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Home My WebLink About33762-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32973 Date: 04/10/08 THIS CERTIFIES that the building ACCESSORY SHED Location of Property: 555 PRIVATE (HOUSE NO.) County Tax Map No. 473889 Section 77 RD #31 (STREET) Block 3 SOUTHOLD (HAMLET) Lot 14 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 18, 2008 pursuant to which Building Permit No. 33762-Z dated MARCH 24, 2008 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" ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to TERRY C & SUSAN NAGY (OWNER) of the aforesaid building. SUFFOLK COONTY DEPAR'l'MBHT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~o~ Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ILP~ 3 7b~ .--- --I \ b APPLICATION FOR CERTIFICATE OF OCCUPANCY <I' c--l This application must be filled in by typewriter or ink and submitted to the Building Department with the follo',Ving: --' 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. r-- 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 Date. .3 - 02 Lj-D 8' New Construction: V Location of Property: ssb" P""tc.t-" ((J 3/ ("'5'OOS~ (!", LI House No. Street Owner or Owners of Property: ~('-r'.!f 1 SL/5C{ >1 Suffolk County Tal' Map No 1000, Sectidn '173 ~8'j - 60'7 Block . . Subdivision Old or Pre-existing Building: ( check one) 5t:JvfhIJ I j Hamlet )JaEJ.~ bOO ~ Lot D/L../ 2.. Date ofpermit. 3. 61 9 - f) 8' Filed Map. Applicant: SD.sa.11 Lot: Permit No. 3.3 7 (..,;z :T 0c~. Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: ~ ( check one) Fee Submitted: $ ~pp~ ~M: ./~ 1011 Co ~ .3.;1. ~ '7 ~ 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. 33762 Z Date MARCH 24, 2008 permission is hereby granted to: TERRY C & SUSAN NAGY PO BOX 1354 SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN AS BUILT SHED IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 555 PRIVATE RD #31 SOUTHOLD County Tax Map No. 473889 Section 077 pursuant to application dated MARCH Block 0003 Lot No. 014 18, 2008 and approved by the Building Inspector to expire on SEPTEMBER 24, 2009. Fee $ 200.00 ORIGINAL Rev. 5/8/02 JJ7 h:;2...Z- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING rf><r FINAL ~" [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS. ~ ~ l:L () , DATE 'f~7-0 t INSPECTOR ~~ ---_..__._---~- - -- 3370';-'7- TOWN OF SOUTHOLD 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 CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: flel~. --ti=- ~ ____ ~ Ci-- ~.~ ~~ ~ 1: ..~., ~ . (;:b DATE L/_ l- -0 0 INSPECTOR ~ ~ . - " FIELD INSPECTION REPORT' DATE I . . FOUNDATION (1ST) ---~-------------------------------- FOUNDATION (2ND) ROUGH FRAMING & PL U1VIl>IN G LNSULATlON PERN. Y. STATE ENERGY CODE FINAL 1-------- COMMENTS -,- . . . . T.[;;)r1. y .n n jJ --f:;;;.... J,/J, ;'h. 0 ~ .n ---li;.... =-,.. (J I~ (),;):..~ ') _~ _,1//7 c? ~.. ./ . y / - 7 1_ ~ 1..0...- Q'TI , ( ;rid t:?;//~ ~ ~, '-... .~ J:g.. .., A) 'f ADDITIONAL COMMENTS ~ ~ ~ .'..f/./) , . ~~ t~ /"' ~ ~ \) t'l ~6 G..l. ~ '" >-l ~~ " >-l ". ? ~q l'1~ ' .;;- ~ '~ !~~ to;:; I~'\:I: P ~ LI f'l 1"-'1 ~~ ~ t ., ~, . ~-- ~ "- ~ ,,~ o " ~ ~\iii ~ ;ll >.. s t I'" i0'd I\,. ~ ~>-l ~ ~ 0 Z [;i ~ >-l ::I: o I'" "" :-l BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ----. 4 sets of Building Plans ~\G~,^, <'_ Planning Board approval ~ Survey Check ':)>,',. ,,0 Septic Farm N.Y.SD.E.C. Trustees Flood Permit Storm-Water Assessment Form_ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. 33 76 ~ ,20~ !:,-,,~ ^) r;. " ~ U !-::....,." r' "~I ,E..' , Examined Approved 54- '! Disapproved ale ,20-r MAR 18 L Contact: Mail to: SU5a V\ Ua ~ PD 00L ) 3:-'i ~,vt 4 o(~ Vl-f Phone: '7&0 -37(,9- Expiration ,20~ iA.P ~O~D AS NDlEDAPPLICA1'ION FOR BUILDING PERMIT ~ B P #~'3 -u.;:;.. -;&-- DAie::::l . .~ Date BY' FEE: , EPA iMENi Ai INSTRUCTIONS NOilFY BUILDING D OR iHE ?6iA692tP#lIAMtiJQI~ b~lcompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of PFol'l(3WltlA.t~ '~II\E5ee according to schedule. ~" ~U\'l!MIi!~~~ 'F!1!~ of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and W:lil~ED I & PLUMBING C2.1IIIe~kc\J%MJ~%y this application may not be commenced before issuance of Building Permit. d3.U\'lSAl~~\I!mO\:iflOO'~n, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be k6pfll'lNhe ~~~.\!p'le for inspection throughout the work. . e. NBlb& lOw gffi\lJ!.i<M8M1uI~in whole or in part for any purpose what so ever until the Building Inspector Issues a CAl:t1ifle~~ 1ffiil'fAl- CODES OF NEW f. R~f g~~t~j)ik liQRe work authorized has not commenced within 12 months after the date of issuance 0){~~8r~ eitOO9\'MGt~Hh~%nths from such date. If no zoning amendments or other regulations affecting the property h~~ 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, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. .3 - /9: ,20~ flt) &.x /351( Sollltll:>/) .AJl; II'! 7/ (Mailing address of applie t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder "WYler Name of owner of premises (/2 tV (As on th ax roll or latest deed) e of duly authorized officer , If applicant is a corporation, signa OCCUPANCY OR USE IS UNlAW~Ul WITHOUT cr '!',\ \fICATE Of OCCUP;" '"y (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location ofland on which proposed work will be done: 350 Grn..-;L (if' J...vJ House Number Street .~dd f1f Hamle County Tax Map No.1 000 Section Subdivision 077 Block _":i Filed Map No. Lot IY Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .3 h-er) - ~+{V'C:; S-<8 b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front / a ~ Rear Height Number of Stories / ~ .p+- Depth ;;;.4- 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 9. Size oflot: Front Rear Depth 10. Date of Purchase 3- /OJ 87 Name of Former Owner II. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO ,r- 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 Address Address Phone No. Phone No 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, )i,ftol k ) -s,:;;Q. r0 (Name of individual being duly sworn, deposes and says that (s)he is the applicant ng contract) above named, (S)He is the ~I'le,... (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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to.b.~e me t . \ '6' day of 20~ BARBARA ANN RUDDER Notary Public, Stata of New York No.4B558D5 Qualified In Suffolk Counl'l. .. I cJ 10 Ires AprIl14,~ Notary Public r--- . ! "\~~~~~--------'--~---- l~~,' : ""__r- I! .+1 , ~ ~ , , 1 - .'j I /'// ""1 I/O' i/t\J il. I: ~ !: . ..1'.., '. -- .vi ~8f2AMS .. 0 " t- I- ........ 0 '! 1\I lI)~ "t II ~ lli ~. 3 ~ :, 1\I >- -: ,g , q ~ '-, I 1tl ll} ..Q.. ~ i (\] 1It.ll , li-- V) ~ I,i ,. 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