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HomeMy WebLinkAbout34469-ZFORM NO. 4 TOWN OF SOL~fHOLD BUILDING DEP~RTS[ENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34655 Date: 04/20/09 THIS CERTIFIES that the building ADDITION Location of Property: 1540 TUCKER LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 59 Block 4 Lot 5.2 Subdivision Filed Map No. -- Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 25, 2009 purs,,~-t to which Building Pezmit No. 34469-Z dated MARCH 3, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION' TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN A & KATHLEEN D'ANGELO (OWNER) of the aforesaid building. SUFFOI=K CO~qTYDEPART~TOFHEALTHAPPROVAL E~t-r~ICAL u~KTIFICATH NO. I~LU~E~S C~KTIFICATION DA'r~U3 N/A N/A Rev. 1/81 2009 BLDG. TOWN OF SOUTHOLO Form No. 6 TO~I OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 [CATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following; For new building or new use: 1. Final survey of property with accurate location of all buildings, pr~pe~'y lines, slxeets, and unusual natural or topographic feature. Z 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 aolder nsed ia syst~ containn less than 2/10 of 1% lead. 5. Commercial building, industrial building, muitiple x~aldoncea andsimilar buildings and installations, a certificate of Code Compliance from architect or engineer responaible for thc building. 6. Submit Planning Board Approval of completed site plan requil~menta; B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sm-vey of property showing ali property lines, street~, building and.unusual natural or topographic ~l~ features. 2. A properly completed application and consent to inapect signed by the applicant. If a Certificate of Occupancy ~s denied, the Building Inspector shall state the reasons therefor in writing to the applicanL Co New Construction: Location of Property: House No. Owner or Owners of Property: ..'"~-"O'l~ Suffolk County Tax Map No 1000, Section Subdivision P¢ t No. Zqq Health Dept. Approval: Old or Pre-existing Building: Street Fees L Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Oecupancy 2 $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Oecupan?y - Residential $15.00, Commereial $15.00 / Date. 4/~ '~/t~ (check one) Hamlet Date of Permit.~ -~- Lot % Filed Map. Lot: Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary C~te Fee Submitted: $ ~ ~ Final Certificate: ~gnature . 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. 34469 Z Date MARCH 3, 2009 Permission is hereby granted to: JOHN A D'ANGELO 1540 TUCKERS LA SOUTHOLD,NY 11971 for : 12X24 REAR DECK ADDITION TO EXISTING SFD AS APPLIED FOR. at premises located at 1540 TUCKER LA SOUTHOLD County Tax Map No. 473889 Section 059 Block 0004 Lot No. 005.002 pursuant to application dated FEBRUARY 25, 2009 and approved by the Building Inspector to eX~ire on SEPTEMBER 3, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING ~"FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: FOUNDATION (1ST) FOUNDATION (2ND) ROUGHpLu1ViBI~GFRAMING & INSULATION PER N. Y. STATE ENERGY CODE __ ADDITIONAL COMMENTS SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved Disapproved a/c Expiration ,20 OC[ FEB 25 BLDG. DEP]', TOWN OF SOUTHOLD PERMIT NO. l/Er- BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Flood Pernfit Storm-Water Assessment Form Contact: Building Inspector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ,20 &~} 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 alter 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 re?~lations, and to admit authorized inspectors on premises and in building for necessary inspections. /,~ ~,~ .~'~ ,,,~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~0~t~ ~> I- )~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 be done: /5'40 TV c House Number Street Hamlet Block ~ County Tax Map No. 1000 Section _~ Lot ~'-t ~ Subdivision --t Filed Map No. Lot 2. State existing use and occupancy of premises a{ld intended use lind a. Existing use and occupancy 5r &~f {~ ~ % b. Intended use and occupancy ~La,ql. ti/// /'O-~.or- 3. Nature of work (check which applicable): New Building. Addition Repair Removal Demolition Other Work Estimated Cost ~~ Fee If dwelling, number of dwelling units If garage, number of cars occupancy of proposed construction: Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 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 . D..e~...t_h Heght Number of Stones ~j Dimensions of same structure with alterations or add tons Fr~cn-t-'~ _ _ ;i ' Rear Depth Height ....---"~ umber of Stor ~'.~1 ii 8. Dimensions of entire new construction: Front ~ Rear '~ 9. Size of lot: Front ~ Rear .Depth 10. Date of Purchase J Name of Former Owner 11. Zone or use~hich premises are situated ~--'x- '~(-~ 12. Does pro/lxfsed construction violate any zoning law, ordinance or regulation? YES __ NO 13. Will lot be re-graded? YES NO /Will excess fill be removed from premises? YES NO 14. Names of Owner of premises 1) [,~.tO~-e(o Address [¢4.C~ 'l'or.~..~-"¢.~ Phone No. Name of Architect ~_)/2 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 * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ufa 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 YORK) SS: COUNTY OF ) ~-~/--/-.- ~ ~-'(~,_- ~)~1.~/~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the t~~ (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 tree 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· Swum to before me this /~-: _ .-~ ~ c~O ~ day of l'"'~ 20 O 7-- /.-/~..~' ~J.~.-, - - .. ....... ry,abhc, St~te of New York ,¢' c.-' ... - ! / 1. /,. , ?qorary ruonc QualiN~..0.1T0~6.1.9.0.6_96 . ~gn u~.gr, e o[.~sppncant 8rl lU ~iUti'OIl( ~ourlly ~ ~ Comm~ssiorl Exp res July 28, 20 t TOWN OF SOUTHOLD PIIOPEilTY ~D CAI~ ~ OWNER STREET / ~' ~//0 VILLAGE DIST. SUB. LOT FORMER OWNER ~-~--~J-~ N E ACR., /-/ ),ES. ~-I ~ SEAS. VL ~ FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS ?~ o 2°° . ~A~ ,Y4,~,,z,~:~o~'"'"'-'-~--~'~'"~'~"~.~..~.,,~.,,,~- / 'ill,hie FRONTAGE ON WATER go~lond FRONTAGE ON ROAD Ae~dowl~d DEPTH ~ou~ Plat BULKH~D 'otol COLOR TRIM Extension Extension Extension Porch Porch Breezeway Garage Patio Oo Bo Total Foundation Basement Ext. Walls Fire Place Type Roof Recreation Room Dormer Beth Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Driveway Dinette LR. BR. FIN. B Tow:n o__f Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M.~. THE FOLLOWING ACTION8 MAY REQUIRE THE SUBMISSION OF A ~ D~I** dot don ,'o~ck ~'~'" 8TORM-WA,~"~ GRADING! DRAINAGE AND EROSION CONTROl. PLAN CroCi iriED BY A DE81GN ROFESSIONAL IN THE STATE OF NEW YOlk' Item Number:. (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yes No 1 2 Will this Project Retain All Sthrm-Watar Rur~.Off Generated by a Two (2") Inch Rainfall on Site? (This Eom will include all mn-off created by site ciesflng and/or construction activities as well as alt Site Improvements and the pewnanent creation of in~ surfaces.) Does the Site Plan and/or Survey Show Ail Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Cofltmlling Surface WatonClowi 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cub c Yards of Material within any Parcel? 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? 5 Is them a Natural Water Course Running through the Site? Is this Project within the Trustees urisdiction or within One Hundred (100') feet of a We land or Beach? 6 Will them be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Horizontal Distance? 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right-of-way? 8 9 Will this Project Require the Placement of Matedal; Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT Include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Bu ding Pemlltl EXEMPTIONt Yes - No Does this project meet the minimum standards for classification as an Agdcuiturel Project? / Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl -- STATE OF NEW YORK, COUNTY OF ........................................... SS That I,~~....~ ............. being duly slqorn, deposes and says that he/she is the applicant for Permit, (Name of individual signing Dccumenl) And that he/she is the ........ ~... . ... (O~mer, Ccntra~toq Agent. Corp~ate Officer. etc.) Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have perforated the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ............... .................. dayo,....C<&.. " ......................... Notary Public.-~..~.......~..~...-.~..~lN.r~..fl2,~l'~fl6fl6.modm ~ffolk County ..... b. "' ' '": ................................ uomm~ssion £x~ires July 28, _~ / FORM - 06/07 EXISTING BOW WINDOW EXIDTING GRADE EXISTING EXIDTING GRADE ffront Deck Section 5cale:~:' = IllOll EXISTING REDIDIENCE Deck ffoundatlon Plan Scale: 74I' = I'~Oll RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE, ~XIDTING RESIDENCE 5/4 Deckln~ Deck Section ALL CONSTRUCTION SHALl. MEET THE REQUIREMENTS OF THE CODES OF NEW Y'OF~K STATE, OCCUPANCYOR USEIS UNLAWFUL WITHOUT CERTIFI( OFOCCUPANCY AP, PROVED AS 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR pOURED cONCRETE 2. ROUGH - FRAMING & PLUMStNG 3, iNSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR CO. ALL CONSTRUCTION SRALL MEET THE REQUIREMENTS OF THE cOOES OF NEW yORK STATE, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. ~Deck Plan Scale:/4" = I'-O" G' 5hder P~ISTING DECK Ex~stmg Deck Plan NYLIC. 031085-1 PA LIC. 9859-X PERMIT SET: Proposed New Deck A-1 Nd 8L'qO:gL 6018 L/g- L qD~ct q~Y/IDIQ--H-~IO0~