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Home My WebLink About36461-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 11/19/2012 CERTIFICATE OF OCCUPANCY No: 36051 Date: 11/19/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: AS BUILT ADDITION 260 Oak Dr, Cutchogue, Sec/Block/Lot: 104.-5-27 Filed Map No. conforms substantially to the Application for Building Permit heretofore 6/1/2011 pursuant to which Building Permit No. 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: "as built" outdoor shower stall addition to dwelling as applied for. Lot No. filed in this ofliced dated 36461 dated 6/8/2011 The certificate is issued to Bowe, Scott & Stacy (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 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 #: 36461 Permission is hereby granted to: Campbell, James & Campbell, Arlene Date: 6/8/2011 118 Third St ~arden City, NY 11530 To; outdoor shower stall addition to dwelling At premises located at: 260 Oak Dr, Cutchogue SCTM # 473889 Sec/Block/Lot # 104.-5-27 Pursuant to application dated To expire on 6/7/2012. Fees: 6/1/2011 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ADDITION TO DWELLING Total: $200.00 $50.00 $250.00 ( Building Inspector Form No. 6 TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This appli~tion must be filled in by typewriter or ink and submitted to the Building Department with the following: building or new use: . . . · and unusual natural or ~-,- new . · ...... ldin-s ,,roperty lines, streets, A. ~'7'Final survey of property with accurate location oI att om ~ , v · lures. topographic fen ..... r...ater su"'qv and sewerage-disposal (S-9 form). 2. Final Appwval from l-tealth ~ept. m w vr J AppwVal of electrical installation from Board Of Fire Underwriters. lead. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate 5. 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 c~ompleted app}ication 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. es ..... ~" ^~;tions to dwelling $50 00, Alterations to dwelling $50.00, C. Fe · · ~,~ ~,,~ncv - New dwening ,ou.vv, ~-~,~, ~-':~;~,~ $50 00, Businesses $50.00· 1. Certificate oi~C~-~--- ,_ ~._a~-- q:q0 O0 Additions to acCessory ou,~,,,~ - Swimming pool $50.00, Accessory u~,,,,~,,~ .... $100.00 2. Certificate of Occupancy on Pre-existing Building - 3. Copy of Certificate of Occupancy - $'25 4. Updated Certificate of Occupancy - $50·00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $l 5.00 Date. ~ Old or Pre-existing Building: _~_~1 / (check one) New C°nstructi°n: ~ ~a~~) ~/~CII~ ~ ~ll~_ Hamlet ~cation of pmpeRy: Strut House No. · . Suffolk County Tax Map No 1000, S~tion ~ Bilk ~ Fil~ Map. ~ ~ 8ubdivision _ p~mit No. ~ Health Dept. Approval: __ Planning Board Approval: _ Request for: Temporary Certificate Fee Submitted: $ ~ Date of permit.__ · Applicant:_ Underwriters Approval: Final Certificate: (check one) Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ [ ] FRAMING / STRAPPING [ .,,,]'FINAL [ ] FIREPLACE&CHIMNEY [ ] FIRESA,-..;flNSPECTION [ ] RRERESISTMITCOflSlRUC110N [ ]RREIIESISTANTI~EHETRA110N REMARKS: __ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Examined Approved Disapproved aJc PERMIT NO. 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 Flood Permit Single & Separate Storm-Water AsSessment Form Contact: Mail to: Phone: Expiration~ _ / o ~t~'20/~:~ /~~ ~~ -- ' ' ~ ~ ~ ~ ~~[ Buildinglnspector ~~ ~1 Ii'APPLICATION FOR BUILDING PERMIT '1 - - ~ J Date 20 I sIRuCTIO S ~ ~. T..:.3 apHlica[Ion MUST be completely filled in by ~pewriter or in ink and submi~ed 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, aBd waterways. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such a permit shall be kept on the premises available for inspection throughom the work. e. No building shah be occupied or used in whole or in pa~ for any purpose what so ever until the Building Inspector issues a Ce~ificate of Occupancy. f. Eve~ building permit shall expire if the work authorized has not commenced within 12 months aEer the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the prope~ have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the pemit for an addition six months. Thereaaer, a new pemit shall be required. APPLICATION IS HEREBY MADE to the Building Depam~ent for the issuance of a Building Pe~it pursuant to the Building Zone Ordinance oftbe Town of Southold, Suffolk Count, 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 a~t g~ees to comply~ith all applicable laws, ordinances, building code, housing code, and regulations, and to admit a~d~pectors~.o~r~nisesi7~ ~ and in building for necessa~ inspections. ~ _ ~ (Signature of applicant or name, if a corporation) (Mailing address of applicant) (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. State whether applicant is owner, lessee, agent, architect, engineer, general cont~c~oPr}'?3e0c~,~l~n~ or builder Name of owner of premises &~ ~J~a (As on the tax roil or lat~ ~CTIONS: [~ ~pp[[c~t is a co~omfio~, s[~atum o~ dul~ antho~zed officer 1. FOUNDATI~. ~ ~QU~ED FOR ~ED C~ 2 ROUGH. F~, ~, STEAPPING: ELECTEIC~ & ~ULKING 3 INSU~ON 4 FINAL- CONSTR~TION &E~CTRICAL MUST BE CO~E~ F~ C.O ALL C3N~RUCTtON l. Loc~fio~ of l~d o~ which proposed wor~ will be d~e:~ r D~stGN OR CONS~T~N ERROr. ~ouse ~umber Street ~,-.~ Hamlet County Tax Map No. 1000 Section [0 ~ Block ,C Lot 2--~'fl Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and ~ccupancy of proposed construction: a. Existing use and occupancy b. Intended useandoccupancy ~ ,J~L)[/_..T"- ~~ 3. Nature of work (check which applicable): New Building_ Addition . Repair Removal Demolition Other Work 4. Estimated Cost Fee (To be pal~ On ~illrtg t~k ~mpl'i[ationl 5. If dwelling, number of dwelling units Number of dwelling unttslq-~.e¢~h~l~ibl~ - ~a,'~: [ If garage, number of cars , . ;(~v:'.;v.<)~ If business, commercial or mixed occupancy, spec,fy nature and extent of.g.~ ¢)pe,~ .:: Of t~se. . 7. Dimensions of existing structures, if any: Front Rear Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height. _Depth Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 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__Will excess fill be removed from premises? YES.__ NO__ 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No 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 poin{ 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 __ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF' ) being duly sworn, deposes and sa~tha~a)he is the applicant (Name of individual signing contract) above nmned, ~ Pui~, ~ts o~ ~ Vo~ ~. o~8~ (S)Heis the ~- ~Jn~ ~ ,~ (Contractor, Agent, Corporate Officer, etc.) ~,,,,-~, ~ ~m 14, ~ ot~ 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. Sworn to before me this ) ~-1L da,y of ,-'~l.x_, [)'~ 20 / [ Notary Public Town of Southold ;, Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $'C'T'M'~' THE FOLLOWING ACTIONS MAY REQUIRE THE SU~]~i=~_~!ON OF ~S~L~ ~- ~') S¥OI~NATER~ GRADIHG~ DRAINAGE AND BRO~ION CONTROL pLAN ~ mock C=~; ;r;=u BY A G~,GGN PRO~iONAL IN THE STATE OF ~ YORK. a. What b the T~al Area ~ the project Pa~eb? (InchJde Total Ama of all Parc~s located v~hln 1 Will t~ls Project Retsin NI St~m-Wato~ Run-Off the ,~:ope of Work fo~ Propoesd Co~) ~naratnd by a Two (2") Inch Rainfall on Site? · r=....1 b. What ts the Totsl Ama of Land Clesdng (~F./~) (TI'~s Item wil inc~de ail rumolf oreated by site clemtng and~ constna:~lon activities as well as all -- and/or C,-,~and Dtslurbar~ce for the propesed ~::~ Site Improvements and the permanent creation of construction activity? - impervious surfaces.) (S.~./.~,--) 2 Does the Site Plan and/or Survey Show .NI Propesed Item shall include all Proposed Grade Changes and -- /~ ~- ~ ~:)L.~I.~T' Slopes Control~ing Surface Water FIow. and m~:limont esntrol ~ta~ that witl bo uesd to ~on~l si~e oresion and otorm wator dtsOm~les. 'rh~ -- it~a must b~ maintoined thro~hout tho Entire Construction PoHnd. 4 Wiil thi~ Proi~q:l Roqalm any Land Ftiliog, Gmdio§ or Excavation where there is a change to the Natural Existing Grade Involviog more than 200 Cubic Yards of Material within any Parcel? 5 Witi this Application Roqalro Land Distorbing Acti~tie~ ~"1 _~ {5,g00 S.F.) Squaro Foot o~ Ground Surfaco? 6 Is there a Natural Water Coume Running through ther--'-I site? is this Project within the Trustees judsdiction I I General DEC SWPpp Requirements: or within One Hundred (100') feet of a Wetland or co~stmctsd to reduce Itc pelutants ;n stom~ water d~ec~arges and to sssurereflufred, p~sl-eoretnx:~m slom~ wet er management Ixac~ces thai v/Z4 ~ used and~. Removal of Vegetotlorl and/or the Cofls~ of any COUN']~/OF ........................................... SS Qualified in Suffol~ County ~ duJy sworn, dcpo.~s ~nd says d~t hc/sbe is thc applicant for ?crmk, (Na~e of Ind~dud ~n~g O=cumant) · ~d tl~t he/she is thc ..... ~ ....................... Owner and/or representative of thc Owl)ct or Owners, and ~s d~]y =uthor;.zcd to pcn%nn or have perJ'onncd thc s~d wo~ and ma}[¢ and t'dc this application; that a]J sta/~'ncnts centered ;n d~s application ~ true to thc best o£h~s knowled~ and b~:t'; ;md that ~c wOr~. w~}] be pcrt'ormcd ~n thc manner sc{~ £o~J] ~n thc :~ppl[ca~on filed hero.th. Sworn to bel'orc mc this; ........................ .. .. /.-L.. ____ ............................ . ......... FORM - 06/10 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 OFSOUTHOLD August 9, 2011 Jerry Cibulski PO Box 598 Southold, NY 11971 Re: Campbell Residence - 260 Oak Dr, Cutchogue TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $25.00. Final Health Department Approval. ,/'/' Plumbers Solder Certificate. (All permits involving plumbing after 4/t/84) __ Trustees Certificate of Compliance. (Town Trustees #76§-'1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 3646'1 - Outdoor Show Stall 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 December 20, 2011 Jerry Cibulski PO Box 598 Southold, NY 11971 Re: 260 Oak Dr., Cutchogue TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. 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. __ Final Fire inspection from Fire Marshall. - Bob Fisher __ Final Landmark Preservation approval. BUILDING PERMIT: 36461 - Outdoor Shower Stall