HomeMy WebLinkAbout40463-Z l'I
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`' U&FOt, �a Town of Southold 3/10/2016
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� S P.O.Box 1179
n 53095 Main Rd
4 0 Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 38141 Date: 3/10/2016
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 65 Gin Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 88.-4-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/9/2016 pursuant to which Building Permit No. 40463 dated 2/12/2016
- 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 addition to an existing one family dwelling as applied for.
The certificate is issued to Mcloughlm,Kenneth&Dorothy
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A at rized ignatire
,OS0FQd.1% Town of Southold 3/10/2016
'!# P.O.Box 1179
53095 Main Rd
{;oy.�O ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38142 Date: 3/10/2016
THIS CERTIFIES that the building HOT TUB
Location of Property: 65 Gin Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 88.-4-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/9/2016 pursuant to which Building Permit No. 40463 dated 2/12/2016
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"accessory hot tub as applied for.
The certificate is issued to Mcloughlin,Kenneth&Dorothy
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40463 2/24/2016
PLUMBERS CERTIFICATION DATED
;4/11W,
Aut q • d Si. atur:
-gUFFoi�- TOWN OF SOUTHOLD
BUILDING DEPARTMENT
2? TOWN CLERK'S OFFICE
SOUTHOLD, NY
1 yh�1 *
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#: 40463 Date: 2/12/2016
Permission is hereby granted to:
Mcloughlin, Kenneth
65 Gin Ln
Southold, NY 119714238
To: legalize an as built deck as applied for.
At premises located at:
65 Gin Ln, Southold
SCTM # 473889
Sec/Block/Lot# 88.-4-1
Pursuant to application dated 2/9/2016 and approved by the Building Inspector.
To expire on 8/13/2017.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $513.60
CO -ADDITION TO DWELLING $50.00
(/To 1: $563.60
• Building Inspector
Form No.6
i 5- , �c3 �J
TOWN OF SOUTHOLD
1
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
Date.
New Construction: Old or Pre-existing Building: \./. ..-
. e. (check one)
Location of Property: (.675- G--1 Ni LANE cJ 0 UTL-(-O L._ •
House No. Street Hamlet
Owner or Owners of Property: PA G L DOG-N L,( NJ •
Suffolk County Tax Map No 1000, Section 8 8 Block 4- Lot ( •
Subdivision—__ Filed Map. Lot:
Permit No. LICA3 _Date of Permit . - , .,,pplicant: tYlC LOU 64-0-1 N •
Health Dept.Approval: N A Underwriters Approval:
Planning Board Approval: N
Request for: Temporary Certificate Final Certificate: k, (check one)
i5i
Fee Submitted: $
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pplicant Signature /
/,iii g SO1/l. '
Town Hall Annex t�'~® `� l® : Telephone(631)765-1802
54375 Main Road IIII ilig % Fax(631)765-9502
P.O.Box 1179 ,r
Southold,NY 11971-0959 • old ���t` roger.richert(a�town.southold.ny.us
11
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mcloughlin
Address: 65 Gin Lane City: Southold St: New York Zip: 11971
Building Permit#. 40467&40463 Section: 88 Block: 4 Lot. 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: "AS BUILT" DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub x
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph Heat OIL Duplec Recpt 35 Ceiling Fixtures 11 HID Fixtures
Service 3 ph Hot Water OIL GFCI Recpt 6 Wall Fixtures 6 Smoke Detectors 1
Main Panel NC Condenser 1 Single Recpt Recessed Fixtures 6 CO Detectors
Sub Panel 1 NC Blower 1 Range Recpt 40A Fluorescent Fixture 1 Pumps
Transformer Appliances DW Dryer Recpt 1-30/ Emergency Fixtures Time Clocks
Disconnect Switches 29 Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS"
200A Over Head Service,3-Exhaust Fans, 1-Paddle Fan,6 Ft.of Lighting Track,Self Contained Hot Tub with
Notes: GFCI Protected Disconnect,1-Paddle Fan in Gazebo
Inspector Signature: Date: February 24, 2016
Electrical 81 Compliance Form.xls
,,,,,,
1 ��o440 , f SO(/l4olo`i
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TOWN OF:SOUTHOLD BUILDING-DEPT.
765-1802
INSPECTION.-
[ ] FOUNDATION 1ST [ ] ROUG LUMBING
[ ] FOUNDATION 2ND [ ] ULATION
[ ] FRAMING / STRAPPING [ FINAL its `F
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ .] ELECTRICAL (FINAL)
[ ] CODE VIO ATION [ ] CAULKING
REMARKS:
61' ‘ro , as—
DATE ,--5/6/76 INSPECTOR `'
FIELD A
1 „ i :..„C?N T1EpOR'T AS COM
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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
FAX: (631) 765-95020 Survey
SoutholdTown.NorthFork.net PERMIT NO. 1.1 / Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
.3' Storm-Water Assessment Form
( I 'J Contact:
Approved ,20 Mail to: D C 1 Q E S
Disapproved a/c To 'O>c 40( 3 6 cJ"(k�h147
Phone: 3(-2 ,4-k24/
20 - I
Building Inspector
<<r � FEB _ 9 2016
PPLICATION FOR BUILDING PERMIT
f Date a 6 20
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 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.
�i LLQ
gnature of applicant or name,if a corporation)
�C17 $O, 461 S O O—O L—_D
(Mailing address of applicant) N,,4
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
A-61557—
Name of owner of premises t.E C,LO U C.. c_(
(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:
(0 G- SO v
House Number Street •.G ,Hamlet
, ..•,., ,! , , 4 Lot
County Tax Map No. 1000 Section 88 ._, , ,'Block,
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 S/i) e‘s l®- Ch"
b. Intended use and occupancy c5 YY� W 'I/ -3 v 1 t—�ir i✓
3. Nature of work(check which applicable):New Building EC(4-- Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units NI k Number of dwelling units on each floor I�
If garage, number of cars IJ e
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. l\.l A
•
7. Dimensions of existingstructures, if any: Front ' 61 Rear k:265'-01
e r Depth 31 -
Height 9.0 I-O` Number of Stories I
1 il
Dimensions of samer structure with alterations or additions: Front �j �l_D Rear ro cD G
Depth 441 E5IHeight 2-1" Number of Stories ^�
8. Dimensions of entire new construction: Front A- Rear N k Depth N A-
Height 2_1 Number of Stories lS f 3I--7",c
9. Size of lot: Front 'Ili CI Rear 151. b Depth (2 S°OI T° I 2-7,�, 19f
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated - ' i& -A-0*
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded?YES NO Will excess fill be removed from premises?YES NO
14.Names of Owner of premises K mc-Lou6dFess (o3 G-1 kJ LANE Phone No. 1(65— 2�35
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.
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 OFSup`t)
The n Chan)be_A S being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the _ - - - - _
__(Contractolltirgent, orporate 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 tQ before me this
IO day ofebnnarj 2011,
•J TRACEY L. DUVYER
/L 244_ • .. ' STA rev RIJBLIC STATE or NEW YORK
I Not.!i Public NO.O1DW6306900 'is ature of Applicant
Ut LIF:ED IN SUFFOLK COUNTY
C,Olv ,ISSION .XPIRES JUNE 30,201g
04 FF
Scott A. Russell .a� �°sU ei'`�'��••. STORM[WA\T]ER
SUPERVISORMANAGEMENT
SOUTHOLD TOWN HALL-P.O.Box 1179 +t
53095 Main Road-SOUTHOLD,NEW YORK 11971 i �` �'� Town of Southold
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)
[Zi A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
®Er B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑ErC. Site preparation on slopes Which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑
alp. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area. •
0 aE. Site preparation within the one-hundred-year floodplain as depicted -
- -on FIRIVI lap- of any watercourse:
012;F. 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. #: 1000 Date
VQ D �ci
NAME: 3o a\-A �3 2- 13'
- 13
. l ems°
Section Block Lot
031 -2P1,4--42-41•e.t., x�:R� FOR BUILDING DEAR/"��y6 `�S:ONLY ..x:
Contact information: - / ,
T<.p Nu,na„
Reviewed By:
Date: '11/ 6
Property Address /Location of Construction Work:
l fsc'NJE- Approved for processing Building Permit.
l(� Stormwater Management Control Plan Not Required.
3-0 U L'D Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review)
FORM " SMCP-TOS MAY 2014
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Town Hall Main ARnnex
* .• ; Telephone(631)765-1802
54375vs a��aaxx(631)765-gg502
P.O.Box 1179 ; @ �� roger.richert TOWn.SOuthO .ny.US
Southold,NY 11971-0959eCOUNII,ttoil�Q . °�+
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- !
- • REQUESTED BY: Q i l\ i✓1 - Date: 2 3 • ( •
Company Name: ;
Name: K1E/\i OC- L O U G-(AL_I NI •
License No.:
Address: (Q 3-1 LJ e 1 (SO• �j t t[a O(_p •
Phone No.: 3 ( — 7(p5-— 2 S 35 - C
JOBSITE INFORMATION: (*Indicates required information)
*Name: 1Kei YY'C L.O U 6-{tL-i l'-J - cs- (fl Eo\C,
*Address: (2 C t N LAN (5'O U711-61-0 -
*Cross Street: I N B/1/4-'V
*Phone No.: 7(oS-- ZS 35
Permit No.: A-PPL- • Fb (�
Tax•Map District: 1000 Section: B8 " Block: 4- Lot: J
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) - IN) C Ka-As-el)
�2 V tC iV .
(Please Circle All That Apply)
•
*Is job ready for inspection: 0/ NO Rough In Final
*Do you need a Temp Certificate: YES I NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
"
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