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Home My WebLink About35785-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34653 ~te: 11/04/10 THIS CERTIFIES that the building COVERED FRONT PORCH Location of Property: 250 KEWNYS RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Coua~ty T~ ~ap NO. 473889 Section 59 Block 3 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 2010 purs~uknt to which Building Pez~nit No. 35785-Z dated AUGUST 18, 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 COVERED FRONT PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS & NOREEN HAMLIN (OWNER) of the aforesaid building. S[~FDLKCO[~FYDEP;~9~]~E/~T OF }~L]~{PPRO~J~ N/A ELEC"~RIC3%L C~/{TIFIC~%~]~ NO. 35026 10/13/10 PL~EP~ U~TIFIC3%TION D~r~o N/A gnature 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. 35785 Z Date AUGUST 18, 2010 Permission is hereby granted to: THOMAS & NOREEN HAMLIN 250 KENNYS RD SOUTHOLD,NY 11971 for : CONSTRUCTION OF A FRONT PORCH TO AI~ EXISTING DWELLING AS APPLIED FOR at premises located at 250 KENNYS RD SOUTHOLD County Tax Map No. 473889 Section 059 Block 0003 Lot No. 018 pursuant to application dated AUGUST 10, 2010 and approved by the Building Inspector to expire on FEBRUARY 18, 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 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 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 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: 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 Date. New Construction: Old or Pre-existing Building: Location of Property: 2~:~ ~/f ~1~.O_{ '> House No. Street Owner or Owners ofProperty: -~x~prO~'¢ ~O~¢qJ"~ Suffolk County Tax Map No 1000, Section ~.-~ _-~ q~c~ Block Subdivision Permit No. ~ ~*1 <ff ~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate (check one) Hamlet Filed Map. ~ Lot: DateofPermit. ~1~i'2_OIO Applicant: "q"-~t0ct~a~-r-b~0reoq Underwriters Approval: Final Certificate: ~ (check one) Applicant Signature l'.t). Box 1 Soulhold, Nh' 11!)71-09,59 '1 clcphonc (ti3 l) l-ax (ii:H) 7t13-9502 ro.qer, richert~,town.southold.ny, us B! II,DIN(; I)I'~PARTMI'~NT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Noreen Hamlin Address: 250 Kenneys Road City: Southold St: NY Zip: 11971 Building Permit #: 35026 Section: ~c1 Block: ~ Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: homeowner DBA: License No: SITE DETAILS Residential Commerical New Additioe Service 1 ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: Office Use Only Indoor ~ Basement ~ Service Only ~ Outdoor 1st Floor Pool Renovation 2nd Floor Hot Tub Survey Attic Garage INVENTORY Hot Water GFCI Recpt NC Condenser Single Recpt NC Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock Ceiling Fixtures ~] HID Fixtures Wall Fixtures I J Smoke Detectors Recessed Fixtures~ CO Detectors Fluorescent Fixture ~_~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures [__J TVSS Notes: front porch Inspector Signature: Date: Oct 13 2010 81-Ced Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ F~OUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING / STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION REMAR~ DATE ~/~//~/0 INSPECTOR ~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUndATION 1ST [ ] ROUGH PLBG. [ ]~I~NDATION 2ND [ ] INSULATION [~FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION I I F'"E"E"STA"T C0"STR~ REMARKS: 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 ~]~ELECTRICAL (ROUGH) [ ] ELE~i,ICAL (FINAL) REMARKS: DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~ATIoN [ ] FRAMING / STRAPPING [ b,]/FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] raRE RES~ANT C0NSTRUC.0. [ ] F~R~ R~Sm'Am' ~t=.ttRA'rlO. REMARK~~ FOUNDATION (IST) FOUNDATION (21~D) .,./, INSULATION I'I~ N. Y. STATE ENERGY CODE · ADDITIONAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ALL SOtJ~'HOLD, NY 11971 TEL: (631) 765-180:2 FAX: (631) 765-9502 SoutholdTown.NorthFork.nct Examined Approved Disapproved a/c Expiration ?o/(~ .20 /c33. sets AUG 1 0 2010 3!.7,215, ~...~.m,~tc plvt plan to scale. PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, belbre applying? Board of Health 4 sets of Building Plans Planning Board appmval Smw'ey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phonef~ ~'2 ~" Building Inspector PPLICATION FOR BUILDING PERMIT Date ~/[O ,20fO INSTRUCTIONS ~pletely filled io by typewriter or in ink and submitted to the Building Inspector with 4 ce according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationslfip to ad:ioining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced belbre issuance of Building Permit. d. Upon approval of tbis application, the Bnilding 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 tbr any purpose wbat so ever until the Building Inspector issues a Certificate of Occupancy. [ 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 Ii'om 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 nec/permit shall be required. APPLICATION 1S HEREBY MADE to the Building Department fbr the issuance of a Building Permit pursuant lo the Building Zone Ordinance of the Town of Southold, Suftblk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or tbr 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 fbr necessary inspections. '('Sg atu e ofapp ' o e. ifa cm-poration) (Mailing address of applicant) State whether applicant Qessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises"~~ -- ~,~N ~.. ~ (As on the tax roll or latest deed) If applicant is a cmporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers LicenseNo. ELectricians License No. Other Trade's License No. Location off,land on whictl{~::0q/Vl./~pr°p°sed work will--,.~-f13°- ne: ~tM.V/,40(.,~ , House Number Street -- Hamlet County Tax Map No. 1000 Section ,_5 q Block 3 Subdivision Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructions, a. Existing use and occupancy I ..~.~tl.l~ b. Intended use and occupancy ' [ ,~I,I,A LL4M ~-.(~-'¢--~.L¢'~ 3. Nature of work (check which applic~.~ble): New Building Addition Alteration Repair ~ Removal Demolition ~ Other Work~ (Description) 4. Estimated Cost 1~ }/~, ~C> Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Nu, l.~ of dwelling units on each floor If garage, number of cars 6. If'business, commercial or mixed occupancy, specify nature and extent of each type of usc. 7. Dimensions of existing structures, if any: Front Rear Depth Height ~ q:; Number of Stories ~t~ Rearz:~ Dimensions of same structure with alteratiol~s~or additions: Front Depth ~ Height '/'/..,~-'~ Number of S!ories 8. Dimensions ofenCre, new construction: Front Rear ; Depth Height t/~..~' NumberofS~ / ~¢ Size of lot: Front / q Rear -, Depth I0. Date of Purchase 1440 Name of Fenner Owner I 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinancc or regulation? YES__ 13. Will lot be re-graded? YES NOX Will 14. Names of Owner ofpremise; j,,~l.,llq Name of Architec~ c~tlz,~¢v ~ Name of Contractor NOX excess fill be removed from premises? YES__ NO X Addres~O [~,t~.~g,~ . PhoneNo. ~] ~ ' 16 ~7 Addre~ ~~hone No &~l ~%.~ Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a fi'esi~water 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~k- * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 1 6. Provide survey, to scale, with accurate fnundation plan and distances to property lines. 17. It' 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 .~ · 1F YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworu, deposes and says that (s)he is the applicant (Name of individual signing contract) above uamed, ¢.;01'1~1£ 0. BUNCH Notmy Public, State of New Yor~ No, 01BU6185050 (S)He is the ,, Ou, a!if~., in, Suf~lk Count~ (Contractor, Agent, Corporate Officer. etc.) t,~nm~ss~0~ utp~res/tpnl 14, 20. of said owner or owners, and is duly authorized to pedbrm or have perforlned the said work and to make and file this application; that all statements containe8 in this application are true to the best of his knowledge and belief: aud that the work will be perlbrmed in the manner set fbrth in the application filed thcrcwilh. Sworn tel before me this/~ ] OnL4% day ot',,-'ZJ~ ~W~ 20)_? Notary Public Signature of Applicant Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 119714)959 Telephone (631) 765-1809 ro~er richert(~.~w(~n .t~[07 u~oS(J(~, n ¥. us BUILDING DEPARTMENT TOWN OF SOUTHOI.I~ APPLICATION FOR ELECTRICAL INSPECTION BY: company Name: Date: Name: License No.: Address: Phone No.: *Name; *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required information) ~000 Section: 5 q BIook: ~ *BRIEF DESCRIPTION OF WORK (Please Print Cleady) Lot: (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 *New Service: Re-connect Underground Additional Information: YES~-~ ~ Rough In YES / NO Final 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form ' TOWN OWNER ISTREET OF SOUTHOLD PROPERTY ,/,/,J-~-~-~<.-.~. x~..; s RES. SEAS. VILLAGE E RECORD CARD SUB. LOT ACR. ~ I . rillable Reaclowla~l ' DEPTH ~ouse PiG BULKHEA. D FRONTAGE ON ROAD LAN D IMP. / 2..00 TOTAL j DATE COMA~. CB. MIC5. REMARKS FRONTAGE ON WATER Mk' Value Ext'~r~ion Pa~ I:lo~h Breezeway Patio IOOf Foundation ~s~r~e~t Fire Place ~ecmotion Room Rooms 1st Floor Rooms 2nd Floor Driveway i~[nette DR. BR. FIN[, B Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ~d~ _-~ I ~'~ STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROl. PLAN District seca~n Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT [ Yes No a. What is the Total Area of the Project Parcels? (Include Total Ama of all Parcels located within 1 Will this Preject Retain AIl Storm-Water Run-Off the Scope of Work for Proposed Consbuction) Generated by a Two (2") Inch Rainfall on Site? b. What ls the Total Area of Land Cleadng (S.F. I .~cres) (This item will include all run-off craated by site clearing and/or construction activities as wall as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? impervious surfaces.) IS.F., mi 2Does the Site Plan and/or Survey Show Ail Proposed PROV3/)~. BR]E~F PROJ-EC7 D,ESCRZFZ3ON (P.~V,d, ~ P~. ~s N~e~d) Drainage Structures indicating Size & Location? This Item shall include all Proposed Grade Changes and -- Slopes Controlling Surface Water Flow. 3Does the Site Plan and/or Survey desc~be the erosion and sediment control practicas that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. 4Will 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 Material within any Parcel? 5 Will this Application Require Land Disturbing Activities r--'l Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? 6~sthere a Natural Water Course Running through the I'--"1 Site? Is this Project within the TnJstees jurisdiction General DEC SWPPP Requirements: or within One Hundred (t 00') feet of a Wetland or Submission of a SWPPP is required Ior all Construction activities involving soil Beach? disturbances of one (1) or more acres; lac~udlag disturbances of ~ess than one acre that 7Will there be Site preparation on Existing Grade Slopes ~ are pad: of a larger common pisn that will ultimately disturb one or more acres of land; which Exceed Filteen (15) feet of Vertical Rise to [ [ ~' including ConstrucUcn activities involving soil disturbances of lass than one (1) acm where One Hundred (100') of Hor;zontal Dista.n. ce? ~ the DEC has determined that a SPDES permit is required for storm water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious I'-"'--I for Storm Water Discharges from Construction activity. Permit No. GP4)-10-0Ot.) Surfaces be Sloped to Direct Storm-Water RunOff U 1. The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/er in the direction of a Town right-of-way? submitted to the Depad*ment prior to the commencement of construction acuity. 2. The SWPPP shall describe ~ eh)sion and sediment control practices and where 9Will this Project Require the Placement of Material, required, post-constructior~ stotr'n water management practices that will be used and/or Removal of Vegetation and/or the Construction of any r~ consh-acted to reduce the pollutsnts in storm water discharges and to assure Item Within the Town PJght*of-Way or Road Shoulder compliance with the terms and conditions of this permit. In addifien, the SWPPP shall ffFATE OF NEW YORK, CONNIE O. BUNCh Notary Public, State of New Yor~ COUNTY OF ........................................... SS NO. 01BU6185050 Qualified in Suffolk Count~ i '~ 3_%at I, tx:b] dui swom' C0mmi~si0n. Ex0[res.Aoril 14. ~0 I ................ i~'/~'~'f~'~'fiii~i'~"'ig"f~i&~i~g ) ..... g y , acposes ~ma says mat he/she ~s mc appncant'for Permit, And that he/she is the ........................................... i~*,' ~ oh'~'~;/X~i/~i~' 5~4,' ~j ................................................................ Owner and/or representative of thc Owner or Owners, and is duly authorized to perform or have performed thc said work and to make and file this application; that all statements contained in this application are txue to the 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; .... ....................... (Signalum o~/N~plicaat ) FORM - 06/10 ]'.(). Box 1179 October 1,2010 Thomas Hamlin 250 Kennys Road Southold, NY 11971 BI 'ILl)IN(; I)I,;I',\RTM I(NT TOWN OF SOUTHOLD 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. "Nj A fee of $25.00. __ Final Health Department approval. __ Plumbers Solder Certificate. (All permits in¥ol¥ing plumbing after 4/1/84) __ 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: 35785-Z front porch OCCUPANCY OR LISE iS UNLAWFUL t,'ViTFIOUT CERTIFICATE OF OCCIJPANCY UNDERWRITERS CERTIFICATE REQUIRED APPROVED AS NOTED DATE ,d~/~/~/] BP,# :~7¢~-- NOTIFY OUllDINe DE/pARTMENT AT 765'1802 S AM TO 4 PM FOR THE FOLLO~NG INSPECTIONS' 1 FOUNDATION-T~ REQUIRED FOR POURED CONCRETE 2 EOUGH-FRAMING, PLUMBfNG, ~RAPPIN6, ELECTEICAL & CAULKING 3 INSU~TION 4 FINAL- CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C O, ALL CONSTEUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE NOT RESPONSIgLE ¢OR DESIGN OR CONSTRUCTION ERRORS, RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. ~l ¢~" ~qu~¢4 ~x-~T ~or~ r~