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HomeMy WebLinkAbout40866-Z o�g-7-11z'* oTOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE 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#: 40866 Date: 7/29/2016 Permission is hereby granted to: Keupp, Robert 900 Long Creek Dr Southold, NY 11971 To: make interior (bathroom) alterations to an existing single family dwelling as applied for. At premises located at: J \ 900 Lon Creek Dr Southold J Ibu� �( — L- Long �d� N T � U,l r SCTM # 473889 Sec/Block/Lot# 55.4-9 Pursuant to application dated 7/21/2016 and approved by the Building Inspector. To expire on 1/28/2018. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 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 i`s 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: ,`On House No. Street Hamlet Owner or Owners of Property: � � _ O [Lf y Suffolk County Tax Map No 1000, Section Block Lot 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 one) Fee Submitted: $ Applicant Signature MELD ITCSP, E=QN•v. xl?,oRx AAS I{OUNDAION(1ST) FOUNDA,TXON(2ND) ROUGH�Q& •rp 1TiSUSATXON•PEA N.Y. . STATE ENERGY CODB , SIAL , F. ' 75 Cb d 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 �/a 7 �rtvey SoutholdTown.NorthFork.net PERMIT NO. 410 O { � Chet- Septic Form N.Y.SD_E.C. Trustees C.O.Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Fonn Contact: ��y N Approved 20 Matt to:4 idg c&n- Disapproved ate 1 Phone: D �3 Expiration / M20 Building Inspector D JUL A 2016 LICATION FOR BUILDING P t Date 20 INSTRUCTIONS � NG DEPT. ' a. p tpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of� o scale.Fee according to schedule. b.Plot plan slowing location of lot and of buildings on premises,relationship to adjoining premises orpublic 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. £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 tate 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 Dame,if a corporation) (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Qll-,)\� Name of owner of premises MQA f'� -_J x( (As on the tax r ll dr 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 pro osed work will be done: qC� Lo�g Cil-ems- �- , House Number trcet C!Hamlet County Tax Map No. 1000 Section 5 S Block T Lot g Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and inte ded use and occupancy of proposed construction: a. Existing use and occupancy `Z�5 c TEE c3, b. Intended use and occupancy ­iZt 5'4g V\j�A`•o"� 3. Nature of work(check which applicable):New Building Addition Alteration_ Repair Removal Demolition Other Work (Description) 4. Estimated Cost Z 5 r ®0 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 �2, 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. << t cr 7. Dimensions of existing structures,if any:Front G f Rear f Depth qZ Height I ` Number of Stories 1 Dimensions of same structure with alterations or additions: Front ( Rear Depth Y 7 ` Height (� r Number of Stories 1 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front Rear Depth 10.Date of Purchase 2i, Name of Former Owners<-A 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_NOWill excess fill be removed from premises?YES NO foo Lt),,, C k - 14.Names of Owner of premises Address ��� n�l G� Phone No. 6��"g�f> �Z 9 3 Name ofArchitecti+-_ e 16ve Address W .S " Phone No 43/ - F67 6R2!_/- Name of Contractor Address 2 hone No. 6-51 &V—OZ � Ce��t�n �c��Qocn�C lV'f 15 a.Is this property within 100 feet of a t�ial 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_X *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY ORS ffy �K" being duly sworn,deposes and says that(s)he is the applicant (N individual signhfg contract)abolk named, (S)He is the CD W (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 perform tl m s fo a li ti ferewith, BRIAN LANZE Swornt efoday o yb�ate 5.59 Yol{c alifie n Suffolk County jjq15 2w" i SiFmhfre of Ap licant OL OUNTY191 HEALTH. DEPARTMENT, DATE H. D. REF. # S Sv - GSA The sewage disposal and water supply _ facilities for this location have been 6 " wets.+ ,ngiy�inspected by this department and foun� - -- — — --T — — — _ -t-a bior satisfactory. I Chief 4f`G nera n inl�r g ed L �NCs GF2.�,E/G Zal2/t/� Services b 6'` ~5.95.57'::.to .Larlret .Avenue.--- 00 %0 1p �� S.taa k 36 T71J _ O O. • ;. -. ...,"`' •; � �u ALTE7ATION al��+�+ ' To THIS SURVEY IS A VIOUQtON OT SECTION 7209 OF THE NEW YOIIIk S1ATt 5.83"-¢Z �s O�1M. - I3S.O4 EDUCATION LAW. COPIES.OF THIS SURVEY MAP 007-UA! LTHE LAND SURVEYOR'S INK:D SIAL OR n N EMBOSSED SEAL SHALL NOT BE CONSID[tll� i TO SEA VALID TF.UE COPY.'. - I 1 GUARANTEES INDICARD jI04-1 SHALT RUN •: Q „M THE SUP N W. ONLY TO THE.�E:S? F�A.'�' _ _ IS PREPARED.Ac•.D O;. HSS G-:aLf 10.TME .�- AG:Ncr: 9 ` Q� rf� rT TITLE COMPANY;GJVcR'rcn�:NiAL �. //!l--�7� 7K.. LENWNG f�'SSi7U710N LIST:G H•k'IG WT_ - - To THE ASSIGNEES Of THE IENDIIU �y •.-�•�/. .rt. .. . . - - - 1UTIo4.GUARANI ALU K( [1F-94S�- ” RJ�K.✓V/�i/.` �D� . . _ 111510LAWhS Off' LLLl LX _. TO ADDITIONAL y LS3 A7' 6�Or'cYtl.41'A0-9c3'gvr, _ .. . 7' .. P 8•arr,�,,.L�rM_d bS4l/G CO, lila `1 ffO eS4 U•71HOL Cl y ..r'✓: .Y.:. tf �` 1V10 rtvrrrerr f' res nor'f, .:'At.:`Y: N IM _ T kB c LLJ ILcu i cft o t ` to Ld ' 1 `^ I + Ir i i F B 4 y N cn00 LL) PILA ico _ rr �, LO 3� IM q- f v Note,IWs draminS is ati artistic ' = Designo&7a512016 LOii texpretabon of the 8eneraI rik:cai3aiEs4� Qrkuted: W17l20t6 r+ © agpearemce of the design. It is rL ti not meant to be an cxw rendition, N. ; N � y Southotd Mastec Ail L?i3avti*irig#:1 i � N . ' 0 N rn s fl E j e = - I o f W � I LO i (7103 N 9 N r LO E I { E Ir —� , a r m ED � ��I ijs { �xJl Note: This drawing is it arastic �� 8 x D�esigased:7�Sl?A[6 r interpr�etatiou of the gercerc3l 4ECHM7Lo7aif;� P`fUlted:717-7f20M p appoaeancse afrhe design. It is N �` gnat meant to ba an em3l rcndHion. (U n N r �I . k r- i=. g u�`outhoid - A[i T3ratvfng A�I:T, 1291 89" 22" ------ --------------------- ------ ------ --------------------- ------ 28�" 24 11 41" zt 1 40i" goll39 39" 24" to�z A*V ml/' 61 i" 7 1„ 2 5" 21' 22�' �. 15" 36'$ 49" 36" „ 4Q���`� Southold Project 4� -V L vE v201 4" 4 2G 30" 66�" 4h ld r-1- 06 4 Nll�,2 22}" dD 7- IDOL /A ho,L,. 443" 36" 293" 51 22" 81 f„ 36" 0 JSP .� rJ" 193" 12„ 21" " 1 Q 41° 36" -t-15}'� 34" t a 32" L � \ f "'lll�� J00a ;ties. 21" 30C 32" 60" 42" / `�j � ,� �lA�lG ✓r^,� �BGTZ 60 205" 0��� G,)D Lor- Uw l AP ROVED AS DATE: Z . B N } F Z�O� BY: f3 t�K - PLUMBER CERTIFICATION NO IFY BUILDING DEPA.R`[MENT AT t Ufzr LEAD CONTENT BEFORE 765-1002 0 AM TO 4 PM FOR THE CERTIFICATEOFOCCUPAP.CY 1. FOUNDA-IIINTION INSPECTIONS:ORE 1. FOUNDATION - TWO REQUIRED SOLDER USED IN WATEF; FOR POURED CGNCRI-TE SUPPLY SYSTEM CAP`w�OT 2. ROUGH FRAMING & PLU':1BIr1G EXCEED 2/10 OF 1510{,EA9. 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.J. 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