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Home My WebLink About34378-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34378 Date: 02/27/09 THIS u~TIFIES that the building ACCESSORY Location of Property: 370 CRITTEN LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County T~ Map No. 473889 Section 70 Block 12 Lot 14 Subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 8, 2009 pursuant to which Building Permit NO. 34378-Z dated JANUARY 8, 2009 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 GEORGE H & LINDA M BISCHOFF (OWNER) of the aforesaid building. SIIFFOLK COI3N~Y DEPARTb~gNT OF HEAI~TH APPROVAL ELECTRICAL c~KTIFICATH NO. PLI~ERS C~K'rIFICATION DA'r~3 N/A N/A N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~,t~lllil~ S0~llltl} APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 frem Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fxom 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 Planinng 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 enmpleted 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 \ New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. Street Hamlet OwnerorOwnersofmroperty: ~,~,t~/~ % ~c~\~..,r -~ ~,~,~,~,~,~,~:- Suffolk County Tax Map No 1000, Section Subdivision Block Filed Map. Lot: Applicant: -~"~'~ ~- Underwriters Approval: Permit No.-~t'l ~"~ 7~- Health Dept. Approval: Planning Board Approval: Request for: Date of Permit. Temporary Certificate Final Certificate: (check one) Fee Submitted: AI~plica~t Signature FORM NO. 3 TOWlq OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII/)ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) P~IT NO. 34378 Z Date JANUARY 8, 2009 Permission is hereby granted to: GEORGE H & LINDA M BISCHOFF 370 CRITTENS LANE SOUTHOLD,NY 11971 for : "AS BUILT" ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 070 pursuant to application dated JANUARY Building Inspector to expire on JULY 370 CRITTEN LA SOUTHOLD Block 0012 Lot No. 014 8, 2009 and approved by the 8, 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 Examined //~ , 20 ¢ Approved //f ,20 ~' Disapproved a/c Expiration 7/ ~'' 20/~ ii!! JAN 0 8 2009 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans ~'x I ?ONk'~'J Planning Board approval "~Survey Check '~,O0-0o Septic Fora N.Y.S.D.E.C. Trustees Flood Pe~it Store-Water Assessment Fo~ Contact: Mail to: Phone: f'~~ing Inspector APPLICATION FOR BUILDING PERMIT 3 Y: .................... 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 b~ 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 code, ho.using code, and regulations, and to Itdmit authorized inspectors on premises and in building for necessary inspection~ (} J .,...~ ~igna re ofapplicdnt or aK corp~on) (Mailing address of applicant) State whether applicant is ?wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ·/~ Name of owner of premises [, ~''''~' 'W7'' ,; l' r) t.'~ (As on the tax roll or~ latest deeit). ;, .. ~ ~~ If applic~t is a co~oration, si~amre of duly authorized officer D.~TE: ~ .... FEE:~ ...... (N~e ~d title of co,orate officer) NOTIFY BL:~L' 7; ' . ~,~ ~, :T AT Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on wh"0~}r~o~ "bze:' % House Number Street 765-1802 8,-,,.,, 4. r ; FORTHE 1. FC;Ui',DA'flOtl - '7' :0 : ,,:. :r- FOF! ?OUF;:.D CC 2. ROUGH - rP,.¢ ;~ c* 3. INSULATION 4. FINAL - CONSTRUCTION MUST :~ork will be done: BE ~MPLETE, FOR C.~. r'~i~t : r County Tax Map No. 1000 Section Subdivision Block:1'3-. ' %t 1 Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ~'~ b. Intended use and occupancy --~e..-.l ~-K-~:>~A,~ 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost [~'-~:::~>-~"~-- 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~ Rear __Depth Height. Number of Stories I Dimensions of same structure with alterations or additions: Front Depth. Height. Number of Stories D~mens~ons o~f entire new construction: Front t~-..' --t Rear Height [ I - t.~ t~ Number o~ St~rie~- Depth Rear Size of lot: Front Rear .Depth 10. 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 ~o 14. Names of Owner of premises ~>t~'-~-~-~-~-~-~-~-~-~-~ Address'Id'7t~ ~-~-~t~one No. ~ - ~_~ Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland. YES NO * 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet cfa 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 __ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) co ¥ ~ ~-~ /-{ '-D~t~-t~ being duly swam, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, C0~'l~lll: O. Notary Public, State of New York No. 01BU6185050 (S)He is the a,,~m,~ i, ~,,~,,~ e~,,,~ (Contractor, Agent, Corporate Officer, etc.) Commission Expi(~ 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 tme to thelbest of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ~ -~tJr~ day o f '~O~.~l.~',.r ~/ 200~ Notary Public TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION FIRE RESISTANT PE#,-, ~ATION DATE iNSPECTOR.~/~, ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ]INSULATION ~,.FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE COMMENTS FIELD INSPECTION REPORT I DATE FOUNDATION (1ST) FOUNDATION (2ND) PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS N : W~E S Lot # 24 Lot # 23 Lot # 22 JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERFIEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\kHp server~l~ROS~03 - 153.pro Erosion, Sedimentation & Storm Water Run-off ASSESSMENT FORM PROPERTY LOCAT/ON: S.C.T.M,#: THE FOI LOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER; GRADING; DRAINAGE AND EROSION CONTROL pLAH C,-I~iI'ilED BY A DESIGN PP. Orr:S81ONAL IH THE STATE OF NEW YORK. Item Number:. (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? Ye._.~s No 2 3 4 5 6 7 8 9 (This item will include all mn-off created by site cleating and/or construction activities as well as alt Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Wated:lowi Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cub c Yards of Matedal within any Pamel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Nature Water Course Running ~hrough the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Wtil there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15} feet of Vedical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Material; Removal of Vegetation and/or the Construction of any item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) Wit this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? D NOTE: If Any Answer to Questions One through Nine ts 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 to Issuance of Any Building PermlU EXEMPTION: Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm.Water, Grading, Drainage & Erosion Control Plan is NOT Requlredl Yes No STATE OF NEW YORK, COUNTY OF ..~ ........ SS That Ig.~.,.l~.'h~.4~,...t.d...~...~~ .................. being duly sworn, deposes ~d ~ys ~at h~sbe is ~e app~t for Penni~ (Name of individual signhg D~menl) CO~J~J[ D. BUNCH ~' . N~ ~blic, ~ ~ N~ York d mat he/she s ~e N0 01BU618~05~ ......................................................................................................... QU~i~ .f~. ~U ~,,. v5 ~i;[~ .......... (~ner. C~ct~. Agenl. Co.ate Offi~. etc,) Commission Owner ~n~or mprcs~nadv¢ m~¢ ~d file ~his application; · at ~c work wil] bc performed Sworn to before me this; ............... · .~..~...~..., ................. day of ........i .~..~.'.x../TXx,~.43,.r. 5~ ..... Notary Public: ..... ~7..~ h....~. '~7~........~......~....~......~..~2~ ...................... FORM - 06/07 SURVEY OF LOT 23 HAP OF: ?~)UTHINOOO 1=11~]2 NOV..24, I~ A~ ~ 2141 51~A~, ~T~LD TO~, ~~LD ~U~VE~E~ 04-01-0~ ~DFFOL~ ~OUNT~ TAX ~ ~OO0 - ~0 - I~ - 14 GF_.ORGE H. B~SCHOPF L~NDA MAR~ BISCHOPF NOTES: · h4ONU~ENT AREA = 44,114 SF OR I.OI ACRES ®tO-.APHIC SCALE I"= 40' Lot # 24 Lot # 22 Lot # 23 N JOHN Co EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 R1VERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\LHp server\dXPROS\03-153.pro