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Home My WebLink About44375-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)765-9502 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined,—,- 20 Single&Separate__ Truss Identification Form– OCT 2 8 Storm-Water Assessment Form,.._..___._, Contact: Mail W Approved4---,20 0 JT Disapproved a/c Phone: ........... DExpiration20 Btdil gInspnector APPLICATION FOR BUILDING PERMIT Date October 28th 2019 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) PO Box 1727 Riverhead,NY 11901 (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder General Contractor Name of owner of premises Kelly Collamore..... . ........... (As on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer Adalberto Benitez (Name and title of corporate officer) Builders License No.32759-H Plumbers License No. Electricians License No. Other Trade's License NO.-- 1. Location of land on which proposed work will be done: 700 Glen Ct Cutchogue House Number Street Hamlet County Tax Map No. 1000 Section ...—.—Block—[ Lot f Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and Occupancy Residential b. Intended use and occupancy ............. 3. Nature of work(check which applicable):New Building Addition .............Alteration Repair ,, .. Removal Demolition Other Work Window Replacement (Description) 4. Estimated Cost$11,875Fee ......... . (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______.......................... ..—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 rrrrrrrrrNQ 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 AddressPhone 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.C.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 OF NEW YORK) COUNTY OF:��1121 Adalberto Benitez ..............—being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the General Contractor (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 "'A SW:2, a before me this ............ day of 2W 9 �-C 2 Notary Public Signature ofApplicant 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. I U � Cj New Construction: Old or Pre-existing Building:_ m (check one) Location of Property: House Na Street � � �Ham�t 1^� A.. Owner or Owners of Property: Jif C 0 (L VVk Suffolk County Tax Map No 1000, Section Block Lot e Subdivision Filed Map. Lot: Permit No, 1 ?13 Date of Permit. Applicant:µµwww Health Dept. Approval: Underwriters Approval; Planum Boar Approval: . pproval: ............................ Request for. Temporary Certificate Final Certificate: mmmmmmmmmm� (check one) Fee Submitted: $ Applicant SignalWiire Ar A:g Andersen Andersen Windows - Abbreviated Quote Report 41f3167SW Project Name: Restoration Energy Collomore ............. ............. Quote#: 195435 Print Date: 10/11/2019 Quote Date: 10/08/2019 iQ Version: 19.1 Dealer. RIVERHEAD BUILDING SUPPLY Customer: RESTORATION ENERGY INC BUILD SMARTER.BUILD BETTER. Billing 1-800-378-3650 Address: WWW.RBSCORP.COM Phone: Fax: Sales Rep: RANDY ROGERS 22 Contact: Created By- Trade ID: 163715 Promotion Code: Item Oty Item Size(Operation) Location Unit Price Ext. Price 0001 5 TW2846(AA) $ -- — - ROSize=2'101/8"Wx4'87/8',H Unit Size=2'9 5/8"Wx4'8 7/8"H 400 Series Unit, Equal Sash, Nailing Flange Installation,White/PI White, High Performance Low-E4 Glass, Finelight Grilles-Between-the-Glass, Colonial, 3W2H, White/White,3/4"(Each Sash) Insect Screen,White Viewed from Exterior Zone.North-Central U-Factor.0.30, SHGC:0.28, ENERGY STAR®Certified:Yes I Fil 1 0002 1 TW2846-2(AA-AA) $ RO Size=5'77/8"W x 4'8 7/8" H Unit Size=5'7 3/8"W x 4'8 7/8"H 400 Series Composite Unit,White/Pre-finished White, High Performance Low-E4 Top/Bottom*High Performance Low-E4 Top/Bottom Glass, Finelight Grilles-Between-the-Glass Top/Bottom*Finelight Grilles-Between-the-Glass Top/Bottom, Mulling Location: Factory(Direct), Mull Type: Narrow Mull, Mull Priority:Vertical Viewed from Exterior Insect Screen,White Zone:North-Central Unit U-Factor SHGC ENERGY STAR®Certified ------------------------------------------------------------ 1 0.30 0.28 Yes 2 0.30 0.28 Yes Quote#: 195435 Print Date: 10/11/2019 Page 10f 3 iQ Version: 19.1 6 �y Item Oty Item Size(Operation) Location Unit Price Ext.Price ® 0003 2 TW3032(AA) $ ---- --- - -•-------- ROSize=3'21/8"Wx3'47/8"H Unit Size=3'15/8"Wx3'47/8"H 400 Series Unit, Equal Sash, Nailing Flange Installation,White/PI White, High Performance Low-E4 Glass, Finelight Grilles-Between-the-Glass, Colonial,4W2H, White/White,3/4"(Each Sash) Insect Screen,White Viewed from Exterior Zone•North-Central U-Factor:0.30, SHGC•0.28, ENERGY STAR®Certified:Yes 0004 1 TW2432(AA) $ -•-------- -- ---------- ROSize=2'61/8"Wx3'47/8" H Unit Size=2'55/8"Wx3'47/8"H 400 Series Unit, Equal Sash, Nailing Flange Installation,White/PI White, High Performance Low-E4 Glass, Finelight Grilles-Between-the-Glass, Colonial, 3W2H, White/White,3/4" (Each Sash) F1 Insect Screen,White Viewed from Exterior Zone:North-Central U-Factor:0.30, SHGC:0.28, ENERGY STAR®Certified•Yes Subtotal Total Load Factor Tax(0.000%) c Customer Signature 2.387 Grand Total Dealer Signature "All graphics viewed from the exterior Quote#: 195435 Print Date: 10/11/2019 Page 2Of 3 iQ Version: 19.1 Item Oty Item Size(Operation) Location Unit Price Ext.Price **Rough opening dimensions are minimums and may need to be increased to allow for use of building wraps or flashings or sill panning or brackets or fasteners or other items. SUNNI Ask to see if all of the products you purchase can be upgraded to be ENERGY STAR®certified. This image indicates that the product selected is certified in the US ENERGY STAR®climate zone that you have selected. 12 Data is current as of May 2019.This data may change over time due to ongoing product changes or updated test results or requirements. Ratings for all sizes are specified by NFRC for testing and certification.Ratings may vary depending on the use of tempered glass or different grille options or glass for high altitudes etc. Nexia is a registered trademark of Ingersoll Rand Inc. Project Comments: Riverhead Building Supply offers a two year parts and labor warranty on any Andersen Window or Patio Door products ordered through any of our locations. See your Riverhead sales associate for more details. Quote#: 195435 Print Date: 10/11/2019 Page 3Of 3 iQ Version: 19.1