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Home My WebLink About39327-Z fS+CS3.'! Town of Southold Annex 10/30/2014 P.O.Box 1179 : 54375 Main Road 11 Southold,New York 11971 v�''rSIfLX tx CERTIFICATE OF OCCUPANCY No: 37244 Date: 10/30/2014 THIS CERTIFIES that the building SHED Location of Property: Pvt Rd Off E End Rd, Fishers Island, SCTM#: 473889 Sec/Block/Lot: 4.-3-9.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/29/2014 pursuant to which Building Permit No. 39327 dated 10/30/2014 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: "as built"accessory shed as applied for. The certificate is issued to Madden, Edward&Madden,Marcia (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut ' ed Signature TOWN OF SOUTHOLD °lx BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE {} SOUTHOLD, NY y{v 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#: 39327 Date: 10/30/2014 Permission is hereby granted to: Madden, Edward & Madden, Marcia 455 Australian Ave Palm Beach, FL 33480 To: as built" accessory shed as applied for. At premises located at: Pvt Rd Off E End Rd, Fishers Island SCTM # 473889 Sec/Block/Lot# 4.-3-9.1 Pursuant to application dated 10/29/2014 and approved by the Building Inspector. To expire on 4/30/2016. Fees: ACCESSORY $296.00 CO -ACCESSORY BUILDING $50.00 Total: $346.00 Building Inspector 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 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 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- $100.00 3. Copy of Certificate of Occupancy- $.25 v,< Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. I n(A �. Z i '.� New Construction: Old or Pre-existing Building: V/ (check one) Location of Property: 1 -7 7 3 S S M&%r R n"IA - - --, a v-,4 House No. Street Hamlet Owner or Owners of Property: it A W cj rd E . M ei^d 1!?, n Suffolk County Tax Map No 1000, Section bo y Block `�Lot !a T 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: $ 5-0 . Oa CL¢J�- l l Applicant Signature TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502Q Survey ✓ SoutholdTown.NorthFork.net PERMIT NO. { Check ✓ Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Form Contact: Approved 20 Mail to: '9, Sa' Disapproved a/c 3,04. (025- Phone: OX (02JrPhone: LV Expiration 20 1 Building Inspector APPLICATION FOR BUILDING PERMIT Date 10/ -3,3 20_I INSTRUCTIONS [�� a.This application MUST be completely filled in by typewriter or in ink and submitted to the �'d I}ispeoi wffh 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 pre public streets or areas,and waterways. OCT 2 9 204 a The work covered by this application may not be commenced before issuance of Building P it. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the pplic t.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 he Building Insp&dtfbf, issues a Certificate of Occupancy. T0'; r, 0 S 0!_;T X10 LD 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. (Sig_nahve of applicant or name,if a rp tiV /I&G of Dy otic (0 2 S' /C-J State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder J Name of owner of premises 11 f _;r--. maa cf,p L4 (As on the tax roil or latest deed) 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. 1. Location of land on which proposed work will be done: r, 1*77 'A% E n s-V 671at.i r-� Rez.a<j 1 CL U House Number Street 1-Iamlet County Tax Map No. 1000 Section M^ q Block .� Lot Q Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intend 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 Addition Alteration Repair Removal Demolition Other Work c5 P ►�?L t A N C� 17 Q G 0 (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, 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 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 Rear Depth Height Number of Stories 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 Address Phone No. Name of Architect Address Phone No Name of Contractor^c d t4 QylddressZX if 4-7 Phone No. [,# 3 I — -7-19"d t-isV4M Ts Ad4 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 of a 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 NO_s4 *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF I V e � � Si ; y Cd r I I-AU-- being duly swom,deposes and says that(s)he is the applicant (Name of in ividual 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 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 therewith. Sworn to before me this -day of OC&DJ- 20_LL�_ � G •C, "�- 'Pu'f Z� - Notary Public Signature of Applicant Scott A. Russell d°5 �' STORMWATER SUPERVISOR 2 MANAGEMENT SotrrHOLD TOWN HALL-P.O.Box 1179 1b� � Town o,f Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 �1 CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT E WOLVE ANY OF THE FOLLOWING Yes No CHECK ALL THAT APPLY! Q A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. A. B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑E] C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. E]Ej D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑0 E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. [:]El F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. U yon answered N0 to all of the questions above,STOPI Complete the Applicant section below with your Name, Sisnature,Contact Infor129100,Date &Connty TAX Map Nnmberl Chapter 236 does not apply to yaw projecL U you answered YES to one or more of the above,please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Dwaft Departowd wltS_your Building Permit A APKJCAN T-. (Property owner.noun Proremw at Agent contractor.ouKd I&C.T.M. *. 1000 Date NAME- Richard H. Strouse, P.E.L.S. (e gine ) 004 3 9.1 10-22-2014 for Edward Maclen(owner) Seaton Bock Lot ""FOR BUILDING DEPARTMENT USE ONLY Coatact Infanmtj= 860-290-4100 Reviewed By: — — — — — — — — — — — — — — — — Date: Property Address/Location of Construction Work: — — -- — — — — — — — — — — — — — — 17738 East Main Road Fishers Island Approved for processing Building Permit. Stormwater Management Control Plan Not Required. 10 x 12 garden shed — — — — — — — — — — — — — — — — — Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM 0 SMCP-TOS MAY 2014 \�Ny\JQ J1*-40WO' IL ' BLOCK 12 LOT M95 BLocK 13 Lor t LOCATION NAP S t PARCEL 2 + j f ^AREA 1.23.ACRES IIiII t � 1.1116 aA1xY Ia9 PaPNIlD r9R M IARIaa/IO R9MOI NRGIm �Jt < \ � N�NM OIIRIaW 0 M III 9[Y9MD M NIlOam 1911®ro // �� fT T �\ t OIGQOOIT.GAIT Mp M a11IrRl OR7®I M awr9 A M ,Ry(}T \ FF IOI�F / / 1)a a�rT¢AnaN ar M nArz auua9N ua r9R rNr ramp, r- ff �'� + uam IcnNo u9I1 M 9ratTl9x I.1KBI�I.ao awxroA ro pAe E ; '� xm1,w Iml R Nlr rwr. n�� j, � alar wrlo I na aAncr a�rTN M wo alRlmn � M urn a�waµTa°00M�orz9®a 9a aAL Nrz M RmIM.R ar yy BLOCK 12 g U PARCEL 3 LOT 5 ♦1 wana�x mrum luc awrm nma ua m�ir wo 99m[m (/J awur 1wwaaan9x aran9x ononlaHT a AREA 2.2.ACRES � s)arz 9I a M row ar aounlaa,mwrc a alrr9ul rul aw �N P E'�3_ r \ 1a90.aama aat 8091 a Im al. Y .� � r.)arz n Iaurz9 x a-Im Z91a. _ ff��Fn'f \� � I a)aNIE f01 lFAld N9Rf t9b. �_ � BLOCK 13 LOT 2 NONAax� m®a. N9xRaMr PARCEL 1 Nlav« AREA ZJ.ACRES a ♦ wiAilfoWa BLOCK 13 LOT JB a raurr NATaIK m1a 941RIIII mrNlr wVAN �M aT rot mu al9Tan v M � 1c � N 9aL11 / � IIIE 2 tiODTTAI /\ -N I (r9lrl9) G 4 \ �T aarl BLOCK 12 LOT 10 slorz slol I oRwE / �33 ie000 i i _ N/F N9a 9R rawaar OIMa11Y CONTROL CERIR1 ATION N 4M'T9'a NOrIINI;It } $ E F ,q w 9R91R I119ID Opt d� // aS 66 G BLOCK 13 LOT x 4 f y9z// DATE: 09/18/20)4 1' SHEET: 1 OF 1 s r s yW pip i! r solo or 10Oil r � �r rrrrrrr r rallr 14, r� 7777 "" � - 77 17- ,- p. liq I l CV% so VN I ' 3R v5�''T 4Y? , c