HomeMy WebLinkAbout38917-Z 7/22/2014
Ofppt Town of Southold Annex
P.O.Box 1179
~ 54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37036 Date: 7/22/2014
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 1430 N. Sea Drive, Southold,
SCTM#: 473889 Sec/Block/Lot: 54.-5-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/30/2014 pursuant to which Building Permit No. 38917 dated 5/30/2014
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:
PERGOLA ADDITION TO AN EXISTING DECK ON A SINGLE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Conboy, Stephen&Conboy,Diane
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
l
Au o ed Si ature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
l
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#: 38917 Date: 5/30/2014
Permission is hereby granted to:
Conboy, Stephen & Conboy, Diane
9 Heath PI
Garden City, NY 11530
To: construct pergola additions to an existing deck as applied for
At premises located at:
1430 Sea Dr
SCTM # 473889
Sec/Block/Lot# 54.-5-8
Pursuant to application dated 5/30/2014 and approved by the Building Inspector.
To expire on 11/29/2015.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $278.40
CO -ADDITION TO DWELLING $50.00
Total: $328.40
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$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. QV7) ILA .
New Construction: ✓ Old or Pre-existing Building: (check one)
Location of Property: \L*,1_6 C) C V h q - ,,I,-- S V\
House No. Street Hamlet
Owner or Owners of Property: a`�� C o r_1
Suffolk County Tax Map No 1000, Section P5 f-�- B k 17) 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: $ O . a�
pp i t Signature
i
OF SO(/lyo
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROU PLUMBING
[ ] FOUNDATION 2ND [ ] I ULATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
U4
L
DATE AC INSPECTOR Xg,
FIELDIlVSPECrXQN REPORT COMMENTS
'Q�/T ro
FOUNDATION(IST) ^
�o
FOUNDATION(ZND)
' z
ROUGH FRAMINQ& y
PLUMBING
INSULATION PEA N.Y.
STATE ENERGY CbDE
FINAL
ADD ON``• ,.
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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 X 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. 3g x Check 2 o U
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined 20V Storm-Water Assessment Form
v
ntact
Approved ! 20 ��Y Mail to:
Disapproved a/c
BLDG. DEPT.
Phone:(03(
Expiration 1 20 / 5 TOhiPi OF SOUTFIOLD
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date , 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 dateAf 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,Co t ,Ngvy,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.
`'(Signature of applicant or name,if a corporation)
(Mailing address of applica t) $
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
a C_`t-Or
Name of owner of premises
(As on the tax oll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
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:
1 Lt3o Num,
House Number Street Hamlet
County Tax Map No. 1000 Section j}L-k 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 <!Z'i
b. Intended use and occupancy
3. Nature of work(check which applicable:New Building .Addition Alteration
Repair Removal'' Demolition Other Work_ a_
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 carsof t
a
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.&C. PERMITS MAY BE REQUIRED.'
b. Is this property within 3`00 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 )
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.
Swor to efore me this
1!�.L of 20
VIC TOT of New
Na 0P1 14-k196 i ature f A licant
Notary Public gn o pp
Qualified in Suffolk Coun
Commission Fxnires luiv?8 2 ��
SIJFFQ,
Scott A. Russell TOR IM[WA'7C']E][�
SUPERVISOR AMAINAGlElMUENT
SOUTHOLD TOWN HALL-P.O.Box 1179 �
53095 Main Road-SOUTHOLD,NEW YORK 119710 Town of So u th o l d
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)
❑OA. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
[:IQ B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
ElC. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
EIEPD. 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.
❑ 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: G o �4 `�
Section Block Lot
r
t i'tiI.'i
Contact Information n
Reviewed By:
- - — — - - - - — — — — — — — — — —
Date: 5l ✓
Property Address / Location of' Construction Work: — — — — — — — — — — — —I
Q �� � ❑ Approved for processing Building Permit.
/, Stormwater Management Control Plan Not Required.
��T f�_ �`�-`� � ���C— Stormwater Management Control Plan is Required.
►'\0`tC'� (� (Forward to Engineering Department for Review.)
FORM * SMCP-TOS MAY 2014 '"
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ACC:)R" CERTIFICATE OF LIABILITY INSURANCE 05113/2014
PRODUCER 631-273-52()0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
D'ANGELO INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1097 SUFFOLK AVE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
BRENTWOOD,NY 11717
INSURERS AFFORDING COVERAGE NAIL#
INSURED INSURER A;TRAVELERS INDEMNITY CO
VICTORIAN FENCE INCINSURER a: HARTFORD
PO BOX 73 INSURER C:STANDARD SECURITY LIFE INS
ST.JAMES NY 11780 INSURER D:
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICYMW§t)TION1
INSR ADM -n POLICY NUMBER M LIMITS
A X GENERA—LIABILITY 680-007C398783 01/15/2014 01/15/2015 EACH OCCURRENCE r— S 1,000,000
X COMMERCIAL GENERAL LIABILITY I EsEa Q=rmncol $ 600,000
CLAIMS MADE I A I OCCUR MED EXP An one perow) $ 10,000
CONTRACTUAL UAB PERSONAL&AM INJURY $ 1,000,000
X PRIMARY INCLUDED GENERAL AGGREGATE $ 2,000,000
GEM AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMROP AGG $ 2,000,000
F-1POLICY FXI WT r-�LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LOOT
ANY AUTO (Ea aacidwg)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per pwsm)
HIRED AUTOS BODILY INJURY
NoN-amw AUTOS Ipw amww*
PROPERTY DAMAGE
"MOE LIABILITY AUTO ONLY-EA ACCIDENT
HANY AUTO OTHER THAN EA ACC S AUTO ONLY. AGG 6
MMESS I UMBRELLA LIABILITY EACH OCCURRENCE
OCCUR El CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE 6
I RETENTION S $
WORKERS COMPE 3Anom
8 AND EMPLOYERS' YIN 13WECBKO173 01/05/2014 01/05/2015 x 1 TWIMS I I IDETR11-
ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000
OFFICEPAIEMSER EXCLUDED?
(M-ft-y in NMI E.L.DISEASE-EA EMPLOYE S 500,000
Udo>PRQVu0"dQwNS below E.L.ENSEASE-POLICY LIMrr1 6 500,000
C OTHER L72717-000 02/06/2014 02/061201 5
DISABILITY
093COUPIM OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS AWED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ALSO ADDITIONAL INSURED.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
TOWN OF SOUTHOLD DATE THERE-OF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
54375 ROUTE 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 80 SHALL
SOUTHOLD, NY 11971 IMPOSE NO OBLIGATION OR UABKM OF ANY KIND UPON THE W3UREK ITS AGENTS OR
REPRESENTATIVES- 42
AUTHORIZED W3pftAM
ACORD 25(2009/01) ®1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
12' x 12' Vinyl Pergola Kit
Special Pergolas can also be ordered in other sizes and options.(see page 4)
Options in Bold are included in White, Tan,andAlmond pergola Idts.
t Clay Idts include 2"x 6"Hollow Rafters.(Wooden owe required.)
Rafters(10)..............................................................................................................................(Pages 242s)
^; 2°x 5 112"Ribbed 2"x 6"Hollow 2"x 6"Ribbed 2 x 6"Arched
Aluminumfor Rafters(10).............................................................................................................(Pages 33-34)
"x 1 7/8" 13/4"Sq. None untended for wood insen
Beams(4).......................................................................................... ...................................(Pages 2247)
2" x 6" Hollow 2"x 6"Ribbed 2"x 8"Hollow
Aluminumfor Beams(4)...............................................................................................................(Pages 32-33)
' 3114"Sq. 2"x 8"Beam Support Norte(intended for wood insert)
PergolaPosts/Columns(4)............................................................................................................(Pages 17-21)
Pi.-�I 6"Vintage 3" Recessed 8"Square sa�annah 8"Rd.Tapered 3°Rd. Fluted 0"Rd. TaQered
ShadeCover(13).......................................................................................................................(Pages )
1 1/2"Sq 9 314"Sq 7118"x 3" "x 8'VI,I , Lattice
7000012th-'* 42"�1 ' irEyt Pergola IGt $42$2:35 ea: $4566x59 ea. $456E)5!#ea. `''`$43f7.56 ea.` IY/A
12 COUNTRYACCENTS
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PERGOLA 1 FOOTING FL 765-1802 8 AM TO 4 PM FOR THE
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(q YORK.. \\//\�� DEEP CO1NC. COL. FTG. (TYP.) YORK STATE. taOT ''F=SPONSIBLE FOR
DESIGN OR CONSfR PJNJ ERRORS.
DATE
RETAIN STORM WATER RUNOFF SEPTEMBER 20,2013
PURSUANT TO CHAPTER 236
OF THE TOWN CODE. SCALE
f4 I L 1 AS NOTED
DET
SCALE: 1/211=1'-O" DRAWING
ARCHITECT'S CERTIFICATION A- 1
THIS ARCHITECT CERTIFIES THAT TO THE BEST OF HIS KNOWLEDGE,
INFORMATION AND BELIEF,THE PLANS ARE IN ACCORDANCE OF
WITH APPLICABLE REQUIREMENTS OF THE 2010 RESIDENTIAL
BUILDING CODE OF NEW YORK STATE,THE 2001 WOOD FRAME 1
CONSTRUCTION MANUAL(WFCM) &THE 2010 ENERGY 1
CONSERVATION CODE OF NEW YORK STATE,NFPA 70 STANDARD
AND THE LOCAL ZONING ORDINANCE.