUNDATION (2ND) iS z S C ROUGH FRAMING& 4- PLUMBING +� r INSULATION PER N.Y. -- --- STATE ENERGY CODE FINAL p00, lior ADDITIONAL COMMENTS 03 aSG O �z m z — I X z a x v m TOWN OF 5OUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying'? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans` TEL: (631) 765-1802 Planning Board approval_ FAX: (631) 765-9502 Survey «-ivw. northfork.net/Southold/ PERMIT NO. 30710 -Z- Check $ 1 t/ 78 c Septic Form N.Y.S.D.E.C. Trustees Examined, 200th Contact: Approved /0//9/ ,20py Mail to: Disapproved aed c Phone:76.5- 000 Expiration 200 (, -T M`C-A'� 767- �Y 3 S Building Inspector APPLICATION FOR BUILDING PERMIT 42004 Date /U //,a- , 200 � INSTRUCTIONS —a-This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 law's, ordinances,building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (S na re of applicant or na e, if a corporation) 70lHoal/,vGg/R/1 L1:,d (oteTIWO rry.//F7/ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder A 6-Ei✓f Name of owner of premises k.S(fATf Df C - }}F_ g LSQ fjh (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: ��S /AWV SAY Ilex/hA0cfo(d7-ko L4 House Number Street Hamlet County Tax Map No. 1000 Section -7(7 Block US T23816K 3 Subdivision Filed Map No. A0waw t ca�Rd a ': (Name) t{ta `"ttesittr QUOS$I teuB�A occupancy of premises and intended use and occupancy of proposed construction: , e and occupancy i FAM 1Ly RES, 1 .ntended use and occupancy 11� v. 3. Natare of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. r __ 7. Dimensions of existing structures, if any: Front 3Z. y fT• Rear 3 . 4/ Fr. Depth Height /z/ ' Number of Stories 6.4/d` A,�D %} Dimensions of same structure with alterations or additions: Front 33 •y Rear 3a.4 ` Depth (�ja •R fy- Height !4 ` Number of Stories 1 /a S. Dimensions of entire new construction: Front r Rear Depth - Height r Number of Stories — 9. Size of lot: Front - / _Rear 0,� ' Depth a o O •:O(F .r 10. Date of Purchase D Name of Former Owner 11. Zone or use district in which premises are situated Q -9 D _ 12. Does proposed construction violate any zoning law, ordinance or regulatiorr? YES_NO L,� 13. Will lot be re-graded? YES_NO Will excess fill be removed from premises? YES_NO-,/ �iQ6P� 14. Names of Owner of premises lift RS _crn tip tS OTE Address )7L p'1• A 9valrw Qa. Phone No. 74-�--000�, Name ofArchitect Address Phone No Name of Contractor AAddress Phone No. 15 a. Is this 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. 16. Provide sun:ey, 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 Oo i�l/ i _, aj /)I<«{ZN being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named. )He is the - ��i -fAli (Contractor, Agent, Corporate Officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; t all statements contained in this application are true to the best of his knowledge and belief; and that the work will be "formed in the trtamter set forth in the application filed therewith. lom to b fore me this /Aay of GC (n 20 bE Notary P lic —Signature of Applican "a'nla.o � 1wr own jail ---- *.' t CLQ_ _ Zo-05 S3 91, Et' . i ►�_d' �i t . _ f _._. 2bI_6 `• v _0 ' 4w t b � 1 1 it APPROVED A�lNOTED DATE: B.P.;It mar - - L z;;G7 fL_._ FEE: ,m�. BY: NO'i4Q'00"W 7&00' s� A NOTIFY BUILDING DEPARTMENT AT . ` `-e. �4'- '-�� a AM TO 4 P FOR THE OCCUPANCY OR INSPECT UNLAWFUL iREQUWM- MAX BA YV" 05 W/ W C 'A, '�l! iv; _« ;�: i)�:v _ , R POURED ETV oU I CC RD 3. LAT- j PLOT MAN �� 4.! STRqJONAPST 17 04 N404 P-*I Vt MW gAAU f I i f COM TEF 0-61, WALE: i oujw +l T CTIO MEET THE SOWI I> Otn Nq 11971 REM SOF tS OF NEW WAS A.S41WAINA YOSTAT, , NOT ; PON iBLE FOR CC�NVtX.T'p4ls TJpN ERRORS. olumm P.O.BOX•=COAT LAMB _ _ X11.1 GON ME .:_>-, ., s•- y__ I ,_... :ek+« t��, „ .. . ._ t �—;. ,, t_ �� v .:.•i --1=:T`THER SHALL�x ' � " � CODES OF NYORK STATE. JdA . i eA "g",y ` i