HomeMy WebLinkAbout34189-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33632 ~te: 04/02/09
THIS ~KTIFIES that the building ACCESSORY G~d~AGE
L°cation of Property: 265 BARLEY LA
(HOUSE NO.) (STREET)
County Tax Map NO. 473889 Section 59 Block 4
Subdivision
Filed Map NO. __ Lot NO. __
SOUTHOLD
(HAMLET)
5.12
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 29, 2008 purser to which
Building Permit No. 34189-Z dated SEPTEMBER 29, 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 ACCESSORY NONMABITABLE UNHEATED TWO CAR GARAGE WITH STORAGE ABOVE
(NO ELECTRIC) AS APPLIED FOR.
The certificate is issued to CORI & KAREN LANG
(OW~NER)
of the aforesaid building.
SUFFOLK COUNTYDEPARTM~qTOFHEALTHAPPROVAL
~LRCI-KICAL c~TIFICATE NO.
PLI~4BERS C~TIFICATION DA'£~D
N/A
~/A
N/A
hor/~ed Sd~nature
Rev. 1/81
BLDG. OEPT,
TOWN OF SOUTHOLO
P,d'J'L
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
2ATION FOR CERTIFICATE OF OCCUPANCY
JX
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 leeation of all buildings, property lines, streets, and unusual natural or
topographic featurea.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (8-9 form).
3. Approval ofeleetrical installation fi'om Board of Fire Underwriters.
4. Sworn statement fi'om plumber certifying that the solder used in system contains less than 2/10 of 1% Iced.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for thc building.
6. Submit Plannin$ 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
featmes.
~ 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
New Construction: /
Location of Property: jt~ S
House No.
Owner or Owners of Property: CO 1'-I'
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No. ~ ~//0~/ Z
Health Dept. Approval:
Date.
Old or Pm-existing Building:
Street
(check one)
0 ~--? Block 000 q
Filed Map. Lot:
DateofPermit. ?/OOT/OY Applicant: .CO~ ~ ~''I~}TtylA-j
Unde~te~ Approval: ~
Hamlet
Lot 0 0.~', 0/o~
L,t,u 6
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ j~, O O
Final Certificate:
~ (check one)
Applicant
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. 34189 Z
Date SEPTEMBER 29, 2008
Permission is hereby granted to:
for :
CORI & KAREN LANG
PO BOX 1083
CUTCHOGUE,NY 11935
CONSTRUCTION OF AN ACCESSORY GAP~AGE IN THE REQUIRED REAR YARD AS
APPLIED FOR. REPLACES EXPIRED BP # 27731
at premises located at
265 BARLEY LA SOUTHOLD
County Ta~ Map No. 473889 Section 059 Block 0004
Lot No. 005.012
pursuant to application dated SEPTEMBER 29, 2008 and approved by the
Building Inspector to expire on MARCH
Fee $ 443.40
29, 2010.
ORIGINAL
Rev. 5/8/02
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 27731 Z
Date SEPTEMBER 25, 2001
Permission is hereby granted to:
CORI & KAREN LANG
PO BOX 1083
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN ACCESSORY GA}~AGE IN REQUIRED REAR YARD AS
APPLIED FOR
at premises located at 265
County Tax Map No. 473889 Section 059
pursuant to application dated AUGUST
Building Inspector.
BARLEY LA SOUTHOLD
Block 0004 Lot No. 005.012
16, 2001 and approved by the
Fee $ 443.40
ORIGINAL
Rev. 2/19/98
REMARKS:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECT
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION [
[ ] ROU PLBG.
[ ] ;ULATION
[ FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
DATE ~ INSPECTOR ~~~~~
765-1802
BUILDING DEPT.
INSPECTION
[//'] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ]FRAMING [ ] FINAL
REMARKS:[ ] FIREPLACE~& CHIMNEY _
DATE
INSPECTOR
~Om~DAT~ON ( IST)'
ROU~ ~ &
INSULATION I~R lq. Y.
DATE
ADDITrOIqAL CO~flKI~'S:
LOT ~ 4124D MI. fl.
~' 154J2'
lOT NO. 12
BARLEY LANE
LOCATION CF WATrR ~ A~D ADdiX~I~ WATER
C(~Y & KAREN LANG
SUNRISE ABSTRACT ~.
CO~ITgYWIDE HOME LOANS. INC.
of record, if any.~ no= sbov~':~ ;:.'~ ,~ ~4c;.m~eed.
JO~ NO. 00-104 r~. ~AT~
SURVEYED F~ C~Y ~ ~ ~G
~i4
~A~D AT ~
~WN ~ ~-~ ~ KY.
H~OLO F. T~CHON ~R. P.C.
LAND SURVEYOR
~/-A''~I}' LIC..NO. 048992
HAROLD F. TRANCHON .IR. PENN LIC NO. 211t5-E
1866 WADING RIVER-MANOR RD. WADING RIVER
NEW YORK, 11792
516-929-4695
TOWN OF SOUTHOLD PROPERTY ~RECORD CARD
OWNER STREET '~?~>~-~ VILLAGE DIST. SUB. LOT /,/__
RES. ~ I 0 S~5. V~ FARM COMM. CB. MitS. Mkt. Volue
~ND IMP. TOTAL DATE R~RKS
Tilloble FRONTAGE ON WATER
Wo~nd FR ON ROAD /~o
Meedowl~d :OEPTH ~ ~
House Plot BULKH~D
Totol
TRIM
Extension
Extension
Extension
u
Porch
Breezeway
Garage
Patio
O.B.
Total
Foundation
Basement
Ext. Walls
Fire Place
Type Roof
Recreation Room
Dormer
Both
Floors
Interior Finish
Heat Z4 J
Rooms 1st Floor
Rooms 2nd Floor
Driveway
Dinette
LR.
DR.
BR.
FIN. B
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Approved ~'"~ta~j''~z- .~ ~, 20 t~./
Disapproved a/c
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying ?
Board of Health
3 sets of Building Plans
Survey.
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to: C~,rl Lt~
'hone: '-765'-
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
se~s 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 apphcatiun 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 a Certificate of Occupancy
is issued by the Building Inspector.
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. ~
(Signature of applicant Or~fiame, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ('tL'gi ~ ~Qlt-(¥t,.//.r°ft¥(.~
(ns 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. .-D'('>_ }:
Plumbers LicenseNo.
Electricians License No.
Other Trade'sLicenseNo.
1. Location of land on w~ch prgposed, work will be done:
House Number
CountyTax Map No. 1000 Section ._~/ Block
Subdivision
Filed Map No. Lot
(Name)
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
Repair Removal
4. Estimated Cost I
O
5. If dwelling, number ofdwell~g units
If garage, number of cars r]_
Nature of work (check which applicable): New Building
Demolition
Fee
Addition Alteration
Other Work ~ !~eCi'
(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. ~ t'a'
7. Dimensions of existing situctures, if any: Front ~ Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front /L~ Rear
Depth Height.
Dimensions of entire new construction: Front
Height
9. Size of lot: Frotu
10. Date of Purchase
Number of Stories
Rear Depth
Number of Stories
Rear Depth
Name of Former Owner ~J3c~.~
11. Zone or use district in which premises are situated ~'-~%~ (~ ~ ~
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be re-graded
14. Names of Owner ofpremises ~ ~q /}Ifjohn{- Address
Name of Architect Address
Name of Contractor c~ ~I~' Address
Will excess fill be removed from premises: YES ~
Phone No.
Phone No
Phone No.
-,~
15. Is this property within 100 feet ofatidal wetland? *YES NO ~
· IF YES, SOUTHOLD TOWN TRUSTEES 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.
STATE OF NEW YORK)
SS:
COUNTY OF )
CO ? ~ ]--/¢~'J (~ 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 tree to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application flied therewith.
Sworn to before me this
Not~ublic
~ A ~A~IS
~ARY ~B~G, ~te of N~ Yo~
T~ ~ Ju~
' :,: OCCUP
ISE IS U
,APPROVED,ASNO1T]I , USE IS U
765-1802
FOL~OW;NG INS E~ONS.
I~ FOUNDATION. TWO
FOR POURED CONCR~
Z ROUGH. FRAMING A RLUMBIN~
~ I~SU~TION
· FINAL . CONSTRUCT/ON
BE COMPLETE FOR C,O.
ALL CONSTRUCTION 8HALL
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, NOT
DESIGN OR CONSTRUCT E F~
DO NOT PROCEED \'V!TH
FRAMING UNTIL SURV['Y
OF FOUNDATION LOCATICN
HAS BEEN APPROVED.