HomeMy WebLinkAbout29363-Z FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 29363 Z Date MAY 5 , 2003
+
Permission is hereby granted to: O� �
MARY P FURLONG
1745 NAKOMIS ROAD
SOUTHOLD,NY 11971
for
PORCH ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR
at premises located at 1745 NOKOMIS RD SOUTHOLD
County Tax Map No. 473889 Section 078 Block 0003 Lot No. 035
pursuant to application dated MAY 5, 2003 and approved by the
Building Inspector to expire on NOVEMBER 5, 2004 .
Fee $ 150 . 00
Au q' ' zed Signature
ORIGINAL
Rev. 5/8/02
FIELD INSPECTION REPORT DATE CONIlYIENTS
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FOUNDATION(1ST) y
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INSULATION PER N.Y.
STATE ENERGY CODE
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FINAL
ADDITIONAL CONIlIZEN'TS
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Town Hall,53095 Main Road Fax(631)765-9502
P.O. Box 1179 G Q Telephone(631)765-1802
Southold,New York 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
February 22"d 2007
Richard Hokanson
1635 Nokomis Road
Southold,N.Y. 11971
RE: 1745 Nokomis Rd. (porch addition) 2nd NOTICE
SCTM: 78 3 35
Dear Mr. Hokanson,
Please be advised that your Building Permit#29363 issued May 5th, 2003 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit, please submit a fee of$150.00 at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
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Town Hall,53095 Main Road Fax(631)765-9502
P.O.Box 1179 G Q Telephone(631)765-1802
Southold,New York 11971-0959 • �O
olyooum
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 8th, 2006
Richard M. Hokanson
1635 Nokomis Rd.
Southold, NY 11971
RE: 1745 Nokomis Rd.
S.C.T.M. # 078 0003 035
Dear Mr. Hokanson,
Please be advised that your Building Permit#29363 issued May 5th, 2003 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit, please submit a fee of$150.00 at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
EXISTING HOUSE I S6g fi
NEW PORCH CONSTRUCTION
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ADAPTED FROM SURVEY FOR SCALE 1" = 20'
MARY P. FURLONG TAX MAP NO. 1000-78-3-35
1745 NOKOMIS ROAD
BY RODERICK VAN TUYL, P.C. SOUTHOLD, NY 11971
DATED SEPT 28, 1992
SEE ATTACHED
r� MAP OF PROPERTY .
<� SURVEYED FOQ
MARY P FURLONG
io.0 SOUT0
QOW OF CEOAM oN u-rt 0 TOWN OF SOUTHOLD, N.Y.
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MONUMENT
1b00g e ;`, ' AREA-12,650 S,F.(0.29K.)
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'3L1FF CO TAX MAP DATA IJ00-78.9 �5 AS IUV1L,ID
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL 51 Board of Health
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. �� 3 \►Check )Sr ==r
Septic Form
N.Y.S.D.E.C.
� Trustees
Examined ' 20 Contact:
Approved 20 Mail to:
Disapproved a/c
Phone:�d
Expiration 20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date 0S; U5 , 20 G:S
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
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.
(Sign ture of applicant or name,if a co ration)
I14S ttA �t5 2I7 R5 II )7
(Mailing address of applicant)
�ic�c.�r►k�:r>,o q 11q-11
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
l'Sy1 Irl
Name of owner of premises N t9 R �] F(4 R IV C—
(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 e done:
5 rV,-1 k� nA
House Number Street Hamlet
County Tax Map No. 1000 Section 1 Block -3 Lot .3�
Subdivision L._--t W(.r H I NG-- VJ A T 1= r S Filed Map No. Lot
(Name)
2. State existing use and occupancy of premi es and intended use and occupancy of proposed construction:
a. Existing use and occupancy C_ IV
b. Intended use and occupancy ��ES I p E I\/CF
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost L40.0o Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units J Number of dwelling units on each floor
If garage, number of cars :�;L
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front '- + Rear Icc ' -O = Depth 241-60 ��
Height ��1 -��' Number of Stories
Dimensions of same structure with alterations or additions: Front '-61i-C7" _Rear
Depth 32 i-(o Height `�Y ' Number of Stories
8. Dimensions of entire new construction: Front 2L!A Rear Depth
Height 1:5- -1 Number of Stories
9. Size of lot: Front Jr-- Rear Depth
10. Date of Purchase l 0—l 5 ` Name of Former Owner /))CL %A10
%11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V
13. Will lot be re-graded? YES NO✓ Will excess fill be removed from premises? YES NO
14.Names of Owner of premises MAS J�U2UJ>`IGj Address 11,P
�5 !.,��hone No.
Name of Architect CAPS. CgcAr- Address gyjA_ L. wj. ,i✓Z Phone No4-1"1.o4cx)
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO t,�
* 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.
STATE OF NEW YORK)
SS:
COUNTY OF )
!M�l P- ( �' G being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the O 6j IV4—
(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
day of 2003
Notary Public Signature 6f Applicant
r
LINDA J.C :yk:I F<�
(Votary Pubic,State of New YorL
BUILDING PERMIT EXAMINER CHECK LIST
DATE REVIEWED: 5 /5-/03
APPLICANT: y DATE SUBMITTED: ,
SCTM# /03
DISTRICT: 1,000, SECTION: ��, BLOCK: _',Z, LOT: -�n SUBDIVISION: VJJA
ADDRESS: Ja+ NjS CITY: 6U7}101,D ZONING DISTRICT: CONFORMING? AIo
BUILDING PERMITS OPEN/EXPIRED:
BP -Z/ C/0 Z- INFO /BP -Z/ C/0 Z- INFO
BP -Z/C/0 Z- INFO /BP -Z/C/0 Z- INFO
PRE CO: Y OR N BP -Z/ C/o Z- ,
SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconfonning at any time after 7/1/F
REQ. LOT SIZE: ACT. LOT SIZE: /"C'Z- REQ. LOT COV. 2 D� ACT. LOT COV. 13°0
REQ. FRONT 3f PROP. FRONT X6.5 REQ SIDE j� ACT. SIDE
Q• BAR f PROP. REAR REQ. ryHGHT PROP. HEIGHT
PROJECT DESCRIPTION
ESTIMATED PROJECT COST: IL ARCHITEC • l vnoww FAST TRACK N
WATER FRONT? WO DESCRIPTION:
PANEL #: 6 FLOOD ZONE: , COMPLIANCE:
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES or 0(BED #): DTE: / / PERMIT #:
TOWN SEPTIC RECEIPT: Y oro
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or I®
SOUTHOLD TOWN TRUSTEES: YESor
TOWN ZONING BOARD APPROVAL: YES or
TOWN PLAN. BOARD APPROVAL: YES or
TOWN HISTORICAL PRE (SPLIA): YES or O
NEW YORK STATE CODE COMPLIANCE (SEE PAGE' or NO
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
1. _SF)- ( SF)= SF X $
2. (_SF)- ( SF)= SF X $
3. (_SF)- CSF)= SFX $
FINAL TOTAL: $
NEW YORK STATE CODE COMPLIANCE CHECKLIST
USE/OCCUPANCY CLASSIFICATION: P S Qe �
HEIGHT/FIRE AREA: I ���' ✓ k-� • ,/
TYPE OF CONSTRUCTION:
DESIG CRITERIA: ENGINEERED l9Rs' SRL wFcl�1
L FRAMING DES EMENTS:
HEADERS: WALL STUDS: Y/N /
GIRDERS: YCEILING JOISTS: Y/N
S. ✓/
FLOOR JOISTN ROO TERS: Y/N /
LUMBER SPECIES AND GRADE:%Y�
DESIGN LOAD CALCULATIONS: Y/N.'e�
SHOULD INCLUDE LIVE,DEAD,SNOW,SEISMIC AND WIND(INCLUDING UPLIFT AND EXPOSURE)
WIND AND DOOR SCHEDULE:
MIS SLE TEST REQUIREMENTS: Y/N tv 14
XGRESS, LIGHT, VENT: Y/N
APATHS: Y/N
ROOF TO FOUNDATION
NAILING/CONSTRUCTION SCEDULE: /N
MEANS OF EGRESS: Y/N
PLUMB INGRI ER DIAGRAM: Y/N /�A
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N Al 4
TRUSS DESIGN: YZ
CERTIFICATION: Y /
ENERGY CALCS: Y/N ! tj A'
TOTAL COMPLIENCE'I N(RETURN TO PAGE ONE)