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HomeMy WebLinkAbout41646-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE '�y. • o� 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#: 41646 Date: 5/18/2017 Permission is hereby granted to: AGACG LLC PO BOX 206 New Suffolk, NY 11956 To: replace two windows and a door in an existing commercial building as applied for. At premises located at: _ I r 6580 New Suffolk Rd, New Suffolk (0 'i�'�i 5 (� r A)/l SCTM # 473889 I,��- GS D I�� J� —�ee_ 2, �f(,5 Sec/Block/Lot# 117.4-33 k)ed Pursuant to application dated 5/10/2017 and approved by the Building Inspector. To expire on 11/17/2018. Fees: COMMERCIAL ADDITION/ALTERATION $250.00 CO -COMMERCIAL $50.00 T 1: $300.00 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. Wim,, %! New Construction: Old or Pre-existing Building: �/ (check one) Location of Property: Ce5 PC, Na-, Sv' 1{��� �S ACC ��[ 1(4 r. G House No. //�� Street l Hamlet Owner or Owners of Property: A Z S i_, 4 lA � Suffolk County Tax Map No 1000, Section Block L` Lot 3 Subdivision // / Filed Map. Lot: Permit No. �lo Date of Permit. Applicant: Ar nca\ C--,o<z,_�yr Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 50 A 'cant Si ture FMLb SPW370N M- VORr'S :DA= Cd , FpYT�Ib,A.�'SON(XS'I� • 1 ............ ..•w..P.•Y►►..Y�►Y,IY FOUNb?�,Tx4N(2N13) AL z ROUGH FW`Q& ._�,..,.Y.►,_._ PLUMBING . 'ZI I OLATION•PER N.Y. STATE ENERGY GORE FINAL ` r . y r 1 • 15 •M . r 1 f1IT�555 ^S } WN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? OWN HALL Board of Health SOUTHOLD, NY 11971 4 s is of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 �,. Survey South oldTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single*&Separate Storm-Water Assessment Form 1 Contact: Approved ,20 Mail to: Disapproved a/c Phone: Expir ' n C1 ding Inspector MAY - 9 2017 APPLICATION FOR BUILDING PERMIT BUILDINGDEPT. Date Vt J , 20_[(4_ TOWN OF SOUTHOLD 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. (S' e o plicant or name,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 (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. S`JSJG }k Plumbers License No. Electricians License No. Other Trade's License No.. 1. Location of laiid-18fi`,,?liich proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section 1 Block Lot 3 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 CG,e b. Intended use and occupancy Ce,.r ae,.1k QC S�rp n 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work��r�„�Cw-S (Description) 4. Estimated Cost an '-I [ 1 ®c o�00 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 t q 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, ordinarxc'6 or regulation? YES NO-t"� 13. Will lot be re-graded? YES __ NO .Will excess fill be removed from premises? YES NO�! 14. Names of Owner of premises Arnold G'o�z.)YAddress N4..3 Up kV. Phone No. (o11A'1%,ll(07 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 NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OFf f /`'fir.► ex `Z Gokm J r being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the CL"'�V C-}OY (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. YVONNE M MCNA9 WOiAfNY PUBLIC-STATE Of NEW YORK Sworn to before me this No.OIMC6205430 0001Ifled In Suffolk Cour. . _day of Ut–�r ?O.�L ' , MY,CommisslM Explrof'MGYA. c Notary Public a re of Applicant ,�-°5��� ST(O��E���JCW A�T)EIR, Scott A_ Russell � SUPERVISOR IM A NA(G IE UEN T SOUT HOLD TOWN HALL-P-O.Box 1179 p 53095 Main Road-SOUTE01M,NEW YORK 11971 �syo Town of South o Zd CHAPTER 236 - STORRMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT) , DOS-TMS--PRO-J ECT—INVO F` BE--FOIMWING ----=:-----— Yes No - (OlEIX ALL MAT APPLY) [][A A. Clearing, grubbing, grading or stripping of land Which affects more than 5,000 square feet of ground surface. El® B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. []M C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑0 D_ Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. E}© E. Site preparation within the one-hundred-year floodplain as depicted OJITIRM'Map 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_ ------------ F�an answered NO to all of the guestions above, STOP! Complete the Applicant section below with your Name, ure, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project- answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan ompleted Cbeck List Form to the Building Department_withyouur Building Permit Application. APPLICANT_ (Property Owner,Design Professional,Agent:Contractor,Other) - S.C.T M. 1000 Date District NAME r Section Block Lot i-ti... .`..._, F=OR UILD1ING DE.PART:Ntr.NT UL ; f; Corrcxt)ntormatiort Reviewed By_ q— D Property Address / Location of Consti-bction Work: — — — — — — — — — — — — — — — — — CD/ `k Approved for processing Building Permit. SQ�pP�_ V O Stormwater Management Control Plan Not Required. ------1 Storm.vater Manage nen: Control P:ac ,s Rcy�,rec. (Forward to Engineering Department for Revxe-.) FORM - SMCP - TOS MAY 20 1,1 APPROVED AS NUTED ED DAT :� i B.P.#Lq F $Y: C0;',F,:'!`( loll T H k,'L C:;1DES OF NOT Y BUILDING DEPAR HENT AT Nr_--WYON" S O i E & TOWN CODES 765- 802 8 AM TO 4 PM FOR THE ASFiEQUiREV.",""�' ^r�n�n'�in�`;�F FOLLOWING INSPECTIONS; \ 1. FOUNDATION - TWO REQUIRED --- �. � FOR POURED CONCRETE j PI�N�ING BOARD 2. ROUGH - -FRAMING & PLUMBING � � 3. INSULATION _ SC-ti --I. I i� ,',';'i u� EES 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE r,_-� REOUIREMENTS OF THE CODES OF NEW �/ YORKBLE FOR STATE. ORORK ECONSTRUCTION SIERRORS. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE ,� �\ OF OCCUPANCY tA3 t6_ �\ r - I ' I 1 if ----