Loading...
HomeMy WebLinkAbout35683-ZFORM NO. 4 TOWi~ OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34468 I~ate: 07/15/10 THIS CERTIFIES that the building ADDITIONS Location of Property: 2985 HIGHLAND RD CUTCHOGUE (HOUSE NO.) (STREET) (HANLET) Co%ulty T~ Map No. 473889 Section 102 Block 8 Lot 14 Su]~]ivision FiledMap No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in tb/s office dated JUNE 21, 2010 pursuant to which Building Permit No. 35683-Z dated JULY 1, 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 "AS BUILT" CO~-ERED ENTRY AND MUDROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to THOMAS & KATHLEEN HALL ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL EL~t-rKICAL ~KTIFICATH NO. PLUMBERS c~TIFICATION DA'i'~D N/A N/A N/A thorize Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~]ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35683 Z Date JULY 1, 2010 Permission is hereby granted to: for : THOMAS HALL 1210 BRIDLE LANE CUTCHOGUE,NY 11935 "AS BUILT" PORCH & MUD ROOM ADDITIONS TO A SINGLE FAMILY DWELLING at premises located at 2985 County Tax Map No. 473889 Section 102 pursuant to application dated JUNE Building Inspector to expire on JANUARY HIGHLAND RD CUTCHOGUE Block 0008 Lot No. 014 21, 2010 and approved by the 1, 2012. Fee $ 400.00 Auth6'rized Signature ORIGINAL Rev. 5/8/02 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 the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval fi'om 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 of 1% 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. B. 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. 2. A properly completed application and consent to respect 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 Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, A]terations 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: Date. Old or Pre-existing Building: House No. Street Owner or Owners of Property: Icheck one) ~ Hamlet Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~'~(~ ~ Health Dept. Approval: Date of Permit. Block Filed Map. Applicant: Underwriters Approval: Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~'~- ~ 0 Final Certificate: (check one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION FINAL [ ] FIRE SAFETY INSPEOTION ] FIRE RESISTANT PENETRATION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ]m, mm~'t,~m'~mJ~m'~m [ REMARKS: DATE TOWN Or SOUTUOLD BUILDING DEPARTMEN~//~- SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFor[~et Examined 7 ~' / ,20 /O Approved 7fI ,20 /O Expiration I -- / ,20 loQ'-- 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 x/Storm-Water Assessment Form Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date 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 sliall 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 I8 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 fbr 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. ~ ~--"7 ~~(Signature o~on) (Mmhng address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownbrofpremises "~'ff/~'w'~,'P~ /g/Z/~~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 work will be done: House Number Street H~'mlet CountyTax Map No. 1000 Section ~ Block Subdivision Filed Map No. Lot // ~ Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .,~)~,/,~' vz"r')M~,?~ b. Intended useandoccupancy 3"71..-~./r~' /,,'p*'*7-~t7 Nature of work (check which applicable): New Building .... Repair Removal Demolition 5. If dwelling, number of dwelling units / If garage, number of cars ,9--- Addition' l.~ Alteration Other Work (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 ~ S~ ~ Number of Stories Rear ~" ¢7 / Depth Dimensions of same structure with alterations or additions: Front Depth c~ fi' / Height ~ C- t 8. Dimensions of entire new construction: Front ff~r'_.f--- Height ff'--(~/' Number of Stories 9. Size of lot: Front /~/~ r Rear ,~ 5/d2 10. DateofPurchase ///~/ /~t~ ~'~Name of Former Owner riff' / Rear Number of Stories Rear .Depth .Depth 4/Y ~ / 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO b// 13. Will lot be re-graded? YES__ NO /Will excess fill be removed from premises? YES__ NO v'/ 14. Names of Owner of premises Name o f Architect Name of Contractor AddressZ¢~F-,'~:~V,;/'/~t~hone No. 7~-~'r Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland. YES * 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 U// * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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 J · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF 7-~/_7~j/./~4t,5- /gp/,~.-~ d~(' being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above 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 true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application f'l~II~.'.h. Sworn to before me this ~.~_ day of ~,o,.~._ 20~mmi[~'onF. xp,resSept. 2b,~---~'~.~ - o__f Southoid Erosion, Sed,mentat,on & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 5TORM-WATEI~ GRA~iHG, DRAINAGE AND EROSION CONTROL pL~_H CERTIFIED BY A b~'~i~rl PROFE~81ONAL IN THE STATE OF NEW'yO~ Item Number: (NOTE: A Chec~ Mark (~) for each Question is Required for a Complete Applica~on) Yes No Will this Project Retain All Storm-water Run-Off Generated by a Twa (2")Inch Rainfall on Site? ,J r~ (This item will include all run-off created by site cleadng and/o* construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan andlor Survey Show Alt Propased Drainage Structures Indlcaitng Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Wate~Flowl -- Will this Project Require any Land Filling, Grading or Exsevaiton where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel?L.~ Will this Application Require Land Disturbing Activities Encompassing an Ama in Excess of Five Thousand (5,000) Square Feet of Ground Surface? L.~ -- is there a Natural Water Coume 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 Vertical Rise to One Hundred (100') of Horizontal Distance? I~l -- intoWill Driveways, Parking Areas or other Impervlous Surfacas be Sloped to Direct Storn~Water Run.Offand/or in the direction of a Town dght-of-way? r~ _ any Item Within the Town Right-of-Way or Road Shoulder Ama? (This item will NOT laclude the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Fleedp a n of any Watercoume? r~_ 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 Issuanse of Any Building Permitl EXEMPTION: Yes No Does this project meet the minimum standards for classiticatiee as an Agdcutiural ProlecF/' Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan Is NOT Required! STATE OF NEW YORK, co , r¥ ............ ss (Name of Individual signing Doctnnent) And that he/she is the ............... ...~....../~....,~....~..~ Owner and/or representative of the Owner of Owner s, 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 h~and belief; and that the work will be performed in the manner set forth in the application filed herewith.I~ar/.~i.ct..S.~..te,~f ~.ew ~o. mW~b~u~4 Sworn to before mc this; Qualified in Suffolk Count'/ Commission f,&0ires Sept. 25, ........... ..................... ........................... Notary Public: ~....~?.. ~ ........................................................................................ ~~ BUILDING PERMIT EXAMINER CHECKLIST Applicant: Architect/Engineer: SCT # 1000- / o Property Address: *Date Submitted: Owner: Subdivision: Buildin, ,.g Permits (,pO eh/Ex BP/ta~- g-g/C/OZ-1637~,Info:~BP -g/C/0 z- Single & Separate Search Required? Y N(~)etermination: REQ. Lot Size: ACT. Lot Size: REQ. Front ACT. Front REQ Side REQ. Height ACT. Height_ Project DescripJ[ion: ~' ~ ~ / Waterfront? Y o~) If yes, water body: Panel// Date Reviewed: Estimated Cost..-~ Zone: Conforming? City: ~~ PreCOs? BP 1375- -z / o0 z-/37 7, Info: BP__ -Z / C/0 Z- , Info:. ACT. Side REQ. LOt Cov. __ REQ. Rear__ ACT; LOt Cov. PROP. Rear Flood Zone: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y or(~- If yes, '~Bed#: *Date: / / _~ermit#: - If no, certification requiredi Y 0 Nf~Received: Y or N By: NYS DEC: eRE-V~C~a/7S Y or~- Date: / / Permit #: Southold Trustees: Y or(~- Date: Soutboid ZBA: Y o~- Date: / Southold Planning: Y or~ Date: Town Landmark C of A: Y oODTE: Notes: Permit #: Permit #: Permit #: / Town Septic: Y or N or NJ Letter - Notes: or NJ Letter - Notes: - Notes: - Notes: *NYS CODE Compliance (page 2)Oor N Fee Structure: Calculation: Foundation: SF l. ( First Floor: SF Second Floor: SF Other: SF 2. ( Total: SF SF)- ( SF)- ( SF)= SF X $__=$ +InitialFee:$ i,q~oo, aa + Addition{il Fee ( ): $. SF)= SF X $ =$ + Initial Fee: $ + Additional Fee ( ): $. ~-o o, oO TOTAL:$ r~at:', oo NEW YORK STATE CODE COMPLIANCE CHECIGLIST CLIMATIC/GEOGP,~PHIC DESIGN CRITERIA: · Ground Snow Load: ~0 , Wind Speed; 120MPH Weathering: Severe __..Frost Depth: 36" __ Termite: M~H Decay: S-M Design Temp: 11 tee Shield Underlay: YES . Flood Hazai'ds: USB/OCCUPANCY CLAS SIFICATION: ? HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: w~ ff~_<_ DESIGN CRITERIA:~ ENGINEERB~ FULL FRAMING DESIGN ELEMENT~N HEADERS: ~/N _ WALL STUDs: CEmlNG JoisTs: ~k~ rLpOR JOISTS~/N LUI~BER SPECIES AND GRADE~/N Seismic Design Category/B , GLP. DERS: YfN ROOF ILtFTERS: Y/lq WDJDOW AND DOOR SCHEDULE: · NIISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N 1rENT 4%: Y£N NAILING/CONSTRUCTION SCHEDULE: ~ MEANS OF EGRESS:~iq PLUMBING RiSER DIAGRAM: LOCATION OF FIILE PROTECTION EQUIPMENT: Y~ TRUSS DESIGN: CERTIFICATION: ENERGY CALCS: TOTAL COMPLIENCE Y~ (RETURN TO PAGE ONE) TOWN OF SOUTHOLD PROPERTY~RECORD CARD VILLAGE E ACR. .9~O W LOT / ?. TYPE OF BUILDING f COAAM,. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meac[owland DEPTH ~. ~j, House Plot BULKHEAD Totol COLOR Extension Extension /~e~ Porch Breezeway e~lo7 Total 80" Foundation Ext. Walls Fire Place Type Roof Recreation Room Dormer -JF G ~. ~. j Floors Interior Finish Heat Rooms 1st Ficor Rooms 2nd Floor Driveway r inette DR. BR. FIR. B SURVEY OF LOT I-/ HAP OF HI~HLANP EL~TATES FILED APRIL 26, IqT7 FILE NO. 65~'7 51TUATE, CAJ'r~ TOi~I, 5OUTHO[ D SUFFOLK GOUNT(, NY' SURVEYED I1-~g-2004 5LIFFOLK CODNTY TAX # IOOO-IO2-~)-14 N AREA = 40/~O'7 5.F. or O.q2 ACRE 6RAPHIC SCALE Il'= [~O' 0 0 JOHN C. EHLERS LAND SURVEYO1; 6 EAST MAIN ~ N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\~Ip se~'vefi~PROSV)4--330.pro COLLAR TIE~ ~ [~," O.C IN UPPER THIF~ OE ATTIC 2. IF ~TRAPP1N~ 15 INSTALLED OVER 5HEATHIN~ U~E IOd NAILS A~ / NAILIN~ ~CHEgULE ALL 5TRAPPI~ HAY 80 OVER OHEATHIN(~ HHEN IOd NAILS USED TURN-UP (I) NAIL @ FAC/~IA APPROVED AS NOTED NOTIFY BUILDING ~T 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS. 1 FOUNDATION. ~ REQUIRED FOR POURED CONCRETE 2 ROUGH- FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3, INSULATION 4 FINAL - CONSTRUCTION & ELECTRICAL 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 ERROR~ISTiN~' (TO MATCH EXI~TJ ALL CONSTRUCTION SHALL MEET THE REQUIFIEMENTS OF THE CODES OF NEW YOB ( SLATE. o PAt .TIAL Ft .ONTN ELEVATION 5GALE: I/4"= I'-O" (AT FRONT ENTRY) 'R-Iq) INCJJLATION NEN MUD~,OOH Ok,tALL HOLD- OHN 5T APPIN I. (I) ~TE~-AP ON EACH HALL STUD, ~ HI~.AP UNDER 5ILL PLATE (UPLIPT ONLT') AND UP ON INSIDE FACE OF 5ILL INSTALL MIN. I/2" ANCHOR E~DLT5 - ~PACIN~ A~ PER TABLE D.2A, THIS SHEET ~112" ®ENERAL NOTES. I. ALL ROOF EAVES, RIDGES, RAFTER SPACES ABOVE iNSULATION, UNHEATED ATTIC SPACES AND FOUNDATIONS CI~&HL SPACES SHALL BE 'vENTILATED AS IHOIGATED ON THESE PLANS AND IN CONFORI'4ANCE HITH C-OVERNIN¢ RECCdLATfONS. 2. ALL SHEATHIN~ AND 5UBFLC:~DRIN~ SHALL BE EXTERIOR ®I;~ADE AND AS REQUIRED BY ALL C~OVERNIN¢ REGULATIONS. D. ALL ROOF RAFTERS SHALL HAVE HURRICANE TIES THAT ATTACH TO TOP PLATE ~ STUD. 4- BLOC. KIN~ SHALL BE PROVIDED TO SUPPORT ROOF GUTTE~.S, EAS(~IA END~, PROVIDE PO~TS BELOH ALL ¢It;~DER5 ~ BLOCK SOLID DOHN TO FOUNDATION HALL OR ~IROER BELOH b. ALL PLUMBINg, ~AO, AND ELECTRICAL ~RK 5HALL DE PERFORMED DY LICENSED AND IN%~D CONT~CTO~5 AN~ IN AGCO~OANCE HITH ALL APPLICABLE CODE5 AND ~E~ULATIN~ A~NOIES. N. OONT~6TO~ SHALL iNSTALL M~TAL ~LL TIES AS IN ACCORDANCE HITH THE NEH 'CORK. STATE RESIDENTIAL BUILIDIN® CODE. DETAIL SHEET ATTACHEO HITH THESE PLANS EOR HALL TIE LOCATIONS. ,9,. LUIviBER TO BE HEI'4 FIR ~2, Flo=~,50, E= I.~ × I0 ~' PROJECT= AS-BUILT ENTRY AND MUDROOIvI fOt~. THE HALL P..ESI PENC.,E 2qBD HI®HLANID I~ID, CUTCHO®UE, NY IIq:~5 SEE EXIST. RESIDENOE APPROVED AS NOTED DATE'~)~')~ B.P · '~°~-~/')~ FEE b~-~o ,bcd BY d'~'~- *~'~ NOTIFY BUILDING DEP/~RTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUNDATION- TWO REQUIRED FOR POURED CONCRETE 2 ROUGH-FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3 INSULATION 4 FINAL-CONSTRUCTION&ELECTRICAL MUST BE COMPLETE FOR C O. 'S OF THE CODES OF NEW NOT RESPONSIBLE FOR PAt TIAL FLOOR PLAN SCALE: I/4"-- I'-O" (AT FRONT ENTRY) ¢ib~RWRITERS CERTIFICATE REOUIRED LE®ENP J EXISTINg, CONSTRLI~TION EXItSTIN~, CONSTRUCTION (TO BE ~MOVEO) COMPLY WITH ALL CODES OF NEW YORK STA-FE & TOWN CODES AS REQUIRED AhiD CONDiTiONS OF ¢ /, SOUT-~D TOWN.ZL~'/ ¢//. tL SOUTNOED'~LANNING BOARD ON 'A' 5C-ALE, I/4"= ILO'' PAt TIAL FLOOr;2-, PLAN (AT REAR DOOR) (I'4E~ I~ 5~. FT.)