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Home My WebLink About29858-Z~ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29846 Date: 11/18/03 T~IS CERTIFIES that the building ACCESSORY Location of Property: 505 KAYLEIGH'S CT EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 4 Lot 16.9 Subdivision Filed Map No. -- Lot No. __ conforms substantially to the Applicasion for Building Permit heretofore filed in this office dated NOVEMBER 5, 2003 pursuant to which Building Permit No. 29858-Z dated NOVEMBER 6, 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 ACCESSORY SHED "AS BUILT" AS APPLIED FOR. T~e certificate is issued to TAMMY HAP~NED of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF ~L~LT~ APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA:J_'~uJ Rev. 1/81 N/A N/A Authorized Sig~r~ 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. 29858 Z Date NOVEMBER 6, 2003 Permission is hereby granted to: TAMMY HARNED 505 KAYLEIGH'S CT EAST MARION,NY 11939 for : AS BUILT ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 505 KAYLEIGH'S CT EAST MARION County Tax Map No. 473889 Section 031 Block 0004 Lot No. 016.009 pursuant to application dated NOVEMBER Building Inspector to expire on MAY Fee $ 150.00 5, 2003 and approved by the ~~///~//A~aori~d_Si~g~ure~ COPY Rev. 5/8/02 Form No. 6 TOXVN OF SOUTHOLD BUILDING DEPARTMENT TO~,~,?/HALL 76~-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This applicatiou must be filled in by t~q)ewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final sutw'ey of property with accurate location of all buildings, properly 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 Unde~'riters. 4. Sworn statement from plumber certifying that the solder used in system coutains less than 2/10 of 1% lead. 5. Connnercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from amhitect or engineer responsible for the building. 6. Submit Plarming 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 smwey 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 $25.00, Additions to dwelling $25.00, Aherations to dwelling $25.00, 3. 4. 5. New Construction: V Old or Pre-existiug Building: Location of Property: ~' oX [~l>~{e,~J Cp House No. Street OwnerorOwnersofProperty: [ ~r~m,_,r ['[0 Suffolk County Tax Map No 1000, Section O .~ [ Subdivision Swimming 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 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commemial $15.00 Date. / '/,~/o~ (check one) Permit No. 2 ~2;~' ~-~"~___~' Date of Peri'nit. Health Dept. Approval: Planning Board Approval: Request lbr: Temporary Certificate Fee Submitted: $ ~ ~ -'---- Hamlet Block O OO c/ Lot Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: ~(chlck one) v AppliFnt ~/ignature' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING TION [ ] FIREPLACE & CHIMNEY REM~KS: / ~.~_' ~' ~ ~: DATE INSPECTOR( TOX~qN OF.SOUT. HOLD BUILDING DEPARTMENT TOW"N HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork, net/Southold/ It Examined ~"/ 20 Approved Disapproved ~c Expiration ~ ,20 J~ PERMIT NO. aQq ~6~ BUILDING PERMIT APPLICATION 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: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT 2OO3 , ' Date /cJ/..,~ ~ ,20 0,9 ' ~ .......... I INSTRUCTIONS a..T4'dqs'nppltcati6ri IglLTST-15~'~ompletely 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 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 an5, 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 an~endments 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 Departmeut for the issuance ora 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, ifa corporation) (Mailing ~ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, 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 rifle 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: House Number Street County Tax Map No. 1000 Section Subdivision (Name) Hamlet Block Filed Map No. 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 OC bc ,'lar ghe 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work ~- £e~ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, speci~ nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear __Depth Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Sizeoflot: Front Rear Depth 10. Date of Purchase Name of Former 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 NO __ Will excess fill be removed from premises? YES NO__ 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a 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 ora tidal wetland? * YES__ NO __ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide sum'ey, to scale, with accurate foundation plan and distances to property, lines. 17. If elevation at an)' point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) [~L rr*u, Ho~( 17~4-- being duly sxvorn, deposes and says that (s)he is the applicant (Name of indiqidual signing contract) above named, (S)He is the 0 (Contractor, Agent, Corporate Officer, etc.) of said oxvner or owners, and is duly authorized to perform or have performed the said xvork and to make and file this application that all statements contained in this application are tree to the best of his knoxvledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. 20c 3 /i~k~ture of Applicant