HomeMy WebLinkAbout38010-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
5/9/2013
CERTIFICATE OF OCCUPANCY
No: 36230
Date:
5/9/2013
THIS CERTIFIES that the building
Location of Property:
SCTM ti: 473889
Subdivision:
FARM BUILDiNG
38920 Route 25, Peconic,
Sec/Block/Lot: 85.-3-12.1
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore fried in this ofllced dated
5/9/2013 pursuant to which Building Permit No. 38010 dated 5/9/2013
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:
agricultural building
The certificate is issued to
Briarcliff Sod Inc
(OWNER)
of the aforesaid building.
SUFI~OLK 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 #: 38010
Permission is hereby granted to:
Briarcliff Sod Inc
PO BOX 180
Peconic, NY 11958
To:
agricultural building
Date: 5/9/2013
At premises located at:
38920 Route 25, Peconic
SCTM # 473889
Sec/Block/Lot # 85.-3-12.1
Pursuant to application dated 5/9/2013
To expire on 11/8/2014.
Fees:
and approved by the Building Inspector.
FARM BUILDING - NEW
CO - ACCESSORY BUILDING
Total:
$150.00
$50.00
$200.00
~ector
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 ofpreperty 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 eleetrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2il0 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~ 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 $$0.00, Additions to dwalling $50.00, Alterations to dwelling $$0.00,
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 ofOccupuncy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
House No. Street
Owner or Owners of Property: ~'0 - :o.,, c~- ~'- C¢
Suffolk County Tax Map No 1000, Section ~
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~/) j
Old or Pre-existing Building:
Date of Permit.
(/3
(check one)
Hamlet
.~,e.
Block ~ Lot ! 2 . ~
Filed Map. Lot:
Applicant:
Underwriters Approval: A/,//5~
Final Certificate:
(check one)
~icant Si~ature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork. net
Examined ,20__
Approved 20 __
Disapproved a/c
Expiration ,20
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, b~fore applying7
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 Assessmem Form
Contact:
Mail to:
Phone:
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date ~-/'7 ,20/,j~
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 pennit
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, 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.
(Signature of applicant or name, ifa corporation)
(Mailing ad*=, of applicanty { ~--oc~
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 ap~tio?,..ai~mpm,e)of duly authorized 9fficCr
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which,proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section ~ Block 3 Lot I 2, · /
Subdivision Filed Map No. Lot
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
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
Addition Alteration
Other Work
(Description)
Fee [oo
(To be paid on filing this application)
Number &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 ! ~ r Number of Stories
Z~'2 ' Rear z~ Z ' _Depth 7_~'-~ '
,/
Dimensions of same structure with alterations or additions: Front
Depth 2-~--~ ' Height I ~ r
8. Dimensions of entire new construction: Front
Height Number of Sto'ries
9. Size of lot: Front
10. DateofPurchase 3[2[g
I
11. Zone or use district in which premises are situated
Number of Stories
Rear
I
Rear /~/A- Depth
Rear Depth
Name of Former Owner
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 ofpremises~r,'~-o/,'~r' ~ 4'~ddress ~_o. _~. ( g'o hone No.
Name of Architect /t//,~ Address Phone No
Name of Contractor . ./¢//~ 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 >Z
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 __ NO
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNeT~F. )
_~.~'X~.4~-.~. ~ I~ ~'x' being duly swom, deposes and says that (s)he is the applicant
~me of individu~ing con,t) ~ve nmed,
(S)He is the (Con~ctor, Agen~ Co~m~.)
ofs~d owner or ownem, ~d is duly ~o~d m peffo~ or have ~ffo~ed ~e s~d work ~d to m~e ~d file ~is ~pli~tion;
that ~1 s~tem~ con~in~ in this application ~ ~e to the ~st of his ~owl~ge ~d ~lief; ~d ~at ~e wo~ will ~
~ffo~ed in the m~ner set fo~h in ~e appli~fion fil~ ~wi~.
Sworn to before me this
d0 'p''/'3 day of fl3t~O
20 lB
-- Notary Pu61ic ~7 '
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2_,d xZl2.' FRAME DAP. N: g_AST g/_g.VATION
2zl xa2' F~-AM~- 15AIZN: ~o~ c~ cVA'RON
z~ATION:
P-Z~LIT~_ 25, Pg_..¢ONl¢
All--
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