HomeMy WebLinkAbout39935-ZTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
1?samined, 120
Approved 20
Disapproved We
Expiration yi �,'m L 1i
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
PERMIT NO. � � C(S 5�
�l
'i
Contac
Check
Septic Form_
N Y.S D E.C.
Trustees
C.O. Application
Flood Permit
Single & Separate
Storm -Water Assessment Form
t:
Mail w
Phone:
TION FOR BUILDING PERMIT 0.
�'('
Date Jyne .22 20
INSTRUCTIONS
AW, ap@,at' USTSe°am Eetei,I filled in by typewriter or in ink and submitted to the Building Inspector with 4
of plans, accurate plot plan to ca F y, according to schedule
b. Plot plan showing locati n of l S. and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c The work covered by this appation may not be commenced before issuance of Building Permit.
tltlIrrrvalo n, 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 - r
authorized inspectors on premises and in building for necessary inspections. �tg Y ¢}Lt $S 51 Q It I.Ty & MOII V iy
gfl 1.V f 10 n9J y I Ioc-
(Sa,grraa a applicA.., if a corporation)
S i, 34 5�Q / lJ
(MMling address of applicant) I I
State whether applicant is owner, lessee, agent, architect, engineer„ general contractor, clectriman, plumber or builder
di,ev)* 19-T CowTR+4c-To
Name of owner of premises 1 "I' R I Cly votsAl
( r latest deed)
As on the tax roll o
�" 1 authorized officer
i �ture of d
and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No,.
Other Trade's License No. P 11G N
1. Location of land on which rirotsosed work will be done:
House -Number Street
Hamlet
ty p 5' lock Lot t ®,
Coun Tax Ma No. 1000 Section
wroromm 1
Filed Map No Lot
2. State existing use and occupancy of preinis vs and intended use and occu anew of roposed construction:
( ....
a Existing use and occupancy c 1,� - S� � 6,1k 4 f(5
L- �L . . . .........
b. Intended use and occupanqi, (-
3 Nature of work (check which applicable) New Build ing,_Addi Addition -a- 0 — Alteration
Repaii Remw�al jK Dernofition Other NAlork MA a �m Q V., A'i La P 1"
4. Estimated Cos' Fee (Description)
. ......................
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling its 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 Dear 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? S® NO -Z
13. Will lot be re -graded? YES— NO v -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 MAYUIRED.
BE
b. Is this property within 300 feet of a tidal wetland? * YES— NO �W
• IF YES, D.E.C. PERA41TS 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
18. Are there any covenants and restrictions with respect to this property? * YES_ NO 7ey'
"ry
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS
COUNTY OF
Z
0 oa��0'1' being duly sworn, deposes and says that (s)he is the applicant
0 g) 5: (Name of individual signing contract) above named,
0
(S)He is the tjik )Cov4irn r � or
Z , L� --
9 W a (Contractor, Tgent, Corporate Officer, etc.)
r- M
<
M
a of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
Z > that all statements contained in this application are true to the best of his knowledge and belief, and that the work will be
0, > 6)
® > perform * flic, manner set forth in the application filed therewith.
0
0
l6- 0 Z Swo t' or me it",
a
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M olary Public VXZ�X-4dure of Wpheant
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Scott A. Russell II e
I 111�1" 10I
SUPERVISOR 51—` ��I"
SO OLD TOWN HALL - P. O. Box 1179 IF, 7 ) �iqr%"
53095 Main Road -SOUTHOLD, NEW YORK 11971
Town of Southold
(TO BE COMPLETED BY THE APPLICANT)
DOES TFHS TIROJECT INVOLVE ANY OF THE FOLLOWING;
ICHECK ALL T HA r APPLY)
A. Clearing,grubbig) bngrading or stripping of land which affects more
0
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.
b1c. Site preparation on slopes is exceed 10 feet vertical rise to
d100 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 fl lain 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 for water 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 (PropertyOwner, Dmgn. Pro I fessional, AFent, Contractor, Other) S.C.T.M. 10FriCt
00
Sect ion Block Lot
"I'"FOH BUH Dlh',(� DERAP
Reviewed By.
Property Addres's / Location of COIIStfi.101011 W00,'
�s Our . .. ...
.-AXJ lin
101 (j 4–Ay—uill
—.—
FORM * SMCP - TOS MAY 2014
Approved for processing Bnilding, Permit.
Slormwater Management Control Plan Not. Reqnired.
Storm water Management Control Plan is Required.
(Forward to Engineering Department for Review.)
11�1111�1111e%i,atirbg Lifesty'le�s
We hereby propose to remove and dispose of the existing, disabled lift and replace it with a
vertical platform lift model Mutilift Enclosure by Savaria. This will travel approximately 61
inches with two stops.
50 Hempstead Gardens Drive, West Hempstead, NY 11552
T: 516.486.LIFT f E: sates@dayelevator.com
SMVE: S CERTIFICATION
SURVEY FOR
ST. PATRICK CHURCH
At Sou O- Tarn It 5olthold
sowk !A"q New Y—
R �FHICAL SURVEY tns
Young a Y-9
ILL
1Z,
M
SMVE: S CERTIFICATION
SURVEY FOR
ST. PATRICK CHURCH
At Sou O- Tarn It 5olthold
sowk !A"q New Y—
R �FHICAL SURVEY tns
3,.
PIT DEPTH
EL. 0.00
ELEVATION B -B
rAhfl OR
Cil_ T �
A 1-
T_ I� }
CEf
OF OCUPANCY
Load bearing walls are optional with tria. Bracket
1321- 152 3/16'7 TRIANGULAR BRACKET
FINISHED RUN WAY LENGT
f (PIT LENGTH A
14,C9f16'1
r
RUNNING
L
CLEARANCE
TOWE
I
�lI688-
C27 1/16'1
13.59 L37 3/4',
L
1418nn IJS 13/ 16'1
i
ENCLCISJRL WIDTH
j
IL
A-, CONST
I
ENTRANCE
CLEAR 114
t
[IDTH
CAB
L—c-�B":AR
ENTRo
h �
'(IINSIDE
Q�
I,
1
CAH LENGTH
TOP OF MAST
ti
M
LANDING 2 a
C
130D- 151 3/16'1
UNIT
g.
J
w
. ?
�y
:r a
p.J
h
LANDING i
1
�
3,.
PIT DEPTH
EL. 0.00
ELEVATION B -B
rAhfl OR
Cil_ T �
A 1-
T_ I� }
CEf
OF OCUPANCY
Load bearing walls are optional with tria. Bracket
1321- 152 3/16'7 TRIANGULAR BRACKET
FINISHED RUN WAY LENGT
f (PIT LENGTH A
14,C9f16'1
r
RUNNING
L
CLEARANCE
TOWE
I
�lI688-
C27 1/16'1
13.59 L37 3/4',
p
1418nn IJS 13/ 16'1
ENCLCISJRL WIDTH
j
IL
1067n � 142'
I
ENTRANCE
CLEAR 114
[IDTH
CAB
L—c-�B":AR
ENTRo
'(IINSIDE
I,
1
CAH LENGTH
76mn C3'7 � � 13- C112'
RUNNING -
CLEARANCE
C
130D- 151 3/16'1
UNIT
mman venal MI..
L4-[9/16'1
RUNNING
CLEARANCE
GENERALARRANGEMENT : . tnls T FR T lv K 7�"u F;� c� i--�
� E�— 1 � = M A I N Fz 17-7I L1
ENCLOSED VERTICAL WHEELCHAIR PLATFORM LIFT S O LJ T H E1 I_ Z7 , N Y 1 1 � _71 1
Cll 3/4.1
MR
1607- [�3 5/16']
FINISHED RUNWAY WIDTH
(PIT WIDTH)
W gal
of N1 ;
' `a 1
ESsi11�4
MULTILIFT EN
9Nw30005964
e savarim
GENERAL
HDISTWAY - THE HOISTWAY MUST BE DESIGNED AND
BUILT IN ACCORDANCE WITH 'SAFETY STANDARD FOR
PLATFORM LIFTS AND STAIRWAY CHAIRLIFTS' OR 'SAFETY
CODE FOR ELEVATORS AND ESCALATORS' AND ALL STATE
AND LOCAL CODES,
PLUMB RUNWAY- DUE TO CLOSE RUNNING CLEARANCES OWNER/
AGENT MUST ENSURE THAT HOISTWAY AND PIT (WHERE PROVIDED)
ARE LEVEL, PLUMB (-/+ 1/8" (3 mm)) AND SQUARE AND ARE IN
ACCORDANCE WITH THE DIMENSIONS ON THESE DRAWINGS.
MINIMUM OVERHEAD Cl ARAN E- OWNER/AGENT MUST
ENSURE MINIMUM OVERHEAD CLEARANCE IS IN COMPLIANCE WITH
CODES,
CONSTRUCTION SITE- OWNER/AGENT TO PROVIDE ALL
MASONRY, CARPENTRY AND DRYWALL WORK AS REQUIRED AND
SHALL PATCH AND MAKE GOOD (INCLUDING FINISH PAINTING) ALL
AREAS WHERE WALLSIFLOORS MAY REQUIRE TO BE CUT, DRILLED
OR ALTERED IN ANY WAY TO PERMIT THE PROPER INSTALLATION
OF THE LIFT,
DIMENSIONS- CONTRACTOR/CUSTOMER TO VERIFY ALL
DIMENSIONS AND REPORT ANY DISCREPANCIES TO OUR OFFICE
IMMEDIATELY.
STRUCTURAL
FLOOR/SUPPORT WALL I ORDS -STRUCTURE TO ANCHOR
A CRANK SHAFT AND SAFETY HARNESS, WHERE APPLICABLE/
NEEDED, TO BE PROVIDED BY CONTRACTOR.
CONTRACTOR TO ASSURE THAT BUILDING AND SHAFT
WILL SAFELY SUPPORT ALL LOADS IMPOSED BY THE LIFT
EQUIPMENT. REFER TO THE LOAD DIAGRAM ON THIS DRAWING,
MAST TO BE SECURELY FASTENED- WHERE REQUIRED THE
MAST MUST BE SECURELY FASTENED TO THE STRUCTURAL SUPPORT FLOOR.
REFER TO FLOOR SUPPORT LOAD DIAGRAM AND ANCHOR DIMENSIONS (IN THIS
DRAWING. FOR ENCLOSURE .ABS WITH TRAVEL OVER 48' OR CANADIAN
PUBLIC JOBS, SUPPORT NEEDS TO BE PROVIDED AT THE TOP OF THE MAST.
WHERE DOURS ARE REQUIRED- SUITABLE LINTELS MUST
BE PROVIDED BY OWNER/AGENT, DOOR FRAMES ARE NOT DESIGNED
TO SUPPORT OVERHEAD WALL LOADS.
=�1
ELECTRICAL
GENERAL- ELECTRICAL EQUIPMENT AND WIRING TO COMPLY WITH
SECTION 38 OF CSA C221 (CANADA) OR SECTION 620 OF NEC
ANSI/NEPA 70 (USA).
POWER SUPPLY-12OVAC, 20A, 60HZ, IPH CIRCUIT THROUGH A
FUSE DISCONNECT WITH AUXILIARY CONTACT ON MAIN POWER
SUPPLY. PROVIDE TWO 18 AWG CONDUCTORS BETWEEN CONTACT
AND CONTROLLER.
LIGHTING -LIGHTING OF 100 LX MIN. AT PLATFORM AND LANDINGS.
LIGHTING WITH SWITCH AND ELECTRICAL GFCI OUTLET IN
HOISTWAY PIT.
PHONE- NEED A DEDICATED PHONE LAND LINE (NOT VoIP) FOR THE
PHONE, WHERE APPLICABLE. FOR VoIP PLEASE CONTACT SAVARIA.
GENERAL
CLASSIFICATION.
APPLIED CODE:
MODEb
CAPACITY.
SPEEID
TRAVEL:
PIT DEPTH.
PLATFORM SIZE:
POWER SUPPLY:
BATTERY BACK UP,
SUSPENSIONt
POWER UNIT
MOTORt
SPECIFICATIONS
Ddm vertu G akfAG P6tfom LFt
ASME AIRDSection 2 (Pubtic)
MultlLift Enclosure
750 lbs (340 kg)
8'/Min (0.04 m/s)
69.25" (1759 mm)
3" (76 mm)
42" X 48" (1067 nM X 1219 m)
IIOV,15A,6OHz,SINGLE PHASE
No
ACME SCREW 25mm
CONTROLLER
MODELi
MULTILIFT
TYPE,
CPFS
ETL #,
94307
CONTROL VOLTSt
24VAC/12VDC
CONTROL AMPSt
1 A
AMPS]
15
MFR.,
SAVARIA
0.75 HP, 110/115 VAC
ENTRANCES DOORS t GAT / CA I STAT ONC
UPPER LANDING GAT - WHERE REQUIRED, SMOOTH SOLID
BARRIERS ARE TO BE SUPPLIED AND INSTALLED ON BOTH SIDES
OF ENTRANCE AT UPPER LEVEL AND MUST BE A MINIMUM OF DOOR TYPE
42' (1067 mm) HIGH. ENTRANCE ASSEMBLY MUST BE IN PLACE PRIOR CNTRANCE SIDE
TO THIS PROVISION. DOOR SWING
FASCIA PANEL BELUW UPPER LEVELDOOR ENTRANCE- LOCK TYPE INSERT
WHERE REQUIRED, FASCIA PANEL MUST BE FASTENED TO A SOLID AUTO DOOR OPENER
WALL AND BE PERPENDICULAR TO THE FLOOR AND WALLS. IN FRAME CALL STN.
HOISTWAY FASCIA IS NOT SELF-SUPPORTING FOR LONG, CONTINUOUS. CALL STN. TYPE
CALL STN. KEYED
RUNS VOID OF ENTRANCES. ADEQUATE SUPPORT FIN2 THE FASCIA
CALL STN. STS BUTTON
MUST BE PROVIDED. CALL STN, MOUNTING
ENTRANCE ASSEMBLIES- ENTRANCE ASSEMBLIES MUST BE ISOLATED PRODOOR KIT
ADJUSTED TO ALIGN WITH PLATFORM AND INTERLOCK EQUIPMENT.
OTHERS TO ALLOW AN ADEQUATE ROUGH OPENING.
RETURN N WALLS- RETURN WALLS AT ENTRANCES MUST BE
BUILT-IN BY OTHERS AFTER ENTRANCE ASSEMBLIES ARE IN PLACE,
ENTRANCE LOCATIONS
ENTRANCE ASSEMBLY MUST BE SECURELY FASTENED TO
WALLS.
371 (959]
(210]
—t
30 (7 78] 81
0
II II
ON
II II
AANCHOR `
POINTS 35 5 (902] tA% [0+14]
(WALL / FLOOR SUPPORT LOAD DIAGRAM
WALL LOADING
472Lbs(21M R2
(ANY BRACKET
LOCATION) R3
FLOOR TO
HADSUPPORT
LOAD
R3 ❑F:320OLbs(14,2MN
x(INCLUDES IMPACT)
OPTIONS PROVIDED
TOUCH UP PAINT,
BUILDINGi
UNDERPAN SENSORI
m a
SIDE A SIDE C
SIDE B
1 can(s) RAMP,
Pubtic Bullding EXTRA KEYS,
no SAFETY PINS/BLOCKSt
MANUAL LOWERING DEVICE,
Yes PIT SWITCH,
No Ramp Requlred
no
yes
yes
1" (281 DOOR WON'T
OPEN 90 DEG IF
NOTES:
HYDRAULIC -
FLUSH RETURN WALL
AI) DRYWALL OR PARGING (BY OTHERS)AS REQ'D.
DOOR CLOSER
42' 110671
S'
DO SEE DATASHEET OF THE INSTALLATION DRAWING FOR
LANDING ENTRANCE SCHEDULE AND RUNNING CLEARANCE.
INSIDE HOISTWAY
C,) ALL INFORMATION IS SUBJECT TO CHANGE.
VISION PANEL
HALL CALL
FLUSH HANDLE FOR
MANUAL DOOR WITH
wR500/GAL LOCK
GENERAL INFORMATION:
(OPTIONAL)
C:>
u')
CU
N
u
N SELECT ONE F
THREE OPTIONS
OD PROLOCK
VR500
GAL LOCK
\
\
-
10 Z
r, H
= (U Z
nJ pL7 (uw
M WO(11 W u 11 O_
o< u =
IL = CQ =
`-' � L7
p Q p
00 o O 00 [If
Q
- EACH LANDING ENTRANCE SHALL BE SUPPLIED AS A
FINISHED ASSEMBLY WITH DOOR AND FRAME BLANKED,
REINFORCED,DRILLED AND TAPPED FOR ALL COMPONENTS
DETAILED, READY FOR INSTALLATION.
- FRAMES SHALL BE 16 GA„FULLY WELDED CONSTRUCTION
WITH ALL WELDED JOINTS GROUND TO A SMOOTH,
UNIFORM
UNIFORM FINISH,
- DOORS SHALL BE 18 GA„ 2' THICK, SWINGING, FLUSH,
STEEL REINFORCED CONSTRUCTION COMPLETE WITH
GLASS LITE(S) AS INDICATED,
DOORS/FRAMES TO BE FABRICATED FROM ZINC WIPE
COATED GALVANIZED STEEL WITH ZINC RICH PRIMER,
FACTORY APPLIED TOUCH-UP AT THOSE AREA WHERE
COATING HAS BEEN REMOVED DUE TO WELDING/GRINDING,
j
- UL/ULC LABELLED ENTRANCES PROVIDED AS INDICATED
1 I/2 HOURS RATED.
_ I
"ill
TANCHOR
MANUAL DOOR, HYDRAULIC DOOR CLOSER PROVIDED.
f-+�—
50' 112701 —�
55 1/2' 114101
ROUGH OPENING
50' 112701
TO WALL
4' 11023
FRONT VIEW
(WALL NOT SHOWED)
42' 110673
s ata- [let) DRY WALL
`Ai➢,,,fLM VIED DOORc;5
O O O 1.TJ0 Oil]
o
0.375^[I07- gifilCb
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I�"� �� jFR C savaria.
Lff7 PLATiOGR SI�ACE•}�=-
STRB(1 JW{BDO HINGE JAMB
Second Level DoorR.,
JAY E-L-VAT®FZ
EIREPR� DOORS T
LEFT HAND SWING 1
ENCLOSED VERTICAL WHEELCHAIR PLATFORM LIFT S C3 lJ T I ---I CD
®� L NG Na
L_ n, IVY 1 1 7 1 %� M- 9 5 9 7 0 3 DO R
PANEL DRAWING
IN
INSERT INSERT
STYLE, Door and Gate STYLE.
Enclosure
SHEET METAL SHEET METAL
Clear Plexiglass r G t o, s s