HomeMy WebLinkAbout51356-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#: 51356 Date: 11/04/2024
Permission is hereby granted to:
Marco Sacchi
19 Greenview Ave
Princeton, NJ 08542
To:
Construct accessory pool cabana as applied for,with SCHD approval.
*Construction of dwelling and pool must commence priorto construction of cabana.
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:
Fees:
CO Accessory Structure $100.00
Accessory-New Structure $366.50
Total 466.50
� �� Building Inspector
0 f"4'N
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 iLttp.,s,�/wWW,.,southoldtowiLny ,ov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only %
PERMIT NO. �� Building lnspector:_.-
A P/Ppmp 0! M AY 2 2 4
a6�1,forms mu
st I
'-apolkitl6ns Will not acceptedApplicant is� *t' %imeri an
z'atil 6-6'forMi (Page 2)ihaii/Itt 1 6d, e comp et
Date:
qwNfR(S)OF PROPERTY.,
Name: 00-
'A4AR sk(cWS01i
Project Address: to() )4RqUW k:swb F- COIJ lis
Phone#: 609 SS2 Email: N 0, C,0 S 0_GC - o
Mailing Address: �ttJc2
CONTACT PERSON:
Name: 9 J�" S
Mailing Address: l[J ORSLP
Phone#: 601 SSA 3?-�?- Email:-
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: i0-0 Vou-T� ?>WOAZ,`CI} SUITF- « U)'ArLL
Phone#: '??j2- '+6 1 919 2- Email: WWUI' L6&A L
CONTRACTOR INFORMATION:
Name: Kb H r
Mailing Address: -W Pori 4,-,, k Pj !l klva /4 ALK Iq
Phone#: 'i Email�
(6 3 1 - 4,66- cvi i ' 76 //o,-
DESCRIPTION OF PROPOSED CONSTRUCTION
XNew Structure ElAddition ElAlteration DRepair DDernolition Est'T JJC sitofProject:
E1Other
Will the lot be re-graded? OYes XINo Will excess fill be removed from premises? DYes ONO
7, PROPERTY INFORMATION
Existing use of property: intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
4 ® this property? ❑YesXNo IF YES, PROVIDE A COPY.
❑ Check,Box After Reading. The owner/contractor/design professional is responsible for all drainage and storm'water issues as provided by
chapter i;Ib,of the Town Cope.-APPLICATIQN IS HER EBY`MA,DE to the`Building Department for this lssuan�e of a Building Permlt pursuant to the Building tone
Ordinance of the Town;of Southold,Suf#olk,County;New York and other applicable Laws,ordinances or Regulations,for the cgnstruction:of buildings,
additions,alterations odor removal dr demoiition as herein described.The applicant agrees to comply with all applicable laws;ordinances;building code,
housing code and regulations and,to admlf authorized inspectors on premises and trr boilding(s�for necessary lnspittions.False stafernents rtaade herelnare
punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law,
Application Submitted By(print name): CC,(k( ❑Authorized Agent A�wner
Signature of Applicant: Date: 5- ►(o—,29
STATE OF NEW YORK)
SS:
COUNTY OF f-
Q YC-0 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
day of a _ , 201)LL
tart'Public
TRACEY L. DWYER
PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
(Where the applicant is not the owner) QUALIFIED IN SUFFOLK COUNI-
COMMISSION EXPIRES JUNE 30,20ik
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
0.
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
0 Telephone (631) 765-1802 Fax (631) 765-9502 t1ps:// yw. outhoidto)ynn oy
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"
ADDITIONAL DOCUMENTATION MAY BE REQUIRED AS IDENTIFIED BELOW:
❑Suffolk County Department of Health Services Approval (original copy)
❑Approval of the Zoning Board of Appeals, Planning Board, and/or Historic Preservation Commission
(if applicable)
DElectrical Permit Application (FILED SEPERATELY): Electrician must have an active license with Suffolk
County
El 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 fresh water wetland
❑1 copy of ComCheck/ ResCheck (if applicable)
❑1 copy of Manual J, Manual D and Manual S (if applicable)
❑Utilization of truss re-en ineered wood timber construction form (if applicable)
❑Single and separate title search (if applicable)
❑Curb cut permit (NYS or Suffolk County form 23F) (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 11971-0959
Telephone 631 765-1802 Fax (631) 765-9502 htt ash ,//wr Kw.sotithpidtowji.�ily. ov
A�4v
INSPECTION &CERTIFICATE 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
Town Hall Annex
5475 Alain Road w,
P. 0• Box 1179 Telephone(631)765-1802
,°
Southold, NY 11971-0959 Fax(631) 765-9502
BUILDING DEPARTMENT
NT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION
PRE-
WOOD CONSTRUCTION AND/OR TIIIIISE�R CONSTRUCTION ENGIIV EREIJ
Date: �� I
Owner: ►�J�C� S —�Z—�—I
Location of P
roperty: tCd kpow t+�
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
(check applicable line): ve will utilize
Truss type construction (TT)
Pre-engineered wood cons
truction (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 . 9 (F
Signature:
Name (person submitting nW �-.-_..._._....._,w_...�.�.�...�_�
g this fo ): .�,. . .�.��'��C_c3 Sd�l�
Capacity(check applicable line): ---
_._.. Owner
Owner representative
TrussReg15.docx
Effective 1/1/2015