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35738-Z
FORM NO. 4 TOWlq OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34494 Date: 08/05/10 THIS CERTIFIES that the building ACCESSORY SHED Location of Property: 800 NORTH BAY~IEW RD (HOUSE NO.) County Taxx Map No. 473889 Section 70 Subdivision SOUTHOLD (STREET) (HAMLET) Block 13 Lot 14 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 2010 pursuant to which Building Permit No. 35738-Z dated JULY 29, 2010 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" ACCESSORY SHED AS APPLIED FOR. ·"ne certificate is issued to DOROTHY BEAULIEU ( OWNER ) of the aforesaid building. SUFFOLK COUIFrY DEPART~gNT OF HEALTH APPROVAL EL~t-rKICAL U~KTIFICATH NO. PLI~BERS U~KTIFICATION DA'r~U3 N/A N/A Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35738 Z Date JULY 29, 2010 Permission is hereby granted to: D MC CABE BEAULIEU P O BOX 612 AQUEBOGUE,NY for : "AS BUILT" ACCESSORY SHED AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 070 Block pursuant to application dated JULY 12, 2010 Building Inspector to expire on JANUARY 29, 800 NORTH BAYVIEW RD SOUTHOLD 0013 Lot No. 014 and approved by the 2012. Fee $ 200.00 / Authorized Signature ORIGINAL Rev. 5/8/02 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 tupographic features. 2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. iions to dwelling $25.001 !5.00, Busio~sel~0.0O ,11~I ~L .... C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory buih 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. BLOG. DEPI. New Construction: Shed Old or Pre-existing Building: Location of Property: 800 North Bayv±ew Road House No. Street Owner or Owners of Property: Dorothy McCabe-Beaulieu Suffolk County Tax Map No 1000, Section Subdivision N/A Permit No. '~'~/.~ Health Dept. Approval: Planning Board Approval: Date of Permit. N/^ N/A (check one) Southold Hamlet 70 Block 13 Lot 14 Filed Map. Lot: ~/--~-~[I 0 Applicant: Charles R. Cuddy, Esq. Underwriters Approval: N/A Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted: $ 25.00 ~ppllca~t Signatur~ ' ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ~' FINAL~ [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRATION REMARKS: ~'~/~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BU1LD,ING DEPARTMENT ' TOWN HALL SOUTHOLD, NY 1197 I TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net PERMIT NO. E~ined Approved ~//~,20~~ Disapproved Expiration ~ ,20/.~~ 2010 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Buildthg Plans Planning Board approval Survey. Check Septic Form Trustees Flood Permit Storm-Water Assessment Form Contact: Maflto: Charles R. Cuddy, Esq. PO Box 1547, Riverhead, NY 11901 Phone: 369-8200 Building Inspector s, PPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS July 12, 20 10 rnpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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. £ Every building permit shall expire if the work authorized has not commenced within 12 months afier 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. Thereafrer, a new permit shall be require& APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to the Building Zone Ordinance of the To'am 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. USE IS UNLAWFL}L (Signature of applicak(or name, if ~co~tion) Box 154-7, R±verhead,d'q'/ 11901 IT CERT!FI * , . ~... (Mailing address of applicant) State whether apphcm[ IS,0W~, I~see, agent, mh~ct, engineer, general contr~tor, electrlct~, plu~%er or buff~er Agent "' DATE; ~/~OBp ~ SS' 7~ ~ Nameofownerofpremises Dorothy MeCabe-Beaulieu FEE: ,~.~, ByP./5'/l'¢/'..~-~ (As on the tax roll or lal~'~J~c~ I~UILDING DE,bARTMEN? AT If applicant is a corporation, signature of duly authorized officer 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) Builders License No. N/A Plumbers License No. Electricians License No. Other Trade's License No. I. Location ofland on which proposed work will be done: 800 North Bayview Road House Number Street 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH- FRAMING, PLUMBING, STRAPPING. ELECTRICAL & CAULKING 3 INSULATION 4 FINAL. CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C.O. ALL gO~S.TRUCTION SHALL MEET THE ~"~r"-"'~,,,o '~" ,r,~ ~.UU,'~ U~' n~-W STATE. NOT RESPONSIBLE FOR Block 13 DESIGN OR C~STR[I~TION ERRORS Filed Map No. Lot County Tax Map No. 1000 Section 70 Subdivision ~ ll~' ~2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy residential, one-family dwelling 4. 5. 6. b. Imended use and occupancy residential, one-fmrMly dwelling Nature of work (check which applicable): New Building X Addition Alteration Repair Removal Demolition Other Work Shed (134 sq. ft.) (Description) Fee (To be paid on filing this application) N/A Number of dwelling units on each floor Estimated Cost If dwelling, number of dwelling units If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of eanh type of use. N/A Dimensions of existing structures, if any: Front Rear Height Number of Stories One story Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front One Rear Height Number of Stories 9. Sizcoflot:Front 95.50' Rear 95.50' Depth 150t 10. Date of Pumhase. 2009 Name of Former Owner Depth Rear Depth 11. Zone or use district in which premises are situated R-40 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO X 13. Will lot be re-graded? YES__ 14. Names of Owner of premises Dorothy McCab~rdress Name of Architect Iq/p, Address Name of Contractor Iq/p, Address NO X Will excess fill be removed from premises? YES__ NO X Beaulieu PO Box 612, p,quebogue, NY Phone No. Phone No Phone No. 15 a. ls this property within 100 feet of a tidal wetland or a freshwater wetland? * YES __NO __ · IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. ls this property within 300 feet of a tidal wetland? * YES__ NO X · IF YES, D.E.C. PERMITS MAY BE REQUIRED. X 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevatlon at any point on property is at l 0 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ NO X · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF Suffolk Charles R. Cuddy being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)Heisthe p,gent for the owner (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 ,.~C~n' dayofQ{Oi~I 2010 ~/~)/...//,.~ ~'~' Not~ Public (J ~ Publlo, ~ate of N~ ~ S~amre of App~c~t '~ - - 'No, 01KO~88S88 ~ ~lon ~lr~ M~h ~ ~{ OWNER LAND ' I~f. TOWN OF SOUTHOLD PROPERTY RECORD CARD I Ac.. , 32-7 TYPE OF BLD. PROP. CLASS '~[D TOTAL DATE SUB. LOT FRONTAGE ON WATER ERONTAGEONROAD DEPTH iBULKHEAD TILLABLE WOODLAND MEADOWLAND HOUSE/LOT TOTAL ::rEMARKS TOWN OF SOUTHOLD ~'~OPERTY RECORD CARD ~.~ RES. ,~ SFAS. STREET,, ' VILLAGE DISTRICT SUB. LOT VL. ~ TOTAL TYPE OF BUILDING FARM- j COMM- lIND. tCB. M1SC. DATE NEW Form Tillo61e I Tillable 2 Tillable 3 WoodJ0~cl S~-mpJond Brushlonc~ · ~xHouse Plot ---.-BL NORMAL BELOW ABOVE Acre Vakse Per Acre Volue 70.-13-14 9/09 ~e~sion t i Basement ~ ~ ~ ~ Fl~rs [ ~' ~ Inter~or Finish Edensi~ Fire Place~/~ J He~ ~ ~2 , r 1~ j Porch ic ~ i Br~z~aY ,-- · J Patio R~s 2nd Floor SUR'V'E¥ OF= PROPER'FY SITUATE-. 5OUTHOL.~ TOI, NN: 5ot,rr~LO E~FFOLK C, OUNTY, NC' E~JRVE'f'EI~ JUNE I-/, 2OIO REVISED JULY ~, 2OIO ~FFOLK COON~ T~ IOOO- ~O- I~- 14 ~'~'~'~ ~ o m~ 7~ NOTE~ t,183o05'30"1~ ,% ..4' ~p...~. Otq 02'N' t~ sHOV'~EP-- tS0.00' o,,d 'woo'P N 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.C:~uments and Setllngs\OwnefiMy Documents~My Dropbox\10\10-145.pro JOHN C. EHLERS LAND SURVEYOR TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net PERMIT NO. Examined ,20 Approved ,20 Disapproved Expiration ,20 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying9 Board of Health 4 sets of Building Plans Planning Board approval Check Septic Form Trustees Flood Permit Storm-Water Assessment Form Contact: Mailto: Gharle$ R. Cuddy, Esq. PO Box 1547, Riverhead, NY 11901 Phone: 369-8200 Building Inspector BUILDING PERMIT Date July 12, ,20 10 b. Plot ¢. The wor} d. Upon a shall e. No building shall issues a Certificate of f. Every buildth propelly have been enacted J addition six month~ APPLICATION IS ] Building Zone Ordinance ~ Regulations, applicant agrees to comply v authorized inspectors on State whether applicant is Agent Name of owner of premises If applicant is a corporation, signature of duly authorized officer Dorothy McCabe-Beaulieu (As on the tax roll or latest deed) (Name and title of corporate officer) Builders License No. N/A Plumbers License No. Electricians License No. Other Trade's License No. OCCUPANCY OR USE IS UNLAWFUL W!T!--OliT CERTIFICATE (!r' ";~" ~ ~'~ 1. Location of land on which proposed work will be done: 800 North Bayv±ew Road House Number Street Southold Hamlet County Tax Map No. 1000 Section Subdivision 70 Block 13 Filed Map No. Lot 14 Lot 95.50' APPROVED AS TED FEE:-~t)77 BY NOTIFY BUILmNG a~ 76~1802 8~ TO4 ~ F~ FOLLO~NG INSPEC~ONS: 1. FOUNDATION - ~ REQUIRED ~ FOR ~URED CONCR~ ~ 2. ROUGH - F~I~, ~U~, STRAPPING, ELECTRICAL & CAULKING 3. I~ 4. FINAL- CON~TI~ & E~CTRICAL MUST BE C~ F~ C.O. ~ C~ ~L ~ ~ REQUIREMENTS ~ THE C~ES OF NEW YORK STA~. ~T ~ F~ DESIGN ~ ~S~ E~8. 245 STO©,.C. AE)E FE, 0.4' ~q. lq06o54,30.W 95.50' NOV~ 0~- ~O~E~LY LAN~ NO~ O~ POtbElLY OD: