HomeMy WebLinkAbout40302-Z g�EFdt,rCOG Town of Southold 6/27/2016
P.O.Box 1179
53095 Main Rd
12y4ol • j9'
Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 38355 Date: 6/27/2016
THIS CERTIFIES that the building SHED
Location of Property: 255 Hillcrest Dr, Orient
SCTM#: 473889 Sec/Block/Lot: 13.-2-8.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/18/2015 pursuant to which Building Permit No. 40302 dated 11/30/2015
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 Yohai,David&Pamela Koner-Yohai
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Author e Signat e
TOWN OF SOUTHOLD
o`� cow BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
3 oy46SOUTHOLD, NY
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#: 40302 Date: 11/30/2015
Permission is hereby granted to:
Yohai, David
6 Circle Dr
Hastings on Hudson, NY 10706
To: construct an accessory shed in the required rear yard as applied for.
At premises located at:
255 Hillcrest Dr, Orient
SCTM # 473889
Sec/Block/Lot# 13.-2-8.3
Pursuant to application dated 11/19/2015 and approved by the Building Inspector.
To expire on 5/31/2017.
Fees:
ACCESSORY $167.20
CO -ACCESSORY BUILDING $50.00
Total: $217.20
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$15.00 r
Date. it /0_jO
New Construction: Old or Pre-existing Building: i/ (check one)
Location of Property: 205 I-//I-Iz 2 sT `22�LIE I l [
House No. Street Hamlet
Owner or Owners of Property: P.4 VIZ) ,V(��/-j 3! if-fig-4C4, /b&JEQ
Suffolk County Tax Map No 1000, Section /3 Block 02 Lot z53 ei 3
Subdivision Filed Map. Lot:
Permit No. e4-{,7&Z? _ Date of Permit. ,r/ /l.. Applicant: 9--721-1/de aL7L/ U24W(
Health Dept.Approval: G Underwriters Approval: ,
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
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Fee Submitted:$ D0 I ; f
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- TOWN OF SOUTHOLD BUILDING DEPT. '
765-1802
_ _ _ _ __ INSPECTION -
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] 1 CATION '
[ ] FRAMING /STRAPPING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
,. [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: C
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] F,UNDATION 2ND [ ] 1 LATION
[ vIIRAMING / STRAPPING [ FINAL (n.)
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATI N [ ] CAULKING
REMARKS:
DATE '° 9/2",A7 INSPECTOR
Frank Wolfgang Uellendahl Architect
123 Central Ave POB 316 Greenport, NY 11944 t: 631.477.8624 e: frank@frankuellendahl.com
June 2,2016
Submitted to: Building Inspector's Office
Town of Southold
Project: Construction of an accessory shed in the required rear yard
at 255 Hillcrest Drive in Orient,
Owners:David Yohai and Pam Koner
C @ 11CA`tfJCal
Permit#40302
FOUNDATION INSPECTION
I hereby certify in my professional opinion that in regards to the above referenced building permit the shed
foundation was installed in accordance with my design and specifications.
/cerely,
4ith11: 12 EZEINE ---
....../
rank Uelle dahl,RA JUN - 2 2016
BUILDING DEPT.
TOWN OF SOUT}IOLD
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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) 765-9502Survey
SoutholdTown.NorthFork.ne't PERMIT NO. I40S00.1... -- Check ,
Septic Form
- N.Y.S.D.E.C.
- Trustees'
C.O.Application
Flood Permit
Examined ' I t`SO ,.20 ', '6 Single&Separate
Storm-Water Assessment Form
Contact:
/ / '
Approved 11 ,20�� Mail to: • 1 Uk-- s.
Disapproved a/c
Phone: ( 1.` 4T)-41i[4
piratiTAT- Ii ' ,115\--17\1-11/ i;;20,'
- . I I ---.._ (2 - `01) Com.(lSi:\9
DI 1I NOV 1 8 2015
l Li 1 Building In tg `rA �
APPLICATION FOR BUILDING PERMIT . ��
— BLDG DEPT - -- j j -�� ��
__ _— C1-!w Co'sr i_�tio'.t; Date , 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•coinmenced 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)
- . (Mailing address of applicant)
State whether applicant is owner, lessee, agent, archite-ct, engineer, general contractor, electrician, plumber or builder
Name of owner of premises !V U-(P l'pttPr i £ TP i--4-6114 kD 1\i g
. (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 Street " ' - Hamlet "
County Tax Map No. 1000 Section Block , ;., . } Lot
. 1
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 Q �
b. Intended use and occupancy (Z �1<CJ.6.41-1, _ • ASS&sok 6ctO ' ' '
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work
�\, (Description)
4. Estimated Cost 6l OI�U Fee 101) se 9C) (Co)
(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 structure's, if any: Front .14- i Rear i` - Depth (21
Height -t--(-- « Number of Stories '
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
114
Dimensions of entire new construction: Front ' i' r 1 Rear t
Rear
Depth 12)
Height -t-- MI . Number of Stories l
9. Size of lot: Front 1917 Rear 150` Depth 2h� -
10. Date of Purchase 1-- e9 —2-0(4 Name of Former Owner- ((-4.4 k E U WS
11. Zone or use district in which premises are situated a.- 40
12. Does proposed construction violate any z mg law, ordinance or regulation. YES NO
V
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14.Names of Owner of premises rower-You'd I, Address-40,1 -OLc.-etwo 11 one No. 414- 9("322D
Name of Architect v24 1 tettit . ieeit( Address ebb gf -(I� 'hone No .&3(-4 d'b 4-
Name of Contractor -' Address Phone No. V 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 V
* 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 sur ey.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
( fraiSt_.) ._
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 u
(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. ,-,(
i
Sworn to before me this i 1 , -
t 4"l day of OO13& L49_( 20 (� , , ( "
'
t(4:5-i-)),,,,,o‘ J A--liu,.. .0,, CONNIE D.BUNCH \ t.,i° 4
Notary Public Notary Public,State of New Yet c - Si: ature of Applicant
No.01 BU6185050 , V
Qualified in Suffolk County
Commission Expires April 14,24'
f r
K` II
* a°$-`- (bei STORM[WAT]ER
Scott A. Russell ,# .�� ��
SUPERVISOR z 53 tt M[A N AG]EMOEN T
SOUTHOLD TOWN HALL-P.O.Box 1179 `
53095 Main Road-SOUTHOLD,NEW YORK 11971 ,'4 c ,.�, 'Town of So u th o l d
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4:litiSs,I's
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)
❑ A. Clearing, grubbing, grading or.stripping of land which affects more
than 5,000 square feet of ground surface.
El le. Excavation or filling involving more than 200 cubic yards of material
within any parcel or-any contiguous area. ,
E1131(. Site preparation on slopes which exceed 10 feet vertical rise to '
❑V100 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 floodplain as depicted
,� on-FIRM-Map-- of-any watercourse: - - ,
❑L� 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- (Propert Ow her,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date
/� I Di,ttrict
NAME: ��/i..�,lr,Ll���!i i 1 gl_ to o2_ 11—ts—'g
L1
Section Block k30-1.
__, , I / ,
"4-''= FOR BUILDING DEP'\RTNENT L:-1: ONLY
Contact Information
C.. 1, -477-J''2'
Telephone�,,nbtt
Reviewed By: AL4-1\--4\
Date: j1-15-15 ,
Property Address / Location of Construction Work:
•Q_D- kliii Q.k Et `D -, Approved for processing Building Permit.
0i Stormwater Management Control Plan Not Required
LiC `( `�lt° ❑ Stormwater Management Control Plan a Required
(Forward to Engineering Department for Review)
FORM 4 SMCP-TOS MAY 2014
ze•
, ,
4 APP,IOVED AS NOTED
DATE:l 3® C13 P.#- 00
FE : LLk7 J BY:._.wt/I,..;E. -.
NOTIF BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. •
NEW Oi .K STA1 + & TOWN CODES
AS REQUIRED .f-V- :' c, E �S
u eF
soLI kin-I 1 r, , UI ARD
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4
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
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LOT AREA = ca.40,050 SF = 100.00% SCTM# = 1000-13-02-8.3 Y
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EXIST'G POOL COVERAGE = ca. 640 SF = 1.60% SUFFOLK COUNTY, a DWG. NAME��,: STORAGE SHED ADDED SHED COVERAGE = ca, 168 SF = 0.42% TI a A-1
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SURVEY BY PECONIC SURVEYORS, P.C. TOTAL BLDG. COVERAGE ca. 2,998 SF 7.49% BUILDING
DATED: JANUARY 2, 2014 MAX. BLDG. COVERAGE = ca. 8,010 SF = 20.00% FRANK W. UELLENDAHL, ARCHITECT P.O. BOX 316 CREENPORT, NEW YORK 11944
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READYLFOOTINGS,MIX CONCRETE.FOUNDATIONS, ETC SHALL REST ON — STORAGE SHED o
UNALL
ALLDIFOOTINGS AND FOUNDATIONS SHALL BE FORMED. c -RBED SOIL. a o
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FOUNDATION PLAN 2'-9" 2'-9„ ll 3-o„ Al 2'-9” 2'-9”
N ELEVATIONS
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o2 A-2
FLOOR PLAN STORAGE SHED ® DWG. NO