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Home My WebLink About29451-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-30731 Date: 01/31/05 THIS C~KTIFIES that the huildlng ELECTRIC SERVICES Location of Property: 2675 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (F=~MLET) County Tax Map No. 473889 Section 78 Block 1 Lot 13.1 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 30, 2003 pursuant to which Building Permit No. 29451-Z dated JTJNE 2, 2003 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 INSTALLATION OF ELECTRICAL SERVICE IN EXISTING NON-HABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to WALTER G PERSSON ( OWNER ) of the aforesaid building. SUFFOLK COUN~f DEPARTMENT OF HEALTH APPRO%K~L ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'&'~O N/A 83152C N/A 12/10/03 Rev. 1/81 FORM NO. 4 TOW~; OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30732 Date: 01/31/05 T~IS CERTIFIES that the building ELECTRIC SERVICES Location of Property: 2675 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 78 Block 1 Lot 13.1 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAy 30, 2003 pursuant to which Building Permit No. 29451-Z dated JUNE 2, 2003 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 INSTALLATION OF ELECTRICAL SERVICE IN EXISTING NON-HABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to WALTER G PERSSON ( OWNER ) of the aforesaid building. SUFFOLK COUNT"fDEPARTMENTOF~IEALTHAPPROVAL N/A ELECT~ICAL CERTIFICATE NO. 83152C 12/10/03 PLUMBER~ CERTIFICATION DAT~u3 N/A Rev. 1/81 FORM NO. 4 TOng OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30733 Date: 01/31/05 THIS CERTIFIES that the building ELECTRIC SERVICES Location of Property: 2675 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 78 Block 1 Lot 13.1 Subdivision Filed Map No. LOt No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 30, 2003 pursuant to which Building Pertmit No. 29451-Z dated JUNE 2, 2003 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 INSTALLATION OF ELECTRICAL SERVICE IN EXISTING NON-HABIT~JBLE ACCESSORY STORAGE BARN AS APPLIED FOR. · ~ne certificate is issued to WALTER G PERSSON (OWNER) of the aforesaid building. SUFFOLK COUIF!mfDEPARTMENT OF I~gALTHAPPRO~ N/A ELEC'Iq~ICAL CERTIFICATE NO. 83152C 12/10/03 PLUMBERS CERTIFICATION DA'A'~D N/A 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. 29451 Z Date JUNE 2, 2003 Permission is hereby granted to: WALTER G PERSSON 1675 MAIN BAYVIEW RD SOUTHOLD,NY 11971 for : INSTALLATION OF ELECTRICAL SERVICES TO THREE NON-HABITABLE ACCY STORAGE BUILDINGS AS APPLIED FOR. 3 COS REQUIRED SIMULTANIOUSLY. at premises located at 2675 MAIN BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 078 Block 0001 Lot No. 013.001 pursuant to application dated MAY 30, 2003 and approved by the Building Inspector to expire on DECEMBER 2, 2004. ~ri~ed ~ature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ,t N 3 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 surrey 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 thc 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 cemficate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board ApprovaI 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 x~qfting 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. New Construction: ~ Old or Pre-existing Building: Locationoferoperty: ~ '~_~-' /]ilA_(/~l/~ ~x/b//~t4~ /~o~D House No. "~ ~treet Owner or Owners of Property: {AJA'- C-NF-~v-- ~- ~-~, ~r'~O Suffolk Counb, Tax Map No 1000, Section 7 t~ Block Subdivision Filed Map. Permit No. ,~,.Qf~, ~cTg.~'-/~._, Date of Permit.~ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Hamlet (check one) Fee Submitted: $ Applicant Signature / Lot /3./ Lot: Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 JAN 3 APPLICATION FOR CERTIFICATE OF OCCUP.~NCY 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: I. 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 o f electrical installation from Board o f Fire Under~vriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. C°mmercial 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 'axiting to the applicant. C.' Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dxvelling $25.00, Swimrmng 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. o vt-.,/ New Construction: ~ Old or Pre-existing Building: Locationoferoperty: o~ '~'- /{qA-f&/4,~?/,/[~t4/. ~o4~D House No. ' ' gtreet Owner or Owners of Property: {AJA-- t~-'~'-~-~ ~ ~"?~s~' o ~ Suffolk County Tax Map No 1000, Section ? ~ Block Subdivision Filed Map. Permit No. ~ Date of Permit.~ Applicant:. Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: [/ (check one) Hamlet / Lot Lot: Fee Submitted: $ (check one) Applicant Signature Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 3 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" laud uses: 1. Accurate survey o£ 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 ;wiring 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. New Construction: ~ Old or Pre-existing Building: Location of Property: O~House~'~ ~"-No. AdAkf&l .~~. Xo~D SuffOlk Co~ T~ Map No 1000, Section 7 ~ Block Subdivision Filed Map. Health Dept. Approval: Unde~ters Approval: Planning Board Approval: Request for: Temporaw Ce~ificate Final Ce~ificate: ~ .. (check one) Har~let / Lot Lot: Fee Submitted: $ co-Z_ 3o')33 (check one) Applicant Signature C~ ~ce, Inc. Application ~l~~ Dunton Avenue --83152C ~'~hogue, NewYork 11772 ~'" ';J (631) 286-6642 ~~ued To: Walter Persson ~. ~_6~ M~in Bayview Road ~. 1 ~7~ lown: Southold Section: Block: Lot: Contractor: North Electric Company Lic. # 890-E Was examined and found to be in compliance with the National Electrical Code. ~ Commercial [] NV Defects [] Pool [] 1st Floor [] Indoor ~ Basement [] Hot Tub [] Residential [] Det. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 9 12 18 5 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Bldg. Permit: 29451-Z Jacuzzi Television CO Detector Other Equipment 2-50A Sub Panels rl-40A Sub Panel -220V Rec Hugo S. Surdi President Rough Inspection: 12/09/2003 Inspecl:or: Sean P. Hightower Final Inspection: 12/09/2003 Inspector: Sean P. Hightower This certificate must not be altered in any manner. Inspectors may be identified by their credentials. TOWN OF S. OUTHOLD BUILDING DEPARTMENT TOWN'HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ww~v. north fork.net/Southold/ Examined ,20 Approved Disapproved Expiration BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Buildink InSpector APPLICATION FOR BUILDING PERMIT Date ',~ .... INSTRUCT IONS 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 the Building Inspector issues a Certificate of Occupancy. f. Evers' building pemfit 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 perrmt 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 laws, ordinances, building code, housing code, and r,~lations, and to admit authorized inspectors on premises and in building for necessaw inspections., . t (Signature of applicam or name. ifa corporation) ,/., (Ivlailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, ~eneral contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of dui)' authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be, done: House Number S~eet e ,f/'/4oc p Hamlet County Tax Map No. 1000 Section /~ ~ Block ( Subdivision Filed Map No. (Name) Lot I .1 Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ,a ~- ,~,C'.- ¢_ b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~;.F'~, -~'--~--~ If dwelling, number of dwelling units If garage, numberof cars - ._52 -- Addition Other Work Fee Alteyation (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each t.vpe of use. Dimensionsofexisting~structures, ifanv:Front '-,)t~). ~'~ Rear ~,~}, ~- Height ,/,2 Number of Storie'~ Dimensions of same structure with alterations or additions: Front Depth_ Height. Number of Stories Depth Rear 8. Dimensions of entire new construction: Front Rear .Depth Height Number of Stories 9. Size of lot: Front /57r~' Rear ~.~ 5-T-) Depth ~ ,-~ t' tt/C,,2 Name of Former Owner 10. Date of Purchase 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X 13. Will lot be re-graded? YES__ NO X Will excess fill be removed fi.om premises? YES NO )( 14. Names of Owner of premises 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 fi.eshwater 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 ~X' * 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. Sworn to before me this day of 20__ NotaO, Public Signature of Applicant IPLOT AREA = 4~,264±SFI Z 40' go00 GLENN ¢" ROAD UNDERWRITERS CERTFJCAIFE _ RFlUR£D Jt~OVED AS NOTS) ~ BUI~ING DEPAR~E~ AT ~1~ 8~ TO 4PM ~RTHE ~ ~S~TI~ ~NOAT~ - ~0 RE~IR~ ~ ~R~ ~NCR~ ~. IN~ 4, FIN~ - ~STRUCT~ ~T ~ ~MPL~E FOR C,O. ~ CONSTRUCT~ ~L ME~ R~UlREME~S OF ~E ~D~ NEW YORK STATE. NOT RE~N~I~ FOR D~IGN OR ~NSTRUCT~ ERR~S, N/F KAELIN COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REgUIRED AND CONDITIONS OF '~I+~ SOUTHO~TOWN~ ~ sOuTH(iD TOWN PL~NNIN~ ~ 4r /'l SOUTHOt~ TO~ TRUSTEES ,~ ,/xN.y.s. eEC / EOOI)ZO _ COMPLY WITH CHAPTEI~ "46" -- FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. CD 0