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HomeMy WebLinkAbout36335-Z F"y f~ Town of Southold Annex 1/15/2014 4r 16P.O. Box 1179 54375 Main Road 10 Southold, New York 11971 a, CERTIFICATE OF OCCUPANCY No: 36716 Date: 1/15/2014 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 21800 Route 25, Cutchogue, SCTM 473889 Sec/Block/Lot: 109.-1-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/20/2011 pursuant to which Building Permit No. 36335 dated 4/20/2011 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: deck addition to an existing dwelling as applied for The certificate is issued to Timothy Caufield - (OWNER) - of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Authorize ignature TOWN OF SOUTHOLD BUILDING DEPARTMENT N TOWN CLERK'S OFFICE ! SOUTHOLD, NY f 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 36335 Date: 4/20/2011 Permission is hereby granted to: Caufield, Timothy 21800 Route 25 Cutchogue, NY 11935 To: construct a deck addition to an existing dwelling as applied for At premises located at: 21800-Route 25 SCTM # 473889 Sec/Block/Lot # 109.-1-2 Pursuant to applicatioi d dated 4/20/2011 and approved by the Building Inspector. Io-o-1a To expire on 4482@1-2. Fees: SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $228.80 CO - ADDITION TO DWELLING $50.00 Total: $278.80 Building Inspector 7N- -7,f:511 Form No. 6 TOWN OF SOUTHOLD 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 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 2110 of 1% lead. . 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliahce'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: p Old or Pre-existing Building: (check one) Location of Property: a 0n 0- IN- C-A, House No. Street Hamlet 11 A -1-P Owner or Owners of Property: _ _ i 4 C l~ Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approvals Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) 6D , / Fee Submitted: $ IV I licai gnature ~O 2 ~o~,f,Of SO!/1~06 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING/ STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL UGH) [ ] ELECTRICAL (FINAL) J 1 REMARKS: DATE ~ DB Zl INSPECTOR 2 aoe sour" TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ®J~ 4~2 (2-01 DATE ~3 i3 INSPECTOR FIELD NDR DATE COMMENTS. FOUNDATION (1ST) FOUNDATION (2ND) ~O C~ ROUGH FRAMING & PLUMBING --h INSULATION PER N. Y. y STATE ENERGY CODE r / d2 %f /o MAI ;Joe- ADDITIONAL COMMENTS c- Z m z 1. e 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 Southold[Town.NorthFork.net PERMIT NO. 3 w 3 35' check Septic Form N.Y.S.D.E.C. Trustees Flood Pennit__ Examined, 20 I Storm-Water Assessment Form Contact: n - . Approved, 20~ Mail to: DolLt 5 A' UN fib,-:L Disapproved a/c Phone: PSG Expiration o, 20 'Y Building Inspector APR 1 1 2011 CATION FOR BUILDING PERMIT BLDG. DEPT. Date 20 ! l TOWN OF souTHOto 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 OF 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. 'i attire f ph ant or name, if a corporation) al 6Uu VY t133s- ( ailing address of applic ! State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder CAW VtQ(~ Name of owner of premises I tt n~o hku ) l a two i e (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. jtS q t) Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: '2-Igo0 NA3t,'1 Ca- House Number Street Hamlet County Tax Map No. 1000 Section D~ Block Lot 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 res i o(e a b. Intended use and occupancy Same 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work DEcK 4_1> I 770IJ (Description) 4. Estimated Cost 0 7 o i o, 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 i 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. rQ S J" a 7. Dimensions of existing structures, if any: Front V2 Rear NZ Depth 3/ Height / t Number of Stories Single J Dimensions of same structure with alterations or additions: Front 112 Rear a Depth 37 Height Number of Stories s /e 8. Dimensions of entire new construction: Front I Rear I Depth Height W -F10ar Number of Stories 1 9. Size of lot: Front Rear a L(O, q7 ' Depth 03 10. Date of Purchase a o~ 3 Name of Former Owner J u C Yc) r E'CK / 11. Zone or use district in which premises are situated 1-e S dP n a 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO~ 13. Will lot be re-graded? YES_ NO~C-Will excess fill be removed from premises? YES NO- _ 006, Mai„ Kid 14. Names of Owner of premises Address ufrdioue. Phone No. Name of Architect Ti-a Has ae ( Address s29y e_ 41116 Phone No W S -a 075 Name of Contractor DpefAnna/,Pl Co. sf-. Address Soon Cox LaJ Co4ckgePhoneNo. F0 V- 9 95-y J 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X 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 k 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 -K- * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) -TT L4 e te'. ~i4 'e being duly sworn, deposes and says that (s)he is the applicant (Name o dividual signing contract) above named, (S)He is the 1) ner- (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. Pert L. Grandone Notary Public State of New York No. 01 YO6042591 Sworn to before me this Qualified in Suffolk County $1'C` day of f}pr: 1 2011 Commission Expires 5/30/2011 Notary P c Si atu of Applicant y ` Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM $ PROPERTY LOCATION: s.C.T.M.11: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A j k Qq L STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN rte'-si'll' 3edAn oC Tot- CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within Will this Project Retain All Storm-Water Run-01f the Scope of Work for Proposed Construction) 72 S F Generated by a Two (2") Inch Rainfall on Site? (s F / Ages) (This item will include all run-off created by site ? b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all andlor Ground Disturbance for the proposed ONE Site Improvements and the permanent creation of construction activity? impervious surfaces.) - (S.F./Ages) 2 PROVIDE BRIEF PROJECT' DESCRIPTION (PrewdeAdmua,dPeyea asNaeded) Does the St Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This A / Item shall Include all Proposed Grade Changes and -w/ _ a h f/ h v 0 Y~ d 042 r Slopes Controlling Surface Water Flow. / / 3 Does the Site Plan and/or Survey describe the erosion ? WQ / 7~7 O rl and sediment central practices that will be used to / control site erosion and storm water discharges. This IX6~N LN pp pieS 2)C / .$'l-7 rT R item must be maintained throughout the Entire Construction Period. mod/ //7cK0 feJ C-C Yf r T 4 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? 5J 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 Weiland or Submission of a SWPPP is required for all Conshnction activities involving soil Beach? disturbances of one (1) or more acres; including disturbances of less then one acre that 7 Will there be Site preparation on Existing Grade Slopes ? are part of a larger common plan that will ultimately disturb one or nave acres of land; which Exceed Fifteen (15) feet of Vertical Rise to including Construction activities involving soil disturbances of less than one (1) acm where One Hundred (100') of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges. ( SWPPP's Shall 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? El x submitted to the Department prior to the 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, ? required, postconstruction 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 tems and conditions of this permit. In addition, the SWPPP shall Area? 0111,1a inm wm Nor l,cwae uw rmml.non of oavaway AProm.) Identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Ouesdons One through Nine Is Answered with a Check Mark 3. All SWPPPS that require the postconstructbn storm water management practice in a Box and the construction site disturbance is between 5,000 S.F. 81 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water, Grading, Drainage 6 Erosion Control Plan Is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management Southold and Must b. Submitted for R.A. tsPrior to Issuance of Any Building Permit (NOTE: ACheck Meth() ardmrAmeerfurea Oueslbnis Requiredfora CgmpNm ApPr"a ) STATE OF NEW YORK, COUNTY OF SS That I, t.Na......CF!.@ being duly sworn, deposes and says that he/she is the applicant for Permit, (Marne of Individual signing Document And that he/she is the .............f~wne IZ_ (Owner Contractor, Agent. Coryorete Officer. atcj Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have perfo AM d work and m make and file this application; that all statements contained in this application are true to the be Qc A Ietw _ and that the work will be performed in the manner set forth in the application filed herewith. No. 01 Y06042591 l~lk Sworn to before me this; Oualified in Suffolk Courtly g . A day of , , 20...).E Commission Expires 5/30/201 Notary Public: ............_"'Y" nature plica t) FORM - 06110 SURVEY OF PROPERTY N SITUATE: OUTOHOGUE TOM SOUTHOLD W E SUFFOLK COUNTY, NY SURVEYED II-25-02 S SUFFOLK GOUNTY TAX # 1000-109-1-2 CERTIFIED TO: Timothy Eank / SUffolk Crnm y NUional ce Fidellly Natlonel Tithe Insuran Company of New York 5 post 1 I roadW'y' 0 ~ 5 0f a_p---~ 1 edge " ~ N N81 5~. o c = 1,42"115" " ~ _K , o ewe« 0 4 o flay pnln ~t p s oolb V F Fro °e a^de ~C: Q u t M r p p O Z J I m i C L l a a E3N X J 0~6 L i I 1 O I J i y I=rame s, 23. e 6 Un Garag CL J _ wx s i N O Lu x ¦ N ~o 0 a ~ s I e Ines HOOd I oPost 1 shad 7 Wv E N ~ i In O~ N85°05'10" W f3~sl i'b wo O _ 240.47, od Poet z~ Land Now or Former) _N Anne Elok d John y of O o Elak 0 NOTES: yr .~...o..,......,,.,.,,.m,.. MONUMENT FOUND SFG LAND SVP .~..y..."i.,...3.."...,°.,~ eti..~....AREA = 86,829 sf or 1.99 acres JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 GRAPHIC, SCALE 1"= 40' RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\Hp server\d\PROS\02-333.pro Southold Town Building Department P.O. Box 1179 Permit 36335 54375 Main Road ~~450 Southold New York 11971 Permit Date: 4/20/2011 (631) 765-1802 Expiration Date: 10/19/2012 s'f Parcel ID: 109.4-2 BUILDING PERMIT RENEWAL LETTER Dated: 7/29/2013 Applicant: TIMOTHY CAUFIELD Location: 21800 ROUTE 25, CUTCHOGUE Work Description: ADDITION/ALTERATION construct a deck addition to an existing dwelling as applied for A FEE OF $114.40 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: TIMOTHY CAUFIELD Address: 21800 ROUTE 25 CUTCHOGUE, NY 11935 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. - _ ~ L ' Y ~ lsvtrLC'~ -LIb'x <~lAins f2/~! 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Oki .`Xrsr SNEATNiNG~ INI DESIGN OR CJNGTRUCTION ERRORS. ~PoEerVFR wercH„ I I s,oiNG Nr, ax.o ~.F,R UDsT -a,/G,o,c. w/ °A6W. CAP o G4PD SR /iLUM. CAP ~engr g_7}c4 (2E?/SEA - Sf •/9.201/ 77 =7 PLAN BEGTION , Ira Haspel O 31,I I ~ i 1 Q 11 ArcMtect,P. C. EX, d/2 . r-- --I~%rntt mac. dnTU FX, aR. III I h ~ III 59945.Main Romd r SouthoK N.Y. 11971 d 631-765-2075 -phone 1 631-765-5715 - tax u = ~ z W V~1 516-396.8753 - cell u ~ y ih=pel@imha".com - emdl o Q a ~ .o I `x ex• RNPY i K/TCN£N civ N e C~ `r I CAUFIELD RE51DEhCE n p cu ~ 21600 MAIN RD. CUTCHOGUr, N."r.. i NEW G x 12 DECK I Copyright c im Hupel All Rights Reined 2.58 H.D,GLW. _ 0OVTS (TYp.~ EX. 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