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Home My WebLink About40633-Z =�Q�c��FFD��,oG�� Town of Southold 7/20/2016 P.O.Box 1179 a �' � 53095 Main Rd ��y,�y0� ��p,�� Southold,New York 11971 � CERTIFICATE OF OCCUPANCY ,No: 38395 Date: 7/20/2016 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 9562 N Bayview Rd., Southold SCTM#: 473889 SecBlock/Lot: 88.-2-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in tlus office dated 4/12/2016 pursuant to which Building Permit No. 40633 dated 4/20/2016 - 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: REAR DECK ADDITION TO AN EXISTING ONE FAMILY DWET,LING AS APPLIED FOR The certificate is issued to Bazata,Martin of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED � Auth ' d Signature o�S�FFaa�,�O TOWN OF SOUTHOLD � �� BUILDING DEPARTMENT � � TOWN CLERK'S OFFICE � • � SOUTHOLD, NY y�o� � �ao� , 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#: 40633 Date: 4/20/2016 Permission is hereby granted to: Bazata, Martin 9562 N Bayview Rd Southold, NY 11971 ' To: construct deck addition to existing single-family dwelling as applied for. At premises located at: 9562 N Bayview Rd., Southold SCTM # 473889 Sec/Block/Lot# 88.-2-19 Pursuant to application dated 4/12/2016 and approved by the Building Inspector. To expire on 10/20/2017. Fees: ' � SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $555.20 CO -ADDITION TO DWELLING $50.00 Total: $605.20 Bui ' g Inspector Fo�m No 6 `CO�'�'N O[�SOUTC-fOLD BUILD[NG DEPAFtTMEN"C TO�N C-iALL 765-1802 AI'PLICATION �'OR CERTIFLCATE QF OCCUPANCY Ttus applicat�on must he filted in by typewriter or inlc and submitted to the Building Department with the following: A. �'or new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograpliic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3_ Approval of electncal 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% 1ead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible £or the building. 6_ Submit Planning Fioard Approval of completed site plan requirements_ B. For existiug buildings (prior to A.pril 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 buiiding$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 - �- - - ..... . _ . . 3. Copy of�Certificate-of Occuparicy i � ti��OF SO(/T�,olo , '� '� -� • � • �o - ��DUNi'1,0ct1� � TOWN OF SOUTHOLD BUILDING�DEP7'. ' 765-1802 NSPECTION � _ . [ FOUNDATION�,1 ST [ ] ROUGIi PLUMBING [ ] FOUNDAT_ION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL � [ ] FIREPLACE � CHIMNEY [ ] FIRE SAFETY INSPECTION - [ ] FIRE RESISTANT CONSTRUCTIAN [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: �-, � � DATE � INSPECTOR - �}.�� ho��OF SOUlyOlo - W , - - '� '� � � _ - , � • �o ' . � ��y�OUM`I,� . - TOWN OF SOUTHOLD BUILDING DEPT. -� � - � � 765-1802 � 1111 �PECTIO�N � - � ` [ ] FOUNDATION �1 ST [ ] ROUGH PLUMBING [ ] F NDATION 2ND [ ] INSULATION � [ FRAMING / STRAPPING [ ] FINAL � [ ] FIREPLACE � CHIMNEY [ ] FIRE SAFETY INSPECTION ` [ ] FIRE RESISTANT C�NSTRUCTION [ ] FIRE RESISTANT PENETRATION � [ ] ELECTRICAL (RAUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATIO [ ] CAULKING � RENAARKS: �-� � c . DATE � � �� INSPECTOR ' � ,. G � ' l• ';,� FIELD?2`YS�,'��41�71�p�oz��hC A� � �o�, � � +' ` � � , • _ � � � • � � , ' �'OU�IDA'�'SO�i(1S'Z'} , � � �� ' � ' � . � � � . � . � � w �r�rrrwr�'4�wi�rsV�w��Y��Y�� ' . . ' ' ' , ! ' �� , � �ot�xn��xQx'�2rm> . . ' � , .. . , . , . �o � �� , . , � , , , � � � . . � � y � Rov�x��xG& ' � � ' � ' ' . '� , � ' � �� . PLU•NA3Tl�i'G �� . ,� , � ' � ' . ,� � • .' . . � � , ;. � , . , , , ; . ' ' r ' ..-:.. �. „ , , . , . � , 'r • ,. . , � , � � . � , � � � � TNSULATXON PE1�.N��', . • . � • �`� , STATE EN'E'RGY�QS�� , , , , � , � � , � � � _ . • f ,., . !� c. p . . , , , � � , � � • , � , • . . . � , ' �'Tt��A� , ' • • . . • ' • , . ., . , , • � � � . . , � , , � � `�z -r� _' . , , .. , . . . � �-a, l�� 5,.2a, � � Sa� , ��- , 3� .. � , � � , ,. , . . ., . , . . , �o , � , • � � � . . ��--�� ...., .�. . , .. , � „ , �� ' , . . . � � � � . . , � ' ' . ' , , . , . � � , . , � ' . i . , . . � ' c . . , . . , � , �� . � • � � � � � , . . . . � � ' . . . � • � z . • , • , � . � ' . � � ,� ' . . - , , • . , � . � , .� E� . ' � � � � . � i� ' a ,..' � ' , " ' ' � ' , , � t� . � , - . � ; , � � , � , . J � TOWN OF SOUTHOLD BUII.,DING PERMIT APPLICATION CHECKLIST � . �y, BUILDING DEPARTMENT Do you have or need the follow�ng,before applying7 TOWN HALL Boazd of Health SOUTHOLD,NY 11971 4 sets of Buildmg Plans l TEL:(631)765-1802 Plannmg Board approval FAX:(631)765-9502 O f_ 22� Survey , SoutholdTown.NorthFork.net PERMIT NO. (P��J Check Sephc Form D ��.O('0 n� N.Y S D E.0 , - V Trustees n C O.Applicat�on �y Flood Permit Exammed V 20 Smgle&Separate , - „ APR � 2 2p16 Storm-Water Assessment Form coote�t: • Approved 20� B�D�G DFPT� 16fdfr� 1�(ar D�sapproved a/c � TOW1�1 OF SO LD � � �_ .7��I� �� Phone• Expiradon V 20 / . . Bu ing Insp or ' APPLICATION FOR BUILDING PERMIT Date f 1 t- f L 20 f � • INSTRUCTIONS a:This application MUST be completely filled in by typewriter or in ink and submitted 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,relationslup to adjoining premises or public streets or areas,and waterways. � c.The work covered by th�s application may not be commenced�before issuance of Building Pernrit. , d.Upon approval of this application,the Buiiding Inspector will issue a Building Pernrit to the applicant.Such a permit shall be kept on the premises available for inspection throughout We 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 a$er the date of issuance or has not been completed within 18 months&om such date.If no zoning amendtnents or other regulations affecting the property have been enacted m We interim,the Suilding 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 Pemut pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regu(ations,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,ho mg co ,and regul ' ,an Q admit authorized inspectors on premises and in building for necessary inspections � � I ' � (Signature of appli t or name,if a corporation) ��o� �P�v=!� 1�� C1l�C� �c� (Mailmg address of app icant) �c:��t l C`J z—� � State whether applicant is owner,lessee,agent,azchitect,engineer,general contractor,electrician,plumber or builder (�Ww�c/ Name of owner of premises �"` ,�/'i i� �u.Z�°-�`� (As on the tax roll or latest deed) ,If applicant is a corporation,signature of duly authorized officer (Name and title ofcorpor �o,�tcgr)�� Builders License No. � 7 / , Plumbers License No. , � Electricians License No. ' � Other Trade's License No. ' � 1. Location of land on whic pr posed work will be done: yJ v�� , z��' � ��lP��a� r�o�� rr,.��,.�.�b�,��.� a� ��. ��y�,� sm�.vw House Number Street �� Hamlet County Tax Map No. 1000 Section � Block C�Y' Lot v � �� - l� �,; Subdivision ��/I<<a^'� �,+�ov Ci� Filed Map No. Lot J �' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a E�sting use and occupancy ,Pi��r,�y �� b. Intended use and occupancy ��'�� !J v'"`� 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition �ther VJork ��i�G�- ' (Description) 4. Esrimated Cost 12�nA� Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing shuctures,if any:Front Rear Depth Height Number of Stories � Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front Z6s•� Rear �� Depth ��> ' 10.Date of Purchase Name of Former Owner 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��VJ'ill excess fill be removed from premises?YES NO v 14.Names of Owner of premises �'!r,/�'h �5��' Address L�t 3 Phone No. �6��—�3 F l Name of Architect Address Phone No Name of Contractor 5��- Address Phone No. —.�Z� -73(o� 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 1VIAY 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 NO � *IF YES,PROVIDE A COPY. STATE OF NEW YORK) TRACEY L. DWYER SS: NQTAFiY PUBLIC,STATE OF NEW YpF�K COUNTY O�� ) NO.01 DW6306900 AUALIFIED IN SUFFOLK COUNTY � V�� 2 a being duly swom,deposes and says that(s)he is�p�]jg�1pN�p�R�JUNE 30,� (Name of individual signing conlract)above named, (S)He is the �� , (Contractor,Agent,Corporate 01�'icer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file Uus application; � that all statements contained in ttus 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��efore me tlus day of � 20� � Notary Publ' " Signature of App ant , , ` .�"t�`��z%�.r Scott A. Russell �b° 'f�� [��0�]E�.I��J[\�vA\�C'JE]E�. SUPERVISOR `�j � � \cG��EI��IUE��C' � ��. I��1[A\I�A SOUTHOLD TOWN HALL-P.O.Box 1179 4p �'•� � 53095 Main Road-SOUTHOLD,NEW YORK 11971 �� . To wn of So u th o l d O� �.7r��,� �C CHAPTER 236 - , STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) l��l� '�']E-�d5 1P�8��lE�'�' �1��1[,�]E ��1' olE' '�']E�IE ]E'�lL�.,��d�I�: - Yes No . (CHECK ALL THAT APPLI� ❑�. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑[�B. Excavation or filling involving more than 200 cubic yards of material . within any parcel or any contiguous area. . ❑�C. Site preparation on slopes which exceed 10 feet vertical rise to ` � 100 feet of horizontal distance. � ❑[j" D. Site preparation-within 100 feet of wetlands, beach, bluff or coastal , � erosion hazard area. ' � � ❑�E. Site preparation within the one-hundred-year floodplain as depicted - -- -:-- - - - - � � -on-��R1V�--�Vlap-of-any wate�r-cou-r-se_- -- --- -�--- - -� - --- - - ❑�. Installation of new or resurfaced impervious surfaces of 1,000 square � , feet or more, unless prior approval of a Stormwater Management ` Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. � If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of ihe above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. ' S.C.T.M. #- 1000 y Date APPLICANT• (Property Owner,Design Professional,Agent,Contractor,Other) �j� / � � �f Disinct�' / �—��—/� NAME � �� "' � � � � �`� w, Sectian Block Lot K °�s"'�"", / �'.. i�OR IiL�iLDI\G DE}':11?"1'��t�i�T t.�L c�i1L�� „" Cont�ct Inform�tion. �O � /� �(�J�� / �C7 I -rn�vi�,r��nn,o Reviewed By- — — — — — — — — — — — — — — — — — — � — — Date• " !'��'�� Pro ert Address/ Location of Co��struction Work: — — — — — — — — — — — — — — �j�� ' nU�� j'� �1�� Approved for proces�ing Bwlding Permrt. � l�� Stormwaler Management Control Plan Not Required �l � �. /9`"` f (� � � Stormwater Management Control Plan ia Required. � (Forward to Engineenng Department for Review) FORM " SMCP-TOS MAY 2014 i �.� �..1 �--� . .F� �� ` �,,<.�"�,-�� ,--- ,- r-.. � " - � � ,�' � �'� � � , =c�...-�; ` ��~��--� W� �.�� .,� �� TOWN OF SOUTHOLD PROPERTY RECORD CARD d �� ;,:�� OWNER � STREET � VILLAGE DIST. SUB LOT � � {��"��' �� "` ----- � f��: -� t`��f�e,� . 11r: ��I i�� 1��f� �� , �� ' �.�.� ,�, v� ��.r �� . �� t� � t� .�� i��.� �� .��' .� ,� ACR. �e � T� REMARKS � �- . �a TYPE OF BLD. ,�,� , PROP. C�I,ASS �'�� '' _ ` _ : I�,�� -r 1 � � ��? �-� �l� � �`�� \ LAND IMP TOTAL DATE _ `l - _ �,r/��e'�, ,++a'.��a t.=:: (�hJ,/p"', + ,n tp'q�:= �ry 1�yp� ,s� � y ,.j f� W `,� (��1 d� �e t� 1 ^ ,�q • +n. 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V I� FRONTAGE ON WATER TILLABLE �'' .. �° �S`�' - '�-r`� � , FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND �� ----- — �C ... � �� BULKHEAD HOUSE/LOT TOTAL r-j ��" ------------- --�---------------- --- --- - — �i=.. 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'�.... _ ••• -_ _ - '� � � � � t _ � __... . �..:. _.._.._ ! � o � .. .....rr .. ...__.. � 686.96' TO � SEAWOOD DRIVE NORTH BAY__ �_ _ -- _ __ — — — -_ _ .__.._. .��._..___.,.�._ ; �, , _ ,a .. = ; � � � ' _ �' .^ j I I � - ; ,� ',( �, - .,�� } ;; � I I "-. . - , o - .,r .�:�:i � - P __ � (� I��C� �`: � I .', `" ;>t C: a�7 c; � � Q � �I ' �- ' '- i`-a i j i. .;� ? � I � I , yyi y� !'S � � i 'r� . -_ -- - � . j;;� 1 N � . :i; t .. '� , f?'� z�`' � I ~ i , f ` �� `� Ta� i � . ? _ -- ' , l�� Sc-� ia ? I in � , I ` ; ? �'� � I N _ 9 �• r � R=50.�Q' � - '' _ - E W `'� L=52.36' - - -- --- --- - - _ - _ :- =-�--i�- � —� - -� - -, I . �- - - - -_- _ , - - - ; � . -� --• ~•~ LOT No. 2 .. S6 '52'50"E 118.30' o.�. o,io o.i. LOT No. 4 �� • S67'52'50"E 190.00'o�N� - �� BI�K�Rlyp �RHS s�w in f� l.P LP. m � w S7. � � PORCH R ' � y� 7J.1 - � FLACP �� at ' b,s.e z s1Y. FR.Ze � STONE � 1 1/2 ^ DWELLING w DFI�E STY .Y GAR. Z U �f VTJOD � . (n �. Y Q � � L � d' O '��/�� M Z CERTIFIED T0: J �� a� o w �« �� r� ° �,��,� \C�\�� HUT ^ 5.9' � _�_ N 3 rHE EXISTENCE OF RIGN7S OF WAY Z � AND/OR EASEMENTS OF RECORD lF ^ ANY, NOT SHOWN ARE NOT 0 GUARANTEED. LOT NO. 3 N N UNAUTHORIZED ALTERAT/ON OR ADDITION Z.40 ACRES N TO THIS SURUEY lS A 1/IOLATION OF ' SECTlON 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURI/EY MAP NOT BEAR/NG TNE LAND SURUEYORS INKED SEAL OR r�o Mor� EMBOSSED SEAL SHALL NOT 8E CONS/DERED o.se — TO BE A VALID TRUE COPY. N69�26 �J� W 265.�� GUARANTEES lND/CATED HEREON SNALL RUN ONLY TO THE PERSON FOR WHOM THE SURL�EY IS PREPARED, AND ON H/S BEHALF TO THE LAND N F AKSCIN TITLE COMPANY, GOVERNMENTAL AGENCY AND � LEND/NG /NSTITUT/ON LlSTED HEREON, AND � TO 7HE ASS/GNEES OF 7HE LENDING INSTI— � TU770N, GUARANTEES ARE NOT TRANSFERABLE. SURVEY OF: DESCRIBED PROPERTY 1�� ALSO KNOWN AS LOT No. 3 ON MINOR �� SUBDIVISION OF °PELLICANO WOODS" ��,� ,� KENNETH H. BECKMAN. L.S. SITUATED IN• BAYI//EW ��`°^ �� Surveying and Land Planning ' �� &�, � 1814 Middle Country Road TOWN OF: SOUTHOLO ``'�� `�^' N.YS 11981 ��°�� Ridge, SUFFOLK COUNTY, NEW YORK �`��'� a`�a (631) 345-9427 FAX (631) 345-9429 DATE: 4/7/97 JOB N0. B7-2737 S�ALE: 1.� = 60' DIST. SEC. BLK. LOT ` � S.C.T.M. N0. 1000 .� ° �.--8�8' �T SURVEY BROUGHT TO DATE 11/30/2010 B10-13146 , - p.�- ,*- FINAL,SURVEY 6/4/02 802-6926 rS FOUNDATION LOCATiON 3 10 98 88-3491 'P � �` ,jl � �ba� ��,� �� o�� DATE: I� .�Q�.P.�# � � � FEE: 5� BY: , , NOTIFY BUILDlNG DEPART�9 , AT 765-1802 8,4M TO 4 PM FOR THE FC�LL�V�ING INSPECT{0�lS: i. FOU[�dDATIQN - ?�li0 REQUlRCD _ FOR PGURED CUNCREi"E 2. ROUGI-i - FRANfING � I'LUIV1�!{�!G 3. lNSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLE�rE FQ� C.O. ALL GO�ISTF�tJC�I�N S4-IAI.L (NEET TNE " REQU{RE�PE�iTS nF 7HE CODES OF NEW YOR64 STATE. NOi' RESF'ONSIBLE FOR DESIGN OR CO�lSTRUCTIaN ERC�ORS. 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