HomeMy WebLinkAbout36113-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34801
Date: 01/14/11
THIS CERTIFIES that the building ACCESSORY STABLE
Location of Property: OFF EAST END RD
(HOUSE NO.)
Coualty Tax Map No. 473889 Section 10
Subdivision
FISHERS ISLAND
(STREET) (HAMLET)
Block 6 Lot 1.7
Filed Map NO. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 15, 2010 pursuant to which
Building Per,it No. 36113-Z dated DECEMBER 29, 2010
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 STABLE AS APPLIED FOR.
The certificate is issued to HIRIAM F & SARAH R MOODY JR
( OWNER )
of the aforesaid building.
SUFFOLK COUNTYDEPARTM~T OF HEALTH APPRO~-AL
EL~t-rKICAL C~K'rIFICATH NO.
PL~Ei~S C~KTIFICATION DA'r~o
~/A
N/A
N/A
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 fi-om 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 a 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, 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 of Occupancy - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction: Old or Pre-existing Building: ~ (check one)
Location of Property: ~
House No. Street Hamlet
Owner or Owners of Property:
Block Lot I,!
Filed Map. Lot:
__ Applicant:~
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No. Date of Permit.
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate: ~ (check one)
Applicant Sig~. a?re
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUIIJ)ING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 36113 Z Date DECEMBER 29, 2010
Permission is hereby granted to:
HIRIAM F MOODY
PO BOX 506
FISHERS ISLAND,NY 06390
for :
"AS BUILT" ACCESSORY STABLE AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 010
pursuant to application dated DECEMBER
Building Inspector to expire on JUNE
OFF EAST END RD
FISHERS ISLAND
Block 0006 Lot No. 001.007
15, 2010 and approved by the
29, 2012.
Fee $ 846.40
? ?
Auth"ri zed Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [/~AL
[ ] FIREPLACE&CHIMNEY [ ] FIRESAf..~¥1NSPECTION
[ ] RREnEmStANTCONS'mUc'no~ [ ] RRERESm'~T~ETR~T~
REMARKS, ~ ~ (~'~
///
DATE ~ INSPECTOR
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork.net
Ex,mined / '- ,20 t O
Approved
Expiration
PERMIT NO.
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:
BLOB. DEPT.
TOWN OF SOUTHOL~}
Building Inspector
ATION FOR BUILDING PERMIT
INSTRUCTIONS
Date~ 20 ~_l~
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 Pemfit 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 inspecti~ h PI I i
~ - - ~(lSignature of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee~ngineer, general contractor, electrician, plumber or builder
Name of owner of premises
If appli~y
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
~ ('As on the tax roll or latest deed5
authorized officer
1. Location o£ land orhwh~a proposegkwor.k will~g clone:
House Number Street Hamlet
County Tax Map No. 1000 Section
Subdivision
Block 6 Lot
Filed Map No. 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
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
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
8. Dimensions of entire new construction: Front
Height !/~ Number of Stories
9. Size of lot: Front ~ Rear
Number of Stories
Rear' .,~, ~ Il
Rear
Dep '
10. Date of Purchase lq.T! Name of Former Owner ~=[j~,4~
11. Zone or use district in which premises are situated 1~-- [ 2~2)
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
13. Will lot be re-graded? YES NO KWill excess fill be removed fi.om premises? YES
14. Names of Owner of premises~,~_~C~Address~hone No.
Name of Architect Iq~- ' I Address. .Phone No.
Name of Contractor ~- Address Phone No.
__NO X
__NO ~
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X
* 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.
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 ~
· IFflSES, PROVIDE A COPY.
(2.*-) o.eC Co-t-
STATETOF N~W YC,~*()
ss: oo& dc
CO~ OF~J~
~ln &~ ~ being duly swom, deposes md says that (s)he is ~e applic~t
~m~f individuai si~ing con~) above nmed,
(S)He
is
· e~ (Con2actor, Agent, Co,orate 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,12efore me this
)q' ~ dayof~
Notary Public
20~0
sUSAN M. LALUMIERE, Notary Public
My Gommi~ion Expi~l Februa~ 28, 2013
BUILDING PERMIT EXAMINER CHECKLIST
*Date Submitted: ]$--]S- -/O Date Reviewed:
Applicant:
tCTM# 1000- t~0 ~(~ [~"Z Subdivision:
I~ullding Permits ~): BP I D/o~-Z / ~0 ~ ~', ~o: ~- ~
tP -Z / ~0 Z-~~ BP -Z / C/0 ~ , ~fo:
t~gle & Separate Search Required? Y or N Determination:
~. ~t S~e: ACT. ~t S~e: ~Q. ~t Coy.
~Q. Front ACT. Front ~Q Side ACT. Side ~Q.
Estimated Cost:
Zone: Conforming?_
cit : cos?
-Z / CJ0 Z- ., Info:
BP -Z / C,/0 Z- , Info: _
IBQ. Height. ACT. Height
?roject Description:
Naterfront? Y o~.
if yes, water body~ Panel#
ACT: Lot Cov.
PROP. Rear
__ Flood Zone: Bulkhead/Bluff Distance: ~
iDDITIONAL APPROVALS REQUIRED
luffolk County Health: Y o(~- If yes, ~Bed#: __*Date: / / *Permit#:
- If no, certification required: Y or N Received: Y or N By:
~IYS DEC: PRE-DIgCg/1/75 Y or ~- Date:
louthold Trustees: Y o~- Date: __ __
louthold ZBA: Y o~ Date: /__/
louthold Planning: Y or~- Date: :/__
['own Landmark C of A: Y o~)DTE: __
~otes:
Town Septic: Y or N
/ / _ Permit#:
Permit #:
Permit #:
Permit #:
/
or NJ Letter - Notes:
or NJ Letter - Notes:
- Notes:
- Notes:
CODE Compliance (page 2~Y)or N
tee Structure:
Calculation:
~oundation: SF
~irst Floor:
lecond Floor: SF
)ther: SF
?oral: SF
Yo - SFX$ ,q* =$
+ Initial Fee: $
+ Addition.al Fee ( ): $
SF X $ =$
+ Initial Fee: $
+ Additional Fee ( ): $
T~sTA I · g2
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
· ~rolin~l Snow Load: ~0
Weathering: Severe ..Frost Depth: 36"__
Design Temp: 11 'Iee Shield Underlay: YES.
USE/OCCUPANCY CLASSIFICATION:
HEIGI:IT/FIRE AREA: ..,
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEBREDfpREsCRIPTIVE
· Wind Speed; I20MPH ~olsmlc Design Category." B
Termite: M-H' Decay: S-M_
Flood Haza/'ds:
FULL FP,2kMING DESIGN ELEMENTS: Y/N
IlEAl)ERS: Y/N WALL STUDs: YfN
CEILING JOISTS: Y/N FLOOR JOISTS:
LUI~BER SPECIES AND G1LADE: Y/N
GLRD ERS: Y/N
ROOF ~ERS: Y/lq
WINDOW AND DOOR SCHEDULE!
.MISSLE TEST REQUIREMENTS: Y/N
EGRESS 5.7 S.F.: Y/N
LIGHT 8%: Y/N
'~rENT 4%:
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: YfN
PLUMBING RISER DIAGRAtd: Y/N
LOCATION OF fi[RE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: Y/N
TOTAL COMPLIENCE¢~)/N (RETURN TO PAGE ONE)
CME Associates
Engineering, Land Surve.Cng & Architecture, PLLC
32 Crabtree Lane, PO Box 849, Woodstock CT o6e8~
Phone: 86o.9e8.7848 Fax: 86o.9~8.7846
December 13, 2010
Ms. Connie Bunch
Town of Southold
Building Department
54375 rout 25
P.O. Box 1179
Southold, NY 11971
Re: Hiram F. Moody Shed and Barn
Dear Ms. Bunch,
Please find attached a site plan showing the location of both the shed and stable which require permitting
and certificate of occupancy preparation. I believe that the following actions are required to obtain the
certificates for each structure.
Shed: Existing permit no. 18360 Z dated August 8, 1989 requires extension and the structure
requires inspection in order to obtain the CO.
Stable: A building permit is required based on the attached "as-built" drawings and the structure
requires inspection in order to obtain the CO.
After your review of these attachments and permit applications, please advise me of the associated
permit fees and any further steps required to bring these projects to closure. We are hopeful that you will
be able to inspect the properties on your visit to the island on Thursday of this week.
Thank you for your attention to this matter.
Evelyn Cole Smith, AIA, LEED-AP
Director of Architecture
Cc: Stephen L. Hamm, III
Attachments
/ ~ / ' MART~A A~NE
~ / N/F (aLOCK 41-LOT 8)
~ / HENRY L. FERGUSON MUSEUM, INC, / --
5 PORTION OF /
~ / ~ AREA=77.75~ ACRE5 "=400' '
LOCATION MAP SCALE 1
.... ~ S 1983, 65
s 893520 E 5od TOTAL ~ 540.00
/ ~y~ ~I"N~" ~ ~ -~' ' r I 1.) F~N OF PROPER~ TO BE CQNV~ED BY FISHERS IS~ND DEVELOPMENT
CORP. TO HElM F, MOODY, dR,; BLOCK 41 LOTS g,10,11,12; FISHERS
/ RESID~CE~ '~ / // ~ I NEW YORK; SCALE: 1"=100 ~,; CHANDLER, PALMER ~ KING; NORWICH, CONN.;
I~ // V .... ~H R, GOU~RD ~~, .' ~ r J YORK; SCALE: 1"=100 ~*; CHANDLER, PALMER ~ KING; NORWICH, CONN,; NOV,
/~ BLOCK ~ I-LOT 9 ,/ 1979 ·
// AR~ = ~,21~ ACRES ~ / ~ I ~ 3,) PROPOSED LOT LINE CHANGE PREPARED FOR K. LOUISE NOBLE BOGERT;
, BLOCK 41; FISHERS kS~ND, NEW YORK; C,M.E./C,P.K, DESIGN GROUP; NORWICH,
CT,; DATE: 02/21/03; SCALE: 1"=100'; SHEET 1 OF 1
~ ~F~GPOLE / / / / / ,.) P~N OF PROP~ TO BE CONVEYED BY F, SHERS IS~ND DEVELOPMENT
ENGAGEMENT, W
2.) IT IS A VIO~TION OF THE STATE EDUCATION ~W FOR ANY PERSON, UNLESS
~/~/~/ ///? ACTING UNDER THE DIREOTION OF A MCENSED ~ND SURVEYOR, TO ALTER AN ~ ~ ......
" / iTEM IN ANY WAY.
~ ~ &) ONLY COPIES OF THIS SURV~ MARKED WITH THE ~ND SURVEYOR'S
SIGNATURE AN~ AN ORIGINAL EMBOSSEB OR INN SEAL ARE THE PRODUCT OF
~ ~ . JF: ~ , SURV~ TRIANGU~TION STATION "NTH"
SECTION 10, BLOCK 6, LOTS 1,4,1.5,1.6 · 1,7.
H ~ ' //' 6,} IOTAL AR~ = 9,87~ ACRES,
7.) SiTE iS LOCATED IN R-120 ZONE.
~ DATE: 11 / 15/2010
QUALI~ CONTROL CERTIFICATION _v_v_v_v_v_v_ EDGE OF ~WN
T-Ill ~TABLE
APPROX.
i'4~TE~, aND
~l~T
G FLOOI~ PLAN
E'oC, AL..~ ~ I/4'"= I"O"
~LE pAI~L
DO0~
T.O. PLATE
PAINTEm T-Ill
elPlNO
QFI 2NT FI FVATION
~9A/~% I/4"=1'-0"
PAIN'i'ED T-Ill
~IDINE,
SHEATHIN~
HALL,
HOf~IZONT,~..LY
NAILED PIAL.L
12
OII
OHIN~hE~
OABLE END "/h'NT
4) 2X~,' E~'AM
2X,~" ~O I~" O.G.
2X4"
TOP PLATE
5Ill
OATE
FOUNDATION'
h
%0. PLATE _~v~
CERTIF!CATION Of
NAILING & CONNECTIONS
REQUIRED,
114 =1-0"
ELECTRICAL
INSPECTION REQUIRED
/M.UHINUM
IX PAINTEI2 'ftKIH
O'q P.T. ~ND,
LANDINO ~
PAINTED T-III J
ga, 0 GONG. PIE~* C~ml
G 5112E ELEVATION
~C. ALIE~ 1/4"= I"O"
12
COMPC~ WrTH At.L CODES OF
NEW YORK STA-i-F & TOWN CODES
AS REQUIRE~ONS OFFS.
_ / . S(Y~HOLD TOWN Z~Z~&~
../~__.~ SOUTH'~T/~PCNflING BOARD
.~ ....~.s
RETAI~ STORM WATER RUNOFF
PURSUANT TO 6HAPTER 236
0F THE TOWN CODE
A~E~ DOUBLE
DOOR WJ E, ABLE
~INCLE HUNE,
PAINTED
T.O. PlAT~
_
GObOUIT
~UILT UP
APPROVED AS NOTED
DATE /2 %~'~'/~' B P. # ~ ~'
/
/
FEE BY -
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWtNG INSPECTIONS'
1 FOUNDATION - T~ REQUIRED
FOR POURED CONCRETE
~ ~ uu~H - ~RAMING, PLUMBING,
STRAPPING. ELECTRICAL & CAULKING
3 INSU~TION
4 FINAL-CONSTRUCTION&ELECTRICAL
MUST BE COMPLETE FOR C.0
ALL CONSTRUCTION SHALL ~ET ~E
REQUIREMENTS OF THE CODES OF NEW
YORK STATE NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ER~S
CME ASSOCIATES
ENGINEERING,
LAND SURVEYING &
ARCHITECTURE, PLLC
32.Crabtree Lane, Woodstock, CT 06281
55 Main Street, Nontvlch, CT 06360
333 East River Drive, E. Hartford, CT 06108
50 Elm Street, Southbddge, MA 01550
Phone 868-29t-3227
veww. cmeengineedng.com
· ~GUPANY ¢;4~C~P, U - UTILITY
C~ON~TPJ.~.TION TYPE, V -
E~LO~EO - ~lO ~.
LIVE LOAD~ 15 ~F
IHPO~TA~E FACTO~ CATE~Y~ IV
~EI~HIG F~TO~ I,OO
MOODY
STABLE
ISABELLA BEACH ROAD
FISHERS ISLAND,
NEW YORK
REVISIONS
Date Description
PLAN, SECTION,
&
ELEVATIONS
PROJECT NO
SCALE
DATE
DESIGNED
DRAWN
CHECKED
2010841
AS NOTED
NOVEMBER 29, 2010
RAC
ECS, RAC
DRAWING NUMBER
A1