HomeMy WebLinkAbout40742-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
AX: (631)765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. ��t Check
.... ......
Septic Form
Trustees
_.._ C.O.Application,_
Flood Permit
C aarnn „Y
x ed 20� Single&Separate
Storm-Water Assessment Form
,� � ��t' Contact:
pprovd. 20 .....--�.,...,..,..
D 7presv dWN a/c
F SO
Phone: ..I!.,..t�_.�/ — r i
Exp�ratio20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date _ AIffFt-Gf¢ 2-6........__a 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.
(Signature of applicant or name,if a corporation)
Po 190) S83 , S> l/f4o( P1 ray
...........
(Mailing address of applicant) 1 19 W
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
O WN E12
Name of owner of premises C.k!Z-/5 �C K
....................._
(As on the tax roll or latest deed)
If applicant is a corporation,signature of duly authorized officer
........m.m.m............
(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:
5265'0 Pa0U7 2S 5®v7-"L-D
House Number Street '
:thMa't v .a ,
4
�i
t •�;�r,. o,
taw� x�tt
County Tax Map No. 1000 Section „-, I,''
`,�„ Lot .............._....m...................._
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 P P=d,JA-r
b. Intended use and occupancy ll d 1
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work _ _
(Description)
5. If dwelling,number of dwelling amts taf L
4. Estimated Cost 0 °" "
ck
on filing this application)
g i ber of dwelling units Onc ch floor
If garage, number of cars �f ,, ,
6. If business,commercial-or mixed occupancy,specify nature and extent of each type of use.
VJ0 _
7. Dimensions of existing structures,if any: Front_._ Rear� Depth 7-`�
Height 10® Number of Stories 71 `
Dimensions of same structure with alterations or additions: Front 5 Ate- q5 ct&oveRear
Depth Height Number of Stories
8. Dimensions of entire new construction:Front . OtS `t6 eat Depth
Height Number of Stories
9. Size of lot:Front < If
gear 30/ Depth 2-00
10.Date of Purchase Tawe_. 2-015- Name of Former Owner jog± Kvr
11.Zone or use district in which premises are situated A't' r~ �
12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO sC
13.Will lot be re-graded?YES NO X Will excess fill be removed from premises?YES NO
14.Names of Owner of premises. j4 c„ Address EZ. G.E - 'hone No.
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
*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 OF, IaE
C-lf'')( i C _, 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.
Swfore me this
or tge �r
day of i 20J
BABRWA M BORN
IP
ubl'ic,State of N Y
Notary36
Public f3 31k Co Signature ofApplicant
�ualifiett ttt Suffolk County g
missionComExpires,Dom 22,201$
OW
A. r l l
41 -FScott � 1
SUPERVISOR
[A N A [] N
SOUTHOLD TOWN HALL-P.O.Box 1179 6 4
r � ` 2
53095 Main Road-SOU OLD,N YO 11971 " "'k-' ' � X Town of Southold
�
DIES ,
CHAPTER 236 ® STORMWATER MANAGEMENT WORK SHEET
..........,. .........m.
( TO COMPLETED APPLICANT )
IOES THIS Pf(OJECT' INVOLVE ANY OF THE FOL IN :
(CHECK ALL THAT APPLY)
"es No
A. Clearing, grubbing, grading r stripping is affects more
than 5,000 square feet of groundsurface.
B. Excavation or filling involving ore than 200 cubic yards of material
within any parcel or any contiguous area.
c. Site preparation on slopes which exceedfeet vertical rise to
100 feet of horizontal distance.
D. Site preparationwithin feet of wetlands, beach, bluffor coastal
erosion hazard area.
Site preparation within - -year f loodplain as depicted
0111 IR ap of any watercourse.
rse
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 f impervious surfaces.
If yanw answered to o all oftequestions above, STOP! Complete a Applicant section below with y®nName,
Signature,
Information, ate & County Tax Mapbar. 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 pour Building Permit Application.
S.C.T. . #: 1000 Date:
APPLICANT: (Property Owner-,Design Professional, t, ,Other) District
NAME: i,,,,,,,
.._. ,,„__ ._.. sane Contractor,oR......�.. Block
LotSection
l°0'iUf 1111 DD”G DE P.`1.R )i vfl l r,i]...,.
Contact Information_
_..2—
Reviewed Py.
.._t � F�ddr�.�s l �.rJ6.�tR(�Y..
Propert _ rate: „
�. .�..._ _�___.� u cel` C�`orl.�Cu�ta�:fioPa Work:,
p.
.MIT... proved herr processing Building Permit.
.......... Storsmwvater Management Control Platt Not Required.
m
m. Stormwrateir Management Control Plan is Required.El .
(Forward to Engineering Department for Review.)
FORM 11 ,S..MC"P _1-CSS MAY 2014
S.C.T.M. NO. DISTRICT: 1000 SECTION:61 BLOCK:3 LOTS):2
1-1
AI ROAD
CONI,CURB
N80.45'40"E 85.70'W; Cows. u.a.
�_' ....... CONC.SICEWALK° a
85.00' 2 g• STONE
COLUMN
h
® w+(c R
4
o I.zw 27.,3'
x
651 n t°`
Ut
a.m• °' W
!Y a srr Fen.
OWELLlN6
0 a. 2.5" 1526M
M.FI.0
a.a
2.7
Fac � iL
X
FRM.
GARAGE
y.r.
�1
c7
STGCKAOE
561.30'00"F 75.91'
o�
LAND
OF NfF
ANITA MILLER
JENNIFER WILSON
THE WATER SUPPLY, WELD DRYKUS AND CESSPOOL
LOCA77ONS SHOWN ARE FROM F7ELD OUSERVA7701VS
AND OR DATA OBTAINED FROM OTHERS,
AREA:16,178.44 SQ.FT. or 0.37 ACRES ELEVATION DATUM: ________________________
UNAUTHORIZED ALTERATION OR ADDITION TO T141S SURVEY 1S A VIOLATION OF S£CDON 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURN_YORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY 1S PREPARED AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON. AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS
AND/AR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EI4DENT ON THE PREMISES AT THE 77ME OF SURVEY
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO:CHRIS BUCK,
MAP OF: FIRST AMERICAN TITLE INSURANCE COMPANY,
FILED:
SITUATED AT: SOUTHOLD
TOWN OF:SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
P.O. Box 153 Aquebogue, Nes York 11931
` PHONE (631)298-15813 FAX(631) 298-1588
FILE #155—t02 SCALE:1"-30' DATE:JULY 11, 2015 N.Y.S. LISC. NO. 050882 maintaining the record.of Robert J.Hennery&Kenneth M.roychuk
N Ilk
WND RESISTANT CONSTRUCTION CONNECTORS LO
0%
DECK 8c PORCH CONSTRUCTION DETAILS 8c WIND LOAD PATH CONNECTION DETAILS CONNECTION—OCATION PART NUMBER 40TES
44 POST TO,FOOTING ANCHOR PAU44 OR WE44 :IAU44: USE w/ MIN, 1/2" DIA, x 7" ANCHOR T z
6x6 POST TO Q ;
-FOOTING ANCHOR PAU66 OR WE66 :)AU66: USE w/ MIN. IZ2" DIA. x 7" AN B LT 0- _y i
U
x4POSTIC rARDERZH ADER BS44 / PBSE44 / KCA SE ONE E FOR EACH POST
%0
x6 POST TC GIRDERMEADER BS66 / PBS 66 / KC66 JSE ONE TYPE FOR EACH POST 0%00
OST/COLUM. T GIRDER HEADER LSTA12 OR LSTA24 JSE (2) FOR EACH POST COLUMN
O\
TAI STRIN *R CONNECTION TMU26 OR MPA1 JSE QN.._EACH STRINGER
RAFTER C Cm
LU _0
AFTER ZJOIS TO HEADER TYDOWN RT15 USE FOR EACH RAFTER a
0 M'0
USE ON EACH RAFTER. MPA1 USE ONLY 0
RAFTEAFTER TO Ll AGER BOARD TMU26 OR MPA1
1V ERE IMU26 CAN NOT BE USED 0 W
R---e
LEDGER— U - THE FOLLOWING OR APPROVED USP METAL CONNECTORS FOR PROPER WIND RESISTANT CONSTRUCTION.
K LOW MANUFACTURE'S RECOMENDED INSTALLATION INSTRUCTIONS TO ACHIEVE MAXIMUM UPLIFT LOAD CAPACITY.
V)
RIDGE NAILING SCHEDULE
HEADER
ROOF FRAMING:
RAFTE JOINT DESCRIPTION NAIL. ISPACING NAIL, NOTES
IV_
OTY
RA TO Ir WALL-3-8d COMMON EACH
TOE-MAIL
TOP PLATE 10'WALL:4-8d COMMON RAFTER
CEILING JOIST V WALL:3-8d COMMON EACH TOE-NAIL
TO TOP PLATE 10'WALL:4-8d COMMON JOIST
CEILING JOIST TO AS PER TABLE 3-7 EACH FACE
TYPICAL RIDGE TO RAFTER STRAPPING RAFTER TO WALL CONNECTION ALTERNATIVE RAFTER TO HEADER CONNECTION PARALLEL RAFTER WFCM-SBC LAP NAIL
CEILING JOIST LAPS AS PER TABLE 3.7 EACH FACE
OVER PARTITION WFCM-SBC LAP NAIL
COLLAR TIE AS PER TABLE 3.4 EACH FACE
TO RAFTER Wrcm-SSG END NAIL
STAIR TREA BLOCKING 2-Od COMMON EACH rOE
TO RAFTER END NAIL
GIRDER/HEADE-R- E)
RIM BOARD 2-16d COMMON EACH END
RIM BOAR TO RAFTER END NAIL z
POST— E)
WALL FRAMING:
JOINT DESr.RIPTIN NAJIL NAIL NOTES
POST/COLUMN STRINGER QTY. SPAC140
;> PLATE R
RIM/DECK JOI -0 0 TOP TOP PLATED
2-16d COMMON FOOT FACE NAIL
0 TOP PLATES AT 4-16d COMMON JOINTS FACE
RINGERTO DECK/PORCH CONNECTION INTERSECTIONS EA.SIDE NAIL
4.
STUD TO 2 FACE
GIRDERIHEADER TO POST/COLUMN CONNECTION STUD 2-16d COMMON O.C. NAIL
HEADER TO 16d COMMON 16r O.C. FACE
HEADER ALONG EDGES NAIL
POST TO DECK/PORCH CONNECTION TOP OR BOTTOM 2-16d COMMON PFI?Zx4 STUD END
PLATE TO STUD 3-16d COMMON PER 2x8 STUD NAIL
BOTTOM PLATE TO:
FLOOR JOIST,BAND JOIST, 2-18d COMMON PER FACE NAIL
END JOIST OR BLOCKING FOOTtr
bECK JOIST FIRMING:
JOINT DESCRIPTION NAIL — NAIL NOTES C4
QTY. SPACING
JOIST TO: PER TOE
GIRDER/HEAD GIRDER 4-IW COMMON
o
SILL,TOP PLATE 61�G JOIST TIDE
41
EACH TOE
BRIDGIN-3
GIRDER/HEADE-R TO JOIS IF 2-8d COMMON END NAIL
BLOCKING EACH TOE v—
iols 2-8d COMMON
TO JOIST END NAIL
POST/COLUMN— 00 '__/ I U)
POST/COLUMBLOCKING TO: EACH TOE
SILL OR TOP PLATE 3-16d COMMON BLOCK NAIL
N e
LEDGER STRIP EACH FACE
TO BEAM 3-16d COMMON JOIST NAIL
GIRDER/HEADER JOIST ON LEDGER 3-Od COMMON PER TOE
TO BEAM JOIST NAIL
BAND JOIST 3-18d COMMON PER END W
TO JOIST JOIST NAIL
SILLTOP D JOIST TO: PER
SILL PLATE 2-16d COMMON FOOT TOE NAIL
ROOFSH 4
GIRDER/HEADER TO P-QSTZCOLUMN CONNECTION GIRDERZHEADER TO POST/COLUMN CONNECTIONJOIST TO GIRDER HEADER CONNECTION JOINT DESCRIMON NAIL NAIL NOTES
1QTY. SPACING
STRUCTURAL PANEL I 8d AS PER TABLE 3.8
WFCM-SBC
DECK AND COVERED PORCH NOTES:
1).Unless otherwise noted,ell frarning material to be 01 ACQ pvmn treated knber.
AN Insterwa,hangers and anchors to be getvirfted or stainless steel.
2).GMm for dock joists Io be bolted or anchored iD each post or pier with wfthers and nuts.
Ghdom on concrete piers shall be anchored with proper at"omwKkn anclKm
kilo concrete with a minimum 1/7 dia x 7'"anchor bolt with washers;and nuts.GIRDER— 3).Posh supporting gkxbm shell be anchored to a 12*x12*x12'Vft concrete looting.
Use a minimum 1/r dim x r long anchor boft with washers and mita.Footings Shell
POST—e be3ft.below grade.Girders with roofs shall have 12 dle.com plem 3'below grade.
WOOD J O I 4).Dock Joists lo have blociding at 8V o.c..
5).Aminirnumol"10inchilleshk shall be Installed between the builift and ledger.
A
0 A Ledger to be fastened to building wIth 1/2'die.bob with washers and mft
V A(,. '
v GIRDER/HEADL-11.1
st1ro.c.
CONCRETE PIE 12 x12 x12" CONCRETE FOOT*�GT
v � A �
I A A 1 1.A 6).Concrete piens aNd be a mWmm 8"above grade.
V , I . WOOD JOIS-T—
V.
A 7).AN joists to be supported with hangers and anchors.Each Joint shall also be wchored
to glirdW(S).
V, POST TO FOOTING CONNECTION 8).Covered Roofs shah be assembled and anchored the swne rrmneres @typical building.
A CLIMATIC & GEOGRAPHIC DESIGN CRITERIA
JOIST FRAMING
FLUSH WITH GIRDER/HEADER
GROUND WIND SEISMIC FROST WINTER ICESHINE-LID FLOOD
SNOW SPEED DESIGN WEATHERING LINE TERMITE DECAY DESIGN UNDERLAYMENT
HAZARDS I
TO
GIRDER TO CONCRETE PIER CONNECTION 91 J I LOAD (MPH) CATEGORY DEPTH TEMP. REQUIRED ji
I. C MODERATE SLIGHT TO
45 LBS. 120 B SEVERE 3 FT. Vy MODERATE 11 NONE
I FIEJAVY
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