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HomeMy WebLinkAbout35371-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Mall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34362 I~mte: 05/21/10 T~I$ CERTIFIES that the building DECK ADDITION Location of Property: 2300 MAPLE LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) Country Tax Map No. 473889 Section 38 Block 9 LOt $%~bdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 24, 2010 purser to which Building Permit No. 35371-Z dated MARCH 5, 2010 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 BRIAN K KAVANAGH (OWNER) of the aforesaid building. EI~u-l'~If3~L ~TIFICA~I~ NO. PLIERS CERTIFICATION DATED N/A N/A N/A ~A/th°rze~d~gnature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~ I,,t ,'~v ?? 3 BLDG DEPT. TOWN OF SOUTHOLO 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: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical iustallation fi~om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1°,4 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning 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: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. "~) A/ ~l'/~o ' . . 2. A proporly completed application and consent to ~nspect s~gned by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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: '- Old or Pre-existing Building: House No. Street Date. (check one) Hamlet OWner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~,Jf3 7 / Health Dept. Approval: Lot Filed Map. Lot: Underwriters Approval: Date of Permit. ~ -~----/O Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ;°~ a,~ ~,, ~ Final Certificate: (check one) A~'] (earn t Signaturcl~__ 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. 35371 Z Date M3%RCH 5, 2010 Permission is hereby granted to: BRIAN K KAVANAGH 2300 MAPLE LA GREENPORT,NY 11944 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 038 pursuant to application dated FEBRUARY Building Inspector to expire on SEPTEMBER 2300 MAPLE LA GREENPORT Block 0009 Lot No. 001.002 24, 2010 and approved by the 5, 2011. Fee $ 200.00 ~ Authori~e~[ Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~FOUNDATION 1ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION REMARKS: ,~~.~) [ ] ROUGH PLBG. [ ] INS~ATION [ ~'~NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION TOWN OF SOUTHOI BUILDING DEPART] TOWN HALL SOUTHOLD, NY 119' TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.Northg FEB 24 2010 BLDG. DEPT. ~rk.net lOW~Elll~h'~NO. Examined '~[~' ,20/O Approved 5J ~ ,201D Disapproved a/c Expiration 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: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20,/0 a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 seis ~>f 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 ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,(--'~igna~ure of apl~li~a corporation) (Mailing address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner ofpremises .~,/~[ ,,~4/ /k/ ,/%-/~)t/'jOA/~.- ~/ (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. 9 Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed House Number Street work will be done: HamleI Block 0 ~ Filed Map No. County Tax Map No. 1000 Section Lot /. ~ Subdivision Lot 2. State existing use and occupancy of premises an.d intend~d'.use and occupancy of proposed a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Repair Removal Demolition Other Work 4. Estimated Cost . ~- Fee 5. If dwelling, number of dwelling units If garage, number of cars 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. Dimensions of existing structures, if any: Front Height ~O r Number of Stories Rear ~ 5-, V Depth Rear /~ Depth Dimensions of same structure with alterations or additions: Front Depth -~ - ~ Height --~o "' Number of Stories Dimensions of entire new construction: Front /W Height c~ ' Number of Stories Size of lot: Front r~2ff'ff-- Rear ,,~ Fo O. O0 10. Date of Purchase ~,0190 Name of Former Owner 11. Zone or use district in which premises are situated ~ ~. .Depth fl ooC' 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 f'~tt,~t/X/,q~/,eltv,t~kddress ,;2,~Or_.)"'P//~'~(~ ~ Phone No. q77 NameofArchitect ,j~rnex' /¢ /~,c~}p~'r~ Address 'To_C-t~'~g/-gt~.~/- PhoneNo 4,'77-0/crC4z 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 of a tidal wetland? * YES NO /t~ * 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 'x/c/ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is tbe i,iotaty Public, State ot IXie¢, ., b~n. 018UG185050 (Contractor, Agent, Corporate Officer, etc.) 0ualified h~ Sufff){}~ 0e,,t,,,' ' of said owner or owners, and is duly authorized to perform or have pertbrmed 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_ 2)q4 o dayof ~-~3~ JX.~Ot,C~L 20/(') Notary Public ~ - ~ignatur~o~Ap~lp icant . To w.n o_ f Southold Erosion, Sedimentation & Storm-Water Ru.-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M.~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A //~ '~o~' ~/~ //. d'~ 8TORM-WATERf GRADING, DRAINAGE AND EROSION CONTROL PLAN ~ ~ BIo~4 Lot C~-~¥i~iED BY A DESIGN PROFE881ONAL IN THE STATE OF HEW YORK. Item Number: (NOTE: A Chank Mark (~) for each Question is Requirod for a Complete Appfication) Yes No 1 2 3 4 5 6 7 8 9 Will this Pmjecl Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall oe Site? (This item will include ell run-off created by site clearing and/or constmctioe activities as well as all Site Improvements and the permanent creatio~ of impervious surfaces.) 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 WatanClowl Will this Pi'ojest Require any Land Filling, Grading or Excavation where there Is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? Witi this Application Require Land Disturbing Activities Encompassing an Area in Excess of F'we Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees 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 Ver'dcal PJse to One Hundred (100') of Horizontal Distance? Will Driveways, Paddng Areas or other Impervious Surfaces be Sloped to Direct Stom~Water Run-Off into and/or in the direction of a Town right-of-way? 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 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 he Submitted for Review PHor to Issuance of Any Building Permlfl EXEMPTION: Does this project meet the mlaimum standards for classification as an Agricultural Project? Note: If You Answered Yea to this Question, a Storra-Water, Gradthg, Drainage & Erosion Control Plan is NOT Regulredl Yes No STATE OF NEW YORK, d'~ ........ Ss That I, .......~....~.../...~.....?.....~.......~....~.....Y'....~.....~.....t~....¢...~....i.. being duly sworn, de'poses and says that he/she is the applicant for Penni, (Name of kadiv~dual signing Document) -- And that he/she is the ............... ~ ......... t..Y..i ................................................................. N0ta~,~eb~.$l~of. flev,,.yo~ ................ (Owner, contractoq Agent. Con, ate Office. etc~ N0. 01BU6185050 .... ~ ........ 0ua!ified in Suffolk Count'/./~- ~vner and/or representaitve m me t.nener o~ ~wners, and ~s duly authorized to perfofmmmhaim ~ II~tid work and to make and file this application; that all statements contained in this application are tree to the best of his lmowiedge and belief; and that the work will be performed in the manner set forth in the application [fled herewith. Sworn to before me this; .............. ,~...~..~ ............ day o f .. ~.~..L...L.....6~....?.~ ........ 20..]..D FORM - 06107 New York State Insurance Fund Workers' Comp~nsa~on & Disability B ene~s Specialists Since 1914 8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW YORK 11747-3129 Phone: (631) 756-4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE JOEL DALY PO BOX343 SOUTHOLD NY 11971 [PO~ic~6ED£R JOEL DALY PO BOX 343 SOUTHOLD NY 11971 [ CERtiFicATE HOLDER TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD NY 11971 ' POLICY NUMBER cERTiFiCATE NUMBER PERIOD COVERED BY THIS CERTIFICATE ] DATE 11374 005-5 55572 I 12/09/2009 TO 12/09/2010 ] 4/20/2010 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1374 005-5 UNTIL 12/09/2010, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WiTH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 12/09/2010 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLYANDCONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. U-26.3 NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING This ce[tiflcate can be validated on our web site at https://~wv, nysif.com/cert/certval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 598638442 ACORD CERTIFICATE OF LIABILITY INSURANCE I PRODUCER (631)283-8000 FAX (631)287-2207 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Maran Corporate Risk Associates HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 300 Hampton Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Southampton, NY 11968 INSURERS AFFORDING COVERAGE NAIC # INSURED 3oel Daly Hoee Tmprovea~ents INSURER~ Tnterstate Fire & Casualty PO BOX 343 INSURERB Southold, NY 11971 INSURERC: INSURER O: I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. G~NERALUABiLiI~ LHBlO00865 07/16/2009 07/16/2010 EACH OCCURRENCE $ 1,000,000 ] CLAIMSMADE [] OCCUR MEOExP(Anyonepemon) $ 5,000 A PERSONAL & ADV INJURY $ 1,000 ~ 000 GE N ERAL AGGR E -C-C-C-C-C-C-C-C-C-GATE $ 2,000 ~ 000 ~ OccUR [] CLAII~S MADE AGGREGATE S $ wo.~.~ ¢o~.~N~oN I ~OR~ [,~,~ [ I~- lo~n of Southold Southold, NY 11971 AUmORIZEDREPRESENTATIVE Jg~JP~r~l~l~ I Beth --- ----baraner/JCa R .......................~?~,v~,-----~ ACORD 25 (2009101) © t988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer dghts to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009101) AN)' AL TEhA TION OR ADDITION TO THIS SURVEY I$ A VIOLATION OF SECTION Z209 OF THE NEFl YORK STATE E~ LA~. EXCEPT AS PER 3ECTI~ 7~09 - SU~ E. ALL ~~ HEREON ARE VALID FOR T~S ~P A~ C~ T~ ~ Y ~ WHO~E 31GNA ~URE APPEARS H~RE~ ADDITIOt~I~LL Y l'O COMPLY WITH SAID LAW TERM °AI. TERF_.O BY MUST BE USED BY ANY AND ALL SURVEYORS UTILI2~N~ A COPY OF' ANOTHER SURVEYOR'S MAP. TERMS SUCH · INE~ECTET~ · AND * BROUGHT - TO ~ DATE ' ARE NOT IN COMPU.4NC~ WITH THE I. AFI. AREA = 42,323 sq. ft. -¢ SURVEY OF PROPERTY A T EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. ~000 - 3a. ?,9 - ,z2 SCALE I = 40 JUL Y 17, 2003 ' SEPT. 17, gO07 (ADDITION) FLOOD ZONES X FROM FIRM 36103C0176 Moy 4, 1998 / /.o' ,-:':~ ~%\ ' N. Y.~ ~9618 (631) 765 ' 5020 FAX (631) 765 ' 1797 P. O, BOX 909 1230 TRA VEL~ STREET SOUTHOLD~ N.Y. 11971 03- 182 2 x 6 DECK JOISTS ~ I O 2 x 6 DECK JOISTS ~ 6 ~u woou ~ ~ ~ 16" ox. 4. G~V~IZED ~CHOR BOLTS fl ~T~ JOIST ~GER. / / ~ -~ POST ~CHOR. ~. 4 x 4 T~A~D WO ~ ~v~s~u ~ ~o~ ~ ~~o~xs ~ ~" o.c. I~ BOLT,~. · ~ ' '. ' -- ' ': ".' '" 2 - 2 x 6 T~ATED WOOD BOX k BE~Wi~ I-I/2"D~E~R I ' ' '~ Ju ~F~, , ~. G~V~ED ~CHOR BOLTS ~ '~/ T~OUGHEACHPOST.~. ~ ~' D~ETER 3,0~ PSI TYPICAL SECTION DETAIL () () Scale: 1/2" = 1'-0" FOUNDATION s~: v2"= ~,-o,,