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Home My WebLink About34716-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA~RTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34149 Date: 12/28/09 THIS CERTIFIES that the building ACCESSORY SHED Location of Property: 735 COREY CREEK LA SOUTHOLD (HOUSE NO.) (STREET) (HA~fLET) County Tax Map NO. 473889 Section 78 Block 4 Lot 24 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 14, 2009 pursuant to which Building Perm/t NO. 34716-Z dated MAY 27, 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 SHED AS APPLIED FOR. The certificate is issued to DENNIS A & PEGGY A FERLIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL E~ICAL u~KTIFICATE NO. PLIERS U~KTIFICATION DA'£~U N/A ~/A N/A ~Au/t~ i/zed~ig natu 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 electrical 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 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. 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 cc~~uilding $25.00,)}dditions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupanc~mting 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, Cmmnercial $15.00 New Construction: i/'~-5 Location of PropertY':/''73 ,~ House No. Date. ISL,/], ~'/O 7 / / Old or Pre-existing Building: (check one) / Street Hamlet Owner or Owners of Property: Sufl:blk County Tax Map No 1000, Section Subdivision Cc' ;',f..j~ Permit No. ~/'/' Block 0 t/t Lot Filed Map. ~ ql[..~ Lot: Applicant: ~ ~'~ d ~ ~v,[. ~' ,~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ .,~,~,~7~O Underwriters Approval: Final Certificate: /,,/(check one) Applicant Signature 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. 34716 Z Date MAY 27, 2009 Permission is hereby granted to: DENNIS A & PEGGY A FERLIN 3~62 DEMOTT AVE 'q~ ~ f~{ W~R4TAG~,L~' 1179-3- ~o~'~x~ ~J for : CONSTRUCT ACCY SHED IN REQUIRED REAR YARD AS PER APPROVED PLANS AS APPLIED FOR. at premises located at 735 COREY CREEK LA SOUTHOLD County Tax Map No. 473889 Section 078 Block 0004 Lot No. 024 pursuant to application dated MAY 14, 2009 and approved by the Building Inspector to expire on NOVEMBER 27, 2010. Fee $ 100.00 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 .....--INSPECTION [,~]' FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]RRE RESISTAI~I' CONSTRUCTION [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE ~/" /C)~ INSPECTOR 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: ~"!~.~ ~/~ ~ ~ ~-~'~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUN~ON 1ST [ ] ROUGH PLBG. [ ] .~qDATION 2ND [ ] INSULATION [j/]/I:RAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT C0~/~UCTION [ ] FIRE RESISTANT PENETRATION REMARKS: / ~ ~ ~'~'~ DATE /0/7/ ~'~INSPECTOR //~'~'~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] ROUGH PLBG. [ ~"~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ]FIRERESISTANTCOflS~UCTIOfl [ ]FIRERESISTANTPENETIMTION REMARKS: DATE /~///~/~)//~ INSPECTOR ~ ~~~ FOUNDATION (1ST) FO~ATION (2~) ROUG~ ~G & PL~G ~S~ATION PER N. Y. STATE ENERGY CODE 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 ,20 Expiration ,20 OlOHIAOS :I0 NMOI 'ld](l '9018 PERMIT NO. :-~/~/ 7/&> BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, betbre applying? Board of Health 4 sets of Building Plans Plamfing Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: phail to: Building Inspector APPLICATION FOR BUILDING PERMIT Date Mt<~ INSTRUCTIONS ,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 fi'om 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 ail applicable laws, ordinances, building code, housing code, and regt~lations, and to admit authorized inspectors on premises and in building for necessary inspections. /: ' '~ (Signature of applicant or name, ifa corporation) · - - (M/filing hddress of aPl~iicant) ' ' 7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises D6~/Q?,!a /~ / :~'~-6:'9' /gl /L~/e/i~L,/,/~ (As on the tax r/oil o~ iatest'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 on which proposed work will be done: Ca House Number S~reet / County T~ Map No. ~000 Section ~ '7 ~ Block Subdivision eons/ Hamlet ' Lot 0o9--.~/ Filed Map No. ~/:l. 3 Lot [~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy C'~?q/~,./)~ofl~) .q--/~eFa/_ ~ Addition Alteratiou Other Work (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor b. Intendeduseandoccupancy _/'Q.Sfi.,5~?)~/k) 3. Nature of work (check which applicable): New Building. Repair Removal Demolition 4. Estimated Cost ¢f?/,5--d)dPdg, 5. If dwelling, number of dwelling units If garage, number of cars 7. Dimensions 9,f ¢(~st4'og stjuctures, if any: Front Height Dimensions of same structure with alterations or additions: Front If business, commercial or mixed occupancy, specify nature and extent of each type of use. Depth. Height Number of Stories / 8. Dimensions or entire new construction: Front t/ ~ /~ Depth Rear Rear _Depth.~Z~~ Height /y / ~' //' Number of Stories 9. Size oflot: Front /J;~9! Rear /~)~/ 10. DateofPurchase ~-Z3 -tqq~ Name ofFormer Owner Oo~i.5 11. Zone or use district in which premises are situated ,..q i,,-4 l~-- Po. ~; L ~! R ¢.~;~,¢~uT/o~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES __ NO v//Will excess fill be removed fi*om premises? YES__ NO ~'/ 14. Names of Owner of premises Address Phone No. Name of Architect STevt~vT ~. "~eo~e~l', ~ ~., Address~ sr~e t[ve.- Phone No ~Jt.J~ - Name of Contractor IDe,~s,;,, F-~*'k;~, Ad. dress/05"lg*~'e~ e~'*¢h LRPhone No. 7~'~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland7 *YES NO t~ * 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 b~ · 1F YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF& ~'~Oot Iq ) DCan.,;$ ~'~rk ,,vt being duly sworn, deposes and says that/he is the applicant (Name of individual signing contract) above named, (~)He is the 0u-/t~r ~. a (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. og~fore me tki~ ~ 5~[ day o f ~'~///~'-0~")0 (D ~ Not~ Public SARBARA kfi~ RUDDER ~eta~'/Public, State of H~ew Yo~k, c~ml,~lon ~plr , Signature of Applicant .To wn of Southold Erosion, Sedimentation ~ S--~orm-Wate------~ Run-o-------ff ASSESSMENT FORM · "E ~O'' OW,NE AC~,ONS .^y.EQU,.E T.E SU..,.S,O. OF I'~O(~ ~-~ ~ ~ ~ ~ C~R~ G~DING, D~INAGE AND ~0810. ~OL Dlst~ ~on BI~ L~' K~ ,r~U ~Y' A D~IGN PROF~81ONAL IN ~E STATE OF N~ YO~, It~ Num~c (NO~: A Che~ M~ (~) f~ ea~ Ou~fl~ Is Requ~ ~ a ~mp~ta ~flofl) ~ Yes N~ 1 ~11 ~ P~ Re.th ~1 Sto~-W~tar RunOff Ge~mt~ ~ a T~ (2") In~ Rain~ll ~ S~e? ~is ~ ~ll in~ude all mnmff ~at~ ~ s~e ~eadng ~ ~ns~ a~fl~ as ~1 as all Site Improve~n~ and ~e peanut ~a~ ~ su~s.) D~s ~e Si~ Plan ~or Suwey Sh~ ~1 P~s~ ~nage S~c~ Indi~U~ S~ & L~fl~? ~ls Item s~ll In~e all P~s~ Grade Changes and SIo~s ~n~l(i~ Su~a~ Wat~ ~11 ~ Pmj~t Require any Land Filling. Grading or ~n ~em ~em is a ~an~ to the NaOmi ~isflng Grade thvoMng mom ~an 200 Cubic Ya~s ~ Matedal ~in ~y Pa~l? ~1~ ~is ~li~on R~uim Lend ~stu~ing A~es En~mpassing an Area in Ex.ss of five ~sand (5,~0) Square F~t of G~nd Su~? 2 5 is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100' feet of a We and or Beach?' 6 oneWill thereHundredbe Site(100,)preparatiOnof Horizon~al°n ExistingDistance?Grade Slopes which Exceed Fifteen (15} feet of Vertical Rise to 7 intoWill and/orDrivewayS'in theParkingdirectionAreaSof a Town°r otherright_of, way?lmpervious Sudaces be Sloped to Direct Storm-Waler Run~)ff r~ 8 Will this Projecl Re0uire the Placement of Material; Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? 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 is Required and Must be Submitted for Review Prior to ~ssuance otAny Building Permltl EXEMPTION: Yes No Does this project meet the minimum standards tot classification as an AgHcul[ural Project? Note: ~fY~uAnsweredYest~thisQuest~~n~a~t~rm-water~Greding~Dratnage&Eresi~nC~ntre~P~an~sN~TRequiredI COUNTY--L ~Tc~ l ut~'~ ............ ; ...................... SS ............................................................................... oeing duly sworn, del~ses and says that he/she is the appLicant for Pennir~ athe e,, e .............................. ....... Owner and/or representative of the Owner of Owner's, and is duly authorized to pedonn or have performed the said work and to make and file this application; that all statements contained in this application are true co the best of his knowledge and belief;, and that the work will be performed in the manner set forth ~n the application filed herewith. Sworn to before me this; day ........... - ........... ..~ ................... 90.....~7 ~ VlCKI TOTH Notar7 Public: ...................................... Notm~c.L_Slate~fNew¥o -'~1106190696 FORM - 06~07 uomml~slon Expires (Signature of ~p~cantl SURVEY OF PROPERTY A T BA YVIE~Y TO~[N OF SOUTHOLD SUFFOLK COUNTY, N.Y. , I ~1 ,. 0 II ,/ H ~9~2PhJ k/A~l~ -- lj¢,O A I'lu-b-,Idl 'l ~'1- 'IHO 'F~pxL. ~df~ ~j APPROVED AS NOTED FEE PO"O0 BY: 9'I~F-- NOTIFY BUILDING DEPARTMENT AT 76D1802 8AM TO 4PM FOR TRE FOLLOWrNG INSPECTIONS' I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGR - FRAMING & PLUMBING 3. INSULATION 4. FINAL - COD~TOI~nTfON MUST BE COMPLEqF -0; '0 ALL ccr~,7~fL~r dC, N Sh~,LL HEET T " REQUIREmE,qTS OF THE COOES OF N~I ~ A ,,~ bd A P~ YORK SiME Nor RE%~ONSIB/E-FO'R~ ;~' ~.~, ~b~JN,21 .,1,,~ DES GN OR CONSTRUCTION ERRORS. ~"~ ~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE, ALL Cnu' ' .... ~I ,u, /IONS IA.j. MEET TIlE REQUIF~EMENTG Z/,: THE CODES OF NEW Y',';iK S FATE, l--/ilt. Jl,,./Jdl,--i 61.-'-¢,d4rJ-~Cx d.~J-I,I ~,=,_4,/b- G,'TF~¢iJE~i'H 4:¢ TA~-b-~ F-, xJo~, ~L- ~ I,..... ,¢..¢ HID NJ s4 #P~¢..-T