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Home My WebLink About33301-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32585 Date: 09/10/07 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property: 155 SHEPARD (HOUSE NO.) County Tax Map No. 473889 Section 78 DR (STREET) Block 1 SOUTHOLD (HAMLET) Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9, 2007 pursuant to which Building Permit No. 33301-Z dated AUGUST 9, 2007 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 GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to JOY A KAELIN (OWNER) of the aforesaid building. N/A SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 3043177 08/27/07 N/A PLUMBERS CERTIFICATION DATED ~/~ Authorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT r:~--,- TOWN HALL I ~~ ~ r;: ~ n W [; 765-1802 ,'u [0__ -I~ ~ ;' . , U APPLICATION FOR CERTIFICATE OF OCCUPANCY IIJ " _ 8 i I : . J This application must be filled in by typewriter or 1I1k and submitted to the Building Department w~ ther\5:J.MIm~~~;ho'p__ 1loS-'SO\\ "7,,~,\....,c.Jc... ~"""""Cl< . - . A. For new building or new use: I. Final survey of property with accurate location of all buildings, propeliy 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 statemenr1rom plumber certifying that the solder used in system contains less than 2/1 0 of I % lead. 5. Conunercial 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: I. 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. New ConstlUction: C. Fees I. 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 - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 j Date~1 B(07 Old or Pre-existing Building: (check one) s,~\"J Dr. ~~()\c\ Street ..:I 0'1 IJ\ _~(:\ \ \~ 018 Location of Property: \55 House No. Hamlet Owner or Owners of Property: \ __Lot~ Suffolk County Tax Map No 1000, Section Block Subdivision Filed Map. Lot: Pennit No. =- \'1,:\<1 \ Date of Permit. _ Apphcant: Health Dept. Approval: ~___ ____ Underwriters Approval: Planning Board Approval' _______ Request for: Temporary CCliificate Final Certificate: ____ (check one) Fee Submitted: $ ___----'-.. l. '. ()...M:. -1)6 J.V CO cy.<5S5 ,,~ A. \<~\ Applicant Signature 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. 33301 Z Date AUGUST 9, 2007 Permission is hereby granted to: JOY A KAELIN PO BOX 1719 SOUTHOLD,NY 11971 for : CONSTRUCT A DETATCHED GARAGE AS APPLIED FOR. THIS PERMIT REPLACES BP # 17491 at premises located at 155 SHEPARD DR SOUTHOLD County Tax Map No. 473889 Section 078 Block 0001 Lot No. 016 pursuant to application dated AUGUST 9, 2007 and approved by the Building Inspector to expire on FEBRUARY 9, 2009. Fee $ 75.00 ,,'j" . / .; /'.( . ,.,C~'t.-....... c~/ -- Authorized Signature ORIGINAL Rev. 5/8/02 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I Located at ~ Application Number: I Section: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I I!I~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~ ~ ~ I ~ ~ ~ ~ ~ ~ ~ ~ ~ .I!I BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by DANIEL WILCENSKI ELEC. CONTR. PO BOX 319 SOUTHOLD, NY 11971, JOY KAELIN 155 SHEPARD DRIVE SOUTHOLD, NY 11971 155 SHEPARD DRIVE SOUTHOLD, NY 11971 3043177 Certificate Number: 3043177 078 0001 Block: 016 Lot: Building Permit: 33301 BDC: n511 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Attached Garage, Attic, A visual inspection of the premises electrical system, limited to electrical devices and Wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 27th Day of August, 2007. Name OTY Rate Ratilll! Circuit ~ Miscellaneous I st floor & outside of detached garage Wiring and Devices Outlet 12 0 6 0 6 0 7 0 4 0 5 0 I 0 Fixture Incandescent Flourescent General Purpose General Purpose General Purpose GFCI Fixture Fixture Outlet Receptacle Switch Receptacle seal I of I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 333~ I z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. [ ] INSULATION ['t>4-FINAL 4-: [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION ;-~ ~~. ~ oft2 :f ~ ~., ~~~~~ DATE r - } I ,.- 07 INSPECTOR ~ ~ 33.30 I z. TOWN OF SOUTH OLD BUilDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING pq FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ]jJ;E RESIST~. PENETRATION REMARKS: ~ ~) d- c.vt. ~ A~-AL' ~. " ~ tI~~_ DATE '1'-/3.-07 INSPECTOR~~ ~ 1:::: -;:t; ~ i~~t~,:- ) ~ ~~ \. ~ If- /7V1/ 765-1802 BUilDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PlBG. [ J ~NDATION 2ND [ ] INSULATION If1" FRAMING [ ] FINAL REMARKS: tJl:- DATE 1J-1a-1/~f INSPECTOR 1~ [ J 7 C/CfJ 765-1802 BUILDING DEPT. INSPECTION [~UNDATION 1ST [] ROUGH PLBG. [.{ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR "" ~ ,'ELD ==- t I:~S~;2C71():J 1. FOUNDATION (1st) ------- 2. FOUNDATION (2nd) ROUGH FRAME 3. / ,PLUMBING INSULATION PER N. Y. STATE ENERGY CODE 4. FINAL I/lJ;'7E I[ ~/~i1IP)' ~" I ( CO!'1MENTS ./ ~ -r;:.. .." OJ '" LN '" -'- UJ H 'cl A, "" "" :Ic?rj L ./. ~/ ~ 4..,7 ~ t7 IV/It ~~R ~'<. Z o ~ ~ ~~ .. 'cl ~. ~ ~ 1J-/,.1J /JP VA~ "R-l.. f " ". k""S.:::;z.' / / I IV/A . " ::1: "'" .,. Tr13- 01.{;Y'/. .o~ '. -J"n ,y r~ /J 'fr . 5 1\ ~I\,~ d-- V,A XI/, Ala ~/~ ,hA 'r!- ') fJ' If 1K~ '1f v ,,' I ~ ~'..-w~V-" .~ f,~ ~~' I'tJJA 17 L. '.A :a. o-/;-, ;=::: .0... " . . ADDITIONAL COMMENTS: , , . . . . . '" >< . ..>1~-," '"0 ffi H "" 2-' :x> 0-; -.{\ >- ~ 0 ~ ~ , .:. ~ 1 - . - '" ~ "'" r- 'cl - ::1: 0 '" "'tl 'cl .. . "" TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD. N.Y. 11971 TEL.: 765-1802 Examined /~~_ t'. - . .. . _ ., 19$: ~ 933 {J'!--6 /,,- y. t;! . J7j'1'~/~ Approved. ... ... ... _... . ., 19. . _ Permit No. . . . . _ .... .. -:v-"'~~~............ "....'.l.' ,.-" ,. <J 1 ,..c-.. -" ............ ...",. a'WIl" CIl10M FORM NO.1 BOARD OF HEALTH .~......... 3 SETS OF PLANS ............ SURVEY ..................... CHECK I.7S,If!J: .Yl'I.(J. [5'.~.'J.1.'<J~"~. . . TIC R'l "0 }-J.c:.,(/~ SEP FO ,. ....,. .,.....,....... NOTIFY CALL J&5.-:3./.~.$........... MAIL TO: Disapproved alc ..... .......0....... ... .0. ...... ..... ..............................~~i~~i.... APPLICATION FOR BUILDING PERMIT " Date. ....~.7......, g,% . 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 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 appli- cation. 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 issued 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 County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, a4ditions 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 neces~a~ ~n.s~ . . . V ~~. W. . . . . . . . . (Sig~~tJ;~~pplicant, or name, ~rauon) ..;:'0.,. Aw... J;5~. .~~h kL .~. . . . (Mailing address of applicant) llf1 t State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................Q~............................................................. Nameofownerofpremises .......... .r. '(~~"ih~'i!~~~;~' .~. .'::?......:.. If applicant is a corporation, signature of duly authorized officer. ..................... ...... ....... ..... ....... (Name and title of corporate officer) Builder's License No. .,..~......... Plumber's License No. ........................ ~ Electrician's License No. ...................... Other Trade's License No. ..................... 1. Location ofland on which proposed work will be done. .. .1.5.5... S.~.E?p.~. .S?r. OJ.......... ....... .. J55. . .. .. . .. . .. Sh e.(.J. PrU.. . ..'1 r.i ll.e. .. .. 00 .. . . . . .. 00 . .50 u:-\f....o {d.... . .. .. . .. House Number I Street Hamlet County Tax Map No. 1000 Section 00 009.7.~ 00... 00.. Block. 00. 00/" .. ....... Lot.....%..! P.... Subdivision. . . . _ . . . . . . . . . _ . . _ . . . . . . . . . . . . . . . . . . . Filed ~Iap No. .............. Lot............... (Name) 1. State eXisting use and occupancy of ~ises and intended us,~ and Occupancy of proposed construction: a. Existing use and occupancy..... i'e..t:5 .<l.{.\./'r/.... 51</.:;}/<" . Fi.rn_/y. .~welliCJ""""" 0.. '. Intended Use and occupancy ....... ~.AJe.~~... ..... . '" . ..... . .......... ................... 3. Nature of work (check which applicable): New Building. . . /. . Addition,. . . . . . . .. Alteration ......... Repair .............. Removal .. . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . I (Description) 4, Estimated Cost. . . . . .$1 q~? '. ?~ . . . . . . . : . . . . . . . . . . . . . . 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 .......9,..............,................................................. 6. If business. commercial or mixed OCcupancy. specify nature and extent of each type of use. . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing stmctures. if any: Front. . . . . . . . . . . . . . . Rear .............. Depth.............. Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. " " . . ... . . . . . Dimensions of same stmcture with alterations or additions: Front ................. Rear.................. Depth. . . . . . . . . . . . . . . . . . . . . . Height. . . . . . . . . . . . . . . . . . . . . . Num ber of Stories. . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new constmction: Front. . . . . . . . . . . . . .. Rear............... Depth ............... Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' 9. Size of lot: Front. . . . . . . . . . . . . . . . . . . . " Rear...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ....~..................... II. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. D~es proposed construction vi~y zoning law, ordina~ce or regulation: .......1'>1. Q. . '. . . . . . . . . . . . . . . . . . . 13. W,ll lot be regraded .......~.. .NQ......... WIll excess fill be removed from premIses: . Yes @ 14. Name ofOwn~r of premises .. ::rPh'l!l.~...'?:lyw.:JJ>. Address.. SC.l.l..~ld..... . Phone No. ;jf.,:5:.-.;U"J'.?.. Name of ArchItect .............. . . . . . . . . . . . . . Address .. . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . .5.~ t F. . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. .........: y . . . 15.Is this property located within 300 feet of a tidal wetland? *YES....NO.V.. *If yes, Southold Town Trustees Permit may be required. . ... 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 comer lot. - <- .< 0" &.. /~O. 6 J , . 1 , --../ 4,1 ff'} ~/ o / S- ') "----"'-T--. ."'1.. 01> -3-~ o '. 0----_ ./' I I ~ - , ~ "'----. ~ ~ t~C):v ~ :/{'Of~;Gb7("..;,. ~ G~~~~~_I ?II{,QI . (}v.c - ._. . , ::U o :t:':.i t71 I , , \ I . L.. LoT<;y , @fsl'~t:I7J... olA.,:t) -, HO\A5t=' I ~ -, LoT 1t3 !.oT ~,.? V-4(' 1911_ . "I ---- -- . :5 H;;~A~ t:J 1 l;o b R, V0' .~- b,'o, "01, >worn, "po~, m' .~" ~~~. he applicant , . , aSh. :l':! He IS the, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .'.:. . . . . . . . . . . , (Contractor, agent. corporate officer. etc.) . : of said owner or owners. and is duly authoriz~d to ~erform or have performed the said work al?-(f !<t'make,jand file this application; that all statements conta1l1ed 111 thIS applicatIon are true to the best of his knowledge and belief; and that the work will be perfonned in the manner set forth in the application filed therewith. Sworn to before me this , . . . " . . . . . . . . . if, t-l~ay of. . . . Notary Public, ..~... ..... STHEOFNEWY~~( kss COUNTY OF . . . . . . . . ';.:,' . . . . .... ...~.t.-I... Vf'!r:-.. ..v~?-.~~.................. tt%me of individual signing contract) above named. "- ", , "", , ~ .....19... ...., -Nf'!'L......__ - -,....-. ~ c......1 . . ..... I iJl" ~ ...~~ ../~~~.... . . . '(J' G (SignatukJof applicant) 108M NO. . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N. Y. ?;o\ ')f BUILDING PERMIT <THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017491 Z Date ....(P..."'::...}!..................................., 19.~.8 Permission is hereby granted t>. :::::...~ ~ d.i! AAfh~ J'7t t/~......~...~.v..~.~:.~.::.....r~~ ''''r'' ~ ~. ...62.t!7...f6.."k............................................... .....a5~~72;7-jL'l.]/ _ _.LZ to.~~.~.....~... ~.~........~.....7'7~ r-....................................................................................................,.............................................. ot premises located at ......1.2:.5... .. . ..... ........2~............................................ .......................................................~.........................................r................................................. ~~~.~.~.;~~..~~~..~~....;.~~.~..~~~~;~~..................ii.'.....::...~.I:~......................1..................~~~.~~:.............................>.~...... , pursuant to application dated .....71:2..:;7....................................., 19.cf8; and approved by the Bui Iding Inspector. Fee $....7~ .........~..~L:A:t..... /lIdlpnspector Rev. 6/30/80