HomeMy WebLinkAbout40598-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 f f Planning Board approval
FAX:(631)765.9502 1� Su cy
SoutholdTown.NorthFork.net PERMIT NO. I Check
Septic Foran
N.Y.S.D.E.C.
Trustees_
C.O.Application
Flood Permit
Examined _ w _..a,20 Single&Seepumtc
Storm-Water Assessment Form
Contact: , /I•�
ApprvVed_ _m ... ,20 _ Mail to: V
Disapproved a/c
Phone• "� � 3
Esga� teon. ........ 20
g Building Inspector
D � APPLICATION FOR BUILDING PERMIT
��
APR — 1 2016 9 INSTRUCTIONS Oat �� � � 201&
a This application MUST be completely filled m by typewriter or in ink and submitted to the Building Inspector with 4
lot plan to scale.Fee according to schedule.
TOVA
location of lot and of buildings on premises,relationship to adjoining premises or public streets or
t s.
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.
(Signatureof applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Name of owner of premises Ae 4 w Y - k
(As 6n 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. Locci��}}'o�gqol"land n which prc sed wor willbedone:
113 CJ � , 1�-ir.�rt �r/ �G�S� /% i2�®/✓
House Number Street Hamlet
County Tax Map No. 1000 Section lllo..&:
Oc L01 `J
�,W 3
Subdivision 1'flffl Map No.______ Lot
2. State existing tm-and occupancy of M. mfises and intended use and occupancy of proposed construction.
a. Existing use mid occupancy
b. bacaided use,andoccupancv................
3. Nature of work(che&which appficable):New Building Addition Alteration
Repair Removal Dernolition Other Work:37-
Lf/hylk/1"A14L
....................................................................... i
(Des6ipdon)
4. Estimated Fee
(To he paid on.filing this application)
5.. If dwelling.,number of dweftg unils__Number,ofdwellfiing units on each.fp oor
If garage,number of cars
6. If business,commercial or mixed occupancy,speciffy riaLure and extent of each type of Lise.
7. Dimensions of existing structures,if any:Front R= Depth
Height Number of 8-11odes ........... -
Dimensions of same structure with afterations or addifions- 14 iront URear..................................
Depth .................... 11 Ileight................................................................................. Number of Stories
8- Dimensions of entire new construction:Front Depth
U--Ieight Number of Stories
9. Size of lot:Front....__—Read .—Depth
10.Date of Purchase —Name off: ormer Owner
11.Zone or we district inwbich premises ane spit ed.
12.Does proposed construction vialate gray law,ordinance or regulation?YES.........—NO...........................
11 Will lot be to graded?YES—NO Will excess fill.be removed.fturn premises?Y`ES NO_
14.Names of Owner o.f premises Address Phone No.
Name of Architect Address................ IPdaeane No - ---------
Name of Contractor Address ................—Phone No.
15 a.Is this property within 100 feet of a tidal wedand or a.freshwater wetland?*YES NO
IF YES,SOLMIOLDTOWN TRUSTEE.S&DX C.PERNUTSMAY B..R-EQW.11:M.
b..Is this property within M)feet of an tidal weflan&*YFS_NO
IF YES,D E.0 �."ERMTS MAYBE REQPM.D.
1.6.Provide survey,to scale,wilb.wvurate famidatlean plan and.distances to projxrty fines.
IT If elevation at any point on property is at 1.0 feet or below,must prov.ide topographical data on survey,
18.Are there any covenants and restrictions widi respect to this property?*YES_NO—
*IF YES,PROVME A COPY,
STATI',QFNEM YC&K�
SS a.
COLNTY OF,��
being diily sworn,deposes and says that(s)hv is the,41R-AGEY L DWYER
YORK
VL k
NOIARY PUBM�STATE OU::- M..'W
IMO�01M6306900
(S)He is dw QLLLA FIED IN SUFFOLK COUNTY
Agm I,rofporale 0'ffimr'etc.) C01MIMBS110N EXP111131ES JUNE 30,2L"S
of swd owner or owners,and is My authorized to perfonn orliave perfiormed the sound w4kand to make and file this application;
that all stateanents cerin taiwd in this application.are trw to the best of his knowledge and belief,and flea the work will be
perfonued m the manner set foidi in the application filed therewith.
Swore to be-fore®e this
..............
x
ace '/n"
Notary Pubc Sign.dum of.Af.qi1icant
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ST�O IKIMI SVA\7C'1E��
SUPERVISOR hAAC A\G IEMIEN
SOUTHOLDTOWN HALL-P.0.Box 1179T�tiVn fiJ�u�ILQL �(�]
53095 Main Road-SOUTHOLD,NEW YORK 11971 . J
CHAPTER 236 - STORMWATER MANAGEMENT WOE SHEET
( TO BE COMPLETED BY THE APPLICANT )
�. __ �..
DOES 'THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
(CHECK ALL THAT APPLY
�j 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.
D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
E. Site preparation within the one-hundred-year f loodplain as depicted
on FIRM Map of any watercourse.
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 on dicopies ater catiotlement Central Plan
and a completed Check List Form to the Buildinging rt .e mit yot Buildig Permit a Stormwater Manan.
_ _ e.
iPro m Owner, S.C.T.M. 1000 Date
APPLICANT:
pe _ign Profe_conal.Agent.Contractor,Other) D trict
XA�1E;
Section Block Lot
FOR BUILDING DEPARTMENT ONLY
USE 01L�
Contact Information:
Reviewed By:
Date: � ,�
Property Address / Location of "cel s° rust ion Work: ff�Sltormwater
'- """" — -- — — -� �-
ppro�ed for processing Building Permit.
d Management Control Plan Not Required.
...... — � mwatr Management�Control Plan is Required.
eq uureed.
El Forto
Engineering Department for Review.)
FORM # SMCP-TOS M<
me....
MAY 2014
Young & Young
400 Ostrander Avenue, Riverhead, New York f t 30 t
\ 631-727-2303
". Howard W. Young, Land Surveyor
Thomas C. Folper€, :profes"o-Aal Engineer R��
< di&nald B. PfuhGTLsndseape Ar"hitecf
ADoug[os E. Adams, Profeass€�'al Engineer
es
fy a
W E AREA- 41,542 50.FT.
0\ • SUBDIVISION MAP-"SUMMIT ESTATES,SECTION 2"FILED IN THE
OFFICE OF THE CLERK OF SUFFOLK COUNTY ON MAY 21,2002 A5 fill
sx
FILE NO.I0T66. 6
�4 Fz
3 C
F
a � � '� < SURVEYOR'S CERTIFICATION
Cid" a €" t�`
• WE HEREBY CERTIFY TO CHRISTOPHER CAPOBIANGD,
_ i„Qt Iq � <9 - NEIL CAPOSIANCO & FIRST AMERICAN TITLE
I N S U RAN C E G D M PANY THAT TH15 SURVEY WAS PREPARED pig
atrO\- .'. o110
IN ACCORDANCE WITH THE CODE OF PRACTICE FOR LAND
S§S _
y� �J, SURVEYS ADOPTED BY THE NEW YORK STATE
e 6 .,+ PROFE55IONAL LAND SURVEYORS. a� Y
N.
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H
a�
Q�
ax ' rY
t- nom. 2��.PRr - HOWARD W.YOUNG,N.Y.5.L.S.NO.45693Qg
LA
HoUm
Z � o „ + r�
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SURVEY FOR
04RISTOPHIM GAPOSI
IL GAPOSI
LOT III "SUMMIT E5TATES, SECTION 2”
_- At East Marfan, Town of Southold
CIO .00' Suffolk County,New York
R=1 0
1, County Tax Map orstrke 1000 Sacaon 35 sic Oai poi 10.5
O 1� (A1.5CNOyNN
s� o t r
FINAL SLRvrzy
%'0 AENTS
A B
24' FINAL 5LlRYEY DEC,.24,2005 ,E
WATER MAIN- -°'°per G.P.1 22' 44' FOUNDATION LOCATION A716.24,2005 e�$
e ''
----------- SURVEY MAP COMPLETED JAN.13,2005
- - C.P.2 84' 49' FIELDSURVIE'r COMPLETED JAN.15,2005 e
SCALE: I200 �J 1'
JOB NO. 005-OOII logo
er®•,nonMNr ranro A•sr�xe xr ♦•nrAKe ram w.wor ovoe s.sxwr c c�NrEr DWG.200'3_001 t_fe p
LEGEND:
PLAN ELEVATION SECTION
LED LIGHT co)
511-611
CIRCULATION RETURN 0
41-011 431-611 41-011 PLAN SECTION
9" SQUARE OUTLET COVER
TYPICAL AUTO F I LL <r
Notes :
............................................ ........... . ..... -----------
. ... .......
5-1011 101
-oil I-011 I
-
51-011 Y-011 10 51-01
il
40 -o
11 3011
-----------------7-1
\—TYPICAL CIRCULATION
RETUTN DEEP END
(WATER DEPTH:T-9")
AUTOMATIC
COVER
li 9"X9" FRAME GRATE MAIN-----<��
SWIMMING POOL
DRAIN , T'D TOGETHER IN
(800sqft) ACCORDANCE WITH VGB ACT
4
rn
SHALLOW END
(WATER DEPTH:3'-3")
71-011
15 -011 131-011
250W INCANDESCENT 18"R SWIMOUT
00 POOL LIGHT
O
TYPICAL SKIMMER TYPICAL SKIMMER
2" THK. STONE COPING
41-011 111-911 41-011 ON MUD BASE
Y2" EXPANSION JOINT, W/ 6"H FROST FREE
xx
6F N.
1-911 41
15 X 151-911 BACKEROD AND SEALANT WATERLINE TILE
WATERLINE CENTER OF TILE
STONE PATIO
(743sqft) V it
00
If
IN POOL WALLS WITH WATER
-
DEPTH OF 5' 0" OR LESS
4" MIN. SAND BASE, WHEN NECESSARY TO AID
REBAR SHALL BE PLACED
HORIZONTALLY AND
DRAINING IN SLOW DRAINING SOIL
t VERTICALLY @12"O.C.
201-011
SWIMMING POOL WALLS, BOND BEAMS, AND FLOORS Y2 THK. POOL FINISH
SHALL BE STEEL REINFORCED GUNITE. GUNITE SHALL
7".
BE MINIMUM 4,000 P.S.I. @28 DAYS. STEEL RE BAR zz
'4
SWIMMING POOL AND PATIO LAYOUT SHALL CONFRIM TOAST, A615 STANDARD GRADE
7" THK. GUNITE POOL
SCALE: Y V-101" r. Ei: ;V { ."Y . .;
SHELL
REV: DESCRIPTION: BY: DATE:
IN POOL WALLS WITH A WATER DEPTH GRATER THAN
DESIGNER:
Y-O", ADDITIONAL VERTICAL BARS SHALL BE PLACED
VERTICALLY FOR A SPACING OF 6" O.C. AND EXTEND
BANDERA
FROM TOP OF WALL AND BENT INTO THE BOTTOM OF
FLOOR EXTENDING 24" HORIZONTALLY.
P 0 0 L
Phone: (6 6) 400-3850
Website: www.Banderapool.com
VERTICAL BARS 12" O.C. SHALL BE BENT IN BOND
Email: Info@Banderapool.com
FLOOR REINFORCING SHALL
BEAM AS SHOWN. ZL
CONSIST OF RE-BAR CAGE PROJECT:
SPACED @ 121, O.C.
It CAP ODIA NCCS
_ ! Ht
RESIDENCE
CRUSHED STONE, WHEN NECESSARY TO DRAINAGE IF
T T7k
GROUND WATER IS ENCOUNTERED IN SLOW DRAINING SOIL A j
EAST MARION, NY
TITLE:
t -r77,'l
4.4
SWIMMING POOL
4
LAYOUT
TYPICAL WALL SECTION SCALE AT AO: DATE: N: CHECKED:
2 SCALE: 1'-0" AS NOTED 4-04-16 VG VG
PROJECT NO: SHEET NO:
1600A P 2