HomeMy WebLinkAbout28043-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28221 Date: 02/19/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1155 MAIN ST GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 34 Block 1 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 28, 2002 pursuant to which
Building Permit No. 28043-Z dated JANUARY 28, 2002
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 SHED AS APPLIED FOR.
The certificate is issued to ROBERT W BRUCE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
(Z .
Authori2od Signatu e
Rev. 1/81
FORM 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. 28043 Z Date JANUARY 28 , 2002
Permission is hereby granted to:
ROBERT W BRUCE
2085A SHIPYARD LA
EAST MARION,NY 11939
for
REPLACE EXPIRED BP# 25734Z FOR AN ACCESSORY BUILDING AS APPLIED
FOR WITH NYS DEC AND TRUSTEE ' S APPROVALS
at premises located at 1155 MAIN ST GREENPORT
County Tax Map No. 473889 Section 034 Block 0001 Lot No. 009
pursuant to application dated JANUARY 28, 2002 and approved by the
Building Inspector.
Fee $ 75 . 00
Authorized Signature
ORIGINAL
Rev. 2/19/98
FORM NO. 3
TOWN OF SOUTHOLD VQ /Q
BUILDING DEPARTMENT c
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25734 Z Date MAY 19, 1999
Permission is hereby granted to:
ROBERT W BRUCE
2085A SHIPYARD LA
EAST MARION,NY 11939
for
REMOVE EXISTING 18 X 20 ACCY BLDG. & BUILD NEW 12 X 20 ACCY BLDG
IN SAME LOCATION AS APPLIED FOR. DEC#1-4738-02193/00001 TRUSTEE WAIVER.
at premises located at 1155 MAIN ST GREENPORT
County Tax Map No. 473889 Section 034 Block 0001 Lot No. 009
pursuant to application dated APRIL 6 1999 and approved by the
Building Inspector.
Fee $ 56 .00
AuXhq&i0d Si nature
ORIGINAL
Rev. 2/19/98
y Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT 4--
TOWN HALL
765-1802 Com' e zr4�'o
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 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 a 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$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00,
Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property:
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map, Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: check one)
Fee Submitted: $
scan ignature
BUILDING DEPT.
INSPECTION
[Vf"�FO UNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
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REMARKS: /a4L 40.
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DATE INSPECTOR
� goy3 �
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR_9�2dc�Af 4
[KLD INSPECTION REPORT DATE COUNTS
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FINAL
__. ADDITIONAL COMMENTS:
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O�QSUFFO(�`►O Town Hall
Albert J.Krupski, President �.r Gy 53095 Main Road
James King,Vice-President o= t P.O.Box 1179
Henry Smith ti Z Southold,New York 11971
Artie Foster O
Ken Poliwoda Telephone(516) 765-1892
y
��! a0 Fax(516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
December 17 , 1998
Robert S. Hughes, Esq.
P.O. Box 128
Greenport NY 11944
RE: ROBERT BRUCE
SCTM #34-1-9
Dear Mr. Hughes,
The following action was taken at the Southold Town Board of
Trustees meeting on December 16, 1998 :
RESOLVED, that the Southold Town Board of Trustees grant the
request for a Waiver to remove an existing garage and replace it
with a storage shed with a smaller footprint.
However, this does not constitute approval from any other
agencies .
If you have any questions, please call our office at 765-1892.
Sincerely,
Q
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/djh
cc. Bldg. Dept. L-"-"
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC PERMIT NUMBER EFFECTIVE DATE
1-4738-021.93/00001 ■ March 31 1999
FACILITY/PROGRAM NUMBER(S) P E RM I T EXPIRATION DATE(S)
Under the Environmental
Conservation Law March 31, 2004
TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate
O Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR
of Waters Certification 360: Solid Waste Management
❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR
Supply 373: Hazardous Waste Management
❑ Article 19: Air Pollution
❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion
Transport Management
❑ Article 23, Title 27: Mined
❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floodplain
Island WeLLS Management
■ Article 24: Freshwater Wetlands
❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37;
Scenic and Recreational Rivers ❑ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control
PERMIT ISSUED TO TELEPHONE NUMBER
Robert Bruce (516) 477-1738
ADDRESS OF PERMITTEE
2085A Shipyard Lane East Marion NY 11939
CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER
Robert S. Hughes Esq., P.O. Box 128 Greenport, NY 11944 (516) 477-2700
NAME AND ADDRESS OF PROJECT/FACILITY
Bruce property, 1155 Main Street Greenport, NY 11944
LOCATION OF PROJECT/FACILITY
SCTM #1000-34-1-9
COUNTY TOWN WATERCOURSE NYTM COORDINATES
Suffolk Greenport NYSDEC FWW GP-16 E:721.0 N:4554.5
DESCRIPTION OF AUTHORIZED ACTIVITY:
Remove existing shed and replace with a new shed within the existing footprint. Construct a 6' high stockade fence on
the north, west and south sides of property and a 4' high picket fence on the east side of the property. All work shall
be done in accordance with the plan stamped NYSDEC approved on 3/30/99.
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the
ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as
part of this permit.
PERMIT A7ij�eLand
NISTRATOR: AD SS
Joh A. .. (MRP)
Bldg. 940, SUNY Stony Brook, NY 11790-2356
AUTH I SI NATURE DATE
March 31 1999 Page 1 Of 4
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APR 6 1999
-
BOARD OF HEALTH . .. . . .. . . . . . . . .
BLDG.DEPT. FORM NO. 1 3 SETS OF PLANS .. .. . . .. . . . . . . .
TOWN OF SOUTHOLD TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . ... . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . .. . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-18021 NOTIFY: -7
CALL . . �/. . .��. .7d.�
Ex mined....... . CC,�G...... 19.Q9 C J. % MAIL TO: . . . . . . . . . . .. . ... . . . .
pp 010 J
Approved..... �a........ 19.1,1. Permit No. ..:............. ....................................
Disapproved a/c .................................. ....................................
......................................................
(Build• •or)
APPLICATION FOR BUILDING PERMIT //
Date. .z,.J.?. . . . . . . . . ., 19. `c
5
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector Witt
3 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 giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
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
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 whatever until a Certificate of
Occovancy shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MATE 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 bui i for i/n tions.
G
(Signature of apple /, or name, if a corporation)
(Mailing addre
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricf 'lder.
c
Name of owner of premises ..... P ....................... .
(as on the tax roll or latest deed) VUNJWQ '-•• •• AT ,
If applicant is a corporation, signature of duly authorized officer. 7613-19OZ 8 AM 10 4 PM THE
FOLLOWW Mr8PECTKM-
......................................................... 1, FOUNDATION • TWO REQUIRED
(Name and title of corporate officer) POPOMCONIMETE
Z. ROU&I • FRAMING • PLUMBING
8. INSULATION
Builders License No. 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
Plumbers License No. ......................... ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
Electricians License No. ..................... STATE CONVrRUCTION dh ENERGY
Ocher Trade's License No. .................... CODES. NOT RESPONSIBLE FOR
DESIGN OR .00NSTRUCTION ERRORS
1. Location of land on which proposed work will be done..............................................................
L-� (Lc� NPoQ
....... .: ....................� !J`1 ...1.�rte..)......................... .................1:..................
House Number Street Hamlet
County Tax Map No. 1000 Section .....3."J....... Block ......1......... Lot ..... .........
Subdivision ...................................... Filed Map No. ............... Lot ...............
(Name)
2. State existing use and occupancy ofpremises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ................c1. ...................... �. . ...................
b. Intended use and occupancy .......4 CS i D ems; !&x. .................................................
y
3. Nature of work (check which applicable): New Building ....k- ... Addition .......... Alteration ..........
Repair ............ .Ronoval ............. Demolition .k►......... Other Work .................................
(Description)
4. Estimated Cost ...... a................. fee ...................... ......................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ....N...... Number of dwelling units on each floor ................
Ifgarage, number of cars ......................................
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 .....1.<� ...... Depth 2,R
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 ......L?%....... Rear ...I.L........ Depth .Z.�'.........
Height .......................... Number of Stories ....t................
9. Size of lot: Front ...R. .......... Rear ........... Depth ... ......:.....
10. Date of Purchasef c, .... Name of Former Owner ....... .....................
.
II. Zone or use district in which promises are situated ................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ....P.p..............
13. Will lot be regraded .... ........... Will excess fill be removed from premises: NO
14. Names of Owner of premises .�1�K"�-�..�.�:�.�a...... Address �o�S�Stt�PYi}„c��,},�,d .... phone No A.R.-./735..
C-A-s T k-C
Name of Architect .................................... Address .............................. Phone No. ............
Name of Contractor ................................... Address .... .........................Phone No. ..............
15. Is this property within 300 feet of a tidal wetland? * YES ... .. ND ..........
*IF YES, SQTIiM MM TRtb'W FMffT MAY BE MgfflM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions,
from property lines. Give street and block amber or description according to deed, and show street names and indicate
whether interior orAA corner lot.
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....s -•�:�-- i�ly,��.yr rlotlo �. .................being duly sworn, deposes and says that be is the applicant
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(Name of indivj44 _
above naamed, � JA a r {
Heis,the ......3. 'Jr f .....................................................................
(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 true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed thgirewith.
Sworn toTorg me this Gj
...................da�A 19.`. ...
Notary Public ........... .. ........ .... .�
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NICA F. CIDONE (Signature of Applicant) V
kWARY PURE. Sate of New York
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