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Home My WebLink About35746-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 6/24/2011 CERTIFICATE OF OCCUPANCY No: 35021 Date: 6/24/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ACCESSORY 425 JACOBS LA SOUTHOLD, Sec/Block/Lot: 88.-1-1.5 Filed Map No. conforms substantially to the Application for Building Permit heretofore 7/30/2010 pursuant to which Building Permit No. 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: Lot No. ~ed in this officed dated 35746 dated 8/2/2010 run-in shed addition to an existing barn as applied for. The certificate is issued to Toth, William & Toth, Vicki (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A/~ed S~atu~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35746 Z Date AUGUST 2, 2010 Permission is hereby granted to: WILLIAM A & VICKI TOTH 425 JACOBS LANE SOUTHOLD,NY 11971 for : RUN-IN SHED ADDITION TO AN EXISTING BARN AS APPLIED FOR at premises located at 425 JACOBS LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0001 Lot No. 001.005 pursuant to application dated JULY 30, 2010 and approved by the Building Inspector to expire on FEBRUARY 2, 2012. Fee $ 200.00 Authorized Signature COPY Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35746 Z Date AUGUST 2, 2010 Permission is hereby granted to: WILLIAM A & VICKI TOTH 425 JACOBS LANE SOUTHOLD,NY 11971 for : RUN-IN SHED ADDITION TO AN EXISTING BARN AS APPLIED FOR at premises located at 425 JACOBS LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0001 Lot No. 001.005 pursuant to application dated JULY 30, 2010 and approved by the Building Inspector to expire on FEBRUARY 2, 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 of property with accurate location of all buildings, property lines, streets, and unusual natumt 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 o f 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 properIy 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 $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: ~ Old or Pre-existing Building: Location of Property: House No. Street ' Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision "~.~ F ,~' ,~, ~ (~ P~mit No. 3,~'7 4¢ Health Dept. Approval: Planning Board Approval: DateofPermit. ~le~/ ~0 Request for: Temporary Certificate Fee Submitted: Sx_q~), ~) ~ Date. '--~ O'-Jk-~ _~__ 3, ~[ I (check one) Hamlet Block / Lot Filed Map. Lot: Applicant: I) 1&~4 ~-[-~ Underwrite1~ Approval: ~._) { 1~ . Final Certificate: ~ (check one) Applicant Signatm e TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROU/GH PLBG. [ ] FOUNDATION 2ND [ ] I/NSULATION [ ] FRAMING / STRAPPING [~] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SA~-..t ~' INSPECTION [ ] FIRE RESlSTANT CO. STRUCT.~ [ REMARKS: ] FIRE RESISTANT PENETRATION DATE .... COMMENTS FO~A~ON (2~) TOWN OF SOUTHC BUILDING DEPAR] TOWN HALL SOUTHOLD, NY lit TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. North [ll~[ d!!( ? ~' ?,!0 BtDG. DEPT. 'ork.net TOWN I~P~II~I-T NO. / Examined ~/;g--- , 20 IO Approved ~:'>_, 20~/0 Disapproved a/c Expiration '7'/ 7- ,20 12.~ ~ 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: Building Inspector APPLICATION FOR BUILDING PERMIT Date ~7"t~.-{c/' o20 ,20 lo INSTRUCTIONS 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 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, Suflblk 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. (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 Name of owner of premises (As on the tax roll or latest 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: House Number Street Hamlet County Tax Map No. 1000 Section <~- ~7 Block tt Lot /, SubdivisionOt,~K~r~tt.b~ee;/oq~C~rrg"k Filed Map No. /O~'9(_.~ Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ,~J~t,<Lo~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars Additi6n'' Other Work Alteration (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 C/? .Depth Dimensions or same structure with alterations or additions: Front (o c> Rear Depth ~"~ (~' Height. Number of Stories ..'/'/'/'/'/'/'/'/'~-- 8. Dimensions of entire new construction: Front (o O Rear Height Number of Stories 9. Sizeoflot: Front Rear .Depth 10. Date of Purchase Name of Former Owner 1 l. Zone or use district in which premises are situated ~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ~ 13. Will lot be re-graded? YES NOV/Will excess fill be removed from premises? YES NO J 14. Names of Owner of premises Name of Architect b bO,tklLl~; Name of Contractor t'D ~_~ 5Dt,C//-----~ AddresMc,~ Address Address Phone No. c~,~,J-o~o) ! '~ Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES __ NO / * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE R~UIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. l 6. 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 · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY O&~[ ~,~: V'/c-~V-t ~ Tl~( being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing 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 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 t~ before me this c/~'~ day of x~0~ 20 lC> Notary Public LAUR£N M. STANDISH Notary..Public, State of New York ~ uo. 01ST616400~ ~ / '~ Qualified in Suffolk C~nt~ .~ ( I , ~ Signature of Applicant Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASS_ SSMENT FORu PROPERTY LOCATtON: S.C,T.M. #: Disbict Section Block Lo~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF ~ STORM-WATER~ GRADING, DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRU(Ji'iON a. What is the Total Area of he Project Parcels? (Include Total Area of all Parcels located within the Scope of Work for Proposed Construction) b. What is the Total Area of Land Clearing (S.F. I and/or Ground Disturbance for the proposed construction activity? (S.F. I Acres) PROVIDE BRIEF PROJECT DESCRIPTION General DEC SWPPP Requiremenl~: Submission of a SWPPP is required for all Construction actlvi~es involving soil disturbances of one (1) or mom acres; including disturbances of less than one acre that ar[* part of a larger common pisn that will ultimately disturb one or rr~re acres of lend; including Construction activities iOvolving soil disturbances of less than one (t) ac~e where the DEC has determined thai a SPDES permit is required for storm water discharges. [ SWPPP'$ Shall meet Ihe Mthimum Requirements of the SpIDES General Permit For Storm Water Discharges from Construction activity - Permit No. GP-0-10-00t .) 1. The SWPPP shait be prepared prior to the submiltal of the NOI. The NOI shall be submitted to the Department prior to the commencement of construction activity. 2. The SWPPP shall descdbe the erosion and sediment control pracgces and where required, post-construction storm water management practices that wil~ be used and/or ITEM#/WORK~S~SMFA~ I Yes No Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by Ne cieadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Propesed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Water Flow. Does the Site Plan and/er Survey describe the erosion and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the EnUre Construction Period. Will this Project Require any Land Riling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal within any Pamel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? 6 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 Wetland or Beach? 7 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Horizontal Distance? 8 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right-of-way?, 9 Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town PJght-of-Way or Road Shoulder STATE OF NEW YORK, ~:~ r L COUNI~ OF ....r~.....cL~.?.. .......... :.. ...... SS ........................................................ ucing duly sworn, deposes and says Name of nd vidual s gn m:j Docun~nt - that he/she is the applicant for Permit, And that he/she is the ................................... o~r~~/l~~~:,.;.~.~ ........ i ....... ~'~.g~Vdii;;; ~,~;~i;~'."~'&;.'~i ................................................................ Owner md/or representative of the 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 applicationl.q~ffil~{l~,o$~Rih~t~/ of his knowledge and belief; and that the work will be performed in the manner set forth in the applicationlffili~l~l~l~l~t~ of ~ ~ Swom to before me this; ,,. _,.~.°..0.1S_T6.1.64008 .. ~ ~ . u.aal.ffied ~n.S~.k ClNllttv -- d, 6 da of .... m, lssmrm aes i Ti tl( h _ ........... ~--~ ............. · ............ , ............ .:/. ............. , zu~.u , /-~ ~-~'~A tx( ............ FORM - 06/10 SURVEY OF I,OT 3 MINOR SUBDIVISION DEERI~'[E'I D FARM BAYVIEW Joseph A. Ingegno Land Surveyor 22. '-0 ~ OR L ~: .JNLAWFUL '~ CERTIFICATE ·., ,"~ NCY APPROVEDASNOTED DATE , ,~//¢'T" NOT!FY BUILDING, DEPA~:MENT &T 765-!$0Z ,5 AM TO 4 P'¢ FOR THE FOLLOW~NG )~SPECT~n~ I ) FOR POURED CONCRETE STRAPP,NG. ELEOTR,OAL & CAULKI.G 3 INSULATION 4 FINAL- CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR CO. ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR COI~STRUCTION ERRORS. .> 12- SCALE: V.~'~-. H~,- ,~ APPROVED BY: