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HomeMy WebLinkAbout33885-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34139 Date: 12/15/09 T~IS CERTIFIES that the building MOVE ACCESSORY Location of Property: 1855 DEPOT LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax t4ap No. 473889 Section 102 Block 1 Lot 9.1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 25, 2008 pursuant to which Building Permit No. 33885-Z dated MAY 8, 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 RELOCATE AN EXISTING ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to ROBERT & JOYCE BARRY (OWNER) of the aforesaid building. SuFfOLK COUNTY DBPART~ENT OF HEALT~ APPRO%rA~ ELECTRICAL c~TIFICATE NO. PLUMBERS c~TIFICATION DA'£~3 Rev. 1/81 N/A N/A N/A ~u~ri z d~Sig~t ure 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 mad submitted to the Building Department with A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unus 3. 4. 5. topographic features. Final Approval fi:om Health Dept. of water supply and sewerage~isposal (S-9 form). Approval of electrical installation from Board of Fire Underwriters. ~fo: owinl~ aal na~ Sworn statement fi'om plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineefresponsible for the building. 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 Oocupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming poul $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 ofOocupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: V/ (check one) Location of Property: I~"~' '~Oc')t c--~O ~'e'_ House No. Street Owner or Owners of Property: ~'~ 4 '~ ~ Suffolk County Tax Map No 1000, Section [ O ~ Block Subdivision d~fN i ~LRJCE~O G~ro..~-e._~D FiledMap. Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. ~/Oc~/O% Hamlet Lot Lot: Underwriters Approval: N / ff~' Request for: Temporary Certificate Final Certificate: ~ (check one) Fee Submitted: A~icant Signk-'~~ 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. 33885 Z Date MAY 8, 2008 Permission is hereby granted to: ROBERT & JOYCE BARRY 1855 DEPOT LANE CUTCHOGUE,NY 11935 for : RELOCATION OF ACCESSORY STRUCTURE AS APPLIED FOR. at premises located at 1855 DEPOT LA County Tax Map No. 473889 Section 102 Block pursuant to application dated APRIL 25, 2008 Building Inspector to e~ire on NOVEMBER 8, CUTCHOGUE 0001 LOt No. 009.001 and approved by the 2009. Fee $ 100.00 ~ut ho~ z~e~ 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: INSPECTOR~~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] IN~N [//~NAL ] FIRE SAFETY INSPECTION REMARKS: ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION INSPECTOR~~ DATE />~/~)~ FEELD INSPECTION REPORT ] DATE [ COIvIMF-~TS FOUNDATION (2ND) " ROUGH F~G & pL~G - ~S~ATION PER N. Y. STATE ENERGY CODE F~ ~D~ION~ CO~S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration / I [ ~ ~, 20 0 ~ '25 PERMIT NO. '5 ~ ~/~ ~ 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 Contact: '-~ C. JZ ~ ~ Mail to:~-~qllO~. I~x'llr~a J APEIslCATION FOR BUILDING PERMIT Date ---: INSTRUCTIONS ,20 Op 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. (~/natu~ of applicant or name, Va corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ ,t ~_ ]O~OJ'bh,~J~ 4' ~A~ ~ 0 ' (A'~ on tile tax roll or lates~ deed) ~J 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 on which proposed work will be done: House Number ~ Street Hamlet County Tax Map Nfl~. 1000 Section [0 ~ Subdivision t.~ ~ (Name) Block F) I Lot O 9 Filed Map No ~ ~' ~t 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. Nature of work (check which applicable): New Building_ Repair Removal Demolition Estimated Cost ,,.¢7/73. 07) If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work ~Ll.,rrtL~-t (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 strucmres, if any: Front c,~5~ Height Number of Stories Depth Dimensions of same structure with alterations or additions: Front ~. t{5 Depth /(,~. rtZ(' Height. Number of Stories Rear I 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size oflot: Front x~(70- o~ c~ Rear ,,.~OO,c~9 Depth 10. Date of Purchase e~O ~ Name of Former Owner 11. Zone or use district in which premises are situated t~ ~ 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 NO q 14. Names of Owner ofpremises~ddress g:~,~ Name of Architect "Address Name of Contractor Address [°~hone No. ~ ~' -~.~ 6 ~>' Phone No Phone No. 15 a. Is this properly 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__ NO '~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF~o ~ IL ) dOk.4 ¢d~ \ '2'~(;~[,r ~'~,~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract)labove named, (S)He is the O ~ ~-----...~ (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. Swom to before me thisA .2 ~'t~ day of ~-.o x-~ 20_D°a''' No t ar,~u~ki'~-a..~OOj~ U '~ ;,RY PU~C, ~~ Si(~tur~ of A~plic~t~t O Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M, #: ~ooo ~o~. et o~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER~ GRADING~ DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number;. (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yes No Retain A~I Storm-Water Run-Off Generated by a Two (2") Inch Rainfalt on Site? 1 Will this Project (This item will include all mn-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Contrctling Surface WatarFIow! Land Filling, Grading or Excavation where there is a change to the Natural 3 Will this Project Require any Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? Land Disturbing Activities Encompassing an Area in Excess of 4 Will this Application Require Five Thousand (5,000) Square Feet of Ground Surface? Natural Water Coume Running through the Site? 5 Is there a Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedicel Rise to 6 Will there One Hundred (100') of Horizontal Distance? Areas or other Impervious Surfaces be Sloped to Direct Ston*r'~Water Run-Off 7 Will Driveways, Parking into and/or in the direction of a Town right*of-way? this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of 8 W~II any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) Site Preparation within the One Hundred (100) Year Floodplain of any Watemoume? 9 this Project Require NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan ts Required and Must be Submitted for Review Prior to Issuance of Any Building Permffi EXEMPTION: Does this project meet the minimum standards for classiflcetion as an Agricultural Project? Note: ~fY~uAnsweredYest~th~$Ouesttan'aSt~rm~water'Grading'Drainage&Er~si~nC~ntr~P~an~sN~TRequirad~ Yes No STATE OF NEW YORK, ~ - COUNTY OF ............ t..~ ..w~....~-~, ............... SS That I .................... ....~.........~.~....c=......~O~..C...~. ......... being duly sworn, de'poses and says that he/she is the applicant for Permit, (Name of individgal signing Document) ?md that he/she is the ....................................... .~.~* .~ ....................................................................................... (Owner, Contractor, Agent, Co~pomte Officer, etc.) Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me fids; ........... .'T:..~..~. .................. day of ....'~....~.-. ......................... eO..O...% ~, 01~1~ FORM - 06107 ~ ~ ~ ~ OC( OR -USE IS UN WITHOUT, CERTIFICATE OF OOC -E~..~NCY RETAIN STORI~ WATER RUNOFF PURSUANT IOII~TER ~$ OF TIlE TOWN ~CODE. APPROVED AS NOTED NOTIFY BUILDING DEEAR'iMENT AT 765-1802 8AM TO 4PM FOR TNE FOLLOWING INSPECTIONS: 4 FINAL- CONSTRUCTION MUST ALL CONSTRUCTION SHALL BE COMPLETE ~¢'q C.O. MEETTHEREQUIREMENTSOFTH~-L CONSTRUCTION SHALL MEET TNE CODES OF NEW YOEK STATE. REQUIREMENFS OFTHECODESOFNEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS.