The URL can be used to link to this page

Home My WebLink About36468-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 7/31/2011 No: 35109 Date: 7/31/201 THIS CERTIFIES that the building DECK 1Jocafion of Property: 1805 Jockey Creek Drive, Southold, SCTM #: 473889 Sec/Block/Lot: 70.-2-26.2 Subdivision: Filed Map No. conlbrms substantially to the Application for Building Permit hereto~bre 6/3/2011 pursuant to which Building Permit No. Lot No. filed in this officed dated 36468 dated 6/10/2011 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: Addition to a Single Family Dwelling: Rear Wood Deck, 12' x 32', as applied fur. The certificate is issued to Rubin, Lawrence & Rubin, Virginia (OWNER} of the atbresaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL EI, ECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36468 Permission is hereby granted to: Rubin, Lawrence & Virginia 1805 Jockey Creek Drive Southold, NY 11971 To: Addition to a Single Family Dwelling; Rear Wood Deck, 12' x 32', as applied for. Date: 6/10/2011 At premises located at: 1805 Jockey Creek Drive, Southold SCTM # 473889 Sec/Block/Lot # 70.-2-26.2 Pursuant to application dated To expire on 121912012. Fees: 6/3/2011 and approved by the Building Inspector. CO - ADDITION TO DWELLING SINGLE FAMII,Y DWELLING - ADDITION OR ALTERATION Total: $50.00 $353.60 $403.60 Building Inspector 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/i0 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 inspect signed by the applicant. It'a Cm~ificate 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 $5000. 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, Cmmnercia[ $15.00 New Construction: Locatiou of Property: /~/C; House No. Owner or Owners of Property: Suffolk County Tax Map No I000, Section Subdivision Permit No. ,~ (~ z./6 Health Dept. Approval: Old or Pre-existing Building: Street Block Filed Map. Date of Permit. ~' -/~ · // Applicant: Underwriters Approval: Date. (,L --~_ 3 - / ! (check one) Hamlet Lot ~'~/~ Lot: Planning Board Approval: Request for: Temporary Certificate Fee Sublnit~ed: $ ZT~.' , dZ~/x' ~ Final Certificate: (check one) Applica~ Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~X~ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]RRE RESISTANT CONSTRUCTION REMARKS: DATE INSPECTOR '~' ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION ~FINAL FOUNDATION 1ST FOUNDATION 2ND FRAMING/STRAPPING FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRICAL (FINAL) [ ] FIRE RESISTANT CONSTRUCTION [ [ ] ELECTRICAL (ROUGH) [ REMARKS: DATE INSPECTOR__~', ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net ~oved tx, ration I - ! V , 20 £3 JUN - 3 2011 BIOG. DEPT. TOV,~N OF PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before appbing? Board of Health ~"'-,4 sets of Building Plans Planning Board approval Sarvey Check ~L",G5 4-t-tOq Septic Form ~('~, tC~- N.Y.S.D.E.C. Trustees Flood Permit Single & Separate Stm'm-Water Assessment Form_ Contact: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS O (3 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 scbedule. b. Plot plan sltowing location of lot and of buildings on premises, rclationsbip to adjoining premises or public streets or areas, and waterways. c. The work covered by this applicalion may not be commenced belbre issnance of Building Permit. d. Upon approval of this application, the Building htspector will issoe a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throogbout the work. e, No building shall be occupied or used in whole or m pan For any purpose what so ever until the Building Inspector issues a Certificate of Occopancy. f'. Every building permit shall expire iFthe work authorized has not commenced within 12 months after the date of issnance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting thc property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension oftbe permit for an addition six montbs. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department For the issuance ora Building Perlnit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, fbr the construction of buildings, additions, or alterations or fbr removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, boilding code. housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) State whether applicant is oxvner, lessee, agent, architect. OWN&P-. (Mailing address of applicant) engineer, general contractor, electrician, plumber or builder Name oFowner of premises L 4xtq ,z ¢ ,:.a c~C /~, ~ o ~ ~ ~ As on the tax roll or latest deed) IF applicant is a corporation, signature of duly autlaorized 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: I {ouse Number Street County Tax Map No. 1000 Section Subdivision Block Filed Map No. Hanllet Lot Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy i'~/::' ¢~.t,: }., ,f.~ ~.( -.; {: ,~ ,t,.,.rr: b. Intended use and occupancy_ 3. Nature of work (check which applicable): New' Building_ 0 cc.v... Repair Removal Demolition 4. Estimated Cost ~ ~1500 5. If dwelling, number of dwelling nnits If garage, number of cars Addition Alteration Other Work (Description) Fee ~ ~ ~3 ,l,~0 (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. NJ A 7. Dimensions of existing structures, if any: Front lq/ /~' Height Number of Stories Rear Depth __ Dimensions of same structure with alterations or additions: Front iq Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height a_" Number of Stories 9. Size oflot: Front ~O Rear [~0 Depth Rear .Depth _ } 03... ~/~'O] i~}S Name of Former Owner 10. Date of Purchase 1 1. Zone or use district in which premises are situated 12. Does proposed construction violate an), zoning law, ordinance or regulation? YES NO 5< 13. Will lot be re-graded? YES NO 7, Will excess flu be removed from premises? YES NO 'x 1 4. N ames of Owner of premises r. ,,,,,~ ,z ¢,-~, ~ e,J p, ~ Address Name of Architect Address , Name of Contractor Address :5orVtCl r¢~,~ic Phone No56 5') Tc~ q~t~ Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD ']:'OWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO 'A * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO ~- 16. Provide survey', to scale, with accurate lbundation 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 · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF lq"/ ) L h ~ ~6 r4 C 6 A · 17. x~ ~ ~ N.) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE O. BUNCH Notary Public, S~ate of New York (S)He is the No. 01BU6185050 (Contractor, Agent, Corporate Officer, etc.) CommissionQUalified Expiresin ~uf~O~KApdlGouruT. ,14.2~2.L1-.' 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 bis knowledge and belief; and that the work will be perlbrmed in the manner set forth in tbe application filed therewith. Notary' Public Signature of Applicant 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 i 0() 0 ~,~ :~, ~ STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAH Dtst~ct SecE~n Block Lot C~K I ;rl~U BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION rJ.'l~M # / WORKASSF~S1VI~Wr [ Yes No a. What is the Total Ama of the Project Parcels? (lesiude Total Ama of all Parcels located within I Will this Pr°ject Retain AIl Storm-Water Run-elf the Scope of Work for Pmpesed Construction) Generated bya Two (2")lncfl Rair~allon Site? ' / r~ b. What is the Total Area of Land Cleadng (S.F. I .*o~s) (This item will include all mn-off created by site clearing and/or co~struction activities as well as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? (S.F.! As~s) impervious surfaces.) 2Does the Site Plan and/or Survey Show All Proposed PRO~[DE BRIEF PROJ~C'T DE, SCI~J]~FJON iR.~ ~ P~,~,,~,a,~; Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes arm ~( ~, ~t ~- ~ ~t~{_ ~_ Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey descdhe the erosion and sediment control practices that wtil be used to control site erosion and storm water discharges. This item must be maintained throughout lhe Entire Construct[on Period. 4 Will this Project Requ re any Land Fitting, Grading or Excavation where there is a change to the Natural ~ Existing Grade Involving more than 200 Cubic Yards~ __ of Ma edal within any Parcel? 5 Will this Application Require Land Disturbing Activities r~ Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? -- 6 ~s there a Nalural Water Course Running through the r--'"'ll Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Recjuirementu: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is required for a~l Conctmction activities involving sea Beach? disturbances of one (1) or more acres; irrcluding disturbances of inss than one age that 7 Will there be Site preparation on Existing Grade Slopes are part et a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen (15) feet of Ve~cal Rise to V incJuding Construction activities lavo~ing soil disturbances of less than one (1) acm where One Hundred (100') of Horizontal Distance?L~J -- /he DEC has determined thai a SPDES permit is required for sthnn water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit ~ Will DriYeways, Parking Areas or other Impervious [~ / ;or Storm Water Discharges from Construction actJvay - Permit No. GP-O-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off STATE OF NEW YORK, COUNTY OF ........................................... SS 'l_~at I ................................................................................. (U,me*tin~a, sia,in* ~o~,~,l) being duly sworn, deposes and says that~(~t~l~ ~.eBal[l~J~t for Permit, And that he/she is the Notary Public, State of New York ............................................ ('d~;:'~;~;:'/.~;,;~T&';~i'."~;.';;c~i ............ NO:-0~.B~6-1860~O ........ 'g2: ....... . . . Qualified in Suffolk County ~(..) / Owner and/or representabve of the Owner or Owners, and ~s duly anthonzed to peff~!~.ffi~,O~xc.~ll~ ~ald:~orJ[. 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 thc work will be performed in the manner set fo~,h in the application filed herewith. Sworn to before me this; ............................ :,~. ~ ayof ....... ~:..~. .......... ~. ................ 20-1_ ] Notary Pub c (~ r..~. ~ 5.'~.~f .......... ...P :~.~ ..... ~....~...~.....(....& ................................................................................ FORM- 06/I0 BUILDING PERMIT EXAMINER CHECKLIST Applicant: ~'~~ ~4.c~ Architect/Engineer: SCTM# 1000 -- Property Address: '- ~ -- a~,~1' Subdivision: *Date Submitted: g ~'~ ~ ~ { Date Reviewed: Estimated Cost: Zone: , Conformiag? ~ Building Permits (Open/Expired): BP __-Z / C/0 Z- , Info: BP BP .-Z / C/0 Z- , Info: BP __-Z / C/0 Z- , Info: Single & Separate Search Required? Y o~/N>etermination: REQ. Lot Size: ACT. Lot Size: REQ. Front ACT. Front REQ Side ACT. Side REQ. Height. ACT. Height RE~. ~ov~ $1b~5 -Z / C/0 Z- , Info: BP -Z / C/0 Z-__, Info: REQ. Lot Coy. REQ. Rear ACT ACT~ Lot Cov. PROP. Rear Waterfront? Y o~_Nff ' / If yes, water body: ~ - ' Panel# Flood Z,one: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED ~L,q ~/5 (q-) $1~,q~b~, $~"~t-~'-b SaCV~¥ -~g-~O-r--~m,~ k/'/ 4)- County Health: Y or If yes, *Bed#: *Date: / / *Permit#: Town Septic: Y~'~/) Suffolk ~ If no, certification required: Y or N Received: Y or N By: NYS DEC: ea~-o~c9/u~s Y or(~- Date: / / Permit #: Soutbold Trustees: Y or(j~- Date: / Southold Z, BA: Y or~- Date: / / Southold Planning: Y or~ - Date: / Town Landmark C of A: Y o~DTE: / Notes: / Permit #: Permit #: / Permit #: / L It~BIL I TY or NJ Letter - Notes: or NJ Letter- Notes: - Notes: - Notes: *NYS CODE ~_omplianee (page 2~/or N Fee Structure: Calculation: Foundation: ~ SF First Floor: SF Second Floor: ~ SF Other: ~ SF Total: SF C OF o FEI~ t- Initial Fee: $ Additional Fee ( ): $ SF X $, -$ + hfitial Fee: $ Additional Fee ( ): $ TOTAL: NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGP, APHIC DESIGN CRITERIA: · Ground Snow Load: ~0 Weathering: Severe__ Frost Depth: 36"__ Design Temp: 11 __ Ice Shield Underlay: YES . USE/OCCUPANCY CLASSItZlCATION: · HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRiTEILIA: ENGiNEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: YfN WALL STUDS: CEILING JOISTS: Y/N FLOOR JOISTS: Y/lq LUIM[BER SPECIES AND GRADE: Y/N Wind Speed: 120MPH__ Seismic Design Category." B., Termite: M-H Decay: Flood Hazards: GLRDERS: Y/N ROOF RAIZTERS: Y/N WYN-DOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N ~rENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING IL1SER DIAGI'~dvI: YFN LOCATION OF FtTAE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIYICATION: Y/N ENERGY CALCS: Y/N (R~$CB~CK) TOTAL COMI'L1ENCE? Y/N (RETUIkN TO PAGE ONE) '", \. APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS~ 1 FOUNDATION- TWO REQUIRED FOR POURED CONCRETE 2 ROUGH- FRAMING, PLUMBING, : STRAPPING ELECTRICAL & CAULKING 3 INSU~TION 4 FINAL- CONSTRUCTION & E~CTRICAL MUST BE C~ F~ CO. ALL CONSTR~TI~ ~L ~ ~E REQUIREMENTS OF THE C~E$ ~ NEW YORK STATE. ~T ~1~ ~ DESIGN OR C~S~ E~. COMPL¢ WIYH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED A -' ~,,!~0L D TOWN I P~