HomeMy WebLinkAbout33603-ZFORM 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. 33603 Z Date DECEMBER 27, 2007
Permission is hereby granted to:
TH0 s R RENZ
MASSAPEQUA PARK,NY '11762
for :
CONSTRUCTION OF AN ACCESSORY GARAGE AS APPLIED FOR
at premises located at 1260 BROADWATERS RD
County Tax Map No. 473889 Section 104 Block
pursuant to application dated DECEMBER 18, 2007
Building Inspector to expire on JUNE
Fee $ 162.80
CUTCHOGUE
0009 Lot No. 004.002
and approved by the
27, 2009.
ORIGINAL
Rev. 5/8/02
F~LD INSPECi'ION REPORT I DATE I COM~ENTS
FOUNDATION (1ST)
FO~DATION (2ND) .~
ROUGH F~G &
pL~G
-
~S~ATION PER N. Y.
STATE ENERGY CODE
~DITION~ COUNTS
-
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork, net/Southold/
Examined
Approved
Disapproved a/c
/ ,20
7,20
Expiration
i~UILIJIINi.j I"i~KIVll I A-PPLICAI I{gN CHECKLI~ 1
Do you have or need the follow.g, before apply~g~
Bo~d of H eal~
3 sets of Building Pla~
Plying Bo~d a~roval
Su~ey
Check ~
Septic Fom
N.Y.S.DE,C,
Trustees
Contact:
Phone: '7
Buildifig InSpector
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date December 12 ,2007
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
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 p,e ,rmit
shall [- ~ept 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 fi'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 new p~rmit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance ora 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 cortstmction 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 applicarit or name, if a corporation)
25235 Main Rd. Cutchogue, NY
(Mailingaddressof~plic~t)
State whe~erapp~ic~tis~wner~essee~agent~architect~engineer~genera~c~n~act~r~ec~ician~p~umber~rbui~der
Architect
Name of owner of premises, Tom and Pat i~renz
(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.
Dther Trade's License No.
Location of land o.n which proposed work will be done:
1260 Broadwaters Rd., Cutchogue, NY 11935
House Number Street
County Tax Map No. 1000 Section 104 Block 09
Subdivision ~ Filed Map No.
(Name)
Hamlet
Lot 4.2
Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Residential
b. Intended use and occupancy. "
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost $80,000
5. If dwelling, number of dwelling units
If garage, number of cars t, wo
x 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 45 ' Rear 45 '
Height 20' Number of Stories 1 i/2
Depth" 40 *
Dimensions of same structure with alterations or additions: Front same
Depth same Height same Number of Stories
Rear same
8. Dimensions of entire new construction: Front 20 ' Rear 20 '
Height 18,-9- Number of Stories 1 1/2
.Depth 24'
9. Size of lot: Front 60.85' .Rear 158 +/- Depth 410'
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated R-40
,}
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO x
13. Will lot be re-graded? YES__
14. Names of Owner of premises
Name of Architect Samuels
Name of Contractor
NO x Will excess fill be removed from premises? YES x
Tom & PaL Frexl~ddress1260 Br°adwaterSPhoneNo.
& St, eelman Address Phone No
Address Phone No.
NO
734-6405
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES x 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 ,x NO
* IF YES, D.E.C. PERMITS MAY BE REQUIR.ED.
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.
STATE OF NEW YORK)
Z0UNTY 0 FSv~:
~ ~ ! C~~ :being duly Swoml deposes and says that' (s)he is the applicant
(Name of individual signing contxact) above named,
:S)He is the
(Conlxactor, Agent, Corporate Officer, etc.)
)f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
hat all statements contained in this application are tree to the best of his knowledge and belief', and that the work will be
)erformed in the manner set forth in the application filed therewith.
~wom to before me this,
dayof [~)eC.g~ 20(d-7 ..
Notary Public PITRICIA RICHARDS
Notary. Public, State of New York
No. 01RI6042467
Qualified in Suffolk County
Commission Expires May 30,--200~, -
Signature of Applicant
Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. ~"I~)~"'~" DATE: ,, ~ug. 31, .1999
ISSUED TO ..... THOMAS & PATRICIA FRENZ ......
Authorization
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the ,1~. ws of the
State of New York 1952; and the Southold Town Ordmance en-
titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER IvlATERIALS FROM
LANDS UNDER TOWN WATERS:". and in accordance with the
Resolution of The Board adopted at a meetin9 held on .A.u~ ~.~ ....
19 9.~.., and in consideration of the sum of $. 150..0J) . p~id by
Samuels & Steelma~ Architects on beh~l~ .qt. ?~R~:~.
of Cutchogue .. N.Y. and subject to the
Ter~' a~d '"C. onai~ions liste~ c. the rever~e side hereof,
of Southold Town Trustees authorizes and permlts the ~ollowing:
Wetla~cl Permit to co~s'~uct ~ s~ug]e-£ami1¥ clwelU.~g with ~ttache~
po~ch,~eptic ~¥$tem,~ew ~wo-c~ g~rage with cl~vew~¥ w~h the
co~cHt~o~ that the:e be a 50~ ~o~-cl~stu~b~nce bu££e~ betwee~
wetl~ds,w~h pe~mi8slo~ ~o ~r~d ~tu~
all in accordance with the d~tei~d specifications
.. .... . -, ~o ~o~] dJs~b~ce ~ ~o ~e~
by causes J~ C~rate Semi to 6e a~xed, and thee ~e~.~ to
b~ subs¢rlb~ by a maiori~ of the said Board as of this dat~.
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
PERMIT NUMBER
1-47'38-02387/00001
FACILITY/PROGRAM NUMBE)~(S)
PERMIT
Under the Environmental
Conservation Law
EFFECTIVE DATE
January 28, 2000
EXPIRATION DATE(S)
January 31, 2004
TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate
[]
O
[]
[]
Article 15, Title 5: Protection
of Waters
Article 15, Title 15: Water
Supply
Article 15, Title 15: Water
Transport
Article 15, Title 15: Long
Island We[Is
Article 15, Title 27: Wi[d,
Scenic and Recreational Rivers
[] 6MYCRR 608: Water Quality
Certification
0 Article 17, Titles 7, 8: SPDES
[] Article 19: Air Pollution
Control
[] Article 23, Title 27: Mined
Land Reclamation
[] Article 24: Freshwater Wetlands
· Article 25: Tidaiwetiands
[]
[]
Article 27, Title 7; 6NYCRR
360: Solid Waste Management
Article 27, Title 9; 6NYCRR
373: Hazardous Waste Management
[] Article 54: Coastal Erosion
Management
[] Article 36: Floodplain
Management
[] Articles 1, 3, 17, 19, 27, 37;
6NYCRR 380: Radiation Control
PERMIT ISSUED TO
Thomas and Patricia Frenz
TELEPHONE NUMBER
(516) 777-2900
ADDRESS OF PERMITTEE
117 Queens Court
Massape~ua Park, NY 11762
CONTACT PERSON FOR PERMITTED WORK
Thcm~s C. Samuels - Samuels and SteeLman
25235 Main Road¢ Cutchogue NY 11935
NAME AND ADDRESS OF PROJECT/FACILITY
Frenz Property
1260 Broadwaters Road
TELEPBONE NUMBER
(631) 7'54-6405
LOCATION OF PROJECT/FACILITY
SCTM #1000-104-9-4.2
Cutchogue
COUNTY t TOWN
Suffolk Southold
WATERCOURSE
Broadwaters Cove
NYTM COORDINATES
DESCRIPTION OF AUTHORIZED ACTIVITY:
Establish a 4 foot wide access path. ALL Land landward of t~e 10 foot elevation contour is beyond Article 25 (Tidal-a-a~
Wetlands) jurisdiction.
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the
ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as
part of this permit.
PERMIT ADMINISTRATOR: ADDRESS
Mark C. Carrara CKW Bldg. #4q, SUNY, Stony Brook, NY 11790-2356
AU TH O RI ZED SI G NATURE ~____~/~,, DATE
~ January 28, 2000
Page i or 4
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold, New York 11971-0959
Telephone (631 ) 765- 1802
Fax (631) 765-9502
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
February 17th, 2009
FIRST NOTICE
Thomas & Patricia Frenz
117 Queens Ct.
Massapequa Pork, N.Y. 11762
RE: 1260 Broadwaters Rd. (Accessory Garage)
$¢TM: # 104. -9-4.2
Dear Mr. & Mrs. Frenz,
Please be advised that your Building Permit # 33603 issued December 27th, 2007
has expired. According to the Code of the Town of 5outhold, a Certificate of
Occupancy must be issued before the use of the structure.
To renew your Building Permit, please submit a fee of $242.80; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, pleose call us at 765-1802.
Respectfully,
$OUTHOLD TOWN BUILDINS DEPT
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold, New York 11971 0959
Telephone (631) 765 1802
Fax (631) 765 9502
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 2"d, 2009
SECOND NOTICE
Thomas & Patricia Frenz
117 Queens Court
Massapequa Park, N.Y. 11762
RE: 1260 Broadwaters Rd. (Accessory ~3arage)
SCTM: # 1000-127. -9-1§
To Whom It/~ay Concern:
Please be advised that your Building Permit # 33603 issued December 27th, 2007 has
expired. According to the Code of the Town of Southold, a Certificate of Occupancy
must be issued before the use of the structure.
To renew your Building Permit please submit a fee of $ 242.80: at that time we can
Schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 765-1802.
Respectfully,
SOUTHOLD TOWN BUIbDING DEPT
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M. ~
Item Number:
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
STORM-WATER~ GRADING; DRAINAGE AND EROEION CONTROL PLAN
CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YOEK.
(NOTE: A Check Mark (~) for each Question is Required for a Complete Application)
Yes No
1 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 activities as well as all Site
Improvements and the permanent creation of impervious surfaces.)
2 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 --
3 Will this Project Require any Land Filling, Grading or ExcavatiOn where them is a change to the Natural r'~
Existing Grade Involving more than 200 Cubic Yards of Matedal within any Pamel?
4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of
Five Thousand (5,000) Square Feet of Ground Surface?
5 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?
6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to
One Hundred (100') of Horizontal Distance?
7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off r'~
into and/or in the direction of a Town right-of-way?
8 Will this Project Requlra the Placement of Material, Removal of Vegetation and/or the Construction of [--'"1
any Item Within the Town Right-of-Way or Road Shoulder Area?
(This item will NOT Include the Installation of Driveway Aprons.)
9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watemourse?
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 Submlffed for Review Prior to Issuance of Any Building Permitt
EXEMPTION:
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan Is NOT Requlredl
Yes No
STATE OF NEW YORK,
............... ss .
(Name of individual signing Docum/ent )
And tha[?)she is the ...~.~... ':~...~... : .......................................................
(Owner, Conlractor, Agent. Coq~orate Officer. etc.)
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 tree to the best ofh/s 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;
.................. ........ ............ 0.0..7
Notary Pubhc:~....U/.~'.. ~~,12.,tO ? ................................ : .................. : ................................
Q*4al[fisd [:'~ Suffolk County ~ (Sigflature°fApH*cant)
FORM -06~07 c~,,~:,~ ~ ~,,.~ ~ ,qr ~ ~ay .~o, :~