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Home My WebLink About36044-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 2/11/2011 CERTIFICATE OF OCCUPANCY No: 34840 Date: 2/11/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ACCESSORY 4170 iNDIAN NECK LA, PECONIC, Sec/Block/Lot: 98.-1-27.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 11/10/2010 pursuant to which Building Permit No. 36044 dated 11/22/2010 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: TWO GRAIN SILOS AS APPLIED FOR. The certificate is issued to 4170 Indian Neck Ln Hldgs (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED FOPaM 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. 36044 Z Date NOVEMBER 22, 2010 Permission is hereby granted to: for : INSTALLATION OF 4170 INDIAN NECK LA 4170 INDIAN NECK LA PECONIC,NY 11958 (2) GRAIN SILOS AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 098 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 4170 INDIAN NECK LA PECONIC Block 0001 Lot No. 027.001 10, 2010 and approved by the 22, 2012. Fee $ 200.00 / Authorized Signature ORIGINAL Rev. 5/8/02 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 °f pr°perry with accurate location of all buildings, property lines, strects, and unnsual natural or topographic features. ' 2. Final Approval from Health Dept. of water supply and sewerage~disposal (S_9 form). 3. Approval &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 PI.arming Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 19S7) 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 pr°perly c°mpleted 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. Fees I Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing 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, Commercial $15.00 New Construction: Location of Property: Date. \ ~- -- ~- "- [ ,.~ Old or Pre-existing Building: (check one) House No. Street Owner or Owners of Property: t~[ [ ,~ .. Suffolk County Tax Map No i000, Section Subdivision PermitNo..~-~ ~) L/ [( DateofPermit. Health Dept. Approval: 'Planning Board Approval: Block Filed Map. Applicant: Underwriters Approval: Hamlet Request for: Temporary Certificate Fee Submitted: $ ~-~ , ~' Final Certificate: __ (check one) A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net PERMIT NO. Examined ,* f~' ~, 20 }/0 Approved I ~/7/.7'/20 {'''~ Disapproved a/c, Expiration ! ,20__ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planmng Board approval ' Building Inspector Check Septic Form N. YS.D.E.C. Trustees Flood Permit Storm-Water Assessment Form ~'[~ Contact: Phone: '774.-T:~.~ -4o4 Z. OZ2~O Date 20 INSTRUCTIONS BLDG DEPI. . ~OWN OF SO~I¥.ql~, , · ~t his applicadu,~ ~'~lUO · ~* CO~Ip,, ely 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 promises 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 pumuant 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 promises and in building for necessary inspectionsV% ,~ , (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofowner of premises 41-/0 (As on the tax roll or latest~leed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ..TS 4~$$- I't Plumbers License No. Electhcians License No. Other Irade's License No. l l Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision I~ Hamlet Block I Lot I Filed Map No. Lot 2. State existing use and occupancy of premises and intended us.e and occupancy~of proposed construction: a. Existing use and occupancy '~-~ld~,c'~.. d,. [~O1~ 4C~¢~x 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 ~Cti~ Coll~ (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 ex;~[;,,~ ......uroo, if any. Front ~cD' Rear _~:D' .He.u... g O Number of Stories t4.q Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front 12t'' 2 ~t,n(~ Rear .Depth Height ~.-~,' 2" Number of Stories 9. Size of lot: Front 4~2..g7' Rear ~.2.~' .Depth 2/~12:~t 10. Date of Purchase ~-~]~:~}O~J mameofFormerOwner D~'~',~:I~. 11. Zone or use district in which premises are situated Depth I~;/ Rear 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ~/' 13. Will lot be re-graded? YES NO '~ Will excess fill be removed from premises? YES NO ~ 14. Names of Owner of premises Address~-12- -~/~Z~'-/O~ Phone No. IOe~l ~ Name of Architecf'~ [~t~,~ l~,d{-~' Pg: )kddr ess ~/:'~ r=M O{.~O~- Name o f Cont r acco ~ 614[~-¢ [3t ~].5/~t~ ~;~-/q-~ Address ~D ~lt37A~?~e~ Phone No J:,~ I ~- 7~t 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * 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, DEC PERMITS MAY BE REQUIRED. NO ~-~ 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 properly? * YES__ · IF YES, PROVIDE A COPY. NO ~ STATE OF NEW YORK) SS: COUNTY ~' [ ~) ~:::: ~']/I IL'[ T4 being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, cONNIE O. BONOH Notary Publ~, _8~t._ ~.~..~w .eis e 5-- Qualfimd In ~u,,c-,,.,._~-7'i-.,ar--)l (Contractor, Agent, Corporate Officer, etc.) ..... ires ,,fi:n. Corem aa on =~ of said owner or owners, and is duly author/z~xl 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 there~vith. Sworn to before me this ~ r~. day of ~'x~O"~-~'~r-C.~/~O Notary Public Sigl~e of Applicant CONSENT TO INSPECTION 4170 Indian Neck Lane Holdings LLC, the undersigned, does hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at 4170 Indian Neck Lane, Peconic, which is shown and designated on the Suffolk County Tax Map as District 1000, Section 98, Block 1 Lot 27.1. That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Grain Silos (2). That the undersigned do es hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, does so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: (Signature) (Prim Name) (Signature) (Print Name) Town of Erosion, Sedimentation & Storm Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C,T~: THE FOLLOWINQ ACTIONS MAY REQUIRE THE SUBMI~!ON OF fl SYu~4fl/A?SK~ GRADING~ DI~.IHA,GE AHE EROSION ~ONTROL PLAH CERTIFIED BY A DF.81GH PROFESSIONAL IN THE 8TA?B OF NEW YORK. Item Number: (NOTE: A Check Mark (~') for each Quect[on is Required for a Complete Application) Yes No Will this Project Retain AIl Storm-Water RumOff Generated by a Two (2") Inch Rainfall on Site? (This item will Include all mn-off created by site cleating and/or co~.stmction a~viitce as well as all Site Improvements and the p~rmanant creation of impervious surfaces,) · Does the Site Plan ar, d/or Survey Show All Proposed Drainage Sltectore$ Indisedng Size & Lo<at/on? u"'"'" i~1 This Item shall Include all Proposed Grade Changes and Slopes Controlling Surface WaterRowl Will this Project Require any Land Ftl[thg, Grading or Excavation wt~m there is a change to the Natural Existing Grade Invalvfng more than 200 Cubic Yards ot Material wlthln any Parcet? I~1 -- Will this Application Require Land DiMmbthg Acfivlflec Encompassing an Area in Excess of r'~ Five Thousand (5,000) Square Feet of Ground Surface? I~1 -- Is them a Nateral Water Course Running through the Site? r'~ is this Project within the Trustees judsdlotion or w~thln One Hundred (100') feel of a Wetland or Beach? I~1 -- Will there be Site preparation on Existing Grade Slopes which Exceed Filteen (15) feet of Vertical Rise to r"~ One Hundred (100') of Horizontal Distsnoe? I~1 -- Will Driveways, Parking Areas or other Impe~,ious Surfaces be Sloped to Direct Storm-Water Run-Off r'~ into and/or in the direction of a Town right-of-way? L~ -- Will this Project Require the Piecement of Material; Removal of Vegetation and/or the Conslruot[on of r'~ any Item Within the Town Right-of-Way or Road Sho~dor Area? L~J -- (This item will NOT Include Ihe Installation of Driveway Aprons.) 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 Sex, a Storm-Water, Grading, Drainage & Erosion Control Plan Is Reclulred and Mu~t be Submitted for Review Prior to Issuance of Any Buitdlng Permlfl EXEMPTION: Yea No Does this project meet the minimum standards for classification es. an Agficultond project? Note: If You Answered Yes to this Question, e Storm.Water, Grading, Drainage &Eroston Control Plan is NOT Requlredl STATE OF NEW YORK, COUNTY OF ........................................... SS O~er m~e ~d file ~s appii~don; ~[ ~1 s~temen~ ~n~n~ in ~s appU~on am ~e to ~e b~t of~ ~o~ ~d ~ef; ~d ~ ~c wo~ ~11 ~ ~ormed in ~e ~ner set fo~ in ~c appU~on fdcd h~. FORM - 06107 A~_.~RD-CERTIFICATE OF LIABILITY INSURANCE I ~nr~, 631-727-7767 THIS CI=~ilI'ICATE 18 ISSUED AS A MATTER OF INFORMATION Farm Family Casualty Insurance Company ONLY AND CONFERS NO RIGHT8 UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOE8 NOT AMEND, EXTEND OR 104 EdwardsAve, Suite #2 ALTER THE COVERAGE AFFORDED BY THE POUClES BELOW. Calverton, NY 11933 INSURERS AFFORDING COVERAGE NAIC # INSURED JNSURERA: Fanta Family Casualty Insurance Company 13803 Coastline Building Contractors North Inc. iNSURER E: PO BOX 2157 I Aquebogue NY 11931 ~NSUREN D: THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSrONS AND CONDiTiONS OF SU CH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. A~-'~GENE~M' LIABIUTYil COMMERCIAl. GENERAL LL~BILITY 3101X0414 01/30/2010 01130t2011 I {~AMAGE TO RENTED~ OCCU~RE.CS $ 1,000,000 1C~USM~E [] OCCUR P~MIS~S~E~o~,~ $ 100,000 -- P~[REONAL & ADV INJURY $ 1,000,000 -- GENERAL AaOREOATE $ 1,000,000 ~POUCY~j~r ~--ILOC PRODUCTS-OO~P/x~^eG $ 1,000,000 A ANDE~PLOYER~'f.~.SlLITY YtN 3152W8586 1130/2010 1/30/2011 X I*ORYUU,Tsl IO~'~' [] E.L EACH ACCIDENT $ 100,000 I~_~_dee~beundor E,L. DISF. P~E-EAEMPLOYEE $ 100,000 SPt~.;IAL PROVISIONS I~lew E.L. DISENSE - POLICY LIMIT $ 500,00 ~R CANCELLATION Edc J. Kirk ~ 1988-2009 ACORD CORPORATION. All dghts reserved. Town of Southold Town Hall Annex Building PO Box 1179 Southold, NY 11971 ACORD 25 (2009101) The ACORD name and logo are registered marks of ACORD ~DPF~R 0 Of= 2) HOPPER E^VE Et. 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