HomeMy WebLinkAbout45208-Z SU FF ®l Town of Southold
q�P o 9/26/2020
�q y P.O.Box 1179
0
c 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41467 Date: 9/26/2020
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 1205 Horseshoe Dr, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 95.4-18.31
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/25/2020 pursuant to which Building Permit No. 45208 dated 9/15/2020
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:
"as built"deck reconstruction as applied for.
The certificate is issued to Ireland,Timothy
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
s
uth r' Signature
�o�su �c TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
Co. x TOWN CLERK'S OFFICE
Wo • 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#: 45208 Date: 9/15/2020
Permission is hereby granted to:
Ireland, Timothy
1205 Horseshoe Dr
PO BOX 55
Cutchogue, NY 11935
To: legalize an "as built" deck reconstruction as applied for.
At premises located at:
1205 Horseshoe Dr, Cutchogue
SCTM #473889
Sec/Block/Lot# 95.-4-18.31
Pursuant to application dated 8/25/2020 and approved by the Building Inspector.
To expire on 3/17/2022.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $597.60
CO-ADD O DWELLING $50.00
otal: $647.60
Building Inspector
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. (RA 9
New Construction: Old or Pre-existing Building: (check one)
Location of Property: I a®Sr�
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block LA Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:`�i� t
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 1®C>.0®
At Signa e
Building Department Application
e
AUTHORIZATION
(Where the Applicant is not the Owner)
I,"�—Lrl®VYl ; �_residing at p® ('my- 5� CJA,kc hc) �
(Print proper[ owner's name) (Mailing Address) r-
do hereby authorize J��V CAl fo c
(Agent)
to apply on my behalf to the
Southold Building Department.
�tQ-(4IaD
(O gnature) (Date)
e�mou)
(Prin wner's Name)
i
o
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] NSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL Pal A,-� I
] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE-RESISTANT CONSTRUCTION [' ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL,(FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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DATE Z INSPECTOR
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FIELD INSPECTION REPORT DATE COMMENTS
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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 0 Survey
Southoldtownny.gov PERMIT NO. 0 Check
Septic Form
N.Y.S.D E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Truss Identification Form
i
Storm-Water Assessment Form
IJ Zv Contact:
Appi oved 120 Mail to:
Disapproved a/c
Phone:
Expiration ,20
�(C Bu* g Inspector
DAPPLICATION FOR BUILDING PERMIT
AUG 2 6 2020 Date S�a.� , 20-Z
INSTRUCTIONS
BUILDING DEPT.
TO U,_,T`hi�'ap"MTat�QNUST 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.
( tex - want-or e,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 <X VYAQ�AIL4 -2 t!!XQ�CA
(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 Nod
l:;!.-L'ocation of landlon_vvbich-proposed work will be done:
00
House Number" Street , f, �Lk T amlet
Block
County Tax Map No. 1000 Section Lot
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
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work �$��, rt-.0
(Description)
4. Estimated Cost Fee
(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
I
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
13. Will lot be re-graded? YES NO ✓Will excess fill be removed from premises?YES NO
14. Names of Owner of premise uddress 00ho(IN�oonne No.tar� d LOLL 4 0-1 DS-
Name of Architect 5eA F Address Phone No
Name of Contractor se_l k 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 1/
* 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 tic,
being duly sworn, deposes and says that(s)he is the applicant
(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 th4L the work will be
performed in the manner set forth in the application filed therewith. NOT r RACEY L, p
ARYPUPLIC, 1/VY',A
N�. STfa)-E rJ�r•�.dl
Sworn tc before me this QUALIFIEp I pW�_`"`" YQ�K
day of 20 �MIVIISSION sl r �'� �CUN7y
�4
TRACEYL.. n,As.,�p �
jj N0TARYPUBLIC r, ,
e03MA/"?
NoA�rubLq- QUALIFlV6 'J� Signature of plicant
' rOLK COUN
U®J4tMISS:,,,,t,,,"RES JUNE 30, Z-0—
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Scott :q. Russell SUM 'S 5T�O�JKTM\ [WA\` 1E1K
SUPERVISOR J
5? -z N[A\NAGJEMJEN`7C'
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEWYORK 119710 Town of Southold-
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET-
( TO BE COMPLETED BY THE APPLICANT )
DOLES THIS (PROJECT INVOLVE ANY OF THE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑�A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
t
ElB. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑dC. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of, horizontal distance.
❑[v"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
-- —i------ --on-FIRMMap 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.
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.
APPLICANT- (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. 1000 Date
:M
_—tea (��' District y� � y
NAME 1 ��X1C7Gg 1(/t _+.z � 1 ra.a 1
Section Block Lot
FOR BUILDING'DEPARTINIENI_ USE ONLY .."
Contact Information 61 LauU u1
'ra.pha r+-d-i
Reviewed By: -
- — — — — — — — — — — — — — — — — —
Dat e.
Property Address / Location of Construction Work. — — — — — — — — — — — — — — — — —
❑ Approved for processing Building Permit.
Stormwater Management Control Plan Not Required.
— — — — — — — — — — — — — — —
❑ Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review.)
FORM x SMCP-TOS MAY 2014
NOTES:
1-THIS SURVEY WAS PREPARED ONLY FOR EQUITY SETTLEMENT SERVICES AND TO BE USED FOR TITLE PURPOSES ONLY.
2-NO GUARANTEE IS IMPLIED BY THIS MAP AS TO THE EXISTENCE OR NONEXISTENCE OF ANY EASEMENTS OF RECORD THAT WOULD AFFECT SUBJECT PROPERTY, UNLESS
SURVEYOR HAS BEEN FURNISHED WITH A COMPLETE COPY OF TITLE REPORT.
3.THIS MAP WAS MADE AT A SCALE OF 1'=30' WHEN ORIGINALLY DRAWN.
4.PROPERTY CORNER MONUMENTS WERE NOT PLACED AS PART OF THIS SURVEY.
5.IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR TO ALTER AN ITEM IN ANY WAY.
6.ARCHITECTS MUST ORDER A TOPOGRAPHICAL MAP SPECIFYING THEIR EXACT NEEDS.
7.ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S EMBOSSED SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES
&EXACT LOCATION OF FENCES AND SHRUBS NOT LOCATED
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CERTIFIED TO: DATE SURVEYED: OCTOBER 9, 2012
EQUITY SETTLEMENT SERVICES, INC. GERALD T. O'BUCKLEY `
TIMOTHY A. IRELAND PROFESSIONAL LAND SURVEYORS
43-14 162nd Street s
Flushing, NY 11358
Tel. (718) 321-1231
FAX. (718) 321-8076
TAX MAP: 10
SECTION: 095.00 Town Of SOUTHOLD
TITLE NUMBER BLOCK: 04.00 County Of SUFFOLK GERALD T. O'BUCKLEY, P.L.S
01-00772512-1 LOT: 018.031 State Of New York Y NEW YORK LICENSE 039834
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