HomeMy WebLinkAbout40806-Z �Q�SUF �F �'�CQ�� Town of Southold 7/8/2016
a � P.O.Box 1179
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� � 53095 Main Rd
�y,�rj0` �ao��� Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 38385 Date: 7/8/2016
TffiS CERTIFIES that the building ACCESSORY
Location of Property: 2460 Paradise Shores Rd., Southold
SCTM#: 473889 SecBlock/Lot: 80.-1-7.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/21/2016 pursuant to which Building Permit No. 40806 dated 6/29/2016
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: '
OUTDOOR SHOWER ADDITION TO AN EXISTING ONE FAMILY DWELLNG AS APPLIED FOR
The certificate is issued to Tully,Paul
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. •
PLUIVIBERS CERTIFICATION DATEID �`
l
Author e Signature
��u�QF ��co � T01rVN OF SOUTHOLD
�,�o ��� �UILDIiVC DEPARTMENT
o T011VN CLEI�K'S OFFICE
o� . o�,��'� SOUTHOLD, NY
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BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PRENiISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 40806 Date: 6/29/2016
Permission is hereby granted to:
Tully, Paul
295 Grove Dr
Southold, RII� 11971
�To: construct an outdoor shower as applied for.
At premises located at:
2460 Paradise Shores Rd., Southold
SCTiVI # 473889
Sec/Block/Lot# �0.-1-7.1
Pursuant to application dated 6/21/2016 and approved by the Building Inspector.
To expire on 12/29/2017.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $208.00
CO -ADDI ON TO D LING $50.00
To l: $258.00
_ ,
Building Inspector
Form No.G
TOWN OF SOUTHOLD
BUILDING DEPARTMCNT
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
--- -------------- - --------------�-----------__.------------ -
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New Construction: Old or Pre-existing Building: (check one)
Location of Property:� ���p� �-`G��f S� ��O(/�S �� , �`j U�l0 G�
House No. Street Hamlet
��
Owner or Owners of Prope� � �,5� l
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)
�u
Fee Submitted: $ �
Appl"cant Si ature
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7'01dVN OF SOUTHOLD BUILDIRIG DEPT.
765-1802
1 NSPEC'� ION � �
� [ ] FOUNDATION 1 ST [ ] F�OUGFI PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION �
L ] FRAMING / STRAPPING [�IdAL �
[ ] FIREPLACE � CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESIST�IT CONSTRUCTION [ ] FIRE RESIST�►NT PENETRATION
[ ] ELECTRICAL (ROUGW) [ ] ELECTRICAL (FINAL)
[ ] �ODE VIOLATlON [ ] CAULKING
REIRAAI�KS: �� � � -
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�DATE �� �Z /� INSPECTOR �
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLI), NY 11971 , 4 sets of Building Plans
TEL: (631) 765-1802 Plannin Board approval .
FAX: (631) 765-9502 �Survey �fG�/v� `DW-P/� �
SoutholdTown.NorthFork.net PERMIT NO. ��heck
, Septic Form
N.Y.S.D.E.C.
Trustees
D ���o(�f� C.O.Application
V Flood Permit
Examined ,20 Single& Separate
� � t �� Storm-Water Assessment Form
Contact:
� � �l
Approved ,20� $�Jj�,��j(�+���
�
Disapproved a/c ���FSo��Oj,�
Phone:�'��� /� :� .���5��
Expiration ,20 ,
�
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date �lf lv'� �'o , 20 � �•
INSTI2UCTIONS
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 sl�owing 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 witl�in 18 months from such date. If no zoning amendments or other regulations affecfing the
property llave 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 cod ousing code, and re ulations, and to admit
authorized inspectors on premises and in building for necessary inspections
(Signature of applicant or name, if a corporation)
a� � ����.� ��,�� ��� ,�
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
t�[,v�1 ��
Name of owner of premises 1 � ���1 C S�/-�
(As on the tax roll or latest dee ) `
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 hich proposed work will be done:
��r� �r�r ���e� �S�Q�P� � • l��I-�
House Number , Street . Hamlet
County Tax Map No. 1000 Section �� Block_ , Lot � .. /
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 Ad ' 'on Alteration
Repair Removal Demolition Other Wor c j� �� ��s��p�
�"'""$ ��,""�� ���.�' ��v`:.� °`��" (Description)
'�' ""�{ �'„„�s�„�-`",..��.:.� � �..� a
4. Estimated Cost `��� � I�e� ,�M� �,
(T.o;��paid on filing this application)
5. If dwelling, number of dwelling units �Nu��b���f dv��1���g ui�it�"on each floor
�.a.�
If garage, number of cars
��"����t��',��w=�
6. If business, commercial or mixed occupancy, specif,y°i��ftt�e'�n ,ye��e,� g� �each type of use.
�����t����.�'� ��a-�� r�.�
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 Address Phone No.
15 . 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 r/
* 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
� IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
� SS:
COUNTY OF��
��V - , � being duly sworn, deposes and says that(s)he is the applicant
(Name of individual ning contract) bove named,
(S)He is the ���t���
(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
�►I �. day of ��� 20��
_ ���
Notary Public ignature o Applican
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� �lOT Y BUIL.���1� D��P,R i P�IENT �1T "
; F'�� � ' 765-1802 8 Ah� TO 4 Pl�i F(7R THE
� FOLLOWING INSPECTIONS: '
�� � 1. FOUNDATION - TVVO REQUlRED
�� `� FOR POURED CONCRETE
� 2. ROUGH - FRANIING & PLU�FSING
� 3. INSULATION ,
� 4. FINAL � CONSTRUCTION MUST
� A BE COMPLETE FOR C 0.
� ALL CONSTRUCTION SHALL MEET THE
, � _ � REQUIREMENTS OF T,HE CODES OF NEW
� ,Q � YORK STATE. NO i RESPONSIBLE FOR
� ;� o DESIGN OR CONSTRUCTION ERRORS.
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