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HomeMy WebLinkAbout37102-Z Town of Southold Annex 8/1/2014 � P.O.Box 1179 54375 Main Road AL Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37060 Date: 8/1/2014 THIS CERTIFIES that the building SHED Location of Property: 260 OAK DRIVE CUTCHOGUE, SCTM#: 473889 Sec/Block/Lot: 104.-5-27 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 3/23/2012 pursuant to which Building Permit No. 37102 dated 3/29/2012 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: ACCESSORY SHED IN THE REAR YARD AS APPLIED FOR The certificate is issued to SCOTT&STACY BOWE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 9 A o ' ed Si atur ua"Fft" TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 37102 Date: 3/29/2012 Permission is hereby granted to: SCOTT & STACY BOWE 17 SMITH STREET ROCKVILLE CENTRE, NY 11570 To: construct a 10' X 14' accessory shed as applied for At premises located at: 260 OAK DRIVE CUTCHOGUE SCTM # 473889 Sec/Block/Lot# 104.-5-27 Pursuant to application dated 3/23/2012 and approved by the Building Inspector. To expire on 9/28/2013. Fees: ALTERATION OF ACCESSORY BUILDINGS $156.00 CO -ACCESSORY BUILDING $50.00 Total: $206.00 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 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. �// -Z New Construction. ✓ Old or Pre-existing Building: (check one) Location of Property: �/Z House No. Street Hamlet Owner or Owners of Property: -z- Suffolk Suffolk County Tax Map No 1000, Section Block Lot v Subdivision Filed Map. Lot: Permit No. �� Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: _c/ (check one Fee Submitted: $ Applicant Signature i oF soco olyo� • �o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO [ ] FOUNDATION 1 ST [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOL,ATIO [ ] CAULKING REMARKS: c &Z- A�z �s DATE INSPECTOR 7 2s:. ZA rjv so TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION I FOUNDATION IST ROU P ING FOUNDATION 2ND IN 0 FRAMING / STRAPPING I L i, FIREPLACE & CHIMNEY FIRE INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION CAULKING REMARKS: DAT INSPECTOR DAT, Ca1VIl TS. +OTJ A OI+1(lST). 1N �MMMMw1rlMwtKwr !l0 .. ,v FOUNDATION(2ND) � . o Q- ROUGH FRA G& � PLUMING INSM.A.TION P9P,N.X. STATE EM MGY CODE FINAL ADDITIONAL.CO1OONTS l' h �J C� p rx �v o � Z b 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 SoutholdTown.NorthFork.net PERMIT NO. ?710.2 Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined 20 Single& Separate Storm-Water Assessment Form Contact: Approved_ 20 Mail to: /_j Ste'?/TIS _<r- Disapproved %Disapproved a/c Phone: Expiration ,20-3 !TOWN a0DEPT,. Building Inspector MAR PPLICATION FOR BUILDING PERMIT Date '�j�/ , 20 /2! BLINSTRUCTIONS — � 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. (Signature of applicant or name, if a corporation) i tddress sof applicants hoc State whether applicant is owner, lessee, agent, architect, engineer, generalfcontracr e�lectr}cian, r_or builder F. - 1.�LIENT AT TQ 4 PM FOR THF= ECTIONS:�, Name of owner of premises 40W e, 1 T'NF�'L?EOUIIRMED As on the tax roll or last deed If applicant is a corporation, signature of duly authorized officer S E-ECTRICAL&CQt�q�l(�i 3. A UL6T!;;N (Name and title of corporate 4. Fil%°L, CONSTRUCTION&ELFAV M11-ST BE COMPLETE FOR C.O. Builders License No. USE IS I INII Al/1/F 1 ALL 4NSTRUCTION SHALL MEE ; TF� Plumbers License No. RE( IREMENTS OF TF�E'CODE,9�Qg til Electricians License No. �` (_ 'ATE YOy STATE. NOTRESPONS1ftjtq � Other Trade's License No. DEWN OR CQNSTRUQT10,kq l v `4 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section 1 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 b. Intended use and occupancyi 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. 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 OFU ! ��.yL./P� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 (S)He is the o ualitied in Suffolk County , (Contractor, Agent, Corporate Officer, etc.) commission Expires April 14, _ 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 statementsKcontained 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 th' day ofXVj/ ' 20 �-j�" ) Notary Pubh�c Signature of Applicant i oak Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.0 T.M.# THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A �.�t11 STORM WATER,QRADINOr DRAINAGE AND EROSION CONTROL PLAN ' �k cct S"n -Blom— t CERTIFIED BY A D SIGN PlitornsioNAL iN—TA STATE OF NEW YORK. II SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No C I a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within Will this Project Retain AI Storm Water Run-off the Scope of Work for Proposed Construction) ' Generated by a Two(2")Inch Rainfall on Site? b• What is the Total Area of Land Clearing (�F > (This Item will include all run-off created by site 9 clearing and/or construction activities as well as an and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? F. impervious surfaces.) ) PROVIDE BRIEF PROJECT DESCRdPTZON tPro+aide AddNanl Pages as Needed) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location?This / a Item shall include all Proposed Grade Changes and L Slopes Controlling Surface Water Flow. I 3 Does the Site Plan and/or Survey describe the erosion Q x and sediment control practices that will be used to ZEI control site erosion and storm water discharges. This i item must be maintained throughout the Entire Construction Period. i 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 Parcell E] Will this Application Require Land Disturbing Activities / Encompassing an Area in Excess of Five Thousand ❑ L/ (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 Regulremerrts: or within One Hundred(109)feet of a Wetland or Submission of a SWPPP is required for art Constriction activitles involving soil Beach? disturbances of orle(1)or more acres, including disturbances of less than one acre that l Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; including Constriction activities involving soil disturbances of less than one(1)acre where Exceed Fifteen(15)feet of Vertical Rise to the DEC has determined that a SPDES permit is required for storm water discharges. One Hundred(100')of Horizontal Distance? (SWPPPb Shall meet the Minimum Requirements of the SP DES General Permit 8 Will Driveways,Parking Areas or other Impervious Tor Storm water Discharges frored p Construction sub activity-permit No.GP-0111-Dei.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the Not.The NOI shall be into and/or in the direction of a Town right-of-way? l subrnitted to the Department prior to the commencement of constriction activity. zl 2 The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any i constructed to reduce the pollutants in storm water discharges and to assure item Within the Town Right-of-Way or Road Shoulder compliance with On terms and condttons of this permit In addition,the SWPPP shall identify polandal sources of pollution which may reasonably be expected to affect the Area?(This Item will NOT Include tlw taunt ion of prIV"W Apnats) quality orstorm water discharges. NOTE: N Any Answer to Questions One though Nine Is Answered with a Check Mak 9.All SWPPPa that require the postsonstniction storm water management practice in a Box and the conatruuaon site disturbance is between%M S.F.f1,1 Mac in area, i component shall be prepared by a qualified Design Professional Licensed in New York a Storm-water;Grading,Drainage'&Erosion Control Plan is Required by the Town of j that Is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submk*. d for Review Prior to Issuance of Any Building Permit. SNOTE: A aura Mark(,h and/or Anwar for aach Question Is wgirrm for a 0=0010 Appikeieon) STATE OF NEW YORK, CONNIE D. BUNCH COUNTY OF...........................................SS Notary Public:,State of New York ' No.01 BU6185050 Qualified In Suffolk County -/L/ That I,.. ......l�'T .. ,o`s c being duly sworn,deposes y�.�,�,,,a,. 0 tt (Name of indlvldisil slgritng Diiaiinerrij •. tAf �lltl$rnPrOr.Pe mit, t And that he/she is the ..................................:...... . .......................................... . ... ......................... i (Owner.Coritradar.Agent.Corporate O�icor�ex.) ........................................... ; 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 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 herewith. Swum to before me this;r .......... • ... Notary ....... day of...... .... ..... ,20)....� '...... Public: t•� 5��;.......................... (signature of Applicant) I FORM - 06110 % / �1 - !,► Qf - ? 50, — t1 =N N (V J J l� -j 1 5TH' f7 l� VIP — to G'R t1(1, .rt < a- �l o f t,,_ 00 1}nauthorlse4 altwetion or addition / ` a to tt+ls survpy is a violation of ! / 1 N 7� �„�� (A ILI L N S—r,or,7209 of the NeW York fete 1 1 �Ul Education law 3} J {\ <irlCa "of thte survey Primpp not beterht the land surveyors k*&d aeef or .mbL,gsndseal shall riot baCC Ms,- �I Mn{n lir s valid true Capp - t �'-- ' , AJ� ,,,pranteet,Indic �Indicated Itersen e*11141 / '~'�Jtl nn'y to the person tar whm ifw lllln syL 5 .11(� -r�na'sd and an#s behalf t0 the r„moanv aovernrrrerrtal pencYl ad I FRA -l.1QAtt.. rew-v :` t,.'Tt4 or um5 1N en ,v,n�tautlon tested t»r.on d J A. L Q O W L;Y ', 11Q�ees of the tsndlrta ifratf- 1 „ r „•araces are not treederabfe ; nstltutsons or aubooQuertt I M A P LA�J til YG FaIZti1Sa�ie�n0 , ! 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