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HomeMy WebLinkAbout37276-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 8/2/2012 No: 35854 Date: 8/2/2012 THIS CERTIFIES that the building DECK Location of Property: 5500 Rocky Point Rd, East Marion, SCTM #: 473889 Sec/Block/Lot: 21.-3-1 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 5/29/2012 pursuant to which Building Permit No. Lot No. filed in this officed dated 37276 dated 6/5/2012 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: repairs to existing deck and "as built" deck addition to an existing one family dwelling as applied for. The certificate is issued to Skulikidis, Michael & Ploum (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ~4 z~ed~Signat ure 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 #: 37276 Permission is hereby granted to: To: Date: 6/5/2012 Skulikidis, Michael & Skulikidis, Ploum 40-15 155th St Flushing, NY 11358 repair an existing deck as applied for At premises located at: 5500 Rocky Pgint Rd, East M~rion SCTM # 473889 Sec/Block/Lot # 21.-3-1 Pursuant to application dated To expire on 12/5/2013. Fees: 5/29/2012 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $200.00 $50.00 $250.00 Building Inspector Form No. 6 TOV~N OF $O~FHOLD 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 w!th the following: 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 Dgpt. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical instalIation from Board of Fire Underwriters. 4. Sw. om statement from plumber certifying that tho 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 bnilding~ 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 c~mpleted 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, A6eessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 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 $[5.00 New Construction: Old or Pre-existing Building: t,/ (check one) Locationoferoperty: ~'~O /~/~U/~c ~UC~ ~.,~7'" ,nd~t/Q-t'O,~/ .et/),/ House No. Street ' ' ' OwndrorOwnemo~Pmperty: .t44 t C bf ,ff-~ ~- ~ ~._c.,, ~L./ /~, b/ ~ Hamlet Suffolk Copnty Tax Map No 1000, Section. ~5 24 Bubdivisi0n Permit No. Health Dept. Approval: t~ 4- Planning Board Approval: t/vt ~ Date of Permit, Block · o Filed Map. Applicant:. Underwriters Approval: Lot Request for: Temporary Certificate Fo~ Submitted: $ Final Ce~ificate: (check one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] RO/~t~ PLBG. [ ] FOUNDATION 2ND [ ]//~NSULATION [ ] FRAMING/STRAPPING [//] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ]ELECTRICAL~ [~]E~LEC~_TRI~CAL(FINAL} REM~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.nct Examined Approved Disapproved a/c_. Expiration PERM1T NO. ~7'~'~''- ~ 2.9 BLDG. DEPT. TOWN OF SOUTHOLD Building Inspector 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 C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mailto: /O~,,~~' %~. !~::~ Phone: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 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 througbout the work. e. No building shall be occupied or used in whole or in pa~ for any purpose what so ever until the Building Inspector issues a Ceffificate of Occupancy. f. Eve~ building permit shall expire if the work authorized has not commenced within 12 months a~er the date of issuance or has not been completed with in I 8 months from such date. If no zoning amendments or other regulations affecting the propegy 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 ItEREBY MADE to the Building Depamnent tbr the issuance ora Building Permit pursuant to the Building Zone Ordinance oftbe Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or fbr removal or demolition as herein described. The applicant agrees to comply tx ith all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessar) inspections. , ',c UNi AWFU' ' (Signatureofapplicantorname, aco oration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, geqeral ~ctor eJectric~,plumber or builder ~v 8UILDINO ~p~ AT Name of owner of premises *~5~802 8 ~ TO ~ ~ ~ ~ (As on the tax ~~T~8: lfapplic~t is a corporation, signature of duly authorized officer t rOUNDAT~~ ~O8 PO~D 2 qO~H.~.~, 3 ~NSULATI~ (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: House Number Street 4 F L A L * CONSTRUCTION & ELECTRICAL UuST BE COMI~.ETE FOR C.O. ALL CONSTRU{~ION ~ ~ ~ RE ~d i~' E M ENT8 OF l.H~ COOEs OF NEW Vq~K STATE, NOTRESRON~.E FOR ~$*ON OR ~ ERRORS. Hamlet CountyTax MapNo. 1000 Section ~ 2-/ Block o..~ Lot ~'f Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. intended use andoccupancy. 3. Nature of work (check which applicable): New Building Repair f Removal Demolition 4. Estimated Cost /37,~Oa,o o 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Othqy Work · ': (Description) · Fee : (To be paid on filing this application) N~er~o~d~mg u~n~[s on each floor If business, commercial or mixed occupancy~, sp~i~,/' fiature and ex"te~,J. 92' J,~ch 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. Size of lot: Front /~--0 Rear / 5--0 Depth / W-o 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 t/' Will excess fill be removed from premises? YES__ NO__ 14. Names of Owner of premises ~'~ w//~r,) Name of Architect Name of Contractor Address Address Address Phone No. Phone No 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. INO g/ 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 YORKi ' · COUNTY 0I~0~20~:)¢:¢ :;: ," '15( t~ .......... ?; ,, -, , ~,- being duly sworn, deposes and says that (s)he is tire applicant (Name of individ~al~~i~ve named, (ContractorCAgent, Corporate Officer, etc.) of said owner or owners and is dhly'a~thb~ed to perform or have perfbrmed the said work and to make and file this application that all statements conm?ed ~.~m ap~hcatmn are true to the best of bm knowledge and behef and that the ~ork wdl be performed m the manner s~t ~6~'jS~e,apnl,cat,on file~lh~i_DJ.$H _ Sworn t~ before me this' ~Ii~~ ,C ~ dayof ~1 20/~ ~ u~ ~ I Nota~ Public ~ Signature of Applicant O Town of Southold - Chapter 236 - Stormwater Management SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) property AdOr~: Brief Description of Constxucfioa Activity, Proposed Slructutal BMPa, Soil Stabalizafion BMPs, Project Scoge and/or Sequence of Construction Activity 000 Will this Project Disturbe five (5) or More Acres at Any One Time During the Proposed Development ? Yes No a. Does the Applicant have a Qualifiod inspector On Stag To Conduct the R~quired Inspections ? Yes No Inspections will Occur and for What Period of Time ? Yes No c. Does the SWPPP Adequately Identify AIl Temperary and/or Permanent Soil Stabalizat]on Measures ? Yes No d. Does the SWPPP Adequately Identif~ a Complete r-~ I-~ e. Does the SWPPP Indicate Additional Site Specific Practices that Will be Utile_ed to Protect Water Quality ? Yes No Of intent and SWPPP Acceptance Form for Review by the Town of Southold ? Yes No S*]'Aq~ OF NEW YORK, -~. /' c_. t coum~ or ...3~3.~ ................ ss Owner ;md/or represenl~dve of the Owner or Owners, make a~d file fl~s application; that ail statement~ conic-led that the work will be performed in the mmaner set forth in the application filed II~i~¢exStffalteRa~O~Iw ~u,a Sworn to before ~e this; I0 O1ST6t~uu SWPPP Assessment FORM: 03-12 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY 11971-0959 July 17, 2012 BUILDING DEPARTMENT TOWN OF SOUTI-IOLD Telephone (631 ) 765-1802 Fax (631) 765-9502 Michael Skulikidis 40-15 155th St. Flushing, NY 11358 Re: BP 37276 - Repair Deck 5500 Rocky Point Rd, East Marion Dear Mr. Skulikidis: In order for us to issue a Certificate of Occupancy for the above referenced building permit, you will need to submit 4 sets of "As Built" stamped plans for the additional decking. Once we receive those, we will amend your permit and notify you of the additional fee. If you have any questions, please feel free to call our office. Sincerely, Southold Town Building Department ~g~f--~/: ~_/ TOWN OF SOUTHOLD PROPERTY RECORD CARD - OWNER STREET VILLAGE DISTRICT ' SUB. FOYER OWNER N ~ ~, ACREAGE S. · ~ , W<, .) ~ ~ ~PE OF B~ILDING ~ND IMP. TOTAL, DATE REMARKS Tillable 1 ' j BULKH~D Tillable 2 DOCK Tillable 3 WOodland Swampland Brushland House Plot iTotal A/ 77 /~$o g-- / AU6 - :) 012 ' I '.~ BP 37276 Repair Deck . fi. ,,~, ~ I I ~)^~. 8-2-12 . ~.~ ~.. - . r,~. - ~-:L~ ....... ~ ~ ~ ~; ~o' NO~~s bui,t in a~rdan~ to the I EAST MARI~ . A' r Codes ofthe time of constm~ion.