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HomeMy WebLinkAbout28298-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28568 Date: 07/05/02 THIS C~RTIFIES that the building ACCESSORY Location of Property: 4370 NORTH BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 2 Lot 4.3 Subdivision Filed Map No. __ LOt No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 2002 pursuant to which Building Permit No. 28298-Z dated APRIL 19, 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 ACCESSORY SHED AS APPLIED FOR. The certificate is issued to DONALD F & JOAN E BERTRON ( OWNER ) of the aforesaid building. SUFFOLK COUNT"f DEPARTMENT OF I{KALTHAPPROVAL ELECTRICAL c~TIFICATENO. PLUMBERS CERTIFICATION DA'r~u Rev. 1/81 N/A N/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII,DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28298 Z Date APRIL 19, 2002 Permission is hereby granted to: DONALD F & JOAN E BERTRON 4370 N BAYVIEW RD SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 079 pursuant to application dated APRIL Building Inspector. Fee $ 75.00 4370 NORTH BAYVIEW RD SOUTHOLD Block 0002 Lot No. 004.003 16, 2002 and approved By the Rev. 2/19/98 COPY Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOSVN HALL 765-1802 API'LI(L¥I'I()N FOIl CI(RTIFICATI;, OF OCCUPAN(!Y This application must be filled in by typewriter or h~k and subnfitled to tile Building Departn~ent with tile following: 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 sexverage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn stalement from plumber certil3,ing that tt~e solder nsed in system contains less than 2/10 (~f 1% lead. 5. Com~nercial building, industrial building, multiple residences and similar buildings and installations, a certific of Code Complimme from arclfitect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "Pre-existing" land us~ 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupam is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees . 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.0( Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.0 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 New Construction: Location of Property:. Old or Pre-existing Buildlng: q,3 70 A/0 '774 ,3A Yi/l 'w' House No. Street Owner or Owners of Property: a/A L.]) Suffolk County Tax Map No 1000, Section Subdivision (check one) Hamlet ,T'o A A/ . Block 0 00 o~. Lot O0 ~/, OO 3 Filed p. q738'8Y Lot: Under~vriters Approval: Final Certificate: ~ (check one) Applicant Signatm'e Health Dept. Approval: Plamting Board Approval: Request for: TemporaD' Certificate Fe~ Submitted: $ O~9~'''. O O Permit No. ~ Date ofPemfit. A g__IL [ oa Applicant:_~)~_,4/~d~ t~. ¥~,~Ld/u~'.x~_~r/'~'~ BUILDING PERMIT EXAMINER CHECK LIST APPLICANT: DATE ISSUED: / /02 D. AT m VIEW D: /02 DATE-SUBMITTED: ~ //~' /02 SCTM# DISTRICT: 1,000, SECTION: .~. , BLOCK: ~ , LOT: ~..~ STREET ADDRESS: 4:~ 4 ~tt,~ CITY: ~j~r~t.~ SUBDIVISION: PROJECT DESCRIPTION: ~ ~ax'~-.,,,~_, ~"~ ~_~ _~ N~, .~;~o,~1~ ~m ~ ~ ESTIMATED PROJECT COST: ~ ~9,1 q~"' ARCHITECT / ENGiNEER: - FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? -'"'---- NOTES: LOTS 40,000SF -100-24. Lot recogmition.(CREATED before June 30, 1983), UNDERSIZE[) LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/1/8: ZONINGDISTmCT: ,2$,eV CONFOR2X4ING? REQ. LOT SIZE: ACT. LOT SIZE: __ REQ. LOT COV. ACT. LOT COV. REQ. FRONT ~.- t PROP. FRONT / REQ SIDE ~F r/'~'ACT. SIDE REQ. REAR .f~ t PROP. REAR ~ WATER FRONT? PANEL #: FLOOD ZONE: DESCRIPTION: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: Pm~-nrc 9/~/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO DTE: / / PERMIT #:R10- NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) __ VENT (SQ. FT. x 4%) LIGHT (SQ. FT. x 8%). BUILDING PERMITS OPEN/EXPIRED: BP I ~' ~ ~- -Z / C/0 Z-/_~.~, ,tg'a,t~, ,t~t,~_ ~ HAVE PRE CO'S: Y ORN BP -Z / C/0 Z- , NOTES: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: SF SF SF SF INIT OTHER TOTAL SF FEE FEE FEE 1. ( SF)- ( SF)= SF X $ =$ +$ +$ =$ 2.( SF)-( SF)= SFX$ =$ +$ +$ = $ Z 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION IST [ ] RO~G~H PLBG. [ ]FOUNDATION2ND [ ].~i~ULATION [ ]FRAMING [///J' FINAL [ ] FIREPLACE & CHIMNEY REMARKS:~~~~~_ DATE 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ,~.~FINAL [ ] FIREPLACE & CHIMNEy DATE  INSPECT~ FI]ELD INSPECTION REPORT I DATE I COMMI~TS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ADDmON.t/L co~s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 PERMIT NO. Examined ,20 Approved 20__ Disapproved aJc 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. Cheek Septic Form N.Y.S.D.E.C. Trust, s Contact:  Phone: Expiration L TO~PLICATION FOR BUILDING PERMIT Date ~ INSTRUCTIONS / //~ ,20 © c~ 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, relation.qhlp to adjoinlng 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 ln.qpector 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 commt~noed 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 ln~ector 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 ora 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 ins~ ~ ,._~ ~~ (Sigv~m~ of applicant or name, if a corporation) P a 8~/~x-~x.~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~,~X]~5 t~ ~'x~d ~-~', (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. l. L9cation of land qn which pr!~posed work wi. Il be ~done:~ x.5'o 0 7-hee House Number Street County Tax Map No. 1000 Section Subdivision (Name) Hamlet q flSlook Ffl~xl Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy ofproposec~constmction: a. Existing use and occupancy [~ tidal'- b. Intended use and occupancy. Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~,~, / ~(-~ ,~ ~ If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work ,,~-' ~ (Description) Fee (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 Rear Height Number of Stories Dimensions of same structure with alterations or additions: Front [ O / Depth ~ d> Height ~ / Number 9fStories 8. Dimensions of entire new construction: Front /' t3 Rear /' ~" Depth Height ~ r Number of Stodes ! Depth Rear I 9. Size oflot: Front /DO Rear O. ateo Pur s 11. Zone or use dis~ct ~ whch pr~ses ~e si~ted 12. Does propos~ cons~on holate ~y zoning law, ord~mce or relation? ~S fNO 13. Will lot be re-~ad~? YES NO ~Will exes fiJ1 be r~ov~ ~om pr~ses9 ~S ' ' ~~ o~ ~ h,' NO 14. N~es of O~ ofpr~ise~A ~D ~W Ad&ess~ Nme of~chtect Address Phone No Nme of ConWactor Address Phone No. 15 a. Is ~s prop~ wi~ I00 fe~ ofa fid~ w~d or a ~eshwat~ w~d? *~S NO * IF YES, SOUTHOLD TO~ ~USTEES & D.E.C. PE~S ~Y BE ~QU~D. b. Is this prop~ wi~ 300 f~t ofa tid~ wetl~d? * ~S NO * IF YES, D.E.C. PE~ITS ~Y BE ~Q~D. 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 ) __ A (~~ ....,~.c~~ being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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. Swom to be. fore me this / ~5 °-"~--day of ~ 20t5~ Notary Public ""- HELENE D, HORNE Notary Public, State of New York No, 4951364 Oua!ified ir, ~F<,',H Si&mature of Apphcant Bill To: Gera Gardens, Inc. E~ crytld,,~ Transaction #: 219 ~ O~::> (or)~,r Account #: 631-765-4113 'Backyard! Page: 1 of 1  Date: 4/14/02 Time: Bertron 43~0' Norlh'Bayview rd. 117971 O4X4RAMP Cashier: Register #: Ship To: Donald Bertron 4370 North Bayview rd. South Hold, 117971 2:49:00 PM 1 1 UNDERWRITERS CERTIFICATE REQUIRED Description .. 10 X 20 Mini Barn Almond Siding Clay Trim Slate Asphalt Roof Optional Eve Vents Discount 4X4 Ramp Deliver Sat.4-20-O2 2-4* Ouan'fity" Price I $3,145.00 Extended $3,145.00 ($15o.oo) ($15o.oo) I $85.00 $85.00 I $0.00 $0.00 OCCUPANCY OR 456 Route 25A · P.O. Box 501 · Mt. Sinai, NY 11766 (631) 474-3800 · Fax: (631) 474-3820 · WWWmgeragardens.com USE IS UNLAWFUL Ap?,ROY, ED AS NOTED WITHOUT CERTIFICATE DATE~m... ~.E.~..~ OF OCCUPANCY .,.,.~,'!:~, NOTIFY ~UILDI~-G DEP~ ~'~ ~'~ 766-1802 9 AM TO 4 PM FOR TH[ mE COUp~T~ ~O. CF0. ..... F Su~ ~o~ S~,OSO.OO ~W~R~ 8HALL MEET Tax $261.80 ~T~r~E~TS OF THE ~.[ Total $3,341.80 S~)~~TION & ENERG~ ~ ~endered $3,341 80 *~. on co.s~.ucno. ~.qh , ~~ C,~n~ ~u~ S0~00 FROM :GERA,GARD FAX NO. / room galor~...~ ni~ rll~tic hl~il~in~ the ~RN is evai}abJe in many sizes and manv options (see ~ 4). ~}~. ~re th~ ~e for a]l our bui~i~s (page :16314743820 ~pr. 18 2002 09:11AM P2 I]oors are patnted both .~ides -- note ~oma - Ma~ ....... ~ ).0x12 BA{{~{. Blue w,th white trim shown with c~-L'.or~ i~;~,. Each year we give a~m~y a weathervane to the most purpose for one of our buikiings. L Write to us with yoursl Shown in 12'x15' size with optional cupola and weathervane. 16 White with green trim, slate color roof. a-WE LOI/E OIJII IlAI~. it as our well-lmilt home. a butlding for a as long are getting i~ Importont waste, Our