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Home My WebLink About43276-Z 'f Town of Southold 2/14/2019 . P.O.Box 1179 53095 Main Rd AL Southold,New York 11971 f � CERTIFICATE OF OCCUPANCY No: 40211 Date: 2/14/2019 THIS CERTIFIES that the building SHED Location of Property: 30 Tucker Ln., Southold SCTM#: 473889 Sec/Block/Lot: 63.-5-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/27/2018 pursuant to which Building Permit No. 43276 dated 12/5/2018 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 shed as applied for. The certificate is issued to Zukowski,Janet of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED i uth ed Signature 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) Permit#: 43276 Date: 12/5/2018 Permission is hereby granted to: Zukowski, Janet PO BOX 1616 Southold, NY 11971 To: construct accessory shed as applied for. Must maintain 10' side yard setback. At premises located at: 30 Tucker Ln., Southold SCTM # 473889 Sec/Block/Lot# 63.-5-7 Pursuant to application dated 11/27/2018 and approved by the Building Inspector. To expire on 6/5/2020. Fees: ACCESSORY $164.00 CO -ACCESSORY BUILDING $50.00 Total: $214.00 611/ Bui spector 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. 0-t-2-7 - New _a-7 -New Construction: Yv'114 Old or Pre-existing Building: (check one) f Location of Property: 30 1-64-C_g,,h tc,• 50 et House No. Street Hamlet Owner or Owners of Property: Y Awe I ¢cbte S Suffolk County Tax Map No 1000, Section (02) Block 5 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) Fee Submitted: $ Applicant Signature �yOF SOUIyo # TOWN OF SOUTHOLD BUILDING DEPT. couxn, � 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ULATION [ ] FRAMING / STRAPPING [ FINAL S� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE >4131 >ej INSPECTOR jr i FIELD INSPECTION REPORT DATE COMMENTS ►ti FOUNDATION(1ST) H ------------------------------------ �C 'FOUNDATION (2ND) tri z o c � ROUGH FRAMING& PLUMBING y VJ . O INSULATION PER N.Y; y STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 14.op rrt4 #t. o t � z .rn ( 1 � r z° d b H Scott A. Russell ,�d°Su m STORI��J WA\T]E]R. SUPERVISOR ( f �T I��J[.A\1�A\ G.]EI��JUEI� SOUTHOLD TOWN HALL-P.O.Box 1179 p 53095 Main Road-SOUTHOLD,NEW YORK 11971 ' O Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE )FOLLOWING: i (CHECK ALL THAT APPLY) Yes.No ❑ A. Clearing, grubbing, grading or stripping of land which affects more 1 than 5,000 square feet of ground surface. I ❑ B. Excavation or filling involving more than 200-cubic yards of material within any parcel or any contiguous area. C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑Q D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑ F: Installation of new or resurfaced impervious surfaces of 1,000 square E feet or more, unless prior approval of a Stormwater Management E Control Plan was received by the Town and the proposal includes ! in-kind replacement of impervious surfaces. 1 If you answere(LNO-fo-all of the questions above, STOP! Complete the Applicant section below with your Name, SignatuW,&;'Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. ify u answered YES to one or more of the above,._Please submit Two copies of a Stormwater Management Control Plan nd a completed Check List Form to the Building Department with your Building Permit Application. PPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. *: 1000 Dale District NAME _T'( wr.o Section Block Lot FOR BUILDING DEPARTMENT USE ONL;' "F Contact Information / �d Tckptc�c�lunbcrY Reviewed By: r-7 — — — — — — — — — — — — — — — — — — ate Property Address/ Location of Construction Work: — -- — — — — — — Date., — — — — — — — — — I `/� Approved for processing Building Permit. Tlg'kKtr L ' ��'JJJ Stormwater Management Control Plan Not Required. E] Stormwater Management Control Plan is Required. (Forward to Engineering Depprtment for Review.) FORMA S P-TOS MAY 2014 TOWN 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 04 ets of Building Plans TEL: (631) 765-1802 / Planning Board approval FAX: (631) 765-9502 L4 4� / ({/ Ii vey South oldtownny.govFF3. Check D Septic Form N.Y.S.D.E.0 Trustees NOV 2 tn��$ Application Flood Permit Examined 20 Single&Separate -OMDOG DEPT- TOWNTOWN OF SOUMOLO Truss Identification Form Sbrm-Water Assessment Form t: Approved 20� Na W-M Disapproved a/c Expiration 12 ldmg I pector APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS 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. (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 Name of owner of premises *'A, (As on the tax roll or latest deed) If applic fit is a corporationignature of duly authorized officer �x�j (Name and title of corporate officer) Builders License No. 114 Sy 3 70 Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street / Hamlet County Tax Map No. 1000 Section Block 5 Lot 7 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occu ancy of proposed construction: a. Existing use and occupancy 't-Niirw (,4m_ b. Intended use and occupancy S( 3. Nature of work(check which applicable): Nev�,136j,lding A'daijol Alteration Repair Removal DemOlifion Other Wor (Description) 4. Estimated Cost Fee �To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling upits 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 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—V 13. Will lot be re-graded? YES NO--)�-Will excess fill be removed from premises?YES NO k 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 C * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAX 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) S: COUNTY OFS A/e'tbeing duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contract , 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 thi Q —d day of 20 !V Y L. DWYE Notary Pu lic NOTARY PUBLIC,STATE OF NEW YORK Signature of Appy t NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2jWa_ f Scott A. Russell ,�a°Su m STcO>WWWA\T EIE, SUPERVISOR ( v]HENT I��][A\1�A\ G�EI� 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 OF THE FOLLOWING: (CHECK ALL THAT APPLY) ! Yes .No ❑ A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. i ❑ B. Excavation or filling involving more than 200-cubic yards of material ; within any parcel or any contiguous area. ❑R C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑[!R D. Site preparation within 100 feet of wetlands, beach, bluff or coastal ' erosion hazard area. ❑tA E. Site preparation within the one-hundred-year floodplain as depicted i 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. Ifjy6u answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan nd a completed Check List Form to the Building Department with your Building Permit Application. PPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) _ S-C.T.M. : 1000 Dale District KX NAME: W-0 Section Block Lot FOR BUILDING DEPARTMENT USE ONLY Contact Information, 6 Reviewed By: �-7 j� - - — — — — — — — — — — — — — — — — Date: �� ! ��(� Property Address/ Location of Construction Work: — - - - - - - - - - - - - - - - Approved — — — — — — — — — — — — — — ' w, ElStormwater Approved for processing Building Permit.TUc,1C� r uY ' Management Control Plan Not Required. Id NY 1197 ❑ Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM S P-TOS MAY 2014 lciycj,tc,v 7n� J"t 71 IUPA CY OR ral Ni , MAP OF PROPERTY WFUL E IS W . A SURVEYED FOR - - "J WITHOUT ERTI�ICA. EORGE F. $ CATHRYN M . ERATH SITUAril Ar OU FFOLV. co -O N . Y. o SCALE : 40' c I " y 0AWRT Fl Up Gy W AS NOTED 2 Mor4uiviirm-r lizopi pirc 4� t�l T M ENT AT T) 4 p V, FOR THE PICTIONS: TWO REQUIRri-D ,X)INCRET Pi-UM91NG 42 0 GUARM4YELID rO Wrgg-Ccue4TY -rrmg, (;U&&ANr*o 3-'RUCT10N MUST 6110 %I 4 MOXTGA*rm CO. AS Sultv49VIrp MAY 9. 1943. FOR C-10, V1,. � �- Or*rO Yd. V A 0 -rU V 1. 4. :So f4 0F THE 1168ES 0O ,f k 0- N S I B LE :LANE I-icENSCO LAWD SUjtV6V0IZS APPR VEDAS NOTED DATE: B.P.# 43,21 ERETAINTORM WATER F�;�"FEE: / BY NT TO CHAPTER 2NOTIFY BUILDING DEPARTMENT AT OWN CODE. 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~�r 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMIN,-'3 & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR CO. TRUSS PLACARDING REQUIRED ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOP DESIGN OR CONSTRUCTION ERRORS. MiLl4ae n lb, slk COMPLY WITH ALL CODES OF Yard SL-E'b0.ef� NEW YORK STATE & TOWN CODE AS REQUIRED AND CONDITIONS OF SOk�HA OCCUPANCY OR USE IS UNLAWF!,"_ WITHOUT CERTIF►CATF OF OCCUPANCY WI c ! rent E'e�,�:tl��n Left�1,,�valion PINE °�RBOR vl WOOD PRODUCTS _ Cl , - " PINFHARROR.COM cd � 1-ts00a6eaurD U ` 259 Queen Anne Rwd '{-- H—.h.MA 0264S - P.1S0R1 4303800 IS0e1430-I11S ' •• pr, 1 IwrmPp{nehuboccom i ® f VG1�FFR':STAMP EIEIB — - -" PROJECT � Lx ,f l_3De hr,et Zuko',vski ADORrs� ft_;cers a^e i Rear =levation (DBgh, Elevation P11ONE��I� \V 971 F•AIAtE :ka_'`i7rn.ai Cort AO6RF55 OF PROPASFO WORM zcutrolo \` 971 REVISION DATE. `A 9/28/18 ,r r,r. — DRAWN 01'. G3 Page Al 5