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HomeMy WebLinkAbout34681-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33764 I~te: 06/09/09 THIS CERTIFIES that the building DECK ADDITION Location of Property: 5050 NASSAU POINT RD (HOUSE NO.) County Taxx Map No. 473889 Section 111 subdivision CUTCHOGUE (STREET) (HAMLET) Block 8 Lot 14 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FLaY 7, 2009 pursuant to which Building PeIT~it No. 34681-Z dated MAY 13, 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 FANILY DWELLING AS APPLIED FOR. The certificate is issued to ARTHUR & BRYANT BROWNE ( OWNER ) of the aforesaid building. SUFFOLK CO[~TY DEP~R~ OF ~/~TH APPROV~J~ En~t-rRIC~%L CERTIFICA~ NO. PLIERS CERTIFICATION DATED N/A N/A N/A Ah~rize~ Rev. 1/81 BUILDING DE~'ARTMENT TOWN HALL d 765-1802 APPLICATION FOR CERTIFICATE OFOCCUPi qCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, aud unusual natural or topographic features. 2. Final Apprnval from Health Dept. o f 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 solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Cmnpliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. 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. Photocopy of Certificate of Occupancy - $ 0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Cormnercial $15.00 New Construction: Location of Property: '~-0 ~-~ House No. Date. Old or Pre-existiug Building: Street (check one) Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision PemfitNo. ~ff~ ~ Health Dept. Approval: Date of Perufit. Block O~ Filed Map. Applicant: Underwriters Approval: Lot Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicja/nt Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34681 Z Date MAY 13, 2009 Permission is hereby granted to: ARTHUR & BRYANT BROWNE 11 ROSEDALE RD WEST HARTFORD,CT 06107 for : CONSTRUCTION DECK ADDITION TO EXISTING DECK ON SFD PER APPROVED PLANS AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 111 pursuant to application dated MAY Building Inspector to exlmire on NOVEMBER 5050 NASSAU POINT RD CUTCHOGUE Block 0008 Lot No. 014 7, 2009 and approved by the 13, 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: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-18O2 INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG.  [ ]INSULATION [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI~,-;.ATION REMARKS: DATE FIELD INSPECTION REPORT ] DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) PL~G INS~ATION PER N. Y. STATE E~RGY CODE ~DITION~ CO~ENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT T(CWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. Examined Approved / · % Disapproved aJc ,20 ~ Expiration / / ' , 20 a. This BLDG. DEPT. ,pl icat i nnT{13~l~qS q~ ~ .~_~ ! c:z !5' ,~ Building Inspector 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 Permit Storm-Water Assessment Form Contact: ,20 _ Mail to: Phone: rlON FOR BUILDING PERMIT INSTRUCTIONS Date 5/7 ',ed 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. (Sign/(ture of applicant or n~i~ne, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises /~, .~f3Q/l~-~ (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. Location of land on which proposed woL,k will be House Number Street County Tax Map No. 1000 Section ~ l/{Block¢ Subdivision '~Iamlet Lot Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ~:_~ i 0 C-~q'-t M (_ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ,.~) ~0 O- 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. e,o,,,,o o structures, ~f any: t Depth Height ... Number of Stories D~m~n~io~o~r"~ with alterationslo'r~a'd~itions~70~t Rear Depth ~ Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front Rear _Depth 10. Date of Purchase i (~ (~7 Name of Former Owner l l. Zone or use district in which premises are situated ~ 1,_,~'d~/3 (f 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO~ 13. Will lot be re-graded? YES NONNN, Will excess fill be removed from premises? YES"N NO__ 14. Names of Owner of premises'/~IT'~t4U~/.' _~r~ltJ~-Address Phone No. Name of Architect ~'{Lf.f) I~I"~I')~D5~'~ , ~ , Address Phone No Name of Contractor~2k~P~(TJ~/vx ~47,,Ai~.C~ ¢k Addres~ Phone No, ~'~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO '"X * 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. 18. Are there any covenants and restrictions with respect to this property? * YES__ N0"~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) ,~ - SS: COUNTY tlf'f'0 I(_ ) ~1.[,'~(_,~ ~f~16"} ~']"V~I being duly swom, deposes and says that (s)he is the applicant (Name of indi4idual sighing c0n~ra-ct) alive 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 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. Sworn to before me this "~ota~ Public ~ .o~ae/~.b~§£6~j~ 17 Signature of Applicant / DRAWN BY [4<,,, FILE NO. __~>~.~,.~,.~ ~'~,' 19 ~-7 BY VVlt-LIA~ ~. SIMMONS III, L$.P.o. 11 MEROKE LANE EAST ISLIP, El., N.Y. 11730 (516) 581-1688 Fax: (516) 581-1691 PAGE GR~D · DI~AWN BY OWNER FORMER OWNER TOWN OF SOUTHOLD STREET N P~'iOPERTY RECORD CARD VILLAGE E DISTRICT ACREAGE SUB. LOT/y 7 ?' RES.~ :10 SEAS. VL. COMM. J IND. CB. MISC. Est. Mkt. Value LAND IMP. REMARKS ~ AGE NEW Farm NORA4AL ABOVE Value FARM TOTAL DATE //~, ~:r .-/ ~ ~ ~o/a/~ BUILDING CONDITIOi~ BELOW Value Per Acre FRONTAGE ON WATER FRONTAGE ON ROAD ~., ? Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushlandv House Plot Tota I M. Bide Foundation Bath ExtensionEXtensi°n ,/~f':.~ ~'~.¥~ ~2,. (,~ic(~) ' ~/"~'~';~'~- ~'~ ~1~1 [~EXt'Fire WallSplace ~-[~,'~ ~ ~ ~c_ J~?' ' Heatlnteri°r ~,.~.Finish ,~- ~ ,/~- ~ ~ ~ ~ ,~ ~ ~ L I Porch Roof Type . , ., ,I =~ /~/~/ Porch ~Rooms 1st Floor ' ] ~- . j Rooms 2nd Floor B,e.zeww / V ~ ~ ~.~, P~o Gar~ ~ ,~ / /f :-~'/~ /~ ~ Driveway ~ Dormer ~ ,~= t I Town Of Southol d Erosion, Sed;mentation & Storm-Water Run-off A$- =SSMENT FOR . PROPERTY LOCATION: S.C.T.M. #: District Section Block ' THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF ~_ STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL pLAH CEK I triED ny A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK, Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Ra nfall on Site? Yes No (This item will inclede all mn-off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow! 3 Wilt this Project Require any Land Filling, Grading or Excavation where there isa change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal 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 there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (1 Off) feet of a Wetland or Beach? 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise to One Hundred (100')of Hodzonta 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 Will this Project Require the Placement of Material; Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shou der Area? (This item will NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Wa ercourse? 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 Building PermRI EXEMPTION~ -- Ye~s N~o Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to thts Question, a Storm.Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl ..~ -- STATE OF NEar YORK, _ That I /4¢./../~....C...~..~.?..~:L.?..~?~. ............................. being duly sworn, deposes anti says that he/she is tim applicant for Pennit, (Name of individual signing Document} OaNIE D ~UNCH And that he/she is the .............................................. N0tary~ub c.$tate of New Yogi ........................................ ~c~.'0't 8U6~8~051~ ................. (Owner, Co~iractor. Agenl. Corporate Officer. etc~! Qualified in Suffolk Ceunb/ I~, Owner and/or representative of the Owner of Owner's an make and fil~ "-' ,. . . ,, ,, ,, .,~ ,~,~,y auu,onzeo to pertoriff'or' liaYe p~!rlO?n~d ill/: s,~iWwork and to C: tills appucaQon; Ulat all statements contained in this app cation are tree to lhe 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; FORM - 06/07 ? / ~ ~ D~=C.4,<.. ,, , ~ ~ ~- ~ ) II RETAIN STORM ~ATE~ ~UNOFF PURSUANl TO CHAP~E~ 236 s~M ~: OF THE TOWN GODE.~~ :F~ ~= ...... 765-!~:,:2 3 , , : FOLLO',,% Ct, , :::=4, FOR POURED 2, ROUGH - FR,t?,;L,~ & P~L 5JNG ~ULA'FION ~L - CO~:%T~UOTrON MUST ~ COMPLETE FOR C,O. ~ CONSTRUCTION SHALL MEET THE ~QI'~"-(-.~ i. REQUIREMENTS OF THE CODES OF NEW ... YORK STATE. ~NOT PJ:~nN~BLE FOR T~ ~ ~-T-~pp,¢~, N^" ' f',; c' ' ..... ' t(.