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HomeMy WebLinkAbout44672-Z aFFo� TOWN OF SOUTHOLD O I D O ��oG BUILDING DEPARTMENT .� y y 2 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#: 44672 Date: 2/6/2020 Permission is hereby granted to: Kortgard, Scott 920 Moores Ln N Greenport, NY 11944 " To: construct accessory in-ground swimming pool as applied for. At premises located at: 920 Moores Ln., Greenport SCTM # 473889 Sec/Block/Lot# 33.-2-42 Pursuant to application dated 1/28/2020 and approved by the Building Inspector. To expire on 8/7/2021. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Building Inspector Form No.6 TOWN OF SO UTHOLD RUILDING.DZPARTMENT TowN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must beftlied inby.typewriter or ink and submitted to the Building Department with the following: A. For new building or.new,use: I. Final su' rVey,of property with accurate location of all ,property lines,streets,buildings, � 8t ts,and unusual natural or toplogra,hiAea,ures. ch 2. Final Approval from Health Dept. of water supply-and sewerage-disposal(S-9 forrri). I Approval of electrical installation from Board of Fire Underwriters. 4. Sworn siatem ent&OT-plum ber certifying that the solder used.in system contains. less,than 2/10 of I%lead. 5. Commercial building,industrial building,multiple residences and similar.buildings acrd installations,a certificate of Code COMPliaftc6ftm architect or eugineer responsible for the building. 6. Submit Planning Board Approval Of completed site plan requirements. For existingbuildings fprior to 119, 19.5-1 ,4.g us April non-cong6ru U, 1. Accurate survey Grproperty shiwimg- property linesst es,or buildings xnd'�pre-existia features. ree.W.building L and unusual land uses: ual natural or topographic 2. A properly compl eW aPplicaft0a and consent to-inspect signed by-the applicam If a Ce4t denied,the Building 168P(W tOk"-state the reasons.thaefori iting the • cate of Occupancy is M wd to applicant. C. Few 1. cwfficateiOf 0 —Ndw AW =Wnzy Additions-to Ring4- 5 N00- Ad Gus 00 dwelling 0, � --M -6 -0' terati" to swilam Acce 5 Alin oo, s. Ito 2. S AjLjj� accessorybu�ldng$54:00,ausift"$soxo- Wing- $100-00 3. Moy-rOTCOMMMIM-75 earlpency Ily cy, 4. Updated Certificate Of . OPccuwil'' M-00 S. Teraponlrycmtifiealte.OfOemganey-,,R,'em*denW$IS.00,C-omimercW$-,i5.00 Date. (9_ New Construction. Old Or PMCXWtM9 Building: 112-0 Location of Property: (check one) MRIse No. stred Owner or Owner's of Property: Ham, Suffolk County Tax Map No 1000,Section 33 Block, Lot .41 Subdivision Pemiit No- ( C/---- Filed Map. Lot: --- =?- Date of Permit. Applicant. Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for. Temporary Certificate Final Certificate Fee Submitted: (check one) of4r DDIiCan t Signature y FIELD INSPECTION REPORT DATE COMMENTS ro FOUNDATION (IST) H -------------------------------- FOUNDATION (2ND). VVI,, CIO c� ROUGH FRAMING& PLUMBING y 'S ti ' r INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDITIONAL COMMENTS P-I- Sao 0 9^- Z m • V� .. O . z d r 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 L Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees N C.O.Application Flood Permit Examined 20-W, JA 2 8 2020 Single&Separate Truss Identification Form `Storm-Water Assessment Form Contact: Approved 0e`L 20 ' Mail to: ,�© gm LIJ Disapproved a/c 1 e Cam\ lrane� 70)—1-fsL1 Lt Expiration 20 eQ•�l (� -330 4 But nspector APPLICATION FOR BUILDING PERMIT Date / 2. ___,2020 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 applicht or name,if a corporation) aMMe5 LAJ e,A DrT (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,en sneer,general contractor,electrician,plumber or builder Name of owner of premises `( r- (As on the tax r 1 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. Locatioo land on which proposed workwill be done: + e House umber Street Hamlet -�� Block Do� L �a County Tax Map No. 1000 Section Jot 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�a 114 j iAjP �1 b. Intended use and occupancy SaYy�J 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee A (To be paid on filing this p)lication) 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. 2 7. Dimensions of existing structures,if any:Front J6 Rear J I Depth J-7. 3 Height Number of Stories Dimensions of sane structure with alterations o additions: Front Rear _ Depth Height Number of S ories 8. Dimensions of enti new construction:Front Rear Depth a Height Number of Stories 9. Size of lot:Front Rear /S�r Depth 130 r 10.Date of Purchase Name of Former Owner //� 11.Zone or use district in which premises are situated a,&--Ah--0 f 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO✓ 13.Will lot be re-graded?YES NO ► xcess fill be r Will excess from premises?YES�NO y s� � , M��'es L j 14.Names of Owner of premises o Address Phone No. 62.—7yZ—Lf5L19 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 AZ *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BQUIRED. 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 YRK) COUNTY OF X1` Bf 10&-v1✓fi L -d Aj being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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 TV day of 202D otary Public gignature of Applicant TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2bg-0— Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I, ILA c �residing at C12 o �`JOQ LCJl2 (Print property owner's name) (Mailing Address) � 11 do hereby authorize C (Agent) Jtil��1� to apply on my behalf to the Southold Building Department. 1 /28/20 (Owner's i e) (Date) Scot Kortgard Emily Kortgard (Print Owner's Name) Scott A. Russell ,� OSUIFQ'r S'7C'01kMWA TIER. SUPERVISOR ' AWA NA\G]EAMI)E1vT SOUTHOLD TOWN HALL-P.O.Box 1179 0 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES IMS PROJECT INVOLVE ANY OF THE FOLLOWINCr YesNo (CHECK ALL THAT APPLY) ❑�A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. dB. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑orC. 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. ❑ErE. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑M'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 Tag Map Number! Chapter 236 does not apply to your project. N 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 you•Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contract Other) S.C.T,M, #: 1000 Date: Distric NAME: Section Block Lot Contact c5 �(� 3�O 6O �6 ****FOR BUILDING DEPARTMENT USE ONLY-**** Information: frekphw-Numbvl Reviewed By: - - - - - - - - - — — — — Date: —d-D2D Property Address/Location of Construction Work: — — — — — — — — — — — — — — — — — 900 Moo res � Approved for processing Building Permit. l Stormwater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 Of SO(�r'yo Town Hall Annex Telephone(631)765-1802 54375 Main Roa 'RM �� , x(631)7 5 P.O.Box 1176 Gel • roger.rlChert(v (6 )OU o nV US Southold,NY 11971-0959 l � BUR DING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: 6; .� ��801� � Dater Company Name: , Name: License No.: Address: a� 01:1 . Phone No.: � � �, 36 JOBSITE INFORMATION: (*Indicates required information) *Name: 1 *Address: oo ' *Cross Street: U A n�-s *Phone No.: 331D 6 Permit No.: Tax-Map District: 1000 Section:. �- Block:_ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) t ti-9 P 0. (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Final *Do you need a Temp Certificate: YES / NO Temp Information (If ed) *Service Size: 1Phas 3Phase 100 150 200 300 350 400 *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form \'. FFQ Scott A. Russell ,��°s" '� STO]kMWATIE]k SUPERVISOR c' MANAcG1]EAKIENT SOUTHOLD TOWN HALL,;'P.O.Box 1179 0 2 530%Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF TM FOLLOWING: Yes No (CHECK ALL THAT APPLY) Off"A. Clearing, grubbing, grading or stripping of land which affects more El dthan 5,000 square feet of ground surface. B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. [1E]rC. Site,preparation.on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. El0"D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. E. Site preparation within the one-hundred-year floodplain as depicted on FIRM 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. 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 BuwiMing Department witE your Building Permit Application- APPLICANT .T.M. 1000 Date: #: APPLICANT: Property Owner, Professional,Aigent,Contract Other) f� / NAME: 1> K—�`J�CI(!i� • L � J3 District /?a " — Section Block Lot I ****FOR BUILDING DEPARTMENT USE ONLY**** Contact Information: 51(9 -?3o 6 o 6 6 rre-0—N—bW1 Reviewed By: Date: Property Address/ Location of Construction Work: — — — — — — — — — — — — — — — — — 9ao 1_l 03 re'5 Approved for processing Building Permit. _ Stormwater Management Control Plan Not Required. 'L \ Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 SMS Ref. j R10-13-0064 AREA=.19,500 SQ FT. SURVEY OF PROPERTY AT GREENPORT N TOWN OF SOUTHOLD ND �� SUFFOLKTY, N.Y. p0 -42 L � SCAM V= 90 �y <0 XMM 9, 2013 �' �► APM 1, 2014(FULWDA WN LOC) AUG 4 2014(FWAL) tf8 ® AUG. 24 2014(Rf475ifW8)-_.. Vol Co 0 I waro RUNOFF`CO iTAW ENT °cam HOUSE•1820.4 n. 1020 x Ix 0.17-328 a. 1L F` 3Z/42-1-7.7 W. PROVIDE 2-E'L x 4•deep Ms. (�+�•2b' -`H.SES rtG !� 11_k`r q DW SWAY DRAMS: to�AI2-Co x 0'deep PRECAST oltfa �`. �` arviA � x• sr . A• N\� ��.�� � P4 OEC 7 11/1rL��1 Gy 7ESRf'OLE' 30.6• c O � ' %-A atb o�v, sero- Fy9+" � 6 TEST APOLE DATA voORMPOIdE j PAL tLMMSLT Lt SEP 77C LOCA nON r oEPAar�eKrOFRL�nR /f+pROVFLOFCOIMRUC1 WOrJMFOR A 5lNraLE FRS"iv RESI0.�NCE Sr PAX aR*MANDAWMStn A*& SE_I,51014 � ...RJo.-13.-001, 2Y 44' LP [t]a FT affix It Fr NO/wQasr aMorM LCA000 AMeaa FOIE ro 0�1RSE SMD [f] ruefu MAX Sew.w1 ouMM rr COLLM[ e1AI tat avAL4t tf�6aev AV4M ASL W AWM MAK tr L7RUC—E1VVF9-D-'—; LOT® REFER TO'WP OF EASMIN SHORES AT ORMFOR7 SECTM 5r FLED NR 7NE SUFFOLK COfl11TY CLERKS OFFICE ON 12/31/511,AS FILE N0.5234. 0 'Rye SEP 0 2 29% ■ _ SIIFF.CQHMTH°SERVICES LOT REFER 70'WP OF EAMEMD SNORES AT OREEWORT 'JFM0FWASTMjMp CG sEc7RON s FLED N iRff SUFFOLK MWN CLEWS OFFICE aN 0!/'27/x' AS FILE NO.4475 Orr familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE SE OF tN'j, DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES o•^c wid abide by the conditions set forth therein and onthe > \ �+ � .. ; 1 }i Permit to construct. s. * �, ,-P # The locafian of wells and cesspools shown hereon are �d='t, from field observations and or from data obtained from others. ANY AMU)=LW ALYLt M 10 716 SLWREY IS A IILtAMW Y.S. UC NQ 49618 W SEMN 2MW 7NE AE7P VCW STATE tLM••AIMM ut P.C. MW7 AS FM SECARW= PLOWMAN 2 ALL COMMABONS 1s31} 7 - FAx(631) 765-1797 MEW ARE YARD FW DAS AW AND COMES 7NE aMF Gay F PA BOX 909 SAD YAP Aft CLF�S SEAR 8E APAESSfD SM CK INE SURIE117P ELEVA7KNR3 ARE REFERENCED TO 1230 1RA1' m snMrT sriwl7AaeAFI9EARSNEIRFOK AN ASSIMED OATML SOUMD, 11971 1 '�+°� N.Y- 3-262 ti c APPROVED AS NOTED DATE: 6 B.P.# FEE: Bv; RETAIN STORM WATER RUNOFF NOTIFY BUILDING DEPARTMENT AT . PURSUANT TO CHAPTER 236 765-1802 8 AM TO 4 PM FOR THE OF THE TOWN CODE. FOLLOWING INSPECTIONS: 1. FOUNDATION - T1�.'C -3rQUIRED FOR POURED CCh:rRETE 2. ROUGH - FRAMING 8 PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW ELECTRICAL YORK STATE. NOT 'RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. INSPECTION REQUIRED COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF ALJ.SA� Stfftft Bleft-PL-�G BOARD USTEESIVI Q, .U -- ENCLOSE POOL,TO CODE � rfflON•COMPLET'I'ON OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY NAME. C—ml/ C.� oj r . srPE: �.. .. BmieR PATTLR�V:�_�_ . . . • WAIL PA' Mft • FLOOR PATMRM. �4RNERS: DEPTtt......3 - •-; HUNG OVERLAP (drds GM) ' 20 QMGE 97"M (drds W* a . r . j i i M -JCC; or'6g pjy i oco-- 3 3 - ®a CFour- eArO m �0,t(5 ars r7-49e nm FU Jrc� Gj(.� 36�aD Pss C�eL)e r MSX ; �ynbt5AlfY euery Fj r �-r � 10 _ 1. � o 5r idyl o 1-e