HomeMy WebLinkAbout36667-Z
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
' TOWN CLERK'S OFFICE
SOUTHOLD, NY
X
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMIS S
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit 36667 Date: 9/6/2011
Permission is hereby granted to:
Clanton, Ralph & Clanton, Karen
2780 Delmar Dr
Laurel, NY 11948
To: above ground swimming pool fenced to code
At premises located at:
2780 Delmar Dr, Laurel
SCTM # 473889
Sec/Block/Lot # 125.4-11
Pursuant to application dated 8/19/2011 and approved by the Building Inspector.
To expire on 3/7/2013.
Fees:
SWIMMING POOLS - ABOVE-GROUND WITH REQUIRED FENCING $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building Inspector
I° ~1 II i _
m \ Form No. 6
q~ ?Oll TOWN OF SOUTHOLD
`l BUILDING DEPARTMENT
TOWN HALL
c o€PT. 765-1802
r7r. `,DUiP9lD
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/ 10 of I% 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:
1. 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. 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, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
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, Commercial $15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 0 -7V D, I)t LM '2 'Dr S V F Li~-U)e tL
House No.. Street Hamlet
Owner or Owners of Property: Il ~ ~ P N ll q LAIJ -T I',)
Suffolk County Tax Map No 1000, Section Block ( Lot
Subdivision Filed Map. Lot:
Permit No. ~tPtplp Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
FoeSubmitted: $ So . n"
ADallcant Signature
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/ STRAPPING [FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROU9GnH)~ [ ] ELECTMICAL-p(_FINAL) 1
REMARKS: '
L 04
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DATE INSPECTOR _ /
FIELD ON $EPORT DATE COMMENTS
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FOUNDATION (1ST)
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FOUNDATION (2ND)
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PLUMBING
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INSULATION PER N. Y. G H
STATE ENERGY CODE a
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FINAL hl~ zi~ij
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ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
South oldTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined_ '20 t<~ Single & Separate
Storm-Water Assessment Form
Contact:
Approved, 20AI_ Mail to:
Disapproved a/c 4 2 p /
Phone: ~p~J1 O'?Q- t) 7 qI ,c
Expiration 201 ~31 a~0 70~t.J~14
Building Inspector u
AUG 1 9 2(APP TION FOR BUILDING PERMIT
Date 20
p 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 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.
ATt
~ Y (Signature of applicant or name, if a corporation)
ENCLOSE r OOL TO CODE
i UCFS j iY I1,f1 LIPON COMPLETION
BEFORE "W"~R" (Mailing address of applicant)
,U)PANCY
State whether applicant is owner, lessee, agent, architect, engineer, general contraa>p iIM N"r or builder
DATE f~~~6~~11 B P # ~O 6
Name of owner of premises h R~ P 0 91 C (-Iq rL7a'~~'Y kRiiNEtfiT R7
(As on the tax roll or IaQ~fjWT S AM TO 4 PM FOR THE
If applicant is a corporation, signature of duly authorized officer FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
(Name and title of corporate officer) FOR POURED CONCRETE
Builders License No. 2. ROUGH- FRAMING, PLUMBING,
STRAPPING, ELECTRICAL d CAULKING
Plumbers License No. 3. INSULATION
Electricians License No. 4 F,NAL f,-11~.IZ7R"CTS e = A AL
Other Trade's License No.
1. Location of land on which proposed work will be done: R 'k, F r,
~78D 'DELM4Z W)vC ,LaLV L QANORCONoiNJL;To(;N RR,,
House Number Street Hamlet
County Tax Map No. 1000 Section Block ELECT
Subdivision Filed Map pN y6 0r
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy J N~}1-~ L 1 N C ~ / /2DVi~1~ - N
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
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 Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. ensions of entire new construction: Front Rear Depth
eight 57Y " Number of Stories
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 Address Phone No.
Name of Architect Address Phone No
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.
'provide topographical data on survey.
17. If elevation at any point on property is at 10-fe~t•'ox below, must
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE ,A COPY.
STATE OF NEW YORK
COUNTY OFD, }
5i being duly sworn, deposes and says that (s)he is the applicant
(Name of individual' signiog.conAmi]t44ove named, CONNIE D. BUNCH
Notary Pubk, State of New York
(S)He is the No. 01BU41W= uwnw
J gAPt br,=Agent, Corporate Officer, etc.) Com~99bn ~rea p,ptil 14,
of said owner or owners, and is tluly~ 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 thi
_11141~ day of 20_tL
Notary Public Signature of Applicant
i
I
UE;J1°r Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.CTA4l. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A !
STO TER. INO, DRAtNAOE ANB EItOS10N NTROL PLAN
3&EW- "Samson -MRR- Tor- C~ ~ DESIGN rr- carr easroNAL- I~T~BA OF W YORK.
SCOPE OF WORK - PROPOSED CONSTRUMON rrEM # /WORK ENr Yes No
a. Whet Is the Total Ales of the Project Parcels? - -
(Induda Total Area of at Parcels located within 1 Ge.s said PRIjed Rot* by a Two ( At t3l PhalWear Site?1f
the Scope of Work for Proposed Cor~tr~on) Gar by a Two lsdlR~ on Sae? (rhis. Item b. What to the Total Area of Land
Clearing (aF. /Arses) formes acondq/or Include Coonsnat run-off pietas by are
ansle, Grotad Disturbance for the Pproposed ~ 1mpam nts and d the the activities as well as at _
e pertent creation of
CMSUUCODn acBvty'1 surfaces.)
(.4F.lAaes) impervlouaxPROVIDE BBffir PROJECT' DE41 7'ION p+wesAarpw Pwrs seNrdm) 2 Does the Site Plan and/or Survey Slaw At Proposed /
heDrainage mshall Sbutd a all g Size a Change? This
/ aamitlckNk all Proposed Grade Charges and -
~V pJ~ D O C. Slopes CpdroRng Surface Water Flay.
3 Does the Sao Plan andor Survey describe the erosion / I
and sedfntent ON" practices that wig be used to ? 4
control site erosion and storm water discharges. This
hem must be maintained throughout the Entire
Construction Period.
Q Will this Projeld Require any Lard Fitting, Grading or
Excavation where there is a change to the Natural /
Existing Grade Involving more than 200 Cubic Yards
of Material withinmy Parcert
rJ Will this Application Require Land Disturbing Activities /
Encompassing an Area In Excess of Five Thousand a J
(5,000 S.F.) Square Feet of Ground Surface?
S Is there a Natural Water Course Running through the
Site? Is this Project within the Trustees jurisdiction
General DEC SWPPP Rmulmna mts "within One Hundred (100 W of a Wetland or t
Submission of a SWPPP Is required for all Construction activities irvotvkg we Beach?
diahama,es of one (1) or more aces: Including dYMbarwes of lase than one am Croat
en part of a larger rmmmon pan that we uapmtWy disturb we or none saes or lend: 7 Will there be Site Fpreparation ifteen on Exerting Grade Slopes
Including Oons6uclion actIdtles Involving Sal disnebarces of lass then one (1) am where whirr Exceed Fifteen (15) (15) feet of Vertical R ca to
Me DEC has determined that a SPDES permit Is required for storm water dtadmrges One Hundred (100') of Horizontal Distance?
( SWPPPI Shea meat the minlmwn Requirements of the 8PDE3 Gamrel Permit 8 Will Driveways, Parke ? '
tar storm Water Discharges am eurmi uction activity -Permit No. GP-040-001.) Surfaces Sloped to o Direct Areas
StoarWmhenWatuter r Rur Runeur
1. The SWPPP shat be Prepared prior to the submittal of ft NOI. The Not shat be -01t
'submitted to the DeporNentprior to 0m oo mlencumm of conalm dam actlrsyt Into and/or r In tla direction of a Town right.~
2. The SWPPP shall deem" the ereelm and Sediment meat Prnikw and wawa g Will thls Project Require the Plamentent Of Material. /
required. pod~aaarcimmamm water management praction Mat we be aid wxft Removal of Vegefelbn.andlor the Consthlcltan of J
Constructed to mduce the pollutants In storm water dhdrerges and to esaaa item Within ON Town ht-of- ~
fanplarnmwhr the IN and conditions of NN Permit. In addNm. M SWIPPP aher Area? Rig Way or Read myApmer - -
maearwtarasaia oaswrumaah.q,y,.,,y
ldmwypoleawsatscasapoaatonwhich n"memauy be upciad to a ad In
quokyofsbmwawdh hory NOTE: NMyAmmar lo Omdams Oft Krogh lane N Amwmdwah a Cbnk Mark 3. M SWPPPs umt rergaa ere Pes~bueeon et-mm w "m mgesarx padke In a amr rat the a-nekuailm eft dbhvbanee N behwan 5,0011 3.F. i 1 Am In ny
corriPOriard AM be prepared by a grraated Dealers PrMessbnal tlcwad in New Yank a steam-Water, W0116% Drainage a Esmion COW01 Pion b lbquked by la Tian of I
that Is knowledgable in ma principles and Neclkes of storm Water ktawgemnt. ~ Ap~anMist b* add for v Review Prim to Issmamu O(Ay eaawg Pr„ab
Itequles kr • lxmmakls IppFjraq
STATE OF NEW YORK, C, nO Notary Pulft, St M$ d Now York
COUNTY OF SS NO.0I W1119 W
QuAlN in Suffolk County
That I being duly swom, deposes and saj ns l Itt~dAPaR I~
Mare d kidsidral etgdrrg Darasriesr)
And that he/she is the .:C».........
(owner. Carrtradar. AOar{Cuporsti ONmr. slej•••••.•••••....•••.....••.....••••..•
Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to
make and fide 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 herewith. j
Swom to before a this:
_............I--.1 dayof 20.11
Notary Public:
...........f....I.. w
' ` - ..1X1........
(Sq%d re of APpiom)
FORM - 06/10
r~ Southold Town Building Department
4^ t P.O. Box 1179 Permit 36667
54375 Main Road
Southold, New York 11971 Permit Date: 9/6/2011
*y?1 *OT4d'4 (631) 765-1802 Expiration Date: 3/7/2013
„n Parcel ID: 125.4-11
BUILDING PERMIT RENEWAL LETTER
Dated: 10/18/2013
Applicant: RALPH & KAREN CLANTON
Location: 2780 DELMAR DRIVE LAUREL
Work Description: ABOVE GROUND POOL
above ground swimming pool fenced to code
A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: RALPH & KAREN CLANTON
Address: 2780 DELMAR DRIVE
LAUREL, NY 11948-1845
The permit listed above has expired. Please contact our office as soon as possible to begin the renewal
process. All work on the project must stop on the expiration date.
No work is permitted or authorized beyond the expiration date.
THANK YOU,
SOUTHOLD TOWN BUILDING DEPT.
S: !3°29' 30"E. 124.44' _
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Lot 39 4
Area = 241,115 sq. ft.
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66.54
R = 2304.68' L =124.52'
V1,4 R DRIVE
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