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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southo1d, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32688
Date: 10/23/07
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property: 6955 SKUNK
(HOUSE NO.)
County Tax Map No. 473889 Section 104
LA
(STREET)
Block 4
CUTCHOGUE
(HAMLET)
Lot 33.2
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 18, 2006 pursuant to which
Building Permit No. 32596-Z
dated
DECEMBER 26, 2006
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 UNHEATED ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to ART & LAURETTA BAUER
(OWNER)
of the aforesaid building.
SUFFOLK COmITY DEPARTMEI!IT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
115748C
04/30/07
N/A
PLUMBERS CERTIFICATION DATED
~ze~
Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled lfl by typewriter or iJ!k and submitted to the Building Depar1ment 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 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 I % 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:
I. Accurate survey of property showiug 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 OCCUpatlCY is
denied; the Building Inspector shall state the reasons tnerefor 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 Cel1ificate of Occupancy - $50.00
5. Temporary Cel1ificatc of Occupancy - Residential $15.00, Commercial $15.00
Date. \ u \ \0.\0'\
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New Construction: ~_ Old or Pre-existing Building: (check one)
LocationofProperty G,c)'S~ <;:\KUI\Jf<.. L4^/F r,;t-ChO('~l.JF
House No. Street Hamlet
OwnerorOwnersofPropertY:.~R\ If LAUR.~~AlJFR_
Suffolk County Tax Map No ] 000, Section It> 'f Block tf Lot 33. 2-
Subdivision _ ... . .. _.__ Filed Map. ___ Lot:
Pennit No. 3d5~_?:_-Date o;permjtl.~_ Applicant:-1J..e:L=:B,q UF-f2...,
Health Dept ApprOVal' _.u__ _-==..._u . Underwriters Approval~. . ____.
Plarming BOard Approval: .__._. u__..=---_
Request for:
Temporary Cel1ificate
Final Certificate: ~
(check one)
Fee Submitted $ ~ 5 ,O::J
~--
Applicant Signature
----
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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.
32596 Z
Date DECEMBER 26, 2006
Permission is hereby granted to:
A & L BAUER
21205 SO HARBOR RD
SOUTHOLD,NY 11971
for :
UNHEATED ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR
at premises located at
6955 SKUNK LA
CUTCHOGUE
County Tax Map No. 473889 Section 104
Block 0004
Lot No. 033.002
pursuant to application dated DECEMBER 18, 2006 and approved by the
Building Inspector to expire on JUNE 26, 2008.
Fee $
169.80
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/ Authorized Signature
ORIGINAL
Rev. 5/8/02
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
[~ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
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DATE
/0-/7- 07
INSPECTOR ~~
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ; F~DATION 2ND [ ] INSULATION
[~RAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRlJCnON [ ] FIRE RESISTANT PENETRAT10N
REMARKS:'''--~ ~.
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DATE
INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
P<(FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUC'nON [ ] FIRE RESISTANT PENETRAnON
REMARKS:
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DATE I -()... - t) .h
INSPECTOR
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FIELD INSPECTION REPORT DATE I COMMENTS oJ
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX; (631) 765-9502
www.northfork.net/SouthoIdI
PERMIT NO.
3 ;;5/(,; C
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:
Examined
, 20--.EL
,20~
Approved
Disapproved ale
Mail to:
Expiration
'" Ix ,20QL
.
(~
Building Inspector
Phone :)C)<i, - d. \ \ ~ 4
S~l- S ~0 s (, ( (
DEe \ 8 j
APPLICATION FOR BUILDING PERMIT
Date
,20
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector Wit~
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.
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 inspecti
'vi; .:;> I dO S. l-kYl boR. Rd.. ~vrI-lOLO NVj
(Mailing address of applicant) 1/ l.) 1/
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
O\l)"-! €" e..~d.el
Name of owner of premises -fj i?:\ ~ u€...
~ JA()~{ttc\ bA()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.
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I. Location of land on which proposed wOn
(p ~ 5 un L:
House Number Street
will be done:
K
Lot
Lot
33..d-.
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County Tax Map No. 1000 Section \ 0 l\
Subdivision -.J" A '5~ A U ~Q Rrn""5
(Name)
Block Li
Filed Map No._' \ 1 q
2. State existing use and occupancy of premises and intended use al}d occupancy of proposed construction:
a. Existing use and occupancy I ~Qrnl 'V uwp/l "'(j ,
b. Intended use and occupancy Go1Q ,e \ -::;T\)~ct 1 {'
3. Nature of work (check which applicable): New Building )(
Repair Removal Demolition
>.
Addition
Other Work
Alteration
4. Estimated Cost
_.....,/ """,,,}O
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(Description)
Fee
5. If dwelling, number of dwelling units
If garage, number of cars ~
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use.
-
7. Dimensions of existing structures, if any: Front~ to
Height ~., I ~ 1- Number of Stories ~
Dimensions of same structure with alterations or additions: Front Y L
Depth '-\ "'\s Height d. "\ \-( - Number of Stories
Rear 39
Depth l.j <0
8. Dimensions of entire new construction: Front ~ Ii
Height \ \0' - Number of Stories \
9. Size oflol: Front \ ~ S Rear \ cl 5 Depth 13 cl. . 10
10. Dateofpurchase '~\;).o\()c:.... Name of Former Owner '?f:TFR. LAesel\
\ \ ~
11. Zone or use district in which premises are situated " 40
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~
13. Will lot be re-graded? YES_NO X. Will excess fill be removed from premises? YESX- NO_
14. Names of Owner of premises '5~~-t I . Address Phone No.
Name of Architect \'1"IAI!.\t ~ I :Yo h.. Address \tr dS {'u-tc..h~ Phone No
Name of Contractor 'l\R:r ~~uVt - ()L.v f'I./l1 Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO A--
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MA ~ REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
Rear \ ~
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:
COUNTYOF~
AR. T i3A l) E R.. being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
OWNFe.
,
(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 ~o" rnd". ~
I ~ n_ ~_ 20rJ&
I- 1V- ~.
Notary Public
PATRICIA RICHERT
Ncltary Pubfic6 S~'of New Yorll
, No. 3 -4741154
Oualif!ed. . in Nas~au rSu~Cou~7
ColIImlsSlOn EXpIres / 0) 0
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FORMER OWNER
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ACR.
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TYPE OF BUILDING
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RES;:JLO
LAND
SEAS.
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COMM. CB. MICS. Mkt. Value
FARM
IMP.
TOTAL
DATE
REMARKS
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Tillable
House Plot
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
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Woodland
Meadowland
-7
-,
Total
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Foundation p (', Bath 2-
Extension ?,-.t. I .... '71 Basement rf) I) Floors CJ~k
-
.' r:.. J'~~ G F.xt. Walls .1/ S Interior Finish (' jt
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Extension Fire Place Heat OliN
0."J 52-f ;-,; ;.!2-
Porch 2.. vI , .5 ~ l,.l 'i Pool
Deck Patio
Breezeway Driveway
Garage -5- )(' ) <;:: ' c:s- ) ;!5 3S.i
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O.B.
.$71.'-
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Anic
Rooms 1st Floor .,j
Rooms 2nd Floor
1,)8.23 50 W
BAY AVENUE
r PART Of=L'OT 140
I IN
A '
r ~ ~p OF NASSAU FARMS
1/ OG. TO'WN OF SOUTHOLO
- S FOLK COUNTY, N.Y.
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N/F DREWS
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WIRE fENCE: GENERALLY NORTH or PROPERTY UN!:
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125,00
FM# 140
DATE FILED MARCH 28, 19
SURVEYED FOR: ARTHUR BAUER
LAURETTA BAUER
TM# 1000-104-04-0332
SURVEYED: 14 DECEMBER 2006
GUARANTEED TO:
ARTHUR BAUER
LAURETTA BAUER
COMMONWEALTH LAND TITLE INS. CO.
SCALE 1 "= 30'
AREA = 24,016 SF
OR
0.551 ACRES
GUARANTEES INDICATED HERE ON SHALL RUN
ONL Y TO THE PERSON FOR WHOM THE SURVF:Y
IS PREPARED, AND ON HIS BEHALF TO THE
nTLE COMPANY, GOVERNMENTAL AGENCY,
LENDING INSTITUTION, IF LISTED HEREON, AND
TO THE ASSIGNEES OF THE L[NDING INSmUnON
GUARANTEES ARE NOT mANSFERA8LE TO
ADOlnQNAL INSmUnONS OR SUBSEQUENT OWNERS.
SURVEYED BY
STANLEY J. ISAKSEN, JR.
PO. BOX 294
NEW UFFOLK. NY 6
631- 34-5835
1. II JAN 07 LOCATE POURED CONC roUNOATlON (GARAGE)
UNAUTHORIZED AL TERA TlON OR AOOmON TO THIS
SURV[Y IS A VIOLA TlON OF SECTiON 7209 OF
THE NEW YORK STArE EDUCATiON LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYORS EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE
COPY.