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Home My WebLink About38943-Z �F1kjf Town of Southold Annex 6/18/2014 " P.O. Box 1179 54375 Main Road 10 W Southold,New York 11971 . s� CERTIFICATE OF OCCUPANCY No: 36979 Date: 6/18/2014 THIS CERTIFIES that the building DECK Location of Property: 145 Tepee Trail, Southold, SCTM#: 473889 Sec/Block/Lot: 87.-2-32 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/20/2014 pursuant to which Building Permit No. 38943 dated 6/6/2014 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"DECK ADDITION TO A SINGLE FAMILY DWELLLING AS APPLIED FOR The certificate is issued to Kassner,Robert&Kassner,Ruth (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED "nize t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE '$ ¢ SOUTHOLD, NY 1 # 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#: 38943 Date: 6/6/2014 Permission is hereby granted to: Kassner, Robert & Kassner, Ruth 145 Teepee Trl Southold, NY 11971 To: as built" Deck Addition as applied for At premises located at: 145 Tepee Trail, Southold SCTM # 473889 Sec/Block/Lot# 87.-2-32 Pursuant to application dated 5/20/2014 and approved by the Building Inspector. To expire on 12/6/2015. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $600.00 CO -ADDITION TO DWELLING $50.00 Total: $650.00 Building Inspector 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 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 1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool $25.00,Accessory building$25.00,Additions to accessory building$25.00,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$115.00 Date. J', Z r New Construction: x Old or Pre-existing Building: (check one) Location of Property: L/5- W Lone- _ 5C boy/10 /Q/ House No. Street Hamlet /� Owner or Owners of Property: Adh J�� 1� z S5 ne-t— Suffolk County Tax Map No 1000, Section $? Block Lot c.3y2 Subdivision nFiled Map. Lot: p—IU Permit No. 4 i� Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ 50 `M Applicant Signature i �O��Of SOUryo� o��oU11I'1� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ) FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: A5, I � i DATE C INSPECTOR /L FIELD INSPE qN REP ORT DATE coumImS . wd FOUNDATION(1ST) • o�a•w*wwwwww7ww«wwww.w.wwww. yy FOUNDATION(2ND) ' z o TO ROUGH FRANWQ& PLUMING INSULATION PER N.Y. H STATE ENERGY CODE ' y FINAL , 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 q Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined ,20 - Storm-Water Assessment Form Contact: Approved ,20/ -/ � �, ( c., -.r Mail to: Disapproved a/c T^ Phone: Expiration ,20 I Building Inspector APPLICATION FOR BUILDING PERMIT Date 2 C7 , 20� 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. ignature of applicant or name if a co( oration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder APS OVP AS : B.P. # Name of owner of premises l -�r Gl 1<455/7e/,- (As on the tax roll or latest-, e; If applicant is a corporation, signature of duly authorized officer _ SING DEPARTMENT AT r ;2 TO n PNI FOR THE (Name and title of corp444 Ol'iber) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 'JiREMENTS Gi T,i: C yS ,Q Yr0 ins C STATt.[�OT RESPO"J �3! n& J am,^�SIRUCTI9N�RRQk House Number Street Hamlet County Tax Map No. 1000 Section `7 Block Lot 3 Z Subdivision 4Zc)nr�a fc.910a AU Filed Map No. ✓�`"/Z Lot /9 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ti&ad de aAC. b. Intended use and occupancy WO 6d C) 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work 4. Estimated Cost Fee (Description) (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. Dimensions of entire new construction: Front Rear Depth Height 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. 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 YORK) SS: COUNTY OF"J1., 1pcaYC u a C_- //O�`> being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (Contrac6l,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 to before me this 020 day of_ /✓J�} 20 Notary Public MARGARET C. a of e S Signature of Applicant Notary Pubic,St No. 9$528Nw York Qualified in Suffolk County S Commission Expire&June 3, i Scott A. Russell a � STO]KIMMA\T]ER, SUPERVISORG r E 1ENT l��l[A\I�A\G] l� SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 , Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) E][D A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑ B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑[ZI C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. E]R3 D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑® E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date District _ NAME: "aX 107, Section Block Lot FOR.BUILDING DEPARTMLN" SE ONLY Contact Information: �P ! fO / 30 Reviewed By: - - — — — — — — — — — — — — — — — — Date: Property Address / Location of Construction Work: —[�rApproed — — — — — — — — — — — — r�� , / vfor processing Building Permit. Lct rmwater Management Control Plan Not Required. ElStormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM SMCP-TOS MAY 2014 APPLICANT: S.C.T.M.*: 1000 (Property Owner,Design Professional,Agent,Contractor,Other) �QSUFFQ 41 CHAPTER 236 Stormwater Management Control Plan CHECK LIST NAME: PI.—PWSection Block Lot S M C P -Plan Requirements: Provide ONE copy of the Building Permit Application. Date: . * The applicant must provide a Complete Explanation and/or Reason for not providing 1 y` all Information that has been Required by the following Checklist! �ig�lure T;Lp1—Numbm 1. A Site Plan drawn to scale Not Less that 60'to the inch MUST NO NA If You answered No or NA to any Item, Please Provide Justification Here! show all of the following items: If you need additional room for explanations, Please Provide additional Paper. a. Location & Description of Property Boundaries b. Total Site Acreage. c. Existing -Natural& Man Made Features within 500 L.F. of the Site Boundary as required by §236-1702). d. Test Hole Data Indicating Soil Characteristics&Depth to Ground Water. e. Limits of Clearing & Area of Proposed Land Disturbance. f. Existing & Proposed Contours of the Site (Minimum Z Intervals) g. Location of all existing & proposed structures, roads, driveways,sidewalks, drainage improvements & utilities. h. Spot Grades & Finish Floor Elevations for all existing & proposed structures. I. Location of proposed Swimming Pool and discharge ring. j. Location of proposed Soil Stockpile Area(s). k. Location of proposed Construction Entrance/Staging Area(s). I. Location of proposed concrete washout area(s). M. Location of all proposed erosion&sediment control measures. 2. Stormwater Management Control Plan must include Calculations showing that the stormwater improvements are sized to capture,store,and infiltrate on-site the run-off from all impervious surfaces generated by a two V)inch rainfall/storm event. 3. Details&Sectional Drawings for stormwater practices are required for approval. Items requiring details shall include but not be limited to: a. Erosion & Sediment Controls. b. Construction Entrance& Site Access. c. Inlet Drainage Structures (e.g.catch basins,trench drains,etc.) d. Leaching Structures (e. .infiltration basins,swales,etc.) .................. _.. ....__..... . ... FOIA ENGINEERING DEPARTMENT USE ONLY*"** I 1Additional Information is Required. Reviewed & ❑ Stormwater Management Control Plan is Not Complete. Approved By: I — — — — — — — — — — — — — — — — — — — — — — — — iStormwater Management Control Plan is Complete. Date: 1 SMCP has been approved by the Engineering Department. FORM * SWCP Check List -TOS MAY 2014 BOW ROAD LOT 15 n• co S- 880111001'E. $ aiN i I 116.22 s i o.rE �c epi/ e� o I s1�oac�eence a w�refc"�`� (S mor/ - 1r,Qr r770/7 -- ------_ i f17a cn i w I I W (p W 22.4 p O LOT ,19 O bby 29, "' C.e. .sfory P° LOT 18 conC f,-- 12.0• h arcs e 4LIJ 9a�a9e W W - Q, o o � W 00/ 2 fnd � �6 f�a p N, 88° 11 '00" W. 80. 00 ' ti V LOT 20 F� 0 " as sem, �y t"d0' W � S• 0?24� -73 3 � GWaM WpY W CERTIFIED TO ROBER T G. K A SSNER RUTH Z. KASSNER SURVEY OF Prepared in accordance with the minimum L 0 T 19 •tandards for title surveys asestablished by MAP OF N U N N A K OM A WATERS " A.L.S. and approved and adopted ;ch use by The New York State Land FILED J U L. 9 , 1968 FILE N 0. 5 1 2 6 Association. AT SOUTHOLD TOWN OF S OUTHO L D SUFFOLK COUNTY , N. Y. ti01,ANpS� 1000 - 87 - 02 - 32 •C. MF 9 SCALE I" = 30 ' 9 MAY 22 1986 N N.Y. S. LIC. NO. 49618 PECONIC SURVEYORS a ENGINEERS P.E. ( 516 ) 765 - 5020 P. O. BOX 909 MAIN ROAD SOUTHOLD , N. Y. 11973 86 - 294 n f i t � i 4 XZi:, 7 �Eo qRKASSNER RESIDENCE DAT - CIDe: Ctio. 145 ARROW LANE �'•� ' " RS NUNNAKOMA WATERS . r �. _ SK SOUTHOLD NY 20 9�F CHORNO ASSOCIATES architoctiL SOUTHOLD,NEW YORK