HomeMy WebLinkAbout33112-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32410
Date: 06/19/07
THIS CERTIFIES that the building
ADDITION
Location of Property: 1150
(HOUSE NO.)
County Tax Map No. 473889 Section 52
BAYVIEW AVE
(STREET)
Block 5
GREEN PORT
(HAMLET)
Lot 48.1
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 29, 2007 pursuant to which
Building Permit No. 33112-Z
dated
JUNE 6, 2007
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.
The certificate is issued to CATHERINE V. BECKER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
ed Signature
Rev. 1/81
O{lp 5fp'l y I O~
.. . Form No. 6 (_ -~. n______ ,----
TOWN OF SOUTHOLD ' o~ ~ n w
BUlLDI:O~E::~LTMENT ~: 'U'
765-1802 2 9 2r
APPLICATION FOR CERTIFICATE OF OCCUPANCY ,_L~II~&'~m2-i
I,"
l!:)
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 2/1 0 of 1 % lead.
5, Commercial building, industrial building, multiple residences and similar buildings and installations, a certi ticate
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.
L 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
I, 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:
8~" V(~W
" Street
~
Il~/E,
( check one)
I 5oL'?4d / d
,
Hamlet
1(50
House No.
Owner or Owners of Property: C/f T A e te ( ;u c
Suffolk County Tax Map No 1000, Section 0';) 2, 0 0
Subdivision Su /-I.f'1 €. It IIIf vlt.fV
Location of Property:
.tr- C)< t: If'
Block CJ ), 00
Lot
() 'i g, 00 /
Filed Map,
((3>3
Lot: /(J3' 10 Y./oS- 10.t
, , ,
Permit No.
Date of Permit
Applicant:
Underwriters Approval:
Health Dept Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
v
(check one) ,:?
/
Fee Submitted: $
~ ,)1"):). 5
C ()"r'- 3JI-!16
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.
33112 Z
Date JUNE
6, 2007
permission is hereby granted to:
C BECKER
RR# 2, 1150 BAYVIEW AVE
SOUTHOLD,NY 11971
for
"AS BUILT" DECK ADDITION AS APPLIED FOR
at premises located at
1150 BAYVIEW AVE
GREEN PORT
County Tax Map No. 473889 Section 052
Block 0005
Lot No. 048.001
pursuant to application dated MAY 29, 2007 and approved by the
Building Inspector to expire on DECEMBER 6, 2008.
Fee $
400.00
~WL~
Authorized Signature
ORIGINAL
Rev. 5/8/02
33 1/1-1;
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [
[ ] RRE RESISTANT CONSTRUCTION [
] ROU H PLBG.
] I ULATION
FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRAnoN
REMARKS:
DATE ----'z It i(} 7
{
..:~,.
INSPECTOR
....
FIELD INSPECTION REPORT DATE I
COMMENTS
BJ>c
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FOUNDATION (1ST)
------~-----------------------------
FOUNDATION (2ND)
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ROUGH FRAMING &
PLUMBING __
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INSULATIONPERN.Y. --
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMENTS ~
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/ cJtJO-6-.1- 5" - ..::18. I TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET I
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RES. .;; /0 SEAS. VL.
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VILLAGE
DISTRICT
SUB.
LOT 163 - IO~
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ACREAGE
0.344
TYPE OF BUILDING
v
LAND
IMP.
FARM
COMM.
CB.
MISe.
TOTAL
DATE
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c.r
,.
. I .
/;
8 0;.:)
AGE
NEW
NORMAL
BUILDING CONDITION
BELOW
ABOVE
Farm
Acre
Value Per Acre
Value
,
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pJ-'y / ..n>
\oax Iro
@.. G-J;J"V
,?,.;.
C! B . 86;",
Tillable 1
Tillable 2
Tillable 3
~
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Woodland
Swampland
Brushland
House Plot
Tetal
l
i
M. Bldg.
Extension
Extension
Extension
Breezeway
Go rage
O. B.
~-
... -
S---' ~. -- y / TOWN
'1 ~
,1./,
^'Aa ._....
Foundation
Basement
Ext. Walls
Fi re Place
Patio
Driveway
OF SOUTHOLD
Floors
Interior Finish
Hem
Porch
Attic
Porch
Rooms 1st Floor
Rooms 2nd Floor
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CARD
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LOT /tt'13 - /oJ-
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DISTRICT SUB.
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ACREAGE
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S
W
TYPE OF BUILDING
RES. .:l
SEAS.
VL.
FARM
COMM.
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CB. I MISe.
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LAND
IMP.
TOTAL
DATE
REMARKS
/-)
NEW
NORMAL
ABOVE
Farm
Acre
Value Per Acre
Value
7..r- Y /.JV
~f
Tillable 1
Tillable 2
Tillable 3
/ e'/
'{ ./J
Woodland
h" L)
Swampland
BrushJand
House Plot
Total_ _
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.. 11'
., : 0
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,
I
- - - 3 '1
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Foundation
2'/ ;3 Basement
) Ext. Walls
-
Fire Place C'
Porch
Porch
.,~),J Patio
;; (;, Driveway
f-/-lJd
~" i
. Bldg.
tension
"
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tension
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tension
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Irage
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B.
--
I
I
I
Both
/
Floors
o
)
Interior Finish
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.~'/
) - " '"c.
HeOlt
f3 .Iie,tJ
Attic
Rooms 1 st Floor
Rooms 2nd Floor
--
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971 ,
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southoldl
PERMIT NO.
331 f).. f::/
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:
.
)~~ ,2IDL
G ?', 200 7
Examined
Approved
Disapproved ale
Mail to:
Phone:
Expiration
r.>f (;, ,200 i
~ ff\\7 l~
\Ur
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I Building Inspector
'292
U\
\
I
,
APPLICATION FOR BUILDING PERMIT
0' LJ .Ut.f 1
'~'~I QF <;(" j!!.Q\ ",___
Date
11a.;
:<9
, 20 {j '7
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 oflot 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.
APPLICA nON 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.
(!12.. ,.t(€S J IIIlItPf!.
/I (Si.gnature of applicant r nams, if a corporation)
77U t<ft)~'1 - I/V - ;:/lL T
1:2.( /(,.,;fYP,ei> ]),eri/c
(Mailing address of applicant)
/'( p (tV VU.4J /11'1 (tEN 3
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
If fA) /lJ.E Ie.
Name of owner of premises c../lTII E,4!. / rZI~ &ck-e:,e
(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.
I. Location of land on which proposed work will be done:
If '1'0 154., 1/161/ /II/E. Sol/fA,./c1
,
House Number Street
}J~
Hamlet
County Tax Map No. 1000 Section tJS 2. O()
Subdivision 5 f., M~E R fill I/t' ~
(Name)
Block 0 5"', 0 0
File~.~ap No. (1.33
Lot ()V8,OOj
l LotI03:(6~.IO" 16b
\'
., .....
--,
2. State existing use and occupancy of premises and intended use and occu~ncy of proposed construction:
a. Existing use and occupancy 0 ,v II! ;;/1 k / L y j.) tV ~ t. C l,v r;.
,
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
])W({t.C. /~C
Addition ])6 C J:: Alteration
Other Work
b. Intended use and occupancy () ~ E
f /11// c.. 'f
4. Estimated Cost
/, j- 00
.
(Description)
Fee
5. If dwelling, number of dwelling units
If garage, number of cars I
/
(To be paid on filing this application)
Number of dwelling units on each floor I
7. Dimensions of existinlf structures, if any: Front !J-7
Height I L Number of Stories I I
Rear
5'7
Nt.
/
t(/
6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use.
Depth
Dimensions of same structure with alterations or additions: Front sl Rear 5 7
Depth LI/ Height 17- Number of Stories I
8. Dimensions of entire new construction: Front /3 / II 1/ Rear /3' II v Depth /3:1.1/
Height I - ., II Number of Stories pee 1<
<--
9. Size oflol: Front
(tJo
Rear
/ () (}
,
Depth 15 ()
10. Date of Purchase If? 2
Name of Former Owner
II. Zone or use district in which premises are situated
R C 51 P$AJ T / /l <.
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 ~
""J!.. /2/ f/;1~vt1,0> ])j!lY~ 1/803
14. Names of Owner of premises ('ATllc f/!JL ~.c(K'1\ddress PU.)ltVllt#lV, 'ufPhone No. 5'lt --3/'7 -lot b
Name of Architect Address Phone No
Name of Contractor Address Phone No.
IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO i../"
* 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.
18. Are there any covenants and restrictions with respect to this property? * YES_NO L---"'"
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS'
COUNTY OF5., rlo/ /< ) .
-:J II- tI/~S J, Mil V tJ IE. being duly sworn, deposes and says that ,~ is tlie "Fl'lisaat
(Name of individual signing contract) above named,
(S)He is the
A'te,vT
(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.
20 -1lf-
MElANIE DOROSKI
.OTARY PUBLlC~ State of New "-It
No.Ol0u4634870
_,_Q~alifiedln SuflolkCountY ... "I b
_"'ll>SlO/l Expwes September 30.~
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'lS PltEPAAEO,.' "''''0 ON H.IS' 8EH~Lf TO THE,/."~" "
~ ,lflE COMPANY. GOVER~ENTAl.AGltIC'l1E 'J' '",
J.ENDlNG INSTITUTION usnD HERWN. AND DIA-~'-.A~nD
10"THE ASSIGNEES OF THE LENDING INS-T1 YV~.K,.,
JUT ION. GUARANTEES ARE_NOT TkANSFEaAiu: -
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