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HomeMy WebLinkAbout40264-Z o�g�FFoi,�ee Town of Southold 12/1/2015 ', P.O.Box 1179 {. r' 53095 Main Rd ..'-970/*sr . Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37939 Date: 12/1/2015 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 645 Breakwater Rd, Mattituck SCTM#: 473889 Sec/Block/Lot: 106.-8-52.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/9/2015 pursuant to which Building Permit No. 40264 dated 11/13/2015 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: "as built"deck over concrete patio addition to an existing one family dwellingas applied for. The certificate is issued to Schubert, Charles&Patricia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ,,}teed ed Si ` ture • r„•.. .-sutFocTOWN OF SOUTHOLD ,V. �c�G z 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#: 40264 Date: 11/13/2015 Permission is hereby granted to: Schubert, Charles 239 Breakwater Rd Mattituck, NY 11952 To: legalize an "as blt" patio (deck over concrete) as applied for. • At premises located at: 645 Breakwater Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 106.-8-52.2 Pursuant to application dated 11/9/2015 and approved by the Building Inspector. To expire on 5/14/2017. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $521.60 CO ADDITION TO DWELLING $50.00 otal: . Cs\ $571.60 r 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 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 �f,� Date. 7(491)-- 6 Z o 16 New Construction: Old or Pre-existing Building: i/ (check one) Location of Property jp 455 8 mask ?-8 pa-1T, ;i _k House No. /Street Hamlet Owner or Owners of Property/, -� s f t ;i7�.iCi ii /. `l c=�'►U&.'!71-- Suffolk County Tax Map No 1000, Section _Block Lot Subdivision Filed Map. Lot: Permit No. 110 a(0 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: +� Request for: Temporary Certificate Final Certificate: (check one) Ua Fee Submitted: $ 50 Applicant Signature Liej 2 .(e ` SOUjy; Ag 1 �rcouM'1, I'' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIQN [ ] 1ST [ LUMBING [ ] FOUNDATION 2ND [ ION [ ] FRAMING / STRAPPING [ _ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: _ r --z c DATE INSPECTOR 1.11/1./ FILD NST)1411 REPORT DATA Cd 1S --*•--.-1-- , �� FQUN�,�SON( T) - FOUNDATION(2N33) t __ � -ROUGH FRNQ& • . PLUMBING ..........,-:• -.- - -- , •••. .,1=21.-- -, , ' , , \ H ]N$ULATION PEA N.Y. ' STATE ENERGY CODE . , .. 1' • • F]NAL MI ' xl•rat.••*•t. ...11r.aea,144tvxt.r.roe,..rr.Y....""..nat"'I . \ I A D j�'!"rj DNAL L Go, mm e^t TS — , C .—____ .. .. rn �.. . . � .... __ ._ CVl,) i e• r ` ' . . • ' '.*''.4'. V . \_ 1' . i TOWN OF SOUTHOLD ' BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following;before applying? TOWN HALL ' ` . "' ' "" ' Board'cif ! SOUTHOLD, NY 11971 - - ,4•sets,of Building Plans- TEL: (631) 765-1802Planning Board approval 1 FAX: (631) 765-9502 - ./ n'eY SoutholdTown.NorthFork.net PERMIT NO. �� Check ,1 '' : Septic-Form - N.Y.S.D.E.C. - - . , Trustees 1 C.O.Application Flood Permit Examined ' " ,20 `' ' Single&,Separate ` W+i; , iI ' Storm-Water.Assessmen Form ('3 �. APProved ( 20 Contact: - 3 1 � • ` Mail to: Ery� ! /OriV / • � C W47-6(Z6141771&Disapproved a/c - / f, Phone: -2Q0 0/orl' Expiration ,.......Si ,7/ /'" ti5t -S* /A _ „ , Buildi•!-Inspector- - - 't', - . V&T , 1 70, d��`2 F-N, ! \- \yi ,c,r] ••1-7;:),1 t C 1 " - - ; }APPLICATION-FO•° •UIL-DING"PERMIT' \ 201S al Nov 6 b.-_....,,,1.Li:1 ''-' Date 2i°l , 20 Gr �" `I • .t INSTRUCTIONS----7 - a. This appl�eat{on MUST be cdmpletely filled in by ty,pewrifefror in ink arid_submitted to the Building Inspector with 4 set of_plans,-accux +let-parr=to-s-c-a e. Fee according to schedule. b.Plot plan showing location of lot and of buildings-on premisesi relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application.may°not,be commenced,hefore issuance of,Building Permit. i 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,,ayailablefo-inspection throughout the`work,, . . �'. .a , e.No building shall be occupied used in whole or in pai•t'fii any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. I - f. Every building permit shall expire if the work authorize4'41not Cofnmenced within 12 months after the date of issuance or has not been completed within 18'months from such:datet'If no zoning amendments or other regulations affecting the property have been enacted in the"iriterim,•the Building Inspectorl'inay 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,th'03,u0ding0epartment;for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town,ofSpiithold;'•Suff)k C;onnty;•New,Yfork;;and:other';applicable Laws,,Ordinances"or Regulations, for the construction of buildings, additions, or"alterations or,for removal,ordemolition'as herein described. The applicant agrees to comply with all applicable laws, ordinances,building;code;iho"using code;and'regulations, and to admit authorized inspectors on premises and in building for necessary inspections. 1 ' . .," . (Signature,of applicant or name,if a corporation) 1,4.' 6 reA.Ig-wc--42-) Li ,, )4-Tr; nxii_____ ,, t ` ' • '(lvlailirig'.address'of applicant)' . , 1 1 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Q /� Name of owner of premises O! f5,,,,,r, fl`��, if-b?iL,%A - � v � a '(As"on'the tax ro11,or-latest deed)+ . .. ,. • •• I • If applicant is a corporation, signature of duly authorized officer 1 1 i (Name and title of corporate officer) Builders License No. Plumbers License No. 3`` Electricians License No. f" ' " - Other Trade's License No. { 1. Locationtiof]Qand on which,proposed work will be done: I Ip 4 k6 re,A.k 4- / eA lea . _A-1/9-1"- -0 T?/Gi__ i Hotl'se`NUm'beti4 : Street' Hamlet 1 S CountyT.aX:W1 i°No`3,0:0.0 Section % l Block �j Lot 5 a- 1 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,occuparicy, eE5/f� , . . , b. Intended'use and occupancy - --= _/5(TA/ 3. Nature of work (check which,applicable): New Building - Addition Alteration Repair Removal, : Demolition Other Work ' e D eseps )Nt, OP, 4. Estimated Cost Fee �j 9P l cri (To be paid on filing this application) , 5. If dwelling, number of dwelling units / Number of dwelling units on each-floor If garage, numbef.of cars 6. If business, commercial or mixed,occupancy, specify nature and extent of each type of use. i 7. Dimensions of existing structures, if any: Front I tp> / Rear 16 r Depth`N 1, Height .6•`f --"Number of Stories / `` Dimensions of same structure with alterations or additions: Front /Lo, / 1.G(_31 -2/-Rear /(v,/ Depth 9,g ' Height ;ai!i,,';.' ,.I o.li ,r,,Nutriber of Stories / ' 8. Dimensions of entire new construotion .rFDont.:A,,., % 1.>l: :, ;,, .,KReaz.=., w.3;,,,', Depth Height . - ` (Vumbe'r of'Stories ,t, . vriN 9. Size of lot: Front - 'Rear .,1 l'= k„rt; . Depth 10. Date of Purchase /1 08., ,,•, Name of O Forinez, wner ' ,, . ' • . 11. Zone or use district in which premises,are:situated'`: '.' -4q`r:' .,• , ' ,''• , . , , 12. Does proposed construction',v olate ariyoning law;;ordi i4r pe or,regiilation?iYES•_ • NO/ 13• Will lot be re-graded? YES NOy"Will excess flhl,be moved from premises? YES 'NO 044 14. Names of Owner of remis s ' &4U1;5'0,47—. ,4 /k ,I 1A G .,, •,.: . dies ,,, A,s .w _ o e No. tc `e' Name of Architect t/ �J e Ira -Address ,r�e� �, Silo ,Phone.No '7-34 Z T Q4 Name of Contractor . • ., • • • illi Addres' 'e0 ,. • P,lione No.' 1 . Is this property:within 100,feet'of.a:tidal wetland.or;ahfreshwater..:wetland?�`*tY:ES, . •'fNO✓- * IF YES, SOUTHOLD TOWNTRUSTEES &iD:F C ;PERiVIIT `I Vii: �ErREQUIRED.- • b. Is this property within•300;feefof a;tidal°wetland?,*1YES,'',, NOr`d; , ','`'f * IF YES; D:E.C. PERMITS:MAY baREQUIRED.Fak ''(: -..;,•./'. ; „ ,°J:, ' - • 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point bii propeft is'at 10 feet or below, must provide topographical data on survey. 18. Are there any c,ovenants:and•,restr;ictions with respect to this property? * YES NO it ''• - / * IF YES, PROVIDE A COPY.'' ' STATE'OF NEW YORK) ' SS: COUNTY OF ) - - - . . . C H A)2L S 5 1-44-)l e ,,,..being,duly,svp7i., deposes•and says that(s ie is theapP licart (Name of individual signing contract)abovenamed; `• • '• ' ' (S)He is the OW Q � .•, Y: (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. Swc: to before me this G� day of ea./Ober- 201 dor ' /�,' -v i., Eileen Haynie Not,. &'t1 / � tQ�` ' •¢ � �" 'Notary Public,State of New York Notary Public U P 1 _ JI New , Signature of A�li4�NA4916018 Cr�dz�ri'►;,�,,,u LigJires — Or , res Commission Expires ��// /S s�•„tz 4.♦ ' .�'dsu � z Scott A. Russell STORMWA.T]ER . � ° �� SUPERVISOR z MANAGEMENT SOUTHOLD TOWN HALL-P.O.Box 1179 It5 rn 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of iJ o 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: Yes No (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. ❑©-C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑E D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ . Site preparation within the one-hundred-year floodplain as depicted -on-FIRM-Map-of-any watercourse: - DEK. 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,Agent,Contractor,Other) S.C.T.M. #: 1 000 Date- NAME Dl.,tnct 5-p g NAME el' ( � —.. 1 ()l[/ Fr r2' I I -I3-IS ejz Grp / CSAJ/'� 'I ' Section Block Lot L,snalUrd F•F[•t For, BUILDING DEPARTMENT LSE ONLY ' Contact Information C43/79-0 — �GJ 22- .TelePlionc�Vinlxl Reviewed By: 8v\pe / Property Address / Location of Construction Work: Date U t1 i ��-• Approved for processing Building Permit `�� �� � ��� Stormwater Management Control Plan Not Required CrOCie ) . ® Stormwater Management Control Plan iJ Required (Forward to Engineering Department for Review) FORM a SMCP-TOS MAY 2014 ' --- q I 1.-. 6 r---'_--2--/-, TOW;:s-, "OF S*UTHOLD PROPERTY -_-RECORD CARD r /6 -2- ,5-2_, D .. _., , , I ' ,..• .,..„,-„0- OWNER STREET 4 L...L - VILLAGE DIST. SUB. LOT I j F(ORMER OWNER N .,D- ‘ E ACR. -. . .c. . ' ' 4 u -171.6-R5 RD -- ," . ' „-i-,7-,S'W /. ''''a c'-e-71— • S W TYPE OF BUILDING ,,-.\\ I ____FlJ.L . _ RES. , SEAS. VL. FARM COMM. CB. MICS. Mkt. Value ...-- (7‘ / P / LAND IMP. TOTAL DATE REMARKS . c2-1-/ 0 -0 1 0--6 (s .<M--D V•7/1 '7 I/7/ _57,„o `4f (2) Lg 1--,,t„.., 1,‘,. ,. , -A, :). . 3, /1-c_ s • (1-/7 i rei /7/2 0 -y/77.--- r- , , 1 y ,---- b / 4 / 0--o -/ 1,1/2-677 dr- / /.P/75- (FAmiLy) /9, 5://v/fi- -4-- 14)/s- 1,-; 7: s'y.z_vi A p`” 37z9t , /47 Qe-___ L41:1Y3/7,- /o/26/72 FAmiLy T, _Syzy,/e4. rob "1", 6u /Livia,v i g30-2 (/ a 774-a. /cl o 0 AV. 3 ( 6 6 7a o //7-3/? ` 17„p--t5;e0 74 S9A e h'ijo-, 0 a O ///t $ %I,,Pah 1 a,,/- A 4t3 , 1'-/7/7 Con/P. 2 c 3 a V 0)D . . I •t °0 \ I\ Tillable , FRONTAGE ON WATER Woodland .r. FRONTAGE ON ROAD .:, . Meadow land 1 DEPTH House Plot 7 / J‘66) BULKHEAD :Total [ 1 i ,_ • . k . • L a .. e.•, , .-,,,,4 COLOR TRIM ' a }1j.��r 1 •� %i' a�,^""'ti.P e�F.:% "r • 5e tt� I .y `OM1 1 :i ~ '~ 0 x ' •#^`_ ...—'4,i,-;-,_—_-..,-,--,----7 •.^.``+�`SYS '•.. t.3fY 'r S++ty.+t.- yr ^4elt , t `-. •.. - g .3-. . ,,• ' : I ' m' atm = ... 4 +. .� ' • / / f //i ;,<; -:'a.:.,. • ( .J% , JY ,'^ .ws-r:r� +-r ,,.....::.- ` } ' P ��" ,t:, r,: . ,` ; : ::a`,.,�^r:k« .:. J: ' . >� .._ �w .�±ss:.Y�«.. `Y-i•:.,W::.- t .:-.:•::42-,..77,,,„,“•' m': ;� .7.z:. . • - `2 { 'v • x� JgJ Ji , _ a s-y, I •a f t M. Bldg. 0?ff � = O o S" 5 U ) y Extension - i',IIx/y - .5-4 Extension 7 x r G t Pi `• IS. - - 1 Extension - ' ` f Foundation e /3 . Bath Dinette Porch Basement — p Floors r , �- K. ) Porch , ii _ ... . Ext. Walls Interior Finish LR. Breezeway , Fire Place Heat �; it DR. ) I / --u ` '"Garage ��,; �,� �ao/ Type Roof Rooms lst Floor • BR. 1-+ : �o Feral 6,, ..,,,m. 7-P-04. i 7 ) / G� Recreation Room Rooms 2nd Floor , FIN. B O. B. . --� I ,ryr_ - _7_4_4, Dormer Driveway Total I .1., iii-L S 'i 170*M/>adt� 4 k �r r YiY` ,-ar'i ra, ...,.......„,,,..., , ... .. .., , -,,E- 61 ip .,4„,‘,„,,,-eat ,.qpm u _',":" .'"-0; r,'i'.,',',..,....,..,2:1.Z..,,„ ipw:,..t i _ f... t. ,. ft 46 riu L LI-0 ..(c,'-i , IF t , e ; , t 4 4 yy V 016 bulbi . a)k1 �h SES • . , , T!TL,f fVQ ,7808,-013 . , „ „ ,' \,\ •.' ; - ; ,. ; -, aledz,leki . , ' /. t aut ' + • a Vie r " ,, 6 :�5, i; c:)'' �� h j'4', am+ ' v , `� 1 '''',`',','",,:f:%.',1' , i �^ ti ..• 2`y , „ ' fit t ,,hit,” ,P- , 1. 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F'.�s�'•�1' 4?'M'a c,,'-'717) e,�c.•p:,.,,y. inoNL y ' r ,!0-,.,,.y — — _ — — — -- I T i_•. +�1�( {�,Jj b X1,.,7 :„:,,,,:I't-,.I:NT -i,i -- -1802 8 AM _O • PM ;R r4 . rn �ha'�i �..� i I ti E lJir } a „p GG{lt'6.1. ioe t } f � r'1i�� r ( ��(Ic ea C... Yi U1J Lll I }}'�'� Q [r' V .1..I JL ' Lai ��.h.." ! \ 3. it'd;'Ji;-,ifs 7 al �'. FIU!. L COPi T1 U TK%Pi ""..':<, 1ST F, CQi,:r�!_ TF FCS r.G. in a!_E. CO JSTRU:^,T!Q 1 SHALL ,- T THL7 to 17. d � 1 ; REQUIREMENTS hr_NTS 0 1 r?E Gt}Cr.CF "'ST- DATE/l U4,0-464t � e» nYGi <<AASTltTE/+/P,pp;�T r� FS!'�nPplS! �E FL' L;i 7fY V� Ci:IY.�`�,T t l+.%�i 1Cf\' EeFlRO i 1 , in it r NEWYur,r� S tr f', & TOWN CODES 40 toN i AS REQUIRED AND CONDITIONS OF fi'�t.- D4.....1 t� ..____________________ . SC�U-.=u'DSD NZ A •� 0 IU I!, i t+ ��,._ SOUTE;'I a7 \4'N PLANir:NG BOARD N •I'' TO 0 VI . Nr • o, OCCUPANCY OR L N k�, USE IS UNLAWFUL M WITHOUT CERTIFICATE OF OCCUPANCY N _O W • < y. . 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