HomeMy WebLinkAbout28927-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29090
Date: 11/19/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 6300 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 38
EAST MARION
(STREET) (HAMLET)
Block 1 Lot 1.7
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 19, 2002 pursuant to which
Building Permit No. 28927-Z dated NOVEMBER 19, 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 BARN "AS BUILT" WITH ENGINEERS CERTIFICATION AS APPLIED FOR.
~e certificate is issued to JOSEPH A CHEREPOWICH & ORS.
( OWNER )
of the aforesaid building.
SUFP~DLK COUITI"f DEPARTI~ElqT OF H]~;%LTH APPROVAL
N/A
ELEt-£RICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION D~£~3
Rev. 1/81
N/A
Authorized Sign~re~
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUIT,~ING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28927 Z
Date NOVEMBER 19, 2002
Permission is hereby granted to:
JOSEPH A CHEREPOWICH & ORS.
PO BOX 103
EAST MARION,NY 11939
for :
CONSTRUCTION OF AN ACCESSORY BARN "AS BUILT" WITH ENGINEERS
CERTIFICATION AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 038
pursuant to application dated NOVEMBER
Building Inspector to expire on MAY
MAIN RD EAST MARION
Block 0001 Lot No. 001.007
19, 2002 and approved by the
19, 2004.
Fee $ 150.00
Authorized S~
Rev. 5/8/02
COPY
Form No. 6
TOWN OF $OUTHOLD
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 $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. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
November 19, 2002
Date.
New Construction: xx Old or Pre-existing Building:
Location of Property: 6300 Hain Rd
(check one)
East Marion
House No. Street
Owner or Owners of Property: Joseph A Cherepo~ich & ors
Suffolk County Tax Map No 1000, Section 38
Subdivision
Permit No. 28927
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Date of Permit.
Hamlet
! Lot 1.7
Lot:
11/19/02
Block
Filed Map.
Applicant:
Underwriters Approval:
Final Certificate: X (check o_ne)
· ~ ~pp"ffcant Signaturff
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P.O. BOX 162
GREENPORT, N.Y. 11944
(631) 477-1652
Mr. Michael Verity, Dept. Head
Southold Town Building Dept.
Main Road
Southold,N.Y.
11971
November 12,2002
Re: Aghcultural Barn
Joseph Cherepow/ch, Marion Santacroce, Helen Polak
6300 Main Road, East Marion,N.Y. 11939
Scm # 1000-038.00-01.00-001.007
To Whom It May Concern:
I have inspected the 30' X 40' Agricultural Barn at the above mentioned
property on Saturday, November 9,2002 and certify that this structure
meets the m/n/mum requirements for aghcultural buildings at the time
of construction.
Tuthill, P.E.
STATE OF NEW YORK)
) SS.
COUNTY OF SUFFOLK)
AFFIDAVIT
THOMAS E. SANTACROCE, being duly sworn, deposes and says:
1. I reside at 75 Shipyard Lane, East Marion, New York.
2. I have resided in the Greater Greenport area all of my life. I was bom on
June 25, 1930.
3. I am familiar with the property located at 6300 Main Road, East Marion,
New York.
4. I know that the metal barn at the subject premises has been there since
1955.
THOMAS E. SANTACROCE
Sworn to before me this
,,2~g/~day of October, 2002.
ELIZABET}~ J. FARR SH
Notary Pub c, State of New York
No. 01 FA49732S5
Qualifned in Suf/olk County ~
Commission Expires Oct. 15, 20 ~
TOWN OF SOUTH6LD
BUILDING DEPARTMENT
TOVffN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined 20__
Approved ,20__
Disapproved a/c
Expiration ,20
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
Building Inspector
APPLICATION FOR BUILDING PERMIT
i Date [ / ~' ,20 *~,2.
· ~ ! INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 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 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 fi.om 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 inspectio~,.
~' ~'"' "~tS~"gnatu~e o-f ap~Tmt o"~ naine, ifa coxporafion)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises ,[;,~_~,/~ ~ ~. ~Z~fi/~.¢j~ .~AP.,fq~ &M4i~VTZ-X5~,
"- t ....... ~A's~-n'the t,~x r01i o~-l~test deed) z
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.
Location of lan4~on which p~posed work will be done:
Hou-s¢ Number Street Hamlet
County Tax Map No. 1000 Section 2~ Block [
Subdivision /q//]/~ Filed Map No.
(Name)
Lot
Lot
State existing use and occupancy of premises and intended use and occupancy of proposed constr~ction:
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 ~t~T) j -
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work ?~/
(Description)
Fee
(To be paid on filing this application)
/t
/k'/7~_ 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 ~ ~5 Rear Depth
Height /5 ' Number of Stories /
Rear
Dimensions of same structure with alterations or additions: Front
Depth Height.
Dimensions of entire new construction: Front
Height / ._5" Number of Stories
9. Size of lot: Front ~ ~ I Rear
10. Date of Purchase [~7~ Name of Former Owner
Number of Stories
8. Rear Depth
11. Zone or use district in which premises are situated ~ L/g>
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__
NO /9
13. Will lot be re-graded? YES. NO. .Will excess fill be removed from premises? YES NO
14. NamesofOwnerofpremise~ (/~?~,~JAV~ss 't~_.,qqf/1/~r&/2u/Jq~,~honeNo.
N~e of~c~tect ~T ~ ' ~ Address Phone No
Nme of Con, actor 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 %
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.
STATE OF NEW YORK)
SS:
COUNTY OL-~ r~F~&q~'
t ]r~%o,~ ]~ (JrkP_.P_~ .Z~/t, being duly sworn, deposes and says that (s)he is the applicant
-('Narhe of individual 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~lefore me this
· ~ "Notary Pub'~m
/ ~ ~"f~nature ~.~p-plicant
LESLIE J. BAUER
Notary Public, Sto~e of New York
No.$01814~, Suffolk County ~
Term Expires Sep. 20. o~ o~$
.,'a~,~~N OF SOUTHOLD PROPERTY I~RD CARD
OWNER .... ~'
FORMEJS, OWNER
VILLAGE
~""~, ~,~0 0 Wl'C..7_.. S W TYPEOF BUILDING
COMM. CB, MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS (('~/~/~ [" C~ ~4'{ bCH~
FRONTAGE ON WATER
~dowland DEPTH ~t v
~se Plot BULKH~D
,ta I
NL Bldg.
Extension
Extension
Extension
Porch
PorCh
Breezeway
Garage
Patio-
'Foundation
BQsement
'Ext. Walls
Fire Place
Type Roof
Recreation Room
DorlTler
Both
Floors
Interior Finish
Heat
Rooms ]st Floor
Rooms 2nd Floor
Driveway
Dinette
K.
LR.
DR.
FIN. B
~ STREET ~ VILLAGE ~IST SUB. LOT
, /~, ~ -
S - ' W ~, ' - TYPE OF BUILDING
R~. S~S. VL. FARM /~ CO~. CB.
COLOR ~/-._,,t ,~4.: TRIM
-~xtension
-~xtensJon
-:xtensJon
)omb
~orch
3reezeway
~arage
~ati0
). B.~9 ~tv'
total
Foundation
Basement
Ext. Wa Is
Fire Place
Type Roof
Recreation Room
~OOJ~Ormer
,,~0,
J FIoors
Interior Finish
Heat
Rooms 1st Floor
Rooms 2nd Floor
Driveway
DR-
BR.'
FIN.