HomeMy WebLinkAbout34810-ZTown of Southoid Annex
54375 Main Road
Southold, New York 11971
12/5/2011
CERTIFICATE OF OCCUPANCY
No: 35367
Date: 12/5/2011
Location of Property:
SCTM #: 473889
THIS CERTIFIES that the building ACCESSORY
5223 1NDIAN NECK LA PECONIC,
Sec/Block/Lot: 98.-1-1.4
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
6/22/2009 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
34810 dated 6/22/2009
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 10 x 16 shed as applied for.
The certificate is issued to
Okula, Lisa & De Frese, Robert
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Auth~zo~ Sig~ture /
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. 34810 Z
Date JUNE 22, 2009
Permission is hereby granted to:
!
R DEFRESE
5223 INDIA~ NECK LA
PECONIC,NY 11958
for :
INSTALLATION OF AN ACCESSORY 10X16 SHED IN THE REAR YARD PER
TRUSTEES APPROVAL AS APPLIED FOR
at premises located at 5223 INDIAN NECK LA PECONIC
County Tax Map No. 473889 Section 098 Block 0001 Lot No. 001.004
pursuant to application dated JUNE 22, 2009 and approved by the
Building Inspector to expire on DECEMBER 22, 2010.
Fee $ 100.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN HALL
This applicatiou must be filled m by typewriter or mk and submitted to the Bud&ng Depaa~~
A. For new building or new use: 1. Fiual survey of property with accurate location of all buildings, propeay lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Depl. 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 ia system coatains less dmn 2/10 of 1% lead.
5. Commercial building, iudustrial building, multiple residences and similar buildings aud iustallations, a ceaificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning 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 showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees I. Certificate of Occupancy - New dwelling $50.00, Additioas to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory buildiag $50.00, Additioas 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 Occupaacy - Residential $15.00, Commercial $15.00
Date.
New Construction:
Location of Property:
Old or Pre-existing Building:
5Zz-3 LT-r dh
House No. Street
Owner or Owners of Property: ~1~,9~
Suffolk County Tax Map No 1000, Section ~' ~
Subdivisioa
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request lbr: Temporary Certificate
Fee Submitted: $ r---~ ,
Date of Permit.
(check one)
Hamlet
Block [ Lot [' ~'
Filed Map. Lot:
Applicant:
Underwriters Approval:
Final Certificate:
(check one)
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG,
[ ] FOUNDATION 2ND [ ]INSULATION
[ ] FRAMING / STRAPPING [~11~L ~/~'~'
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [
[ ]ELECTRICAL(ROUGH) [
REMARKS: ~'-~/~/~ /~-'~ ~ ~-~/~-~
] FIRE RESISTANT PENETRATION
] ELECTRICAL (FINAL)
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]~SIJ~
[ ] FRAMING/STRAPPING ['/] FINA~/~J
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTIO# [ ] FIRE RESISTANT PE.ETRATIO"
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: C<~'~ ~
INSPECTOR
FOUNDATION (2ND)
PLUMBING
~S~ATION PER N. Y.
STATE E~R~ CODE
~DITION~ CO~ENTS
TOWN'OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork.net
Examined ,20
Approved
Disapproved a/c
· 20
Expiration ,20__
JUN 2 2 2009
8LDO. DEPT.
TOWN OF SOUTHOLO
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, betbre 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
A Mail to:
!Building Inspector
Phone: ~21- g2',S-- .2'2 0 et
APPLICATION FOR BUILDING PERMIT
Date ,20
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.
t: 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 autborize, in writing, the extension of the permit tbr 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, Ne~v 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.
, WC 7 U;,
' UNLAWFU,.
' UT CERTIFIC, -
OF- CC'3UPANC¥
APPROVED AS NOTED
State whether applicant is owner, ]essee, agent, architect, engineer,
Name of owner of premises
If applicant is a corporation, signature ot~dulv authorized of'ricer
· .,-~L_L.¢_ONSTRUCTION SHALL
(S~f a corporation)
(Mailing address of applicant) ( t~ ,V
general ,.cg_ntrac. to):` ~el~tri.,ci_aq, pl,~ qflr. Tbuilder
LIA/I=:.=.~ [:3.F. #
N?UFY BLiIL! ,: .... t ....,,-,:NT AT
(As on the tax roll or l~t~
POURED C ....
(Name and title of corporate'~;l~l~"'~ej'~t: HEQUIRE&',ENTS OF THE
UODES OF NEW YO~K STATE.
Builders License No. R~TAIN ~Yflm~ W~T~UNOFF
Plumbers License No, PURSUANf~' ~u* ~
-- · ~,,.~T~ 236
Electricians License No, 0F ~-lfla/ll ~ne
Other Trade's License No. ~~R~F~A~
-flEQU~ED
]. Location ofbnd on wNch proposed wor~ wH] ~ done:
Ho~e Number Street Hamlet
County Tax Map No, 1000 Section ~ Block ~
Subdivision ~(~ Filed Map No.
2. ROUGH- FRAMilJG .~ ° PLU~,~,,~'~T~
3. INSULATION
4. FINAL - COL'STR:JCT!ON MUST
BE COMPLEiE :~': C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE· NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
Lot 1. C~
Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~ iw ~'Z
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building ~ Addition Alteration
Repair Removal Demolition Other Work
Estimated Cost ~ ~ ~,
If dwelling, number of dwelling units
If garage, number of cars
Fee l O O
(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.
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
t
Dimensions of entire new construction: Front ~3
Height [ ~ ' Number of Stories
Size of lot: Front Rear
Number of St~o[ies
i'./ ~
Rear
1
_Depth
10. Date of Purchase
Name of Former Owner
11. 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__ NO Will excess fill be removed from premises? YES__ NO
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address Phone No.
Address Phone No
Address Phone No.
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, D.E.C. PERMITS MAY BE REQUIRED.
NO
16. Provide survey, to scale, witb 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.
NO
STATE OF N~W Y94>,K)
'SS:
COUNTY O~ .
_.~.? [o.~'~ ~ 44~-~ - being duly swom, 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 th,e said work and to make and file this application;
that all statements contained ~n th~s apphcat~on are true to the be~'of~lhs Im'owledge and behef; and that the work will be
performed in the manner set forth in the application filed therewith.
Swor~o4~efore me this~t
4~ day of >O ~ 20Oq
Notary' Public Oual?fi°~gt~n'~fgluk~counlY4,~ / Signature of Applicant
6ommissiov ~xpires luly 28,
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town H~lAnnex
54375MainRoad
P.O. Box 1179
Southold, New York 11971-0959
Telephone(631) 765-1892
Fax(631) 765-6641
May 20, 2009
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Mr. & Mrs. Robert Defrese
5223 Indian Neck Lane
Peconic, NY 11958
RE: 5223 INDIAN NECK LANE, PECONIC
SCTM#98-1-1.4
Dear Mr. & Mrs. Defrese:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wed., May 20, 2009:
RESOLVED, that the Southold Town Board of Trustees APPROVES the Amendment to
Permit #6967 to relocate the 10'X 16 'shed, as shown on the plan last revised Apd113,
2009.
This is not a determination from any other agency.
Sincerely,
Oame .~King, Preside~
Board'of Trustees
JFK:lms
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (6311 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0444c
Date: July 8, 2009
THIS CERTIFIES that the installation of an in-ground swimming pool, patio and shed
and maintaining the 50' Non-Disturbance Buffer
At 5223 Indian Neck Lane, Peconic, New York
Suffolk County Tax Map # 98-1-1.4
Conforms to the applications for a Trustees Permit heretofore filed in this office
Dated 7/1/08 pursuant to which Trustees Wetland Permit # 6967 Dated 9/17/08 was Issued
and was Amended on 11/19/08 and on 5/20/09 and conforms to all of the requirements and
conditions of the applicable provisions of law. The project for which this certificate is being
issued is for the installation of an in-ground swimming pool, patio and shed and maintainim,
the 50' Non-Disturbance Buffer
The certificate is issued to ROBERT & LISA DEFRESE owner of the
aforesaid property.
Authorized Signature
:Town o__f Southold
Erosion, Sedimentation & storm.water Run-off ASSESSMENT FORM
~ ~R.~OPERTY~t~O~CA~TION: S~.C.T.M.~: . , .'i'~.E..F.O~__L~WING ACTIONS MAy REQUIRE THE SU~!e~,O.-. OF A
ms~ s~on m,~k Lot/ ~~
Item Number:. (NOTE: A Check Mad((~) for each Queeito~ is Required for a Complete Application)
Ye__s
1 W*dl this Pmject Retain AIl Storm-Water Run-Off Generated by a Two (2.) inch Rainfall on Site?
(This item will include all mn-off created by site cleedng and/or consflucfion ac~vlties es wsti as all Site
Improvements and the permanent creation of knpervlens sudacas.)
2 ODeS the site Plan alld/or Survey Show All Proposed Drainage Structures Indicating Size & Loca§on? ~--~ r~
This Item shall in01ude all Proposed Grade Changes and Slopes Con.oiling Sun'ace WatenClowl
3 Will this Project Require any Land Filling, Grading or Exoavalion where there is a c~ange to the Natural r~
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel?
4 Will this Application Require Land Disturbing Acfivtitss Encompassing an Area in Excess of
Five Thousand (5,000) Square Feet of Groond Sun~aca?
5 Is there a Natural Water Coume Running through the SRo? r~
is Ibis Project within the Trustees Jurisdiction or within One Hundred (100') feet of a Wetland or Beach'~
6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise th
One Hundred (100') of Horizontal Distance?
7 Wi, Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Watec Run-Off
into and/or in the direction of a Town fight-of-way?
8 Will this Project Require the Placement of Material; Removal of Vegetation and/or the Construction of
any Item Within the Town Right-of-Way or Road Shoulder Area?
(This item will NOT include the Installation of Driveway Aprons.)
9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? O --
NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading,
Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Perm~
EXEMPTION~ Yes N._R
Does this project meet the minimum standards for classi§caUon as an Agdcotiural Project?
Note: If You AnsWered Yes to this Question, a Stonm-Water, Grading, Drainage & Erosion Control Plan Is NOT Required] __ __
STATE OF NEW YORK~ ~ £ ~',~
~d ~at he/she is ~e ..............................................
,Owner ~or ~prcscn~fivc of~c Owner of O~cr's, ~d ~s duly au~o~d ~o pc~om~ or have pedDled ~e s~d wo~ ~d to
m~c ~d file ~is ~pli~fion; ~ ~1 sa~cmcnU ~n~ncd in ~is appIi~fion a~ ~c ~o ~ best o[h~ ~owlc~ ~d ~he[; ~d
· ar ~e wo~ will bc performed in ~c m~ncr se~ [o~ in ~c appllcadon filed here~.
Sworn ~o before mc
FORM - 06107
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold~ NY 11971 0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
November 28, 2011
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Lisa Okula & Robert DeFrese
5223 Indian Neck Lane
Peconic, NY 11958
TO WHOM IT MAY CONCERN:
The Following Item(s) Are Needed To Complete Your Certificate of Occupancy:
__ ^pplication for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
"/' A fee of $50.00.
__ Final Health Department Approval.
__ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
__ Trustees Certificate of Compliance. (Town Trustees #765-1892)
__ Final Planning Board Approval.
Final Fire Inspection from Fire Marshall. - Bob Fisher
Final Landmark Preservation approval.
BUILDING PERMIT: 34810 - Shed
,AREA = 16072 Acr
JUL 1 2008
$out~old Town -
Board of Tmst~es
L 0 T NUMBERS ARE.
REFERENCED TO ' MINOR
SUBDIVISION FOR THE O'KULA
/rAM/L. y"
NOV - 5 2008
/O/F ,JOHN POM
'Board el Tmmas ....C,
s. e,~2 ~,o,o. s.
,au. ,~1 · N.
R10-96-0069
IN/OIF M, & E.
MCKIERNAN , ~,
I
~0'~5'00. .-E
37.51,
g,30' ~' .05'4'0"
APPROVED
lines dong ~ ol gullet
Richmond'S Creek
BOARD OF TRUS~
TOWN OF SOUTH~
TOWN OF S'OUTHOLD
DATE ~,~ /7 o8
\
"-t
~- , ....... · ..... ~.., ~. ,
ROBER~ L. & LISA
,
A T INDIA N NECK ~ ~ ~ .:
TOWN OF SOUTHOLD
SUFFOLK COUNTY.,
1000 - 98 - O1 - PlO ~ 1
Sca/e: 1"= 50'
July 3~, 1996
A~.9. 19, I~,E (Cerllflcctlon~ ...,
Ocl. 7, /996 (toundolion)
Nov. /5~ /996 (contou'r$ odded)
Apr// 7/997 (f/nb/)
CERT~I£D lO.
ROS£R r L, O~FRESE
LISA ~, Oef'RESE
REPUBLIC ABSTRAC? CORP.
RDELIrY NA ?IONAL rlrL£ ~tSURANCE OF NEW YORX
8RID$EHA/,¢P I.ON NA I'/ONAL BANN
1 ~m I~m,~ v/ih 1~ STAu~OAROS FOR APPROVAL
~ CONS)RUCl.ION OF ~'UaSURFACE SEYAGE
p~rm? Io co~lrucl.
· 1275.58'
INDIAN NECKRoAD
S~owo fl~reo~ ore /rom /l'~/d observoh'on~ / , .
iSiS)~S5 ' '
CONl.OUR LIN~Z ~ND ELEVATIONS P, O, BOx 90,
~R~ R~RgNC~D rO N,G, VtD, I~0 ~RAV~
SOU~H~D~ N,~, ' 119ZI
78.44,00' W,
$' 20.05'
'0, 4961'8
Over
Cedar Grove Outdoor Products - Sheds - Cape Cod - Sheds, Garages, Gazebos, Playsets .... Page 2 of 2
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