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HomeMy WebLinkAbout38167-ZTown of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37698 Date: THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 9780 Sound Ave, Mattituck SCTM #: 473889 Subdivision: S ec/Block/Lot: 122.-2-24.5 Filed Map No. 8/6/2015 8/6/2015 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/28/2013 pursuant to which Building Permit No. 38167 dated 7/11/2013 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: addition and alteration to an existing non -habitable accessory garage as applied for. The certificate is issued to of the aforesaid building. Koren, Daniella SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut ed ' ignat e SUS QF TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE n 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 #: 38167 Date: 7/11/2013 Permission is hereby granted to: Koren, Daniella 160 Summit Ave Montvale. NJ 07645 To: Additions and alterations to an existing accessory garage as applied for At premises located at: 9780 Sound Ave. Mattituck SCTM # 473889 Sec/Block/Lot # 122.-2-24.5 Pursuant to application dated 6/28/2013 and approved by the Building Inspector. To expire on 1/10/2015. Fees: ALTERATION OF ACCESSORY BUILDINGS $181.60 CO - ACCESSORY BUILDING $50.00 Total: $231.60 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 2110 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 New Construction: Old or Pre-existing Building: Location of Property: Vk00,0 House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section I Subdivision Permit No. Date of Permit. Health Dept. Approvil: _ Planning Board -Approval: Request for: Temporary Certificate - Fee Submitted: $ Date. 61 �� /1 -)�, (check one) 'Block Lot Filed Map. Applicant: Underwriters Approval: Lot: Final Certificate: .(check one) ppl can gnature Hamlet fAf s 0 cou TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION - I FO ATION IST ROUGH PLUMBING A UNDATION 2ND INSULATION A FRAMING / STRAPPING FINAL FIREPLACE& CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION CAULKING 38 q SO(/Ty �o ' holy COY MY,O�e TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECT1014 [ ] FOUNDATION IST [ [ ] FOUNDATION 2ND [ [ ] FRAMING/ STRAPPING [ [ ] FIREPLACE A CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ [ ] ELECTRICAL (ROUGH) [ [ ] CODE VIOLATION [ REMARKS: ] RO N PLUMBING ] SOLATION FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRICAL (FINAL) ] CAULKING DATE l `� INSPECTOR FIE190 DMMLN IMPORT DATE CONIlVIENTS FOUNDATION (IST) � .q.s.i�.M..1.wemssnsws...sKN FOUNDATION (?SND) V .J C7 ROUGH FRAA9INQ & C)\4 PLUMBING C1 IN6ULATION PEk N. Y. y STATE ENERGY CODE FINAL ADDITIONAL COMMENTS Q Q D , �5 Am TOWN OF SOUTHOLD BUILE4NG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.No rthFork. net BUILDING PERMIT APPLICATION CHECKLIST PERMIT NOc99/D 777� Examined , 20_13 Approved , 20 i Disapproved a/c Expiration b , 20_t:5 -- 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: Phone: APPLICATION FOR BUILDING PERMIT Date 2,0 , 20 13 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 beencompleted 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, anew 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, housi�n g�code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. e _ _ /) l L. (Signature iif dpppcant or name, if'a corporation) (o��5.. MV/ Its (Mailing address of applicant) 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 Landon which proposed work will be done: House Number Street County Tax Map No. 1000 Section I '_L "71 Block Hamlet Lot Q-45 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 ed. Ne`5 (,P 1'-A A t 18 FOI DM)CEJ b. Intended use and occupancy S 2 ( P ---A M t U Y l 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work 0 Estimated Cost W,00-0 Fee �— (To be paid on filing this application) Number of dwelling units on each floor (Description) 5. If dwelling, number of dwelling units 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 V is Rear 24 '-6 Depth I'� do Height 1 1-6, Number of Stories Dimensions of same structure with alterations or additions Front' Depth 0�°` > ' Height /Z°-� Number of Stories Rear 2 0 8. Dimensions of entire new construction: Front d Rear G- Depth Height 'iia, 6Number of Stories an 9. Size of lot: Front 01 Rear n ®0 l Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated �_' AD 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re -graded? YES NO WiII excess fill be removed from premises? YES NO i 14. Names of Owner of ress 146 AU S•t Phone No. - -U I Name of Architect ^ '� �� Addressft? &I (a'?7G die 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. t 6. 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 ) Mau l b /ili6' V IQiV (Name of individual signing contract) above named (S).He is the ' being duly sworn, deposes and says that (s)he is the applicant CO NIE D. BUNCH Notary Public, ,tate of New York Ido. 01 BU616b050 (Contractor, Agent, Corporate Officer, etc.) Eviros �Pril 14, 2_� � 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 trace 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 day of tom. 20 Notary Public ()W4L__ IiJrlature of Applicant A UI Town of Southold - Chapter 236 - Stermwater PAanagement SWPPP - Storm Water Pollution Prevention Plan Assessment Form .GENERAL INFORMATION: (All Requested Information is Required for a Complete Application; APPLICANT NAME: Owrrer, Agon Consultant -Contractor or other iCircloone) Property OMER-(Fr Different than Aoollennn l fl r. ins . / i tr /f amft E -Mai E�Maik e o!�g � SST/ sop Brief Description of Conedmction Proposed Structural Bb17s, Soil SlabaGmtic.BAM,Fm*-LScope and/orSegueoeeofConstruction.Activity Dietl rat tProv doAmlat Papel re Neetlpo) farm of Coohaetor and/or Contact Person neseo..e�u, r n Ib)e or Installation 8 -• C Total Area of All Project Parcels: Project Duration: q (AnWpated) /2, Total Area of Landclearin9 1214 andlor Ground Dislurbance; (SF IA—) Start End Will this Project Disturbe five (3) or More Acres et Qfi Any One -Time During.the ProposedDevelopment ? Yes o If YES: Please Answer the Followinrrl a. Does the Applicant have a Qualified Inspector On Staff To Conduct the Required Inspections ? Yes No b. Does the SWPPP Indicate How Frequently the Site No Inspections will occur and for What period of Time ? Yes C. Does the SWPPP Adequately Identify Ail Temporary Y rman andlor Permanent Soil Stabaltzmbon Measures ? CL Does the SWPPP Adequately Identify a Complete. Project Phasing Pian ? Yes No e. Does the SWPPP Indicate Additional Site Specific Q = Practices that Will be utilized to Protect Water Quality? Yes No f. Has the Applicant Submitted a Completed DEC Notice Of Intent and SWPPP Acceptance Form for Review by the Town of Southold ? 'Yes No List the NAMES or description of all PotenUalry 1"aeted Waterbodien and/or Wetlands: ----------Na U Status of HMaeted Wate,beder te— -runt MWIT OF NF.W YORK, COUNTY OF _��/�-/1t-!�- ------ SS 11at I, ....... _..... 9�1 __ •-._---------._-- being drily sworn de -ses and says iNama dividuol Sjrgr ng Dow ent) Po y that he/she is the applicant for Permit And that he/she is the .............»..».Q " tt iZrtracio� Ate, iir............»....»...»..............»..........._».».........._ 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 applicatioxK that all stateinents contained in this application are tete to the best of his knowledge and belief,• and that the work will be performed in the mannei set forth in the application filed herewith. Sworn to before me this; _._._. 1-4 --------- daY Of.... ._20-1 Notary Public: ------ C �. " ------ i - ................ . * ---- 4-6 --------- --- SWPPP Assessment FORM: 03-12 CONNIE D. BUNCH Notary Public, State of New York No. 01 BU6185050 Qualified in Suffolk County Commission Expires April 14, 2_Ul T.O.S. ' ° sWPPP" PrelParation - Chapter 236 Storni Waiter Pollution Previintion Plan Review Checklist Che-eklis't # 1 and/or For Department Use Only: S,C T,Rt. #s Proportyr Address: 1000 YES ; NO ; N.A. 'Explanation for NO or N. a:nLomrs uesrgmeo to contain a Two Inch Ra n all On-Sil_e. 32._ Oonstrvctlan Phasing�Tan indicating �acruence of Pr used Cortstruclion Acti'vltles. . Genera!LosatlonMgp,- _ - -- .-_ 4 Draiange 81te F'ten Drawn to Scats at Six(80 Zfeet to the Inch or la- ar Indicatin the Fo�owin : ; Q Q . .y r= es• �' » - - -- _ �» »-• _ _.. _..9 ..... [� OZAILGACLMMIQL ,,, ,_,c;„141f E�IsU� N,e�tral sndl r Man Made F : - • •• •- -• -- R, eatures on and witftin 50 of the Property Boundary; i [Q (Qi ,•, d: Test Hole_D'ata.lndtcating So11_C•'haraTcterlstlos & de th fo8ee'sonal HI ti WaterTabl'e; e; Contours in ioatln » Pro • ElevaU211 '• ~ f, -Spot Qfatle� � -- ��' she' Min: _ _Finish Floor Elevations for Exis'tiiig and�Propoaed 8t�u'cturFis 9_-Cooalfo»r1 o �I4�oode'd 1 aas & iso7at`ed'I tees with a MTnlmum' f3Fme'rislWoff'8"Dlamefe'r, 7-71: C� h.:9oi1�'onservatfonbrifi sair urvey�--- _ -__» __._..__•.._._......_.__.--.._... 5. Bacitgrouad Info'rmaUon--about the Scopg of the Project, Location & Desc�iptton of the Site, .1 Q' _ Propose? Ctiartgesto_the Slted Aj anl_q; tsting q'evelopment on fMe site Includiho the Followili All loisCaYeros3Ci1& Jrisiiludla9 Tbtal9r�.d.pi Lgnd.Al�tur4a�race.&-TAW. M.Ar��;_ .. _....._ b, All EXCavetion, Filling, Stripping &"Grading Proposed and'Idenfified as to depth, Volume & Nt3ture of M,Pte�lAi$,IJtvglgd; ._.. _ ... _ .. _ _ -. _N -•--___--.___----_-.___..._...__.. '�;©i d. All Are"Where To_...___.._.._-____..__..__.--•--.�Qi��il Topsoil Is to be Removed , Stockpiied-__a_nd where Topsoil will ultimately .._.. •beplacedi____ _ e. All Tampora&_Penna The AAnticip tP necq 1 &Permanent Storm \N L0 RunoffBMPl Me 'Controasures ated pa`tt'ern of Surface Dra'inag'e Dur ing,Peiiods of Peak Runoff.P h. Tine Lagfton oi'�sifl#oa<is,T}'rl'veways, 517ewa7ks, PaOo9tr'uctures, Utrlities & O'ttier � i ©; � ” 1mp�oveinen�a;(no(uargiempo'raryAccess&Co'nstrticUon8fag&igAreas;' 'i -T.5 IMSMrigWmfia"1"t`_gnfcursaneorspotETava$on's`ofttieelle- __.. - - _-_..» ;fes QUI 6. ASc » ____._ hedule of the Sequence forthe.lnstallalion of Ail P'lenried 3011 Ero'sfon, mentation 6 stixowaRuoff ter nControl Measures, eCQ CQ 7, Oe trmo' o_f Pcllu on _P'revention Meas'res that&! l b -e Im lementa ,' _ ._ ._ _... _ _. _. ,• ._._ ,_ ._• . 8. ~A Desctipt on of the M(nlmum i=rosfnn & Sediment Control PrdcUces to be Installed and/or _ im��ertg�tted fur Ch natruction /nativity the C� i CQ t C twill resultln Soll Disturbance. 9. DgscripQon o r�structlon &_W_aste M tgftI Expected tc be Stored OWN18 y � 10. »Temporary &permanent Soll Stabtlliatlon Plan thatmeet's-the Current'Verslon of the + """ i Q i Q C _New York State Sloan Water Design Manual Technical Standard, Q' _GerlelalSliePlanandQonstrucfionbr_'aw'in-»''---- -»- -»� '�'L _ men to _ga fo-r the Erg ect, _ r 12. DI 7. j. aferial 3ge01frcations & Inslalla_Bon Details for Al roslon © � 1;3; Tesevy_Praetiees thatwill 'be Converts to Permanent control Me_a»suresent Contr-ol Practices. , Q I=" 14," Im�lementaijQq 8�ed'ule for Ste in Tempora-- 9_g-__E_►!ErosltintmrolFracttceorB'Mp.._»_...... QQ� 15, _ Mairiten-annoe Scite�ule to Ensure Continuous & Effective OperaUon'of Erosion SsdlrnmControl Practices. 18 Hairlas of Potstills! 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