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Home My WebLink About34534-ZFORM NO. 4 TO,tN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33631 Rte: 04/02/09 T~IS CERTIFIES that the building ACCESSORY Location of Property: 2100 ALDRICH LA LAUREL (HOUSE NO.) (STREET) (HAMLET) Co%~nty Tax Map No. 473889 Section 125 Block 1 Lot 2.20 Sul~iivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 23, 2009 pursuant to which Building per~tlt No. 34534-Z dated b~ARCH 26, 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 JOHN K SR & MARY K GRAUER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL C~TIFICATE NO. pLDMBERS c~KTIFICATION DA'r~3 N/A N/A zed Signature Rev. 1/81 TOWN OF SOUTHOLD Bt LD o Dwr MENT IIh)l ...... 765-1802 ~PLICATION FOR CERTIFICATE OF OCC~ ~LDG. DEPT. [ TOWN ~F SOUTHOLD ~s ~plication m~ ~ fill~ in by t~ewfiter or ~ ~d sub~ to ~e Build~ ~t wi~ ~e follow,g: 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 o f electrical installation from Board o f 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' B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Aecurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and couscnt to inspect signed by thc 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 - $I00.00 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. 3/.~_.~ /~ New Construction: Old or Pre-existing Building: (check one) House No. Street ' Hamlet Suffolk County Tax Map No 1000, Section l ~,~ Block (29 ,/ Lot ~ .c~ Subdivision ~. ~r~,~'~-.-- ~'-'~q7"~/'2~ ~"~'~ 7 Filed Map. Lot: t/ ,1 P it o.%fl 5 Date of Ce=it. ^p licant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Appl{cant Sigfiatnre FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Town Hall Southold, N.Y. BUIDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34534 Z Date MARCH 26, 2009 Permission is hereby granted to: JOHN & MARY GR3tUER PO BOX 217 LAUREL,NY 11948 for : "AS BUILT" ACCESSORY SHED AS APPLIED FOR at premises located at 2100 ~_LDRICH LA MATT/LAUREL County Tax Map No. 473889 Section 125 Block 0001 Lot No. 002.020 pursuant to application dated MARCH 23, 2009 and approved by the Building Inspector to expire on SEPTEMBER 26, 2010. Fee $ 200.00 Authorized Signature Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: INSPECTOR FIELD INSPECTION REPORT I DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (ZND) ROUGH FRAMING & PLUMBING -- INSULATIONPER N. Y. STATE ENERGY CODE F~ ~DITION~ COMMENTS ,~ ~TOWN OF SOUTHOLD ~ROP~RT~R~RD CARD OWNER STREET <:~ /DC) VILLAGE DIST. SUB. ~ S W ~PEOF BUILDI~ RES. ~ /C) SEAS. VL. -, , ( FARM COMM. CB. MICS. Mkt. Value ..... LAND IMP. TOTAL DATE REMARKS Till~ble FRONTAGE ON WATER W~l..d FRONTAGE ON RO~D ) ~ H~ PI~ BULKH~D 125.-1-2.20 3/08 · ~g~ t ~.-~)~t~= ~t9...~ ~50 (~1{o0 Foundation P,C, B~~ ~xtension Ba~ment ~ ~ Floors ~xtension Ext. Walls ~ ~ e~. Interior. Fini~ ~xtension Fire Pla~ ~ - I Heat )orch Pool , A~ic ~e~ 14~ = ~ Z~ ~ Patio Rooms 1~ Floor ]mezeway Driveway ~ Rooms 2~ Floor 3. B. Extension Extension Extension Found~ion Basement Ext. Walls Fire Place Bath Floors Interior. Finish Heat Town_ _of_ Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOR.'," PROPERTY LOCAllON: S.C.T.M. ~, THE FOL~LOWIliG ACTION8 MAY REQUIRE THE SUSMIS~JON OFA ..8..T.ORM_4~_A_T..E _R~_G_RADING! DRAINA~GE AND EROSION CONTROL PL4JI ~*=KI,rleU UT A DESIGN PROFESSIONAL IN THE STATE OF ;.'~.;' YORK. Item Numben (NOTE: A Chec~ Ma~ (~) fo~ each Question is Required fo~ a Complete Application). ~ Yes No ......................... _ Z .= _ W,~illist~l: Pr0..j~t. R., .l~lrl ..All St _or~Wa?r..Ru ..r~ .Ge .l~tsd by a Two Improvements and the permanent creation of Imperious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Dmina{le Slructums Indicating Size & Localion? r~ .l~is item shall th~lude all Proposed Grade Changes and Slopes Controlling Surface WaterFIowl -- 3 Will this Project Require any Land Filling, Grading or Exoevatioe where there is a change to the Natural r~1 Five Thousand (5,000) Square Feet of Gro~Jnd Surface? EXEMPTION~ Yes No_ Does this project meet the minimum standards for classification as an Agflcullural Project? Note: If You Answered Yes to thts Question, a Storm-Water, Grading, Drathage & Erosion Control Plan is NOT Requl~edl That I ................ being duly sworn, deposes and says that he/she is the applicant for PenniL (Name o! i~clivldual signing Document) . And that he/she is the ......... v ................. --------.---,. ........ ,- .................... Owner md/or representalive of the Owner of Owner's, and is duly authorized to perform or have peffomied the said work and to Illa~e and file this application; that all statements contmned 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 tiled herewith. Sworn to before me this; .. ...0~......~.. d~yof .~5..~ .(.~.... ...... ~0...? Notary Public: O-7~'~- N~E P"blLc~_Sl~teof Ne .......... ....................................... I~. b'J~6190696 ,.,. o;'~i,=.,, ' ,.~_ 0ualified in Suffolk Count? FO RM - O6/07 ..... =,,:~;,,,, $-,.i,~s .lulv >_~ ,t, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined 20 / Approved Disapproved a/c Expiration fi/,.~ ,2~'~ PERMIT NO. [tA 2 3 200g BLDG. DEPT. TOWN OF SOLITHOLD Building Inspector 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: APPLICATION FOR BUILDING PERMIT Date ,.~/~ 3 INSTRUCTIONS ' ,20 O¢ 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 st(~ets 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 alter 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. o applicant or name, ~fa corporation) ~,/ ~'Signature ' ' ' ....., (Mai nga dress of applicant) State whether o Name of owner of premises (As on the tax roll o~ ~ate~sfde~ed) If applicant is a corporation, signature of duly authorized officer 1. (Name and title Builders License No. 4. Fi~,?,L - CC:," ', :,I MUST Plumbers License No. : ~, , SE [, i : ~'r /'~'rYl'lr'lr~A-r' ' ALL. COHSTF;L!c:';: ~ ,. ,,i_L MEET THE Electricians License No. ,, ,; i ~a ~_ ~ ~ ~ l~ , r ~ ,~ , ,~, ~ ~, ~, REQUIREf¢.?'F?,5 C,::' ~;~ :F ¢"33ES OF NEW Other Trade's License No. ',,,¢" k,( A,, ,'r~it~; :~ YORK STATE. NOT R~.'::>ONo, t'~*uLI- = FOR BESlGN OR CONSTRUCTION ERRORS. 1. Location~/ooof land on which~~proposed work will be done:~/~ House Number Street ~BTORM WATER RUNO~ County Tax map No. 1000 Section Block Subdivision L~C ~~% ~ Filed Map No. Lot t [ 2. State existing use and occupancy ofpremis_es and intended use and occ,upancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ~.~l/,Ol.J '-F~OC <~'7"0~t/~-~ 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) . Fee (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occup.ancy, ispeeify nature,and exllent o(each type of use. 7. Dimensions of existing structures, if any: F~0nt ,~ F) Rear c-~ Depth Height ! i~) 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 10. Date of Purchase Name of Fon'ner Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO J 13. Will lot be re-graded? YES NO t,/~ill excess fill be removed from premises? YES__ NO c--//' 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 c,~ * 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 __ · 1F YES, PROVIDE A COPY. NO STATE OF NE~W YO,.4RK) ~ ,"/' SS: COUNTY OF,~,t~ ) · 'T'-t3 14 ffl, 5 }"' a ~ being duly swom, 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 filed therewith. Sworn to before me this t~ dayof ~'*~ Ok,~ .b~. 20OC~ Notary Public No. 01106190696 Qualified in Suffo k County ..-~ 00remission E~pires July 28, 20 ~~S~gn'ature of Applicant