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Home My WebLink About37922-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 5/10/2013 No: 36232 Date: 5/10/2013 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 5125 Main Bayview Rd, Southold, SCTM #: 473889 Sec/Block/Lot: 76.-2-22 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 3/28/2013 pursuant to which Building Permit No. Lot No. filed in this officed dated 37922 dated 4/8/2013 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 AS APPLIED FOR The certificate is issued to Rung, John (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED oriz~Si~ature/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 37922 Date: 4/8/2013 Permission is hereby granted to: Rung, John 5125 Main Bayview Rd Southold, NY 11971 To: construct an "As Built" Deck addition as applied for; Flood Pmt. included At premises located at: 5125 Main Bayview Rd, Southold SCTM # 473889 Sec/Block/Lot # 76.-2-22 Pursuant to application dated To expire on 1_0/8/2014. Fees: 3/28/2013 and approved by the Building Inspector. Flood Permit CO - ADDITION TO DWELLING AS BUILT - SINGLE FAMILY ADDITION/ALTERATION Total: $100.00 $50.00 $537.76 $687.76 Building Inspector 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: 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: 1. Accurate survey of property showing all property lines, streeB, building and unusual natural or topographic 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. C. Fees I. 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, Commercial $15.00 New Construction: .Location of Property: ~ 1~5~ House No. Owner or Ownem of Property: _ '~"o H .~ Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: Subdivision Date. prl,xr~ 0~',2. o ~3 I,"" _ (check one) Hamlet Block ~ Lot Filed Map. _ Lot: App cant: Health Dept. Approval: Planning Board Approval: R~uest for: Temporary Certificate Fee Submitted: $ ~'-~ . 6'? / _ Underwriters Approval: Final Certificate: _ {,~ (check one) plicant Signatme TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING/STRAPPING [ ] FIREPLACE & CHIMNEY INSPECTION [ ] ROUGH PLB~-~ [ ]INS~N [ ~q~NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) 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 PERMIT NO. cfi/ ~,P' ~ 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 O46' Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Approved I~ [ ~'20[~ Mail to: Disapproved a/c Phone: ~.~1 '76 5- I [5 ~l_f Expiration f- ....,:~;~'~'-' iV' // ~'i ~_,:_~t\~\\~ BuildinaInsDector ~',~ q~ - 2~3 ~X~ ~ APPLICATION FOR BUILDING PERMIT ~ ~;~ ,~ _~ INSTRUCTIONS -- ~~licatioo MUST be completeh filled in by type~witer or in ink and snbmitted to the Building Inspector with 4 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 a~joining premises or public streets or areas, and watemays. c. The work covered by this application may not be commenced be/bm issuance of Building Permit. d. Upon approval oFtbis application, tbe Building Inspector will issoe a Bnildiog Permit to the applicant. Sncba permit shall be kept on the premises available tbr inspection tbroaghout the ~ork. e. No building slml[ be occupied or used in whole or in pa~ tbr an5 purpose uhat so ever until the Building Inspector issnes a Ce~ificate of Occupancy. h Eve~ building permit shah expire if the work authorized has not con]menced within 12 months after tbe date of issnance or has not been completed within 18 months fi'om such date. If no zoning amendments or other regnlations affecting the property have been enacted in the interim, the Bnilding Inspector may authorize, in writing, the extension of the permit for an addition six months. Tbereafter, a nex~ permit shall be required APPLICATION IS HEREBY MADE to the Building Depamnent for the issuance ora Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Snfiblk 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, bousing code. and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~ (Signature of applicant or ~e, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor electrician, plumber or builder Name of owner of pren~ises ~'-0 t4.0 h. ('~U ~O & (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate of Scer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed~work will be done: House Number ~treet Hamlet County Tax Map No. 1000 Section "7~ Block o~. Lot ~h Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of,~proposedxconstruction: a. Existing use and occupancy OrO~ ~¢-.~,1,/ b. Intended use and occupancy 0/M-- ~T,:xem,ly bO,./¢ [l*'v,,~° Nature of work (check ~vhich applicable): New Building Repair Removal Demolition Estimated Cost Fee If dxvelling, number of dwelling units If garage, number of cars Addition ~ ¢C. 1'(-- Alteration Other Work (Description) (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 Rear Height_ Number of Stories .Depth 9. Size oflot: Front lO0 10. Date of Purchase ~']:Z2. ]O I Dimensions of same structure with alterations or additions: Front Rear Depth_ Height Number of Stories Dimensions of entire new construction: Front ~¢~' Height Number of Stories Rear Rear ~ ~"O Depth Name of Fenner Owner l 1. Zone or use district in xvhich premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES NO )C Will excess fill be removed from premises? YES NO ,X 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal xvetland or a fi'eshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. ls this property within 300 feet cfa tidal wetland? * YES NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 2< l 6. 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, mnst 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) SS: COUNTY OF 5u-~2~ ~ ~ ) '~'6 ~AJ /-q/-, ~ t./,,qe~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual sigaiWg contract) above named. CONNIE D. BUNCH (S)He is the Notary Public, State of New York ,";o. 91B,J~185050 (Contractor, Agent, Corporate Officer, etc.) Ouaiified in Suffolk Coun~ Commission Expiras April !4, p_t.. ~_~ of'said owner or owners, and is duly authorized to perform or bare perfortned the said work and to make and file this application; that all statements coutained in this application are true to the best of bis knowledge and b/e~ef; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . ,-,~/Jrh day of ~(X,0~27~. (-~J'~ 20 ] 7:~ Notary Public natu TOWN OF $OUTHOLD PROPERTY RECORD CARD OWNER STREET ~'/'~ ,~ VILLAGE DISTRICT SUB. LOT TYPE Of BUILDING N :S W RES. LAND SEAS. AGE NEW Farm Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushland House Plot Total' IMP. NORMAL TOTAL FARM DATE BUILDING CONDITION BELOW Value Per Acre COMM. lIND. CB. MISC. JEst. Mkt. Value REMARKS ABOVE Value FRONTAGE ON WATER FRONTAGE ON ROAD DOCK 76-2-22 10/00 Extension Extension Extension Breezeway Foundation Bosement Ext. Wolls ' Fire Place I Potio ! ~ZF Driveway '~3-'~:?J C~;~ Porch Porch Bath Floors llnterior Finish Roof Type Rooms ]st Floor Rooms 2nd Floor )ormer FLOOD ZONE CO,;'M-Y VIITt~ C~,PTER 1,18 FLO~., ,', D~,~,'~ Pd~VENTION SOUThO~' , ~, ~..'. ~OTITY ~lk~l~6 DEPAI:, 705-~8g~ ~ h~ TO 4 Plvl I TO,BowING FOUNDATION -TWO FOR pOgRJD OONGRBT~ ROUGH. FRAMING, PLUMBIb~G, INBV~TION FINAL 4aNSTRLIOTION & ~L~CTRI:( ~UBT E ~,~P~ :B FOR C 0 AB GONBTRijC'FIOT~ SHALL REQLJIREM~N [8 OF THE CC,E: YOR~ ~TA~, NOT RBPONJBLE D~SiGN OR OON~TRU~TiON ~RRORS