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Home My WebLink About41858-Z foq,a�� Town of Southold 11/6/2017 P.O.Box 1179 a' 53095 Main Rd �p Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39329 Date: 11/6/2017 THIS CERTIFIES that the building SHED Location of Property: 255 Dogwood Lane Ext, East Marion SCTM#: 473889 Sec/Block/Lot: 37.-1-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/1/2017 pursuant to which Building Permit No. 41858 dated 8/4/2017 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 Holuka,Arthur of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 009 ignature TOWN OF SOUTHOLD ��guFFot�-�� BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • Jw 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#: 41858 Date: 8/4/2017 Permission is hereby granted to: Holuka, Arthur 33-17 162nd St Flushing, NY 11358 To: consturct an accessory shed as applied for. At premises located at: 255 Dogwood Lane Ext, East Marion SCTM # 473889 Sec/Block/Lot# 37.-1-9 Pursuant to application dated 8/1/2017 and approved by the Building Inspector. To expire on 2/3/2019. Fees: ACCESSORY $148.00 CO -ACCESSORY BUILDING $50.00 Total: $198.00 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: 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 D�, Date. �II New Construction: Old or Pre-existing Building: (check one) Location of Properr�l -Doqu House No. Street Hamlet Owner or Owners of Prope 0 J Suffolk County Tax Map No 1000, Section 3 Block I Lot q Subdivision Filed Map. Lot: Permit No. IflDate of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicddt Signature fg � SOF SOUry �o� olo coUMV,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 1t l7 LZ DATE 7 INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) y o -------------------------------------- FOUNDATION(2ND) LAO ROUGH FRAMING& t� y PLUMBING J INSULATION PER N.Y. y STATE ENERGY CODE FIN FINAL s ADDITIONAL COMMENTS 0 Z X Q y O d b H 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 Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate Truss Identification Form Storm-Water Assessment Form ontact: Approved 20 Mail to: Disapproved a/c ' Phone: Expiration 12-- � DDBuilding Inspect AUG - 1 2017 APPLICATION FOR BUILDING PERMIT BUILDING IDEM Date , 20 TOWN OF SOUTHOLD 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. (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 F Name of owner of premises /nrr-tilt vd` F' /U (As on ge 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 pro osed work will be done: House Numbe Q Street Hamlet �1 County Tax Map No. 1000 Section V "'$ 'Block`'`y !'t �Q : A Lot 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 b 1 itended use and occupancy &. dr- .� a 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work _ (Description) 4. Estimated Cost Fee (To be paid on filing this applieation) 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 ;=->r.�.`} i Rear,-,, Depth Height Number of5'St6rjies•,l �V t i 43 8. Dimensions of entire new construction: Front Rear .,_ ,Depth `. ? Height Number of Stories 9. Size of lot: Front Rear Depth .r v.. 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. 915 Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * F 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) COUNTY 0s , . 1410_77� /� l (� � � 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. Swornn.o before me this =dayof 20 CEY L. DWY Notary Pu lic (NOTARY PUBLIC,STATE OF NE Signature of Applicant NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2j2j$ ti alp i� G, O�Jl\��1\�v A\�l JE K Scott A. Russell ST§-� ; , .� �� (G()EI��J[�E��C' SUPERVISOR r„ f ,� 'I_L �� A- A SOUTHOLD TOWN HALL-P-O.Box 1179 Town of Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE E F OLLOWING: (CHECK ALL THAT APPLY) Yes No ❑ 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 parcel or an within any p Y 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. ❑ E. Site preparation within the one-hundred-year floodplain as depicted p---of---any-w-a#-e->=c--ou-se:------- ❑[P 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 Tag 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.0-T.M. *: 1000 Date_ APPLICANT_ (Property Ow r gy Professional,Agent.Contractor,Other) District 12 h1l NAME (I (J s - ---1— i Section Block Lot r0 -NT USE UtiLI Contact Informatiorx / W ` 1� Reviewed By: - - — — — — — — — — — — — — — — — — Date: l� Property Address / Location of Construction Work- 5 ork 5 Approved for processing Building Permit. — — — Stormwater Management Control Plan Not Required. �jC9?� ( 9� ❑ Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM ° SMCP -TOS MAY 2014 •z .. , 8.442 SQ. FT84 f S 'u j. FD `91ji 1,p .' ti © PIPE (31.1) �� ' 44/A tl��Fjp © FD 7,70 MON 66 0 J0 (29.6) FD end. MON 0) 4 (3o.e� Om W U (31.0)• 18,8 vi 8 (/) cn � rn c 0 Z `Z FC O 7.5 (30.3) O O w 0.4'S F(30.3 9.5 15.6' J a o 18.3 111 O cSTY STY {° gar 1_1©WELL 15.4' � W 28.E (29.7) (3010 rn O 0.7'S Z C m FFL ELEV=42.2 cu C GAR ELm 29.7 CmD WV Z : 4'3 oD to .. m -Iu FD. NOT E: PIPE Loco£ion of-water,mains k ad3ainers water supply' (25.6) 13r by pthere ond'ore not guaranteed. }�'Y 00 ' C''r CD 6 rad (J� ,(22.9) (22:3) P PE 044 APPROXIl�AT ' .>....�.. / ;..".i. ..";�•syytA�,.'v'.'x.:.r,�...,,t�:.. ••7, dip. T. bB<:;t :-1CIf-17 t �„rFIIE eNo: C DINER'S BAY ESTS. ., rf �Qf',1„�,`�' mom CS}:la+SltllCZi W1 x r,s,^ t :e:rsb s - • ".Pirrrrtttca?.ids:;:!u?��nR?+':�o.vBiitt.�?�tas�OR�1u�r' i• � , . ^r, ;: ,.�- - =5��.��t3;�FLQR`"I;�RT}�►t1R's`k'I{)L:l3ICA - ^r. ,:.Ir r.e..'••fr "`°i'ak{P:z4 ..ht°i <,. .• .;. s.i .. •. �'T, ' ,ur'amia"t"z�otwt:�,i�fli:!.�ai•'�namanimi t�,isv�i's�'r=a.n��oii►�ta�;: °`�'§�,',... �.I.C1T�"N �8��;�95�*9,$,` °-' +';�. r .. ,t �:. :.1��t':�'�f'.fk°>p'. •s i• 1 `�'- a +isr:N; �iI("«l?t11t{ll),ss3si4Ay. ESTATES, SEC. a =lcciaty°r�amct►`•stitai:�ur"'troy,tont=:: FM' t: ifltED'Al`> EAST MARIC}N 'StlRV�Y`-S'.[+tPt llNb.tttdcti ': #iliLPiTriCl. ik�PlW1'G• NO «. 'K�lCY Altd'.L�?tifi tis IS,[tRlCt zuSi ';t :: ?.So° 'l f aliE,, rLEtiRvO`'IrLa�riui�atr;a;crcu tip sit 'xpt:rttu± 'tri'i a I;+ri4� rci�r 1b141I OF SOUTHOLD 'OR.SU&SEnIIETdf^�tf1YNEti'3.'�"` .' ' ;QFa1NiSa5URl+FY'UAi?;Piai,SEW4 tHE tAND• Y . ,p iEb•�EAL SCALE 1° 3D' DATE 8-12-2010 'Ei a _sJiu"moi None MNSIDM m At+�vr�a ntu� FILED A+IAP No. 275 DATE 9-23-1927 CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-37-1-9 DISK 2010 HAROLD F. TRANCHON JR.-P.C. LAND SURV EY O R P.O. BOX 616 ,rP 1866 WADING RIVER—MANOR RD. WADING RIVER, f . �k - NEW Y ORK, 11792 N.Y. LIC. No. 046992 631-923-- 695 HA, 13LD F. TA NCHON JR. PENN, LIC. No. 2115—E VEDASNOTED APP clo�llil"r)L"Jl VVI-TH ALL CODES OF DATE: B P.# NEVV YORK STAfl- &TOWN CODES FEE. BY. ONS OF 0.0 AS REQUIRED ACONDITI -212 AND . Y BUILDINC, DEp,-%RTMFNT AT I-,UN Q TOWN 7BA NOTIFY 4 PNI FOR THE ----------- 765-1802 8 AM TO FOLLOWING INSPECTIONS: ----------- 1. FOUNDATION - TWO REQUIRED FOR,POURED CONCRETE 2. ROUGH - FRAMING--& PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C-O. STORM WATER ALL CONSTRUCTION SHALL MEET THE To CQDETERREQUIREMENTS OF THE CODES OF NEW DURS1 TOWN 236 YORK STATE. NOT RESPONSIBLE FOR OF THE DESIGN OR CONSTRUCTION ERRORS. Jv ICUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY m r ' JIM DEERKOSKI.PE phone (631)288-7116 REAR ELEVATION FRONT ELEVATION -—-—-—-—-—-— SCALE-1/4""1'-0" SCALE-114".1'-0" I� 6 ]X4 GUSSETED ROOF TRUSSES ®16°OC ]%4 RAFTER p 16-OC SIMPSON HI IR'SHTG RAFTER TIE DOWN EACH RAFTER SIMPSON LSTA1] HEADER•STUD STRAP 4 EACH SIDE O CO 2X4 STUD WALL V 916°OC Q TI 11 SHTG [Ell Ell W W 5/8'SUEFLOOR 4X4 ACQ GRADE A SECTION A-A LEFT ELEVATION RIGHT ELEVATION `�V• O1�, I I SCALE 3/8"•1'-0" SCALE-114"•1'-0" SCALE,1/4".I'-0" O 1� z TTUD WALL i e•PLT Hr 11 I` II]xaAcdl,misroc H "I , i n r rim Q _m9 41]PITCH hQ , I;IiQ- DRAWN BY:JD � li it L_ _ _ — _ i 4/23/2017 10'!0,1 �. 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