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Home My WebLink About35694-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 7/19/2012 No: 35830 Date: 7/19/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: DECK 200 IHAR LA CUTCHOGUE, Sec/Block/Lot: 83.-4-15 Filed Map No. conforms substantially to the Application for Building Permit heretofore 7/7/2010 pursuant to which Building Permit No. was issued, and conforms to all of thc requirements of thc applicable provisions of the law. Thc occupancy for which this certificate is issued is: rear dock addition to an existing one family dwelling as applied for. Lot No. fried in this officed dated 35694 dated 7/7/2010 The certificate is issued to James & Donna Kowalsick (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII/DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35694 Z Date JULY 7, 2010 Permission is hereby granted to: JAMES P KOWALSICK 680 DUCK POND RD CUTCHOGUE,NY 11935 for : REA~R DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. REPLACES EXPIRED BP # 32948 at premises located at 200 County Tax Map No. 473889 Section 083 pursuant to application dated JULY Building Inspector to expire on JANUARY Fee $ 200.00 IHAR LA CUTCHOGUE Block 0004 Lot No. 015 7, 2010 and approved by the 7, 2012 . ~~&t~re ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ~C~MPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32948 Z Date APRIL 26, 2007 Permission is hereby granted to: JAMES P KOWALSICK 680 DUCK POND RD CUTCHOGUE,NY 11935 for : REAR DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 083 pursuant to application dated APRIL Building Inspector to expire on OCTOBER Fee $ 200.00 200 IHAR LA CUTCHOGUE Block 0004 Lot No. 015 24, 2007 and approved by the 26, 2008. ~orized~Sig~ ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR GERTIFICATE OF occUPANCy JUL 13 2012 ~?OI,IYrN OF SOUIHO~D This application must be filled in by typewriter or ink and submitted to the Building Depamnent w!th the following:. A, For new building or new use: 1. Final survey ofproporty with accaratelocation of all buildings, property lines, streets, and unusual natural, or · topographic features. 2. Final Approval from Health Dgpt. of water supply and sewerage-disposal ($-9 form]. 3, Approval ofeleetrica! installation from Board 6fFire Underwriters. 4. 'Sw. om statement from plumber ceRifying that tho solder usedin system contains less thaa 2/10 of 1% lead 5. C°mmevc'ial building, indnstrial building, mtiltiple residences and similar buildings and installations, a eer,d ficate of Code Compliaaee'from architect or engineer responsible for thc buildiag~ .6. Submit Planning Board Approval of completed site pla~ requirements. B. For existing buildings (prior to April 9, 1957) non-conforming us~s, or buildings and "pre-existing" land uses: 1. Accurate survey of property show ng all property lincs,'streets, building and unusual natural or topographic features. 2. A properly c~mp!eted application and consent to in,peet signed-by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificaie of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Akerations to dwelling $50.00, SWimming po01 $50.00, Accessory building $50.00, Additions to accessory building $$0.00, Businesses $50.00~ C;~rtifioate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updatex/Certificate of Occupancy. $50.00 5_ Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New (3onstruction: / Date. Location of Property: Old or Pre-existing Building: -00 House No. Street '_ (cheek one) 9wn~r or Ownera o.f Property: ~ffolk .Copnty Tax Map No 1000, Section_ ~ubdivisibn ~ D~pt Approval: 'lanning Board Approval: [~lue~t for: Temporary Certificate 'ex: Submhted: $ fit) ~ Bieek ~L'. Piled Map. Dat? of Permit J i) Lx[' -} ~)0[ O ~pE~C.. ~J~ ~ / Und~te~ ~p~: __ Final Certificate: (check one) ~ignatmc Hamle~ 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 REMARKS: ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION REMARKS: ~/~~ ~ INSPECTOR DATE //' -''~ ~- o 7 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ]INflATION [ ~j~FINAL [ ] FIRE SAFETY INSPECTION ( ] RR~R~mSTANTm~RATHm [ ] FOUNDATION 15T [ ] FOUNDATION 2ND ] FRAMING / STRAPPING [ ] FIREPLACE & CHINNEY ] F~ERESm'J.I'~ 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 CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ~?'f ~- ~/"~-- INSPECTOR Fm.D ~a'ECT~ON ~PORT I DATE FO~DATION (1ST) FO~DATION (2ND) PL~G ~S~ATION PER N. Y. STATE ENERGY CODE . -., TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration ,20 PERMIT NO. ,~gt~q~ ~ 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 Contact: Mail to: jPhone: APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a, Thi~pptieation MUST 1SE 6bmpletely 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, 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. (Signature of applicant or name, if a corporation) (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (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. '/-fid.3 Plumbers License No. Electricians License No. Other Trade's License No. Location of land on v~hich pr~oposed work will be done: House Number Street County Tax Map No. 1000 Section ~3 Subdivision (Name) /l?gs Hamlet Block '~g Lot / ~ Filed Map No. Lot /5'~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy p~c~tLtd,/O b. Intended use and occupancy_ 3. Nature of work (check which applicable): New Building. Repair Removal Estimated Cost ~r If dwelling, number of dwelling units If garage, number of cars Addition Alteration Demolition Other Work 'i:>a'r--f2-/xK)-'~ 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 Rear Height ,~ ~ ~ Number of Stories Dimensions of same structure with alterations or additions: Front ~>0 r Depth /./-~ c Height ~ ~' r Number of Stories Dimensions of eatire new col~struction: Front ~t ~R Depl~h~ ~ 8. Height ff'(/~ ~ Number of Stories ~ e~ ~ ~r~)' ~ 9. Size of lot: Front /5o' / Re~ /,~ Depth ~70 r 10. DateofPurchase /~ -/~ ~? Name ofFo~ Owner ~ ~~~ ~ 11. Zone or use district in which premises ~e situated ~ c~ ~ ~Depth 35~ i Rear ~-ff C 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'/Am~ ~ t~t~c~Az ye~_..Address/~-- Phone No. P Name of Architect -'~o~cp f~Zca~ Address rvt,+7~ 7'Lx:4~ .~-~ Phone No ~;~r- Name of Contractor ~ Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ 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 __ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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) SS: COUNTY OF ) -~ret(tx~ ~ /6-z-~aS~Cf/---'- being duly swom, 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 filed therewith. Swo_m to before me this 2l.~ dayof .lSd, fl{ 209-/ LORI H. MONTEFU$CO Notary. Publ~,.S~te of New Yolk no. OZMU6109802 G~lified in Suffolk CoullP/ _ e, C~rnmlssion Expires May 24, 20 ?_~.lr S ignature of Applicant Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM EXEMPTIONS: Yes No A. Does this project meet the minimum standards for classification as an Agricultural Project. ~ Note: If you answered Yes to any of the above, a Storm-water, Grading, Drainage & Erosion Control Plan is not required. .ACTIONS REQUIRING THE SUBMISSION OF A STORM~WATER~ GRADING, DRAINAGE & EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK, Item Number: (A Check Mark (,/) for each question is required for complete application) Yes No 1. Will this project retain all Storm-Water Run-off generated on Site? (This will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) v/ [~ 2. Will 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? r~ ~ Will this application require land disturbing activities encompassing an area of five thousand (5,000)square feet of ground surface or more? Is there a Natural Water course running through the site or is this project within One hundred (100) feet of wetlands or a beach? Will there be site preparation on slopes which exceed fifteen (15) feet of vertical rise to One hundred (100) feet of horizontal distance? Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Right-of-Way? Sworn to before me this; , ............ C~........O ........... day of.... ~ .................... 20.1~.. N°tary Public ~01~ · · ~ .~L~.~t~k~-.~ .... t;Ommtssien Exoires May 24, ;~0 ~ (Signature of Applicant) 7. Will this application require the placement of material, removal of vegetation and/or the .construction of any item within the Town Right-of-Way or road shoulder area? (This item does not include the installation of driveway aprons.) 8. , Will there be site preparation within the one hundred (100) year floodplain of any watercourse? r~ Note: If any answer to questions ~ne through eight 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 issuance of any building permit. STATE OF NEW YORK, -. COUNTY OF...~.~d ~ ......... ss That I, ~j/~W1 ~' ~..(09~:~[._(f~__.._ being duly sworn, ~eposes and says that he/she is the applicant for Permit, (Name of individual signing Document) Aaa that He/She is the 0 (Owner, Contractor, Agent, Corporate Officer, etc.) Owner and/or representative of the Owner or Owner's, and is duly author/zed 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 belier; and that the work sill be performed in the manner set forth in the application filed herewith. ,"~ *q VILLAGE DIST. SUB. LOT OWNER STREET,., FOYER OWNER ~ / ' ~ ~ E ACR. ~ t'~l'~ ~ JJ/~r --~Qf S W ~PE OF BUILDING RES. ~ ~ O S~S. VL ~ ,~ FARM CO~. CB. MICS. Mkt. Volue ~ND IMP. TOTAL DATE R~RKS Titloble FRONTAGE ON WATER W~lond FRONTAGE ON ROAD Meadow~d . ~O? /~ ~o : 1~3 ~) DEPTH ~ TO ' ~ I ~ ....... BULKH~D House Plot ~"i C ~ ~4 ~ ~,;, Toro I TOWN OF SOUTHOLD PROPERTY RECORD CARD ~ sro, ' - ' FIoors xtenslon ...... ~3__~ Basement f',~ l/ , i,. !~ ~ _ 1o~ j~¢ ~n~n ~ ~i ,~, Z ~ ~rO ~ 0 ~x,. Walls ~m,, Interior Finish L "~- Heat xtensi~n F ire Place ~ ~ Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765- 1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 3, 2012 James Kowalsick 680 Duck Pond Rd Cutchogue NY 11935 Re: 200 lhar Lane, Cutehogue TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: ~l~Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (contact your electrician) C~/A fee of $50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees # 765-1892) __ Final Planning Board Approval. (Planning # 765-1938) __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 35694- Rear Deck Iii g LOT NUMIE~:R 14 VACANT cji~ 264 9 E}-34 1 523 S.39°00 '00" E 150.00' 12 5.00 ' POND ROAD DUCK 9-29-1998 FINAL SURVEY 6-23-1998 FOUNDATION LOCATION 5- 15-1998 REVISED DWELLING 1~26~ 1998 PROPOSED DWELLING ', N.Y. LIC. NO, 0.~992 HAROLD F. TRANCHON JR. PENN. LIC. NO. SqllS-E VACANT JOB NO. 97-269 SURVEYED FOR LOT NO. 15 MAP OF WOODBINE FILE NC). WOODBINE MANOR MANOR SITUATED AT CUTCHOGUE TOWN OF SOU T HOLD - SCALE 1" = 50' FILED MAP NO. 8239 TAX MAP NO. 1000- 83- 4-15 SUFFOLK COUNTY N.Y DATE 7-- 23--1997 DATE 12- 1,5 (REF. ONLY) DiSK 1'7~ HAROLD F. TRANCHON JR.P.C, LAND SURVEYOR 1866 WADING RIVER-MANOR RD. WADING RIVER. NEW YORK, 11792 516-929-4695 J I~,~ILOING USE BUILDIJ~G AREA ~ OF C~UCTI~ ~S~ CRITER~ WINTER ~S~N ORY BULB ~ 11 ~ ~ E~ CATE~ of New Y~ S~ & ~ ~ F~t & P~r ~ FReT Li~ ~PTH (AF&PA) W~ Fr~ C~uct~ ~ ~r ~ & T~ TE~ITE OCCUPANCY OR ~ USE IS UNLAWFUL "' WITHOUT CERTIFICATE ~ OF OCCUPANCY ~ ALL CONSTRUCTION SHALL ~ MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. RETAIN sTORM WATER RUNOFF PURSUANT TO SECTION 45'10C ~,,~ ~ ~ ................ OF THE TOWN COOE. ~'~.~ op~'~ APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. . ~ ALL CONSTRUCTION SHALL I~IE~T T~ REQUIREMENTS OF THE COD]~_OF YORK STATE. NOT RESPON~ISLE F~ RESIGN OR CONSTRUCTION ERROI~:J