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Home My WebLink About44307-Z 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)765-9502Sulwy Southoldtownny.gov PERMIT NO. P Check----.-.... .... Septic Form N.Y.S.D.E.C. Trustees C.O.Appticnfion Flood Permit Examined_ 20 Single&Separate Truss Identification Form Stone-Water Assessment Form Contact: Appicived 211_6 loia+w Disapproved a/c.... _ Phone: Expim0on t-) � -2-02.1- BL 1 'Nai�1' for OCT 269 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 il 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 ..... ....................................................... Narne of owner ofpremises ��,Im n")04) (As,on 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. 1. Location of land,on which faro'(Sed work will be done: 7 ------- ..................... ................... House Number Street Hamlet County Tax Map No. 1000 Section Block 9 Lot ........------------— —------ Subdivision Filed Map No,_ www Lot goccupancy 1i e v 2. Statexisting use and o cuancyof premises and intended use and occupancy of proposed construction. b. Intended use and occupancy 50 3. Nature of work(check which applicable):New Building Addition Alteration V � Repair l eitaoval Demolition Other Work 4. Estimated Cost Fee (Description) (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 Number of Stories p _ sions of cxssfin� structures,if an Front Rear Height De tla Dimensions of same stru ture with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new constr ction:Front Rear flepth Height umber of Stories 9. Size of lot:Front scar Depth 10.Date of Purchase N 1c of Former Owner 11.Zone or use district in which premises are sit ,ted 12.Does proposed construction violate any zoning lv,ordinance or regulation?YES_NO 13. Will lot be re-graded?YES NO Will exces fill be removed from premises?YES NO —-14.Names of Owner of premises_ Acle-ess _Phone No. Name of Architect Addr ss Phone No Name of Contractor ,Addre Phone No, 15 a.Is this property within 100 feet of a tidal wetland or a fres, titer wetland?*YES NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMI 'S 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 distani s 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) CONNIE D BUNCH SS: Notary PuWc,State Nell'York COUNTY OF ) No.01BU6166050 Qualified in Suffolk County rani 1�, being duly sworn,dep�� 4' ;�ie is the�1-up ice pit (Name 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. SyyNY01111 to before me tli 0 1 day of 20 P Notary Poli is Sig �ture of licant Building Department Application AUTHORIZATION (where the Applicant is not the Owner) 7. i,.._.. ZOL) >If /1 residing at t' (Print property owner-)name) (Mailing Address) .. wk do herebyauthorize (Agent) to apply on my behalf to the Southold Building Department. .. (Owner's Styattire) (Date) � L) °(Print Owner's Ndme) ._.........��._.��. 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: *ld*location of all bulines, streets, and unusual natural or I- Final surj..,y of property with accurate I ings, property topogropfiic features 2, Finat Approval frot"ri Heati.1-i J)ept, ofwater supply and sewerage-disposal(S-9 form). 3. Approval of electrical irjstjjlatjon fi'-orn Board of Fire Underwriters. 41 Sworn. st,"Itement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. residences and similar buildings a certificate 5 Corn.niercial building, industrial building, inultiIple restidildings and installations, of Code Conipliance from architect or engineer responsible for the building. 6. Subt-nit.planning Board Approval of corripletcA site plan requirements. B. For existing buildings (prior to April 9, 19S7) non-conforming uses, or buildings and Ccpre-exisfing," land uses: L Accurate survey of property sfjowing all property lines, streets,building arid unusual natural or topogr-aptliC features_ 2. A properly completed application and consent to inspect s igried by the applicant. If a Certificate of Occupancy is denied, the Building lrispc�;tor sliall state the reasons tberefor in writing to the applicant. C. Fees 1. Certificate of Occupancy -New dwelling$5'0,00, Add,itions to dwelling$50.00, Alterations to dwelling 550.00, Swil-urning pool$50.00, Accessory building$50,00,Additions to accessory building$50.00,Businesses 550.00. 2. Certificate of OccuPa-RCY Of' Pre-existing Building- $100-00 3. Copy of Certificate of Occupancy-$.2$ 4. Updatcd Certiricate of Occupancy- $50.00 5. 1"empora $15.00, Commercial$15.00 ry Celti ficate of Occupancy-'residential Date. (e New Construction: Old or Pre-existing Building: L/`� ~-- -(check one) <7 '� Location of Property: Hamlet House No- Street Owner or Owners of Property:— Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: .,, Permit No. Date of Permit. Applicant: Health Dept. AppUnderwriters Approval: roval' Planning Board Approval: Request for: Temporary Certificate Final Cerfificatew (check one) Fee Submitted: Ap p jjc a T1 CS i g 11 1 i I Ce GENERAL NOTES: 1.All work shall conform to national, state,and local codes. 2.All unnoted or non-visible easements 1/2" Plywood are the responsibility of the owner/ (1) Simpson strong contractor. drive screws ROOF CONST. 3. It is the contractors responsibility to x 4 c. . Existing roof shingles familiarize himself with all aspects of 16" o.c. Existing roofing paper these documents prior to beginning any 2 x 8 cExisting sheathing R-30 insul .` _. New 4" Spray foam insulation 4 These drawings are the property of New 1/2" Oyp. Bd. Victor Cuneo Architect PC.Victor Cuneo Remove exisitng e. cl joist _ .: _ _ _ _ _ _ _ _ _ _ Architect PC retains all common law statutory and other reserved rights, (4) Simpson strong NOTE: INSTALL NEW CLO. drive screws JOIST BEFORE REMOVING 4" VENT THROUGH ROOF including the Copyright therein.Victor Cuneo Architect PC bears no EXIS71NO G.J. 2" responsibility for their unauthorized use. (� 5. Victor Cuneo Architect PC shall not 3" control nor charge of and shall not be responsible for construction means, Lav EXISTING BATHROOM WITH methods,techniques,sequences, or NEW FIXTURE LAYOUT procedures, or safety precautions and S programs in connection with the work,for R W G the acts or omissions of the contractor, 211 subcontractors or any persons performing :21 g any of the work, or the failure of any of 1 them to carry out the work in accordance 4 EXISTING PLUMBING with the contract documents. A BUILDING SECTION RISER DIAGRAM FOR RECONFIGURED MASTER BATHROOM H d A O z 0 NOTE: EXISTING MASTER BATHROOM NEW FIXTURE LAYOUT. CONNECT TO EXISTING MAIN SEPTIC LINES AND VENTS. w H � o i MASTERno L� z j1 BATHRM. 20'-7" 0 License / Seal i- MASTER BEDROOM SH R _ j . I m � X X ATHRO0Q VIII w CLOSET' _ Existing Ridge SII CLOSET - - - - d. m !LINEN - Il J I BEDROOM 3 VICTOR CUNEO 0 BEDROO 2 New vaultedARC " " — New vault d ceiling HITECT P.C. ceiling - - - - ------ - - -—- Hi h t. of new vaulted clg !, High pt. of new vaulted clg. 1 o g p —--_ it III 154 LAUREL ROAD 1 EAST NORTHPORT,NY 11731 ISI I I. II I ! (631)261-2744 2'-0" -72 j Project Name and Address 795 A FOUNDERS PATH A1.01 SOUTHPORT, NY FLOOR PLAN Date: Scale 10/ 11 / 19 SEEPLAN Sheet No. Z7 - --- � T Fn, . r 4= - - '� ' FEB 2 2 2022 BUILDING DEPT TOWN Or SaUTHOLD I, 121 m , i c � 14 LTI Di OP , 77 I ; 15IN i �fp 17- it O -M e_. '