HomeMy WebLinkAbout37509-Z
Town of Southold Annex 12/5/2013
P.O. Box 1179
~e 54375 Main Road
EI } Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36640 Date: 12/5/2013
THIS CERTIFIES that the building FIREPLACE
Location of Property: 580 Reeve Road, Mattituck,
SCTM 473889 Sec/Block/Lot: 100.-3-15.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/10/2010 pursuant to which Building Permit No. 37509 dated 9/12/2012
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:
fireplace in an existins one family dwelling as applied for
The certificate is issued to James & Susan Hutchinson
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
c
g oriz Si ature
ga~FF TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
Q.; 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 37509 Date: 9/12/2012
Permission is hereby granted to:
JAMES & SUSAN HUTCHINSON
580 REEVE ROAD
MATTITUCK, NY 11952
To: CONSTRUCTION OF A FIREPLACE TO AN EXISTING DWELLING AS APPLIED
FOR.REPLACES EXPIRES B.P. # 35913
At premises located at:
580 REEVE ROAD MATTITUCK
SCTM # 473889
Sec/Block/Lot # 100.-3-15.3
Pursuant to application dated 9/10/2010 and approved by the Building Inspector.
To expire on 3/12/2014.
Fees:
PERMIT RENEWAL $100.00
Total: $100.00
Building Inspector
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
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 35913 Z Date OCTOBER 4, 2010
Permission is hereby granted to:
SUSAN HUTCHINSON
580 REEVE RD
MATTITUCK,NY 11952
for
CONSTRUCTION OF A FIREPLACE TO AN EXISTING DWELLING AS APPLIED FOR
at premises located at 580 REEVE RD MATTITUCK
County Tax Map No. 473889 Section 100 Block 0003 Lot No. 015.003
pursuant to application dated SEPTEMBER 10, 2010 and approved by the
Building Inspector to expire on APRIL 4, 2012.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALT,
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 2/10 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 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
I. 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:
~ 41? f2-d~ t k
House No. Street Hamlet
Owner or Owners of Property: N
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot
Permit No. Date of Permit.----- Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate _ Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/ STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ j FIRE SAFETY INSPECTION
[ j FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE f0 /Q( INSPECTOR
S~ / O~,~pF 8ou,~
f
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUN ION 2ND [ ] INSULATION
[ ] ING / STRAPPING [ ] FINAL
[ FIREPLACE 8 CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
C'
DATE Q L1,z7Lr INSPECTOR
"1moi
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUG
I EIG.
[ ] FOUNDATION 2ND [ ] LATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: G
Z2
DATE ' INSPECTOR
FMLJ) PMT=ON REPORT DATE COMMENTS
o
ro
414
FOUNDATION (1ST) j?
-4 ell
G a
FOUNDATION (2ND)
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ROUGH FRAMING & R, y
PLUMING
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INSULATION PER N. Y.y
STATE ENERGY CODE F
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FINAL
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' g e `1
SoutholdTown.NorthFork.net PERMIT NO. ~3 gyp/ 3 Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined /O , 20/0 Storm-Water Assessment Form
Contact: /
Approved, 20J _ Mail to: fJNic~/Sivl aN
Disapproved a/c S~ ifGBYE A,) /n&7TfTµzK
Phone: l,?/ 17-7`f SYb/
Expiration- 2Q`;L
p ECE E -
Building Inspector
SEP P 10 2010 APPLICATION FOR BUILDING PERMIT
Date 20 /0
BLDG. DEPT. 10
TOWN OF SOUTHOLD 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 co npieted within 18 months from such date. If no zoning amendments or other regulations affecting tite
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.
s
(Signature of applicant or name, if a corporation)
$ 80 ~rZZe /f1/J`777TR6,- /vy 119A-
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 11147e/-It11/fm 1,1-4065 ce 1f',4f'AV 2, A4H 7C11,;VYoA1
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
.-1/A
(Name and title of corporate officer)
Builders License No. ~7~9zf HI
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which propo ed work will be done:
1-~W o /?e7wi /hJ9~T/Tltc%C
House Number Street Hamlet
County Tax Map No. 1000 Section /0,0 Block 3 Lot AS--3
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and o upancy of proposed construction:
a. Existing use and occupancy ~fi?~Le Fffi*riz ylN~/r ~N6
b. Intended use and occupancy A'vc%
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work iRrP~RCC
(Description)
4. Estimated Cost 0 6 o Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units a Nu Number of dwelling units on each floor
If garage, number of cars 7 'we
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. A11A
7. Dimensions of existing structures, if any: Front ~S Rear ~S Depth
Height Number of Stories z
Dimensions of same structure with alterations or additions: Front Rear sS`
Depth Height Number of;Stories 2-
8. Dimensions of entire new construction: Front Rear Depth
Height zo' Number of Stories N/9
9. Size of lot: Front /SO z Rear Depth j 9 9
10. Date of Purchase 111A9109 Name of Former Owner
11. Zone or use district in which premises are situated A0?EA7-V Co')r ;Z/0 /
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V /
13. Will lot be re-graded? YES_ NO V Will excess fill be removed from premises? YES NO V1
6 uiG111,V'J /J 7 RerW- R
14. Names of Owner of premises W, uT ,,))?JOAJAddress M97777uCK Phone No. 63/ 73 S~6/
Name of Architect Address Phone No
Name of Contractor AN wry /?~j~ot i'4ab Address 26` Phone No. S/6 b-/~ W63
AIY
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~tEQUIRED.
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.
18. Are there any covenants and restrictions with respect to this property? * YES NO y
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY O
47Cp 1raf~/? being duly sworn, 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.
Sworn t ore me th 1 O
dayof_
ERONIC F. CIDONE
a of f Now New /
to York
4661406
V Notary P~ lic Qualified in Suffolk County Signature of Applicant
/ Commission Expires Dec. 31, 2013
Town of Southold
Z Erosion, Sedimentation $ Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M.O: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
1 , pp 3~ STORM-WATER GRADING, DRAINAGE AND EROSION CONTROL PLAN
'B ww a on o rf- CERTIFIED BY DE31ON PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM If / WORK ASSESSMENT Yes No
a. What is the Total Area of the Project Parcels?
(Include Total Area of all Parcels located within ~yt Wfil this Project Retain All Storm-Water RurrOff /
the Scope of Work for Proposed Construction) `3 2 lk! Generated by a Two (2") Inch Rainfall ( Sfte? J
(S.F./Acres) (This Item will Include all runoff created by site _ ?
b. What is the Total Area of Land Clearing 7 clearing and/or mnstructlon activities as well as all
and/or Ground Disturbance for the proposed `J Z +d'011--r Site Improvements and the permanent creation of
construction activity? Impervious surfaces.)
(S.F. /Apes) /
z Does the Site Plan and/or Survey Show Proposed -
PROVIDE BRIEF PROJECT ]DESCRIPTION (ROrae aadtlen.IPeaeaea tteedeti) Drainage Structures Indicating Size & Location? This
\ - / r Item shall include all Proposed Grade Changes and
f}JJ~ i T/J/U O/`" M 4T i V.Q y Slopes Controlling Surface Water Flow.
~~Lg $ Does the Site Plan and/or Survey despite the erosion / ?
and sediment control practices that will be used to J
control site erosion and stone water discharges. This
item must be maintained throughout the Entire
Construction Period.
4 Will this Project Require any Land Filling, Grading or /
Excavation where there is a change to the Natural V/
Existing Grade Involving more than 200 Cubic Yards _
of Material within any Parcel?
rj Will this Application Require Land Disturbing Activities -
Encompassing an Area in Excess of Five Thousand
(5,000 S.F.) Square Feet of Ground Surface?
6 Is there a Natural Water Course Running through the
Site? Is this Project within the Trustees jurisdiction
General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or
Submission of a SWPPP is required for all construction actNlees Involving soil Beach?
disturbances of one (1) or more acres; including disturbances of less than ate sore that 7 Will there be Site preparation on Existing Grade Slopes ? -
am pan of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to
including construction activities Involving soil disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance? /
the DEC has determined that a SPDES permit Is required for storm water discharges.
( SWPPP's Shag meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious ? -
for Storm Water Discharges from construction activity - Permit No. GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off
1. The SWPPP shall be prepared prior to the submittal of the Not. The Not shall be into and/or in the direction of a Town right-of-way?
submitted to Me Department prior to Me commencement of construction activity. /
2. The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, ? .V-///
required, post-construction storm water management prectices that will be used and/or Removal of Vegetation and/or the Construction of any
constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-Of-Way or Road Shoulder
compliance with the terms and conditions of this permit. In addition. the SWPPP shall
Identify potential sources of pollution which may reasonably be expected to aaeol the Area? (This M. will NOT kuUie the ImeMiwr at&KM Awana)
quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark
3. AO SWPPPs that require the post-construction storm water management practice in a Box and the construction sae disturbance Is MNreen 5,000 S.F. 81 Am In and,
component shall be prepared by a quali0ed Design Professional Licensed In New York a Storm-Water, Grading, Drainage & Erosion Control Plan Is Required by the Town of
that is knowledgeable In the pncra(ples and practices of Storm Water Management. Southold and Must be Submitted for Rwim Prior to Issuance of Any Bulldog Permit
(NOTE ACheck Mara (4) andror Amw for each pupation Is Required for a Complete Application)
STATE OF NEW YORK,
/COUNTY OF SS
vrTC
That I .
../.J.) d J being duly sworn, deposes and says that he/she is the applicant for Permit,
(Name ol Individuat signtng Document
And that he/she is the t~..Nc
(owrOwn...er, .co..... ntac .....to..r.AgwiL .gen...corpo ........ra ..to ..O....M....Cer, .e... to J
(
Owner and/or representative of the Owner or Owners, and is drily 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 performed in the manner set forth in the application filed herewith.
Sworn to lo71je s;
day of 20. Notary PublCIDONE `Y)Nyi
at bkc..StatarofNewYOfk IN ...........lt.........
(Signature C Apprcent)
No. 01041VI1411A
FORM - 06 Qualified in Suffolk County
Commission Expires Dec. 31, 2013
TOWN OF SOUTHOLD CHAPTER 236 STORM WATER MANAGEMENT
STORMWATER POLLUTION PREVENTION PLAN (SWPPP)
A. General Town of Southold SWPPP Requirements:
(For Land Disturbance between 5,000 SF and 1 acre in area)
1. The SWPPP shall be prepared prior to the application for Building Permit.
2. The SWPPP shall describe the erosion and sediment control practices and where required,
post-construction storm water management practices that will be used and/or constructed to reduce
the pollutants in storm water discharges and to assure compliance. with the terms and conditions of
Town Code Chapter 236 for Storm Water Management prior to the issuance of a Town Building
Permit. In addition, the S WPPP shall identify potential sources of pollution which may reasonably be
expected to affect the quality of storm water discharges.
3. All SWPPPs that require a post-construction storm water management practice component shall
be prepared by a qualified design professional that is knowledgeable in the principles and practices of
storm water management and treatment.
4. The owner, contractor or operator must keep the SWPPP current so that it at all times accurately
documents the erosion and sediment control practices that are being used or will be used during
construction, and all post-construction storm water management practices that will be constructed on
the site. At a minimum, the owner, contractor or operator shall amend the SWPPPi
a. whenever the current provisions prove to be ineffective in minimizing pollutants in storm
water discharges from the site;
h. whenever there is a change in design, construction, or operation at the construction site that
has or could have an effect on the discharge of pollutants; and
c. to address issues or deficiencies identified during an inspection by a Building inspector, or
other regulatory authority.
5. The Building Department may notify the owner, contractor or operator at any time that the SWPPP
does not meet one or more of the minimum requirements of the building permit. The notification shall
be in writing and identify the provisions of the SWPPP that require modification. Within fourteen (14)
calendar days of such notification, or as otherwise indicated by the Town, the owner, contractor or
operator shall make the required changes to the SWPPP and submit written notification to the Town
that the changes have been made. If the owner, contractor or operator does not respond to the Town's
comments in the specified time frame, the Town may issue a stop work order and/or suspend the
current Building Permit.
6. Prior to the commencement of construction activity, the owner, contractor or operator must identify
the contractor(s) and subcontractor(s) that will be responsible for installing, constructing, repairing,
replacing, inspecting and maintaining the erosion and sediment control practices included in the
SWPPP; and the contractor(s) and subcontractor(s) that will be responsible for constructing the post-
construction storm water management practices included in the S WPPP. The owner, contractor or
operator shall have each of the contractors and subcontractors identify at least one person from their
company that will be responsible for implementation of the SWPPP. j
c
7. The owner, contractor or operator shall have each of the contractors and subcontractors identified
in item # 6 above sign a copy of the following certification statement below before they commence any
construction activity: "I hereby certify that I understand and agree to comply with the terms and
conditions of the SWPPP and agree to implement any corrective actions identified by the building
inspector during a site inspection. In addition to providing the certification statement above, the
certification page must also identify the specific elements of the SWPPP that each contractor and
subcontractor will be responsible for and include the name and title of the person. providing the
signature; the name and title of the contractor responsible for S WPPP implementation; the name,
address and telephone number of the contracting firm; the address (or other identifying description)
of the site; and the date the certification statement is signed. The owner, contractor or operator shall
attach the certification statement(s) to the copy of the S WPPP that is maintained at the construction
site. If new or additional contractors are hired to implement measures identified in the SWPPP after
construction has commenced, they must also sign the certification statement and provide the
information listed-above.
8. Erosion and sediment control component - All SWPPPs prepared pursuant to a Building Permit
Application shall include erosion and sediment control practices designed to comply with Town Code
Chapter 236 for Storm Water Management and implement site improvements for Erosion and
Sediment Control. Where erosion and sediment control practices are provided, the owner, contractor
or operator must demonstrate that, at a minimum, the erosion and sediment control component of the
Town SWPPP shall include the following:
a: Background information about the scope of the project, including the location, type and size
of project;
b..A site map/construction drawing(s) for the project, including a general location map. At a
minimum, the site map shall show the total site area; all improvements; areas of
disturbance; areas that will not be disturbed; existing vegetation; on-site and adjacent
off-site surface water(s), wetlands and drainage patterns that could be affected by the
construction activity; existing and final slopes; locations of different soil types with
boundaries; material, waste, borrow or equipment storage areas located on adjacent
properties; and location(s) of the storm water discharge(s);
c. A description of the soil(s) present at the site, including a test hole indicating depth of ground
water;
d. A construction phasing plan and sequence of operations describing the intended order of
construction activities, including clearing and grubbing, excavation and grading, utility
and infirastructure installation and any other activity at the site that results in soil
disturbance;
e. A description of the minimum erosion and sediment control practices to be installed or
implemented for each construction activity that will result in soil disturbance. Include a
schedule that identifies the timing of initial placement or implementation of each
erosion and sediment control practice and the minimum time frames that each practice
should remain in place or be implemented;
f. A temporary and permanent soil stabilization plan that meets the requirements of the most
current version of the technical standard, New York State Standards and Specifications
for Erosion and Sediment Control, for each stage of the project, including initial land
clearing and grubbing to project completion and achievement of final stabilization;
g. A site map/construction drawing(s) showing the specific location(s), size(s), and length(s) of
each erosion and sediment control practice;
,
h. The dimensions, material specifications, installation details, and operation and maintenance
requirements for all erosion and sediment control practices. Include the location and
sizing of any temporary sediment basins and structural practices that will be used to
divert flows from exposed soils;
i. A maintenance inspection schedule for the contractor(s) to ensure continuous and effective
operation of the erosion and sediment control practices. The maintenance inspection
schedule shall be in accordance with the requirements in the most current version of the
technical standard, New York State Standards and Specifications for Erosion and
Sediment Control;
j. A description of the pollution prevention measures that will be used to control litter,
construction chemicals and construction debris from becoming a pollutant source in the
storm water discharges;
B. Reanired SWPPP Contents Taws of Southold Storm Water Pollution Prevention Plan
(For Land Disturbance. between 5,000 SF and 1 acre in area)
MINIMUM SITE PLAN REQUIREMENTS;
1. Applicant information: Provide name, legal address, and telephone number..
.
2. Common address, Suffolk County Tax Map No. and legal description of site.
3. Signature and stamp of registered Design Professional (Architect / Engineer / Surveyor)
and/or design/owner certification.
4. Vicinity map.
5. Existing and proposed mapping and plans (Maximum scale of t° = 50' or greater detail)
which illustrate at a minimum:
o Existing and proposed topography (minimum of 24oot contours recommended);
® Perennial and intermittent streams and/or Natural Water Course;
Mapping of predominant soils and location of test hole or site-specific borehole
investigations that have been performed;
0 Boundaries of existing predominant vegetation and proposed limits of clearing;
0 Location and boundaries of resource protection areas such as wetlands, lakes,
ponds, and other setbacks (e.g., stream buffers, drinking water well setbacks,
septic setbacks);
® Location of existing and proposed roads, buildings, and other structures;
® Location of existing and proposed utilities (e.g., water, sewer, gas, electric) and
easements;
Q Location of existing and proposed conveyance systems such as grass channels,
swales, storm drains or other storm water BMP's;
® Flow paths;
Q Location of floodplain/floodway limits and relationship of site to upstream and
downstream properties and drainages;
Q Location and dimensions of proposed channel modifications, such as bridge or
culvert crossings where applicable;
{Q Location, size, maintenance access, and limits of disturbance of proposed
structural storm water Management practices;
6. Representative cross-section and profile drawings and details of structural storm water
Management practices and conveyances (i.e., storm drains, open channels; swales, etc.)
which include;
Q Existing and proposed structural elevations (e.g., invert of pipes, manholes, etc.);
Q Design water surface elevations;
Q Structural details of outlet structures, embankments, spillways, stilling basins,
grade control structures, conveyance channels, etc.;
Q Logs of test hole investigations that have been performed indicating soil type and
water table elevations along with a supporting geotechnical report where
applicable.
7. Drainage Calculations for all structural components of storm water system to meet the
minimum requirements of Town Code Chapter 236 for Storm Water Management.'
(e.g., Catch Basins, storm drains, open channels; swales, Best Management
practices, etc.) for applicable design storms including:
Q Existing condition drainage swale areas, runoff rptes, quantities of runoff
generated by impervious surfaces, storm water velocities, and surface water .
elevations showing methodologies used and supporting calculations;
Q Proposed containment area, runoff rates, volumes, velocities; water surface
elevations, and routing showing the methodologies used and supporting
calculations;
Q Final sizing calculations for structural storm water Management practices
including, contributing drainage area, storage capacity, piping and outlet
configuration;
Q Final analysis of potential downstream impactleffects of project, where necessary;
8. Final landscaping plans for structural stone water Management practices and any site
reforestation or re-vegetation.
9. Structural calculations, where necessary.
10. Applicable construction specifications.
11. Erosion and sediment control plan that at a minimum meets the requirements of the
local Erosion and Sediment Control Guidelines. i
12. Sequence of construction.
i
13. Maintenance plan which will include:
Q Name, address, and phone number of responsible parties for maintenance;
Q Description of annual maintenance tasks;
Q Description of applicable easements;
Q Minimum vegetative cover requirements;
Q Access and safety issues;
Q Testing and disposal of sediments that will likely be necessary.
14. Evidence of acquisition of all applicable local and non-local permits.
15. Evidence of acquisition of all necessary legal agreements (e.g., easements,
covenants, land trusts, etc.).
f;' fFOt~ Southold Town Building Department
0 t a P.O. Box 1179 Permit 35913
x 54375 Main Road
Southold, New York 11971 Permit Date: 10/4/2010
* lap! (631) 765-1802 Expiration Date: 4/4/2012
` Parcel ID: 100.-3-15.3
BUILDING PERMIT RENEWAL LETTER
Dated: 8/22/2012
Applicant: SUSAN & JAMES HUTCHINSON
Location: 580 REEVE ROAD MATTITUCK
Work Description: FIREPLACE
CONSTRUCTION OF A FIREPLACE TO AN EXISTING DWELLING AS APPLIED FOR
A FEE OF $100.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: JAMES & SUSAN HUTCHINSON
Address: 580 REEVE ROAD
MATTITUCK, NY 11952
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.
SURVEY OF CERTIFIED TO: JAMES C. HUTCHINSON & SUSAN L. HUTCHINSON
N.C.P.D. FEDERAL CREDIT UNION
LOT 3 FIRST AMERICAN TITLE INSURANCE COMPANY OF N. Y.
MAP OF
SEA AIRE ESTATES
74
SI TUA TE A T 1 JOB MAP N NO 0. 6780
6780
FILED:
EVISIONSUARY5, 1979
MATTITUCK R
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEWYORK a
25 13 0 25 50 75 100 125 150 175 200 225
SCALE: 1"=50' DATE: SEPT. 25,2009
LOT AREA: 59,671 SQ. FT. = 1.370 ACRES
LICENSE NO. 050363
HANDS ON SURVEYING
26 SILVER BROOK DRIVE
FLANDERS, NEW YORK
11901
TEL: (631)-369-8312 - FAX. (631)-369-8313
MARTIN D. HAND L.S
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FEE: BY
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE ti, ~t Ce
FOLLOWING INSPECTIONS:
N 1. FOUNDATION - TWO REQUIRED F ~1, r CC1~ 1
`AIIOX f D C; 7-N0 FOR POURED CONCRETE
p 2 ROUGH - FRAMING, PLUMBING,
CGZG STRAPPING. ELECTRICAL 8 CAULKING
3 INSULATION
4. FINAL - CONSTRUCTION 8 ELECTRICAL
MUST BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES NEW
YORK STATE. NOT RESPONSIBLE FOR
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` DESIGN OR CONSTRUCTION ERRORS.
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