HomeMy WebLinkAbout42701-Z o�OSUFFOt,�coG Town of Southold 5/23/2018
P.O.Box 1179
53095 Main Rd
oylfj�- �ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39657 Date: 5/23/2018
THIS CERTIFIES that the building OTHER
Location of Property: 1625 Indian Neck Ln, Peconic
SCTM#: 473889 Sec/Block/Lot: 86.-5-8.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/14/2018 pursuant to which Building Permit No. 42701 dated 5/21/2018
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 OUTDOOR SHOWER AS APPLIED FOR
The certificate is issued to 1625 Indian Neck Hldng Corp
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
00
0 ' Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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TOWN CLERK'S OFFICE
Gy � Oar
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)
Permit#: 42701 Date: 5/21/2018
Permission is hereby granted to:
1625 Indian Neck Hldng Corp
166 Higsbee Ln
West Islip, NY 11795
To: construct an accessory outdoor shower as applied for epr Trustee approval.
At premises located at:
1625 Indian Neck Ln, Peconic
SCTM # 473889
Sec/Block/Lot# 86.-5-8.1
Pursuant to application dated 5/14/2018 and approved by the Building Inspector.
To expire on 11/20/2019.
Fees:
ACCESSORY $100.00
C - CCESSORY BUILDING $50.00
To 1: $150.00
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, 195 )-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
J.,-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 q
Date. (%
New Construction: Old or Preexisting Building: (check one)
rh'•
P
Location of Property: 1 �d � '( ��A� jt,,I(
House No. f Streret /� f r ✓ H let
Owner or Owners of Property: �"��' ^' Zc
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. r - Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ I�
Appli t i ture
OWN 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) 765-9502 qr7hiSurvey
South oldtownny.gov PERMIT M Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
�./ Storm-Water Assessment Form
Contact:
Approved 520 Mail to:
Disapproved a/c
Phone:
Expiration ( f(T o!,20__L_y
D Building Inspector
DD
APPLICATION FOR BUILDING PERMIT
MAY 1 4 2018 y
Date , 20 0
r Bvi IDTI214G L 241V INSTRUCTIONS
41
_ a. �c p ion HH e completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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
�md waterways.
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
_,P -tee 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.
APPROVED AS NOTED (Signature of applicant gr nam ,it a corporation)
DATE:�2�• 1� B.P:t# d' •21U 1 7;?-
ailing address of applicant)
NO" FY BUILDING DEPARTMENT AT
State wheth%�li�a'#isTe,wVT �� ;,ler see;Na ent, architect, engineer, general contractor, electrician, plumber or builder
FOLL 411NG 1NSPECTI Na:
n sxr R-rr
r. r v r r ,..
FOR POURED CONC rT- / �,)t
Name of o�'r} 1p 1pre ? g '' Bl� ;p,�a . �7�1�; qd( MP)
3. INS LATION (As on the tax r 1 or lake deed)
If applicant•isi o fugFg td.i6l ulye<ut o e o n r .ls
BE T FOR tC�c)I rl Al L) eteJ�• �•� OCCg 6 g�
Builders LeriseS - -CR N, USE IS U � ���
Plumbers LgpLGlI
wOl�n.�nNSTRUCTI(�N ERRORS. lTBnDue%u� ,�� ����UATE
Electricians License No.
Other Trade's License No. .®�GUP
1. Location of lan on w 'ch posed or�will be done:
House Number Street r Hamlet
County Tax Map No. 1000 Section b Block Lot (�
Subdivision riled Map No. Lot
2. State existing use and occupancy of premises and intend d use,(and occupancy of proposed construction:
a. Existing use and occupancy 5;J1 e +A' Id �t
b. Intended use and occupancy S ' t re&m
3. Nature of w (check which applicable):New Building Addition s� —Alteration
Repair Removal Demolition Other Work rt f act, e U) ;
6 --� (Description)
4. Estimated Cost d�• 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
Height Number of Stories' `' j t?
9. Size of lot: Front_______,�_.�Rear__�...�epth
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 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES'&D.E.G. 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
* IF YES, PROVIDE A COPY.-
STATE
OPY:STATE OF NEW YORK)
'� SS:
COUNTY OFS4�_
7. A 0)e:) �11 �k 3 being duly sworn, deposes and says that(s)he is the applican
(Name of individual signing contract)above named,
I L
N
(S)He is the
(Contracto Ag t, Corporate Officer,etc.) ua z w o'
X m 6) E
Ly 6P.xw
CL
of said owner or owners, and is duly-authorized to perform or have performed the said work and to make and file thi 'f iliaes
that all statements contained in this application are true to the best of his knowledge and belief; and that the work wi 1 ojein cc i
performed in the manner set forth in the application filed therewith. 4 0
z � d�u'�
OCLZE
Sworn to before me this ® �
day of 20 o
Z E
0
v
Notary Publi i aur of Applicant
Michael J.Domino,President ti0��of So 54375 Town Hall Annex
John M.Bredemeyer III,Vice President 54375 Route 25
P.O.Box 1179
Glenn Goldsmith Southold, New York 11971
A.Nicholas Krupski G • Q Telephone(631) 765-1892
Greg Williamsy00U
O Fax(631) 765-6641
� NTY,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 1445C REVISED Date: May 16, 2018
THIS CERTIFIES that the modifications of the as-built dimensions of the dwelling and
garage to be a 55 5' wide by 37' long dwelling with a landward bump-out of 22 1' wide by 13'
long for the attached garage and a 14 F wide by 9.5' deep seaward bump-out for a new first_
floor total square footage of 2,474.70 with a 875sg ft covered porch on seaward side; the
existing 12.2'x 12 2' wood deck and 4.3'x4.3' enclosed outdoor shower;
At 1625 Indian Neck Lane, Peconic
Suffolk County Tax Map#1000-86-5-8.1
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated May 16, 2013 pursuant to which Trustees Administrative Permit#8231A
Dated June-19, 2013,was issued and Transferred and Amended on Februaa 15, 2017,
and Amended again on May 16, 2018 and conforms to all of the
requirements and conditions of the applicable provisions of law. The project
for which this certificate is being issued is
for the modifications of the as-built dimensions of the dwelling and garage to be a 55.5'
wide by 37' long dwelling with a landward bump-out of 22 F wide by 13' lona for the attached
garage and a 14 1' wide by 9.5' deep seaward bump-out for a new first floor total square footage
of 2,474.70 with a 875sg ft covered porch on seaward side; the existing 12.2'x12.2' wood deck
and 4.3'x4.3' enclosed outdoor shower.
The certificate is issued to 1625 Indian Neck Holding Corp. owner of the
aforesaid property.
e
Authorized Signature
05/1B/2018 13:33 6317656641 SOUTHOLD TRUSTEES PAGE 01/81
M7ohoel J.Domino,President nvv.$DIt. Town HNII Annez
John M.Brodemeyor r]l,Vice-President AS •'O�Q 5P43Q7 HRoute725
Glenn Goldsmith Southold,New York 11471
A.Nicholas Krapeki Telephone(631)766-1892
Greg Williams ^� '� Fax(631)765-6641
,
BOARD OF TOWN TRUSTEES
May 16,2018
TOWN OF SOUTHOLD
'
James Jackson ED 77MED
1625 Indian Neck Holding Corp.
166 Higbie Lane MAY 1 0 2018
W.Islip,NY 11795
RE: 1825 INDIAN NECK HOLDING CORP.
SCTM#: 1000-86-54.1
Dear Mr.Jackson: TOWN OF SOUTHOLD
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday, May 16,2018:
RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative
Amendment to Administrative Permit#8231A for the existing 12.2'x12.2'wood deck and
4.3'x4.3'enclosed outdoor shower,and as deplcted on the survey prepared by Nathan
Taft Corwin, III Land Surveyor,dated March 28,2018,and stamped approved on May
16,2018.
Any other activity within 100'of the wetland boundary requires a permit from this office.
This is not an approval from any other agency.
If you have any questions,please do not hesitate to contact this office.
Sincerely,
Michael J.Domino
President, Board of Trustees
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