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Home My WebLink About36135-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA2{TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34789 Date: 01/10/11 THIS C~KTIFIES that the building ACCESSORY BUILDING Location of Property: 865 NOKOMIS RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 3 Lot 26 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 10, 2011 pursuant to which Building Permit No. 36135-Z dated JANUARY 10, 2011 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 STORAGE BUILDING AS APPLIED FOR. The certificate is issued to DAVID J VERITY of the aforesaid building. (OWNER) SuFfOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELE~-rKICAL CERTIFICATE NO. PLD~ERS CERTIFICATION DA'r~u Rev. 1/81 N/A ~/A N/A 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. 36135 Z Date JANUARY 10, 2011 Permission is hereby granted to: DAVID J VERITY 865 NOKOMIS RD SOUTHOLD,NY 11971 for : CONSTRUCT ACCESSORY STORAGE BUILDING REPLACING TWO SMALLER. THIS PERMIT REPLACES 32819. at premises 10cated at County Tax Map No. 473889 Section 078 pursuant to application dated JANUARY Building Inspector to expire on JULY 865 NOKOMIS RD SOUTHOLD Block 0003 Lot No. 026 10, 2011 and approved by the 10, 2012. Fee $ 10.00 Authorized Signature ORIGINAL Rev. 5/8/02 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. 32819 Z Date MARCH 20, 2007 Permission is hereby granted to: HELEN M VERITY 865 NOKOMIS RD SOUTHOLD,NY 11971 ~for : CONSTRUCT ACCESSORY STORAGE BUILDING IN THE REAR YARD AS APPLIED FOR. (THIS REPLACES BP #11725-Z DATED 6/10/82) at premises located at 865 NOKOMIS RD SOUTHOLD County Tax Map No. 473889 Section 078 Block 0003 Lot No. 026 pursuant to application dated MARCH 20, 2007 and approved by the Building Inspector to exlDire on SEPTEMBER 20, 2008. Fee $ 10.00 ~_~oz ~d S~ ature Rev. 5/8/02 ORIGINAL TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .................................. ./..~.. .............. , Permission is hereby granted to:,.~/7 ~'~' V~,~. ..... ...... .... ...... ~'g'D~;7~"~'"'~"~'""~F~/ ao~.~'~'"'~'~"~'~'~'~'"" ........... '~ - ~-- ~o .......................... . ............................................................ ~.......~ ........ ~ ...... ~ ~//~C/~ ~ ~ ~//~ ....... ~ .... ....... ~ ........................ ~;~......;..7...~ .......................... ;~j ........................................ .... ~ ~~/~ ~. ~ ..... at p~mJses I~OT~ OT ................... ~V"~ ....................... ~'V .............. ~'"": .................~ ............ ~'-' , - ..................................... ~..~E<~~.~...~ ........ ~~.~ County Tax Map No. 1000 Section~......~..~ ........... Block ...................... Lot No ....................... · ~ ~- -~....~ 'th, pursuant to application dated ........................................................ , lY~.. ...... , na approvea oy Building Inspector. Fee ....................... Building Inspector Rev. 6~30/80 Form No. 6 TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or iuk 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 Plmming Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property sbowiug all property lines, streets, building and unusual natural or topographic features. 2. A properly corr~pleted appbcation and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall slate the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dxvelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swin~ning pool $25.00, Accessory bnilding $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate ofOccupaucy ou Pre-existing 13uilding - $100.00 3. Copy of Certificate ofOccnpaucy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Conm~ercial $15.00 Date. ~/,oq-D/~''7 New Construction: ~ Location of Property: ~o5 ~t)~_~.~-t'5~r'~d _ House No. Street Owner or Owners ofProperty: j74e!o_w- ~f v~/~ Suffolk County Tax Map No 1000, Scct~on 0"~ C~ Subdivision eermitNo. D28 lO:-?_-- Date of Permit. g}20[O) Heallh Dept. Approval:_ ()Id or Pre-existing Building: [ [ (check one) Uude~'riters Approval: __ Hamlet ._Block O-~ Lol Filed Mai). Lot: Applicant: ~6~.CJ ¢~ Plam~ing Board Approval: Request for: Temporary £ erlil~cale Final (-.e t'fictte: Fee Submitted: $ o~5'o ~ (check hue) FIELD~i~S?-ECTION 1. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & . ~--~ PLUMBING INSULATION PER N. STATE ENERGY YJ FINAL DITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 _ Disapproved a/c ..... .. . . ~ ..... ~- · - r ~ ' ' ' ~ (Bufld~g Inspector) APPLICATION FOH 8OIkDING Application No. f../-"~- · -~..~. ...... Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 buildings for necessary inr~0~ej~lons,0' (~¢~/[ture of applicant, or name, if~forpo ' ) ' 285 l~akomis ~d ~outhold ]{Y II97I (-Ma~ing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises ,10HN (1 VERI~/~I~..D HELEH M VERITY) (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...O~'N~R ................. Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade s License No ...................... 1. Location~.~flan~d on which proposed, w~work will~b~done .... ~, ............................................ House Number Street Hamlet ' C~)unty Tax Map No. 1000 Section . .~..~.4~ ...... Block.; :~..~.. ........ Lot...O...~.t~. ......... Subdivision ..... ~ .............................. Filed Map No. ~.: ........... Lot . .~ ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposcd construction: a. Existing use and occupancy ONE PAMILY DWELLINO ' sH.q p.,2tx ,.o. NE sToP. os SaoP "-' yy.o. b. In~adod use and occupancy .................... ~ ~,. ~,,:~ ............................ 3. Nature of work (check which applicable): New Building ....X.~.X..X.X. Addition ........... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost :~'[500. O0 Fee ...... ?~I0, O.O. ~'/ (Description) (to be paid on Filing this application) 5. If dwelling, number of dwelling units ............... Number o f dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial 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 ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ..... '[6.~ ...... Rear .. ~[6.' .......... Depth .... RO~ ........ Height ...... ]'5 ! ...... Number of Stories ....... I .................... [ ........................... 9. Size of lot: Front ....... ??..Q .......... Rear ....... .2. ! ..:'~. ......... Depth ... :~.'?. !-.) ............ 10. Date of Purchase ............................. Nar~e of Former Owner ............................. 11. Zone Or use district in which premises are situated ..... ~ ............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................ 13. Will lot be regraded ...... .D.& ................... Will excess Fill be removed from premises: Yes 14. Name of Owner of premises .................... Address ................... Phone No.7.(~.~-.L .~.7'...~ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names an, l indicate whether interior or corner lot. STATE OF NEW YQRK, COUNTy OF. .... ......................... ~ ..................... being duly sworn, deposes and says that he i~ the applicant (Name of individual signing contract) above named. He is the ............ 0~/:/'L .~A~ .... 1~ .t~.LI.~-~,fL .............................................. (Contractor, agent, corporate officer, etc.) ~f :~d ~.:-.'r.c: ~.r ~wr.c.m,. and is duly authorized to perform or have performed the said work and to make and f'fle 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_ (~(-~ · a~;~''"lg~'<~'- N~qt ary Public ....... ~ ....... .~. ,-~x~ff~C ou n t y ~ .... ....... ~,s~;~,~.,~0;~,,~o' ~/~ ~ (Signattu~Sf applicant) N N/o/F K~N & ~LIJAM HAR~NG AREA~26,622 SQ. FT LAUGHING LoT 2 WATER' DATE{) NoVE ' 270.00' SURVEY OF PROPERTY A T LA UGHING WA TER TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000--'78--05-26 SCALE: 1'=30'. AUGUST 18, 2010 AREA=30,775 SQ, Fl' re=MONUMENT AREA=57,397 SQ. FT. ,, l