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40813-Z
r TOWN OF SOUTHOLD �gUFF01� foo �y� BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE Dy 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#: 40813 Date: 7/1/2016 Permission is hereby granted to: 2245 MCR LLC PO BOX 1340 Southold, NY 11971 To: to replace window with n w door i existing fr ork (B ing 5, Unit 1-Taps and Corks LLC) as applied for. At premises located at: 620 Traveler St., Southold SCTM # 473889 Sec/Block/Lot# 61.-1-13.1 Pursuant to application dated 6/27/2016 and approved by the Building Inspector. To expire on 12/31/2017. Fees: COMMERCIAL ADDITION/ALTERATION $250.00 CO -COMMERCIAL $50.00 Total: $300.00 ildin ector Form No. 6 T0\VN Or S0U_FHOLD BU[LD[NG DEPARTMENT TOWN HALL 765-1802 APPL[CAT[ON 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: I- 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 hoard Approval of completed site plan requirements. r 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, imm Swing pool$50 00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. C60y 6f-CertiFicate of Occupancy--$.23-- 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. �27��[n New Construction: Old or Pre-existing Building: V (check one) Location of Property: 632!15 611 '5- cine ( Iv f�!'_4�- �6 J � 10 House No. J StreetHamlet Owner or Owners of Property: rl p Cli d g!�T/ LCC_ Suffolk County Tax Map No 1000, Section Block. d Lot ��• I Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check on ) Fee Submitted.- $ I zww Applric��at�:re SOUTyolo * # TOWN OF SOUTHOLD BUILDING DEPT. `ycou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE `� /7 �2- INSPECTOR FMLD MPS r,�.qN I-M'ORT DATA COI ,NTS i FOUND4TION(1ST) °<) ............... ..Ywrwwr��YwY t , FOTJN 4TIQN(2ND) ROUGH YRAN=CF& PLUNMING " INSULATION•PBA, N,Y. STATE ENE-ROY COM MAT, N� Nrn �-z .. .\ O .r wW 0 o , 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 Q' Survey SoutholdTown.NorthFork.net PERMIT NO. ®® Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20J�J D Single&Separate JUN 2 216 Storm-Water Assessment Form Contact: Approved 1 , —,2010 $ ��D 1 • 1vY0.T1ZV�i _ Disapproved a/cTOWNQF �� Phone: to 90 Expiration ,20 tJ Ty- -T- 1 nspector APPLICATION FOR BUILDING PERMIT Date A4 1 , �° '� , 20 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 applicant or name, if a corporation) S tyu1197 1 (Mailing address of applican 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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House NumberJ Street °;r.. 315,_j,jfA j�,14amfet County Tax Map No. 1000 Section (�' i Bloch`;-'''�`;/'.`°" Yr,;rt:�>�� ,,.'lof . 3 . 1 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 A ii 1aja W CA r.A b. Intended use and occupancy 1 6� (' „o r CA a,Q 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work �11 (Description) 4. Estimated Cost bb ' � d To be paid on filing this application) 5. If dwelling, number of dwelling units -vmb er o. clwelli .ginits on each floor If garage, number of cars ' r''° 6. If business, commercial or mixed occupancypec �i' ` nc �xtent of each type of use. 7. Dimensions of existi str ctures, if any: Front Rear Depth L ` , Height c� ANumber of Stories 2-- Dimensions Dimensions of sa structure with alterations or additi ns: Front Z 5 Rear 25 � - Depth 2, • j2� Height z,o Number of Stories 8. Dimensions of entireziew c nstruction: Front 2-5 -( Rear 2 Depth P 2- Height -z-,C> Number of Stories 2 , 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situatedz- {�� 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO-7y-- 13. Will lot be re-graded? YES NO)�__Will excess fill be removed from premises? YES NO 14. Names of Owner o •f premises 246 Re- t�� AddressT0 924 f�t-tO Phone No. to 3l- q-7,&I (D L17:' Name of Architect u Address '>1-e(1 aycl �J - Phone No(o3?- Z6 5-:7 6-a Name of Contractor bvw Address W-"4• )VL-1--0) Phone No.&31 - Z y 6-- �T 5-Z� 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 NOS * 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_y * IF YES, PROVIDE A COPY. STATE OF NEW YORK) ],NTY OF SO lV- r 10 being duly sworn, deposes and says that(s)he is the applicant -.3K'n'le'ot individual signing contract) above named, (S)He is the Ow 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 oZ day of x(3111 20� gtPSE Oc Danielle C Anderson Notary Public,state of New York TARY 5159 Notar Publ le,, '�� lY pueuc ;alifiedilkSuffolk County Si n ure Applicant ''• Commission Expires 5/181204. vol' I 1 Scott A. Russell � �� (t ST01KAWWAT)E K SUPERVISOR S AM A NA\G)E MIEN T SOUTHOLD TOWN HALL-P.O.Box 1179 td I S 53095 Main Road-SOUTHOLD,NEW YORK 11971 �Sf 7 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOLES THIS PROJECT IISIVOLVIE ANY OF THE ]FOLLOWING: (CHECK ALL THAT APPLY) Yes No ❑E�rA. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑[9 B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑[ C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑Ea"'D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑VE. Site preparation within the one-hundred-year floodplain as depicted ._._._....._..._.._....._on l{fI M-M-a'p'-of-any...wate-r-eau-r-'se:-..-_..- _.................. .-.... ._. .. ..... . ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more unlessAp rior approval of a Stormwater Management P 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. S APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) .C.T.M. I OOO Date #: ` District NAME: 1 l>L S P•1 —v27_l Section Block Lot "'OR BUILDING DEPAR"I' .-HENT USE ONLY i Contact I ormation: i Reviewed By: W Date: , Property Address / Location of Construction Work: — — — — — — — — — — — — — d Approved for processing Buildi g Permit. Stormwater Management Control Plan Not Required. — — — — — — — — — — — — — — — — — ® Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM 4 SMCP-TOS MAY 2014 APR VED AS NOTED DATE: (3.P. 7 FEE: .Db BY: NOTIFY BUILDING DEPARTME AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. OCCUPANCY OR USE IS UNLAWFUL WITHOUT.CERTIFICATE OF OCCUPANCY- FIBERGLASS ; STEEL DECORATIVE SS SIDELITES, & "IMPACT GLA 0PT1,0NS Decorative Grilles Add visual interest to your patio doors with one of our decorative grille options. ra. .'i7ar'Sc _'.4'.r• e,µ •4^Ab �`,'�_ '�+, .t•� ?i.?.ri'�.l 4 a`�asF�i'^.s'j$f'?:.y��,�y.'•yY��•:s. '��Y�,`�4 i�•'p y;�„ ,2 ��: ' i ._ _.__ ;'-: a t — Grilles Between the Glass External Grille* "`Pralne Glass Colonial 15 Lite ;:Coloiiiahl0'Lite` (GBG)* Offers an authentic Easy to maintain and paned look " enhances your home's style *Grilles are for illustration p poses only and may not match grilles chosen. See Sales Associate f details. i;s?Se.4 MCi.:,.„;`i£� °."K'_` ,x.:� ;;�-:� 'k'+d',:rdJ3•=•;'. .+Azy�;>;'�;.".fY Sidelites ^•f tat.�� � ".� t'� ,`i Bringa beautiful radiance to your � 4 "' � ,` 'i,� ���^ 'r.�;a �. •yet;,'«. home by creating a patio systemrt 7 with our coordinating sidelites.* t a�,.;• ^' � ', � v' �.0 { }fid t/.�+•.i.:: �> � a� .{r.°i:'.",',�+79'L%:':r..����:':d'��.zn �..<Y ;`�`:,�S, i i 5 k•,5�;-:. *Sidelites availability varies by region. :t + ! •, t w ''"-i.;:ar: ;'t,;:ji— BS;'r_ i:" ' SeeaSa/es Associate for details. ��. a,II'Y".At4 t: ,'J:;'...,:' `.+5;...�a:'a-i?��.r)C.'„$ ."$ ,' p •�.xgs•.� ?t :3:?:r+ N� ',ks�•;: jy„�-;..pY���1,��'j,.:._:,e _ mow:�,�.;};`�• $.� ,.� ** al mini-blinds are , ` b •3,''. :Ir l ;`��' 'j' Sidelites with internal � `•'� -��,.} 2:,, ':": tilt only and do not raise or lower. JJ z 5Lite Internal mini-blinds** Impact Glass 'tj`�Fi,:.1.,,i i•k� :+i�Q'�r„ro�'�?'SSrY�'"'a`' �;.�s,�,`"` .y'.k:: Designed for homes exposed to tough coastal conditions and hurricane force winds, impact glass provides severe weather protection and u`;'``y '" ` U canithtd impacts traveling at 34 miles ' wsanpg �><?;j��;i:.:r>...>:v,C•j�� t >aareoY' %v t ” per hour. Available with steel patio doors Impact glasso tions are available for an additional charge Florida Product Approval Numbers are available at vvww.floridabuilding.org/Prlpri-app-.5rch.aspx. &hkL<'w•A�t191 �F�`G�`.-M"^:)^'•f^�'�D'S f - See Product Comparison Matrix on page 70 and 71 for all options. 30 HOMEDEPOT.IELD-WEN.COM a0I®■/®®m71m /■■.■ ■■■■■■■■■■■'7..■■.■■mmmaf.m■■■■■■■■■■.■■■...■.taint ��/�Ea®■■■.■■..■■■■ ■IIII■Emmen■■■■■■■ .■.■■ .■ ■■Nm ■ .... 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