HomeMy WebLinkAbout40291-Z ��sY•aZ�a�
gUFFotKeOG Town of Southold 6/19/2017
y� P.O.Box 1179
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_ 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39022 Date: 6/19/2017
THIS CERTIFIES that the building DECK
Location of Property: 30580 Route 25, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 103.-1-7
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. 40291 dated 11/23/2015
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:
DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Episcopal Methodist Chrch
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Chod, Signature
TOWN OF,SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 40291 Date: 11/23/2015
Permission is hereby granted to:
Episcopal Methodist Chrch
PO BOX 1286
Cutchogue, NY 11935
To: construct a deck/ramp additiont to an existing single family dwelling as applied for.
F
At premises located at:
30580 Route 25, Cutchogue
SCTM # 473889
Sec/Block/Lot# 103.-1-7
Pursuant to application dated 11/18/2015 and approved by the Building Inspector.
To expire on 5/24/2017.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $276.80
CO -ADDITION TO DWELLING $50.00
Total: $326.80
Building In pecto
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
Date.
New Construction: Old or Pre-existing Building: V (check one)
Location of Property: �0 590 Main RJ . Cud c f oq U-2,
House No. Street Ha et
Owner or Owners of Property: maS Moi c Leo J
Suffolk County Tax Map No 1000, Section 1 0 3 Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 6b I1V
Applicant Signature
�O��OF SOUjy�lo
eOUNi`4,�
`AWN- OF -SOUTHOLD BUILDING DEPT.,
765-1802
INSPECTION
[ FOUNDATION IST [ ] 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: ®�
s
DATE l�`� INSPECTOR "�
i
OF SOUTy�
�1y00UNTI,N
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] IN LATION
[ MING /STRAPPING 1=
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOL ATIO [ ] CAULKING
REMARKS:
DATE O� �� /� INSPECTOR
SOUIyo
- - -- - --- --- ------ ----------
� o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECT10"' N
L ] FOUNDATION 1ST [ ] ROUGH PLEIG.
L ] FOUNDATION 2ND [ ] SULATION
L ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: (2vvc-A o
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DATE `l2 INSPECTOR
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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) 765-9502 Survey
South oldTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 1 /_,20 / - - J ' , Single&Separate
. l Storm-Water Assessment Form
C Contact:
Approved ,20 ' I -
Disapproved a/c L „' ,' I �.
- ------- Phone:
Expiration Z ,20�
7
B pe or
APPLICATION FOR BUILDIN T
Date /kl o VE,/11 /�, / , 20 /S
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. ` U
(Signature of applicant or name,if a corporation)
gv U
23—� CACk o U e K V� �
(Mailing addressl of applican.
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 License No.
1. Location of land on which proposed work will be done:
,a ?0 K QW\ 2Lk. C�_ktcA� 04ice �� a
House Number Street Hamlet
County Tax Map No. 1000 Section f
��, ,Block''�' Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and inten d use a d occupancy of proposed construction:
a. Existing use and occupancy 1 In f_ I 1 P_� 1(� 1V1 (`.e
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition < b her Work :j C��
_ (Description)
4. Estimated Cost - �- ,o Qo , 0 C) 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 Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
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 OFj&AK j
Thornq5 Ma c Lea-4 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.
Sworn to before me this
)9 day of NO V-eryh-c r- 2015 TRACEY L. DWYER Ax
NOTARY PUBLIC,STATE OF NEW YORK x A �-A
NO.01 DW630690'
Notary Public QUALIFIED IN SUFFOLK COUNTY Signature of Applicant
COMMISSION EXPIRES JUNE 30,2016
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Scott A. Russell ��a ,;�� STORNMA T]ER
SUPERVISORI��1CA\1�A(G�]EI\\I[]EN`]F
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of So u th o l d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY ®1F THE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
[]n,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.
❑ C. 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.
❑Q_E. Site preparation within the one-hundred-year floodplain as depicted
- on-FIRM--M-ap- of any watercourse.
EjaF. Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more,-urlless 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- (Property Owner,Design Professional,Agent Contractor,Other) S.C.T.M. #: 1000 Date.
i DOrict �
NAME. Y�1!J1� lv J Q�7 I, 007 11—IO�i 1
w„nl Section Block Lot
4,Sn71�,1 J ,4:,.., FOR Bt ILD1\t;, DEPr�I' DIi;VT E
LSI: ON ' .<<,
Contact Information. &,31 - 1 �4' (p6 3
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Reviewed By.
D to
Property Address /Location of Construction Work: — — — — — — — — — — — — — — — —
Approved for proceaz)ing Building Permit
Stormwater 1Vlanagement Control Plan Not Required
® Stormwater Management Control Plan iz,Required
(Forward to Engineering Department for Review)
FORM " SMCP-TOS MAY 2014
SURVEY OF PROPERTY
NORTH FORK METHODIST CHURCH
O SITUATE
CUTCHOGUE,TOWN OFSOUTHOLD
SUFFOLK COUNTY,NEW YORK
0 oryw�o. Suffolk Tax Map No.•1000-103-01-007
O' DATE SURVEYED•4/1/2o1S
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GUARANTEED TO:
North Fork United Methodist Church
Abstracts Incorporated
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16, SFA&IS A UNOMy OF SECTION 7205,SUB-ONSION E,OF NEW YORK STATE CIDUOGENUINE
CH IAW,
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CORRECT COPIES OF THE SURVEYM'S OUR— WORK AND MAT T
9 S CER CE WITH
ON THIS BOUNDARY sURVEY O SIGNIFY THAI THE S PREPAR ADOPTED
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NEWAZZ*RDWMCE VRM THE CURRENT EPRCFEC CODE OF PRACTICE FOR WCD SURVEYS F.TK)D BY ME
rrJ NEW YORK STAT[A55(A:IACOX OF PRCTES510NN LMD 9JRUEYORS.PIC THE cERDFIGimN IS UMRED
\J� TO PER FOR WHOM THE DOUNMRY SUMEY YAP 5 PREPARED,t0 i1K 11IEE AVY.TO THC
// _ a GOVERNMENT&AGENCY,AND TO THE LENMNG INSTRURON LISTED ON NtlS OOUNMM JJRW L44P
4,ME CERTIFICATIONS HEREIN ME NOT TRANSFERAOL[
5 ME LDCATNDN OF UNCERGRWND INPRDLI NIS OR FNCPPRCIIMEMS ME NOT ALWAYS MOWN AND
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FOR A SPECIFIC WRPOSE MD USE AND THEREFORE ME NOT IMEHEM TO GUIDE ME ENEc RON OF
FOR—RETAINING WALLS POOLS,PATRIS PLANTING AREAS,ADORRONS TO—DINGS,AND ANY DRIER
TWE OF CONSTRUCTION
T PROPEL CORNER MONUMENTS WERE NOT SET M PART OF MIS S—V,,
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TYPICAL DECK WIND UPLIFT REQUIREMENTS JAPR 'l"rE�ja�� ;'�� ; '
DATE: � 8
FEED gY
NOTIFY EUiL��I^J', DEFF APlUfENT
HEADER GIRDER C❑NNECTIONSt ' USE THE FOLL❑WING USP BRAND OR APPROVED EQUAL GALVINIZED765-1802 g AIS TO 4 R%ll FOR THE
DECK HEADER UPLIF METAL CONNECTORS WITH THE RECOMENDED FASTNERS AND FOLLOWING INSPECTIONS:
INSTALLATION BY MANUFACTURE.
SPAN SPAN lbs. ` 1. FOUNDATION - TWO REQUIRED
6' 1408 PRODUCT UPLIFT GALV. MINIMUM FOR POURED CONCRETE
NUMBER DESCRIPTI❑N lbs. FASTNER REQUIRED 2• ROUGH - FRA vIIN3 & r'LUMCING
20' 8' 1878 3. INSULATION
10' 2347 PBS44 4x4 1815 POSTt (12) 16d COM. NAIL 4. FINAL - CONSTRUCTION MUST
12' 2817 POST CAP BEAM, (12) 16d COM. NAIL BE COMPLETE FOR C.O.
6' 1859 PBSE44 4x4 1430 POST, (8) 16d COM. NAIL ALL CONSTRUCTION SHALL MEET THE
28' 8' 2479 END POST CAP BEAM, (8) 16d COM. NAIL REQUIREMENTS OF THE CODES OF NEW
10' 3098 BEAM/GIRDER, (2) 5/8' BOLTS YORK STATE. NOT HESPONSIBLE FOR
12' 3718 KC44 4x4 COLUMN CA 3265 POST/COLUMN, (2) 5/8' DIA. BOLT SDESIGN OR CONSTRUCTION ERRORS.
6' 2310
36' 8' 3081
10' 3851PAU44 POST ANCHOR 2240 D FOO
/GIRDER,R(12) 816d'C❑MM❑NRNAI❑ )3CCUPANCY OR
12' 4621
4x4 WET POST ANCHOR USE 6 UNLAWFUL
CBE44 COLUMN BASE 3585 POST/GIRDER, (2) 1/2' DIA. BOLT
ITHUT CERTIFICATE
UPLIFT CONNECTIONS FOR, KCB44 4x4 5650 WET POST ANCHOR
JOISTS-TO-GIRDER / HEADER COLUMN BASE POST/GIRDER, (2) 5/8 DIA. BOLTS F OCCUPANCY
� DECK CONNECTION MIN. 8d NAIL
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6x6 POST, (12) 16d COM. NAIL RETAIL STOWWATER RUNOFF� SPAN CAPACITY REQUIRED PBS66 POST CAP- 1815 BEAM: (12) 16d COM, NAIL ��
PURSUANT TO CHPIPTER 236
.0 12' 427 lbs. 4 I PBSE66 6x6 - 1430 POST, (8) 16d COM. NAIL OF THE TOWN CODE.
16' 526 lbs. 5 END POST CAP BEAM, (8) 16d COM, NAIL
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a® � 20' 626 lbs. 5 KCC66 6x6 5225 BEAM/GIRDER, (2) 5/8' BOLTS
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L_- - -_ 24 726 tbs. 6 Q - _ ' ���
COLUMN CAP P❑ST/COLUMN, (4) 5/8' DIA. B L S" "'' F ' ' " Cc
III=III=III=III=III=III=III=III=III=III=III III=III=III 28' s26 lbs, 7qg� q,p�•� �o
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TYPICAL DECK 32 927 lbs. 8 PAU66 6x6 2350 FOOTING/PIER: 5/8-x7' ANCHOR BO
N.T.S.
36' 770 lbs, 7 POST ANCHOR POST/GIRDER, (12) 16d COMMON
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CBE-66 6x6 3570 WET POST ANCHOR �t ,
_ COLUMN BASE - POST/GIRDER: (2) 1/2 DIA. BOLT
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- KCB66 6x6 5640 WET POST ANCHOR � • � •< • - 1aS
COLUMN BASE POST/GIRDER: (2) 5/8' DIA. BOLTS_
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RT10 TY-DOWN 585 JOIST, (6)8d COMMON NAILS
ANCHOR HEADER/GIRDER, (6) 8d COMMON NAI-S
ALT. , 1 TY-DOWN J❑IST: (9) 10x1-1/2 NAILS
RT20 ANCHOR 1105 HEADER/GIRDER: (4) 10d COMMON NAI S 1000-1-03-01-007
INSTALLATION NOTES, B. C• '
1). ALL POSTS TO BE ANCHORED TO F❑❑TING OR PIER W�TH PAST NC �•��,� -py a� 7H ; -ST CH_URCCH
2), HEADER & GIRDER CONNECTIONS TO BE ATTACHED TO EACH POST WIT- �,�-'� r-;4 15 �•p C t=l
3). EACH J❑IST TO BE ANCHORED TO GIRDER OR HEAIWTr! �r?Wt� SF! �a' �
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