HomeMy WebLinkAbout36587-Z ray TOWN OF SOUTHOLD
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BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
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#: 36587 Date: 7/29/2011
Permission is hereby granted to:
Keller, Stephanie
75 Charles St
New York; NY 10014
To: construct an outdoor shower as applied for
At premises located at: \ f
580 Old Shipyard Rd,.Southoldy
rD
SCTM # 473889
Sec/Block/Lot# 64.-2-45
Pursuant to application dated 7/25/2011 and approved by the Building Inspector.
To expire on 1/27/2013.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ADDITION TO DWELLING $50.00
Total: $250.00
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Building Inspector
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STATE ENERGY CODE. .
FINAL
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Fora No.6
TOWN OF SOUTHOLD.
BUILDING DEPARTMENT
TOWN HALL
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 farm).
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 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 building$50.00, Businesses$50.00_
2. Certificate of Occupancy on Pre-.existing Building- $100.00
V
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
Date.
New Construction: r Old or Pre-existing Building: (check one)
Location of Property: J G Qli/j eS'1�?p �, SUy/�er e�
House No. Str et Hamlet
Owner or Owners of Property: S77F
F1'
Suffolk County Tax Map No 1000, Section Block v� LotJ`�
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEIRARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502' = Survey
SoutholdTown.NorthFork.net PERMIT NO. ;_ /oS Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit;
Examined 20iL Single& Separate
Storm-Water Assessment Form
Contact:
Approved 20 Mail to:
Disapproved a/c
Phone:
Expiration '1 20
U E Building Inspector
s ,
JUL 2201i LICATION FOR BUILDING PERMIT
u
Date7 ),X
20�f
BLDG.DEPT, INSTRUCTIONS
TOWWid OF SOUTHOLD
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,relationship to adjoining premises or public streets or
areas, and waterways.
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 a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f.Every building permit shall expire if the work authorized has not.eommenced.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, a d regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
cOAPLeS 3rgN l�
a
APPRM0eASo WfEyt)
(/ 6 Y K7
State whether applicant is owner, lessee, agent, architect, engineer, general cpAtMe �`' ctricg.,, umber or builder
FEE: –2 61 —
;r .
�C L�� 765-1802 8 AM TO 4 PM FOR THE
Name of owner of premises jrPh�A/V/Gr /=�• FOI I OWING INSPECTION'-','-
(As on the tax roll or laths-FATION-TVMO REQUIRED
If applicant is a corporation, signature'of P s l �pj�d. tzied dff .er FOR POURED CONCRETE
+� _ `'�a`�! '�t € 2. ROUGH-FRAh v,\'3 "119IN1,,,
�, m �,,,-. i i STnrPoI�G. ELECTRICAL&CAUL�!.NG
(Name and.title;o. corporate off cer) i ;.!�_ 3. lN0-*-H F 1GN
Builders License No.: -�� '!;j p 4. FINAL-GONSTRUCTICN &P ECTRICAL
Plumbers License No. ` 1 t I 1 L'-'`A L MUST BE COMPLETE FOR C G
'- 0- P I�'Y ALL CONSTRUCTION SHALL MEET THF
Electricians License No. ' ��� � a�!�w�� REQUIREMEN S OF THE CODES GF NEVOther Trade's License No. YORK STAT: N" T RESD9NGIP1 E r'OP
DESIGN OR CONSTRUCTION LKRORS.
1. Location of land on which proposed work will be done:
— 560 OZ-Z) SH 1PV 4R—h Sdyfl/at z)
House Number Street Hamlet
County Tax Map No. 1000 Section Y Block vZ Lot
Subdivisio Filed ap I�pt� ���
1
1
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy :k BEp eooM 3 PAN H O U*
b. Intended use and occupancy3 $EP P-001 I.2 13ANJ A N b OU OC9- S*U� *e.
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work 6Mp6e_,8j+CyJF.X
(Description)
4. Estimated Cost 3oi3.00 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.
� N Rear N� Depth s
7. Dimensions of existing structures if any: Front
Height ' A Number of Stories
Dimensions of same structure with alterations or additions: Front S ;; Rear ,*lop
Depth 70 l Height 7 S �' Number,of Stories
8. Dimensions of entire new construction: Front Rear
Height Number of Stories ;
9. Size of lot: Front J Rear — - Depth ®�
10. Date of Purchase O O /O Name of Former Owner A R E
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_)(Will excess fill be removed from premises? YES NO)r'�
14. Names of Owner of premisesSrSOP*lE 11Ecc.1AAddress 75 0HAP_iXS _Phone No. 51(O'398"S(ae54
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
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* 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.
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.ariy;coyenanis,and restrictions with respect to this property? * YES NO
IF YES, PROVIDE A COPY. _X_
STATE OF NEW YORK)
COUNTY.OFc.�
being duly sworn, deposes and says that(s)he is the applicant
(Name of individualisigning contract)above named, CONNIE D.BUNCH
Notary Public,State of New Yon
(S)He is the W "' No.01BUQ185050
w;(Cciirtractor,,Agent, Corporate Officer, etc.) Qualified n Suffof ,
Commission Expires A,r 14 2���---
of said owner,or owners,,axid is;duly authorized to perform or have performed the said work and to make and file this application;
that all statements:contained in thisl4pplication are true to the best of his knowledge and belief; and that the work will be
performed in,&manner set forth in the.application filed therewith.
Sworn to before me this
57A-' day of Q 20
Notary Public Signature o-IApplicani
v. Southold Town Building Department
P.O.Box 1179 Permit#: 36587
54375 Main Road
Co
Southold,New York 11971 Permit Date: 7/29/2011
(631)765-1802 Expiration Date: 1/27/2013
Parcel ID: 64.-2-45
BUILDING PERMIT RENEWAL LETTER
Dated: 11/14/2014
Applicant: Keller, Stephanie
Location: 580 Old Shipyard Rd, Southold
Work Description: OTHER
construct an outdoor shower as applied for
A FEE OF $200.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: Keller, Stephanie
Address: --Charles St
-I1 6New York,NY 10014
The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please
submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building
Department, P.O. Box 1179, Southold, New York 11971
THANK YOU,
SOUTHOLD TOWN BUILDING DEPT.
I
� Main Flle No.PLAT 1573AC Paae#15
Building Sketch
Borrower/Client KELLER
ProperlyProparly Address 580 OLD SHIPYARDLANE
City SOUTHOLD County SUFFOLK State 14Y Zip Coda 11971
Londa WELLS FARGO BANK,-WA-
30.U
ANK,N.A30.0'
2ND FLOOR
O OOit
AI — PGGin eC
� DUH I'�4�vX�✓;?+..!.E
30.0'
`
Ad 1413.0'
20.0'
6
I C-1 fwm:
� aoalli
17.0' r
D. o
C GMKE N
IafCNElI
IST FLOOR
o —
a rn
Cl) `a"o�'o� 20.0'
1mamr�� ea ^,f � bED
a PDDM
I 60 r9
■\�qi 30.0'
gc� �-�„
Swamolpo M• 4
I
Comments;
a AREA'CALCULATIONS.'SUMMARY°;,_"`:',_,
DING,.'AREA°BREAKDOWN
.Code'. Oe§Erlpiian":.1;. `E '..:Nel.Size Net Totals %:0roakdoWn;:,,. :. '.+su6tolalsj�''.?
GLA1 First Floor 1056.0 1056.0 Fixat Floor
i GLA2 Second Floor 600.0 600.0 13.0 x, 42-0 546.0
Garage 420.0 420.0 17.0 x 30.0 5
GAR 10.0.
I Second Floor
20.0 x 30.0 600.0
7
I
I
I
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Net LIVABLE Area (Rounded) 1656 13 Items (Rounded) 1656
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Fonn 5KT.BldSkI—'WnTOTAL'appraisal soltware by a Is mod a,Inc.—1-806-ALAPhOOE
A-96/1596
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