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Home My WebLink About40775-Z ��q�gU�FQI,I-cow Town of Southold 10/17/2016 o P.O.Box 1179 v' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38594 Date: 10/17/2016 THIS CERTIFIES that the building DECK Location of Property: 515 Crown Land Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 109.-2-12.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/10/2016 pursuant to which Building Permit No. 40775 dated 6/14/2016 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 Lombardi Giuliano Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 0' Ohood Signature ' TOWN OF SOUTHOLD �guFFot�-�o BUILDING DEPARTMENT a TOWN CLERK'S OFFICE o ® 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#: 40775 Date: 6/14/2016 Permission is hereby granted to: Lombardi Giuliano Trust 218-49 Sawyer Ave Queens Village, NY 11427 To: resconstruct an existing deck as applied for. At premises located at: 515 Crown Land Ln, Cutchogue SCTM # 473889 Sec/Block/Lot# 109.-2-12.3 Pursuant to application dated 6/10/2016 and approved by the Building Inspector. To expire on 12/14/2017. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $358.40 CO -ALTERATION TO DWELLING $50.00 Total: $408.40 QBuiling 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-T25 - 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 pec k Date. New Construction: Old or Pre-existing ding: (check one) Location of Property: S�-sr eptigm Uh of b* e Cv�C4 I �-e l V o/ House No. Street Hamlet Owner or Owners of Property: 6,,%1 /"1 Q^ZdW; Z gf Suffolk County Tax Map No 1000, Section J®! Block Lot 12- S Subdivision CO IVIV L4 V C�/�/ s= Filed Map. Lot: 3 Permit No. 40] '1 5 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �j V ApphcLf Signature pF SO!/l�o! eou�v,��' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION VOUNDATION 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 VIOLATION [ ] CAULKING REMARKS: DATE (o INSPECTOR OF SOU cou �o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 (r,)o, INSPECTION l FOUNDATION IST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)- [ ] CODE VIOLATI0 [ ] CAULKING REMARKS: . DATE ®� ® O -INSPECTOR- FSO �� ho��0 Ulyolo cou TOWN OF SOUTHOLD BUILDING DEPT. 765-1602 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ` '@ DATE 401-2101' Z6 INSPECTOR oFso�Tyo uMr N TOWN OF SOUTHOLD BUILDING DEPT. 7654 802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ �ODATION 2ND [ ] INSULATION [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE �� INSPECTOR c� k4 o v� . G • 0 comm, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATI 1ST [ ] ROUGH PLEIGe [ ] FO ATION 2ND [ ] INSULATION [ RAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESIS T PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELE RICAL (FINAL) REMARKS: �r tiv (� DATE Ip INSPECTOR �o �o o�yQuo, � TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION .`- I FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] 1PMULATION ` [ ] FRAMING / STRAPPING [ FINAL 4,6i�'-tOV [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: ill/ iS(0 v- . dAF l DATE �� tuC t , INSPECTO /�i�_1 1 ' : 0 61'•� / b 1 !� w �II�-�_%a=im /� =.:=•��:� � f • ' m f � , • 0 w u n L TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENTDo 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 Flood Permit Examined ,20 Single&Separate —Storm-Water Assessment Fonn Contact: Approved ,20 Mail to: Disapproved a/c Phone: f —" G f 7 7 Expiration 1 \ '20 0 ild' g Inspect4 ICATION FOR BUILDING PERMIT 9Date , 20 INSTRUCTIONS a. Thi .� NpOopaRnnosca�rWmpletely filled in by.t'pewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accura e.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) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises /y� p`�'6 �0^k e-/s �`' ,y r (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer �, , . „ (Name and title of'corp'orate.,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: / > X'/!' pV A/;7 &0A d ' "I e Cy�Chy 9�l Jv/ House Number Street Hamlet County Tax Map No. 1000 Section �® Block Lot ��3 r 41f 1Q Subdivision CR#k,'-IV LMAL Filed Map No. G Z��Lot 2. State existing use and occupancy of premises and intended use apd occupancy of proposed construction: a. Existing use and occupancy ' b. Intended use and occupanc d2(Ctu 3. Nature of work (check which applicable): New Building Addition b4d' Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Numbe7s, le � .; 8. Dimensions of entire new construction: Front Rear i Depth III 4 Height Number of Stories ' 9. Size of lot: Front Rear Depth 10. Date of Purchase 'Name of Former Owner 'o14u 1ff W.Fn;Brio KIVOT 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone 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 ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, COPJNIE D.BUNCH Notary Public,State of New York (S)He is the No.01 BU6185050 (Contractor,Agent, Corporate Officer, etc.) Ouaftd in Suffolk County Commission Expires April 14,2Q:o 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. Sword to before me this / day ofVL 20 Notary Public Signature of Applicant amu,�c�, Scott A. Russell '9 R, ��_i_' S�C'(�)]E��J[��v A��C'�EaE� SUPERVISOR to } IWA\N A\(G IEAWIEN T f � SOUTHOLD TOWN HALL-P.O.Box 1179 p S 53095 Main Road-SOUTHOLD,NEW YORK 11971 if, Y1 � Town of So u th o l d CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOLES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) El 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. ❑ . 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. ElE. Site preparation within the one-hundred-year floodplain as depicted - - -on-"FIRM- --Map-of-any wate-r-cou-r-se:= - -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. S.C.T.M. 1000 Date. APPLICANT_ (Property Owner,Design ProfessioLn/'I,Agent.Contractor,Other) �1/� D nct z NAME 0 �y//ih vSecUoi�i Block �Lot .n°.n,. p ` FOR B4_1LD1\G DEPAUNMEtU"7- 1.ti,: C}NL`t' Contact Informationo. TclryluM<i uintiti �f/7� Previewed By: Date Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — — .S` wn L�� L�� e Approved for processing Building Permit. jWU7 Stormwater Management Control Plan Not Required n4c A ly 'q (�e Stormwater Management Control Plan i�Required (Forward to Engineering Department for Review) FORM " SMCP-TOS MAY 2014 ••�l •,r l. n�r-1[l�� H.S. NO. OWNER: � 7�J�--'1•t'ti..Lr G t �_ � f..i rtit�if-�, tl, CSV��' .�;1 - !AR �' DEED: tz rl, 519 s.- - - - - � SCALE •"�� '� .- �� I��'' 7�y;'. �- 1✓OyL Sit� , j - - � fl�«""':..t••+w� t'7,�'R,. ,r. jl♦q%l1�IMORS2ID ALTESfalilJrl�R�fJWiKAI CO&Z SUtVEY IS A 3AOLA71ON OF '[ECIION 7209 OF THE NEW YOrA STATI ' C U'iTATJOM-LAW. CWFJES OF IHIS 3',Jtliv JQdr;;:Or ai�.run M LAM SUjtwyowS PAM SEtir Or J UE:/aAL SH14il-CT--C•LN•_RorM �( c�•J U-A lAwo i+c` f. • r� 7 r ,m%.7lm-EZt ltiel:a- vf3_ v .tta r. y' _ M��yYY TO IEk Fc'.Sv"r. ?-� k Tw-. ,.P fi.VA-Xt . 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