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39974-Z
FFntK TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o . SOUTHOLD NY V0 BUILDING PERMIT �d 7- 7` (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 39974 Date: 7/29/2015 Permission is hereby granted to: Clausen, Jeffrey & Clausen, Stacy 500 The Esplanade Southold, NY 11971 To: Interior alterations to an exsting single family dwelling as applied for.Replaced BP# 38626 At premises located at: 500 Esplanade, Southold SCTM # 473889 Sec/Block/Lot# 88.-6-13.51 Pursuant to application dated 7/29/2015 and approved by the Building Inspector. To expire on 1/27/2017. Fees: PERMIT RENEWAL $190.00 Total: $190.00 Buil pector So�ot� TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE V5 ' SOUTHOLD, 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#: 38626 Date: 1/14/2014 Permission is hereby granted to: Clausen, Jeffrey & Clausen, Stacy 500 The Esplanade Southold, NY 11971 To: Interior alterations to an exsting single family dwelling as applied for. At premises located at: 500 Esplanade, Southold SCTM # 473889 Sec/Block/Lot# 88.-6-13.51 Pursuant to application dated 12/30/2013 and approved by the Building Inspector. To expire on 7/16/2015. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $380.00 CO -ALTERATION TO DWELLING $50.00 Total: $430.00 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: I. 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. I ,Z/13/ Zv l 3 New Construction: Old or Pre-existing Building: (check one) Location of Property: 6to TVV_�- Soo—\AA U �-o House No. Street Hamlet Owner or Owners of Property: S, 4 Suffolk County Tax Map No 1000, Section U b Block Lot t °r qS 1 Subdivision MN9 0 r ANC- -1- Filed Map. q_12,I Lot: 4 Permit No. (i Date of Permit. Applicant: Q)cyAd'o :FE I L Elz Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ' Applicant Signature FIELD mSPEC Ql!REPORT DATE COMMENTS ( j i FOUNDATION(1ST) - --------------------------------- FOUNDATION(2ND) ROUGH FP AMIr1G& y PLUMBING INSUL•ATION PER N.Y. STATE ENERGY CODE Ji MAL ADDITIONAL COMMENTS -a�-6 a.- uol hElt 3gg7 r•ec-4i71©q &3SO o rn i 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 FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees _ C.O.Application E n E W E Flood Permit Examined C ,20_1 l� 1 I1) Single&Separate Storm-Water Assessment Form DEC 3 0 2013 Contact: Approved 20 111 1 Mail to: Ndo IF La 'L Disapproved a/c BLDG DEPT. pp TOWN OF SOUTHOLD Phone: 2-�i 9 s 54 Expiration ,20—V-57— Building Inspe APPLICATION FOR BUILDING PERMIT Date 'J® , 20 I 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 Pen-nit to the applicant. Such a pen-nit 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 pen-nit 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, ing code,and reg lations, and to admit authorized inspectors on premises and in building for necessary inspections. (Si nature of applicant or name,if a corporation) a his 16 1 2 I tm Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises J �� `� ` S r,,,k �Sl�� (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. I I�J G Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on-which proposed work will be done: . 560 TWEI � pu-,*`N 41-0 C 5o U t{D L House Number — Street , ; , Hamlet I� ilIS"kI$,,Ii 4 07� County Tax Map No. 1000 Section (OcLot i Subdivision M-P-0 f 1,06c3_ S+-IpAt5 Filed Map No. 9-7 2 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 15jidG Ir$ F-P^? i L4:_ j9W-b-t1ArJ b. Intended use and occupancy 1qjP1-M Z_ 3. Nature of work(check which applicable): New Building Addition Alteration 'X Repair Removal Demolition Other Work `` (Description) 4. Estimated Cost I a oz,,b Fee _ (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 d OE 6. If business, commercial or mixed occupancy, specify nature and-extent of each type of use. i 7. Dimensions of existing structures, if any: Front 1 _ Rear Depth Height 2Qa ` Number of Stories 2 Dimensions of same structure with alteration_ s or additions: Front , Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Zla -�-` Rear ( 3 Depth Height 10 ° Number of Stories I 9. Size of lot: Front-' ront' }JT Rear Jit) Depth 10. Date of Purchase IMO Name of Former Owner ZV M ca 11. Zone or use district in which premises are situated JN,C 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X 13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES NO N P algr1-4 S 007HLL:,-5sLqjO,ov 14. Names of Owner of premises aP05E_N Address .S �o Phone No. 65 r 39 Name of Architect Dooevn M%L"-- Address #A iv %MoeTnTLue— Phone No 2118 A 54S3 Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * 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 x * 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 k * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY Ok 'Da 01 v-w 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. Swo tqq before me this. V day of a '` 20 l �NYBED C)A, Notary Public,S Notary blit No.016E6099311 Signature of Applicant Qualified in'Suffolk County Commission Expires Sept.29,. LOT AREA = 41,089 Sq. Ft. o NOTE: MAXIMUM CLEARING'OF LOT-IS'LIMITED TO 57%. -9 "' V o ell tx 7, N' 5, 4x r OPEN SPACE T spa mr P� 'Y I 275.00' ± 1 7 PROP.DRIVEWAY to LLQ i• c� LLQ 5 -oma I o' L� 5 cf z �-- z r, tti LL 14.o y a N _j29 7' � _ 4Y4.1fJ 9. cB W Li � o N ` Lo 271-36' N. 60°04'58" W. LOT NUMBER 48 r' u u'7 s;-ct CESSPOOL, SEPTICa,9d VOTER SERVICE LOCATIONS ARE-BY OTRERS. 7-17-2001 FINAL SURVEY - 4-9-2001 FOUNDATION LOCATION T� • � �..i"'c�.Ca�x1 �'r��' L'r�*ST'F'Y:Ft n� —!`� , JOB NO. 00-354 FELE N0. ANGEL SHORES .i. *: '' ;.a s°'= f5n�K,K SURVEYED FOR JEFFERY S. a STACY ANN CLAUSEN ':H ALL CODES OF =Z ��� o1':r �,. NEW YORK STATE � TOWN CODES ,, + � �„ I �',� . PLUMBER CERTIFICATION AS REQUIRED "„e:. APPROVED ," NOT o ! ON LEAD CONTENT BEFORE �-�''r RO V D AS N T ED CERTIFICATE OF OCCUPANCY - LLD,.i " ! � ,.��,�,• .: �_„ DAT � B.P.#..�. u! 4 SOLDER USED IN WATER SOU T HULL i ;vtiN PLA��1�i,BOARD � 6 FEE:SgpPL�SYSTE&f-1--tN - - - -6t")iiiuri'tT(WtkilTP 1Q7C:Q ; NOTIF BUIG 'DEPARTMENT AT v� � G� ' I E,CEED:2I1 a OF 1%v LEA �' 65-1802 8 A�� TO 4 Pik FOR THE 1�.Y.S.DECGcC FOLLOWING !NSPECT!ONS: Q 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE I� G �i'� G I�LJ N p�`� 2. ROUGH - FRAMING & PLUM1B!NG d 3. INSULATION - G� '`� ('+ tac,asl q 4. FINAL - CONSTRUCTICN MUST BE COMPLETE FOR C.O., " r r� 4! ALL CONSTRUCTION SHALL MEET THE :_:4, ?� — _ =—•- -- --�- :-_-��__«�« - - REQUIREMENTS OF THE CODES OF NEWCD ,. Y z YORK STATE. NOT RESPONSIBLE FOR o> _- o / �' •__- r - , DESIGN OR CONSTRUCTION ERRORS. _ ; PLU ? o c MBING -. ,1 ALL PLUMBING WASTE L- v �jl� E t�1 , , / ` ' 00 _� TE &WATER LINES NEED ,C+ n ENEF2GY�QQE CQt,•PLIANCE 4 DKi, v STING BEFORE COVERING i �" �i N: All construction to conform to the 2010 p z I i FF.•: Energy Conservation Code of NY State - ` / I ` ` \ -- cut`✓�-c h - Project to comply with Section 101 4,3. Q Exception 3: Alterations, renovations or N repair to roof/ceiling, wnli or floor cavities ---- L-- f - - �- which are N - � ! - ---------------_--__� � -.�l-_-- , �r;rY�i.�x - ich insulated to full depth with — t NE�J �t(Y�F.• �W�t WiFy:,Tt�% '} 7' y � , ,�, = to erf � insulation having a minimal nominal value ![ ? • .- .- ���t�tC. of R-3 0/inch. t ! ! • `- WF T i - s•,. t Component Required Providc �� WallIrjd F ' Ceiling r -1•FQ Floor r. R -3 f, D -Gt, �.a t t.-t-... Fenestration V -.35 V . -5 To the best of my kncwledge, belief and d professional judgment, these plans are CJ e with s co 00CUPAN, OR LLJ X00 r\, USE IS U L FOL f � G �l�t�', QI�PAti� O 4L- 11 I `7 , l C��w 7�`•f [�. ice_.! C�•t'L,Y--,1 -•tom Y.-•� 7' , y l��'":,1/�+:. X C (,T O CJ `i D 1 •�' jl �Y F-f"• "r -i. L-r. tT�.i�1 i �' i �n� : .-, k" - i ----I__— __,�' `:.ry>l3i•�- � 1��.,;� c ,.; 't -..Ili � na � L �� I ; ; tti Elf Cu y ` C•r-. t77; ,rrr' ',', s~`✓ - n , , L� ) Lots! -E • _+ LES . -- - -- - - - +— 3O E`t+5�"• vel F� .I r•h:,.;c N r�E-�7i^�=, T , f ------ �?�.� �'., r.-.(� r ' � � � '� � i I I - ! -- �.•1 t G'r`•�`.1u )�.'b!'��'�� ,' --- - - t <i� -'`;1JGia.1"•1.�.^�io`"/a, f'1, j 1 I J �L� ✓t F C J , J t � �A r 11y � � T r-�... '•1 ! 1 � x 0. _ 1 CJ • f I J I 1- 2 I ��M�.�•"'E::.''�; � �..__ 'Sia�t•:,- c.� =,�.r•o <, 'rrt': � '�-J. �-- — __ — __ _- - - G GF� TOtt L.. ��+�►N�jS