HomeMy WebLinkAbout32825-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPD~RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33303
Date: 09/26/08
THIS CERTIFIES that the building ACCESSORY
I~)cation of Pro~rty: 110 SLEEPY HOLLOW LA
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 78 Block 1
subdivision
Filed Map No. Lot No.
SOUTHOLD
(HAMLET)
Lot 10.6
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 21, 2007 pursuant to which
Building Permit No. 32825-Z dated MARCH 21, 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 SHED AS APPLIED FOR.
The certificate is issued to ROBERT F & ELIZABETH A NEVILLE
(OWNER)
of the aforesaid building.
N/A
N/A
N/A
~~Aut/z~S ±g~at~re
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILD1~G 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 $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
Accessory Building- Tool Shed
Date. 8 [21/08
New Construction:
Location of Property:
X Old or Pre-existing Building:
110 Sleepy Hollow Lane
(check one)
Southold
House No. Street Hamlet
Owner or Owners of Property: Robert F. & Elizabeth A. Neville
Suffolk County Tax Map No 1000, Section 078
Subdivision Sleepy Hollow
Permit No. ~ Date of Permit. 3/21/2007
(replaces Permit No. 29261)
Health Dept. Approval:
Planning Board Approval:
Block 0001 Lot 010.006
Filed Map. Lot:
Applicant: Robert F. Neville
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ 25.00
Final Certificate:
(check one)
· ~.[pl-ica~(S ignatur~ -
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. 32825 Z Date MARCH 21, 2007
Permission is hereby granted to:
ROBERT F NEVILLE
PO BOX 995
SOUTHOLD,NY 11971
for
CONSTRUCT ACCESSORY SHED AS APPLIED FOR. THIS PERMIT REPLACES
BP 29261.
at premises located at
County Tax Map No. 473889 Section 078
pursuant to application dated MARCH
110 SLEEPY HOLLOW LA
Block 0001
SOUTHOLD
Lot No. 010.006
21, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 21, ~. ~
Fee S 75.00 ~~u~re ~,~
Rev.
5/8/02
ORIGINAL
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
PERMIT NO.
BUII/DING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
2~9~ Z Date APRIL 4,
2003
Permission is
hereby granted to:
ROBERT F NEVILLE
110 SLEEPY HOLLOW LA
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN ACCESSORY SHED AS APPLIED FOR. THIS PERMIT
REPLACES BP#26714.
at premises located at 110
County Tax Map No. 473889 Section 078
pursuant to application dated APRIL
Building Inspector to expire on OCTOBER
SLEEPY HOLLOW LA SOUTHOLD
Block 0001 Lot No. 010.006
4, 2003 and approved by the
Fee $ 75.00
.zed Signature
Rev. 5/8/02
ORIGI}
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)
~---'-'- J Date AUGUST lit 2000
PERMIT NO. 26714 Z ~.~ ~ D~i~
Permission is hereby granted to:
ROBERT & ELIZABETH NEVILLR
110 SLEEPY HOLLOW LA
SOUTHOLD~NY 11971
for :
NEW CONSTRUCTION OF AN ACCESSORY SHED AS APPLIED FOR.
at premises located at 110
County Tax Map No. 473889 Section 078
pursuant to application dated AUGUST
Building Inspector.
SLEEPY HOLLOW LA SOUTHOLD
Block 0001 Lot No. 010.006
1~ 2000 and approved by the
Fee $ 35.00
Authorized ~ignature
COPY
Rev. 2/19/98
~_ "0 N OFSOUT~O~D I
I:ORM NO,
TOWN OF SOUTHOLD
BUILDING DEPARTh'ENT
TOWN HALL
'rE[.: 765- ]802 .-2~
Disapproved a/c .
(l~ldmg Inspector)
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
DEC ...........................
TRUSTEES ......................
MAIL TO: ..................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application moat be ccxnpletely filled in by ty~iter or in ink and autxuitted to the ltHlding Inspecto~
3 sets of plans, accurate plot plan to ~cale. Fee according to achedule.
b. Plot plan showing location of lot and of b~ildings on premises, relationship to adjoining premises or public
streets or areas, and giving a detailed deacription of layont of property mast be dra~n on the diagram ~dch is part c
this application.
c. 'fl~e ~ork covered by this application may not be comenced before issuance of Building Permit.
d. Upon approval of this applicatiee, the Building Inspector will ismle a Building Pemit to the applicant.
permit shall be kept on the premises available for inspectio~ throughout the work.
e. No bailding mba11 be occupied or used in ~aole or in part for any purpose ~atever until a Certificate of
Occupancy shall have been granted by the Building Irmpector.
API~ICATICt; IS l~m~$I MAIE to the Building Depaztment for the isauance of a l~ilding Pemit purmmnt to the
Building Zoee Ordinance of the To~n of Sonthold, Suffolk County, New York, and other applicable Lawa, Ordinances or
tRagulations, for the construction of I~aildlngs, additim~ or alteratioas, or for remvval or demolition, an herein
described. The applicant agreee to ecmply with all applicable laws, ordinances, b~ilding code, betming code, and
regulations, and to ~it authorized inspectors on pr(xnises and in building for necessary inspections.
(Signature of applicant, or na~, if a corporation)
State wi)ether applicant ia owner, lessee, agent, a~chitect, engideer, geaeral contractor,
Name of c~ner of pr~nises . ~oberA .F...g. Ic[izabatb. A,, J)lj~¥j[ilit ..................................................
If applic~1 t~a corl~ratio~l~ture of duly anttmrized officer.
~ ~wwr~Jo~
............................................................ S~uthold..N.Y .1.1971 . . .
House N~r Street llamlet
County Tax Map No. 1003 Section .... QY.Q,.Q{).... Block ..Q).,{).(~ ....... Lot ..(~).(~,.00.6. ....
Subdivision .,$ I e~el i~.l ............... Filed Hap No. 6-3 $4- ......... Lot .. 4 ...........
2. State existing use and occupancy of pr~nises and intended tree and occupancy of proposed construction:
a. Existing use and occupaagy . p.~.iv_a.'l-_o_ .O. OR .:Family..D.w. pJJi. ng
b. ~ntended use a..-,d occupancy ...Sa~te.v4Lth.~.q(;~;.~q.ry..b.u.i.l.d. ing 7 .t..oem shed-~
/ ..... ,....
~. P.~mre of ~,~rk (d~,.k dHd~ applicable): New Building .......... Addition .......... Alteration ..........
Bepair,............ R~=,~-zal ..~..: ....... Demolition ............ Other Work ..................................
!Descri pt ion)
4. Estimated Cost ......................... fee ..............................................
(to be paid on filing this application)
5. If ct~elling, r~t~er of dwelling tmlts ............ Nt~ioer of &~lling tmlts on each floor ................
If garage, ntmber of care ......
6. If b,~sieess, cc~,ercial or mitred occupancy, specify nature and extent of eech type of use ......................
7. Dir~nsioos of existing stta~ctures, if amy: Froot ................ Rear ............... Depth .................
llelght ...................... . .. l~tm~ber of Stories ......................
Dimeaslo~s of ~ stature with alterations or additions: Front ............... ~ar ...............
Depth .................... Height .................... htmber of Stories ...............
8. Dimensions of entire new cooscruc~on: Fro~t .... 1D). ........ Rear .1.[}! .......... Depth ..12.¶ ........
.... ll) ................... limber of Stories l ....................
9. Size of lot: Fro~t .... ~.~. .......... Rear ..2.8~?. ............ Depth ..~.5~.~.~.~.~?.,. ~$~
10. I~te of Purdmse .... ~a,[~r. iL .2' ,..l~N~re of Former O~mer .. Roberl~ .&..Carpi .[tohn ............
~ ~. Zoos or use district in ~hlch premises are sltt, ated " "
12. Does proposed construction violate any zo~tng law, ordinance or regulation: .... ~ ................
~3. Will lot be regrnded ...~1o .............. Will excess fill be removed fr~n premises: YES NO
~4. Nares of Owner of i,,'~,~ises RabA.&E.£iz. Ne~i.[a Address [~(l.[lo~.~95.~thoo[c[,[~ne
N~wa~ of Architect .................................... Address .............................. Ii,one No .............
~rae of Contractor ~.[=-.~od.[lte$i~s ............ Address P.~"cl~iC~..~.'~...l[]~.[[ ....... l't~one No .............
15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ..........
PLOT DIAGRAM
I~cate clearly and distinctly all buildings, whether existing or propased, and indicate all set-b~ dir~nsions
~ property limes. Give street and block rm~ber or description according to deed, and show street nar~s and indicate
~hetber interior or corner lot.
4.. FINAL - CONSTRUCTION MUST
BE COMPU=i i= FOR C.O.
,9~om to before me this
......
.OT , U L'C,
No. 01BO6020932
Qualified In S~olk ~ ·
Term Expires Mar~ 8, ~
(Sitars of Appl. mant!
ALL CONSTRUCTION SHALL MEET
.......... .E.I..i .z.p.b~.t,b...A.,. H~.v..i.I..I.~ .................. being dul7 ~m, dapaees ~ ~f~l~'r$1~l~y.
(Name of individual slguing.contract) STATE CONSTRUCTION 8[ ENERGY
above rk~od, CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
S I~ is the .O~uer.
(Cc.~tractor, agent, corporate officer, etc.)
of said o~er or ow,ers, and is duly authorized to perform or have performed tile ,said work a~l to make a~d file this
application; that all stat~nents contairw~l in O~is appl. icatlo, are troe to U~e best of his koo~ledge and Pel. jef~ sr~J
that the work will be perfor~fl in tile menner est forth in the application filed tberewlth.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FRAMING / STRAPPING [/,,~FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAF~ECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE
~/~ ~/~) ~INSPECTOR ~ ~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] IN~J~ATION
FRAMING / STRAPPING [~/] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:_
DATE
'IELD INSPECTION'REPORT DATE COI'flqENT S
'_O[INDAT ION (IST_) .... J'
,'OUNDAT I ON (2~)
[NS~TION PER N. Y.
CODE
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET /'/ (~-~, VILLAGE DIST. SUB. LOT
J~ORMER OWNER x / E ACR. ~., '~
/ S W TYPE OF BUILDING
/
RES. y , , SEAS. VL. F~kRM COMM. CB. MICS. Mkt. Volue
LAN D IMP. TOTAL DATE REMARKS
tillable FRONTAGE ON WATER
~o~land FRONTAGE ON ROAD
~eadowland DEPTH
~ouse Plot BULKH~D
'oral
M. 'BId¢~t'
Extension
Extension
Porch
Porch
Breezeway
Garage
Patio
COLOR
Foundation
Ext. Walls
Fire Place
Type Roof
Recreation Roorr
Dormer
Both
Floors
Interior Finish
Heat
Rooms 1st Floor
Rooms 2nd Floor
Driveway
TRIM
.~ Dinette
~-U. tu, K.
..~, ~ LR.
/*,~ DR.
BR.
FIN. B
Totol 7//y
3i~B°
SLEEPY
ii
(i)
10.3
10o4
/ ;f JO. 7 10,8 10.9
, . lc) (e~ I0/ in
13)
I~ lO.eS
lelf~' LtO*
The
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