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Home My WebLink About34481-ZFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPD/qCY No: Z-33634 Date: 04/06/09 THIS CFa(TIFIES that the building ACCESSORY Location of Property: 3585 SODTH HARBOR RD (HOUSE NO.) County Tax Map No. 473889 Section 78 subdivision SOUTHOLD (STREET) (HAMLET) Block 3 Lot 66 Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 4, 2009 pursuant to which Building Permit No~ 34481-Z dated MARCH 6, 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 AS APPLIED FOR. The certificate is issued to JUDY BRODERICK of the aforesaid building. (OWNER) SUFFOLK COUNTYDEPARTMENTOFHEALTHAPPRO%5%L BLEcrKICAL CERTIFICATE NO. PLieRS CERTIFICATION DA'r~u N/A N/A N/A nature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING 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 alectrical 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 residanees 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 Pm-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 Date. q - ~=,~l~q New Construction: Old or Pre-existing Building: Location of Property: '~5~-~ ~ ~OC ~ House No. Street Owner or Owners ofProperty: ~r(-C)t~,,gz~i C/~--j 'x) cACkx Suffolk County Tax Map No 1000, Section~r/ ~ Block (check one) Hamlet Lot (~(¢ Subdivision Permit No. '~q q ~ I Date ofPermit.~-6~Dh Filed Map. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ c-~ -~ · C> C~ Final Certificate: (check one) 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. 34481 Z Date MARCH 6, 2009 Permission is hereby granted to: JUDY BRODERICK 3585 SOUTH HARBOR ROAD SOUTHOLD,NY 11971 for : AS BUILT ACCY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. at premises located at 3585 SOUTH HARBOR RD SOUTHOLD County Tax Map No. 473889 Section 078 Block 0003 Lot No. 066 pursuant to application dated MARCH 4, 2009 and approved by the Building Inspector to expire on SEPTEMBER 6, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 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 REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT I DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUG~ ~aA~ING & PL~G INSULATION PER N. Y. STATE ENERGY CODE ~DITION~ CO~ENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , ' SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined 5 1(-4~ ,20 (~ Approved ~.~[{.Q , 20~ Disapproved dc 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: Building Inspector PLICATION FOR BUILDING PERMIT Date 3/3 ,2005' INSTRUCTIONS pletely 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. ThereatEer, 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. OCCUPANCY OR ai~ppl[cant 6~na%, ifa corcoration) USE IS UNLAWFUL WITHOUT CERTIF!CATE ..... (Mailing address of applicant) '/? ~,/ State whether applicant is owner, lesseQg~t~[J~[~i~teer, general contractor, electrician, plumber or builder Name of owner of premises '~'~;/ /~' APPROVED t~,q NOTED (As on the tax roll o- .~,~,. ___ , B.P. ~ j ~11 If applic~t is a co~oration, signature of duly authorized officer FEE: ~0 O, ~ ._ r,v _ ~ ~ (Name and title of corporate officer) RETAIN STORM WATER RUNOFF Builders License No. PURSUANT TO CHAPTER 236 Plumbers License No. OF THE TOWN CODE. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section "7 ~' Block ~ Subdivision Filed Map No. NOTIFY BUILDIhG 5.[;,:?Tt/ENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CON3TRUCTION MUST BE COMPLETE cOR C.O. ALL CONSTRUCTION SHALL MEET THE ffC'~R&:~UIF~NETS ,~ CODES OF NEW Y~:~ATE. NOT RESPONSIBLE FOR ,SIG OR CO ST UOTIO, ERRORS. Lot ~ Lot 2. 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 i~c: c..~ ~x, ¢! 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars 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 Height Number of Stories Rear _Depth Dimensions of same structure with alterations or additions: Front Depth Height · -48: Dimensions of entire new construction: Front /~ ~ Height Number of Stories 9. Size of lot: Front Rear Number of Stories Rear to t%~_'t- Depth 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 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 NO __ * 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) ~-,,~ r~,§S: COUNTY O ~ltU'~F-k being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE 0. BUNCH (S)He is the N0taw..P_ubl,},ck,,S~,.t~? Yor~ (Contractor, Agent, Corporate Officer, etc.) Oualifi0d in Su~lk gounty Commission Expires April 14, 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 LJ wt~.x dayof Notary Public Signature of Applicant