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HomeMy WebLinkAbout28150-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31441 Date: 02/22/06 THIS CERTIFIES that the building ADDITION Location of Property: 8765 NORTH BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 5 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 6, 2002 pursuant to which Building Permit No. 28150-Z dated MARCH 8, 2002 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 10 X 16 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN F. & DIANA RIDDELL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A oriz d Si nature Rev. 1/81 Form No. 6 TOWN 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 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" 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 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 New Construction: Old or Pre-existing Building: Date. 2- 16 E:- Old , (check one) Location of Property: of . 15mvlr-tj (,D 5-a:.)TF-t rk-6 House No. Street Hamlet Owner or Owners of Property: .T0rV3 -+- 33)rA-,v Suffolk County Tax Map No 1000, Section Subdivision Permit No. 2ffjyO- Z Date of Permit. Health Dept. Approval: o✓ ip, % J 0 tf-L-L-- Block Filed Map. Applicant: Underwriters Approval: ?J A- Lot Lot: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 2- �_ " if q C_yo� Applicant bXnature 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. 28150 Z Date MARCH 8, 2002 Permission is hereby granted to: F JOHN & DIANA RIDDELL SOUTHOLD,NY 11971 for : CONSTRUCTION OF A 10 X 16 DECK ADDITION AS APPLIED FOR at premises located at 8765 NORTH BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 079 pursuant to application dated MARCH Building Inspector. Fee $ 150.00 Block 0005 Lot No. 010 6, 2002 and approved by the ORIGINAL Rev. 2/19/98 TO 650-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] FOUNDATION 2ND [ ] FRAMING [ ]ROUGH PLBG. [ ] INS TION INAL FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) ------------------------------------- b FOUNDATION (2ND) z ROUGH FRAMING & PLUMBING 0 H ,r f "� INSULATION PER N. Y. STATE ENERGY CODE r y C FINAL ADDITIONAL COMMENTS o- a- l� O C' Z r m Aa 0.0b r c z x H x d b y TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examined / 20 Z Approved 120 7__— Disapproved a/c BUILDING PERMIT APPLICATION CHECKLIST PERMIT NO. c--� 6 -SCS Do you have or need the following, before applying ? Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: r `1 v,�-. �? Building Inspector 6 j APPLICATION FOR BUILDING PERMIT T Date INSTRUCTIONS `-f O 2 , 20 INSTRUCTIONS 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 a Certificate of Occupancy is issued by the Building Inspector. 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, i a corporation) �3o�C 15-2.9 , So -j 714o -4U (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder o _1 1 -?e4 -C iyic Name of owner of premises T3Hfl� If aDDlicdnt is a covaoration, 066ature of (Name and titles f/corporate officer) .- D1A(\JA 12,� CP)t--- L--k- (as on the tax roll or latest deed) authorized officer License No. 0-- 17/ 01 - Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: -7 S' g �.�lOs� �� . �v `J House Number Street Hamlet ( , County Tax Map No. 1000 Subdivision (Name) Section Block Filed Map No. V Lot : A0 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ►.J Co L -C= f=A-t"^ I t -z/ QL,J L -r o -1'-j & b. Intended use and occupancy S' '► G vJ► �'/ 4f -E-/ L �D Ag2 a] Nature of work (check which applicable): New Building Addition✓ I) Repair Removal Demolition Other Work Estimated Cost_ d)OT,OR3 Fee (to be paid on filing this application) Alteration (Description) 5. If dwelling, number of dwelling units If garage, number of cars Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: /Jo 13. Will lot be re -graded /�C) Will excess fill be removed from premises: YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES 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 OFSuF- CQQ .. ►'x4 So� Q_ _ed4AtZ__b being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Ccri 'r V-Ae--TOS (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 t day of O-ZCA 20 O (-� (j, Z&_ Inq N tary Public LYNDA M. BOHN NOTARY PUBLIC, State of New York No. 01B06020932 Glualified in Suffolk County- Term our Term Expires March 8, 20 l�IE L L- U o1C r �ANTYrn., Is flualf'; -y�- K_ f A S-rA(k fe(Sd rllT �,TAr/Z Ta 9C /( -�prS 2- LJSH GiROO APPROW AS AA S.R � C, b,.► �xisT�G • NOOTIFY BUILDINBy.. NDEPARTMENT AT `v�T IiJC� 765.1802 ! AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING & INSULATION 4 FINAL - CONSTRUCTION MU i l�,C-s �, r �.J�, C, ks BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEETL,►.,J THE REQUIREMENTS OF-THf-14:11."" STATE CONSTRUCTI©N, & ENERGY CODES. NOT RESPON IBLE FOR DESIGN OR CONSTRUFTION ERRORS ItJ(> Z 6 w-wG l^L1s" E, f /11+1 ( �- y '17-nY� VA- ti W/ ot-.� /,-J `F S ec- V' - Cmc J 'ti �i ,x N 2- LJSH GiROO APPROW AS AA S.R � C, b,.► �xisT�G • NOOTIFY BUILDINBy.. NDEPARTMENT AT `v�T IiJC� 765.1802 ! AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING & INSULATION 4 FINAL - CONSTRUCTION MU i l�,C-s �, r �.J�, C, ks BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEETL,►.,J THE REQUIREMENTS OF-THf-14:11."" STATE CONSTRUCTI©N, & ENERGY CODES. NOT RESPON IBLE FOR DESIGN OR CONSTRUFTION ERRORS ItJ(> Z 6 w-wG l^L1s" E, f /11+1 ( �- y '17-nY� VA- ti W/ ot-.� /,-J `F S ec- V' - Cmc BUILDING PERMIT EXAMINER CHECK LIST APPLICANT NAME: SCTM# DISTRICT: 1,000 SECTION:_ BLOCK: 57— LOT:1 0 STREET: PROJECT DESCRIPTION: DATE REVIEWED: 4 PS /m .DATE SUBMITTED:/ G /0L CITSUBDIV. NAME: ARCHITECT / ENGINEER: FAST TRACK? SINGLE & SEPARATE CERTIFICATION -REQUIRED? yNOTES: LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/ ZONING DISTRICT: _ Ci CONFORMING? A(O REQ. LOT SIZE: 0/° o o ACT. LOT SIZE: REQ. LOT COV. ACT. LOT COV. REQ. FRONT hyo PROP. FRONT_37! REQ SIDE / CT. SIDE AC REQ. REAR PROP. REAR WATER FRONT? D DESCRIPTION: PANEL #: FLOOD ZONE: , AGENCY PERMITS REQUIRED FOR REVIEW APPROVALS REOUIRED: SUFFOLK COUNTY HEALTH DEPT: YE�(BED #): DTE: / / PERMIT #:R10 - NEW YORK STATE DEC: PRE -DEC 9/1/75 YES o��D SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES or P�l� NYS ENERGY: YES 01 EGRESS (18 H min.? 4 sq total) NT (SQ. FT. x o BUILDING PERMITS O XPIRED: BP -Z / C/0 Z_ HAVE PRE CO'S • R N BP -Z /C/o Z_ NOTES-: _el .x C. o . FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : SF SECOND FLR : SF INIT OTHER TOTAL TOTAL: o SF FEE FEE FEE 'OT( /fid SF)- (_SF)= SFX $ =$ +$ +$ _ $ �� M i a WELL 100 ?O 00 goy 3 � ce h / 1,40�rl i QED NiDi� QE v &rn x ooaw* =wAwn=a oP m&m survim POR 0900"L OF ONLY DATE K & fes. NO. TM Ibcat/olni of and cos mown Raman aro haw Raid obsorvaftm and or *on day aim >*, oftem 0 F E 0PV /7_B AAO P,y,E ?'$ es, M� ar,s A DARK BROWN LOAM S. BROWN CLAYEY LOAM 2. BROWN CLAYEY SAAV r I I BROWN MEQKN/ TO COARSE SAAn IIA TER BV BROWN SAI rO COARW T O C Wt /r A ice n 00" 0'qD / vACA4'r/ H.S. Ref # 90 -SO -2 SURVEY OF PROPER T Y A T BA Y VIE W TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000 - 79 - 05 - 10 Scale 1" - 40' May 30, 1990 JUL Y 117 1991 ( found a tion ) Airy 13,1992 (fvd ) CERTFF/ED TO: DONALD OSAIW AREA = 33,607 sq ft. no WWW aid f�rI�1N� fo at da at of A~ 0MAW of Apso Awn*Mt Prepared in accordance with the minimum r. N. Y.S. LIC. NO. 4mys standards for title surveys as established <, by the LIA.L.S. and approved and adopPted p � YORS, P. C. for such use by The Kew York State Cand Tith Association. A/A D SOUTHOLD, N. Y. 11071 90 - 204 A