HomeMy WebLinkAbout12115-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25007 Date MAY 6, 1997
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 1160 SNUG HARBOR ROAD
House No. Street
County Tax Map No. 1000 Section 35 Block 5
Subdivision Filed Map No.
GREENPORT, N.Y.
Hamlet
Lot 39.1
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 7, 1982 .pursuant to which
Building Permit No. 12115-Z dated JANUARy 17, 1983
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 STO~AGE TOOL SHED AS APPLIED FOR.
The certificate is issued to DORIS M. MOLITOR
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
~/a
N/A
spector
Rev. 1/81
TOWN OF SOUTHOLD
BUILD~NG DEFA~TMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING ~E~J~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 12115 Z
Permission is hereby granted to:
........... ...........
,o ............. ~.,.~, ~z~.~'....- -- :-- .~. ~ ~_ ~ ~ ~¥..~-~......~.~ ~ ....................
~&~...~~.....,~.~..¢.....~. ...... ~..~/~.~...z.., ........... ~..~....;~..~.~.~
County Tax Map No. 1000 Section .... ..~....,,?..~ ....... Block ....<~...-~..~.....,. Lot No.
pursuant to application dated '"~~"Z' .............. , ,9.~.~.~...,Z"and approved by the
Building Inspector.
Fee $..~....(~......~'.. .......
Building Inspector
Rev. 6/30/80
0 IgOT
B1.DG. D~PI.
TC~WN OF
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOW~ HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the 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 featu~res.
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 Bolder 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 Planning Board Approval of c6mpleted site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-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 a 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.
Fees
1. Certificate of Occupancy - New dwelling $25.00~ Additions to
dwellS.? 5.~v,
Alterations to dwelling $25.00, Swiunnmng- pool $25,O0~A6cesso~y----~uilding $2~0,~
Additions to accessory building $25.00. Busin~sse~O:OO':~-~----
2. Certificate of Occupancy on Pre-existin~ Buildin~ '- $1'0~.00
3. Copy of Certificate of Occupancy - ~ .25¢.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...q~77.~2 ..............................
New Construction ........... Old Or Pre-existing Building ....... · .........
H~r~9~ Road Greenport
Location of Pro~.$gP~ ..............................................................
House No. Street Hamlet
DORIS M MOLITOR
Onwer or Owners of Property ...................... .. ... . .. ... ~ ......... . . . ....................
County Tax Map No 1000, Section. O.5. .......... Block.. ~ ........... Lot...~P.-.0. O.1 ............
Subdivision .................................. .. Filed Map . ...... ~ .... Log ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval .................... . ...
Request for: Temporary Certificate ........... Final Certicate..//...~..j/ .v
Fee Submitted: $..2.5.. Q.O ...................... ,//' F/~//- ~//~,
..... .................
7G5.1802
BUILDING DEPT,
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH ~PLBG.
FOUNDATION ZND 1- ] INSULAYION
FRAMING [/-~NAL
REMARKS:
DATE ~//,/77 INSPECTOi! i ~~~/~· /
PI~tD INSPECTION
1.
FOU~'DATION ( 1 st)
POUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C,ODE
FINAL
COMMENTS
RDDITION~L COMMENTS:
,/
NEW YORK STATE DEPARTMENT OF ENVtRONMENTAL CONSERVATION
PERMIT
' PERMIT NO.
I0-82-0985
UNDER THE ENVIRONMENTAL CONSERVATION LAW
] ARTICLE 15, (Protectimt of Water) [] ARTICLE 25, (Tidal Wetlands)
ARTICLE 24, (Freshwater Wetlands) ~] ARTICLE 36, (Construction in Eiood Ilazard Areas)
PERMIT ISSU[D TO
'~.. John Motito~t
~t)DRessOEPeRMErte~
32 Snag Harbor Road, O~eenport, NY 11944
LOCI\]lOb} OF PROTECT (Section of slream, tidal welland, dam, building)
G~l Pond; Vi&~age of Greenport, To~n of Sea, hold_,. S~ffolk Cou~
D~SCRtPEiDN OE PROJECT
Pla~em~.~Z of 8' X 12~ ~ol shed 60~ Zan~d of ~d~ w~and bo~yz Thee ~ be no ex~-
v~on and thee ~ be no ~banee f~om the ~?je~ ~ea se~d to the ~ w~and
(OuZl. Pond).
::OMMLJNITY NAME (City, 'lown, Village) ] TOWN
Greenport ] SO,old
LOUNrY [FIA COMMUNITY NO. JDAMNO. ergt Er '[;iRA T N DATE
Suffolk
CONDITIONS
8, That the State of New York shall itl no case be liable for any damage
or ~njury to the structure or work herein authorized which may bo caused by or
result from future operations undertaken by the State for the conservation or
improvement of navigation, or for other purposes, and no claim or right to
compensation shall accrue from any such damage.
9. 1hat if the display of lights and signals on any work hereby authorized
is not otherwise provided for by Jaw, such lights and signa~ as nlay be pre-
scribed by the United States Coast Guard sball be in,tailed nod maintained
by and at the expense of the owner.
10. All work carried out und~,r this permil shall be performed in accor-
dance with established engineering p~actice and in a workmanlike manner~
11. If granted under Articles 24 or 25, the Department reserves the right
to reconsider ~his approval at any time and after due notice and hearirig to
continue, rescind or modify this permit in such a manner as may be found to
be just and equitable. If upon the expiration or revocation of this pe~mJt, the
modification of the wetland hereby authorized has not been completed, the
applicant shall, without expense 1o the State, and to sucb extent and in sucl]
time and mann&r as the Department of Environmemal Conservation may require,
remove all or any ~ortion of the uncompleted structure o~ fill and restore the
s~te to ils for~er condition. No claim shall be made agaisst tile State of New
York on account of any such removal or alteration.
12. This permit shall not be construed as conveying to the applicant any
right to trespass upon the lands or interfere with the riparian rights of others
to perform the permitted work or as authorizing the impairment of any rights,
title or interest in real or personal property held or vested in a person not a
party to the permit.
13. Th~ peimittee is responsible for obtaining any other permits, ap-
provals, la. nds~ easenlents and rights.of.way which may be required for this
project.
14. If granted under Article 36, this permit is grained solely on the basis
of the requiren!ents of Article 36 of the Environmental Conservation Law and
Part 5000[ 6 NYCRR (Construction in Flood Plain Areas having Special Flood
Hazards -;gullYing Permits) and in fig way signifies that the project will be
free from fl9oding.
15. By ,acceptance of this permit the permittee agrees that the permit
is contingent bpon strict compliance with the special conditions on the
reverse side.
GENERAL
1. The perm~ttee shall file in the office of the appropriate Regional
ermit Administrator, a notice of intention to commence work at least 4~
ours in advance of the time of commencement and shall also notify him
omptly in wriling of the completion of the work,
2. The permitted work shall be subject to inspection by an authorized
)presentative of the Departmenl of Environmental Conservation who may
rder the work suspended if the public interest so requires.
3. As a condition of the issuance of this permit, the applicant has
eptod expressly, by the execution of the application, the full legal respon-
dJdity for all damages, direct or indirecl, of whatever nature, and by whom-
vet suffered, arising out of the project described herein and has a§reed lo
~demnify and save harmless the State from suils, actions, damages and
osls of ewry name and description resulting from the said project.
4. Any m~terial dredged in the prosecution ot the work herein permitted
hall be removed evenly, witbmd leaving large refuse piles, ridges across the
ed of the watmway or flood plain or deep holes that may have a tendency to
5. Any material to be deposited or dumped under this permit, either in
:~e waterway or on shore above high-water mark, shall be deposited or dumped
I the locality shown on the drawing hereto attached, nod, if so prescribed
Person, w~thin or behind a good and substantial bulkhead or bulkheads, such
s wdl prevent escape of Ihs nlaterial into the waterway.
6. There shall be no unreasonable interference with navigation by the
7. Thai if future operations by the State of New York require an alteration
bslruction lo the free navigation of said waters or flood flows.or endanger
~e health, safety or welfare of the people of the State, or loss or destruclion
t the natural resources of the State~ the owner may be ordered by the Depart-
hereby wilhout expense lo the State; and if, upon the expirallon or revocalion
f this permit, tile structure, fill, excavation, or other modification of the
ondltion the navlCable and flood capacity of the walercourse. No claim shall
~-:)0-4 (9/75) (SEE REVERSE
SIDE)
SPECIAL CONDITIONS
SEE AT~ACHED CONDITIONS A - J.
PERMIT iSSUE DATE
Dec..emb~r 10, 1982
i PERMiTADMiNiSTRATO, R, ,j~--~-.,,..) (~/w f,--'--T^DDRESS B~g. 40, S NY--Room
"
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
.....
PLEASE TAKE NOTICE that your application dat,d...~..O."~......'7 ........... , 19~d.
Location of Property .,.~(O ..... ~.M~ ~~.~ .........
~ouse rye. , ~ St~t ~ / / Hamlet
Co..t~ T~ M~. No. ~O0~¢t~o.... ~J.~... moo~ ... ~.& ...... Lot ...~ ~ .....
, ~c~ ~ .
Building Inspector
RV 1/80
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
> ~ SOUTHOLD, N.Y. 11971
Examined...~7~.~.('7(..."./..., I9 ~.~ ~
Approved . .J-..~. (.Z..., 1~ Pe~it No.. /~
Disapproved a/c ~:.~ .... C~..~....~..
~ ~D ~'' ~' (Building Inspector)
Application No.. t/. .~./../.~.:. ......
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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
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.
(S~a~ure of applicant, or name, if a corporatio )
.....
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . . . .~:~..~..~...~. · .'.'~..~.-- ..........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .... ~.~. ..............
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
I. Location of land on which proposed work will be done ..................................................
~ House Number '~' Street Hamlet
County Tax Map No 1000 Section (~) "~'~ Block .... ?...~.. ........ Lot . . .O...~. ~. ..........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
b. Intended use and occupancy ....................................................................
3. Nature,of work (check which applicable): New Building . .~. Addition .......... Alteration ..........
Repair .............. Rem6val ............. Demolitionv . Other Work ...............
(Description)
4. Estimated Cost ....... .~../.O?.!f.~ .... : .................. Fee ...... ./~...~. ~ .......................
i (to be paid on filing this application)
5. If dwelling, number of dwelling units. ~.ff.d.L...~../~, .~..~. 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 structure~, if any: Front ..... ~.. ,1?t 7.~.... Rear .. ,97~.-:. ~ ..... Depth ....%-..f~;..'-..r?....
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 ..... ~..v: Z.~'... Rear ..... .~r'?., .'7 ..... Depth .../..>-~.,. ~ .....
Height ............... Number of Stories ........................................................
9. Size oflot: Front ...... 2.l. _,~r. ......... Rear ....... .-~..7~-.5'T. ....... Depth .. r ../.~..~--~ ..........
10. Date of Purchase ..... l .~..~.~'./. ................ ,N, ame of Feigner OwI~er ....t'7~.. '..~ ................
11. Zone or use district in which pr~mises are situated ~ ~ ~ ' '
12. Does proposed construction violate any zoning law, ordinance or regulation: ...'%4> ..........................
13. Will lot be regraded ......... , ................... Will excess fill,be removed from premises: Yes
14. Name Of Owner of premises .ff.~ )~tO./~.-...~q/.~.'.)g~ i Address ?.'..O....~.. q-/.. (o. ~.... Phone No. ~ ~ ~ .-../ ......
Name of Architect ........................... Address ...CT?.v~,p.~: ........ Phone No ................
Name of Contractor ........................... Address ................... Phone No ................
PLOT DIAGRAM
Locate ~learly and distinctly alii buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block humber or description according to deed, and show street names and indicate whether
interior or corner lot.
A
STATE _O.F NEW_ YORK, i~ ~'/,,.- L ~0 ~ D
COUNT~OF. ~P. F ~ ~ ~ ,,S. S , ,,
....... U~. ~ .~ .... l~ ,... ~.e~ ~ 5. ~q.~ ........ being duly sworn, deposes a t~28,t-~applicant
(Name of individual signing contract)
above named.
He is the ...... ~ .................................................................
, (Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is dul~ autho~zed to perform or have perfo~ed the said work and to m~e ~d file ~is
application; that ail statements contained ~ this application are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~ne} set for~ in the application filed therewith.
Sworn to before me this :
.......... ~ ....... day o~. ~M~'-. ..... ,19
Not~ Public, ...... ~ ..... z.: ~... County ~f