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Home My WebLink About39939-Z o�SOFFot��oTOWN OF SOUTHOLD �� Gy BUILDING DEPARTMENT y 2 TOWN CLERK'S OFFICE o . 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#: 39939 Date: 7/13/2015 Permission is hereby granted to: Cappabianca, Matthew & Cappabianca, Eileen 132 N Mada Ave Staten Island, NY 10310 To: Construction of an accessory building as applied for. Additional certifications may be required. At premises located at: 560 Clark Rd, Southold n ��- SCTM # 473889 Sec/Block/Lot# 135.-2-3 Pursuant to application dated 7/2/2015 and approved by the Building Inspector. To expire on 1/11/2017. Fees: ACCESSORY $186.40 CO -ACCESSORY BUILDING $50.00 otal: $236.40 ding Ins ec 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: I. 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 I%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. o.rC. Z 2e New Construction: Old or Pre-existing Buildin (check one) Location of Property: �G,aKlcr House No. Street Hamlet Owner or Owners of Property: ��—yleW pA�,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: (che ne) Fee Submitted: $ Ap is ignature FIELD 3NSP� QN mlOkT AAT CONSMF� 'S3 ;; FOUNDAtION(IST) �J FOUNDA,TxON(2ND) UP ROUGH FRAA'nNQ& H PLUMBING INSULATION PER N.Y. STATE ENERGY cbDF, FINAL All A"'bm. T� 76 �� m 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 4 sets of Building Plans TEL: (631)765-1802 Planning Board approval FAX:(631)765-9502Survey SoutholdTown.NorthFork.net PERMIT NO. � Check Septic Form NYSDEC Trustees Flood Permit Examined 20 Storm-Water Assessment Form ///7 / Contact: Approved 1 20 Mail to Disapproved c !,iP, Phone �/7' go nn � �Q xpi, 5 0— specto, iI I� u JUL - 2 2W I APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS Thrs-~apptrc a 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 beer,completed within 18 months nom such date if no zoning amendments or other reguiations 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) u State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises Lig144 CAO�u+4E 4( �,the tax roll or latest deed) 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. I. Location of land ori which proposed work will be done: C4A§iA 29A House Number Street o� Hamlet County Tax Map No. 1000 Section ✓� Block Lot Subdivision Filed Map No. Lot Y 2. State existing use and occupancy of premises a d intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy_ AJ �l�+ 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition MZr Work �'•rlt�� (Description) 4. Estimated Cost 1 0:,p Fee (To be paid on filing this application) 5. If number of dwelling units Number of dwelling units on each floor garage umber of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. t4la 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 / r 8. Dimensions of entire new construction:Front l Rear---O Depth Height Number of Stories 9. Size of lot:Front Rear Depth �ZC�0 a � / 10.Date of Purchase 2uo57 Name of Former Owner i7cxl�G.Cl�lfc �PCe9 11.Zone or use district in which premises are situated / 12.Does proposed construction violate any zo ing law,ordinance or regulation?YES_NO ✓ 13.Will lot be re-graded?YES_NO - Will excess fill be removed from premises?YES_NO o 14.Names of Owner of premisesftlw L-AffP a� ddress 5Ly (7.A,,k 1%L_Phone No. Name of Architect Address Phone No Name of Contractor K-AVf AddressL , n l� Phone No.1 -11 15 a.Is this property within 100 feet of a tidal wetland or a freshwaterwetland?*YES NO o/ *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?*YES NOS * 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 being duly sworn,deposes and says that(s)he(�bar Notary isono (Name of individual signing contract)above named, SIV Yak (S)He is the N0.01BU61ME-8S0" Wwkf (Contractor,Agent,Corporate Officer,etc) +u ®°IV Qmvl%n.r 14,'X.� COmmiebton Expirm l 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 belie•and that ,Wgg,,(b( U0199IWWOC performed in the manner set forth in the application filed therewith Aw� p�Hnp Sworn t before me this ` `O'ON AJ81ON _day of 20 1' ®; N •Q iOMW C Notary Public Signa of Applicant 1 v Scott A. Russell ��°SU S SF O IKIMMAXIEIK SUPERVISOR Irv][ \,-NA,G 1E1\MUEN`7C' z SOUTHOLD TOWN HALL-P.O.Box 1179 p 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 TM POII.OWING: i Yes No (CHECK ALL THAT APPLY) ❑ A. Clearing, grubbing, grading or.tripping of land which affects more '• than 5,000 square feet of ground surface. ❑[Ej"B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. } ❑EfC. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑[: 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 d 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. 3 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. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building'Department with your Building Permit Application. S.C.T.M. ": 1000 ate APPLICANT. (Property Owner,Design P_ofessional,Agent,Contractor,Other) District NAME I (P—) Section Biock Lot { G FOR BUILDING DEPARTMENT USE Contact Information �1 t 49 1 —.T'2 8(' C ndon�>�m�t Reviewed By: C.► "-p 'Ch Date Property Address/ Location of Construction Work: — — — — — — — — — — — — — — — — — —��L i k ,., ► � Approved for processing Building Permit- (®6 /fit 1 — — — q Stormwater Management Control Plan Not Required- H uLy% E] (Forward Management Control Plan is Required- (Forward to Engineering Department for Review.) FORM A SMCP-TOS MAY 2014 February, 2017 To Whom it may Concern, Please extend my permit work number 39939. If you can please renew to max time. Thank you, Matthew Cappabianca Southold Town Building Department �o�oS�Ff �vy P.O.Box 1179 Permit#: 39939 53095 Main Rd .x. Southold,New York 11971 Permit Date: 7/13/2015 ay 4t (631)765-1802 Expiration Date: 1/11/2017 Parcel ID: 135.2-3 BUILDING PERMIT RENEWAL LETTER Dated: 1/23/2019 Applicant: Cappabianca,Matthew&Cappabianca,Eileen Location: 560 Clark Rd, Southold Work Description: ACCESSORY GARAGE Construction of an accessory building as applied for.Additional certifications may be required. A FEE OF $236.40 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Cappabianca,Matthew&Cappabianca,Eileen Address: 132 N Mada Ave Staten Island,NY 10310 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department,P.O. Box 1179, Southold,New York 11971 -THANK YOU, SOUTHOLD TOWN BUILDING DEPT. aor Var caa:J i7:0o litlaas Yotl� rwwn ew••�-• �,,,/a� •...� •• � • .;?F.o.,•- N/F AURICH10 t• S 23' IS' 40" E } 50.00' �•At~arae . N N 'sr N b TWALIS N� STEMMUD" MME A GAIPA6a< 7. asafty I STW 3 W" zFRAW 4 Cl o. o fir wl M a �a� 0 p cm JV n ,10� 50.00TIE= 558.85' '- CLARK ROAD 7U 1000•-135-02-03 - SURVE7ED 21 SEPT., 199$ SURVEY OF ScAa to= 30, A10.0 Q„k/2-S.F. a+oy �' o ftAVDESCRIBED PROPERTY f AMS y toso drt ,n,�o..io•wha+ �,�, is Pied and v�Fb belrc;! b pes SITUATE u'"' ` `"; "`°""w°•Agony. SOUTHOLD TOW)V OF SOUTHOLD tttctnp ixlhs;cn. If ;tsht3 f�uess;pw � . to tha usirwew of :►: �F; iSUFFOLK COUNTY, N.Y. ctarzateo+em ccr rcrv,':rz�rc is addillor:ol 'vw.�ut•cv� w �.ba:austrf owes. SURVEYED FVR DONATO•CAPPAB/ANCA NCA GUARANTEED TO LUCILLE WPABW DOMAM cAPP, 0TnrAwNo TmE 1+ co. Utre:ohortst►d anaweiw► er adetRioa to no P.O. BOX 25'4 wr4". 1%c--.*A tim 91 Section 72W of NEW UFFOLK, NY 11956 fire Now York dela Eavasim Law. .6 3 �, 5 APPROVED AS NOTED coy fi-,! �� %N11" H ALL CODES of DATE: 1 41 B.P.# NEW yor K S T E TONIN costs AS REQUIRED [A !s GQND_f�S�F FEE.- xSOUTHOLD TOtFJ NO-fIFY BUILDING DEPARTMENT AT 765-11802 8 AM TO 4 PM FOR THE ORD FOLLOWING INSPECTIONS: S{,,��nini�l!N !TRl!STEES 1. FOUNDATION - TWD REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING � — 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. _Y l � F ALL CONSTRUCT ION SHALL MEET THv � REQUIREMENTS OF THE CODES OF NEW LE FOR USE IS UNLAWFUL YORK STATE. NOT CONSTRUCTION !ERRORS. CERTIFICATE DEIGN 0 WITHOUT CER OF OCCUPANCY ��. Z- v4;7- / � 6