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HomeMy WebLinkAbout34612-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34039 Date: 10/27/09 THIS CEi{TIFIES that the building ACCESSORY SHED Location of Property: 675 LAKE DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Co%ulty Ta3~ Map No. 473889 Section 59 Block 5 Lot 18 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 15, 2009 pursuant to which Building Permit No. 34612-Z dated APRIL 15, 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 & ANDREA T MULDER (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPARTMENT OF HEALTH APPROVAL EL4~t-£KICAL CERTIFICATE NO. PLUMBEi%~ CERTIFICATION DA'£F~3 N/A N/A N/A AhoredSignature Rev. 1/81 07/17/2007 14:40 FAX ~002 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 7~5-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Dep~rtment with the following: A, For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, sO'cots, and unusual natural or topographic features. 2. Final Appr°val from Health Dept. of water supply and sewerage, dispnsal (S_9 form). 3. Appr°val °f clectricaI installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains le~s than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a cen'ificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. F~r existing bui~dings (pri~r t~ April 9~1957) n~n~canf~rming uses~ ~r bui~mgs and "pre.exi~ting~ la~d uses: 1. Accurate survey of property showing ali property lines, streets, building and unusual natural or topographic features. 2. A ProPerlY e°mplcted applicati°n and consent to inspect signed by the applicant, if a Certificate of Occupancy is deaied~ 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 o£Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy - $50.00 5. Temp°rary Certificate of Occupancy - Residential $15.00, Conunereial $15.00 (check one) New Construction: Location of Property: Date. Old or Pre-existing Building: House No. Sireet Owner or Owners ofPrope~y: ~t~&B,~,~o ti Suffolk Cowry Tax Map No 1000, Section ~ ~ ~ S.bdi sien. 6. / Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate ~.. Date of Permit. / //..//o6 Underwriters Approval: _ Final Certificate: ~'/(check one) Fee Submitted: $ __2['~ ~,'-o _ Appli6ant ~ignat~:~ Hamlet Block 0/90 ~" Lot Filed Map. Lot: Applicant: FORM NO. 3 TOWN 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) PERMIT NO. 34612 Z Date APRIL 15, 2009 Permission is hereby granted to: JOHN & ANDREA MULDER 3 POLLY LANE GLEN HEAD,NY 11545 for : CONSTRUCTION OF AN ACCESSORY SHED"AS BUILT" AS APPLIED FOR THIS REPLACES BP# 31707. at premises located at County Tax Map No. 473889 Section 059 pursuant to application dated APRIL Building Inspector to expire on OCTOBER 675 LAKE DR SOUTHOLD Block 0005 Lot NO. 018 15, 2009 and approved by the 15, 2010. Fee $ 150.00 Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~.I. ATION [ ] FRAMING / STRAPPING [ ,~'~FINAL [ ] FIREPLACE & CHIMNEY [ REMARKS: ~'~-~ ~-'~ ] FIRE SAFETY INSPECTION DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [, ] I/~ULATION/ [ ] FRAMING / STRAPPING IV] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPEC'nON [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR ~~/~ FI~LDEqSPE, ~tC ~',EPORTI DATE I COMMENTS FOI[YNDATION (1ST) FOUNDATION (2ND) ROUGH F~G & PL~B~G ~SULATION PER N. Y. STATE ENERGY CODE / / ~ c ~ ~b~~ ~ ~DITION~ COMMENTS TOWN dF SOUTHOLD BUILDING Dl~PARTMENT TOWN HALL . SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Approved j/~.~ , 2~ ~ Disapproved a/c Expiration 7/t~b, 200 -~ PERMIT NO. _g/.7 7 BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the following, he. fore applying? Board of Health 4 sets of Building Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees C°ntact:Mailto: J/~_/~ ~E//tnd,~'~7--- Building Inspector ,IAN '--3 APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20m a. This application MUST be completely filled in by typewriter or ih ;mk and subrrdtted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on prmnises, 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 Ingpector 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. APPLIC. ATION IS HEREBY MADE to the Building Department for the, issuanc.e ol~ 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 herci~n described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and/t~ ~a~9~s, and to adm/t authorized inspectors on premises and in bdi!ding for necessary inspections. ~/// /~/~.... ~ ~ (Signature of applica~: or name, ifa corporation) State whether applicant is owner, lesse~t, (Mailing address of applicant) \ engineer;-gCneral contractor, electrician, plumber or builder Name of owner of premises L ~/~.[L- L E- (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. Location of land qn which proposed work will be done,,, 75' L.4K = House Number Street Hamlet County Tax Map No. 1000 Section~ Subdivision (Name) Block Filed Map No..,; 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~/A,t~(_,~ /~,,q~t,,t/C~ b. Intended use and occupancy .,,~"~t,,~/, _f::::~ 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 Fee Alteration_ (Ibescrip~on) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, comrn~ercial 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 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 9. Size of lot: Front Rear ~/ 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 ~X~Will excess fill be removed from premises? YES __ 14. Names of Owner ofpremises~._Address/~,qf£ta,'t~,,,o,?' Phone No. Name of Architect/~/,~'~E ~ t,t~/,~,O~rO"t- ~'ddress Phone No Name of Contractor Adaress Phone No. 15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES 2~ 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 16. Provide survey, to sc~e, 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. ~ ]//~ r JC~//'/"I'/~/v'- ~._ being duly sworn, deposes and says that (s)he is the applicant (Name of individual si'" 'gning contract) hbove named, (S)He is the ~ (Contractor,~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 ~ dayof (,/ I~ottary Public LYNDA M BOHN NOTARY PUBUC, State of New York NO. 01B06020932, Suffolk County Term Expires March 8, 20~? ant James F. King, President Jill M. Doherty, Vice-president Peggy A. Dickerson Dave Bergen .John Holzapfel Tox~m Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone 1631) 765-1892 Fax ¢6311765-6641 At 009~C BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE Date. 1/20/06 THIS CERTIFIES that the 675 Lake Dr., Southold shed and dock Suffolk County Tax Map # 59-5-17618 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 4/8/05 pursuant to which Trustees Permit # 6137 Dated 5/18/05 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued for a shed and dock The certificate is issued to aforesaid property. LUCILLE SEITZ owner of the / Authorized Signatur~t' Board Of $outhold 'Town Trustees soUTHOLD, NEW YORK PERMIT NO. (_.O ~ ,~'"~ DATE: Hay 18, 2005 LUCILLE SEITZ ISSUED TO ...................................... ~ .......................................................................................... uth izati Pursuant to the provisions ~f Chnpter ~1~ ~f ~e ~w~.~f the Sta~ of New York, 1893; and ~apfer ~ ct ~e ~ ct the State of New York 1952; and the Soufhold Toen O~man~ en- tfl~d ."R~U~TIN~ AND ~E P~OlNG OF: OBtRUderS IN AND ON TOWN WATERS AND PUBLIC ~DS and'-f~ REMOVAL OF SAND, ~VEL' OR O~R MATERIA~.~M ~NDS UNDER TOWN WA~RS;E and m ac~an~ w~h'the Resol~ion of ~e Board adopted at a meeting held .~ and in considerafi~ of the sum of $.....;.~.~.~.~ .... paid by ~uc~e Se~. .............................................................. : . of Southold ' ' .. N. Y. and ~biecf fo Che Ter~'""~g'd'""-~'~'~g~'"'j~¥~"'""~''' ~e reve,e side .~reof, of ~ufhdd Tow~ T~es authorizes and ~rmi~ f~ follo~ng:. Wetland Permit to construct ~ 10' x 16' shed and a 3' x 20' timber or fi~rglass grating .dock, 3' x 6' steps to grade , using 4" x 4" posts, and all as depicted on . the plan prepare~ by Sea Level M~i~ last date4b/~4/05. a~ in a~or~an~ w~h ~e defa~d sp~nicatmns es ~nt~ m IN WffNESS WHERe, ~e ~id Board 0f T~dees ~re- be subdued by ~'~lm~ of fha ~la ~ra as James King -. SURVEY OF PROPERTY SITUATED AT SOUTHOLD IOWN OF SOUIHOLD SUFFOLK COUNIY, N[W YORK 1000-59-05-18 SCALE 1"=20, AUGUST 25, 2003 Ingegno Surveyor New York State Department of Environmental Conservation Bureau of Habitat, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0275 5/5/05 De~ise Sheehan Acting Commissioner Re: Seitz Property 675 Lake Dr. Southold, NY. Dear Lucille Seitz: It has come to our attention that you constructed a shed within 100 feet of NYS regulated freshwater wetland # SO-5. Our records indicate that these structures were built without the benefit of a Freshwater Wetlands permit from this agency as required by 6NYCRR Part 663 (Freshwater Wetlands Regulations). Therefore, these structures were built in violation of Article 24 (Freshwater Wetlands Act) of the Environmental Conservation Law (ECL). At this time the Bureau of Habitat will not pursue this violation. However, be advised that ~ahy future regulated activities conducted on this site without the benefit of a NYSDEC permit Wil/be treated as serious violations punishable by fines and/or removal of structures and/or restoration of the area. Regulated activities include but are not limited to: construction of buildings, roads, driveways, parking areas and other structures; filling and excavating; clearing of vegetation; grading or ground disturbance. Please do not hesitate to call me at (631) 444-0275 if you have any questions. You may contact our Division of Environmental Permits at (631) 444-0355 on any Monday, Wednesday, or Friday, if you would like to request an application for permit. Sincerely, Robed F. Marsh Conservation Biologist Bureau of Habitat cc: DEP Analyst file 3MPLY VV!~H AL DES NE 'YORK ST4-E & CO[ -- .... NI)iTION~ )F FOR POURED CC:~C~TE ROUGH - FRAM[KG & PLUMBING INSU~TION FINAL - CONSTF~:5~T,ON MUST I BE COMPLETE FOrt C.C. ~1 ~A~/ L CONSTRUCTION SHALL MEET THE I ~EQUIREMENTS OF THE CODES OF N~ - OF OCCL,:FAk~C': _ Z~)NE. / STORY FRAME NOOSE (ON PiLiNgS) / / / / (LEETON$ LAKE) Alber~ J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 18, 2005 Mark Schwartz P.O. Box 933 Cutchogue, NY 11935 RE: LUCILLE SEITZ 675 LAKE DRIVE, SOUTHOLD SCTM# 59-5-17, 18 Dear Mr. Schwartz: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 18, 2005 regarding the above matter: WHEREAS, Mark Schwartz, AIA- Amhitect on behalf of LUCILLE SEITZ applied to the Southold Town Trustees for a permit under the previsions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of $outhold, application dated April 8, 2005, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 18, 2005 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, · WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, New York State Department of Environmental Conservation Notice of Incomplete Application - This is NOT a Permit Application ID: 1-4738-03508/00001 Facility: SEITZ PROPERTY 675 LAKE DR SCTM #1000-59-5-17&18 SOUTHOLD, NY 11971 Contact: MARK K SCHWARTZ OwnerlD: 1190161 PO BOX 933 CUTCHOGUE, NY 11935 Batch Number: 954435 Permit(s) Applied for: 1 - Article 24 Freshwater Wetlands Project Location: in SOUTHOLD in SUFFOLK COUNTY Your application for Permit is incomplete. The following items are required: 1. The application and supporting documentation submitted show the shed to be an existing structure built without benefit of a Freshwater Wetlands (Article 24) permit. The Department of Environmental Conservation does not issue after-the-fact permits for existing structures. Therefore, we will no longer consider this a portion of the project. Should you have any questions about the shed or the waming letter you received from the Bureau of Habitat, please contact Robert F. Marsh at (63 I)444-0275. 2. Project plans must clearly illustrate all existing and proposed conditions and structures at the site. Therefore, you must show the existing shed on the plans. 3. Department staffwill delineate/confirm the fi'eshwater wetland boundary in the field. You will be advised when the delineation/confirmation has been completed. Once the line is determined, you must revise the project plans showing this boundary line and all proposed work. The project plans must also show a line which is labeled word for word "Limits of Clearing, Grading and Ground Disturbance". This application will remain incomplete until the above items/information are submitted and/or addressed and you have submitted 5 copies of revised plans. Do not heditate to call me at (631)444-0369 if you have any questions. Please submit requested information by No further action can be taken until all of these materials are received. 7 Contact Person: KELLY ANN FELICE NYSDEC SUNY ~ STONY BROOK BUILDING 40 STONY BROOK, NY 11790 Date: September 13, 20~5 Telephone Number: (631) 444-0369 Applicant/ , Architec'd Engineer: ~ ~ $CTM ti: I)isldS~: ],000 Section: _ .~ Block: Ih'ojec~ ~i~le & aeparat¢ Required . cemficati0a: (Y~ (No) R~. Project D'eaeeiption: RF_,QUIRJ~D FOR RI~VEEW Date /~ Rewewed Subdivlsio~ N.A. NO YES Number' :Suffolk Cot~ty Health. Dept. H~w York ~tate. D, E; C. Town Trust~ · Town Zoning Board approval: Town Planning Board approval: Floo~ Plane Elevation 7?? Flood Zone: