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Home My WebLink About34225-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33489 Date: 01/14/09 THIS CEi~TIFIES that the building ACCESSORY Location of Property: 50 YOUNGS AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET} Co~nty Tax Map NO. 473889 Section 141 Block 1 Lot 38 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 8, 2008 pursuant to which Building Permit No. 34225-Z dated OCTOBER 14, 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 AS APPLIED FOR. R~ne certificate is issued to ROBERT N & ELISE PASSEGGIO (OWNER) of the aforesaid building. ELECTRICAL CERTIFI~AT~ NO. N/A N/A N/A t~rized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CEP, TIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and snbmJtted to the Building Department A. For new building or new use: 1. Final survey ofprope~q.y with accurate location of'all buildings, property lines, streets, an, topographic restates. 2. Final Approval from Health Dept. of water supply and sexverage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters 4. Sworn statement from plumber cextifymg that the solder used in system contains less tha~: 5. Commercial building, indust~qal bnilding, mulliple zesidences and similar buildings and of Code Compliance from architect or engineer responsible f'o~ the building. 6. Submit Planmng Board Approval ofcomplcled site plan requirements. vith the ~1 ~- . _,unl sual aatura or[~ ~':1t of l°-& lear [ ~ B. For existing buildings (prim- to April 9, 1957) non-confo~ming uses, or baildings anti "pr 1 Accurate survey of p;cq)el% showing all p~ol~edy linc;, slmets, building and unusual natural or topogral~hic features. 2 A properly compleled applicatioit and consenl 1¢~ m: peet signed by tim applicanl, ifa Certificate of Occnpancy deaied, the Building inspech:~l shall state ill(? ik'ilqr*llq Ihci efOl ill writing to the applicalal. C. Fees 1 CcllificateofOccupanc> N~.v. dwellitlg $25 (It! x, ddhiol~slodwellmg$25.00, Aiterations to dwellmg $25 00, Swinuning pool $2500. AccessoU budding $25 ()0 A(hlifious to accessory I)uildmg $25.00, Businesses $5000 2. CeitificateofOccul)anc3 oulhc existingBttilcling $1(i000 3 Copy of Ce~ifica~c of Occupancy - $25 4 UpdatedCe~aificateof()ccupmcy $5000 5 Temporary Ce~tificalc el ()ccupa~lcv - Residential $15 0iL ( onm~c~cial $1500 New' Colxstmction: ,, Location of Proper(y: Old o~ Pre-existing Building: ltouse No S1 reet (check one) Suffblk (:6ultty Tax Map No 1000, Section f,/wl [ Block Subdivision ~ kiled Map Hamlet Lot 0 % 5--- 1 or: ~ Planning Board Approval:__ Requesl for; Temporau' Certificate Fee Submitted: $ ~.. '5''-'°--'%''' I"inal Celtiiicatc: ._L,,/'''~'~ (check one) '%'4 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. 34225 Z Date OCTOBER 14, 2008 Permission for : AS BUILT is hereby granted to: ROBERT N & ELISE PASSEGGIO 50 YOUNGS AVENUE MATTITUCK,NY 11952 12X16 ACCY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. at premises located at 50 YOUNGS AVE MATTITUCK County Tax Map No. 473889 Section 141 Block 0001 Lot No. 038 pursuant to application dated OCTOBER 8, 2008 and approved by the Building Inspector to ex/~ire on APRIL 14, 2010. Fee $ 2OS.OS j~e id ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: (~ [ ] ROUGH PLBG. [ ] INSULATION ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE INSPECTOR FmLD iN$1>ECTiON REi>ORT [ DATE I ROUGH Fm~G & PI INSULATION PER N. Y. STATE ENERGY CODE FEN AJL ADDITIONAL COMkMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, I~ 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined Approved Disapproved a/c Expiration 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 N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to:__~r-c)/-~rxj ~ ~,4~11 & C~ ~ Building Inspector ~, .,--~'- ' APPLICATION FOR BUILDING PERMIT :' Date 0G~ 8 ~U~]~ INSTRUCTIONS 'a. Th~ application I~IUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of ika~s~ aCCurate plot plan to scfil~. 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 herein described. The applicant agrees to comply with all applicable laws, ordinances, building codeyhousing code, and regulations, and to admit auth~c]~ ~l?ro~es and in building for necessary inspectionT/~(2-- IJSE IS UNLAWFUL , al <~ / / (Signature olappncant or name ila corporation) ITHOUT CERTIFICATE . ..... ,/, / . , ~'i: ~DDIIDAMOV ALLCONSTRUCTIONSHALL { [2f>~/ /qO ~ /l'//':P~'q-~¢l(----./kJ~ /1~12 ,*. vv~¢~J~r*~*~,,~ MEET THE REQUIREMENTS OF THE (Mailing address ofapplic~nt) State whether applicant is owner, l~sUseD~a~)ekn~, ka~ff~e~, ~/~]'ffeer, general contractor, electrician, plumber or builder APPROVED AS NOTED Nameofownerofpremises ~__~[~¢o't.'arlJ,~ f ~-4'~ ~,+-.GBe~.o.x_Cv[Oh,/~iff~,~. 5qaa, (As on the tax roll or l~'d~/~ If applicant is a corporation, signature of duly authorized officer FEE: cO/)/), tQI BY: NOTIFY BUILDING DEPARTMENT AT (Name and title of corporate officer) Builders LicenseNo. Plumbers License No. Electricians LicenseNo. Other Trade's License No. Location of land on which proposed work will be done: House Number / Street County Tax Map No. 1000 Section Subdivision Block 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C,O. ALL CONST~UC4TION SHALL MEET THE ng~t~ I~J:[F-~v~¢~T¢, C)E THECODES OF N~ Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 3C C ~ ~fi 0 fL ~/ 5 /,~ ~ ~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost [Z--oo~ Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor If business~ial or mixed occupancy, specify nature and extent of each type of use. Dimensiolls ofex~st~g structures, if any: Front [' 2__ Rear /' 2-- Depth /(~, Height ~ ~Ft/ Number of Stories__~ Dimensions~of same structure with alterations or additions: Front [ ~ Rear Depth [ (~ Height ~ Number of Stories ( 8. Dimensions of entire new construction: Front { D~_ Height ~ Number of Stories 9. Size of lot: Front [ ~ Rear [ ¢ Rear { ~ _Depth [ oC-- Depth Name of Former Owner 10. Date of Purchase 11. Zone or use district in which premises are situated ( ~2~ ~ O) 12. Does proposed construction violate any zoning law, ordinance or regulation? YES 13. Will lot be re-graded? YES__ NO NO I//W'will excess fill be removed fi.om premises? YES Address ~ g- ~-/~- ¢4.~c/c ! tOFzPhone No. 2--~'J5'~ ~/o 2-~' Address Phone No Address Phone No. 14. Names of Owner of premises Name of Architect Name of Contractor NO Xl 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO /~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notaff Public, State of New York (S)He is the No. 01BU6185050 -, OuaimeO in :suffolk ~oun (Contractor, Agent, Corporate Officer, etc.) ,0mmission Expires April 14, ~ lB- 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 ~-d-% day of C~ C~,~ L,c~ 20 C~ Notary Public Signature of Applicant Town o_f Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOI~M PROPERTY LOCATION: S.C.T.I~, #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF STORM-WATER GRADING~ DRAINAGE AND EROSION CONTROL CERT F ED BY A DESIGN PROFESSIONAL IH THE STATF-OF NEW I~..N unlber: (NOTE: A Check Merk (.~') for each Question is Required for a Complete Application) Yes No 1 Wil this Proiect Retain All Storm-Water Run-Off Generaled by a Two (2) rich Ra nfo on Site? (This item will include all run-off created by site clearing and/or construction activities as well as all Sile Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures indicating Size & Location? ~/~ r"'"'~ This Item shall include afl Proposed Grade Changes and Slopes Controlling Surface Wa erFIow! ~/-- Will this Projecl Require any Land Filling, Grading or Excavation where there is a change to the Natural r"~ ~/, Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? 2 3 4 Will this Application Require Land D[sturbin9 Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feel of Ground Sur'ace? 5 6 Is there a Natural Wa[e~ Course Runr/ir~g through the Si(e? Is Ibis Project ~,,ilhiu the Trustees jurisdiction or vOlhin One Rundred (100') feet of a Wetland or Beach? W0r there be Sile preparalion oo ExislJn9 Grade Slopes which Exceed Fifteen (15) leer of Vedical Rise to One Hundred( 00') of ltolizordal Distance? 7 8 9 Will this Proiect Re ~uire the Placement of Malerial, f".ernoval of Vegetation and/or the ConslPdction of any Hem VVilhin ths Tov, n Right of-Way or Road Shoulder Area? (This item will NOT hlclude tile Installation of Driveway Aprons.) Will this Proicct Require Site Prepa~atioo wilhm Ihe One Hundred (100) Year Floodplain of any Wa ercourse? NOTE: If Any AnSwel to Questions Olio through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior fo Issuance of Any Building Permip EXEMPTIONf Y e~ N~ Does this project meet the minimum standards for classi~cation as an Agdcuflural Project? Note: If You Answered Yestolhis Question, a Storm-Water, Grading, Drainage& Erosion Control Plants NOTRequired~ STATE OF NEW YORK, ~ That l b~:uig duly swoln, deposes mc says dlat he/she is A~clth~ e/s~e s ~' .,. ~0~NI~DBUNCH {O""Orr Co,~r~otor, Agenl Corpora{e O~oer, e[c ) N0, 018U61~050 m&e ~d ~le this applica~on; that all s~t¢ln¢~lts confined ia ~is applica~on are ~e to the best of his ~owledge ~d b~ief; ~d that fl~e work will be performed m the m~mer set [0rth in d~ application filed herewid~ Sworl~ to before n~e this; Notary Public: .......................................................... :7 ........................... FORM - 06/07 l' U