HomeMy WebLinkAbout51354-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 51354 Date: 11/04/2024
Permission is hereby granted to:
Marco Sacchi
19 Greenview Ave
Princeton, NJ 08542
To:
Construct new single family dwelling as applied for,with SCHD approval.
Premises Located at:
100 Arrowhead Ln, Peconic, NY 11958
SCTM# 98.-2-2.1
Pursuant to application dated 05/16/2024 and approved by the Building Inspector,
To expire on 11/04/2026.
Contractors:
Required Inspections:
DRAINAGE, FOOTING/REBAR, FOUNDATION 1ST, FOUNDATION 2ND, FRAMING/STRAPPING , PLUMBING ,
ELECTRICAL- ROUGH, FIRE RESISTANT PENETRATION , ELECTRICAL- FINAL, INSULATION , FIRE SAFETY
INSPECTION , FIRE RESISTANT CONSTRUCTION , FINAL,
Fees:
CO Single Family Dwelling-New $100.00
Single Family Dwelling-NEW $4,065.00
Total $4,165.00
� � Building Inspector ���
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 tt?as.L/�w. cqut oldl'cn Gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only ,""-^ � i S rd a
� r
PERMIT NO. f Building Inspector:, �
Applicat�Ons;3nd;f4rms'must be filled Opt!" their entirety Incomplete MAY I ' ?024
apphcatwQns wiU r�Ot be accepted "Where the Appiicant wrs not tho owner,an
�, iG// /r �� „</%
iwner` uth or�xation form{Pg )shaf l be compt: .
Date:
OWNERS)OF PROPERTY
Name: ... SCTM # 1000-
Project Address: wo kkzQzwt LP Cw N C L NJ/ �) 8
Phone#: 66 1 S-�;R Email: U�
Mailing Address:
CONTACT PERSON:
Name: �A)k-�Zco
Mailing Address: l I tl ��LtJC1 1` 7f],) N 3 Da!!: Z.
Phone#: 60 .Ssg `� � Email: Alt z-c��[�-C C�"�`0 zrax�
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: l 6 o i�T -n r , V)pw,
Phone#: 361 8 1 Email: al.w`c d'
CONTRACTOR INFORMATION:'
Name: ^ D NO V, ✓1 �r��.� ,. ✓� uq L
Mailing Address: 3 3 8 11 yU)
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure ❑Ad dition [Iteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other Cs (i $ ��� ��
Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ❑Yes ❑No
1
PR
QP RTY:INrFORMATM,
Existing use of property: Intended use of property: ,\b ev 0
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
�U this property? ❑YesXNo IF YES, PROVIDE A COPY.
d Check Box After Reading: The owner/contrac#or/design professional is responsible for ail drainage and storm water issWs as provided by
Chapter 236 of the Town Code;,APPLICATION IS HEREBY MADE tq the Buifdinje'Department for the issuance of a 8uiiding Permit pursuant to the building Zone
d,
Ordinance of the Town of Southold,Su066,County,i11ew York and other appU1c bie laws,ordmances'or R±sgulatibintjfor the construstion'vf buildln�s;
additions;alterations or for removal orde,molitlon as'herein'described The applicant agrees to cdmply with'all apo,04able,'laws,ordinances,;bulldin$code,
housing code and regulotlons and to admit authoriYed Inspectors on preen ses and'in,building(sf for necessary inspections:False statements made herein are,
„ ,
punl. able as a Class A misdemeanor pursuantto 5edtlon 210.45"of the New York State Penal Law,
Application Submitted By(print me : ❑Authorized Agent Owner
Signature of Applicant: Date: �— j ( —0�
STATE OF NEW YORK)
SS:
COUNTY OF ( )
Mr 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/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
i �P�day of A 1126
Not r Public
TRACEY L. DINYER
iTARY PUBLIC,STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATIOI' NO.0 1 DW6306900
(Where the applicant is not the owner) QQ6LIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2L2(p
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-95021attps://ww sout ()Idtown goy
BUILDING PERMIT APPLICATION INSTRUCTIONS& CHECKLIST
• Applications and forms must be filled out in their entirety. Incomplete applications will not be
accepted.
• The work covered by this application, including land clearing/site work, may not be commenced before
issuance of a building permit.
• No building shall be occupied or used in whole or in part for any purpose whatsoever until the Building
Inspector issues a Certificate of Occupancy.
• Every building permit shall expire if the work authorized has not commenced within twelve (12)
months after the date of issuance or has not been completed within eighteen (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 additional
6 months. Thereafter, a new permit shall be required.
ALL APPLICATIONS MUST BE SUBMITTED WITH THE FOLLOWING MATERIALS:
❑ Building Permit Application: Complete, signed and notarized.
❑A survey/site plan, drawn to scale at original size, showing the location of lot and of buildings on
premises, relationship to adjoining premises or public streets or areas and waterways.
❑Four (4) sets of plans bearing the signature and original seal of a NYS licensed professional engineer
or architect illustrating compliance with the Building Codes of New York State.
❑Contractor's proof of insurance and Suffolk County license:
• Certificate of Workers' Compensation Insurance (C105.2 or U26.3) AND a Certificate of
Disability Benefits Compensation Insurance (DB120.1)
• Certificate of Liability Insurance
"Note: Final Fees will be calculated by the Building Department using the fee schedule. Fees will be
collected after the permit is written"
ADDITIONA DOCUMENTATNON MAY BE RE UIRED AS IDENTIFIED BELOW:
uffolk County Department of Health Services Approval (original copy)
❑Approval of the Zoning Board of Appeals, Planning Board, and/or Historic Preservation Commission
(if applicable)
❑Electrical Permit Application FILED SPERATELY): Electrician must have an active license with Suffolk
County
❑Flood Plain Development Permit Application (if applicable)
❑Southold Town Trustees Permits may be required: If any work will be done within 100' of a tidal or
fresh water wetland.
❑NYS D.E.C. Permits may be required: If any work will be done within 300' of a tidal wetland or 100' of
a fr sh water wetland
9 opy of ComCheck/ ResCheck (if applicable)
�icopy of Manual J, Manual D and Manual S (if applicable)
❑Utilization of truss/pre-engineered wood/timber construction form (if applicable)
❑Single and separate title search (if applicable)
❑Curb cut permit (NYS or Suffolk County form 2.39F) (if applicable)
❑Original signed Owners Authorization: if applicant is other than owner.
3
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-09599
Telephone (631) 765-1802 Fax (631) 765-950211"s.f w w i uthol townn ....._
u
INSPECTION &CEItTIFICATE OF OCCUPANCY INFORMATION
It is the responsibility of the applicant, owner, or contractor to request inspections from the Building
Department. Construction must be completed and certificate of occupancy must be obtained within eighteen
(18) months, or the permit may need to be renewed. Building permits shall be visibly displayed at the work
site and shall remain visible until the authorized work has been completed.
Work shall remain accessible and exposed until inspected and accepted by the Building Inspector.The permit
holder shall notify the Building Inspector when any element of work described below is ready for inspection.
The following elements of the construction process shall be inspected, where applicable:
• Footing reinforcement or pier excavation prior to pour;
• Footing keyway with foundation wall reinforcement;
• Foundation before backfill;
• Foundation damp proofing;
• Framing,tie down/strapping and plumbing;
• Underground plumbing;
• Perimeter insulation;
• Rough electric;
• Insulation and caulking;
• Solid fuel-burning heating appliances, chimneys, flues or gas vents;
• Energy Code compliance; and
• A final inspection after all work authorized by the building permit has been completed.
After all necessary inspections are completed additional documents, including but not limited to the following,
may be required:
• Suffolk County Health Department Approval—original copy
• Plumbers Affidavit
• Miscellaneous Certifications as requested by Plans Examiners or Inspectors
The Certificate of Occupancy will be issued after all of the required documents are submitted to this office. No
building may be used or occupied in whole or in part, until a Certificate of Occupancy shall have been issued
by the Building Inspector.
The owner/contractor/design professional is responsible for all drainage and storm water issues as provided
by Chapter 236 of the Town Code. The person responsible for this site must call in for all inspections listed
above.
Contact the Town of Southold Building Department at (631) 765-1802 to schedule your inspections. Please
have your building permit number ready.
4
m
Town Hall Annex ��� 1 Telephone(631)765-1802
Fax(631)765-9502
54375 Main Road
P. O. Box 1179w
Southold, NY 11971-0959 °
A 4,k
nG x
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED
WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION
Date:
Owner:
Location of Property. �� �4w "'b .........�
Please take otice that the (check applicable line):
New commercial or residential structure
Addition to existing commercial or residential structure
Rehabilitation to an existing commercial or residential structure
to be constructed or performed at the subject property reference above will utilize
(check applicable line):
Truss type construction (TT)
Pre-engineered wood construction (PW)
Timber construction (TC)
in the following location(s) (check applicable line):
Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof fra g (F
Signature: -�
Name (person submitting this fca
Capacity(check applicable line):
Owner
Owner representative
TrussRegl5.docx Effective 1/1/2015
Sc
ott A. Russell s�F � � F 0�][�l��l[WAX]EIK
SUPERVISOR JEMLENT
SOUTHOLD TOWN HALL-P.O.Box 1179 p 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town�n �o G{
h o G d
CHAPTER 236 - STORMWATER MANAG1WWb&ftffERRAL FORM
( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
APPLICANT: (Property Owner, Design P -ofessional, Agent, Contractor, Other)
NAME: Marco Sacchi Date:
�pE�rrt July 16, 2024
Contact Information: marcosacclii@verizon.net
(E-glad&Telephone Number)
Property Address / Location of Construction Site:
100 Arrowhead Lane S.C.T.M. #: 1000
District
Peconic,NY 11958
609-558-7757 98 2 2.1
- Section Block Lot
� TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
- Area of Disturbance is less than 1 Acre. No S.P.D.E.S. Permit is Required!
Project does Not Discharge to Waters of the State. No S P D E.S. Permit is Required !
I
- Area of Disturbance is Greater than 1 Acre&Storm-water Runoff Discharges Directly
to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit
DIRECTLY From N.Y.S. D.E.C.Prior to Issuance of a Buildin Permit.
Area of Disturbance is Greater than 1 Acre&Storm-water Runoff Flows Through Southold
Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN
a S.P.D.E.S. Permit through,the Southold Town Engineering De rtrnent,
Prior to Issuance of a Buildin : Perrrait.
Date:
Reviewed By. _.
�nRnn # cnnrp-Tnc nr•rnhar gin)a
A ( Ce :ved �� ��