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Home My WebLink About23003-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23875 Date SEPTEMBER 14, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 240 SMITH ROAD PECONIC, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 3 Lot 37 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 31, 1995 pursuant to which Building Permit No. 23003-Z dated SEPTEMBER 8, 1995 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 STORAGE SHED IN REAR YARD "AS BUILT" AS APPLIED FOR. The certificate is issued to MARCELLA F. LIMBACH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A lAuilding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZE / Date NP 23003 Z Permission Is hereby grante ....... . .................... ...X�................ ......... ...... ......... ............... ............,... ....................................... . . ........ ..... ..,........... . .. .. ..................... Ire �/ , rr .... .............�... ........... ............-............................................................................ .................................................................................. ............................................................................. at premises located at........... v. ........................................... ...................... ...................................A� ..................................... ............ County Tax Map No. 1000 Section ........... .... Block.......................... Lot No. ............................ pursuant to application dated ................. ..9/......... 19...Y..1......, and approved by the Building Inspector. 9 Fee$.. ............ ....... .... .. ......l�.. ..... ...... o ..... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL AUG ' 1 1995 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 rIppruv'al 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 a 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . AVOOs�. 3Q.. 9999. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . . 24Q.$mi th. Road,, Peconi c,. New, York, 11958 House No. Street Hamlet Onwer or Owners of Property. . . Mar.C.PJla. F:. LJOD SO. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . 9$ . . . . . . . .Block. 3. ... . . . . . . . . . . .Lot. . 37. . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . ... . . . . . . . . . Health Dept. Approval. . . .. . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . .. . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . .. . . Fee Submitted: $.2�3.Q4 . ...;1� )`. ��+ E�Q�-.$ �+••��Q' P.O. BOX 706 o �6131 CUTCHOGUE, L.I., N.Y. 11935.. . . . . . . . . . . . .. .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 'APPLICANT FIUD 7NSPECTION REPORT DATE COMMENTS __ ________________ --------1=== _______________________________ ro FOUNDATTON— — I ST) —_ II i-- -- ---- --------- ---------'— __ _ FOUNDATION (2ND)------------------ --------------------------------------- i ROUGH FRAME & _ PLUMBING ---- II II - II II II � II INSULATTON PER N_ Y. STATE ENERGY I jj CODE II----ii— FTNAT. ADDITIONAL COMMENTS: pal H Q„ 1 O z Ci7 . ro Y GARY FLANNER OLSEN COUNSELLOR AT LAW P.O. BOX 706 • MAIN ROAD CUTCHOGUE, LONG ISLAND, NEW YORK 11935 • PHONE 516-734-7666 FAX 516-734-7712 I August 30 1995 Re: Limbach to Tholl Our File # 5963 Dear Georgia: Enclosed please find the following: f 1. Application for Building Permit forished as constructed. 2. Check in the sum of $35. 00 for Building Permit. 3 . Application for CO for shed. 4 . Check in the sum of $25. 00 for CO for shed. Very truly yours, j.' ARY F OLSEN GFO:lmk Enclosures Southold Town Building Department Town Hall - Main Road Southold, NY 11971 i i f AUG t i9q i UNAUTHORIZED ALTERATION OR ADDITION - - - TO THIS SURVEY IS A VIOLATION OF I �1 O J/ I ' SECTION 72C9 OF THE NEW YORK STATE- . Oy i EDUCATION LAW- C COFIES OF THIS SURVEY MAP NOT BEARING THE LA!.D SU,.VEYOR'S IP:R`D S:AL OR I ' EMBOSSED SEAL SHALL NCT CE CONSIDLCED - 1{ tlr i TO BE A VA_ID UWE COFf- - I C Q Q 1 �}a GUAFANTEES iNDICATLD HEF.SGn SHALL RUN ' ONLY TO THE PECSO:+FOR V.rJM IHE SU:.YE1 1-- ° -- woff IS FREiAUD, AND O:.H.S C:1,ALF TO TH` '} �. TITLE COMFANY, GOVEF;VAENtAL AtXCY AtiL - •f ��'-. ti-T 0, �� LENCIf:G IKSTiTUTION l:STLC Y._i::O,y. AA"')1 - 'b 9 = 0�'., c " TO THE ASS!G,KEES OF THE LEKDING INSTI- ` TUTION.GUARANTEES Af:E NOT TkANSFEGABLE - ,.� ;,f ADDITIONAL INSTITUTIONS OR SUBSEQUENT l OWNERS. �'`( �� ,w• I- sty �.. 36' � i .qT -_ - - � 0nr ;,a G • LoT p re,s t uak fl 1 0El sail or. .7 � f_P o/ c.rrve, fd Au9u.st 28, I412 • /'�✓G�e �XCe�� Lt.'i'E'%� GTl9FYu�15C rU�� ,r r__ <<?o!A/i? re-�c r MG� t� i l� �l 1 Yl '� it� �•i��t O i�c �• � �• Akck Pork -t _ Fes. `>' i i E �A-5 ��G�. / fin. 7 L lCCyb"1 L rl L�i�� Vc tleUr-4, AAEWN �ari� BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . AUG 3 11995 BUILDING DEPARTMENT CHECK . . . . . . _ . _ . . . . . . . . . TOWN HALL SEPTIC FORK _ . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 �/ p� CALL Examined .O, 19/. , rIA I L TO . . . _ . . . • . . . . . Approved . . . ' 19/.1 . Permit NA 3 3 . . . . . . . _ . . . . . . . . . . . Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . . (Building Inspector) A (CATION FOR BUILDING PERMIT Date . AligUSt. 28. . . . . . . .. 1995. 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection througliout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . ...•. . . . . . . . . . . , . . . . . . . . . . . . . . . Name of owner of premises . Marcella, Limbach, , • , , . • • • • • . , . . . . . . . (as,on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title.of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. 240 Smith Road, Peconic, New York. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . .. Ilouse Number Street Hamlet County Tax Map No. 1000 Section . .98. . . . . . . . . . . . . . Block . . .3 . . . . . . . . . . : . . . Lot . . . . 37. . . . . . . . . . . . . Subdivision Map.9f. lndi an•Neck Park.. . • . • • • : • • , • Filed Map No. 551. . . . . . . . . , . Lot . . 5. . . . . . . . . . .. (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . • Shed as bui 1 t b. Intended use and occupancy . • . Shed as built • . ' Shed as built 3. Nature of work (check which applicable): New Buddingx. . . . . . . Addition . . . . . . . . . . Alteration Repair Removal ; . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work ` 4. Estimated Cost . . .$ZQQ,QQ . . . .. (Description) . . . . . . . . . . . . . . . . . . . . . . . Fee . . . 35;00. ... : . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units oil 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Size of lot: I-ront . . . ..: . .. 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: ' 13. Will lot be regraded . . : . . . .. . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. Name of Architect . . . . . . . . . . . . Address . . . .' . . . . . . . . . . . Phone No. . . ' . . Name of Contractor Address . : . . . . : . . Phone No. 15. Is this property within 300 feet of a tidal wetland? *Yes. . • ' No . . . . . . . " . . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from .property lines. Give street and block number or description according to deed,and show street names and indicate whether interior or corner lot. See annexed survey with location of shed. AR AR' E ss NOTE MATE: -8.P. # o3 NOTIFY I-tflLUING 0 pA �� 755-t J302 9 AM TO THE FOLLOWING INSPECTIONS: 7. rCl.1cJDATION - TWO REOUIRED FOR POUREDF CONCRETE II 1 I'C Y ll 3. RO€ GH'- FRAMING & PLUMBING CrUINSULATION �r�c3 � �,�rrr"1 dr. FINAL d v'rU _ G®P�STFti/CTIC)N MUST BE COMPLETE FOR C.O. `�� r ti �`L THE REQUIREMENTS OF THEMNET � � � I� � Y STATE CONSTRUCTION & ENERGY t ,g CODES. ' NOT RESPONSIBLE FOR 1�`xx+"1 `�•�` t4I DESIGN OR CONSTRUCTION ERRORS"' ;TATE OF NEW YORK, :OUNTY OF . SUFFOLK. . . . . . . . . s.s Marcella F. Limbach bcin��• • ' ' ' • • • • • • • • • • • • • • • • • • • b duly sworn, deposes and says that he is the a > >licant (Name of individual signin., contract) I } Bove named. 'e is tile . ... . owner. . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is dul auth rized to perform or have performed the said work and to make and .file this )plication; that all stat-Dmerits co wined h this application are true to the best of his knowledge and belief; and that the ork will be performed in the m• ner set f rth.. in the application filed therewith. .vorn to before me this . . . . . . . . . . . . . . ?$. . . . :,y f'August , 19 95. Mary Public, ,...• -5,,:,, County p-`' u/`v°RY FtANtscR a�,f�'r� ,, DuUl St�t� �' .. y' .C'�eiyF+d . . . . . . . . . • . . . . . . . . . . 3' �� iot�Caur3�:y . 04 �� (Signature of applicant) , .