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Home My WebLink About36132-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34802 Date: 01/14/11 THIS CERTIFIES t~at the building ACCESSORY BARN/SHED Location of Property: OFF EAST END RD (HOUSE NO.) County 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 JANUARY 10, 2011 pursuant to which Building Permit No. 36132-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 EQUIPMENT SHED/BARN AS APPLIED FOR. The certificate is issued to HIRIAM F & SUSAN R MOODY JR ( OWNER ) of the aforesaid building. SUFFOLK COUNTYDEPART~4ENT OF ~EALTHAPPROVAL ELEt-rKICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'r~u N/A ~/A / ~th~ized ~ignature Rev. 1/81 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. 36132 Z Date JANUARY 10, 2011 Permission is hereby granted to: HIRIAM F & SUSAN R MOODY JR PO BOX 506 FISHERS ISLAIqD,N-Y 06390 for : CONSTRUCT AN EQUIPMENT BARN/SHED AS APPLIED FOR. REPLACES BP 18360 at premises located at County Tax Map No. 473889 Section 010 pursuant to application dated JANUARY Building Inspector to expire on JULY OFF EAST END RD FISHERS ISLAND Block 0006 Lot No. 001.007 10, 2011 and approved by the 10, 2012. Fee $ 100.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOU33'IOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N~ 18360 Z Permission is hereby granted to: ..... ~,.~....~..~~....~ ..... ~z/~/.~~_~~....,. .................... .~.. ot premises located at .......... ~--;~.~...~..~.~..... ...................................................... .................................................. Count~ Tox Map No. 1000 Section ....... /..~. .......... Block ....~..'. ............. Lot No..../.,.......~.... ..... pursuant to application dated ...... ~ ....... ~,-....~.. ...... , 19.~...~and approved by the Building Inspector. Building Inspector Rev. 6/30/80 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 fi.om Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swora statement fi.om 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 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 Date. ~ New Construction: Old or Pre-existing Building: .~_ ~ (check one) Location of Property: I~} House No. Street Hamlet OwnerorOwnersofProperty: J~.'l~'i~l~ .~. J~Mq ~,~. /~. ~'~h ~, Suffolk County Tax Map No 1000, Section Block Lot Subdivision Health Dept. Approval: Date of Permit. Filed Map. Lot: Applicanl~ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: X (check one) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPP, NG FIREPLACE & CHIMNEY ~ R~Sb'TAm eO.STRUC~O. REMARKS: [ ] ROUGH PLBG. [ ] ~JLATION [ 4~FINAL [ ] FIRE SAFETY INSPECTION [ ] Frae RE~STANT PENETRATK)N DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined· .~'-'-~ .... , 19~..~ Disappro ed / .................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: a. This application must be completely filled in by Wpewriter or in ink and submitted 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 9f buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of properW must be drawn on the diagram which is part of tkis 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 issued 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 building for necessary inspections. (S~gn, ature ot applicant, or name, if a corporation) .........., ~ :: :~ :. , , la (Mailing address of applicant) · c · "~' ~'~ State whether applicant is owner, lessee, agent-ar6hlte~ct, 'engineer; general contractor, electrician, plumber or builder· Name of owner of premises .... ~ ' ' a I t a corporation, signature of duly authorCed, offi~'er... ~.~. If applicant is (Name and title of corporate officer) ., . Builder's License No .......................... ,.. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · .............. ..................... House Number Street Hamlet County Tax Map No. 1000 Section ]0.0.9 .-.O. LO..". ,~r./.,.~ Block .... .~l ........... Lot....~. .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 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 ...... F.~(/J.e 00~',,. -~'7 ....... .~ · .. ................................... 3. ,, . rk (check which applicable): New Building ........ Alteration .......... t~epmr .............. Removal .............. Demolition .............. Other Work. ~ yO..0Q. . .~...t~.t (Description) 4. Estimate'd Cost : ........... Fee. ..~r...~. ........................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ........ ~ ....... If garage, number of cars ........................................................................ 6. If business, commercial ~r mixed occupancy, specify nature and extent o f 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 en~ire new construction: Front... I0..~. ...... Rear ..... /Z) .~.~7 .....Depth . Height .... ~'. l~ ...... Number of Stories ..... Of 3C~ ............................................. 9. Size of lot: Front ...(O~c~O~j~.~.~... ...... Rear ....... Depth 10. Date of Purchase .... ~.~.~.. ...................... Name of Former Owner .... ~r~,~)~,(_~ .... i ............ 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 ............................ Will excess fill be removed ~r'o~ ;'r;l~li;e'si}~ .... 14. Name of Owner of premises .~-~- ~t~-~?/.+~-~. J~d~b<.c.r.,Tstc~,.tV.~( ...... Phone No.~o.7.'~ .7.~.~. Name of Architect ........................... Address ~. ................. Phone No ................ Name of Contractor .......................... Address ................... Phone No ........... ./... 15.18 this property located vithin 300 feet of a tidal vetland? *¥P.$ .... *If yes, Southold Town Trustees Permit may be required. 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 and indicate whether interior or corner lot. ~ c~ ~ ~ ru~u~u INS~CTIONS; 2. RO~N - ~MI~LUMBING 4. FINAL CONSTRUCTION MUST BE ~MPL~ FOR ALL CON~u~oN SHALL MEET ~ ~E REQUIREMENTS OF THE N STA~ CONS~U~N & ENERGY STA~ OF NE~O~, S ~ CODES. N~ ~S~NSIBLE gOR - ;CO~ OF ~.~ .... · DESIGN ~ C~8TRUETION ERRORS ~ A. ~e~r~ bein dui swom'~e oses=d ..... ~ ......................................... g y , p says that he is the applicant . (Name of individual signMg~ontract) nam 'd. He is the ..... ~A~(~ ~ .~ ' (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have perfo~ed the said work and to m~e and file ~is application; that all statements contained M this application are true to the best of his knowledge and belief; and that thc work wQl be perfo~ed in the re=her set forth in the application filed therewith. Sworn to befo¢ me this ' ' ' ~ ...... , ........ Nota~ Publ~~ ~, ..... ~,::;;t~ Notary P~bli¢ Stltl of New ¥orx Ne. O~llfflla t~ Surf elk TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ., 20 Approved ~ 20 Disapproved a/c 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: Expiration ., 20__ Building Inspector APPLICATION FOR BUILDING PERMIT Date~~~, 20 Ia INSTRUCTIONS BLDG. D lpg-. j -- a. ~I~N~C~,~[j~t~ MUST beJ :ompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plan-s~-acc~u}ate plot plan to sca e. 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 Ce~ificate 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 inspecti°ns' (Signal'S'of apph~nt or name, ifa corporation) (Mailing a~dress of'applicant) State whether applicant is owner, lesse~ngineer, general contractor, electrician, plumber or builder Name of owner of premises ' J ~./~s on th~ tax roll or latest dee )' iff~ ,~]~~thorized officer k.~"- (NarrJ/~ an~ title Of corporate officer) Builders License No. ~.hT, Plumbers License No. J Electricians License No. Other Trade's License No. 1. L°cajt~nl~andgnw'hich"pr°p~sedwprk~llbed'°ne:~"-'Jr~l~[[~ ~ ~ .tl~l'lO~ ~- - House Number Street Hamlet' ' · County Tax Map No. 1000 Section J0 Block Subdivision Filed Mal~O. ' Lot 2. construction: 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost q~ ~;¢~}O State existing use and occupancy of premises and intended, use,and occupancy of proposed a. Existing use and occupancy ~ _ff~9.t~g~. ~nl~ b. Intended use and occupancy ~-'~_~, Addition Other Work 5. If dwelling, number of dwelling units If garage, number of cars Alteration Fee (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 Number of Stories 8. Dimensions of entire new construction: Front ~ Rear Height ~ Number of Stories 9. Size oflot: Front b~ Rear~Depth.~_.~ 10. Date of Purchase ~ q"~7 Name of Former Owner lift[ 11. Zone or use district in which premises are situated ~ .Depth Rear 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 fi.om premises? YES__ 14. Names of Owner of premises ' ~~, ddress~Phone No. Name of Architect ld/~ ~Address Phone No Name of Contractor ~,[~ Address Phone No. NO X 15 a. Is this property within 100 feet of a tidal wetland or a fi.eshwater wetland? *YES NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora 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 X · IF YEs, PROVIDE A COPY. STATE'OF NE-W-YORK) ss: COUNTY OF ~fl.)t'/odh ~Jl~[~ [~~ being duly sworn, deposes and says that (s)he is the applicant (Nam~ o 'h~Ii~idual s~hing contract) above named, (S)He is the __~ (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 this i~ ~ dayoft~eo-~rnb~- 20 I0 Notary Public CommissiOn EX~iM i-et3ru~y ,