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Home My WebLink About25385-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26176 Date: 12/17/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 1250 SALT MARSH LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 68 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 17, 1998 pursuant to which Building Permit No. 25385-Z dated DECEMBER 7, 1998 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 IN FRONT YARD AREA AS APPLIED FOR "AS BUILT" The certificate is issued to CHARLES SMITHEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A t c it ng Inspector 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. 25385 Z Date DECEMBER 7, 1998 Permission is hereby granted to: CHARLES SMITHEN 212 EAST 69TH ST NEW YORK,NY 10021 for CONSTRUCTION OF AN ACCESSORY SHED IN THE FRONT YARD AREA AS APPLIED FOR "AS BUILT" . at premises located at 1250 SALT MARSH LA PECONIC County Tax Map No. 473889 Section 068 Block 0003 Lot No. 004 pursuant to application dated NOVEMBER 17 1998 and approved by the Building Inspector. Fee $ 35 . 00 01 Buildinci/Inspector ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD 0� BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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 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 completed site plan requirements. B. 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 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. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing; Building - $100.00 3. Copy of Certificate of Occupancy - .25r,,. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $A5.00 Commercial $15.00 Date . J0. . 3P . l. V . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .. . .. .. Old Or-Pre-existing��[[ Building. . . . . .. . . . . . Location of Property. .�9 SQ . . . l;'r -. ... . . . . . . �Y�JK r.. .. . . . . . . . . . . . . . House No. r Street Hamlet Onwer or Owners of Property.. . .C.61 :1. .�.. .V I.L1!1�./:L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . .. ...Block. . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./.Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. s. , .$:: . . . .Date Of Permit. l�2719 K . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . / Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .. . . . . . . Fee Submitted: . . . . . . . . . . . . . . . . . . / P ICANT CAF, �2Gl76 BOARD OF HEALTH . . . . . . . . . . . . . .. FORM NO. 1 `-3 SETS OF PLANS l' TOWN OF SOUTHOLD —_ SURVEY . . . . . . . . . .. . . . . .. 708 BUILDING DEPARTMENT --CHECK .... . . . . .. . . ... TOWN HALL SEPTIC FORT! .. .. . .. . . . . . .. .... . SOUTHOLD, N.Y. 11971 RLpG. DEPT. TEL: 765-1802 NOTIFY: .. � G CALL .. . .. . ... . . .. . . . . .. . . . . . . Exmined..�. .........., 199.. MAIL T0: . Approved...`:.'.7..... 19�.a� Permit No.Z 3 j�5.2... ................................... Disapproved a/c .................................. ................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ii \ -7 / .Date. . .....`.1. .1 b.., 19Sk INSTRUCTIONS a. 'ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 application. 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 issue 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 Comaty, 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. Zbe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and ' ding for necessary tions. ?9 �4 •(•ignature of applicant, or name, if a corporation) . ................... .......... (Mailing address of applicant) State whether applicant is owner, le , agent, chitect, engineer,*general contractor, a �timher or buildeu ........................................................................................... D . Name of owner of premises ... � ................ Aq . (as on the tax roll or latest deed) NOW MONO DE EN AT If applicant is a corporation, signature of duly authorized officer. �'�� C 4 MIA FOR HE 1�Ot,LtaNMlfi MS'ECTIONS: I f01JNDATION • TWO REQUIRED • (Name and title of corporate officer) . • .•-•••.••••.•.•..•. AOR rOUA�CONCRETE !. NOUOM . MIAIIMNG i PLUMBING & INSULATION 4. FINAL - CONSTRUCTION MUST Builders License No. ......................... BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET Plumbers License No. •..................•••••• THE REQUIREMENTS OF THE NY. Electricians License No. ..................... STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Other Trade's License No. .................... PE•i OR CQNS1TR-U_CT_ION ERRORS 1. Location of land on which proposed work will be done...... .......................................................................... c......1.C...................... House Number Street Corr��Hamlet��---- unty Tax Map No. 1000 Section ... i ...... Block .....3........ Ivt ..... .�1..... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and proposed construction: a. Existing use and occupancy ............................ . C.14..:?.:'::.�:.C...�1�"" b. Intended use and occupancy .........�.r.......... .. .,.,... .....�.�........................... 1. Nature of Work (dnc1 Whitt applicable): New Building .......... Addition .......... Alteration+.......... Repair ............ Removal ............. Demolition ............ Other Work ..... .............. (Descri ) . i. Estimated Cost .......................... fee ....... .(to be paid on filing this application) 5. If dwelling, m0ber of dwelling units ............ Number of dwelling units on each floor ................ Ifgarage, number of cera ...................................... 6. If business, commercial or udzed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. height ......................... Nlmmber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... limber of Stories ............... 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Number of Stories ..................... 9. Size of lot: Frbnt .................... Rear .................... Depth .................... 10. Date of Purchase ..................... lame of Former Owner ........................................ Ii. Zone or use district in Which premises are situated ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be removed from premises: YES W 14. Names of Owner of premises ........................... Address .............................. Phone No. .............. Name of Architect .................................... Address .............................. Phone No. ......:....... Now of Contractor ................................... Address ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO .......... *IF YES, SWMD WO TRDSIEBS PERNIIT MAY BE mwm. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. S PA 1,31W)01% OT MA 0 V*r-aer �''.E!:I'�3•i�1�M ilYNllMvtl.fOT -=11 QVVT . MTA0UU014 f 1,'1034(0 01R#IIICMI'!� 01MAJUP641 s STATE Or-'NEW` CNEW YOlatLZ SS� ...... 1 . �5..?�;:;: ' 1................being duly sworn, deposes and says that he is the applicant (Nmmindividual signing contrac above named, Ileis the ............. ..ti........................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfmmW 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. Sworn to bef9re me this .......... .......day of .. 4... Notary Public . . • .•ROBERT I.SC .,JR. Notary Public,Sts of New York .•Signature of Applicant) QuNified in ors county No.01 72 That Expir Mal►31. SURVEY OF PROPERTY 51 TUArTE AT: PEGON I G SURVEYED 10-23-a8 TOWN OF 5OUTHOLD 5UFFOLK COUNTY TAX MAP 5UEEOLK COUNTY, NEW YORK. 1000 - 68 - 3 - 4 eN -- CERTIFIED TO: 1 MATTHEW BARNEY Lona Island Sound FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK N"7003-7'33"E '74.13' line of apparenthigh water r i"Iwtnor,ceu al ter-al lc aOtlrtu r trr. rear rn9 a I1 se•tl 1'enn'�.. alrY v r'u lal lurr ul �r[iP ):tivl. ^.rl�-Jev r'�lyrr�Y� yl�lt n Nerr YCrA State Enrlt at r on�Law. 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