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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 01/30/08
No: Z-32856
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property: 3930 HORTON
(HOUSE NO.)
County Tax Map No. 473889 Section 54
LA
(STREET)
Block 7
SOUTHOLD
(HAMLET)
Lot 23.7
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
MARCH 5, 2007 pursuant to which
filed in this office dated
Building Permit No. 32802-Z
dated
MARCH 12, 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 NON-HABITABLE, NON-HEATED ACCESSORY GARAGE IN THE REQUIRED REAR
YARD AS APPLIED FOR.
The certificate is issued to TIMOTHY & JANE MCINERNEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
OS/27/05
ELECTRICAL CERTIFICATE NO.
05-3793
PLUMBERS CERTIFICATION DATED
N/A
//
Signature
Rev. 1/81
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L-J.c.,zi,c'~F S\','~:TH9LD IAPPLlCATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
Form No, 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
7ft,S ~ IJ J 9
A. For new building or new use:
I. 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 I % 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:
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.
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
Dale.
New Construction: C,I'I2pCf t3 Old or Pre-existing Building: (check one)
Location of Property: -S"i'3o tJrrr::t:;;...... ~ ~
House No. Street
Hamlet
Owner or Owners of Property: 7/ n-n
.r?nL-T/UG'/<..Y
(
~~ Block
7
Lot
..:2-3 ./
Suffolk County Tax Map No 1000, Section
Subdivision
Pemlit No. S b <;Jd'l.. - 'Z.t,ate of Permit.
/l../.q
Filed Map. LOl:
Applicanl: ~~r ~d/V C'/lJtlIIlPcf//:;
Health Dept. Approval:
)V'/4
vf'l
Underwriters Approval:
;/Jl4-
PlalUling Board Approval:
Request for: Temporary Certificate
~~ (check one)
~
Applicant Signature
Fee Submitted: $
.~
6....R.C . I ? 7 1 ~
CO-t..32'i55 ~
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.
32802 Z
Date MARCH
12, 2007
Permission is hereby granted to:
TIMOTHY & JANE MCINERNEY
276 RIVERSIDE DR APT 7G
NEW YORK,NY 10025
for :
CONSTRUCTION OF A NON-HABITABLE, NON-HEATED ACCESSORY BUILDING IN
THE REQUIRED REAR YARD. THIS PERMIT REPLACES BP # 30406
at premises located at
3930 HORTON LA
SOUTHOLD
County Tax Map No. 473889 Section 054
Block 0007
Lot No. 023.007
pursuant to application dated MARCH
5, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 12, 2008.
Fee $
111.00
A
ORIGINAL
Rev. 5/8/02
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Sanford Lent PE
48 Oriole Street
Pearl River, New York 10965
845-300-0707
Southold Building Department
Permit #32802-2
Tim McInernev
FINAL INSPECTION of approved plans dated June 17,2004 has been completed
by Sanford Lent, PE, they are as follows:
Footing and foundations rough framing met Southold Building Department specs.
Grabable rail has been installed as required by Southold Building Department.
Electric approval certificate has been supplied.
Window shutters are on site.
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TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [j{FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONS1RlJCnON [ ] FIRE RESISTANT PENETRATION
REMARKS: ~ ~
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TOWN OF SOUTH OLD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN~TIO. N
[ ] FRAMING I STRAPPING [~NA~
[ ] FIREPLACE & CHIMNEY [] FIRE ~SPECTION
[ ] RRE RESISTANT CONSTRUC11ON [ ] FIRE"RESlSTANT PENE1RA110N
REMARKS: (A LS ~ (LS (j)PbJ) No ~
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ~La N
[ ] FRAMING I STRAPPING [ .{FIN~
[ ] FIREPLACE & CHIMNEY [] FIRE INSPEcnON
[ ] FIRE RESISTANT CONSTRucnoN [ ] FIRE RESISTANT PENETRATION
REMARKS: &x.LtJs.e. ~ J;4tr"~ ~
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DATE (01)--)-/07
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INSPECTOR
FIELD INSPECTION REPORT DATE
COMMENTS
FO~ATlON(lST)
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FO~ATION (2ND)
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ROUGH FRAMING &
PLUMBING
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INSULATION PER N. Y.
STATE ENERGY CODE
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FINAL
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SURVEY OF PROPE.R1'Y
SITUATED AT
SOUTHOLD
TOWN Of SOUTHOLD
SUrrOlK COUNTY. NEW YORK
S.C. TAX No. 1000-54-07-23.7
SCAlf: 1....10.
APltIl. 28. 2002
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AREA = 127~?:'1I.75 sq. ft.
2.933 ft.
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold/
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
PERMIT NO. 3'OY06-C,.
C' j;7
Approved C It 7
Disapproved ale /
I
,20_
,20~
Examined
Expiration
,20
Mail to:
Phone:
J-'"
IF: .
I
I ,~-- APPLICATION FOR BUILDING PERMIT
.j. 1\ r
:' ' i. I -4i I 6-7 Date
~~:~~ . INSTRUCTIONS ,20_
~~~lication MUST be completely filled in by typewriter or in ink and submitted to the Buililing Inspector with 3
sets of plans,~te plot plan to scale. Fee accoriling to schedule.
b. Plot plan showing location oflot and ofbuililings 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 buililing 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 buililing 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 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 Buililing Department for the issuance of a Building Permit pursuant to the
Buililing Zone Ordinance of the Town of South old, 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 0 t or name, if a corporation)
;J 0 /S () yo Ss LJet..()Vft.. /If.r/I
,. (Mailing addreM. of applicant)
-~.
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
~'e~
Name of owner of premises
/71I~J"" p G /( .v~
(As on the tax roll or latest d )
If a~l.~r~n, signa~of du~ authorized officer
I.. 'T ~...~
(Name and title of corporate officer)
//i--?
,
Builders License No. 7 S' (/ / - HI
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
~ if ~ CJ If " ~.J-C.IV
House Number Street
...s "v...'T), ~ L 0
Hamlet
County Tax Map No. 1000 Section
Subdivision
'5\.{
Block
Filed Map No.
(
"!'"
Lot
.
_, Lot
~)-I
(Name)
2. State existing use and occupancy of premises and intem};d use and occupancy of proposed construction:
a. Existing use and occupancy I!I"X.I -/""" b ~ 4.' --LI~ . \l
b. Intended use and occupancy <: _ ,,_ _
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
2.. C.Ae. f!eAIl~~
( escnption)
4. Estimated Cost
~r') 0"W"'"C.l
,
5. If dwelling, number of dwelling units
If garage, number of cars 2--
Fee
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, cOl!lmercial or mixed occupancy, specify nature and extent of each type of use. ~ A
.
7. Dimensions of existing structures, if any: Front
Height ~ ~ ' Number of Stories
:L 1/ Rear
I
2...'1-'
Depth
,3e>'
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth_ a \ 'v\Jv
9. Size oflot: Front
Rear
Depth
10. Date of Purchase
Name of Fonner Owner
II. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES ~
13. Will lot be re-graded? YES _ NO_Will excess fill be removed from premises? YES_NO_
14. Names of Owner ofpremiseshM fYI' r;,,1i'.~'9ddress ..~!o JID..,J;N ~one No.
Name of ArchItect "-'. Address Phone No
Name of Contractor ~ &'"u ~...c.';Address /$" lf~~ 1'.o::,_~;.Phone No. '?e..r /~I f
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 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.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says tbat (s)he is tbe applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
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 tbat the work will be
performed in the manner set forth in the application filed therewith.
Sworn tp before me this
j" ,"y~
A'~0&(~ I
- N Public
20E
~li_
MELANIE DDRDSKI
NOTARY PUBLlCbState of New\tll(
No. 010 4634870
Qualified in Suffolk County >.7\N _
Commission Expires Septemb8l30~