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Home My WebLink About39770-ZNo: 37666 Date: THIS CERTIFIES that the building SHED Location of Property: SCTM #: 473889 865 Nokomis Rd, Southold Sec/Block/Lot: 78.-3-26.1 7/21/2015 7/21/2015 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/6/2015 pursuant to which Building Permit No. 39770 dated 5/15/2015 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 AS APPLIED FOR The certificate is issued to of the aforesaid building. Tlockowski, James & Tlockowski, Claire SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A e igna re Town of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 No: 37666 Date: THIS CERTIFIES that the building SHED Location of Property: SCTM #: 473889 865 Nokomis Rd, Southold Sec/Block/Lot: 78.-3-26.1 7/21/2015 7/21/2015 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/6/2015 pursuant to which Building Permit No. 39770 dated 5/15/2015 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 AS APPLIED FOR The certificate is issued to of the aforesaid building. Tlockowski, James & Tlockowski, Claire SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A e igna re TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,NY V7 � 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 #: 39770 Date: 5/15/2015 Permission is hereby granted to: Tlockowski, James & Tlockowski, Claire 39 7th St Garden Citw Park. NY 11040 To: Construction of an -applied At premises located at: 865 Nokomis Rd, Southold SCTM # 473889 Sec/Block/Lot # 78.-3-26.1 Pursuant to application dated 5/6/2015 To expire on 11/13/2016. Fees: and approved by the Building Inspector. ACCESSORY CO - ACCESSORY BUILDING Total: 1 Building Inspector $180.00 $50.00 $230.00 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 - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ` Date. E/ 101 New Construction: 9ffC-6 Old or Pre-existing Building: (check one) Location of Property: Ro 578 A)De r -C Q;, k.,b U ® L, 6 111 1� 7/ House No. Street Hamlet Owner or Owners of Property: C c e C Z. -A - Suffolk A - Suffolk County Tax Map No 1000, Section Subdivision Permit No. 3 q -�'7® Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ e j () 8 Block 3 Lot 7— a Filed Map. Applicant: Underwriters Approval: Lot: Final Certificate: °' (check one) Applicant Signature fjf so coutom, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO, REMAR FA, MA DATE INSPECTOR OF SOUr,�Olo cOUNi`1, TOWN OF 'SOUTHOLD BUILDING. DEPT. 765-1602 INSPECTIO [ ]FOUNDATION iST [ ] R0)JdHl PLUMBING [ ]FOUNDATION 2ND [ ] SOLATION [ ]FRAMING /STRAPPING [ FINAL [ ] FIREPLACE &CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]SIE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL. (ROUGH) [ ]ELECTRICAL (FINAL) [ ]CODE VIOLATION [ ]CAULKING REMARKS: !sem' ..� � '; o •..�� STATE ENnaoy bm i wlelfeRwoll PTA, ollp, "MMI - r l Wit. 0% mol!i 0 • it t\ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. Examined '20 Approved , 20_ Disapproved a/c Expiration. 20 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 C.O. Application Flood Permit Single & Separate Storm -Water Assessment Form Contact: Mail to: �GL►X1ZS Phone: /(o 6 %S 2 441 - CC) LIF �r, Building Inspector `� lJ 1� APPLICATION FOR BUILDING PERMIT M AY =-6 6 Date , 20 INSTRUCTIONS - t i oG. orPT a 'Ciis'App1,_" " '""' mpletely 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 co #, housing, code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspection . (Signature of applicant or name, if a corporation) 7 7W 14 646 �� et_rY AWk �V I/o4-0 (Mailing address of app icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder %� Name of owner of premises (As on the tax roll 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: F3 /,-//S Ile -.6 __007-#oe�lj House Number Street County Tax Map No. 1000 Hamlet J Section rp,;.i+�=;'B1ockP? �Ld93,, -;D Lot oa-& . 00 f Subdivision Filed Map No. Lot 2. State existing use and occupancy of pre es and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building ✓ Addition Alteration Repair Removal Demolition Other Work 4. Estimated Cost 41440 5. If dwelling, number of dwelling units If garage, number of cars (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor 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 Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Depth Rear Dimensions of entire new construction: Front Zo Rear 2c> Depth Height /O' --o " -�-- Number of Stories 1 M is �. r 9. Size of lot: Front //S o 3 Rear //S D 3 Depth 10. Date of Purchase %bL0 / Z Name of Former Owner 11. Zone or use district in which premises are situated 2-70"04) ✓� 6x7x1v !/ ani m7/ Ae �z, /30. qP, 3 12. Does proposed construction violate any zlaw, ordinance or regulation? YES NO .v 13. Will lot be re -graded? YES NO oni Will excess fill be removed from premises. YES NO_ 14. Names of Owner of premises /70eX'a �ddress Y iio o Phone No. s-76 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 V * 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. 294 73 3�r- 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 50fFol ::T''4-111 &-5 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. Sworn to before me this (o-`'' day of 20_5 IOXP 11 '�4vm� otary Public TRACEY L. D. i nature of Applicant NOTARY PUBLIC, STATE OF NEW YOR NO. 01 DW6306900 QUALIFIED IN SUFFOLK COUNTY, COMMISSION EXPIRES JUNE 30, 2019 _ Scott A. Russell J��-�5UFFQ STOJKI��J WA\``]FIE)E, SUPERVISOR t-- 1\M1A_NA(G!1EM[)EN ` F SOUTHOLD TOWN HALL- P.O. Box 1179 p 'Southold 53095 Main Road - SOUTHOLD, NEW YORK 11971 't' �- Town o f 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 i 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. ❑ C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. . ❑ C D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. 1 ❑ E Site preparation within the one -hundred -year floodplain as depicted A---____-7 -__on- -FIRM Map of�ny-=watercou-rse----....._ - -- ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square - - --- - feet-or:rriore,-unless -prior--approval-of -a Stormwater-Management- r--- f -- 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) NAME. �:JFA S �o(n/f a�J Nmo BiYro�urcl Contact Information Property Address / Location of Construction Work: (o S-8 f ✓o eo Nl rS se 6 SO s/ Tl,�-v& J� /V y 11 9 %/ FORM # SMCP - TOS MAY 2014 S.C.T.M. #: 1000 Date: District 7e Section Block Lot `" FOR BUILDING DEPARTMENT USE OIIL► -°xxf Reviewed By: / Date: ------------- Approved for processing Building Permit_ Stormwater Management Control Plan Not Required. ®Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) SCTM'# o = 7 6 2j°'7�a TOWN F SOUTH®L® PROPERTY RECORD CAR® OWNER STREET VILLAGE DIST SUB LOT aoly �r�� h�il�S��/ !�1 d i I S 1 ia`7k� 1 V ACR.REMAR S, t 2.—s �` Su e1/I��tSA > lOZ�' �Z TYPE OF BLD. PROP. CLAS LAND IMP. TOTAL DATE I ar� On -(-) FRONTAGE ON WATER HOUSE/LOT_ BULKHEAD TOTAL �- PPR l ED AS N0��,� DATE: �, � r- B.P.# 3 0®, _017? FEE: 1° /D�C� ,�� By: Moz - NOTIFY BUILDING DEPARTMENT AT 755-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C 0. ALL CONSTRUCTION SHALL. MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY 10,11- H ALL CODES OF NEW YORIK ST!' -ATL & TOWN CODES AS REQUIRED A.. E i � `. my 1^1M'rn! A 141 Tni *71=0 P4l.Y.S. De **** SECOND COPY ADD VENTED CUPLOA ONLY WITH HOLE IN ROOF WORKING VENTS*** Size And Type 10x20 New England painted wood Customer Name Jim Tlockowski Address: 865B Nakomis Rd Southold NY 11971 Phone#516-695-2444 Quote by . Quote Date- f Payment Type Payment Terms Due Date CL 4/11/15 XXXX XXXX XXXX XXX XXXX Sec XXX .lames Tlockowski 50% down, Balance due on delivery 4-6weeks Qty Description Unit Price tine Total 1 Size and Type 10x20 New England Painted wood $2,780 Siding Color: dark grey Trim Color: white Shutter colors: red Shingle type color: black 2 Windows 2436 side by side between doors $85 $170 1 Shutters red one pair do not attach place in shed do wood trim around windows $30 $30 6" higher walls $1 sq ft $100 54" Double door w transom windows** paint doors red w white trim of doorway included 54" double wooden door w transom window ** Please paint doors red white trim of doorway $170 add window $55 ea $280 **increase door height by 6" $40 each double $80 **** ADD VENTED 18" cupola w hole in roof $125 Sub Total $3,440 250 miles Delivery $1,000 Sales Taxtownship -- PP -mite to itntir Vnrd at ymir Grand Total $4,440 request. We DO n Pa m nt $2 220 Structures a id Kauffman's Transport are not responsible for 5 any ruts or tree branches on your property. A 10% 65 Peach Lane, Ronks, PA 17572 Cancelation fee will be held for any canceled orders after 3 ivmnv.a ishhacl ard_ *�sc t.e co days 717-875-4412 syr. 3 7 7C t Nn" � x 7. r A ti - V, r, WO 'J,{3 1 11 t, 11 Cl 11 "j D 0 41 C; 1, it es N,mo Ot 711,71 -N-- ` ."EG,N'D- SH'. 'J'Q-7c-16 New En' glandC �:'.-,"Q�6�,'NeW:Eng[66d,'St�le giv-5sr. -I- I' with:jrTib n�,,&,6 Kan, g';,'ar c* h yqu.,� q As�icz,pok-wiih',,,,�ii'dbe:tri'm,-,st'e'e'p*e"ri"r'ciof ,V,6ntsl'a rch iie'ctural'shihigleb: aAd:.rra nsom:wj n cows ifi"d6'o*rs'-.:Includ6s'6hL-.doijbl6�'d66rwith w i nd o' ws'.,, Sh6wri-With 6iA!onatstonb,front,"e' ... ktjra'dpor 8',6ve�r'ha"69"'s, cup` 6/q",.'c`oa'c'h'1a-MpA andi5r6hed,t6m 6fi-d P0, -�A F-� Ve-11 L Ne W, j ngl, -S66d Sh'?, w"n inb doors 8i shutters, ',weathiir6d,qray', roof,.fib nal.l.' .single ihe door .arid 2", windows VWO.#!tters SPECIFICATIONS & COLOR OPTIONS are made with maintenance -free vinyl siding or Dura -Temp T1 -11 painted with your choice of colors. Our doors and windows are all trimmed with vinyl perma-trim or Miratec, which comes with a 50 -year warranty and will not rot, crack, peel, or warp. The trim is fastened with stainless Our, I S.i steel fasteners. Over the r ,-tior oil years we have developed , re, a building that is practically maintenance -free in both Dura - Temp and vinyl siding. We use a heavy- duty black powder -coated colonial style hinge, which gives the door a nice unique look, and withstands the elements. Additionally, the keyed lock latch on the door gives you maintenance - free security for your yard and garden tools. N!G,LE COLORS 16° I on center double aluminum sliderwifelows with screens Virryl or Dura Temp TI -11 siding securedWith galvanized nails Pressure Li Treated Sidds 1 1& 10 Were Floam Lj U Li L'i Li L-1 Li U m to 1-6* 1 or W 34, 37 &1 W VAde Roors EM Black Brown Gray Forest Green Tan Weathered White Gray I N G COLORS 4. Black Blue Brown Buckskin Cedartone Clay Cream Sealer q-- lk' Dark Gray Gray Green Pink Red Beige White VINYL SIDING COLORS VINYL TRIM COLORS Black Blue Brown Clay Green Red Beige Colors may vary. ad's i: 6". on center Siding, --.W6dTDu . ta'7.Temp viith,groov 'V� mathin j �',-,M/2774 ly-p '19 - u J - add" mu si I protectorg. "i"d] j u b .. .... Fl I-,-2'k4',- j •grade,01yW66d... E#0fiur,, Siding, Dpra-Temp, or vinyl on, OSB Rafters, 2" xA`-'24` on"center 2"x3'dn6'x10'and smaller Fk6olf S'h'eathing 1/2' OSB plywood Roofing 25 -year 240 lb. self-sealing asphalt shingles Doors Heavy-duty and double framed with 2"x 3" lumber ` i,:V"y1 Sii;ia We use�G66rjPacific,, dg o in r h - le Georgia-Pacific n i' Recommended Site Preparation: 3 to 4 inches of %" clean stone base. Use 4" x 4" treated timbers around perimeter and make 12" wider and longer than shed. While Level stone evenly. % Almond Clay Cream Gray Tan White Blue VINYL TRIM COLORS Black Blue Brown Clay Green Red Beige Colors may vary. ad's i: 6". on center Siding, --.W6dTDu . ta'7.Temp viith,groov 'V� mathin j �',-,M/2774 ly-p '19 - u J - add" mu si I protectorg. "i"d] j u b .. .... Fl I-,-2'k4',- j •grade,01yW66d... E#0fiur,, Siding, Dpra-Temp, or vinyl on, OSB Rafters, 2" xA`-'24` on"center 2"x3'dn6'x10'and smaller Fk6olf S'h'eathing 1/2' OSB plywood Roofing 25 -year 240 lb. self-sealing asphalt shingles Doors Heavy-duty and double framed with 2"x 3" lumber ` i,:V"y1 Sii;ia We use�G66rjPacific,, dg o in r h - le Georgia-Pacific n i' Recommended Site Preparation: 3 to 4 inches of %" clean stone base. Use 4" x 4" treated timbers around perimeter and make 12" wider and longer than shed. While Level stone evenly. 0 K E Y M, A. Sc ;5 00 0 DOE KPOIN WTLIJAM VARDIVNG 27a00 K 4AK ARLA, ix. zn ii s. 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Cco XF D.W. 0 Al y7, colvirr hipmaevr oF I"L M SER �L'- 4 Nat w 0, S8 4. .......... 1--l- . . ........ . ....... alle -W MA *5' PAW 'K % N.- W S4 . . . . . . . . . . . . . . . . g day 4 IWA Sa cr" RVI -Er, V A WAi0eTs, 41 A A u t ym, ir , f 7 Dj 7' rr R40 s4ctto.m.0- lv'T' SOUT -31-D, 45) PLOIT I 2- TO fC GRA rOPOP) AL Al M, 0 TA L A REA - 5731,97 EAST s 'WI s4m t - Al rcr A S 17C; 44 X cow— At Ka L, S, LM K 490,80 p U4 Mill 76,51- 5oZo FX 16, Ma Ac'. Box 909 REE T ,50UT A.r tv,- tL, 1� gn) N