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HomeMy WebLinkAbout34368-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP/kRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33470 Date: 01/02/09 THIS C~TIFIES that the building AS BUILT SHED Location of Property: 135 SUNSET LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) Coua~t¥ Tax Map No. 473889 Section 33 Block 4 Lot 48 Subdivision Filed Map No. LOt NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 22, 2008 pursuant to which Building permit No. 34368-Z dated DECEMBER 30, 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 SHED IN REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to ROBERT JR & GAIL A GHOSIO (OWNER) of the aforesaid building. S~FOLK COUNq~f DEFARTb~ENT OF }~¢ALTH APPRO%g%L EI~-r~ICA~ CERTIFICATE NO. pL~4BERS CERTIFICATION DATED N/A N/A --~hor~ed Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY bi-iC 2 2 2008 bLDG DEPT. T_QWN O.F $._?_~!_~..0~ 9_~ This application must be filled in by typewriter or ink and submitted to the Building Department with the following: Ao 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. Bo 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. 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 New Construction: Location of Property: '3 ~ House No. Owner or Owners of Property: /~o ~-~,c Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: Street Date. /~_- ?_.Z --©<~ (check one) Hamlet Block O y Lot ~"' Subdivision Permit No. ~'O/,//fl~t~ ,~ Health Dept. Approval: Plarming Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~2~~. Filed Map. Lot: Date of Permit. J~9,.JgO-O~ Applicant: Underwriters Approval: Final Certificate: b///(check one) Applican~~// 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. 34368 Z Date DECEMBER 30, 2008 Permission is hereby granted to: ROBERT JR & GAIL A GHOSIO 135 SUNSET LANE GREENPORT,NY 11944 for : AS BUILT SHED IN REQUIRED REAR YARD AS APPLIED FOR at premises located at 135 County Tax Map No. 473889 Section 033 pursuant to application dated DECEMBER Building Inspector to expire on JUNE SUNSET LA GREENPORT Block 0004 Lot No. 048 22, 2008 and approved by the 30, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. 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 DisapprovedApproved a/ Expiration ,20 N.Y.S.D.E.C. Trustees Flood Pem~it Storm-Water Assessment Form Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 promises available for inspection throughout the work. e. No building 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 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 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 Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suftblk 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 applic~ o~name, if a corporation) (Mailing address of appli6ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name ofownerofpremises ~e~44---P- ~_w-/405,O -,Jr-. ~:7-,q-~'/ /~. (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title 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: .g.g 5onSe_y- House Number Street County Tax Map No. 1000 Section Subdivision Hamlet Block Lot t.J ~, Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~$, Z/e.,q'Tq;'/-/ ~/ ado/~ b. Intended use and occupancy /~S~Mr,~,X/~;t/ q ~/7/-~ Nature of work (check which applicable): New Building Repair Removal Demolition ~ Estimated Cost ~ fl--ff-OI Od)C> Fee If dwelling, number of dwelling units If garage, number of cars I Addition Alteration Other Work Fe-&,, (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify 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 10. Date of Purchase Rear .Depth Name of Former Owner 1 I. 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__ NOZWill excess fill be removed from premises? YES__ NO 14. Names of Owner of premises Name of Architect Name of Contractor 'bo,q 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 ora tidal wetland? * YES__ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Address ~g X,,~ 44. ~-~Phone No. '8'7~L 3'3 '7¢ Address Phone No Address Phone No. 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~O (~''~'-''(- ~740 _'5 t ~ Jr"~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~G.) 4 ~e~ (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 tree 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 before me this ,'O~FId[ dayof TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I/N~LATION [ ] FRAMING / STRAPPING [ j,~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT_CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~'~/~ .~-., TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved Disapproved a/c { b~OG. DEPT. ' ~___T_QWN QF $0~ ITHO[ 0 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Expiration ,20.__ Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 any 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 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 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 heroin 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. OCCUPA',,!, USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY (Signature ~)~f a~i~ or name, if a corporation) (Mailing address of appli~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder APPROVED AS NOTED DATE: Jc~/-~"'°/(f¢~ B.P. #. Nameofownerofpremises ~c-~- ~/c9(5A~; Jr~ [[p ~__. :,/. on the tax roll o~tatlt~at (t~l.¢~h' .-'- - , ~TMENT AT If applicant is a corporation, signature of duly authorized officer 765-1802 8 AM I O 4 ,"'M FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) Builders License No. ALL CONSTRUuTI(JN SHA I Plumbers License No. MEET THE REQUIREMENTS OF T~E Q ,- Electricians License No. C ¢D~8 OF NEV'/YOF, K STATE. Other Trade s License No. 1. Location of land on which proposed work will be done: Block Filed Map No. House Number Street County Tax Map No. 1000 Section Subdivision 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMiSG & PLUMBING 3, INSULATION 4. FINAL ~ CO,"?~'~'UCi'ION MUST BE COMPLEL': !OR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR RROaS. Hamle~ Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~9?e-'~+~ ~ '~ r,'~ e_ ~'/~ ~ b. Intended use and occupancy. 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5~/[oo 0 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration t OtherWork a-'w,~4,~ S~ Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front /~ ~C ~ Rear /(,, ~ 1c- .Depth Height -7 ~c-f. Number of Stories 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 I 0. 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 of a tidal wetland? * YES__ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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 ) '-~o ~-t-~-IL ~'~Ao ~ 0 -.-J t'~ being duly sworn, deposes and says that (s)he is the 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ,~,-'~nd dayof O~!r~l~¢~ 20Og Notary Public BERNABETTE L. TAPLIN NOTARY PUi~UC ~844893 State of New ~ork ~.~d,n[ m Sufl~k County FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (IST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS .$URVEY OF PROPERTY .~ITUATE~ C~;~-NPOt~T TOPIN= ~'HOI~ ~IJI=FOLK C_..,OUNT~, NY' ~ 0~--2.~-200-/, 04-10-200-/ .~U~-'OLK COON'r'( TAX # I000-~ -4-4~ ROBERT ~ ~ ,mil Al, II'iON I"IATION.'~., BRID(2{ AB~-I~.~CT N Nec~ = 12~'33.O"3 50,: Fl:. OR O.2q46 Ac~es LOT ~ F<EP~-~ TO "H~P OF F_~T~RN E~ORE~ AT ~P. EENPORT" C,~P-.~PHIG fi::~,A{ F I"= ~O' JOHN C. El-II.ERS LAND SURVEYOR 6 EAST ~ STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\\Com?aq~"rvet~)s~g-133REDO.pro