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Home My WebLink About29577-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29603 Date: 07/29/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 820 GABRIELLA CT MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Ta~ Map No. 473889 Section 108 Block 4 Lot 7.25 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULy 11, 2003 pursuant to which Building Permit No. 29577-Z dated JULY 15, 2003 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" ACCESSORY SHED AS APPLIED FOR. The certificate is issued to ROGER T & CHRISTINE L FOSTER JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'l'mu N/A N/A N/A ~//d~i~nat ute Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29577 Z Date JULY 15, 2003 Permission is hereby granted to: ROGER T FOSTER JR MATTITUCK,NY 11952 for : CONSTRUCTION OF AN ACCESSORY SHED IN THE REQUIRED REAR YARD "AS BUILT" AS APPLIED FOR (PRIOR TO 2003) at premises located at 820 GABRIELLA CT County Tax Map No. 473889 Section 108 pursuant to application dated JULY Building Inspector to expire on JANUARY MATTITUCK Block 0004 Lot No. 007.025 11, 2003 and approved by the 15, 20O5. Fee $ 150.00 ! Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~4-&-;/ .. - - APPLICATION FOR CERTIFICATE OF OCCUPANCY Ii This application must be filled in by typewriter or ink and submitted to tile Building A. For new building or new use: ~._ 1. Final survey of property with accurate location of all buildings, property lines, str¢~s-, 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 1% lead. 5. Commercial b~ilding, industrial building, m~ltiple residences and similar b~ildings 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. 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, streets, building and unusua1 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 tbe 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 $25.00, Swimnfing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Cmlificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Constrnction: Location of Property: ate. q-03 Old or Pre-existing Building: i~'~ _ (check one) House No. Street Itamlet OwnerorOwnersofProperty: Chr'~-'~//~C7 /-~C)~t~J'"' ~,q~-~Leff"~ Suffolk County Tax Map No 1000, Section ] 0 7 ~J Block Subdivision ~ Filed Map. eemfit No. 2~ ~ ~ ~ Health Dept. Approval; Plamfing Board Approval: Request for: Date of Permit. *'~'/~- 0_3 Temporary Certificate Lot 025-'- Fee Submitted: $ o.~,~_ O0 Q jif' ~p~hcant Signature' - Lot: Applicant: ~---~tq~//?e ~/~,~ ~/"~ Underwriters Approval: Final Certificate: 1...-~ (check one) Date Reviewed: ~ Date Submit,ed: 2~//~ I.ocalion: Project Description: AGENC'Z?ERMITS ~_UIRED FOR p, EV!EW Suffolk County Health Dept. New Yor~k State D. E. C. Town Trustees Town Zoning Board approval: Town Plaiming Board approval: Flood Plane Elevation 777 Flood Zone: NO YES _Permit : Numbe_r Notes: 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~JL~A~ON [ ] FRAMING [ ~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c 7/~,~ , 20 03 ~_, 20 P3 Expiration ,20os-- PERMIT NO. BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans plannmg Board approval Sm'veX Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: c~/~'o~/2 Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS G- / 0 ,:o 0.5 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 cornmenced 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 inspection throughout the work. e. No building shall be occupied or use{ 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 admit authorized inspectors on premises and in building for necessary inspections. k'-~(Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises '~O~-'f- f~SJC4r~Tr' ~ O)t')S~-;flC (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. 1. Location of land on which proposed workkvill be done: Gab iclla, Court- House Number Street Hamlet County Tax Map No. 1000 Subdivision (Name) Section /0 ~ Block 000 L~ Filed Map No. Lot Lot State existihg use'and occupancy of premises and inten.ded use and occupancy of proposed eonstnlction: a. Existing use and occupancy ,~hCC~ D U'~ U/') [F~ ~ 1- L/e6l/~ l t r)eed CO b. Intended use and occupancy 3. Nature of work (check which applicable): New Building. Addition Repair Removal Demolition Other Work Estimated Cost ~ /-/0 0 0, 0 0 Fee If dwelling, number of dwelling units If garage, number of cars Alteration (Description) (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 ofexisthag structures, if any: Front [ ~- ~' ~-~ '~ Rear .Depth Height. c~ i Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 9. Size of lot: Front 10. Date of Purchase 11. Zone or use district in which premises are situated Dimensions of entire new construction: Front Height Number of Stories 150,35' Rear 15Q.3(o' Name of Former Owner Rear .Depth 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO t~ 13. Will lot be re-graded? YES__ NO t'~Will excess fill be removed from premises? YES __ NO t~ C rtsttne oqe. r T oSle 8'20 6abr tlr C 14. Names of Owner of ~remises U ~'-t" Address ?-164 f~t'tt/O(- Phone No. ~--c~ - ((4~J2 Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES * 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 MAY BE REQUIRED. J 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) COLrNTY OF~_~S: CJr){l,~'llq~ (O~3[e.~ being duly sworn, 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 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,~ i I dayof Notary Public Monlc. Cedse NOTARY PUBLIC State of New No. 01CE605940~ Qualified In Suffolk County Commission Expires May 29, 201~3 of Applicant I r~' 0