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Home My WebLink About29408-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29661 Date: 08/27/03 T~I$ CERTIFIES that the building ACCESSORY Location of Property: 4805 DEPOT L~ CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 96 Block 5 Lot 2 Subdivision Filed~ap No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 21~ 2003 pursuant to which Building Permit No. 29408-Z dated MAY 23, 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 REPAIR AN EXISTING ACCESSORY SHED AS APPLIED FOR. ~e certificate is issued to TROIS ANGE LLC of the aforesaid building. (OWNER) SuFFOLK COUNTYDEPARTMENT OF~%LTHAPPROVAL ELECTRICAL CERTIFICATE NO. PLUMBBP~ CERTIFICATION DA'r~u3 N/A N/A N/A nature Rev, 1/81 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. 29408 Z Date MAY 23, 2003 Permission is hereby granted to: ANGE LLC TROIS NEW YORK,NY 10012 for : REPAIR/RECONSTRUCTION OF AN EXISTING ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 4805 DEPOT LA CUTCHOGUE County Tax Map No. 473889 Section 096 Block 0005 Lot No. 002 pursuant to application dated MAY 21, 2003 and approved by the Building Inspector to expire on NOVEMBER 23, 2004. Fee $ 75.00 ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN I~_LL 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. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement fi-om plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial buildiug, industrial building, multiple residences and similar buildings aud installatious, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existiug" land uses: 1. Accurate survey of property sho ~ing all property lines, streets, bnilding and unusual natural or topographic features. 2. A properly completed application and consent Io inspect signed by the applicant. Ifa Ccrtificale of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the appficant. C. Fees 1. Certificate of Occupancy - Ncw dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinmm~g pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existi~*g Building - $100.00 3. Copy of Certificate of Occupancy ~ $.25 4. Updated Cetlificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / New Construction: v/ Old or Pre-ex/sting Building: (check one) L°cati°n ° f Pr°pertY: ~/H~ooHo[;s et9 NT~. Strect °{7'~t//t~ - ------~t~--~ -- Owner or Owners of Properly: Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Plmming Board Approval: Request for: Temporary Certificate ~ Block 000 ~ Lot O C.~.~_ . Filed Map. Lot: DateofPem~it.~_~ Applicant: -7-',,Q'O/5 .A~A/¢~- /--~-~-- Underwriters Approval: Final Certificate: (check one) Fee Subnfitted: $ ' AppliL'-Jmt'Signature'~ O BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: 5 ~03 APPLICAN (qC ~ /~L'C_ DATE SUBMITTED: ~L.Q }/03 SCTM# DISTRICT: 1,00Q, SECTION: Q/::> , BLOCK: ~ , LOT: _o~ SUBDIVISION: ADDRESS: _24~ _C~::~.~'~,~P0T CITY: ~~_ZON1NG DISTRICT:__ CONFORMING? BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- , INFO / BP BP ~/C/0 Z- - ,1NFO / BP PR~ coY~_~ N~g BP -Z / C/0 Z- SINGLE & SEPAR^TE CERTI,~ICATION-REOUn~D -Z / C/0 Z- ,1NFO -Z / C/0 Z- , INFO NOTES: LOTS 40,000SF -100-24 1 ot recognition(CREATED before June 30, 983~, UNDERSIZED IX)TS FROM JAN.1997 100-25 Merger (A nonconforming at any time aftra 7/1/: REQ. LOT SIZE: ~, ACT. LOT SIZEil~q~5)REQ. LOT COV, _C:~ACT. LOT COX.'. ~ REQ. FRONT__ ~_ PROP. FRONT -~ ~,,~Q SIDE~T. SDE. / ._ RBQ. REAR_ ~'.'.'.'.'.'.'.'.~5_~ PROP.~R~AR ~ _REQ. HEIGHT PROP. HEIGHT__ PROJECT D ESC~IPT~_T~_ -- ~:e_2 k~ c.-~----~ ,*x.~l~ ESTIMATED PROJECT COST: ~.~ ARCHITEC~ ~~k,~_FAST TRACK WATER FRONT? ~ '~/'"~g/0 DESCRIPTION: , COMPLIANCE:. ~ ~ PANEL #: FLOOD ZONE: ~PROVALS~nRE~QUIREDAP SUFFOLK COUNTY HEALTH ~ YES oral'ED #): DTE: / / PERMIT #: TOWN SEPTIC RECE,eT: 2 KN / NEW YORK STATE DEC: lab'~jg... 9a/?s YES o~ SOUTHOLD TOWN TRUSTEES: ~ . YES ~ TOWN ZONING BOARD APPRO1 AL. YES o~.,~ TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YE~../ NEW YORK STATE CODE ISEE, P~O COMPLIAN(~E i NOTES: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: SF SF SF . ~ SF INIT OTHER TOTAL 2.( 3.( NEW YORK STATE CODE COMPLIANCE CHECKLIST USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERE~'r-'-~tESCRIFT__T_I~ k/q ~"~ FULL FRAMING DESIGN ELEMENTS: HEADERS: Y/N WALL STUDS: Y/N G1RDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/iq DESIGN LOAD CALCULATIONS: Y/N SHOULD INCLUDE LIVE, DEAD, SNOW, SEISMIC AND WIND (I1NCLUDING UPLIFT AND EXPOSURE) WiNDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMEN~ EGRESS, LIGHT, VENT: LOAD PATHS: Y/N ~/ ROOF TO FOUNDATION / NAILING/CONSTRUCTION SCHEDULE:~q MEANS OF EGRESS: Y~ LOCATION OF FIRE PROTECTION EQUIPMENT: TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N ./ TOTAL COMPLIENCE~/N (RETURN TO PAGE ONE) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INS~JI~ATION [ ,~NAL [ ] 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/ PERMIT NO. Examined__ ~ e5 ! __, 20 ~ Approved i ~_~, 20_ ~ Disapproved a;c ] l~'~ l~ ~ Expiration .r ' 20q )ector BUILDING PERMIT APPLIC-ATION 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: APPLICATION FOR BUILDING PERMIT · ..5).,__ Date ,20 INSTRUCTIONS 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 adj oinh~g premises or public streets or areas, and waterways. c. The work covered by this application may not be conunenced before issuance of Building Permit. d. Upon approval of tins application, the Building Inspector will issue a Building Permit to the applicant. Such a pernfit 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 pem~it shall expire if the work authorized has not cormnenced within 12 months at2er the date of issuance or has not been completed within 18 months from such date ,lfno zopJng amendmcuts or other regulations affecting the property have been enacted in the interim,~khe Building Inspector may authorize, in wr/ting, 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. (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 Nan~e of owner ofpremises /.-~/¢/~ b~k~ ~--~: ~, /t~5 r'~ ., ~'q~ _';5-- "/ ./~'.- , (As on th¢ tax roll or la[kst deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. c~ B 0 3 ~? ~' P'~ Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: , House Number Street / Haml~[ '7 County Tax Map No. 1000 Section Subdivision //) :'~x~ (Name) mock Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy Addition Other Work 3. Nature of work (check which applicable): New Building_ Repair 2<, Removal Demolition Fee Alteration 4, Estimated Cost (.,/AJ ,~ , 5. If dwelling, number of dwelling units if garage, number of cars (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 of existing structures, if any: Front c,2~~- ~ Rear ~7 ~ ' Depth __ /-~? Height ~' ' ' ,,2 ~,' Numberof Stories / Height_ Number of Stories Dimensions of same structure with alterations or additions: Front Depth Rear 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front / 0° C) Rear ~a. [ O 10. Date of Purchase ~'~-/7f/ Name of Former Owner / Rear Depth Depth 11. Zone or~ase district in which premises are situated k/&/' -lq., 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO/~_Will excess fill be removed from premises? YES NO -'~ 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No NameofContractor l."tl~L~(a~4l. 0oI,'~T. Address ?0~ //(y', Ct,Tcl~-PhoneNo. }zT? ~ /~'~ff 15 a. Is this property within 1 O0 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 MAY BE REQUIRED. l 6. Provide sarvey, 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 being duly sworn, deposes and says that ~]~'h~ (Name of individual signing contract) above named, ~f~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 fi~ed therewith. Sworn to before me this /~ ~ day of /'~? 20~ Notary Public -- GREGORY B. GOBURN Notmy Public, S~te of New York No 4~82785 Qualified in t'~assau County Commission Expires April 30.20 ~7 7 signature ;f A~plicant d~- [7