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Home My WebLink About28243-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28374 Date: 05/30/02 THIS CERTIFIES that the building ADDITION Location of Property: 365 BAYER RD (HOUSE NO. ) County Tax Map No. 473889 Section 139 Subdivision Filed Map No. __ MATTITUCK (STREET) (HAMLET) Block 3 Lot 11 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 4, 2002 pursuant to which Building Permit No. 28243-Z dated APRIL 4, 2002 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to CHRISTOPHER M & BARBARA K TALBOT (OWNER) of the aforesaid building. suFFOLK COU1FI"fDEPARTMENTOFHEALTHAPPROVAL ELEctrICAL CERTIFICATE NO. CERTIFICATION DA'£~u Rev. 1/81 N/A N/A N/A ~/<'~ u/tho~r Zed Signature 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. 28243 Z Date APRIL 4, 2002 Permission is hereby granted to: CHRISTOPHER M TALBOT MATTITUCK,NY 11952 for : CONSTRUCTION OT A REAR DECK ADDITION AS APPLIED FOR. at premises located at 365 BAYER RD MATTITUCK County Tax Map No. 473889 Section 139 Block 0003 Lot No. 011 pursuant to application dated APRIL Building Inspector. Fee $ 150.00 4, 2002 and approved by the Rev. 2/19/98 COPY 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. Approx~al 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. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conformiug uses, or buildings and "Pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topograplfic features. 2. A properly completed application and a 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. l~ees 1. 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. Photocopy of Certificate of Occupancy - $ 0.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 jDate' [/~h~ b~ I aO~[l. New Construction: Location of Property: Old or Pre-existing Building: House No. - I Street Block Owner or Owners of Property: Suffolk County Tax Map N9 1000, Section Subdivision Permit No. ~ Health Dept. Approval: ~/~. Piing Bo~d Approval: Request for: Tempor~ ce~ificate F~ Sub~tted: $ _ (check one) ' ~ _ Hamlet Filed Map. I1 ¥^ Lot: Applicani: ~_~tq I'"~ t hot Underwriters Approval: }-a /a Final Certificate: J (check one) / Ap~'[cant ~ig~ature BUILDING PERMIT EXAMINER CHECK LIST APPLICANT: ~^ e.l~-~k { ~,l-1~xzrr SCTM# DISTRICT: 1,000, SECTION: ].~ STREET ~D~SS: ~ ~ ,~y~ ~. CITY: PROJECTDESC~TION: ~ ~9~/~/~ DATE ISSUED: / /02 DATE REVIEWED: DATL~SUBMITTED: 4//q /02 , BLOCK: _~ ,LOT: // /~d.r;? 77/f2f SUBDIVISION: ESTIMATED PROJECT COST:/~/~,~a ARCHITECT/ENGINEER: ,,a/,, FAST TRACK? /kao SINGLE & SEPARATE CERT{FICATION-REQUIRED? A/o NOTES: LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/1/831 ZONING DISTRICT: ~-t/'0 CONFORMING? REQ. LOT SIZE: qo, o~o ACT. LOT SIZE: ~.,7,,,oo REQ. LOT COV. o~o ACT. LOT COV. REQ. FRONT ~ PROP. FRONT o~Q SIDE ~oja~ ACT. SIDE REQ. REAR c56- PROP. REAR ~(.~.) ~ .... t,~ .-~el,'~4~'~-- ~t~4, o~ WATER FRONT? ~ DESCRIPTION: PANEL #: /~ff FLOOD ZONE: A~ , ~ APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or~, (BED #): TOWN SEPTIC RECEIPT: Y ort~ NEW YORK STATE DEC: PRE-DEC9/l/75 YES or~ SOUTHOLD TOWN TRUSTEES: YES or~ TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES oI~ TOWN HISTORICAL PRE (SPLIA): YES oreo~ DTE: / / PERMIT #:RI0- NYS ENERGY: YES OR NO : ~ / EGRESS (18 H min.? 4 sq total) ~ VENT (SQ. FT. x 4%) t--/'~ LIGHT (SQ. FT. x 8%) BULLDOG PERMITS OPEN/EXPII~ED: BP~-Z / C/0 Z- lq. !r~) ,. HAVE PRE CO'S: Y OR N BP,::~.~qgg,4 -Z / C/0 Z-_...Q_fi~3,~,$ , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST .FLOOR: SF SECOND FLOOR: SF OTHER: SF TOTAL: ,~q'~r~ SF INIT OTHER TOTAL FEE FEE FEE 1. ( 3~'9~ SF)- ( SF): SF X $ :$ +$ +$ = $ I~'~C> 2. ( SF)- (. SF)= SF X $__=$ +$ +$ = $ 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~PLBG, [ ] FOUNDATION2ND [ ] I~ULATION [ ] FRAMING [ //] FINAL DATE I I FmLD INSPECTION REPORT I DATE [ COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL CO1VIMENTS TOWN OF SO~THOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined ,20 ApprOved ,20 Disapproved ~c Expkafion ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 200;1, a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 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 ~spection 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 adrrfit authorized inspectors on premises and in building for necessary inspections. x'---"~Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant~-'~essee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises C Lg :$5f~:~, ~. ~ ~)¢~1~ k. (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer t ,.. (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians LicenseNo. Other Trade'sLicenseNo. Location of land on which proposed work will be done: House Number ' Street CountyTax Map No..1000 Section Subdivision [/~t~4&l-od: ~'Ok{$ (Name) Hamlet . Block 03 -I/'Zq'llq~ FiledMap No. I[l~q Lot Lot State existing use and occupancy of premises and intendeq! use and occ~upanc¥ of proposed construction: a. Existing use and occupancy O~ 54~ ~,,,~[.t ~.1,1 ~('h ,-~[gom-Co~ct~q. b. Intended use and occupancy~ 5!c~I ~.sll,.e -~'^~ly ho~/l,;j ~ / ~t~_ ~ ~ 5. If dwelling, number of dwelling units ~/^ If garage, number of cars ~' [~ 3. Nature of work (check which applicable): New Building Addition ,/ Alteration Repair Removal Demolition Other Work ~ ~C ~ (Description) Estimated Cost ~ffOg.'*°- Fee (To be paid on filing this appfication) Number of dwelling units on each floor r~ {~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~'~ 7. Dimensions of existing structures, if any: Front ~.c~ Rear ~3.ff Depth Height. Number of Stories I Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front { OO oo ' - Rear { OO. o~ ' Depth 10. Date of Purchase * [q(~ Name of Former Owner 3A4&E5 Rear Depth 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO j 13. Will lot be re-graded? YES NO '/Will excess fill be removed from premises? YES NO '/ 14. Names of Owner ofpremises ~_~, .4~ T{g~r[-Address '~ ~ex_ f-~. Name of Architect ~/,A - Address Name of Contractor ~,. ~ Address Phone No. Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BEfl~EQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO ~' * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 7' 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: COUNTY OF ) '~ (~(~ ~r'0- T~i~)~[''' being duly sworn, deposes and says that (s)he is the applicant (~,T~n4~ o:Fifid)Mdfial ~igning contract) above named, (S)He is the (Contractor~gent, 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 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 Notary Public ' " Nota~ Public, S~a~ o[ New ¥o~ 'gn ture of Applicant *oo II