HomeMy WebLinkAbout40557-Z TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631)765-1802 /� Planning Board approval
Southo drow76579502
No t hFork.net PERMIT NO. Llb- � �"';" Survey
( ) �� ��"` Check
Septic Form_.......
N.Y.S.D.E.C.
Trustees
-....-
C.0,Application
Flood Permit
Examined— ,,, 20114Single&Separate
Storm-Water Assessment Form
Contact:
Approved_.... � 20 � `� Mail to:_............
Disapproved afc.. ..............m.. ......,......
Phone:
Expiration 20
..._.
Buil I� ector
WAR 17 20% APPLICATION FOR BUILDING PERMIT
Date �... ' _. 20 i
IMMING DEM INSTRUCTIONS
T0"QK*9VWWST 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 pen-nit
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. g
(Signature of applicant or name,if a corporation)
Vy..........m.
(Mailing address of applicant) l l q"7 J
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:
House Number i�-7j�S Streetft it 40 10 0cf b t( Hamlet 1(>1Tq 0,I-L
County Tax Map No. 1000 Section � Block Lot `��
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 , -JokAO� AA'4Vq WA69 AA 1hVCU94
b. Intended use and occupancy �TDti P,Ge, .Aawg &A kk6a" MV�qq�5�
.................. A-4
3. Nature of work(check which applicable):New Building Addition ,..-: Alteration
Repair—,-,,,,,.Removal.-..—,- Demolition OtherWork�/ adE FiZ4
;�5" 9�� �-1 41 (Description) Vj, say
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units_- Number of dwelling units 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 66 Rear 66 —Depth Iq
Height '30" Number of Stories Q
Dimensions of same structure with alterations or additions: Front Rear
2-11 ,n
Depth Height 3a - Number of Ston "s"I � Zs �: �i
V
8. Dimensions of entire new construction: Front M Rear
epth
Height Number of Stories
&% T r RAV
9. Size of lot:Front I IC Rear Deptli --�* -
31(10
10.Date of Purchasel-L'LIttf- Ia. Name of Former Owner
11.Zone or use district in which premises are situated 0-40
12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO
13,Will lot be re-graded?YES NO, /WIII exc ,s fill be rernoved from premises?YES NO
jr jw,�AJ 0 aq-71
14.Names of Owner of premises RMCAV0Pd kt"hone No. OW-76s--010
Name of Architect Vla Address Phone No
Name of Contractor 111,4, 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 B>REQUIRED.
b.Is this property within 300 feet of a tidal wetland?* 'YT--,S—NO
IF YES,D.E.C.PERMITS MAY BE REQUIRED.-
16.
EQUIRED.-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 dataon 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_)
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 nic this
4-f-. day of K\0A C+) 201(,, CONNIE D.BUNCH
--Nwary Public, to of Now York
No.01 BU
Ulm QuafflW in,9.'fflo"tZkoMont�
Notary,Public Ctiffifflimlon Expims Ap"',4-1- —----------------
-QD;w Signature of Applicant
2 }
Ar
Scott A. Russell 7C'OWWWA7C°]E]
SUPERVISOR 'J
I� CA'N AGI IE T
SOU OLD T® -TALL-P.�3.Box 1779
53095 MainRoad®SOUTHOLD,NEW YORK 11971 5�, rTown of Southold
" =
CHAPTER 236, - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES S °rI- IS !PIW1.I.x,(71' INVOLVE ANY O 'ITIS F01,L OWIN :
Yes No (CHECK ALL THAT APPLY)
. Clearing, grubbing, grading or stripping land whichaffects more
than 5,000 square feet of ground surface.
2' Excavation or filling involving ore than 200 cubic yards of material
within any parcel or any contiguous area.
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 F.IRM--- -a- -of any wat-ercourse.
° . 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,on, Date & CountY as a Number! Chapter 236 s not to 0
Protect.
ITITmm. ... ITmm
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.
tractor,Other}
.C.T.M. #: 1000 Date:
APPLICANT: (PropertyOwner,Design Professional,Agent.Con
iDistrict
NAMIE & a.. I � a ESection Block Lot
r
Contaca h ffoirrnanorr
ices r
p atlon of Construction Work: _.
Reviewed By:
Date:
ro erty A rens oc ._.. ....
ri • ff Approved for processing Building Permit.
.. — — .
•.��. Stormwater Management Control Plan Not Required
Li
,_ ........
`"....._ lormwater Mzm ageunent Cbwrol HanHanis R.e(p.iiired.
Qt or
ward to t.gime en irng Department for R.ewiiew)
FORM "° SMCP ... -1...OS MAY 2014
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ISSUES/REVISIOtir "1 Yh � (�
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2'x 4'CALCAR TIES
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HANGERS
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EACH FLOOR JOISTS
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2'X 6 RIDGE 2'X 12'RIDGE I 2'z b RIDGE /S O
2351 ASPHALT SHINGLES 16-O.0 RR
2-x6'-I6'OG CJ
2'X6'-Ib'O.G RR 1 2'xb'-Ib'OL RR
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FELL-LAP 6'
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PLTki00D ROOF DECK
2'x6'-16'OG LJ r' _ u
• 0)2'X 10•HO R 12 � •
R-22 INSULATION , 12D I n
b'FACIA
b'VINYL SOFFIT
WGONT VENT 2'XB 16'06
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2351 ASPHALT SHINGLE5
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MASTER BEDROOM I/2'PLY
WOOD ROOF DECK ATTIC I BEYONDR RE
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2'%6'-I6'OG RR '
3/4'SLBFLOOR B VINYIL SOFFIT I 3/4 5U8FLOOR 'I I^
' 2'%4'-16'OG LJ .11 CONT VENT i Q Toll loll l��`` ^^i^ W
(2)2'X 6'TOP PLATE n III!k 11 t 11 R I`
R-Iq INSULATION L1 I"-
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2•x 6'-16.OIC STIRS BEAM IL.
I/2'05D SHEATHING ` !3)2'x 10"GIRDER I O
15t FELT-LAP 6• 2'X 10'-Ib'OG VINYL SOFFIT VINYL SIDING I I I
VINYL SIDING S b'SO POSTS 5 FELT
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2'x 6'BOTFLATS - 2'X 4'-Ib'OG STUD 1 I I W
2'X 10•RIM J015T 'q POWDEB 3112-STEEL COL 1 I I
FOYER 1 I I I W THESE PLANS ARE AN INSTRUMENT OF L
2'X 6'GLA SILL 9/4•SIIBFL SEE FON PLAN 2'x 6•LGA SILL I I I I THE ARCHITECTSERVI 1! E THE ROPERTT MUCO L
I!1'DIA A BOLT 7 FOR STRUCTURE 4'GONG SLAB W I I I I
11 D W AIJM 1/T DIA/ BOLT
® 4'OG W ALUM 6 X 6 IOAO 1S I I I 1 1 BE PR05ECVTED
TERMITE FLASHING TERMITE FLASHING 1 I I I •
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R-221 NSULATION 1 II 4 4 N C
6'PL WALL ;� 3'X10'-16,or f
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31/2'STEEL COL I PL FOOTING z 1
BAr+FHFNT TECO JOIST Q FTC, KEYWAY �l
9'GONG SLAB W HANGERS
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SARRIERLY VAPOR 5 E G
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I'-4'X B'P G • C
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DONT KEYWAY PL FOOTING 'It 'y? •F/1 t(� CLIENT/OWNER
5 E G T I O N t�QD S Q [� AD r� a' o�
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and � in DIAMOND BUILDERS
4'INCREASER Vl V�-""'TTT��� 443 MAIN 5T
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I 11-1/2• 1_-----__-- rtRAV101.lTkXt OFTHE 1 O PROJECT TITLE
1 1 I 1 1 I - �NaAN1'PTA>o`t i�o- R n f '
I I 1 1 1 I vee ALlwllwrozaTxE j Vt
12• 11-I2• l 1 I 11-U2• DnIkL11aNGJa LictRl] yj I
I 1 12' I AkaulCCTL,ITJI SYNAN RESIDENCE
1 Z BRIGANTINE DRIVE
ay..
2� 2� 3• 2' 2" 3' �2, 2NO FI ' N
W DRAWINS TITLE
3• _ FRAMING NOTES
2 3' I All Iranhg ILZ- Moll be aCe stamped DCUI FIR- RESIDENTIAL GENERAL NOTES
3' 2• Lerch SLrlKtural Bade no 2 or Leel., 12 An roof rafters Ston be attached to the plate mtl stud with SECTIONS
-"-I -1 2 All sheothblg to Le APA raletl e.posure I,5/6'mon thlcknese galvanized hw'rK1r0 type comectas by'TECO'a approved z
I I i I 3 All subFloor to be APA voted 5TLRO-I-FLOOR 1, I All work shall be as the requlremenLS of NYS 9 PrOvWe smoke detectors 09 per code
2' I 11-1l1 I 1-1/2. I h9 exposure equal For tomb.,pole Foufdatlans proud.hm,lcarn clips at au Build Code HMn W1111n h ocher btrlLLlolg 10 All headers t0 be(2)2'z H•unless noted otherHlx O
11-1/2' 1 1 I I-1/2' 3/4'mh thlckn0,>All edge,of plywood to t Set on Sola pertrleter JolstS to gi,der conrlecLlans 9 Jam'
1 blocking Gore and null all Sheets vabtlons a odlustmeMs may be required,VO,IFy My Such 11, Double Fbor J Isis vrxler parallel part.t m
I 13 All pre-engheered Iumixr 9hail kx;Geo,to PaclFlc GPI 4erles requirements wit the IaL11 code 12 Indoor deSkTl temp shall be max l2•For heathd and mh TB'
TK I 4 All headers bb'ad Ower shall be supported Hlth doWle g For coolh tl on Coble the NCH York Stale Ener DATE SCALE
,priors,q-0-and over with triple I.prlylt,All header,Shell be Woodbl-B.—_d LVL products a agv11 All J11>ts,grders and 2 These plms to be used h Junction with[He 0,LN,e,Spea, 9 41
Q 1�, t tl. hea.-fers 51111 have Lb0' ,tlFfener,I Slalled as FCwdmer5 N+en provided GOdO dated Mach 1 1991 1/4' 1'-0'
1 a mM of 2-2'x B'a as shown an d-oHhg per nems
TdatloM Web SLI/eners 91111 Lc re ked at all load oaf 3 Assumed Sall Bear G It 2 ton> It 13 All expos d water Iphg and/or he.hg
Mets to be k-1.ted
5 50114 blocking shall be provlebd Fa all JolSt6 rnd Near beans boor. bits at o m I A s 13/4'LVL rM 1 L fail be 4 CarKreta to 1-'v 1 umreehfoyced,25�m-2B test p ISSUE_30 1993
1 1ST FL NY 5 code or m marcs•b'-0'tic mh i+oxlde 2' p° kg O Ja s s s p a day kc'1813 0l NeN Yak Slots Erorgy Lode dated March r�� PYtf
as per requbed at Noor perlmeler5 Haldling,stooge ord ercLtlon of 5 All tootklgs to rest Ln vir In undbWrbetl still Iggl 0 t1-
—Ia-all CYLVlltlpn h"'P
3• 2' 2' 2' 2' TO APPROVFD p components shoo tx as per monuloeturen recammerdotbns b All lumber to be Fern Flr 2 II50 P 51 unless noted on 14 All court—tlan Is to be h--do-.with prevollklg codes W
SUFFOLK LNtt 'G 6 Doublo 1-9
affil d all openings(SKYLIGHTS,STAIRS ETGJ PplonS ad strndo-ds JE DRAWING NO
HEALTH DEPT- or as roted �' LOCATION Lba DEAD DEFLECT LIMIT IS All wkoo.s to b0 thermal.»Mated glass h
l T Double up Froming order all posts oaf porallel potltlo,s Or a> I6 T}I.ARGHITECi OOsvmO>ro re rolll for the LoeWLtlen Q
3' SEPAL SYSTEM I noted on�a,1h9' 1>C FI 40 LB 10 LB L/360 sP ' bJ
l 8 All/W>h H2od corviectbrn shall be/mtened Mth rated 2rd FI(Step Mea) 30 LB 10 LB Ll360 methad9 teclNques,sequence,or procedures a fa
r•'Q 3' alvenlzed nVtol cornecton 'TECO'a owed e l Attic Mal Storage) 10 LB 5 LB 1-/360 Solely pr.ea,elons arta programs ec=tkm Hlth the Work
9 �) 0..a Roof 30 LB SndH 15 LB L/360 There ore no lorruntle.,nor ay chontlblllty of foto.,,
q Nailing schedLle shall be as per the MY Build-9 Gude as a Far 1,peclFlc ux ex(mesxtl o bnpllpd h the use Of the,. r,�
minbnxn All 2•x 6-studs sholl recel,&5-IOD palls at 5111 oaf L.Ilbig LYOM mty hove t1 be bN;reaxd for Star a attics and t1-
PLUMBING RISER DIA6RAM .It!M vur.a>ed For r,naw land, °g p L Q
4•L I.HOII,ETRAP poll.All exterior molls Shall be th 5 0xed higher A Lmlractor LO velli 111 dhienbre beFae stat
NOT TO Al F 5.0 10 P y+aod et+el I,. to be rolled•+Ith B D Y 4'tic exterior 8 Electrical Hork to conform.1 the-dh Iq I,c d lc Gode.New Last—tI- Do rot scab cl—I s FolbH dlr�nenslons only
`B1LIL HIN edges ord 6 D•12'os hts—ellat0 Yak Skate Energy Lade,doted NIa-ch 1991,and ary cpplic ble y L REF NO
11 All Interior oto Oxterbr fkIIShe.,Flashhg Ind Hoterproolbg sholl local codes
be by A"wt.ct
ci 10 II 12 15 14 15 16 1-7
1551.E5/REVISIONS
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L E F T S I D E E L E V A T I O N F R O N T E L E V A T I O N DIAMOND E443 MAIN 5RS
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PROJECT TITLE
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Q5YNAN RESIDENCE
BRIGANTINE DRIVE
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WORAKN6 TITLE
z ELEVATIONS
DATE - SCALE
4.9-gT I/9'a I'-O'
WAPR 30 1999 }
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