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HomeMy WebLinkAbout45141-Z o�gUEF�t�cd�, Town of Southold 11/24/2020 a P.O.Box 1179 53095 Main Rd Z'✓.J �ao� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41628 Date: 11/24/2020 THIS CERTIFIES that the building RESIDENTIAL REPAIRS Location of Property: 595 Rogers Rd, Southold SCTM#: 473889 Sec/Block/Lot: 66.-2-43 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/18/2020 pursuant to which Building Permit No. 45141 dated 8/26/2020 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: roof repair due to storm damage as applied for. The certificate is issued to Hale, Scott&Bjofneboe, Stephen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED tho ' ed Xlirnature TOWN OF SOUTHOLD �g�FFO(kco� . 00o aye BUILDING DEPARTMENT TOWN CLERK'S OFFICE o }4,V� SOUTHOLD, NY H $ 5 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#: 45141 Date: 8/26/2020 Permission is hereby granted to: Hale, Scott & Bjorneboe, Stephen PO BOX 635 Southold, NY 11971 To: roof repair due to storm damage as applied for. At premises located at: 595 Rogers Rd, Southold SCTM # 473889 Sec/Block/Lot# 66.-2-43 Pursuant to application dated 8/18/2020 and approved by the Building Inspector. To expire on 2/25/2022. Fees: CO -ADDITION TO DWELLING $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 BuildVg Inspecto 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. 08 1-� &Odo New Construction: Old r Pre-existing Building: (check one) Location of Property: �C � er5 OcfU &'Adi House No. Streett // Hamlet Owner or Owners of Property: &A rale C ApAeo �a oroeio Suffolk County Tax Map No 1000, Section 4 300 Block 6(. , 2— Lot Subdivision :�3Q I LO �C� Filed Map. Y' Lot: / 0 E* Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ica t ignature # TOWN OF SOUTHOM BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] 'FOUNDATION 2ND [ ] SULATION/CAULKING FRAMING /STRAPPING [ FINAL 106 A;OPJ ' [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ " ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: , - Lo/ DATE 11 INSPECTOR Lnz - low- i' o � ;-��ti �- � � i _ � ..��- -�_ ��, i _```` ```�\ !�. '�� :i',i� . .�� .. �. 1 ��I'. �' � _ I I I I I � :� ��� ��� �� i � . 4 .;s t. 'alp. r flip _. lo, r- - . `;��� �`� r � " �.% r � r jF: 'i � �\„��. r �. �i ��� k1 3•� < Y .� r :� � ., '.� wx 4 _ ,�• ,� ', ,y�, �, j � '' �.#� ' � �, `i- .. 4.. c�j�' c'-:Y., - ��� �i. Y. ,.y-..-�_ -.. �.. _ ` _ c 1 .. v,. _ 1 ` �.�. _ 1■ 0 '• t �r ��e..._._... _ .. V� .. 1 . .i '�.. FIELD-INSPECTION REPORT DATE COMMENTS r FOUNDATION(IST) Q FOUNDATION o ROUGH FRAMING& � W PLUMBING ® H INSi:LATION PER N.Y. H STATE ENERGY CODE s LW om FINAL ADD C N MENTS- �500 0 ue 06, 0 z � z z H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health ( _SG*-kTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 /4 Survey Southoldtownny.gov PERMIT NO. !! Check Septic Form N.Y.S.D E.C. Trustees C.O.Application j� Flood Permit Examined �/'� 20 Single&Separate Truss Identification Form Storm-Water Assessment Form ,t q � Contact: Approved®v 19/14 14 ,20 107-00 Mail to- Disapproved a/c 4 Phone: )0 lx�ir ao I_e ,20 n,ll Building spector A U G 1 8 2020 1_�' APPLICATION FOR BUILDING PERMIT Date ,201L MIMING DEQ.,. INSTRUCTIONS 'rn$' 4; =a.:ThiS appli�atloiiylt%TUST 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. ao Ooa. cant or name,if a corporation)635-�U�old, ,114'119 1 (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder OW/)et- Name W/)eP-Name of owner of premises � G✓ Q e � ��8 JC�� �• U)O!'/1G'OOe (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 proposed k will be done: 5 c�UTJG/d�Car' f House Number stfeet Hamlet County Tax Map No. 1000 SectionBlock - 7— Lot 6} Subdivision� 6SIdA'Filed Map No. Lot 16 2-;!,State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy_ Sllrqlp-�OIMIN C 0 i 6anc Q b. Intended use and occupancy ,S"j lhi��ymj l�1'eS I UQI1C� 3. Nature of work(check which applicable):New Building Addition Alteration RepairRemoval Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units__ of dwelling units on each floor ;3 If garage, number of cars OIIP_ 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing structures,if any:Front �o� Rear, a Depth Height P fir. 12.0' Number of Stories -fW6 Dimensions pj same structure with alterations or additions: Front Rear Depth 63 :3'/ Height E.&. f2•8-1 Number of Stories :in/G 8. Dimensions of entire new construction:Front AIA Rear Depth Height Number of Stories 9. Size of lot:Front C55 I Rear �7 t Depth r DU 10.Date of Purchase 0J16 VName of Former Owner l GhOe, �WIIVI 11.Zone or use district in which premises are situated 12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NOZ 13.Will lot be re graded?YES NO /Will excess fill be removed from premises?YES NO- - � 3�0-#dd� 14.Names of Owner of premises En �Mt'b�Address J @!$ J� Phone No. Name of Architect Address Phone No Name of Contractors &�a� Address Phone No. wad AM", N //19Z 15 a.Is this property within 100 feet of a tidal wetland or a shwater wetland?*YES NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE SQUIRED. 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--V" *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF 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 that the work will be performed in the manner set forth in the application filed therewith Sworn to before me this day of 20 Notary Public Signature of Applicant N SCDHS REF# R10-18-0047a SURVEY.OF PROPERTY QilBVG A T SO UTHOLD vo," 2 a TOWN OF SOUTHOLD s �g oo � SUFFOLK COUNTY, N.Y. 1000-66-02-43 SCALE. 1'-20' 0 1 F MARCH 20, 2018 Yong o1 OCTOBER 16, 2018 (SEP77C AS—BUILT) 11 ZPd 2 31�// is G�Ge e�r�cLACA710N �G P R G OVAs'-.0. s'0. \ 10, v+ti` r o0 � La e pUeV PRP oLO OF�R `( 1 � LA2 2r 2D• .,� 0�� �'• Igo 0 '(oR o • _ L03 ao• 2e' moo. ppA PG. `R. \ S �0• �,�yt� �� L04 27' s2' i r1 A i TEST HOLE DATA McDa GEOSaMCE 210712018 °6, �� PA No f,fl�a a4� // ti P � 5�00 EL 1a2' D s,DARK aWW LOAM OL cL 0. 'OGP' awkw swDr CLAY a. EL zr zs O TO L7 �+ — / PALE BROI{N FINE TD APRON MEDIUM SAND SP EL.aa• a9' -%F WATER 9r PALE BROW 01 "4 V ;I,gY1V'a �R FINE SAND SP k O OPV- G P NOTE WATER ENCOUNTERED 9.9'BELOW SURFACE h O. BRICK APRON ,Y G� d.Q C,ZG LOT NUMBERS REFER TO MAP OF BEIXEDON ESTA 7ES BLOCK 7" FILED IN 7HE SUFFOLK COUNTY CLERKS OFf7CE AREA-8,250 SGS. FT. ON MARCH 16,1946 AS FILE NO. 1472. ELEVATIONS ARE REFERENCED TO NAVD.88 I am familiar with the STANDARDS FOR APPROVAL AND CONSTRUC77ON OF SUBSURFACE SEWAGE M Y.S LIC. NO. 49618 ANY ALTERA770M OR ADDITION TO THIS SURVEY IS A WOLA77ON DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES PECON/C SURVEYORS, P.C. OF SEC77ON 7209OF THE NEW YORK STATE EDUCA710M LAW. and will abide by the conditions set forth therein and on the EXCEPT AS PER SEC770M 7209—SUBDIVISION 2. ALL CER77FlC47IONS permit to construct. 631 765-5020 FAX (631) 765-1797 HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 The location of wells and cesspools shown hereon are SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR from field observations and or data obtained from others TRAVELER STREET 1 8-110 WHOSE SIGNATURE APPEARS HEREON. SOUOUTHOLD, N.Y. 11971 r� eoA'II a , APPR VED AS NOTED Additional DATE ' ' B P. # ,� Cadfication May Be Required. FEE20•60BY NOTIFY BUILDING DE7PAPR -NT AT 765-1802 8 AM TO 4 .THE FOLLOWING INSPECTIONS 1 FOUNDATION-TWO REQUIRED FOR POURED CONCRETE 2 ROUGH-FRAMING,PLUMBING. 0 STRAPPING, ELECTRICAL&CAULKING 3 INSULATION - 4 FINAL-CONSTRUCTION &ELECTROILI��� MUST BE COMPLETE FOR C 0 ( AA ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS �. hwv ere rerav-5 V(/( ALL CONSTRUCTION SHALL EET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. dvte,,I-o 4fre of- r06 F, �pers ow, 04 /0 117 1� yid e, ®- aT A///( � j� Wale 3JO LIP - ., LIP!