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Home My WebLink About36029-ZFORM 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. 36029 Z Date NOVEMBER 17, 2010 Permission is hereby granted to: BRIAN HOWARD 275 SLEEPY HOLLOW LA SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL FENCED TO CODE at premises located at County Tax Map No. 473889 Section 078 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 275 SLEEPY HOLLOW LA SOUTHOLD Block 0001 Lot No. 038 4, 2010 and approved by the 17, 2012. Fee $ 250.00 / Authorized Signature ORIGINAL Rev. 5/8/02 NOV 4 2010 BLDG. DEPT. TOWN OF SOUTHOtO Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 'LICATION 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, p?operty 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 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 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 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 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 buiIding $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, Commereial $15.00 Date. New Constmction: ~o~ O(~1~o[ Pre-existing ,Building: Locationoferoperty: ~ ~, >/~'~L/ /~'/~ L~ House No. Street Owner or Owners of Property: /~/[~z~j,~ Suffolk County Tax Map No 1000, Section ~F~ Block Subdivision Filed Map. Permit No. ~ d~ ~ ~f Health Dept. Approval: Planning Board Approval: DateofPermit. ]]- / 7- /~) Applicant: Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ ~'-O, 0t~ Final Certificate: eck one) Lot '--~' Lot: Hamlet (check one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined Approved Disapproved a/c Expiration PERMIT NO. NOV - 4 ;CiO BLDG. DEPI. TOWN OF SOUI'ROLO BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Survex Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Building Inspector 2ATION FOR BUILDING PERMIT Date INSTRUCTIONS Mail to: 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 fbr 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 frmn 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 inspections. "IMMEDIATELY" (Signat,re of applicant or name, ifa corporation) ENCLOSE POOL TO CODE UPON cOMPLETION 9700 /#~,74) ~ M~7'7~'~-o~2~ /t~//f~ BEFORE "WATER' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ; ;? 3VED AS NOTi':D Name of owner of premises ,~ ~ ' Ya-rt4~ /~0(,~/'/~ D&TF- //~B'" #"~~ ro. If applican~ ~co~or~n, signature of duly authorized officer NOTIFY BUILDING DEPONENT ~ /~~ Z OCCUPANCY C)R 765-1802 8 ~ TO 4 ~ FOR mE .... FOLLO~NG IN~ECT~: (Name =d title ofco,orat~ UNLAWFUL ~. FOUNDATI~-~RE~IRED FOR POURED ~ Builders License No. WITM I IT TIg, ATg z aOUGH-F , m, .................. ~' '--~ 8TRAPPINO, ELEC~L J CAULKING Plumbers License No. ~ ~' ~ ........... 3. INSU~ Electricians License No. k.)J- [.Jblo ,~'\BI~Y Other Trade's License No. q&a~.~ f-/~/ 1. Location of land OnWhich proposed work will be dong: House Number Street County Tax Map No. 1000 Subdivision 4. FINAL- CONSTRUCTION & ELECTRICAL UUST BE COMPLETE FOR C.O. REQUIREMENTS OF~THE CODES OF NEW YO R ~K~E~RE~PO N SiB L E FOR La! ilqtSTORM WATER RUNOFF · PURSUANT TO CHAP P(g36 Section Filed Map No. REOUIRED 2. 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 Z~p'C'z,.,~~'J') ~:;v.,3~ 3. Nature of work (check which applicable): New Building Alteration Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work 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 Rear .Depth Height. Number of Stories , , ,: Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories , Rear ,. Depth 9. Size of lot: Front Rear _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, with accurate foundation plan hnd di~tances.,tblp,~operty lines. 17. If elevation at any point on property is at 10 feet or below, tnu~t proVide topographical data on survey. 9* 18. Are there any covenants and restrictions with respect to this property. YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY '~ .t~.i :4rqq:4.~j 0~! being duly sworn, deposes and says that (s)he is the applicant (Name df in~d~~ntr~t)pbgue named,,. (S)He is the ~T ~3~Oa Ot~i iO'a 9i. a O~q~8~OJq .~c~'~ent, Co¢orate Officer, etc.) of said owner or owners, and is duly ~6~ to, peffom or have perfomed the said work and to make and file this application; that all statem~'~l~~r* tree to the best of his ~owledge and belief; and that the work will be perfo~ed in the ~,~s~}~~u--~, ~~ filed therewith. Sworn to before me this ~, , I~ day b~~ 20 Il ~ Nota~ Public , ' Signature of Applicant Town of Southold iErosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM $.¢.T.M. ~. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A PI~OPEF~ ~_ TION: ) ,~ S~-WATE~ G~ING, D~E ~D ER~ION ~ROL P~ D~ ~n B~ ~ ~ I IrlKU BY A ~SIGN PRO~IO~ IN THE ~ATE OF N~ YO~ sCOPEOFWO~ - PROPOS~ CON~U~ON 1'1'~ / WO~S~ [ Y~ No a. ~t ~ ~ To~ ~a of ~ Pm~ P~b? (Infl~e To~l ~ of a~ Pa~ b~d ~in ~ ~11 ~ Pmje~ R~ln ~ ~Wa~ Ru~ ~ ~ ofWo~ ~r Pm~d ~) Ge~m~ by a T~ (2') In~ ~1 ~ Si~? ~eafl~ an~ ~s~ ~ ~ ~11 ~ all ' (~v.t~) 2 ~theSitePianan~orSu~Sh~l~ PRO~E B~ PRO~ D~ON ~~.~ Drainage ~ I~flng Size & L~n? ~ls Item ~all include all P~ ~e ~es a~ SIo~s ~n~lling Su~ace Wa~r Flow. 3 D~s ~e Site Plan an~or Su~y des~ ~ e~ion a~ s~iment ~1 ~s ~at ~ll ~.us~ ~n~ s~e e~n ~ s~ ~r dl~. item must ~ maln~in~ ~m~ho~ ~e En~m ~s~n Ped~. 4 ~1 ~ Pmje~ R~uim a~ Land Riling, G~i~ Ex~vaUon ~ere ~em is a ~ge to ~ Natural E~sUng Grade Involving ~e ~n 200 Cu~c Ya~s of Matedal wi~in ~y Pa~l? 5 ~11 ~ ~li~fion R~uim ~nd Dis~ A~vifles En~m~ing an ~a in Exc~s ~ Five ~ou~nd (5,000 S.F.) Square F~t of Ground Su~ce? 6 is there a Natural Water Coume Running ~h ~e S~e? Is ~is Pmje~ ~in ~e T~t~ juHsdi~n am ~ab~r~n~a~d~m~ o~or ~a~ of~nd;d~ ~ ~ (1) ~ ~m a~; I~dhg d~s of ~ ~an ~ a~ ~at 7 Will ~em be Bite prepamgon ~ ~sUng Gra~ Sl~s ~ich Exc~ Fiff~n (15) f~t of Ve~l ~se to ~ ~n a~l~ ~i~ ~'dls~ ~ ~ ~n ~e (1) acm ~ One ~undmd (100') of H~n~ D s~n~? 2. ~e ~ ~ ~ ~ e~ a~ s~[~ ~ p~ and ~ 9~11 ~is Pmjea R~ulm ~ ~m~ ~ Ma~al, ~'A~OFNEWYO~ ~' ~ ~ t~ C~NIED. BU~H COU~W O~.~.~ .............. SS Nota~ P~, ~ ~ ~ Yo~ ~. 01~1~ ~r, ~r, ~.~ ~'~:~a ..................................... ~cr ~or mpmsen~fivc of ~c O~cr or O~c~, ~d is d~y au~o~d m ~Eo~ or ~vc ~o~cd ~c ~d ~e ~s apph~don; ~at ~1 s~tcmcn~ con~ncd ~ ~is apportion ~e ~ m ~e ~st of his ~o~cd~ ~t ~c ~rk ~1 ~ ~do~cd in ~c m~ner set fo~ in ~e appli~don rgM hcrc~. Sworn m ~[orc mc ~s; ............ FORM - 06110 151TUATE: 50UTHOLD I:' / TOi~N, 50LITHOLD '/ ¢'~It=FOLK ¢___,OUNT~, N'r' ~_0~ OF