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Home My WebLink About34701-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33742 I~ate: 05/27/09 THIS CERTIFIES that the building ACCY SHED Location of Property: 1705 VILLAGE LA (HOUSE NO.) Co~ulty Tax biap No. 473889 Section 107 Subdivision MATTITUCK (STREET) (HAMLET) Block 11 Lot 2 Filed [Jap NO. __ LOt No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 20, 2009 pursuant to which Building Permit No. 34701-Z dated MAY 21, 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 ACCESSORY 8X16 SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to RAYMOND & THERESA VAN ETTEN (OWNER) of the aforesaid building. S~FOLK CN~L~F~Y DEPARTIWE~YT OF }~g~J~TH ~t-rKICAL CEKTIFIC/%TH NO. pL~B~ C~gRTIFICATION N/A N/A Signature Rev. 1/81 Fo~m No. 6 TOWN OF SOUTHOLD IIIJILD]NG DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTI~'ICATE OF OCCUPANCY -'.. ~ spplication must be filled in by typewriter or ink and stdmfit~, to the:Building Department with the following:. ii. For new building or 'new use: -1. Final survey of property with accunae'locaaion of all buildings, property lines; sm~s, and unusual natural ot ~. ~Fin.I. Approval from Heal,th I)ept of water.supply ~md ~v~l.(S-9 form). 3. Approval Of electric, id-installati°n from Board of Fire O-der~il~rs. 4. Sworn State~. ont from plumb~ c~i~ that~the solder Used in syst~m covtsi., less than2/10 of 1~/~ lead. $. Commci~'inl'building, industrial buildin~.mulllplo rosidt~m:~ and similar buildings and ins~lla~ol~s,.a certificate ofC_.ode Complianc~ frofii amhlt~loren_oin~r, respolmible for the building. 6. Submit Plsnning ~oard Approval ofcompleted site plan requirements; B.. Ii'or exisli~ig'buildlng$ (prior to April 9,' Ii)f/) nOn-COnformlng.uses, 0F buildings and ,pre'exis(i~g, Isnduses:' 1. Aocurate sttrveyofproperty's_h0wing all property lines, str~t~, building and.unusual natural or topographic fcatm~. 2. A propc~ly completed 'apptiCationand OOnsant to inspect signed by th~ applicant. If a Cetiiflcate of Occupancy is denied, thc Building Inspector shalt.stat¢ the reasons therefor in writing to the applicant. New Construction:. ,~ / Old or Pre-existing Building: - HoUSe No. . . Street ~ ,Owner or O~ers ofPropOlty: ..//.z~,,. '?/.:~ ~ ' · Su~Ik C0unOff Tax Map 'No 10~0 ', S/~tio/n- /ffg/~ Bl0c~'. C.- Fees L Certificate of Occupancy - New dwelling $25,00t Additions to dwelling $25.00. Alterations to dwelling $25.00, Swimmin§ pool $25.00, A.q, cessory building $25.00, Additions to accessory building $25.00, Busin~ses $50.00. Ce~ficate of Occupancy.on Pre-e .xisting Building- $100.00 3. Copy of CertificateofO~upancy- $;25 4. Updated Certificate of Occupancy .. $50.00 5, Temaporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Filed Map. DateofPennit..f"-~2/. ~f Applicant: Undenvriter~ Approval: ' Subdivision (check One) Final Certificate: Request for: Temporary Certificate Fcc Submitted: S ~d~. ~ / Appli~nt S~ture . Planning Board Approval: (check one) Hamlet Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT' TOWN HALL 7~-1802 APPLICATION FOR CERTIFICATE OF OccLrpANCY This application must be filled in by typewrite~ or ink and ,xthmitted to the Building Department with the following: ~ For new building or'new use: 1, Fin~t survey of property with ~:eurato loeatio~ of all buildings, ~perty lines; stxeets, and unusual natunfl or topographic featm'es.. Z Fin*l Approval from Health Dept. of~ supply and ~'~verage-dispns~l(8-9 form). 3. Approval of electrical installation ~om Board of Fire Underv~tem. 4. Sworn stat .e.anent from plumber eel~ifyiag that the solder treed in ~]atem oontsin.q !~8 thall 2J10 of 1 *A lead. 5. Commeroial building, industrial building/.multiple re~klene~a and similar buildings and ins~allafions, a cortiflcate of Code Compliance from arehitaet or en~neer t~ponaible for the building. 6. Submit Planning Board Approval of completed site plan requix~ments: IL For existingbuildings (prior to April 9, 1957) non. conforming m~, oF buildings and -pre-e~fing- iaad us~: 1. Accurate survey of prepen'y Showing all property lines, street, building end.unnsual nateral or topograp~e 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 dwetling $25.00, Swimming pool $25.00, A~gesory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy ofCeffificate of O~upancy- $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, CommereiaI$15.00 Health Dept. Approval: New Construction: ~,/ Old or Pm-existing Building: House No.. / .Street / ( Suffolk County Tax Map No 10~0, ~ec~on ///~ 7 Block Subdivision Filed Map. eermit/'/O. Dat ofPermit. d-'d/-C)f AppUcant: IJnderwfitem Approval: Planning Board Approval: Tempgrary Certificate Finai Certificate: Request for: Fee Submitted: $ Date. .~/ ~ jedT./° (check one) Hamlet (check one) Applicant ~isfia'ture / / FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34701 Z Date MAY 21, 2009 Permission is hereby granted to: for : ACCY SHED 8X16 R3kYMOND & WF VANETTEN 1705 VILLAGE LANE MATTITUCK, NY 11952 IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 1705 VILLAGE LA MATTITUCK County Tax Map NO. 473889 Section 107 Block 0011 Lot No. 002 pursuant to application dated MAY 20, 2009 and approved by the Building Inspector to expire on NOVEMBER 21, 2010. Fee $ 100.00 Authorized Signature ORIGIN~-L 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 tS ,20 Approved (~' /~/ ,20 C' 5'?' Disapproved a/c Expiration /////7-f,/ , 20/'¥~:' PERMIT NO. --~L/7'~7 / BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the/bllowing, belbre 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: Mailto: Phone: Building Inspect~)r APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ,~q ,_,, ,20 c / 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 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ///~ (Signature ofad~licant or name, ifa corporation) ./Ts c"z. /75 .--,-/7.-. I-- ' (I¢lailin~ ~ddres~ df ~l~plic'ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises . / / ~ ~ -,~-//~ 3w' ~s 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. Plumbers License No. ElectficiansLicenseNo. Other Trade's License No. Location of land on which proposed work will be done: / 7ri s -' /./5, c ,--/. House Number S{reet (/ ' Hamlet County Tax Map No. 1000 Section ,~/~ Block Subdivision Filed Map No. Lot o~ 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 ~_/,~'/~,d7 /r'//~ 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair Removal Demolition Other Work Estimated Cost %/2~,)d Fee If dwelling, number of dwelling units If garage, number of cars (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 Number of Stories Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Sizeoflot: Front Rear _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 14, Names of Owner ofprem~ses/'r,~¥,, ~-,~..z4~,.4c,'~..'.,--Address ./,)"Of'"~/f.'///?l~[ Name of Architect / Address Name of Contractoy(~..,.; (.J'~ . ,d~'e//e,~,a Zd.".a~ ? ..v. Address 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__ * 1F YES, D.E.C. PERMITS MAY BE REQUIRED. NO Phone No. ~.dde_/7./~/~' Phone No Phone 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 __ NO -~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ......-.----~..~¢. ~ ~ being duly sworn, deposes and says that (s)he is the applicant ~ (Name of in~vidudl 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 pertbrmed in the manner set forth in the application filed therewith. Sworn to belbre me this O q c~ c~ day of ~,.t:X,t~ 20 Notary Public Qua{~{[~ 3~9l~ ~ Commission ~pl~ july Signa~re of 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) PERb~IT NO. 34701 Z Date MAY 21, 2009 Permission is hereby granted to: for : ACCY SHED 8X16 RAYMOND & WF VANETTEN 1705 VILLAGE LANE MATTITUCK, NY 11952 IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 1705 VILLAGE LA MATTITUCK County Tax Map No. 473889 Section 107 Block 0011 Lot No. 002 pursuant to application dated MAY 20, 2009 and approved by the Building Inspector to expire on NOVEMBER 21, 2010. Fee $ 100.00 COPY Rev. 5/8/02 TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ~/2' , 20~t~ Approved Disapproved Expiration 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: Building Inspect~)r APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ~/~j ,20 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 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 ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of qt~licant or name, ifa corporation) ' (Mailing~ddres~ 4f ~!~plichnt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises / (,As 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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location oflan~d on which proposed work will be done: House N~ber ~reet ( ' H~let Co~ty Tax Map No. 1000 Section /~ Block // Subdivision Filed Map No. Lot ~ Lot a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~.,2~)(),/j Fee State existing use and occupancy of premises and intended use and occupancy of proposed construction: 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 Height Number of Stories Rear .Depth 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. 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 14. Names of Owner of premises/~,.%-~t~//~-~,~,',~Address Name of Architect "/' f ' ' Address Name o f Contract o,r,~,,, ,-~('/~o ~/-~'~ovoZ)z~5? ..~, Address 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. NO Phone No. Phone No Phone 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 NO -/ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) .,~,,__ ~ ~ being duly sworn, deposes and says that (s)he is the applicant f (Name of"l'n~idu~l 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 true 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 C~- ~ day of ~Vk~ 20 0'q Notary Public~'~x O~lifiz~t[i~i~ ,. o. ~ I~Z,~ Si~e of Applicant TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. 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