Loading...
HomeMy WebLinkAbout34841-ZFORM NO. 4 TOWqq OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34048 ~te: 10/18/09 THIS c~KTIFIES that the building DECK ADDITION I~)cation of Pr~rt¥: 725 SCHOOLHOUSE RD (HOUSE NO.) County Tax ~ap No. 473889 Section 102 Subdivision CUTCHOGUE (STREET) (HAMLET) Block 1 I~Dt 25 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JWJNE 29, 2009 pursuant to which Building Permit No. 34841-Z dated JULY 8, 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. · ~ne certificate is issued to MICH3%EL & KELLY EIrERS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEP~RT~NT OF HEALTH AP~RO%rAL ELECTRIC~J~ c~KTIFICATH NO. RL~{B~RS u~KTIFICATION N/A ~/A N/A z~d Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with tl A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unu,~ topographic features. 2. 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 solder used in system contains less than 2/10 5. ~1 n ltura[ ~r Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit planmng Board Approval of completed site plan requirements. 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 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. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: ,O e ct<. HOuse No. Old or Pre-existing Building: Street Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. Date of Permit. 7/~>/t9 ~ (check one) Hamlet Block Filed Map. Lot: Applicant: Underwriters Approval: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~_~ --' Final Certificate: (check one) Applicant Signature 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. 34841 Z Date JULY 8, 2009 Permission is hereby granted to: for : MICHAEL & KELLY EVERS PO BOX 274 CUTCHOGUE,NY 11935 CONSTRUCT DECK ADDITION TO REAR OF EXISTING SFD PER APPROVED PLANS AS APPLIED FOR at premises located at 725 County Tax Map No. 473889 Section 102 pursuant to application dated JUNE Building Inspector to expire on JANUARY SCHOOLHOUSE RD CUTCHOGUE Block 0001 Lot No. 025 29, 2009 and approved by the 8, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONS[RUC' [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOU~D~ION 1ST [ ] ROUGH PLBG. ].~00NDATION 2ND [ ] INSULATION FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION REMARKS: '~ ~- [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ~'I~AL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEk,-..ATION REMARKS: ~.~ ~]=C'no~T [, DA~ ' C(~S ROUG~ ~G & PL~G ~ q ~S~A~ON P~ N. Y. STATE E~R~ CODE ~DITION~ COUNTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~o SOUTHOLD, NY 11971 ~ TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFo rk.net Examined ;] [ (~* ,20 L'~-[ Approved ,20 ;;I Disapproved a/c Expiration _ 'tOWN OF SOUTH~L,p, ~o ~, ,,, ~ a. This appllcadun l,,. ..... _~2 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health N. d 4 sets of Building Plans Planning Board approval ) Survey. Check ~'~. C~C) ,iD t~ Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Pho.e Oq' 'h Building Inspector PPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,2ooq ~pletely 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 pan 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. (Signature of applicant or name, if a corporation) (Mailing address of apl2Oicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises [v~ i dh 0~e[ ~xc[ I(~ it~ E V't('~ (As on the tax roll o.J 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 whichproposed work w~lye done: 7 2 5 ,Scl e lho Se' .. House Number Street Hamlef, d County Tax Map No. 1000 Section } O~,,, Block Subdivision Filed Map No. Lot Lot State existing use and occupancy of premises and intended use and occupancy of ¢~u'~)sed construction: a. Existing use and occupancy ~ ~. Intended use and occupancy b e C ~'/~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work Fee (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 Height Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height. Dimensions of entire new construction: Front ~ ~ / Depth Height Number of Stories 9. Size of lot: Front Rear Depth Rbar Number of StOries Rear 0epth j 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed 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 Name of Architect Name of Contractor Address Phone No. Address Phone No 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 RE~IRED. b. Is this property within 300 feet of a tidal wetland? * YES NO. [-t IF YES, D.E.C. PERMITS MAY BE REQUIRED. 7' 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) COUNTY · ' '(Na~t~ of individual (S)He is the CONNIE D. BUNCH Notary Public, State of New Yom No. 01BU6185050 Qualified n Suffolk County [;omm ssion Expires A0ril 1.4.20 being duly sworn, deposes and says that (s)he is the applicant signing contract) above named, (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 perforated in the manner set forth in the application filed therewith. Sxvorn to before me this ' ~;,~C~'nq-3 dayof c~r',-~ 200~ Notary Public Signature of Applicant F~ N 46' 57' 30" E N/'F GPA TTAN 100.0' N/F ~ McCAFF"~RTY 1 STORY .... "" WOOD FRAME RESIDENCE CONC. STOOP emcK .-~ CHIMN~ Y 26. 7' S 46' 57' 30" W SCHOOL HOUSE DIA GUN TIE= 351.70' 100.0' ROAD TAX MAP NO. 1000-102-01-25 SURVEY OF DESCRIBED PROPERTY SURVEYED 08 DECEMBER, 2000 SITUATE SCALE 1"=20' CUTCHOGUE, TOWN OF SOUTHOLD AREA= ~5,000 SF SUFFOLK COUNTY, N.Y. oR 0..744 ACRES SURVEYED FOR : MICHAEL A. EVERS SURVEYED BY GUARANTEED TO MICHAEL A. EVERS SAFE HARBOR TITLE AGENCY, LTD. FIRST AMERICAN TITLE INS. CO., OF NY SUFFOLK COUNTY FEDERAL CREDIT UNION STANLEY J. ISAKSEN, JR. P.O. BOX NEW ~UFFOLK, NY 11956 NYS LIC. NO. 49£?..~ 00R970 TOWN OF SOUTHOLD PROPERTY RECORD CARD J OWNER STREET '7 ~" VILLAGE DIST. SUB. LOT ' , ~' C,:/) ACR. j~ ~E~. Z/O SEAS. VL. FARM COm. CB. MICK MkL Val~e LAND IMP. TOTAL DATE REMARKS o/7/7 '' ' AGE BUILDING CONDITION NEW NOR~L BELOW ABOVE FA~ Acre Value Per Value Acre Tillable FRONTAGE ON WATER Wo~land FRONTAGE ON ROAD / ~ ~ ~ ~ ~ ~. O 0 ~ ~ g g Meadowland DEPTH / y ~ ~ ~, BULKH~D Hous~ ~ ~ Total D~K COLOR TRIM M. Bldg. Exter~ion Extension Extension Porch Porch Breezeway Garage Patio Oo Bo Total Foundation Basement Ext. Walls jFire Place JType Roof l RecreatiOn Room Dormer Bath Floors ln~erlbrF~hish Heat Rooms ]st Floor Rooms 2nd Floor Driveway Dinette LR. DR. BR. FIN. B Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C,T.M. #: THE FOLLOWING ACTION8 MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING; DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (~') for each Question is Required for a Complete Application) Yes No 1 2 3 4 5 6 7 8 9 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") inch Rainfall on Site? (This item will include all mn-off created by site cleadng and/or construction activitias as well as all Site Improvements and the permanent creation of iml~rviees surfacas.) 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 WaterFIowl Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Mateital within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trastees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15} feet of Vertical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-WaIer Run-Off inio and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Mateital, 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 Building Permitl EXEMPTION: Does this project meet the minimum standards for classification as an Agitcutiural Project? Note: If You Answered Yes to this Question. a Stom~,Water. Grading, Drainage & Erosion Control Plan is NOT Requlredl Yes No r^xE oF NEw .... c0,,,E u. co w oF ss ........................................ No, O1BU61~50 (Name of individual s~n~g D~ment) (~er, Con~, Agent, C~e ~, etc.) O~er ~n~o~ rCp~en~ve o[ ~ ~ner of O~er's, ~d is duly au~o~Jz¢d ~o ~dorm or h=ve pc~ormed ~ s~d work ~d to · ~t ~ work ~1] ~ pe~o~e~ in ~ m~nCr set [o~ in ~ appli~don ~led here~, Sworn to before me this; .... ...~.....~....~ ....................... day o f .....~......tx~_.~ ................... 9~0...0.. CI (Signature of Applicant) FORM - 06/07 .] A OCCUPANCY USE IS UNLA/~ WITHOUT CF ', ,F!CATE OF OCCUPANCY RETAIN STORM WATER RUNOFF PURSUANT TO CNAPTER 236 F THE TOWN CODE, ALL cONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW N~OP, K STATE. APPROVED AS NOTED NOTIFY BU]LBIt '~ DEPARTMENT AT 765-1802 8AM ~0 4PM FORTHE FOLLOWING iNSPECTIONS' 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3, iNSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS.