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Home My WebLink About39391-ZTown of Southold Annex �.VA P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37379 Date: THIS CERTIFIES that the building SHED Location of Property: SCTM #: 473889 26915 CR 48, Cutchogue, Sec/Block/Lot: 84.-2-4.2 1/12/2015 1/12/2015 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/31/2014 pursuant to which Building Permit No. 39391 dated 11/26/2014 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" accessory shed as applied for. The certificate is issued to Bergmann, Diane (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut d S' atut; Town of Southold Annex P.O. Box 1179 �r 54375 Main Road �b fit` Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37378 Date: THIS CERTIFIES that the building IN GROUND POOL Location of Property: 26915 CR 48, Cutchogue, 1/12/2015 1/12/2015 SCTM #: 473889 Sec/Block/Lot: 84.-2-4.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/31/2014 pursuant to which Building Permit No. 39391 dated 11/26/2014 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" accessory in ground swimming pool with fence to code as applied for. The certificate is issued to Bergmann, Diane (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 39173 9/24/2014 A o . eY4 ature Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 1/12/2015 No: 37380 Date: 1/12/2015 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 26915 CR 48, Cutchogue, SCTM #: 473889 Sec/Block/Lot: 84.-2-4.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/31/2014 pursuant to which Building Permit No. 39391 dated 11/26/2014 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" shed addition to an existing accessory garage as applied for. The certificate is issued to Bergmann, Diane (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 39391 12/8/2014 h ed. ignature Town of Southold Annex 1/12/2015 P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37377 Date: 1/12/2015 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 26915 CR 48, Cutchogue, SCTM #: 473889 Sec/Block/Lot: 84.-2-4.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/31/2014 pursuant to which Building Permit No. 39391 dated 11/26/2014 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" enclosed sunroom and covered deck addition to an existing one family dwelling as applied for. The certificate is issued to Bergmann, Diane (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 1/12/2015 39391 12/8/2014 alter Marczewski, III oriz Si ature 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 #: 39391 Date: 11/26/2014 Permission is hereby granted to: Bergmann, Diane 26085 CR 48 PO BOX 311 Peconic, NY 11958 To: As built additions and alteration to an existing dwelling, as built in -ground swimming pool, as built accessory shed, and as built additions and alterations to an existing accessory garage as applied for. 4 COs required. At premises located at: 26915 CR 48, Cutc SCTM # 473889 Sec/Block/Lot # 84.-2-4.2 Pursuant to application dated 10/31/2014 and approved by the Building Inspector. To expire on 5/27/2016. Fees: AS BUILT - SWIMMING POOL $500.00 CO - ADDITIONS TO ACCESSORY BUILDINGS $50.00 CO - ACCESSORY BUILDING $50.00 CO - ADDITIONTO D G $50.00 CO ING P OL $50.00 AS BUILT - S LE F ILY ADDITION/4L E ION $630.00 uilkiing Inspector TOWN OF SOUTHOLD 0„ BUILDING DEPARTMENT I I* TOWN CLERK'S OFFICE SOUTHOLD,NY t 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 #: 39391 Date: 11/26/2014 Permission is hereby granted to: Bergmann, Diane 26085 CR 48 PO BOX 311 Peconic, NY 11958 To: As built additions and alteration to an existing dwelling, as built in -ground swimming pool, as built accessory shed, and as built additions and alterations to an existing accessory garage as applied for. 4 COs required. At premises located at: 26915 CR 48, Cutchogue SCTM # 473889 Sec/Block/Lot # 84.-2-4.2 Pursuant to application dated 10/31/2014 and approved by the Building Inspector. To expire on 5/27/2016. Fees: AS BUILT - ACCESSORY AS BUILT - ACCESSORY $358.10 $304.30 Total: %1-992.40 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: q j LB'I(,n ,, Lkru House No. Street Hamlet Owner or Owners of Property: �t (j� a a Cq{ryta n n Suffolk County Tax Map No 1000, Section Block Lot ;L 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 Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 pF SOUjyo� 0 IA 'routml BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax (631) 765-9502 roger. riche rt(a)-town. so Litho Id. ny. us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Diane Bergmann Address: 26915 Rt 48 City: Peconic St: NY Zip: 11958 Building Permit #: 3 9 1 7 3 -j 39172 Section: 84 Block: 2 Lot: 4.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: 51TE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool X New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 6 Ceiling Fixtures 1 HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 3 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 1 CO Detectors Sub Panel A/C Blower Range Recpt 40a Fluorescent Fixture Pumps Transformer Appliancesdw Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 6 Twist Lock 11 Exit Fixtures �] TVSS Other Equipment: includes kitchen addition and swimming pool, 2 -paddle fans, 1 -exhaust fan, pool to include, 1 -pump, 1-recp, 1 -time clock, 1-GFCI Notes: AS BUILT ------------ELECTRICAL SURVEY ---------NO VISUAL DEFECTS ------- Inspector Signature:!i� Date: Sept 24 2014 81 -Cert Electrical Compliance Form.xls pG SO(/j�o� 0 Town Hall Annex 54375 Main Road P.O. Box 1179 ' Q Southold, NY 11971-0959 Q BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Building Permit No. 2`3 �/ Owner:�'rrl2 / � (Pl�eyase print) Zzz—k--zPlumber:-3(c C5 � (Please print) lead. Date: Telephone (631) 765-1802 Fax (631) 765-9502 I certify that the solder used in the water supply system contains less than 2/10 of 1% A��le'� �Ftoe:P7- � �r (Plumbers Signature) Sworn to before me this l �-- day of 20 ( 5 /� VICKI TOTH Notary Public, County Notary Public Stat of New Yor4 No. 01t061�0696 Qualified in Suffolk County Commission Expires July ?P '"` Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax(631)765-9502 roger.richert(ab-town.southold.ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Bergmann Address: 26915 County Rd 48 City: Cutchogue St: NY Zip: 11935 Building Permit #: 39391 Section: 84 Block: 2 Lot: 4.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 2 Ceiling Fixtures 5 HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect 11 Switches Twist Lock Exit Fixtures TVSS Other Equipment: OPEN DECK, east and south side of house, AS BUILT ---ELECTRICAL SURVEY ---NO VISUAL DEFECTS --- Notes: Inspector Signature: Date: Dec 8 2014 81 -Cert Electrical Compliance Form(3).)ls Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax(631)765-9502 roger. riche rt(a)-town.southoId. ny. us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Bergmann Address: 26915 County Rd 48 City: Cutchogue St: NY Zip: 11935 Building Permit #: 39391 Section: 84 Block: 2 Lot: 4.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor X Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 2 Ceiling Fixtures 4 HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 4 Twist Lock F1 Exit Fixtures �] TVSS Other Equipment: AS BUILT ---ELECTRICAL SURVEY ---NO VISUAL DEFECTS-----GARAGE-- Notes: Inspector Signature: Date: Dec 8 2014 81 -Cert Electrical Compliance Form(1).xls Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (63 1) '765-1802 Fax(631)765-9502 roger. riche rt(cb-town. so utho Id. ny. us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Bergmann Address: 26915 County Rd 48 City: Cutchogue St: NY Zip: 11935 Building Permit #: 39391 Section: 84 Block: 2 Lot: 4.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: Residential Commerical New Addition X Indoor Outdoor Renovation Survey Heat Duplec Recpt SITE DETAILS Office Use Only X Basement 1st Floor 2nd Floor Attic INVENTORY Service Only X Pool Hot Tub Garage Service 1 ph Heat Duplec Recpt 3 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures1d Time Clocks Disconnect Switches 3 Twist Lock Exit Fixtures TVSS El Other Equipment: sun/screen room, 1 -paddle fan Notes: Inspector Signature: Date: Dec 8 2014 81 -Cert Electrical Compliance Form.xls Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax (631) 765--9502 roger.richertCaD_town.southold.ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Bergmann Address: 26915 County Rd 48 City: Cutchogue St: NY Zip: 11935 Building Permit #: 39391 Section: 84 Block: 2 Lot: 4.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: Heat Duplec Recpt Hot Water GFCI Recpt A/C Condenser Single Recpt A/C Blower Range Recpt Appliances Dryer Recpt Switches 1 Twist Lock POOL HOUSE/GARAGE ADDITION 1 Ceiling Fixtures 2 HID Fixtures Wall Fixtures Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixture Pumps Emergency FixturesH Time Clocks El Exit Fixtures TVSS ---AS BUILT ---ELECTRICAL SURVEY—- ---NO VISUAL DEFECTS ---- Notes: Inspector Signature: Date: Dec 8 2014 81 -Cert Electrical Compliance Form(2).xls 1 I Of SOUIyo TOWN OF S;Tlch4ot, DING DEPT. r ' 6S.180 INS;; T ' y=� FOUNDATION 1 ST ROUGH PLUMBIN [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL�� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATIO, [ ] CAULKING REMARKS: --L-` iii DATE �� INSPECTOR of SO!/l�o N iC row, ^� i` L TOWN OF SOUTHOLD BUILDING D PT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE A CHIMNEY [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [T} ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE -INSPECTOR ' �� Of SOUryo� . TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION IST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLATION REMARKS: `e-a&--fDrATE [ ]ROU PLUMBING SUL [ FINA I 1 FIRE SAFETY INSPECTION [ ] FIRE nESIsranr roNernanoN I ] F1ECiRlCnl (FINAL) [ ] SAULKING Geoffrey Freeman ARCHITECTS 561 Broadway New York New York 10012 Tel: 212 219 9044 Email: gfarch@usa.com Cell Phone: 9179028158 January 2nd 2015 To Whom It May Concern Town of Southold Building Department Town Hall Southold, New York 11971 RE: House at 26915 Route 48, Cutchogue, New York 11935 S.0 Tax No. 1000-84-02-4.2 I ,Geoffrey Freeman, am a Registered Architect in New York State, Lic. No. 010673. To the best of my knowledge, belief, and professional judgement, the recent additions to the above residential property are in compliance with the Building Codes of New York State. Yours Sincerely Geoffrey Freeman Riverhead Office 129 Riverside Drive Riverhead New York NY 11901 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined o ,20 Approved ( , 20 Disapproved a/c PERMIT NO.51 ( L'1 Expiration:V2`7 , 2014� BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm -Water Assessment Form Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT OCT Date , 20 INSTRUCTIONS i; a. This applicattoiiPM mpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 seti: 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. P441t, 94,*� (Signature of applicant or name, if a corporation) Il6 4MMcf 3(tjA a (Mailing addrets of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of 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 House Number will be done: Ham County Tax Map No. 1000 Section g4 Block Z Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of a. Existing use and occupancy 93 b. Intended use and occupancy Nature of work (check which applic Repair Removal L'%'111.11«V11 __.._ " - intended use and occupancy of proposed construction: 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor M'-�. 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 rah.ho use, P uatlb kouse, q 8. Dimensions of entire new construction:ront * 32.1 sua, Rear Depth Height Number of Stories 9. Size of lot: Front /�d Rear • $g Depth M 26'q Ce) 10. Date of Purchase/ Z4 / 7 j Name of Former OwnerMa d"e. S0 C, - 11. Zone or use district in which premises are situated G 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO__ 13. Will lot be re -graded? YES NO --X Will excess fill be removed from premises? YES-- NO z4o`t l5 erAk 14. Names of Owner of premises Address CV-4-CRP%J-e- Phone No. 4'%5434 ' ff,30 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_y * 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) < 5s; COUNTY OF ) f�F f f being duly sworn, deposes and says that (s)he is the applicant (Name of. individ}al signing contact) above named, (S)He is the (Coptractor, 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 then 'n1h.:, Sworn t before me this day of _ 20 )Q ��►��L�ICUNNIE D. BUNCH Nota Public aryFn4ifi ,Slate of Nova 1°o Signature of Applicant No. 01 BU618&xr) Qualified in Suffolk County /- Commission Expires April 14 2�0 Scott A. Russell °s� � STO]Kl��l WA\T]ER, SUPERVISOR MANAGEMENT �T (,it � l��l[A\1�A\G�]EI��I[]E�T SOUTHOLD TOWN HALL - P. O. Box 1179 53095 Main Road - SOUTHOLD, NEW YORK 11971 o 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: (CHECK ALL THAT APPLY) 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. 100 feet of horizontal distance. D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. E. Site preparation within the one -hundred -year f loodplain 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, gen)Contractor, Other) NAME: �LAJ :R� Contact Information: (p_ 3 1 (I 1rph— Nw ,br6 Property Address / Location of Construction Work: :18 c�c�t oc�wZ. FORM # SMCP - TOS MAY 2014 S.C.T.M. #: 1000 Date: District ��'' Section Bloc Lot 1,0R. BUILDING DI P:ARTN-1)-NT USE ONI.,Y Reviewed By: Date ❑Approved for processing Building Permit. Stormwater Management Control Plan Not Required. F]Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) Town Half Annex 54375 Main Road P.O. Box 1179 Soudiold, NY 11971-0959 Telephone (631) 765-1802 roQer.rlcherl(�ISW�11 SO� nV uS BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: *`Address: -� *Cross Sfreef:42 ,� �,r.{� 4C/�-<? *Phone No.. 0 Permit No.: Tax -Map District: 1000 Section: 7 Block: Lot: . y *BRIEF DESCRIPTION OF WORK (Please Print Clearly) I dAi4 i" . A k -J ,1; . ,. n t oe e A. (Please Circle All That Apply) Is job ready for inspection: 6D! NO . Rough In Final *Do- you need a Temp Certificate: VC0 , Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re -conned Underground Number of Meters Change of Service Overhead Additional Informafion: PAYMENT DUE WITH APPLICATION 824Rewest for Inspection Form C ZO 5 STREET 6 j : 'V,,: SUB. LOT e4, r �?.1t.; AftliF�'SOOT7 ERT TOWN , FORMER OWNE N "M4q `'�v •ry r'• FlN•�b. :�-T!'I 5 STREET 6 j : 'V,,: SUB. LOT e4, r �?.1t.; , FORMER OWNE N "M4q `'�v •ry r'• FlN•�b. :�-T!'I i� 1 C�a� � TYPB'OF BUILDING ��.r' �lrt.'�a G.. i� �� S� w G a� / '"d �a, e SES:l SEAS. VL. E� ARM COMM, CB. mics. Mkt. Value LAND IMP, TOTAL DATE REMARKS '� oL 11 5�� b c,1� a1 14 d i it rG. //7/70 ve, :S"6d ..; �. �p0 b 3/ i `" �3 �Y�r4 io0� LCA. �o►✓ J_.:. _ •` c �_ ' . n 403 Al. `7G a t :i /30/7/ pN� !o /8 5Gt 3 Pk+e t I s 1t7 80.,6e.4-4AC RtC s at. P y9' 'iter 3 d 117-00 y>it Y%tom ,.. % /lf/%% &-n5 ,, c..4✓/: /I 4,-V Si 6"l3 r a',3 3 1 Jl f X, aswH .4112 .. 'fillo a t • E FRONTAGE ON WATER FRONTAGE-ON'RQAD' ��1t 4�AAeadowlcred . � . DEPTI K -louse Plot BULKHEAD Total :r_ •� - '' I I 0 1-w- 5111F Scott A. Russell Jo rD SUPERVISOR SOUTHOLD TOWN HALL - P. O. Box 1179 53095 Main Road - SOUTHOLD, NEW YORK 11971 5`]F01KMWA\r]F1E1K IMIANAG1]ENDENT Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes I No (CHECK ALL THAT APPLY) ❑® A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑(7�f B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. 100 feet of horizontal distance. ❑ ® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ ® E. Site preparation within the one -hundred -year f loodplain as depicted on FIRM Map of any watercourse. ❑ [a 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, gent, Contractor, Other) S.C.T.M. #: 1000 Date: District NAME: —?!I,�- 4 Section Block Lot 1Aa t<is emrd <.:....=. /A� ' FOR BUILDING DI: P: l"I':11t_ NT t til 0-NJ..`t' Contact Information: �L I /� 3 r7 n Ielpll Nw,twd // A ^ Reviewed By: (-,"j� 1 --—————————— — — — — —— Date• Property Address / Location of Construction Work: 4 15 S cac�h . FORM * SMCP - TOS MAY 2014 Approved for processing Building Permit. Stormwater Management Control Plan Not Required. — — — — — — — — — — — — — — — El Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) 339 � DATE SUBJECT TO r j or 131,00,& W j--j;�j FOO-ri 4111 RJ -D V 2..1:r- w -A 4-1- 3y 1 92 0VU S;—= SIGNED FORM F377 Available from GRAYARC CO., INC., Brooklyn, NY 11232 _ Use with 2NIEw Envelope #E480. 518.7448100 sWdM Route 25A Rocky Pant New York 11778 339 � DATE SUBJECT TO r j or 131,00,& W j--j;�j FOO-ri 4111 RJ -D V 2..1:r- w -A 4-1- 3y 1 92 0VU S;—= SIGNED FORM F377 Available from GRAYARC CO., INC., Brooklyn, NY 11232 _ Use with 2NIEw Envelope #E480. 'Pot OF PROPERTY )ITUATE ECONIC DF SOUTHOLD )UNTY, NEW YORK . 1000-84-02-4.2 &,LE 1 "=20' OBER 20, 2014 40,001 sq. ft. 0.918 ac. I i PREPARED IN ACCORDANCE WITH THE MINIMUM vI°°/ + o • STANDARDS FOR TITLE SURVEYS AS ESTABLISHED SSFPp5 oo BY THE L.I A.L.S. AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND 1 � _ -• TITLE ASSOCIATI 510GKrpE FENCE / \ � i VP�LE n , \ � ,�� OF Nejpv i / �� • IPAF7 v' COiQ T �i / W PLL i / • .• � - • � � Z Y x°' _ •'� 7� CO �o O ° p P'59 PNr�� /°NG c . N.Y.S. Lic. No. 50467 GV�ER UNAUTHORIZED ALTERATION OR ADDITION I • o LAW. THIS SURVEY IS A VIOLATION OF Fa�•NOE / 71 o o SECTION 72LA OF THE NEW YORK STATE Nathan Taft. Corwin iii . / 15-50 0 - r EDUCATION W. J . o • - J COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR 32 62 j\`\� ( r� • . - • ' ` �� TO BE A EMBOSSED VALID BE CONSIDERED Land Surveyor 1' -0- CERTIFICATIONS INDICATED HEREON SHALL RUN N�E� • ONLY TO THE PERSON FOR WHOM THE SURVEY • . IS PREPARED, AND ON HIS BEHALF TO THE NSR 5 Rp Rr • Successor To: Stanley J. Isaksen, L.S. R-42 , /NERN� ur LENDING INSTITUTION LISTED HEREON, AND TITLE COMPANY, GOVERNMENTAL AGENCY AND Joseph A. Ingegno L.S.S . (�4S 98 j Y Ys — Subdivisions — Site Plans — Construction Laurve TO THE ASSIGNEES OF THE LENDING INSTI- Title Sout 0 0 TUTION CERTIFICATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fax (631)727-1727 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Mcin Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 —204 �4 •,k 51TE PLAN 5cale,: a5 5hown ect O n : 8 �- "IMMEDIATELY" APPROVED AS NOTED ENCLOSE POOL TO CODE UPON COMPLETION DATE: 2 B. P. ## n ' Block. 0 2 BEFORE 2V FEE:��.�1-- BY: � �_ RETAIN STORM WATER RUNOFF NOTIFY BUILDING DEPARTMENT AT PURSUANT TO CHAPTER 236 765-1802 8 AM TO 4 PM FOR THE Lot: 4.2 OF THE TOWN CODE. FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED Zonin�: fC FOR POURED CONCRETE 2. ROUGH - FRAMING &PLUMBING 3. INSULATION �j 4 P7�1- - CONSTRUCTION MUST 5. C. Tax No. 1 000-84-02-4 .COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE e w York YORKREQUSTATE.S OF THE CODES OF NEW NOT RESPONSIBLE FOR, 5TATE: N DESIGN OR CONSTRUCTION ERRORS. COUNTY: Suffolk MUNICIPALITY: Town of Southold Y CONSTRUCTION TYPE: F\e5idential CONfjr LY WITH ALL CODES OF .�yL NEW YORK STATE: & TOWN COI AS REQUIRED F ARD TEES XCUPANCY OR SO I EE USE IS UNLAWFUL S i i H01-� T ',' I UL Ky WITHOUT CERTIFICATE -----�-r - OF OCCUPANCY Architect Geoffrey Freeman Architects 5 6 I Broadway Sixth Floor New York New York 100 12 Tel: 2 12 2 19 90,44 Fax: 212 2 9790 9 '7Oo . o "J "JO .1 01 ADDITION #3 FRAME GARDEN SHED I G. 2'x 12.2' FRAM E SHED IfXi- prope groperty line Additions: Extended Porch, Enclosed Sun Room and Shed. at the, Single Family house 269 15 Route 48 Cutcho ue, New York I 1935 Owner: Diane Bergmann 5QUARE FOOTAGE CALCULATIONS FOR ADDITIONS Addition # I : Enc105ed 5unroom = 143.42 Square Feet /property line Addition #2: Wood Porch = 125.37 5�uare Feet Addition #3: Garden Shed = 197.44 Square Feet NOTE5 REGARDING DIMENSIONS � CON5TRUCTION DETAILS NOTE 1: THE DRAWING DIMENSIONS ARE FKOM A SURVEY BY NATHAN TAFT CORWIN DATED OCTOBER 20Th 2014. NOTE 2. THE ARCHITECT HAS PRODUCED THE DRAWING DIMENSIONS FROM A V15UAL � PHOTOGRAPHIC SURVEY. ARCHITECT HAS NOT CONDUCTED ANY CON5TRUCTION PROBE5 IN THE BUILDING. THE OWNER. HA5 PROVIDED CERTAIN CON5TRUCTION INFORMATION A5 DESCRIBED IN NOTE5 ON DRAWING5 RELATED TO THE ADDITIONS THAT HAVE BEEN MADE TO THE BUILDING ORIGINALLY FILED. ITE FLAN 0■il■.t':✓riaN..1�Y/h'fi/,•r,�sr.,yiii/fid///mrd �rFrrius �;dfYWfiW: �ttiitOftttttlMRkM7frtttttl YY//iYfMtttttl'fhMflfDlitttttl7ry�"A7�MMtttttl7MfSMFfri;t�10 15 20 25 30 40 50 64: r •i I asphalt tiles � Plan at Addition #3: Garden Shed A-003.00 Scale: as shown line of original 2 story hoU5e, I line of original wood porch i line of original 2 story h line of original wood porc ELEVATION Ent Scale: as shown 2x, line of original garage .! GRADE VARIES 2 � Elevation at Addition #3: Garden Shed )3.00 Scale: as shown ion -I'- DE VARIES t roof teles '4" structural plywd. ert. wd. 51d1n� on 11211 plywd. ;t 1n concrete 4 cols. treated wood SECTION CC 3 Section at Addition #3: Garden Shed A-003.00 Scale: as shown ptd. wood gate to pool self closing hinge original ptd.. pool fence asphalt tiles line of original hoUSe line of original pool r at Addition #2: Wooden Porch Extension asphalt roof tiles 3/4" structural plywd. 2x85 at ! 6" ocs. I x8 fascia bd, ptd. contln. eave vent 11211 /2" lywd . ptd. FORCH EXTENSIO 51_311 cn x6 decking ptd. 2x65 at 16" ocs/ I 2x6 ledger SECTION BB SECTION DETAIL at Addition #2: Wooden Porch Extension 5cale: as shown 2" overhang 2# 2x 10 headers 4x4 treated wd. c0lumn5 clad with I'' thick clear pine ptd. 2x6 top �a11 ptd. I " balU5ter5 ptd. 2x4 bottom rail ptd. GRADE VAIZf E5 � metal col. connection embedded 1n cont. 0 concrete filled conc. block Revision: Owner Architect 269 15 Route 48 Cutchogue, New York I 1935 Diane Bergmann Geoffrey Freeman Architects 56 I Broadway Sixth Floor New York, New York 10012 Tel: 212.219.9044 Fax: 212.219.9790 Addition #2 Wood Porch Addition #3 Garden Shed PLANS ,SECTIONS ELEVATIONS �Djli� \ ,fay 446. 0 Date:11/15/14 Project No: 1491 DRAWING BY: KE CHK BY: GF DWG NO: A-003.00