HomeMy WebLinkAbout40715-Z F04tQG� Town of Southold 10/13/2016
P.O.Box 1179
53095 MaimRd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38579 Date: 10/13/2016
THIS CERTIFIES that the building DECK
Location of Property: 395 Kouros Rd.,New Suffolk
SCTM#: 473889 Sec/Block/Lot: 117.-6-11.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/17/2016 pursuant to which Building Permit No. 40715 dated 5/24/2016
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:
DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Foschi,Olivia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
t o ' ed Signature
SSU of ��c TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y s TOWN CLERK'S OFFICE
wp . 4 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#: 40715 Date: 5/24/2016
Permission is hereby granted to:
Foschi, Olivia
PO BOX 119
New Suffolk, NY 11956
To: construct a deck addition to an existing single family dwelling as applied for.
At premises located-at:
395 Kouros Rd., New Suffolk
SCTM # 473889
Sec/Block/Lot# 117.-6-11.1
Pursuant to application dated 5/17/2016 and approved by the Building Inspector.
To expire on 11/23/2017.
Fees:
CO -ADDITION TO DWELLING $50.00
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $326:00
Total: $376.00
Buildingnspector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN FALL
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. MQL4 A,, 24>16
New Construction: Old or Pre-existing Building: (check one)
Location of Property:
House No. Street Hamlet
Owner or Owners of Property: Jck__I �
Suffolk County Tax Map No 1000, Section JJ Z Block Lot
Subdivision ` / — Filed Map. — Lot:
c
Permit No. `1 d_7( Date of Permit. Applicant: N", m
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificat4Ap�;�aant
✓ (check e)
Fee Submitted: $
Signature
OF SO(/T�OI
COUMV,Oc�
.TOWN OF SOUTHOLD BUILDING- DEPT.
765-1802
INSPECTION
[ FOUNDATION 1 ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATIOP ] CAULKING
REMARKS:
DATE INSPECTOR-/ '
V OF SO(/r�o
N o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] I ULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
It
REMARKS: ��� (%I i, 4-pm AnA I" zj
''CiP� i,5 l ttJ�✓ �Y"�
Ani i
DATE �� INSPECTOR
ho��OE SOUTyolo
H �O
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] RO GH PLEIG.
[ ] FOUNDATION 2ND [ ] SOLATION
[ ] FRAMING / STRAPPING [ FINAL((l ,
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] EL CTRICAL (FINAL)
REMARKS: I Lb-Al-
DATE
IIL
DATE lO l INSPECTOR
• /C I
f
•
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
3VILDING DEPARTMENT Do you have or need the following,before applying?
II,OWN HALL Board of Health —
3OUTHOLD,NY 11971 4 sets of Building Plans ✓
ICEL: (631) 765-1502 Planning Board approval,
FAX: (631) 765-9502 �/ �Survey t/
9outholdTown.NorthFork.net PERMIT NO. ® 1' Check
Septic Form —
N.Y.S.D.E.C. ---
E:3 ----
��o V Trustees —
c-0.Application
Flood Permit
Examined 20 Single&Separate
MAY 17 1016 ti Storm-Water Assessment Form t/
lContact:
ABTJILDIN
pproved ,20 G D)�i r " Mail to:
Disapproved a/c 5Q LYJ---ObAel�IPJ rt►7.e>m
Phone:
Expiration 20
Spector
APPLICATION FOR BUILDING PERMIT
Date ,201
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 pemut
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,housin code,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
J,
( a
9tL ap icant or name,if a corporation)
4-)fr)w
.22,5235
(Mailing address of applit) )) 35
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises
(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-LicenW Np;-,
to
1. LocaticiA,,of.lai d,on'_which,proposed work will be done: I
6L) l
House Number Street Hamlet
County Tax Map No. 1000 Section 117 Block Q& Lot 11 d f
Subdivision Filed Map No. Lot
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy �I nq I& Qmi u
- E
b. Intended use and occupancy rY,
Nature of work(check which applicable): New Building Addition�� Alteration
Repair Removal Demolition Other Worker (Description)
Estimated Cost5, 11 Fees'-`�'
(Toj�e paid on filing this application)
If dwelling,number of dwelling units ( ') Nulriber`of dWeng�"units on each floor - -If garage, number of cars
If business, commercial or mixed occupancy, spegjfy�.nature and extent pf each type of use.
Dimensions of existing structures, if any: Front F Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front 5� pun Rear
Depth Height Number of Stories
3. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories -�
3. Size of lot: Front 66 ` Rear Depth
l0. Date of Purchase 21:215 Name of Former Owner
11.Zone or use district in-which premises are situated -�6
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NOS
13.Will lot be re-graded?YES NO%_Will excess fill be removed from premises?YES NO
Jai Kr�x��r,�►-
14.Names of Owner of premises 0)iyl,,51 fog!-,i Addres&T5" 6L Phone No.
Name of hone No 9a -k4
Name of Contractor Address Phone No. _
15 a. Is this property within 100 feet of a tidal wetland or a freshwater,,wetland? *YES NO y
* 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(��
being duly sworn, deposes and says that(s)he is the applicant
(Name ot individual signing contract) above named,
(S)He is the
(Contra or,Agent, rporate 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 t TR MPr&
performed in the manner set forth in the application filed therewith. NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
Sworn to}before me this 1 QUALIFIED IN SUFFOLK COUNTY
17 — day of H(,I 20I COMM SION EXPIRES JUNE 30,201 S
otaryC)NPublic ignature of Applicant
Scott A.. Russell STORMWATIER.,
SUPERVISOR N, MANAGIEMIENT
Z
SOUTHOLD TOWN HALL-P.O.Bo)i 1179
.53095 Main Road-'SOUTHOLD,NEW-YORK 11971 • Town of Southold
CHAPTER 236, - STORMWATER MANAGEMENT WORK'SHEET
( TOBE COMPLETED BY THE APPLICANT ),
DOES 'THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
Yes N6 (CHECK ALL THAT APPLY)
A. Clearing, grubbing, :grading•or stripping of land which affects more
than 5,000square fee ground surface.
, : groi
El Q B, Excavation or filling involving ,more, than 200 cubic yards,of material
:within any parcel or any-contiguous area..
E. Site,prepa-rat ion on slopes,which exceed 10-feet vertical- rise t&
100 feet of horizontal distance'.
D', Site preparation within 100 feet of wetlands, beach, bluff or coastal
'erosion hazard -area.,
01PE. Site preparation•within the,-one-hundred-year floodplain 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 appiova'l of a $tormwater Management,
Control Plan was received by the Town, and the proposal includes
in-kind-replacement of impervious surfaces.
If•Oii answered NO to all-of the questions above, STOP! -Complete the-Applicant section,below,mith your Name,
Slinatt!re, Contact Information, Date & County'Tax Map-Numbefl- Chapter 236 does not apply to your project.
If you�afiswcred YES to one-or-more of the above,pleak'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' 'S.C.T,.M. 1000 Date-
(Property Owner,Desi'gn Professional,Agent,Contractor,Other) District
-Z
I NAME- 11P6 All G
Section!• Block Lot
721'74 T -USE ONLY';FOR'BUILDING,I)EPAR MENT' A
RekpAonehi
Contact,lnformdti6.rL;
V
ReviewediBy: Ln-iJA
- - - - - - - - - - - - - - - - - -
: 15'�/ 7- /(e
Property Address/Location of Construction Work: ---- — — — — — — _Date_
Date— — — — — — — —
ka MApproved for,processing Building Permit.
i Stormwater Management Control Plan'Not Required.
'Stormw aterManaQement Control Plan is keqLpr6l
(Forward to Engineering Department for Review.)
JIL
FORM7#--SMCP--TOS MAY 26f4�-------
7- TOWN OF SOUTHOLD PROPERTY RECORD -CARD
OWNER STREET�q,5 VILLAGE DIST. SUB. LOT
5,
I vo At e,
L<
_FORMER OWNER M0 ;IN E ACR.
4SW TYPE OF BUILDING
RES. r, l SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
t
LAND IMP. TOTAL DATE REMARKS
f�117 q, Z-2
O 'Zon I
U,-7 we ( 0
41
L /o5
4r
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ql't 1 5-1 14
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD 5;-S
Meadowland DEPTH
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4•�...r o� ,e �4 3A3l .,xT�..D SITE DATA
DATE:S.IZYN F-,.P.>f-. Y /� N 51d 21' 50 w Q5.00' SCTM # 1000-117-06-11.1
NOT rY AT
PROPERTY: 395 KOUROS ROAD
765-18c:.- :,' -10 4 '''.? FOR THE
I'`! °cGT10"i S. NEW SUFFOLK, NY 11958
FOLLO'`
1. FOl i 'N - TWO I E01, RED
OWNER: JOEL KRETSCHMAN
FOF. 0,UF E:D CONCRETE
OLIVIA FOSCHI
2. R0'G,-i - FR!', ":.NG & PLUM2,!ING
NEW SUFFOLK, NY 11958
3. IP�.:aULATION
4. Fl-AL - COi,.';)TRUCTION MUST UJ
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SMALL MEET THE N �y SITE: 17,672 SQ. FT. - 0.405 AC. �
REQUIREMENTS OF THE CODES OF NEW n1 � AREA U 0
YORK STATE. NOT RESPONSIBLE FOR - T'
DESIGN OR CONS-1�WCTION ERRORS.
_ ZONING: R-40
SURVEYOR: JEROME D. AMARO, SURVEYOR Q uJ
Z
1265 SUNRISE HWY
,,.,f..„� O A HORE, NY 11705
OF
1\l C_.'a' `�'U:L` 1! i-Le i C�?� I`,! C00E a _
516 968-8480
AS F; CL�i; E ;'°.'< v �, . "�= -OF dJ LIC. NO. 037209uJ
A DATED: AUGUST 19, 1988
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