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HomeMy WebLinkAbout40983-Z ZZ00FOL,(c Town of Southold aov oGy� 10/5/2024 P.O.Box 1179 o _ = 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45631 Date: 10/5/2024 THIS CERTIFIES that the building ALTERATION Location of Property: 330 Village Ln, Orient SCTM#: 473889 Sec/Block/Lot: 25.-1-8.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/2/2016 pursuant to which Building Permit No. 40983 dated 9/12/2016 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"roof repair/replacement in-kind to existing accessory barn/storage building as applied for The certificate is issued to Harris,Theodore&Wogan,Deborah of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED fA iz S ature �aoFso�ryo TOWN OF SOUTHOLD BUILDING DEPARTMENT o • TOWN CLERK'S OFFICE Comm SOUTHOLD, NY BUILDING PERMIT RENEWED (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 40983 Date: 09/12/2016 Permission is hereby granted to: Renewal Date: 09/20/2024 Theodore Harris PO BOX 594 Orient, NY 11957 To: legalize a roof repair/replacement in-kind as applied for.Any change will require approval from the Southold Town Historic Preservation Commission.All work to be done in-kind. Premises Located at: 330 Village Ln, Orient, NY 11957 SCTM#25.-1-8.2 Pursuant to application dated 09/06/2016 and approved by the Building Inspector. To expire on 09/20/2026. Contractors: Required Inspections: Fees: Renewal Fee $125.00 Total $125.00 Building Inspector ��uFEo�.r TOWN OF SOUTHOLD BUILDING DEPARTMENT co 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#: 40983 Date: 9/12/2016 Permission is hereby granted to: Mould Jesse A Revoc Trust 330 Village Ln PO BOX 445 Orient, NY 11957 To: legalize a roof repair/replacement in-kind as applied for.- Any.change will require approval from the Southold Town Historic Preservation Commission. All work to be done in-kind. At premises located at: 330 Village Ln, Orient SCTM # 473889 Sec/Block/Lot# 25.-1-8.2 Pursuant to application dated 9/6/2016 and approved by the Building Inspector. To expire on 3/14/2018.- Fees: AS BUILT-ACCESSORY $200'.00 CO -ACCESSORY BUILDING $50.00 To 1: $250.00 Building Inspector- Form 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 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 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. Z New Construction: 'Old or Pre-existing Building: (check one) Location of Property: 330 House No. Street Hamlet Owner or Owners of Property: �� Suffolk County Tax Map No 1000, Section ? 5 Block Lot �. Z Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ 17nature tf SOUT�O� * # ' TOWN OF SOUTHOLD BUILDING DEPT. cou 631-765-1802 1"NSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION .2ND [ ] SUL TION/CAULKING [ ] FRAMING /STRAPPING [ FINAL Aet6 44ft*7 F [ ] FIREPLACE & CHIMNEY' [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION" [. ] FIRE RESISTANT PENETRATION [. ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]. RENTAL REMARKS: L l DATE D. 0 INSPECTOR r' FMLb )V.sUl SON V—2VOR ' :D= ' , . , • ,h7 IL ................. , . .......... FOUNDATION (2N19) ROUGH `; & a PLUNZBV'G y— . ' O INSULATION PEA N,`Y, STATE ENERGY CODZ CN DIAL ............. z ' I ' I , � • � ', � 1 ' • 1 �ISM Y 1 1 ,11 5 ' ' 11 ' 1 • ` TO�VN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST `^ BUILDING DEPARTMENT 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. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Form / 601 Contact: Approved 20 Mail to: M ,4y-� Disapproved a/c Phone: Expiration 20 nspec APPLICATION FO BUILDING PERMIT Date L/) 10?, 111� 20 INSTRUCTIONS,- 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. I f.Every building permit shall expire if the work authorized h s not commenced within 12 months after the date of issuance or has not been completed within 18 months from such dat7lf 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 agree0=1 prbui a laws,ordinances,building code,housing code,and regulations,and to admit authoriz c�i iding for necessary inspections. (� A ,016 (Signature of applicant or name,if a corporation) ��' �bINGD�T• 4'^-77l OF SOUTHOLD (Mailing address of applicant) State whether applicant is owner, lessee, age , architect, ineer, 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) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: rJ House Number Street Hamlet Q County Tax Map No. 1000 Section 7, 5 Block Of Lot • 2- ,subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and i end e and occu annccy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 57A/q 3. Nature of work eck which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 o�r mixedFoccupanc , specify nature and extent of each type of use. 7. Dimensions of existing structures, if any:Front' Rear Depth 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 Rear Depth Height Number of Stories so/?-voLl"y 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Fortner Owner 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 N6—/ Will excess fill be removed from premises?YES aNO w dew ?o �' 14.Names of Owner of premises j2►21.s Address Phone No. 917',S •J 0 Name of Architect G 't- 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 * 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 any covenants and restrictions with respect to this property? * YES NO� * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF� - being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)ab v named, � CONNIE D.BUNCH Notary Public,State of New York (S)He is the G No.01 BU6185050 (Contractor,Agent, o orate Off cer,etc.) Qualified in Suffolk County Commission Expires April 14,2 022WD 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 filed therewith. Sworn,tRQ before me this —'-M day of 20 Notary Public Signature&Applicant Scott A. Russell s-°SU �� STOR IM[WA\TE K SUPERVISOR MANAGEMENT SOUTHOLD TOWN HALL-P.O.Box 1179 0 53095 Main Road-SOUTHOLD,NEW YORK 11971 �o� Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOES THIS PROJECT IINVOLVIE ANY OF THE FOLLOWING: Yes I No (CHECK ALL THAT APPLY) ❑ A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑( B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ElC. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. EIR D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ E. Site preparation within the one-hundred-year f loodplain as depicted F on FIRM-Map-of--any-wat-ercourst- -- - ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES.to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Prof, al,Agent,Contractor,Other) S.C.T.M. #: 1000 Date: /Distrrict NAME: ��--- (i / y Q , Z- " Section Block Lot Snamre)7 �•k-k:i �OR BUILDING DEPARTMENT USE ONLY "'I� Contact Information r a ✓ � :Telrplgrce umRr: Reviewed By: 6 Property Address/ Location of Construction Work: _ _ _ _ _ _ _ _ Date_ _ �3 0 V IC f`i�G E C /Q r Approved for processing Building Permit. �J�7L 0 Stormwater Management Control Plan Not Required. ©� y�/ �� ❑ Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM ` SMCP-TOS MAY 2014 Southold Town Building Department O�OSOPFOl� 2 . P.O.Box 1179 Permit#: 40983 y 53095 Main Rd Southold,New York 11971 Permit Date: 9/12/2016 oy �� 631 ( )765-1802 Expiration Date: 3/14/2018 Parcel ID: 25.1-8.2 BUILDING PERMIT RENEWAL LETTER Dated: 12/14/2020 Applicant: Mould Jesse A Revoc Trust Location: 330 Village Ln, Orient Work Description: ALTERATION legalize a roof repair/replacement in-kind as applied for.Any change will require approval from the Southold Town Historic Preservation Commission.All work to be done in-kind. A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Mould Jesse A Revoc Trust Address: 330 Village Ln PO BOX 445 Orient,NY 11957 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. l t� tilt •t„ 1 •3 I :tl. 1 j{I 1' •I` li 7 L r y. t ! 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