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HomeMy WebLinkAbout35835-ZFORM NO. 4 TOWIq OF SOLVfHOLD BUILDING DEP~RTMBNT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34599 Date: 10/06/10 THIS CERTIFIES that the building OUTDOOR SHOWER Location of Property: 1380 SIGSBEE RD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 144 Block 1 Lot 6.2 subdivision FiledMap No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in t~/s office dated AUGUST 19, 2010 pursuant to which Building Permit NO. 35835-Z dated SEPTEMBER 7, 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" OUTDOOR SHOWER AS APPLIED FOR. The certificate is issued to JT & PJ SAP~NO, TRUST (OWNER) of the aforesaid building. SuF~OI~( COUNT~ DEPARTMENT OF }~ALTH APPRO%5~L EI~cr~ICAL C~TIFICATH NO. PLU~ERS Ci~TIFICATION Dkr~ N/A N/A Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUII~ING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35835 Z Date SEPTEMBER 7, 2010 Permission is hereby granted to: JOHN & PAMELA SARNO 519 DALLAM CT. BEL AIR MD, 21014 for : "AS BUILT" OUTDOOR SHOWER AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 144 pursuant to application dated AUGUST Building Inspector to expire on MARCH 1380 SIGSBEE RD LAUREL Block 0001 Lot No. 006.002 19, 2010 and approved by the 7, 2012. Fee $ 200.00 Authorized 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 DopaCanent with the following: A. For new building or new use: 1. Final surv~ of property with accm'ate location of all buildings, ptopcxty 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 installation from Board of Fire Underwriters. 4. Sworn statement from plumber c, ta~/fying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple rcsidcacos and similar buildings and installations, a certificate of Code Compliance from architect or angineer mspensible 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 consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall ~ate the ~ns tbemfor in walling 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, Aceessmy building $25.00, Additions to aeeessosy 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 Ce~ificate of Occupancy - $50.00 5. Tempormy Certificate of Decupancy - Residcotial $15.00, Commercial $15.00 New Construction: Location of Property: Owner or Omm of o .y: ,loC Suffolk County Tax Map No 1000, Section Subdi,fision Date. ~Old or Pre-existing Building: House No. Street Permit No. ~'~ Health Dept. Approval: Block Filed Map. Date of Permit. ~7/r)-//O Applicant: Underwriters Approval: (cheek one) Hamlet Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ _ Final Certifica~: ~ ~heck one) f / ~A~-'~icant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FEERmST~rCONS~UCTION ( REMARKS: ROUGH PLBG. INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION ) FEE RES~TANT PEHETRAlmN TOWN OF SOt BUILDIN. G DE TOWN HALL SOUTHOLD, N TEL: (631) 765- FAX: (631) 765- SoutholdTown. I 9502/ G DEP IorthFor~'SOil~T~o~MIT N Examined ~5/'7 , 20 /c7 Approved ~'~/7 ,20 / O Disapproved a/c Expiration ~/ '7 ,20 ! ~ 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: Building Inspector~'~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ,20 I'D 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 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, Suflblk 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 auth°rized inspect°rs °n premises and il building f°r necessary inspecti°ns' ~/'~ ". . ~ //F(Signature of ap~'i{cant or name, if a corporation) ' ' ' '? (~F~' ~ ': ' "' A W' (Ma,hng address ofapphcant) State whether applicant is owner, lessee, agent, afdllitect, engineer, general contractor, electricj 'a~, pl~eer or builder 0 co/ APPROVED AS NOTED Name of owner of premises dP'd~{5.~---~o~-/'(~ (As on the tax roll or latest c~:~ ' UILDING Ir'applicant is a corporation, sisnature of duly authorized officer 765-1802 8 AM TC , :,:~_ (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 prgposed work will be done: House Number Street Block Hamlet County Tax Map No. 1000 Section ~'~ ~[ Subdivision Filed MapNo. FCLLcI, V!NG !NSPEC', / ©iIND,q:rON. ': FOF ~ JREo,', ~', ,,. ', dak hOT RESP0NSIgkE =0~ ~'~ ~ CONSTRUCTION ERRORS. Lot Lot 2. State existing use and occupancy of premises and intended use arid o&'~pancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy_ 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 Affdition Other Work Fce 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 Height_ Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth. Height. Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Sizeoflot: Front Rear Depth 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 * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES NO * 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 · IF YES, PROVIDE A COPY. STATE OF NEW YORK) CouNTy O F,~L~. ~.! i~-)~ ~,~'-b ~,~ ~1~ ~ 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 perlbrm or have perforated 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 filed therewith. Sworn to before me this ~ ~ ~ ~ ~oUwPublic,~teof ~ ~~ t. ~ , . No. UH06190696 /~ .-, - · - Qualified in Suffo ~ ~ - ~ Nota~Pubhc Ik un Signature of Apphcant Commission Expires July 28, 2B/~ ~ TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STR~'/~$0V,L~GE D,S*. SUB. LOT FORMER O~NER" N ~ E ~ .~ ~ ~PE OF BUILDING AGE BUILDING CONDITION N~ NOR~L BELOW ABOVE FA~ Acre Value Per Value Ac re Tillable 1 Tillable 3 W~dland Brushl~nd ~ FRONTAGE ON ROAD BULKH~D ~otel D~K COLOR ii.M. Bldg. Extension vtension i ~"Extension ,% 8 Total I -- ,.Fy, Foundation ~__~,~ Basement /~,~ ~xt. Wails ~e Place Type Roof Bath Floors Interior Finish Heat ~ / ~_ Rooms 1st Floor Recreation Rooms 2nd Floor Driveway / / Town of Southold Erosion, Sedimentation & S,torm-Water Run-off ASSESSMENT FORM PROP£RTY LOCATIOM: ~. S.C~,M. #~).~, THE FOLLOmNG ACTION~ MAY REQUIRE THE SU~S~,__,~_~,O~ OFh ~ !ec~ben~ · STORM-WATER, GRADING, DRAINAGE AND EROSION COHTROL pLAN District Block Lot CERTIFIED BY A DESIGN PROF";~I~HAL IN THE STATE OF NEW YORK, a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within 1 Will this Project Retain Ail Storm-Water Run-Off ~/~ the Scope of Work for Proposed Construction) Generated by a Two (2') Inch Rainfall on Site? ~ ~ b. What is the Total Area of Land Cisadng ($.F.i ~) (This item will include all ran-off created by site clearing and/or constmctfan activities as well as ell end/er Ground Disturbance for tha proposed Site Improvements end the permanent creation of construction activity? (e.F.I ~,~) impervious surfaces.) PROVmE pEO -rr 2 Does the Site Plac and/or Survey Show All Proposed Drainage Structures Indicating Size & Locatien? This Item shall include all Proposed Grade Cbeagas and, (~T'?~ OL~)0C~...~C../~1~ Slopes Controlllng Surface Water Fiow. ' - 3 Does the Site Plan and/or Survey describe the erosion and sediment control practices that will be used to control site eroelon and storm water discharges. This -- item must be maintained throughout the Entire Censtmcflen Pednd. 4 VVI# this Pr°ject RequIra any Land Filling' Gradlag °r Excavation where there is a change to the Natural Existing Grade Involving mom than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in ExCess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface?~ 6 is them a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction ~ ! General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or Submission o~ a SWPPP is requirnd for all Construction activities involving soil Beach? disturbances of one (t) or mom acres; incleding disturbances of less than one acre that 7 Will'there be Site preparation on Existing Grade Slopes are part of a larger common plan that will u~timately disturb one or more acres of ~and; which Exceed Fifteen (15) feet of Vertical Rise to r~ including Constmctinn aclN~es involving soil disturbances of less than one (1) ac~e whereL,~ the DEC has determined that a SPDE$ permit is required for stu~m water dischan3es. One Hundred (100') of Horizontal Distance? SWP~P's Shatl meet the Minimum Requirements of the SPDEe General Pamtlt 8 Will Driveways, Pad(fag .Areas or other Impervious for Stetro water Discharges from Co~strdctfolt activity - Permit No. GP-O-t 0-001 .) Surfacas be Sloped to Direct Storm-Water Run-Off~ 1. The SWPPP shall be prepared p~or to the submittal of the NOt. The NOI shall be submitted fo Ibe Gepamnect ~ to ~be commencerr~nt of cons~uctfon activity, into and/or in the direction of a Town dgM-of-way? 2. The SWPPP shall describe foe emslon and sediment control practices and wbem 9 Will this Project Require the Placement of Material, constructedrequhed' pest-c~nstmctfon sform wate~ managernect prectices that will he used aedfo~to reduce lhe pollutants in storm water dbcherge$ end to assure Rem°Val °f Vegeteit~n aedl°r the C°nstroctf°n °f any ~1 compliance with the terms and com~J~ons of thi. s permit. In addifi~t, th~ SWPPp shall Item Wi~ln the Town Right-of-Way or Road Shoulder '~ ~'~}~'/~'~~x~ ~ ~ ~ .................... being duly sv¢om, deposes and says that h~sbe i~ the applicant for Permit, Owner and/or representative of the Owner or Owners, and is duly authorized to perfonn 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 flied herewith. N0f*~ ~'ublic Stat0 o[ N0w ~0~ .................... : ............ : ................................ FORM - 06/10 Q~lified in Suffolk County Co-~,m ~io~ E×gires JuN 28.20 Town 1 lall Anm'x ,g~',~7,5 Main Road P.(). 1½o× t 179 biomhold, NY 119714)!)59 Telephoto' (631) 76,3-1802 l;ax (631) 76.34t,302 1½1 Hi)IN(; I)EI~AIITMENT TOWN OF SOUTHOLD September 30, 2010 John and Pamela Sarno 519 Dallam Court Bel Air, MD 21014 RE: 1380 Sigsbee Road, Laurel TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: ~. Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. ~ A fee of $25.00. __ Final Health Department approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board approval. __ Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. __ Final Landmark Preservation approval. Building Permit: 35835-Z outdoor shower NOTE: 18 MONUMENT LOT NOS. REFER TO AMENDED MAP OF PRO,PERTY OF MATTITUCK PARK PROPERTIE. INC..FILED IN THE SUFFOLK COUNTY CLERKS OFFICE. O *,SURVEY FOR EDWARD E LITCHHULT MATTITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. SCALE -' I"= 40' MAY 9, 1969 PROFESSIO R ANO LAND SURVEYOR,N.Y.S:/L C. NO. 1284! RIV ERH E AO., N.Y.