HomeMy WebLinkAbout40219-Z ..4'�511'FFOLte6,, Town of Southold 3/10/2016
P.O.Box 1179
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p 53095 Main Rd
in
y�dl #.-0 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38139 Date: 3/10/2016
THIS CERTIFIES that the building SHED
Location of Property: 700 Youngs Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 141.-1-19
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/19/2015 pursuant to which Building Permit No.. 40219 dated 10/27/2015
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 Baruth,Kathleen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED t
, ifrAillik7M7
Authi ed Sig ature
TOWN OF SOUTHOLD
°S) BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o� �� SOUTHOLD, NY
L �lpj *
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#: 40219 Date: 10/27/2015
Permission is hereby granted to:
Baruth, Kathleen
PO BOX 7
Amargasa Valley, NV 89020
To: construct an accessory shed as applied for.
At premises located at:
700 Youngs Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 141.-1-19
Pursuant to application dated 10/19/2015 and approved by the Building Inspector.
To expire on 4/27/2017.
Fees:
ACCESSORY $156.00
CO -ACCESSORY BUILDING $50.00
Total: $206.00
Al
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 c�
Date. ' 0 ' ! —/S-
New Construction: Old or Pre-existing Building: (check one)
Location of Property: r)00 k/001()1-3 ( 117 kf G`L
House No. / (/Street Hamlet
Owner or Owners of Property: Chetfr f eS S2q_Oq
Suffolk County Tax Map No 1000, Section I (f Block Lot ( 1
Subdivision r Filed Map. Lot:
Permit No. LI Od•( ij Date of Permit. Applicant:
Health Dept.Approval: ( Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ S -659
Applicant Signature
i
tel(t ,,:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG LUMBING
[ ] FOUNDATION 2ND [ ] 1 LATION
' [ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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FIELD D SPEOI7QI`7 REPORT DATE CO EFCS
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TOWN OF SOUTHOLD ' BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following before applying?
TOWN HALL ' ' ` '"` ''' "'` ;l '" ' ' •''- •Board'a Health I
•SOUTHOLD, NY 11971 - 4•sets.of Building Plans'
TEL: (631) 765-1802Planning Board approval
•FAX: (631)765-9502 - - - - - - • - - u •ey'-Sr ' ' ' ` I
SoutholdTown.NorthFork.net PERMIT NO. i001/ ' Check "
" t1 """ ' SeptieForm' !. - ,
;f •: ,: , , , _ N.Y.S.D.E.C.' .
Trustees
C.O.Application
- Flood Permit
Examined ' // '',20' ,Single&;Separate
( U I
, r .X Storm-WaterAssessmenForm
7 i--k- Contact:
Approved ,20 - •''• ' • , i. ' ,'r' ' - t With:
Disapproved a/c - �I
. Phone: CI 1'P-).--- D D-I ® 51
Expiration 07 ,20_I Fr-- � : 1
1
---- ---7-77.-'7\ ^' ' 'i'' Building Inspec or-_ t
APPLICATSCiN•FORBUIL-DINGPERMIT• .*e,-.
�[OCT 1 9 2015 ;,Date 0 AQ, . , 20 1 i-
- `' INSTRUCTIONS=- • - -
^;IDG DEN r 'a, r:,,s'
a. This application';MUST be completely-filled in by tJ,peZvr"•iter or to inl'arid.submitted to the Building Inspector with 4
sets of plans;acurs of plan to scale. Fee according to schedule.
b. Plot plan showing_location of lot and of buildings-onpremises;TelatiorisFii to adjoining premises,or public streets or
areas, and waterways. •
c. The work covered by this application.may„not.beoommer}cedllefore: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,availables.for inspection throughout•the work. , , - - ti,�,, '.-- — ., a - ',
e,No building shallbe occupted'&used fn whole or in part I'or any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy. - . ,
- f. Every building permit,shall expire if the world authorized,f ias_not c-gri menced within 12 months after the date of
issuance or has not been completed:within 18'months from suet dale,'If no-zoning amendments or other regulations affecting the
property have been enacted iht theInterim,the Building Inspect6r;n aq�authorize;-in-writing�the extension of the Ipermrt for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBYMADE:to,thq,,Buildmg,Depalitmeritfpr the issuance'of a Building Permit pursuant to the
Building Zone Ordinance of the Town,of•S,qutl old,)$4foll courityi`Nevior'k2, and,other';applicable Laws,,Ordinances or
Regulations, for the construction of buildings,addition s,_or alter`atiops ortfor removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances,buil�'ding'codehousing code;and regulations;'and to admit
authorized inspectors on premises and in building for necessary inspections.
. " .
}
.-(Signature,o"f applicant or name,if a corporation)
., 7e90 ,)49l1AJG 5 4-7r/171 ,/UK
- '(Mailing'.address of applicant)-
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Ca///,./ .7e
Name of owner-of premises. G' ,.,94 4 s,:, ,:Y. •!� ,:7�4/ -R
'(A•s'on the tax roll,orlatest=deed)-i ,,,--i ,, "- f •
If applicant is a corporation, signature of duly authorized officer 1
(Name and title of corporate officer) j' ' `' ;;, . '
Builders License No.
Plumbers-License No. ' ' ''` ' .' ``''' "' ' ' '•`''' ' ' ', -" - ''; '' ` - '
Electricians Li'cense•No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
7C 2 yoax.)6'sS moi/ . 14,4rrt rvce- ti
House Number StreetHamlet
County Tax Map No. 1000 Section CO Block 7 Lot 7 2
I
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 "
b. - Intended use'arid occupancy
3. Nature of work (check which;applicable):New Building ►/ -- Addition Alteration
Repair Removal, • Demolition Other Work S>y .2j
(Description)
4. Estimated Cost $3,'92O,c,e, Fee
(To be paid on filing this application) ,
5. If dwelling, number of'dwell_ing units Number of dwelling units on each-floor
If garage,'number'of cars ' 'J
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 'N'umber of Stories --
Dimensions of same structure with alterations or additions: Front 'Rear
Depth Height • -�C-,�.:c, ? ,'ii:;...!'i Number of Stories _
8. Dimensions of entire new constructioFDont-,:/,,, , a,i;f-'.a '.rRe'ar-.t,K, ,•.,„`. Depth
Height Numbe'r of Sto"ries ' ' ' ' '
9. Size of lot: Front Rear -.,3i ,,;,,;t : . • , Depth
10. Date of Purchase ' Name,of Fortn'er.Owner ' ....
11. Zone or use district in which premises•are situated ':.'`... . ..
12, Does proposed construction'tviolate..any,zoning law, ordiriance'or'regulation?,YES°- , _• • NO
13. Will lot be re-graded? YES__NO .V Will excess fill'be'remoye'd,fr nipremise's� YES 'NO
14. Names of Owner of premises , " .,,, . ••.!. ,Address • J . .. Phone'No.
Name of Architect: .... :_,....,:,..',1•':',-.;,;:5'.;-- Phone• ,:lb; Address u 4,i•:• "-: $.'1„ ,
r, •P,h,one No.
15 ar Is this property:within 100;feet of;a,,tida•l wetland;or:abfreshwater'AVetland?M`AYES• .i.-;' 'NO•
* IF YES, SOUTHOLD TOWN,FRUSTEES'&i1 E/A;:PERMITs'NIA,Y;BEnREQUIRED.- -
r
b. Is this property;within•�300;feet"of a',tidal•wetldrid?,' ,YES�'tt� ' , NO',;:,: :;;-- • • •
* IF YES; D:E.C: PERMITS•MAY'BEREQUIRED: :'''' ' •, ' - '
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on•p`roperty i's-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 V
* IF YES, PROVIDE A COPY. '
JACQUELINE JEROME .
STATE OF NEW YORK)" ' ' ' Notary' PublicState df New York!J'°'
No 01JE6254861
SS: Qualified in Suffolk County
COUNTY OF $ My Commiss,on Expires Jan,30,2016
C/4/t/e6 f it/ J—Z.72(7 ., .being,duly,swprn, deposes and says that(s)lie is the-applicant
(Name of individual signing contract) above,named; "• • ' '• '
a
(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 ofhis knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn tote ore me this � �
/ j .[ -ay of -O,kQ- 20 L5 . .N -' /i - -Z."
,
votary Public Signature of A plicant
Scott A. Russell f6l
�as>sr�c���,• ST(ORMWATER
SUPERVIS®R z ' 12MA\NAG)EM[]ENT
SOUTHOLDTOWNHALL-P.O.Box 1179 4. Q S il Town of Southold
Main Road-SOUTHOLD,NEW YORK 11971 L'. l j- 4"
!Qt * ' "
•
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
rIO ES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑p'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
Il
within any parcel or any contiguous area.
❑L�' C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
OLAN Site preparation within 100 feet of wetlands, beach, bluff or coastal ,
erosion hazard area.
❑ .
E. Site preparation within the one-hundred-year floodplain as depicted
0ion-FIRM-Map-of-any watercourse. - -
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:
Dutncl
NAME: C 7691e-,(-L�J 4,". I 2-�J%� ILO 1 1 f -----/
Section Block Lot
`
.s-<..< FOR BUILDING DEPARTMENT LSE ONLY
Contact Information ��� - "V
Reviewed By. r
Date 10Ifilfr
Property Address /Location of Construction Work.
70 a��G f- 19v D/Approved for processing Building Permit.
Stormwater Management Control Plan Not Required
"grri /L-'%,-' / /fS ❑ Stormwater Management Control Plan a Required
(Forward to Engineering Department for Review)
FORM e SMCP- TOS MAY 2014
SURVEY OF PROPERTY
,
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I L CODESSITUATE : MATTITUCKNEVEYORK Si/ & TOWCODES
ASREQUIRED �;i�7_. L^ e I itis OF W :�.- E
TOWN : SOUTHOLD ,.�ul�� ,.
SUFFOLK COUNTY NY
SURVEYED 7-24-20 15 �-� SCu-
t;F; ' Hi �QARD S
..._..-. ..___- �.n t i`ryV.3 .'J t• t t i
4',i 1 dL
SUFFOLK COUNTY TAX # O
1000 - 141 - I - 19 SS "//f—
CERTIFIED TO: a�° ; - ds
CHARLES W. SZARKA Q �� ro
LISA B. SZARKA ,� d9'
CHICAGO TITLE INSURANCE COMPANY 1 (\\. ;+<'' may < ' QCCJPANCY OR
WELLS FARGO BANK n,,%:, - ',7
0 RSE k) UNLAWFUL LAFO
�� ,;,,Po�� r WITHOUT CERTIFICATE
: : : :} OF OCCUPANCY
Sia v F ." /Sr ' -i-/ e>� 2
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eft, �0 0 d/ gs ��'' ! 0
• �� DATE: .L R P. �I_l�
f• �u 0 2�? FEE/4.3 EiY _
NOTF/f Y BUILDifNG DLFAP ME FT
,T.��N f n l
p�''` 765-1802 8 AM TO 4 Pill FOR THE
' \ o -1 J0 FOLLOWING INSPECTIONS;
� � ��,�'�� 1. FOUNDATION - TWO REQUIRED
•>\+N. 0 ,\N FOR POURED CONCRETECf:
k �; 2. ROUGE I TRAP IN 3 & PLUMBING
//ki,,,t_ 'CP�n' �O��Q 3. INSULATION
p 4. FINAL - CONSTRUCTION MUS T
NOTES �o ,, s -
•
MONUMENT
FOUND �'(, `CLQ �*- ALL COOCSTRUCTIO<N SHt LL MEET THE
y --x— CHAIN LINK FENCE 7` (�
a a WIRE FENCE 20i�F'i S� REQUIREMELNTS E OF TH S r
�eO �'l/l 6V ECODESOFFOW
,/ `` � I Q\ PORK STATE. NOT RESPONSIr�LE FOR
x//,p!y 1� ry� DESIGN! OR CONSTRUCTION ERRORS.
Area = 17,456 S . Ft. �C�gp�0J('�O /OO 4 x �. (/�J
Area = 0.4007 Acres O tWo
PHI SCALE I"= 30' 't''PCi'�'T- 'o F' D0/°i� o)
I= MII t{�� t, "Unauthorized alteration or addition to a survey
JOHN C. E H LE RS LAND SURVEYOR ►► 4 __ map bearing a licensed land surveyor's 2,of(s
`,i�,g � C ee'�� 0�. -violation of section 7209, sub—division 2, of the
NNN
[� `e N ski, ��^.'.v'� New York State Education Low"
1 Pp.,,�e,,^ 0 `4.f`` 'A "Only copies from the original of this survey
�'d marked with an original of the land surveyor's
I r. stamped seal shall be considered to be valid true
Z* e ms .t, ` copies•
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 ` "Certifications indicated hereon signify that this
RIVERHEAD N.Y. 1 I 369 8288 Fax 369-8287 x tit E survey was prepared in accordance with the ted
�,�i � ,(�'+r. f istrng Code of Practice for Land Surveys adopted
`402 rt. by the New York Slate Association of Professional
Ion151andlandsurve or.com F2 '� S� Land Surveyors Said cerhficotions shtll run only
9 Y ' SFQ 50202 �Q,(y+ and on hhs behalf loo theh Utle tcom uarney is prepared,
p y, governmen—
CJ tat agency and lending institution listed hereon, and
LAND �
15-160 ''''''...weit,"' to the assignees of the lending institution Certifica—
tions are not transferable to additional institutions
N Skoof. .
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STANDARD FEATURES
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225 lb 20 Year guarantee
2" x 4" Double gusseted -oof
asphalt self-sealingSlln{185 - C.D.X.
l�Lr�at: tor UTIr„'.c7t`.r"'.�C�
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NO'll: SI 11:,I) IS 'I'O BE TIED DOWN TO GALVANIZED STEEL "IRON ROOT" DOUBLE HEAD , DOUBLE HELIX EARTH
A1\1(1-1016 AT ALL CORNERS OF FOUR CORNERS, AS MANUFACTURED BY TIE DOWN ENGINEERING OF ATLANTA,
(rl?ORGIA, ATTACHED TO BOTTOM OF FOOTINGS &PERIMETER TIMBER SUPPORT TIMBERS. DETAILS APPLY TO ALL
c,1-.rcr- c' 1 1D ' •n {'1 a?T cirrnrr 1)v nn 1?T I n111. '