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Home My WebLink About36709-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 12/16/2011 No: 35342 Date: 12/16/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: SHED 5640 WESTPHALIA ROAD, MATTITUCK, NY., Sec/Block/Lot: 113-10-15.5 Filed Map No. conforms substantially to the Application for Building Permit heretofore 9/14/2011 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. filed in this officed dated 36709 dated 9/23/2011 construct an accessory 12' X 24' shed as applied for The certificate is issued to Springer, Ryan & Springer, Lisa (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36709 Date: 9/23/2011 Permission is hereby granted to: RYAN & LISA SPRINGER 5640 WESTPHALIA ROAD MATTITUCK, NY 11952 To: construct an accessory 12' X 24' shed as applied for At premises located at: 5640 WESTPHALIA ROAD, MATTITUCK, NY. SCTM # 473889 Sec/Block/Lot # 113-10-15.5 Pursuant to application dated To expire on 312412013. Fees: 9/14/2011 and approved by the Building Inspector. ALTERATION OF ACCESSORY BUILDiNGS CO - ACCESSORY BUILDiNG Total: $215.20 $50.00 $265.2O Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy Th/s 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 0fFire Underwriters. 4. 'Sworn statement from plumber certifying that tho solder used in system contains less than 2/10 of 1% Icad. 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~ I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly e.~mpleted app}icati0n 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, ~. Certificate of Occupancy on Pre-existing Building - $I00.00 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: ~-(_O House No. Owner or Owners of Property: . Suffolk County Tax Map No 1000, Section Subdivision Health Dept. Approval: Date. Old or Pre-existing Building: (check one) ' Street Hamlet Filed Map. Lot: DateofPermit. ~-~93- / / Applicant: Undetwriter~ Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~-'-0 · ~ · Final Certificate: V (check one) Applicaut Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~LATION [ ] FRAMING/STRAPPING ['--"]~=INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 7 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-180;l FAX: (631) 765-9502 SoutholdTown.NorthFork. net PERMIT NO. Exam ined Approved Disapproved a/c ¢/,'L~, 20 {I Expiration Building Inspector 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 Single & Separate Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled m by typewriter or in ink and submitted to tile 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 a4joining premises or public streets or areas, and waterways. c. Tile 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 througbout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever tmtil the Building Inspector isgues a Certificate of Occupancy. f. Every building permit shall expire ilthe work authorized has not commenced within ! 2 months after the date of issuance or has not been completed within 18 months from such date. If ilo zoning amendments or other regulations aflbcting 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 tbr 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 oa premises and in building for necessary inspections. OCCUPANCY OR (Signature of applicant or name, ifa corporation) IJSE IS UNLAWFUL .-~6,'.,'o OOe~ ~Ok,, I,k,,, Rd/~ ;¢~,'f',dq /°2' 11~¢ t WITHOUT CERTIFICATE&ailing address of applicant) State whether applicant is owner, leQ~, ~~[~gineer, general contr~tol¢, e!~ci~, plum~er or builder Nameofownerofpremisesn/,<,~ t/.,S~ .~)""%~ /'- ~ (As~)n the tax roll or 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 County Tax Map No. 1000 Section //5 · Block Subdivision ~[~Jt~l~ ~r ~LUING DEPARTMENT AT 17b~'1~'8 AM TO4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH- FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3. INSULATION 4. FINAL. CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR CO ALI. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW ,Y,O~( STA~E. NOT RESPONSIBLE FOR ~'( q ~J~3~ CONS IR tic TI ON I IaI~I~AIN STORM WATER RUNOFF PURSUANT TO CHAPT~P~236~- ] 0 OF THE TO'tlS~tgflBE /.5 - b Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and oggppan, cy of proposed construction: a. Existinguseandoccupancy X,',-,)lt ~.'1~/ h~ x b. Intended use and occupancy S 1-~)~ sM d 3. Nature of work (check which applicable): New Building_ ~X' Addition Alteration Repair Removal Demolition Other Work Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling Ulfits 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 Rear 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size oflot: Front 17~-qO Rear /7'L.-~O Depth 2, L/(-(. 70 10. Date of Purchase Nalne of' Former Owner 11. Zone or use district in which premises are sitnated 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 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 · IF YES, PROVIDE A COPY. NO ~( STATE OF NEW YORK) COUNTY , ,. , ,,,~ ~;,, being duly sworn, deposes and says that (s)he is the applicant (Na ne of ihdi'v 'dual signi_,. ~g ,con[riic, b,.: ,.,,alPbYe named, O~NIE D. BUSH (S)He is the i ::)~ ~. 01BU618~ ' (COnt~t0ff, A~ent, Corporate Officer, etc.) Quai~ in of said owner or owners, and is duty a~{ltld~ed~to perform or have performed the said work and to make aud file this application: that all statements contmned m th~s apphghtIon are tree to the best of his knowledge and behef; and that the work wdl be perfonned in th~ roamer set foah n t~.a<p~ '~'o ~ fi ed t ~erewith · Sworn to before me this NotaryPub Signature of Applicant bOT %[TUAT£D 4T MAlT[PUC TOWN OF SOUTH~'ED:''~ ,, SuFfOLK cOUNTY, NEW YORK S.C. 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