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Home My WebLink About31371-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31192 Date: 10/0~/05 THIS C~TIFlq~S ~hAt the buila~-g ADDITION I~,ati~of ~ro~rty: 10775 MAIN BAYVIEWRD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET} Co%~*ty T~apNo. 473889 Se~tio~ 88 Block I Lot 6 ~ubdivieio{m. File~Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 26f 2005 ~lr~m-t to wb/ch Buil~-3_ Permit No. 31371-Z dated AUGUST 17~ 2005 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 SINGLE FAMILY DWELLiNG AS APPLIED FOR. T~e certificate is iaaued to MARYLEE DELL of the aforesaid building. (OWNER) uu~OLK CO~]~gTY DBP~T OF ~T~ APP~ ~a~L~x'KIC~L tu~KTIFICATE NO. PLOWerS tu~KTIFICATI~ DAa-mm N/A N/A Rev. 1/81 Form Nb 6 TOY~N OF $OUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ in by typewriter or ink and submitted to the Building Department with the following: 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey o f 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. 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 access6ry buildiiag $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: Old or Pre-existing Building: Location of Property: fOTVY House No. S{~ect Owner or Owners of Property: ~, ( ( , /~c~ ~% Suffolk County Tax Map No 1000, Section <) ~ -C) t ~ Subdivision PermitNo. ~r~ ] ~..~ / DateofVermit. Health Dept. Approval: ¢,d,,'A Planning Board Approval: _ ~¢_( Request for: Temporary Certificate Fee Submitted: $ (check one) Hamlet Block <~ f Lot OO G Filed Map. 'Lot: Applicant: /9~r-,,-t z-.e.,, .j~ it" Underwriters Approval: Final Certificate: 2e'~...., (check one) Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDIN~ PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31371 Z Date AUGUST 17~ 2005 Permission is hereby granted to: for : AS MARYLEE DELL PO BOX 1434 SOUTHOLD,NY 11971 BUILT DECK ADDITION AS APPLIED FOR at pre~%ises located at 10775 MAIN BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 088 Block 0001 Lot No. 006 pursuant to application dated JULY 26~ 2005 and approved by the Building Inspector to expire on FEBRUARY 17, 2007. Fee $ 300.00 ORIGIN/LL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBCi. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FIIAMINGI~NG~FINAL [ ] F~L~C~&~,~,~ [ ] REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. ?~S- 1802 IN CTION FOUNOATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ] I~.AMING I ~'RAFI"DIG [ ]FINAL FmEPLACE&~ [ ] FmE~~ DATE .J/3 7/7_-. ~ TOWN OF SOUTHOLD BUILDING DEPT. 76S- t 802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGtH PLB~I. [ ] FOUNDATION 2ND [ ] INSULATION ] FRAIMN~ / STRAPINNG~/~ FINAL [ [ l ~t~g~&~ [ l Fm~k,m'wm~-r~m REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration UL7 3. ~ T~.WN OF ~ ~T)'OLD B~'Tding APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health .~ 4 sets of Building Plans // Planning Board approval Survey Check::~ Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to:~ Pho.e: 7¢S-- Z74r ,e~:to~' ~' a. This application MUST be completely filled in by typewriter ,or in ~ 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 sweets 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 Iasl~tor will issue a Building Permit to thc applicant. Such a permit shall be kept on the premises available for inspection throughoiil 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. Il'no zoning amendmeats or other regulations affoctiag the property have been enacted in the interim, the Building Inspector may authorize, in writing, thc extension of thc p~mfit for an addition six months. Thereafter, a new permit shall be required. . - ,.. .., AP.PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zdne Ordi6ahce of the Town of Southold, Suffolk Coan~y, New'York,' and other applicable Laws, Ordinances or Regulations, for the consla-uction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to coraply with all applicable laws, ordinances, building code, housing code, and regulatious, and to admit authorized inspectors on premises and in building for necessary inspections. _h ~--~ (SignaYm'~ of ~p-plicant ~ ~arhe, ifa co~paration) (lvlai{ing address of applicant) State'whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name o f owner of premises /~[]~Q' / (As on thc 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 o~f land on which pr_Q~sed work will b~ doric:. House Number Streei-' ~ - ' ' Hamlet County Tax Map No. 1000 Section Subdivision (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy / b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling un/ts If garagei ~u.m. ber of. cars Fee Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial_or mixed occupancy, specify nature 7. Dimensions of existing structures, if any: Front Height Number of Stories and extent of each type of use. Rear Depth Dimensions of same structure with alterations or additions: Front Number of Stodes 9. 10. Date of Purchase R~lr Depth Depth. Height Dimensions of enth;e new construction: Front Height Number of Stofles Size oflot: Front ~ Rear Depth Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed coustmction violate any zoning law, ordinance or regulation? YES__ 13. Will lot be re-graded? YES__ NO V Will excess fill be removed from premises? YES__ 14. Names of Owner of pr _ernises~~_Address Phone No. Name of Architect~Address Phone No Name of Contractor Address Phone No. NO NO NOz _ UNDA J COOPER NOTARY PUBLIC, 8tMe of New York~ NO. 01~, Suffolk Cour~y£ Tena Exgat~ Deceml;~r 31,20..E.F 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. PERMITS MAY BE REQUIRED. b. Is this property within 300 fe~t of a.lidal wetland? * YES__ NO · * IF YES, D.E.C. I~ERlVflTS gl3,Y BE REQUIRED. 16. Prgv}de ~uryey1 to!. scale, ..with ,ac'~u~, tgf, outlflatian plan and distances to property lines. t7.~ ffe[evafion at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF),.-, ~ T'~_ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ,,/~~ (CgntractJor, g~,~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 tree to the best of his knowledge and belief; and that thc work will be performed in the manner set forth in the application filed therewith. Sworn to before me this /¢ dayof ~O.~ 20 Nota{y Public 1- t of Applicant ' I