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HomeMy WebLinkAbout12771-z FOEI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12771 Z Permission is hereby granted to: .... ..~.~.,,,'~...~..~_~......~..~...~ ......... ~./_~.~.z~.~....~.~..~ ~ ....................... / ' ..... .~.oo.z~.~.~.=:~..~.~ .................. to ...... ..m.-..~,~..~...~ ............... ,~Z'~-'~~'""~'~'~-- ,, ~,,,,r, // ...................... .z.. .......................... at premises located at ....~.'~..(.~1 ......... ,/,~..~..~ .~.2..~.....~...~.~.~...-/~ .,d~-....~'....~.. ................................... ................................. ~ ................................................................................ .~..~. a...7..~. ~..~..~L4 ~7C', .... L//,..r/~..... ..~.~z~ ............. ~.,~ ...... ../..~.~. .~/..~ .................... r County Tax Map No. 1000 Section ........................ Block ...................... Lot No ......................... pursuant to application dated ...... ..~...~....~.........~... ...................... , 19Z.-~,.., and approved by the Building Inspector. Fee $...~..~....~... Budding nspector Rev. 6/30/80 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ~ PERMIT NO. 10-81}-0998 PERMIT UNDER THE ENVIRONMENTAL CONSERVATION LAW [~ ARTICLE15, (Protection of Wate,) [~ ARTICLE 25, (lidal Wetland$) ARTICLE 24, (Freshwater Wetlands) ARTICLE 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO Leonard Lang ADDRESS OF PERMITTEE 37 Maureen Drive, Smithtown, ~Y 11787 LOCATION OF PROJECT (Section of stream, tidal wetland, dam, buildin§) West side of Budd's Pond Road, Budd's Pond~Southold DESCRIPTION OF PROJECT Construct a two story single f~mily dwelling a minimum of 65' landward of mean -high water, lnstall a sanitary sygt~o~fe~m:~-h~ t~u~s~ ~nd the z-o~d a~-~ = minimum of 100' landward of mean high water. Construct an oyster shell drivews ~All activz~gT~ as per supp±ied-p-lans received Ocli, 1983. COMMUNITY NAME (City, Town, Village) J TOWN Southold $outhold COUNTYsuffolk FIA COMMUNITY NO. [ DAM NO, GENERAL 1. The permJftee shall file in the office of the appropriate Regional Permit Administralor, a nolice of intention to commence work at J~ast 48 CONDITIONS 8. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or ~es~it from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorized (SEE REVERSE SIDE) SPECIAL CONDITIONS SC #l There shall be no disturbance to the vegetation or topography within 40~ of. mean high water iexcept to remove poison ivy, dead trees and to Clear a 10' wide path to the :shoreline. #2 ~ The deck and hot tub shown on the plan received October 4, 1983 are not approved under this permit. #3 C6u$~ruction of house must conform with local and federal flood plain ordinances. See additional conditions A-J PERMIT ISSUE DATE Oct. 26, 19~3 ~'Cc: U~A(JE PERMIT AD alNISTRATOR J .~ /~ ./~ I ADDRESS Daniel' J. La.kin /~, ,~,~(/~ ~.,x %!~ NYSDEC Bldg ~0 SU~ S~ony Bro¢ THE NEW YORK BOARD OF FIRE UNDERWRITERS lOOl071 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the el~tr~al equipmeng ~ ~scrlbed be~ and int~duced by t~ applicant named on the ab~ application number ~n the prem~es of inthefol~ingloca$ion; ~ Basement ~ lgtFL ~ 2nd FI. ~. il; Section Block w~ exam~d on and ~ound to be in complianee wi~h the requirements of th~ Board. FIXTURES RANGES OVENS EXHAUST FANS FIXTURE SWITCHES DRYERS SYSTEMS NO. OF FEET NO OFpERC~.COND, A W.G ND. OF HI-L~a A.W.G NO, OFNEUTRAL$ 2/0 .1. 2/0 Lic#5?~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR I~,UILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FIEPD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF BOUTHOLD Building Department Town Hall '~ ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal), 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and sin~ilar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 land use --Pre-Existing C.O. $15.00 Vacant'land C.O. $ 5.00 Date .~J. Lk, '7' ~0.~. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .......... Hou~ No. Street HamNt Owner or Owners of Property County Tax Map No. 1000 Section ...O.O ......... Block ...... Lot ...... /..~ ....... .............. Filed Map No. ~¢.~.~?..Lot No ........ PermitNo.~.~. Date of Permit /~ .......... Apphcant ........... -, ¢ .............. ....... ' Health Dept. Approval ........................ Labor Dept, Approval ........................ Unde~riters Approval . ~ ............. Planning Board royal .................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $,. ~. ¢h ..................... Construction on above described building and perF)it meets all applicable codes and regulations. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTItOLD, N.Y. NOTICE OF DISAPPROVAL Oo~y~T~p~z~.000~on ...O..~. .... ~o~ ..... ~'.~...~o* .O.:~ ...... Subdivision .td-d~...t/.t~...2~'Z. g.~ :.. Filed Map No..~ .-.27. ...... Lot No ..... ./'..~.'i. i ...... is returned herewith and disapproved on the following grounds ....... Building Inspector RV 1/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE ........ INSPECTOR / / 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ].ROUGH PLBG. FOUNDATION 2ND INSULATION FRAMING [ ]~ FINAL REMARKS: /? .. DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~j'~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [/]k ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~,] FRAMING [ ] FINAL REMARKS: ~ tI INSPECTOR FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE OMB 3067-0077 This form is to be used for: 1) New/Emergency Program construction in Special Flood Hazard Areas; 2) Pre-FIRM construction after September 30, 1982; 3) Post-FIRM construction; and, 4) Other buildings rated as Post-FIRM rules. BUILDING OWNER'S NAME LEONARD LANG ADDRESS 37 Maureen Dr,. Smithtown, N.Y. 11787 PROPERTY LOCATION (Lot and Block numbers and address if available) 850 Budd Pond Road, Southold, Suffolk Co., New York 11971 I certify that the information on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. code, Section 1001. SECTION I ELIGIBILITY CERTIFICATION (Completed by Local Community Permit Official or a Registered Professional Engineer, Architect, or Surveyor) ~ NO It is intended that the building described above will be constructed in compliance with the community's flood plain [] ordinance, The certifier may rely on community records, The lowest floor (including basement) will be at an elevation of ft, NGVD. Failure to construct the building at this elevation may place the building in violation of the community's flood plain management ordinance. YES NO The building described above has been constructed in compliance with the community's flood plain management [] I~ ordinance based on elevation data and visual inspection or other reasonable means, If NO is checked, attach copy of variance issued by the community. YES NO The mobile home located at the address described above has been tied down (anchored) in compliance with the [] [] community's flood plain management ordinance, or in compliance with the NFIP Specifications. MOBILE HOME MAKE MODEL YR, OF MANUFACTURE SERIAL NO. DIMENSIONS X Community Permit Official or Registered Professional Engineer, Architect, or Surveyor) SECTION II ELEVATION CERTIFICATION (Certified by a Local Community Permit Official or a Registered Professional Engineer, Architect, or Surveyor.) FIRM ZONE Al-A30: I certify that the building at the property location described above has the lowest floor (including basement) at an elevation or--feet, NGVD (mean sea level) and the average grade at the building site is at an elevation of '?.__'-- ~., feet, NGVD. ' FIRM ZONES V, VI-V30: I certify that the building at the property location described above has the bottom of the ioweet floor beam at an elevation of feet, NGVD (mean sea level), and the average grade at the building site is at an elevation of feet, NGVD, FIRM ZON ES A, A99, AH and EMERGENCY PROGRAM: I certify that the building at the property location described above has the lowest floor elevation of _ feet, NGVD. The elevation of the highest adjacent g rede next to the building is __feet, NGVD. FIRM ZONE AC: I certify that the building at the property location described above has the lowest floor elevation of feet, NGVD. The elevation of the highest adjacent grade next to the building Is feet, NGVD. SECTION III FLOODPROOFING CERTIFICATION (Certification by a Registered Professional Engineer or Architect) I certify to the best of my knowledge, information, and belief, that the building is designed so'that the building is watertight, with walls substantially impermeable to the passage of water and structural components ha¢ing the capability of resisting hydrostatic and hydrodynamic loads and effects of buoyancy that would be caused by the flood depths, pressures velocities, impact and uplift forces associated with the base flood. YES L3 NO [] In the event of flooding, will this degree of floodproofing be achieved with human intervention? (Human intervontion means that water will enter the building when floods up to the base flood level oc- cur unless measures are taken prior to the flood to prevent entry of water (e.g., bolting metal shields over doors and windows). ~ YES E~ NO El Wilt the building be occupied as a residence? If the answer to both questions is YES, the floodproofing cannot be credited for rating purposes and the actual lowest floor must be completed and certified instead. Complete both the elevation and fioodproofing certificates. FIRM ZONES A, AI,-A30, V1-V30, AC and AH; Certified Floodproofed Elevation is feet, (NGVD). THIS CERTIFICATION tS FOR [] SECTION {[ E3 BOTH SECTIONS ~ AND ~ll (Check One) CERTIFIER'S NAME COMPANY NAME LICENSE NO, (or Affix Seal) TITLE ADDRESS ZIP SfGNATURE DATE CiTY STATE PHONE The Insurance agent should attach the original copy of the completed form to the flood Insurance policy application, the second copy should be supplied to the policyholder and the third copy retained by the agent INSURANCE AGENTS MAY ORDER THIS FORM FEMA Form 81-31, SEP 83 REPLACES FEMA FORM 81-31, APR 82, WHICH IS OBSOLETE. P.O. BOX 728 SOUTHOLD, NY 11971 FORM NO. 10 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 TOWN HALL ~IN ROAD SOUTHOLD, NY Instructions: The application to the Building Inspector includes (each mn auplmcate) lo Form No. l0 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above mean sea level~ 3. Drawings of pro- posed work. The application must give complete information to show that the proposed c~u comply to the Local Law No. 1-1980, Chapter 46 of'the Code of the Town of Southold known as "Flood Damage Prevention Law" of the Term of Southold. The applicant must submit approvals that any.other agency requires. General Sbandards as required in Section 46-17 of the law to minimize flood d~aage: A. B. C. D. Anchoring of structures, including tanks and mobile homes Use of construction material and methods Desi~ and location of utilities Subdivision proposal with drainage, public utilities design and base flood elevations ~fie Standards as required in Section 46-18r A~O~-~i construction B. Non-residential construction C. Mobile homes The applicant must submit plans and specifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the baoe flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodyn~uic loads and effects of buoyancy, 3. applicant must sub~it certification by a registered professional engineer or architect that the standards forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazzard area (V Zone) 46-19. Applicant shall submit plans, speczfzcatzons mncludzng the required certifications and such other in- formation as the Building Inspector may require in that ~he provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural members of the loMest floor cannot be lowe?than the base flood elevation with all space below open except breakaway walls. Sand dunes. If sand dunes exist on the premises and the applicant pro- poses ~o alter same, plans and specification must be shown in detailed nature of any alteration submitted. eo A Building Permit is also required for any structure. nt aud a Building Pe~it must be issued before any work can start in a special flood hazzard zone. ~ written~disapproval or a permit must be issued within ten (10) working days. During construction, the inspector ~hall be notified in time so he may make the required inspections. Upon completion, the required certification fo the final elevations and work must ~e submitted before the approval to use or occupy can be approved. (Fill out the form on the back of this sheet) 4/8O Disa~pval Issued Application Received FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT , In the Town of Southold Type of Development Proposed: New St'ructu~e (including storage tanks~/ Addition and/or Alteration[] Flood. Proof Below Baee Flood Elevation[] Other (specify) Elevation Data in'relation to above mean sea level of: (a) Lowest floor elevatzon, including bas ment _~_~ feet (b) In a V Zone~ bottom of lowest structural member ____ feet '.~___ inches FIRM--Flood Insurance Rate Map, Owner of Premises ___~_~z~D Location of P~opegty: Zone designations___~i_~ ...... -~ County Tax Map No:., District, 1000 Section ~ Block ~ Lot(e) Su'bdivision ...... Filed Map # Lot(s) P~ermission to be ~g~nted: ~wne~ as aboveU~New 0wne~ ~ ApprovaZ fsom other(s) before Po~mlt i~ issued: z 770 BUILDING PERMIT , WETLANDS (Town ZBA PLANNING BOARD 0~ner~TNew Owne~~ Con.tractl tractb~ and agree t? comply with all applicabIe sec~l, ons or ~ne uo~e of the f~ of S6uthold, Co~ty, and State ~d to a~it authorized in- spectors to premises authorized to perfo~ or have performed the said work ~d to make and file this applicatzon, that all statements contazn- ed in this applidation are true to the best of my knowledge and belief and that the work will be perfo~ed in the mannerset forth in the application filed therewith. COUNT OF _ S ' __ address l~d phone # if not given above: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examinedff~?. b(...~, ~. ..... Approved .~. O..]r(. dg?~...., 19 .~.~.;mermit No. d/.~~. ~..?.~.~.~ Disapproved a/c ........................... (Buildin~ Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plaBs, 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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) . .C:.o. ~ .o..~..~?..c,.....?,.~. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... ~..o..~ .t~.r¢..~.~.. ....................................................................... Name of owner of premises .... ['~ .~...[~ .~2~.~0.~, ~-.~ .... L ~k ~..~ ...................................... (as on the tax?oll or latest deed) If appti~cant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... /~.~. ............... Plumber's License No.. ~/~....~. · · ~ Electrician's,License No..w. .................... Other Trade s License No ...................... / 1. Location of land on which proposed work will be done ....................................... {. ......... ............ ............. ........ House Number Street Hamlet County Tax Map No. 1000 Section .... .O.~'"7. (v ....... Block ..... t~--~. .......... Lot .... ~. ...... ~' . Subdivisiou ....... ~. t ~,-.~.~.o~ , . .~O./.t~ i.'~ ....... Filed Map No .... .'~ .~..~....~... Lot...~...[?. ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~.~..~. t~U~.. ...................................................... b. Intended use and occupancy ....Og/~....'f~..~,1/~.~..~.....'~.~ ~l.~ ........................... 3. Nature of work (check which applicable) New Building .. M'.~..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ (Description) 4. Estimated Cost../.OC2! .......................... Fee .~...~..F..'~'~. .......................... (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 egisting structures, if any: Front .... ~... Rear . .x .8~(' ..... Depth ...~ ...... tteight ... ~. ...... Number of Stories ...~ ...................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ........... ~ .......... Number of ~tories ...................... 8. Dimensions of entire new constrUction· Front '~. Rear ... De th /' . .... 44 ............. ....... p .......... tteight ....... l~.hc ..... Number ~f Stories ...... ~,~ ............................................... 9. Size of lot: Front ....... ~.qg~:~ .......... Rear .... ./..~/..7'. ....... 7 ' ' Depth .... .~.~. ~ ........... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does prop0sed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be iegraded ..... ,e~/& ................... Will excess fill be removed from premises: Yes ~ No 14. Name of Owner of premises Z~.~t,,,~O...d~.....; Address .gX../~.~4~.,'~, ~-~... Phone No Name of Architect ...,~ .... ; ........ Address . ~..,~.~'~. ~'~tg4~l~ Phone No ................ Name of Contractor .&'~ ~.,,~,..~.'~. Address .~'(-~,~,..~. .... Phone No. ~'~(~..-:,f.~--~. .... PLOT DIAGRAM Locate clearly alld distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block:number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ..... $.~ ~.~/.~. S.S .............. · '~.~. ~. · .ff~.~'~'~.~.~'-~. ~. ......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is he. ..... ..................................................... (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 perfor}ned in the manner set fsrth in the application filed th'erewith. Sworn to before me this · .~.... ....... day of .... Z(//~.~'~. d~.., 19'~ Notary,Public,~~. ................ (~gcV ~ ~.~. ~..i~ ... County /~-~'-~fic. st, t~ o~ ~ew Vot~ ' (Signaturdof applicant) '[ No. 52-8125850, S~[foll{ ~ Term Ex,ires March 30, LICE~ED LAND SUR~YO~ GR~N~RT NEW YORK ....... /,/?o / SUFFOLK CO. HEALTH DEPT. APPROVAL H. $. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOC-K ~C¢). DEPT-r-QF tC~ALTH SE?V~CES. SUFFOLK COUNTY DEPT, OF HEALTH SERVICES -- FOR APPROVAL OF cO~T"UCTION ONLY O q ~K CO. TAX MAP DE.NATION: DIST. ~CT. BL~K PCL. LAW. SEAL