HomeMy WebLinkAbout43859-Z gUt TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 43859 Date: 6/13/2019
Permission is hereby granted to:
Schott, Peter
230 First St
PO BOX 49
Cutchogue, NY 11935
To: legalize "as built" accessory shed as applied for.
At premises located at:
230 First St., Cutchogue v (�
SCTM # 473889
Sec/Block/Lot# 103.-7-6.1
Pursuant to application dated 6/3/2019 and approved by the Building Inspector.
To expire on 12/12/2020.
Fees:
AS BUILT-ACCESSORY $328.00
CO -ACCESSORY BUILDING $50.00
Total: $378.00
Buil ctor
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 �y
Date. �" g)-— I /
New Construction: Old or Pre-existing Building: (check one)
— Location of Properly: � a n
House No. Street Hamlet
Owner or Owners of Property: ?1 t2..VeM- 0-7)(`�A 1 `
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit.-I Applicant:
Health Dept.Approval: Underwriters'Approval:
Planning Board Approval:
Request for: Temporar ,,Certificate Final Certificate: (check one)
Fee Submitted: $ lJ
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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 ets.of$;wilding 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
.. 7 ;C,O.Application
(, � a Flbod Permit
Examined 20 Single&Separate
YA
1�1f Truss Identification Form
- JUN -3 2019
Storm-Water Assessment Form
Contact: /�r ( l
Approved ,20�
7-j
Approved ..,,, X� A4a+l-ta; (�. l�krjstbad�s
Disapproved a/c �� �EDIJ�?i5: 1
Phone: 1,(p' ID-0 -sof
Expiration 20 '
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date �� aa- I q , 20_�q
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 appliccvtt or name,if a corporation)
Bok 3--?q, C�,kc
(Mailing address of a `licant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises TIJo-
(As on--fhe tax roll or latest deed)
If applicant is a corporation, signature of duly authorized of1ficer
(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 work will be done:
,7_3 a T 1 R-S-r s�
House Number Street Hamlet.
County Tax Map No. 1000 Section103 Block 7 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 !S) no) - nxrn k I-poq1
b. Intended use and occupancy
S
3. Nature of work(check which applicable):New Building dition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost
To be ` atd.on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on�each floor
If garage, number of cars r1
6. If business, commercial or mixed occupancy, specify nature and extent;of each type of use.
7. Dimensions of existing strictures, if any: Front 1(p Rear Depth l0
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 NO
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 Address Phone 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 NOY _
IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY OF ,
M (r it C h�I -o C� I S being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contract r,Agen)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 themanner set forth in the application filed therewith.
Sworn to before me this
day of —,T1)trW— 20�_
S'jo� 14 U4u TRACEY L. DWYER
Notary Public ELIC,STATE OF NEW YORK Signature of App an
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2Q 2i_
Scott A. Russell. °Su p ���'OIRI\ [���1'\�C')E)I�
�
.A (Gl)ENUEN T
SUPERVISOR � _ .. ���1���
SOUTHOLD TOWN HALL-P.O.Box Town of Southold
53095 Main Road-SOUTHOLD,NEW YORK 11971' �d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
(TO BE COMPLETED BY THE APPLICANT)
DOLES TMS pROJECr INVOLVE ANY OF THE 'FOLLOWING:
(CHEM ALL THAT APPLY)
Yes No
o
® A.'Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
F1 NJ B. Excavation or f ill ng involving more than 200 cubic yal~ds of material
within any parcel,or any contiguous area.
El® C; 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.
El Jul E. Site preparation within the one-hundred-year floodplain as depicted
on FIRM Map of any watercourse.
F1 0 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'. Cbaptqr 236 does not apply to your project.
YIf you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan
and a coin rih�k ust-F to the Building Department wit�your Building Permit Application.
r S.C.T.M. #: 1000
date
ZpL105rr, (Property Owner,Design Professlonat Agent,Contracto, ther) District
E:
Section Block Lot
RmJ
sem, '* ' FOR BUILDING PARTMENT USE ONLY
Contact Information )
rtdRe�y mea
Re dewed By: /
- - - - - - -r - - - - - - - - Date
Property Address /Location of Construction Work: — — — — — — — — — — — — — — —
Approved for processing Building Permit_
+� CCS pG LLQ Stormwater Management Control Plan Not Required.
Stormwater Management Control Plan is Required.
(Forward to Engineerings Department for Review.)
•y
RM " SMCP-TOS MAY 201`4-
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FIRS T S TREE T
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N/F YOUSIK Z t7714=0001-07-06ZTM 1000-103-07-05 (f)
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N 44' 51' 30" E 185.70'
N/F CHEN
SURVEYED 6 AUG. 1999
SCALE 1`40'
SURVEY OF AREAOR 28,190.271 SF
DESCRIBED PROPERTY 0.647 ACRES
TM 1000-103-07-05 SITUATE
TM 1000-103-07-06
Guarantees indicated here on sholl Tun CUTCHOGUE,
only to the person for whom the survey TOWN OF SOUTHOLD
Is prepared, and on his behalf to the SUFFOLK COUNTY, N.Y.
title company, Govermentol Agency,
lending institution, if listed hereon, and
to the ossignees of the lending instituti URVEYEO FOR SUSAN OIESTAD
Guarantees aro not transferable to
additional institutions or subsequent owners.
GUARANTEED TO SURVEYED BY
SUSAN wEsra° STANLEY J.•ISf+K".•SEN, JR.
FIDELITY NATIONAL TITLE INS CO. , 7.
UNITED MORTAGE CO. Unauthorized alteration or addition to this P.O,- EOX:=45� ';
TOWN OF SOUTHOLD
survey is a violation of Section 7209 of
the New York State Education Law. 51~57311-5835_
p Copies of this survey snap not beormyICIC "o'JI YOR
3 the Land Surveyors embossed seal shall /N 2
not be considered to be a valid true
} 99R821
co
AP ROVED AS NOTED
' 3
DATE: ""i-�
p� B.P.# &s
COMPLY WITH q
LL FEE: ®� BY. NEW YORK STATE & TpWN S OF
NOTIFY BUILDING DEPARTME T . AS REQUIRED AND CODES OCCUPANCY OR
765-1602 .8 A TO 4 PM FOR THE CONDITIONS OF
FOLLOWING .INSPECTIONS: �41 USE IS UNLAWFUL_
t. FOUNDATION - TWO REQUIRED WITH
FOR POURED CONCRETE p OUT CERTIFICA i
2. ROUGH - FRAMING & PLUMBING S s ®F OCCUPANCY
3. INSULATION NC Y
4. FINAL - CONSTRUCTION MUST ai=
BE COMPLETE FOR C 0.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
RETAIN STORM WATER RUNOFF INSPECT IOELECTRICAL
N REQUIRE® �rn of n�( (�
PURSUANT TO CHAPTER 236
OF THE TOWN CODE I
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