HomeMy WebLinkAbout39230-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
1/8/2015
No: 37357 Date: 1/8/2015
THIS CERTIFIES that the building ACCESSORY
Location of Property.: 200 Maple Ln, Greenport,
SCTM #: 473889 Sec/Block/Lot: 35.-5-5.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/19/2014 pursuant to which Building Permit No. 39230 dated 9/30/2014
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:
ACCESSORY SHED AS APPLIED FOR
The certificate is issued to VanCleef, Ann Marie & VanClee% Robert
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
/uAoq ed Si ature
Permit #: 39230
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)
Permission is hereby granted to:
VanCleef, Ann Marie & VanCleef, Robert
200 Maple Ln
Greenport. NY 11944
To: Construction of an accessory shed as applied for.
At premises located at:
200 Maple Ln, Greenport
SCTM # 473889
Sec/Block/Lot # 35.-5-5.1
Pursuant to application dated 9/19/2014
To expire on
Fees
3/31/2016.
Date: 9/30/2014
and approved by the Building Inspector.
ACCESSORY $180.00
CO -ACCESSORY BUILDING $50.00
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.
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, Commercial $15.00
Date. a I iq /,+
New Construction: Old or Pre-existing Building: c (check one)
Location of Property: fn Q jo ke La �{
House No. Street Hamlet
Owner or Owners of Property 9, cDo ± Pi'l an Jr (�(���''�Pc �� Qj,
Suffolk County Tax Map No 1000, Section 5 Block Lot 5-1
Subdivision G 7 Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate:
(check one)
C�( M\inn
Applica 'Signature
qso
COY
TOWN VF SOUTHOLD BUILDING- DEPT.
765-1802
INSPECTI
]FOUNDATION IST RO - H PLUMBING
FOUNDATION 2ND SULATION1
L
FRAMING/ STRAPPING FINAL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION' FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) ELECTRICAL'(FINAL)
CODE VIOLATION CAULKING
MIT&RAMErEft.
... DATE fl -Z-Z -1.1( Z-- INSPECTOR
FIELD INSPEMON RE?C
FOUNDATION (1ST)
FOUNDATION (ZND)
ROUGH FRAU tN r&
PLUMBING
INSULATION i'EA N. Y.
STATE ENERGY CODE
FINAL
H
H
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined , 20
1, f .
Appi
Disa
Expi
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
PERMIT NO.S'( 2'; 0 0—
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm -Water Assessment Form
aact:
Mail
Phone: q-1-1— 0 ��lg
WIT
Date@Ta ip , 204
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 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.
Q&2J �� Q QQA-:�
(Signature of applicant or name, if a corporation)
Mailing address oI i app`lic�t)
, �i�%/ art'
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
0 w ncr-
Name of owner of premises
(As on the tax roll or la
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:
House Number IStreet A Ham
deed)
County Tax Map No. 1000 Section 3,;5 Block b Lot `5 e I
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 ,r�; ��l C� WE'�i ►� q
3.
b. Intended use and occupancy
0
Nature of work (check which applicable): New Building t✓ Addition
Repair Removal Demolition Other Work
4. Estimated Cost d rho Fee
5. If dwelling, number of dwelling units
If garage, number of cars
Alteration
(Description)
(To be paid on tiling 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
Height Number of Stories
Depth
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front 10 ' Rear 10 Depth QC's
Height 10 ` Number of Stories 1- i'6 a, !E.' 4
9. Size of lot: Front 4Q- o `cib Rear 0211 e S Depth Nav-A- 1105, O
10. Date of Purchase I 1 13 1 I a Name of Former Owner Carl � 61 0-r- en P. 1� 1 V
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO—Z
13. Will lot be re -graded? YES NOS/ Will excess fill be removed from premises? YES ` NO
Ono ' RobeNt 6r-eenpor ' NY
14. Names of Owner of premises Van Q I ear Address Aoo m ple_ 1.- Phone No. &31 477-0309
Name of Architect 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 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 NOy,
* 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. f`�o
18. Are there an -y --covenants and restrictions with respect to this property?* YES NO ✓
* IF YES, PROVIDE A COPY.
STATE OF PWYO
COUNTY O� �t `P� being duly sworn, deposes and says that (s)he is the applicant
(Nam of individual signing contract) above named,
(S)He is the (7-�) (0 Y�
(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 'AC day of '� 20 1
VICKI TOTH
j%
I `�n�otary PubGc'Stat� aCOr. York
Notary Public Qualified in Suffolk County \
Commission Expires July 28, 20 `
Signatdre of Applicant
;t
Scott A. Russell STO][ZMWA\T]E K
SUPERVISOR IWA\N A\G]EAMI EN T
SOUTHOLD TOWN HALL - P. O. Box 1179
53095 Main Road - SOUTHOLD, NEW YORK 11971 Town of So u th o l d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
DOES THIS PROJECT INVOLVE ANY ®1F THE FOLLOWING:
_ _ . _ _ (CHECK ALL THAT APPLY)
A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
B. Excavation or filling involving more than 200 cubic yards of ,material
within any parcel or any contiguous area.
100 feet of horizontal distance.
❑ [M D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
El [A E. Site preparation within the one
f loodplain as depicted
on FIRM Map of any watercourse.
❑� 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..
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project.
If 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 Building Department with your Building Permit Application.
APPLICANT, (Property Owner, Design Professional, Agent, Contractor, Other)
NAME: IJ �� � • wC
IPrInU
uup_
�"
s,g„ar�re)
Contact Information: (a 31 1 lry ty
1 0,3 x 9
�fcicplione NumAeri '
Property Address / Location of Construction Work:
apo Cno®1e 1 onp- 1 ,I
FORM # SMCP - TOS MAY 2014
S.C.T.M. #: 1000 Date:
District
�6 SI-►�
� r L
Section Block Lot
�:"::Y FOfi. C�li1LI)I�1C;� D1P: ��t�
Reviewed By: NV
"'
Date:
— E
�(Approv'd for processing Building Permit.
ormwater Management Control Plan Not Required.
❑Stormwater Management Control. Plan is Required.
(Forward to Engineering Department for Review.)
SCTM #'
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET
VILLAGE
DIST.
SUB. LOT
ov, ifobe van
P
D
ACR.
REM A KS }} j Vone)&
TYPE OF BLD.
/_
G CA-
PROP.CLASS
LAND
IMP:
TOTAL
DATE
FRONTAGE ON WATER
HOUSE/LOT
BULKHEAD
TOTAL
W s e
.,® t. O -. ., HQ LD ;_®, •? as C R ,!. (' .. _ .. a D CARD,
,0 WER s ,
STREET},'
VILLAGE
DIST.
SUB. LOT
LAND
IMP.
TOTAL
DATE
REMARKS
FOR ER OWNER`,.0 `�°'`
N
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W
TYPE OF BUILDING
11 0 . `fit r-
GJAp ,
RES. IO
SEAS.
VL.
FARM
COMM. CB. MICS. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
I
3"C� ¢�
a
Ll-L'Z.
11 0 . `fit r-
$
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Tillable
FRONTAGE ON WATER
Woodland
FRONTAGE ON. ROAD
I
Meadowland
DEPTH
rv; LAP,
House Plot
1b.
4
V17Z
BULKHEAD
Total
S.C.T.M. N0, DONCT TWO SECTTON:35 BLOCK: 5 LOT(S):5,7 .�
• r��d�ol�o18�.
«^ •C'i CIL'
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to 3
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- uN0 ro/F OF s es�s'uo� E.
rc.0 RO J. CRON =83 ��a ail
`
Land N/F OF 10' MUM EASEMENT '
JOHN d& ANNA GWVNARIS
00-25-03TH£ WATER SUPPLY. If ELLS AND CESSPOOL
'Tom sum FOUNOAMON MATH 2 -3-02 LOCA AGNS SHOWN ARE FROM FIELD WSERVAAONS'
RPM 11-6-01 NOD MW
AND GYP OATH �TA/NED FROM OTHERS
AREA: 41,048.7 S.F. OR .0.97 ACRES WWI 0-28-01 ovm Hm £LeVA11ON VATUM. ASSUME,
UNAVTHORIZ£O ALTERI AOIV•OR AD&170tj TO 7HIS SURtCY IS A WOLAAON.`OF SfCAON 7209 OF 7HE NEW YORK SIA7E EOUCAAON LAW:. COPIES OF THIS SURVEY .
MAP NOT BEARING THE LAND SURVEY, s FA/BOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE- COPY. GUARANI= INDICATED HEREON SHALL RUN
LYVLY TO IK PERSON FOR WHOM WE SURVEY IS PREPARED AND ON HIS BEHALF TO THEDRE COMPANY, GOVERNMENTAL AGENCY AND LENAWG INSMITON
US7E0 HEREON, ANO To 77IE ASSIGNEE= Of. INE L£NDWG W5177VTON, GUARANTEE$ ARE NOT M"SFERABLE
THE OFFSETS O4 DIMENSrON$ SHOWN HEREON FROM fE PROPERTY LINESIV V W SAMUCIURES ARE FOR A SPEWC PURPOSE AND USE 1NZWORE WNLY ARE
NOT INTENDED TCT MONUMENT THE PROPERTY LINES OR TO GUIDE WE 0IECVON OF FENCES• ADDIRONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASELIENIS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECOROEO ARE NOT 1GUARAN7EED UNLESS ANYSICALL Y EVIDENT ON THE PREMISES A T 7NE TIMI OF SURVEY
SURVEY OF; DESCRIBED PROPERTY CERTIFIED T0: CUSTOM DESIGNER HOMES OF
MAP OF. - - - LONG ISLAND; CAMpo BROTHERS• ..
4" Overhang on
a'I four sides oll.minates
sida*.mali streakinc fx,Irn
waterr,,rie-�ff
U I
Maintenance Free
alurninum drip
edge or painted
wood corners
2 Aluminum Jalousie '
%,vindows screens
& shutters, or choose
optional vvindows.
Custom placement at
no additional charge,
STANDARD FEATURES
225 lb. 20 Year guarantee
asphalt self-sealing shingles
in your choice of 6 colors
Latex/acrylic exterior paint
in your choice of, 13 colors
or clear -sealed
518" T- 1 - 11 Fir Siding or cnoose
6ptional Horizontal Wood Siding
or Vinyl Siding
Plywood roof
sheathing
Reinforced Double Doors
painted on both sides
With 2x4 ftay-ning
701���R
DATE: B.P. #
V1
Y�11
2"
F I
4CZLE6ARTMENT AT
Org- 4 P1+1 FOR THE
7. LLOWING INSPECTIONS:
FOUNDATION - TWO REQUIRED
(Wlq. POURED COPP,: Ni 'Is for
PRESSURE TREATED B.C. PRESSURE TREATED
5 ply plywood floor. secured 2x4 floor j,,)i,; Is 1G" 0.C.
with ring shan"ICUPANCY OR
J . acks & headers in all door Ud
framinq to meet all State and USE IS UNLAWFUL
flqintness
AUC riON MUST
FOR C.O.
)N SNA I FEET THE
-ODES OF NEW
RESPONSIBLE FOR
S I RUCTION ERRORS.
End Vents
both ends
provide proper
ventilation
F0 21-x4
Kiln dried stud
(' X
i 8'/2 walls
Galv.
Hurricane
Clips (Typ.)
Puil 2x4 sill
pies on all
four sides
PRESSURE TREATED 4x4
foundation Ueanis
NOTE: SHED IS TO BE TIED DOWN TO GALVANIZED1p
X I -A" DOUBLE HEAD, DOUBLE FIELIX EARTH
I I q
ANCHORS AT ALL CORNERS OF FOUR CORNERS, ASUN T I I Y TIE DOWN ENGINEERING OF ATLANTA,
GEORGIA, ATTACHED TO BOTTOM OF FOOTINGS & PERIMETER TIMBER SUPPORT TIMBERS. DETAILS APPLY TO ALL
-T T" T K 1 T " I n r.w-r 11lyy-%I7 "i7 nn UrV T CVKTI_