HomeMy WebLinkAbout36039-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~d~TMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34765 Date: 12/28/10
THIS u~KTIFIE$ that the building DECK ADDITION
Location of Property: 1860 NORTH BAYVIEW RD EXT SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County T~ Map No. 473889 Section 79 Block 6 Lot 3.4
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in tkmls office dated NOVEMBER 19, 2010 purs,,mmt to which
Building Permit No. 36039-Z dated NOVEMBER 19, 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" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to JUDITH H & ALVIN A BICKER
(OWNER)
of the aforesaid building.
SUFFOLK COONq"f DEPAR!~4ENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLiErS ~KTIFICATION DA'r~u3
N/A
N/A
N/A
Rev. 1/81
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. 33972 Z Date JUNE 11, 2008
Permission is hereby granted to:
for :
J & A BICKER
1860 N BAYVIEW ROAD
SOUTHOLD,NY 11971
"AS BUILT" DECK ADDITION AS APPLIED FOR
at premises located at 1860 NORTH BAYVIEW RD EXT SOUTHOLD
County Tax Map No. 473889 Section 079 Block 0006 Lot No. 003.004
pursuant to application dated MAY 28, 2008 and approved by the
Building Inspector to expire on DECEMBER 11, 2009.
Fee $ 400.00
Authorized Signature
COPY
Rev. 5/8/02
New Construction:
Location of Property:
Owner or Owners of Property: .~Vl ~J
Suffolk County Tax Map No 1000, Section
Subdiyiaion
permit No. ¢¢O c~t~~ Date of Permit.
Health Dept. Approval:
Planning Board Approval:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
;ation must be filled in by typewriter or ink and submitted to the Building Department with the following:
~r new bnilding or new use:
Final survey of property with accurate location of all buildings, pyoperty 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 Pl.a~ing 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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, Coramercial $15.00
la o~r Pre-existing Building: ~he~k one)
House No. Street Hamlet
,"J oDtT CKE B,., . tlq7l
Filed Map. Lot:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~'C), 1~
Final Cert ficate: V/ (check one)
Applicant Signature '
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [[ ~
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY [ ] FIRE 10N
[ ] mE.ESm~rr comm.~ [ ] ..E.E.STA.T PE. ETRATW.
REMARKS: ~~ ~
DATE
INSPECTOR~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined ~//~ ,20
Approved ~dl~ ,20__
Disapproved a/c
PERMIT NO.
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
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to:
Phone:
Expiration .//t~// ,20 D/O
Building Inspector
APPLICATION FOR BUILDING PERMIT
; Date ]b]/~. ~g ,200~
~ ~ 8 :j: INSTRUCTIONS
a. Th.4s application MUST be c4npletely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan, to~scaleJFee according to schedule.
b. Plot plan showing locatlb-fi o--f 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.
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 inspections.
(Signature of applicant or name, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
' (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.
1. Locatio_n.of land/~,O0 '~,°n which,~/I.Lh/~L/)pr°p°sed work/~ dj ,will be~-'"/"-]'-~ne' ~_,
House Number ~r~et
Hamlet
County Tax Map No. 1000 Section
Subdivision
Block /0 Lot 3,0hq'
Filed Map No. q ! J_-, Lot
1
2. State existing use and occupancy of premises and intended use and occupancy ofprop~)sed construction:
a. Existing use and occupancy
b. Intended use and occupancy ~_' _.~} I)C
3. Nature of work (check which applicable): New Building
Repair Removal
Estimated Cost
If dwelling, number of dwelling units
If garage, number of cars
Addition -/ Alteration
Demolition Other Work
Fee
(Description)
(To be paid on filing this application)
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
Depth Height
8. Dimensions of entire new construction: Front
Height
9. Size of lot: Front
10. Date of Purchase
Number of Stories
Rear Depth
Number of Stories
Rear .Depth
Name of Former Owner ~tl4,J
Rear
11. Zone or use district in which premises are situated
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__
14. Names of Owner ofpremises~l[tt I~j .&.. '~lr.4(g:RAddress~2p~3~Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
NO
15 a. Is 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. 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
· IF YES, PROVIDE A COPY.
NO
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named, CONNIE O. BUNCH
Notary Public, State of New Yod~
(S)He is the .... .N.--o:~O.1-B~U6.I'.8~.,.O.-50 -
(Contractor, Agent, Corporate Officer, etc.) C0mm'~[;~ir~'[~il 1~,'~0 I ~
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 the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
~ 8'4~ dayof ;~-~ 20 67~/
Notary Public
Signature of Applicant
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
December 15, 2010
ALan & Judith Bicker
1860 N Bayview Rd, Ext.
Southold, NY 11971
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy
Application of Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
A fee of $50.00.
Final Health Department approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
__ Trustees Certificate of Compliance. (Town Trustees #765-1892)
Final Planning Board approval.
__ Final Fire Inspection from Fire Marshal.
__ Final Inspection from the Building Dept.
__ Final Landmark Preservation approval.
Building Permit:: 33972-Z deck addition
: / o o o--? ? --~ - _~ yTOWN OF SOUTHOLD PROPERT~Y ._RECORD CARD _.. ~,.., - ,~'
OWNER STREET /,,~-/~ <_ VILLAGE DIST. SUB. LOT
FOYER OW~R N E · ACR.
~O~a~5 d S W ~PEOF BUILDING
~ND IMP. TOTAL DATE R~RKS
Tillabl~ FRONTAGE ON wATER
w~land FRONTAGE ON
M~adowland DEPTH
House Plot BuLKH~D
~otal
COLOR
TRIM
M. Bldg.
~o Extenej,on
Extension
2_xtz= Iq t
Extension
Porch
Foundation
Basement
Porch Ext. Walls
Breezeway Fire Place
Garage Type Roof
Bath
F oars
Interior Finish
Patio Recreation Room
O.B. )r~er Driveway
Total ~' /
Heat
Rooms 1st Floor
Rooms 2nd Floor
Dinette
K.
LR.
DR.
BR.
FIN. B
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
Fax (631) 765-9502
September 29th, 2010
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
FIRST NOT~CE
,Tudith & Alvin Bicker
1860 N. Bayview Road
5outhold, N.Y. 11971
RE: 1860 N. Bayview Rd. Ext. (AS-BUZLT DECK ADD-I ,ON)
SCTM #1000-79.-6-3.4
To Whom It May Concern:
Please be advised that your Building Permit # 33972 issued ,Tune 11th, 2008 has
expired. According to the Code of the Town of 5outhold, o Certificate of
Occupancy must be issued before use of the structure.
To renew your Building Permit, please submit a fee of $400.00. At that time, we
can schedule an inspection by one of our Building Znspectors.
If you have any questions, please call us at 765-1802.
Respectfully,
SOUTHOLb TOWN BUZLbING bEPT.
Town I hdl Annex
,5 t375 Main Road
P.O. 1½.x 117!1
Somh~hl, NY 11 !t71-(}959
Tclci)honc (631) 765-1802
Fax (631) 765-9502
November 18th, 2010
BI IILI)IN(; DEPARTMENT
TOWN OF SOUTHOLD
FINAL NOTICE
Judith & Alvin Bicker
1860 N. Bayview Rood
5outhold, N.Y. 11971
RE: 1860 N. Boyview Road Ext. (AS-BUILT bECK Abbll[ON)
$CTAA: #1000-79.-6-3,4
To Whom It N~ay Concern:
Please be advised that your Building Permit # 33972 issued .Tune llth, 2008 has
expired. According to the Code of the Town of 5outhold, o Certificate of
Occupancy must be issued before use of the structure.
To renew your Building Permit, please submit a fee of $400.00; at that time, we
can schedule on inspection by one of our Building Inspectors.
If you have any questions, please call us at 765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
-- (
~)~ 4~
~7"
V4" ' lU O~
"'~JCTION Si
']REMENT:
iuW YORK
c3CUPANCY OR
,.~SEIS UNLAWFUL
dTHOUT CERTIFICATE
DF OCCUPANCY
1 SGo
DATE ..,~
NOTIFY BUILDING DEP~RTMENT
FOLLOWING INSPE~TIONS:
4, FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YOR~( STATE. NOT RESPONSIBLE FOR
DBS[GN OR CONSTRUCTION ~RRORS,
r-.cuM p,ATI o M
,SBoTIOh./ _
c'