HomeMy WebLinkAbout41964-Z SUFFO4co�y Town of Southold 10/11/2017
0
P.O.Box 1179
53095 Main Rd
��5011 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39275 Date: 10/11/2017
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 29400 CR 48,Peconic
SCTM#: 473889 Sec/Block/Lot: 74.-4-2.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/7/2017 pursuant to which Building Permit No. 41964 dated 9/12/2017
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:
"AS BUILT"DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Ryan,William
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
t d Signature
S�FFna ., 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#: 41964 Date: 9/12/2017
Permission is hereby granted to:
Ryan, William
29400 CR 48
Peconic, NY 11958
To: legalize "as built" deck addition to existing single-family dwelling as applied for.
Additional certification may be required.
At premises located at:
29400 CR 48, Peconic
SCTM # 473889
Sec/Block/Lot# 74.-4-2.1
Pursuant to application dated 9/7/2017 and approved by the Building Inspector.
To expire on 3/14/2019.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $728.80
CO -ADDITION TO DWELLING $50.00
1 Total: $778.80
ildin2jpisfpector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPAR'T'MENT
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 l%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)nom-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
I. 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$15.00
Date._
New Construction: Old or Pre-existing Building: (check one)
Location of Property: `� -(�'� � ���
House No. Street Hamlet
Owner or Owners of Property: 12y
Suffolk County Tax Map No 1000,Section Block_ 4- Lot ,
Subdivision Filed Map. Lot:
Permit No. Date of Permit Applicant:
Health Dept.Approval: Underwriters Appro
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (chec she)
Fee Submitted:$
licant Signature —
OE SO(/lyo
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coUM`1,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL Ad gmm OW4-
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
Y �
DATE 0 INSPECTOR
FIELD DZSPEC. 0 nBpmr DAT=
.............. ............
�OUNDATZQN (2Nl5) \yam
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INSULATION PjBA N.Y.
STATE ENERGY COX)D
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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.
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 Form
Contact:
Approved 20LI Mail to:1—r`�p��°� /✓�� �%-
Disapproved a/c
Phone--- Z,7:tY?'!
Expiration
[EVEOV19 D
Bui ctor
SEP ® 7 2017 APPLICATION FOR BUILDING PERMIT
Date_0 106 20
INSTRUCTIONS
BUILDING DEFT•
PST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
ate p of p an 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.
orke.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 pernut 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,age architect, gineer,general contractor,electrician,plumber or builder
Name of owner of premises (�
(As on the 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. Loc t of land on ch rpos work will be ne: C_ r
House NumberHamlet !�
County Tax Map No. 1000 Section y
_Block 0 - Lot `/ r
Subdivision Filed Map No. Lot
2. State existing use and occupancy of prem esand' tended use and occupancy ofyro osed construction:
a. Existing use and occupancy — � i � i_7
b. Intended use and occupancy ��-
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work - 1 (✓_ j]Js C�4.
(Description)
4. Estimated Cost Fee
(To be paid on filing t 's application)
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage,number of cars
6. If busmes commercial or ed oofpancy,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:Fro��� r'-j`Rey Depth
10.Date of Purchase Name of Former Owner
11.Zone or use district in which premises are situatedI�Sf' I
12.Does proposed construction violate any zoning law,ordinance or regulation?YES NOX
13.Will lot be re-graded?YES NO4'Will excess fill be removed from premises?YES—XNO
14.Names of Owner of premises L Address Phone No.� e Mo .j
Name of Architect ltJ. 1--Z-Address Phone No =G Z-q-
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 BEREQUIRED.
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 dattaa 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 OF �(✓���,,��>d�����; �r
being duly swom,deposes and says that(s)he is the applicant
(Name of individual signing con act)above Aamed,
(S)He is thex 949 '
(Con rac oar,Agent,Co orate 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 m 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.
g2TARY
TRACEY L. DWYER
Sworntbefodamof 20 PUBLIC,STATE OF NEW YORK
01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
Public
Signature ofAppliMMISSIGN IRES JUNE 30,24
Scott A. Fussell
SUPERVISOR - MANA\(Gr1EM1EN`]F
SOU'I'HOLD TOWN HALL-P.O.Sox 1179 ® Town of Southold
53095 Main Road-SOUTHOLD,NEW YORK 114711
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
DOES THIS PROJECT' INVOLVE ANY of THE FOLI:.oWING-
KNECK 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 .
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.
❑ E. Site preparation within the one-hundred-year f loodplain as depicted
on-FIRM-Map-of-any-watercourse:-- -
❑i� 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 Cheek List Form to the Building Department rvitF your Building Permit Application.
S.C.TN. 1000 Date.
APPLICANT: (Property Owner, gfgrofessional,Agent,Contractor,Other) DLitrlct
z
NAME:
Section BY1 _k
Lot
,� `FOR BUILDING DP.PARTNIENT USE ONLY '44`
Contact Information: moi'
Reviewed B
Date:
Property Address/ Location of Construction Work:_ — — — — — — — a — — — — — — — —
Approved for processing Building Permit.
Stormwater Management Control Plan Not Required.
❑ Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review.)
FORM -- SMCP-TOS MAY 2014
z
ks� JNAUTHOa1ZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
t SECTION 72D9 OF THE NEW YORK STATE
N S�,y EDUCATION LAW.
7 ��1��•1/1��� IelE1D 1N01 C�}' �'
COPIES OF THIS SURVEY MAP NOT BEARING
THE Lc t-D SU L SHALL N:,,D 5_At SI
EMBOSSED SEAL SHALL P::.T EL CONSIDERED
-.,TO BE A VALID r uE COPY.
GUARAAlTUS .NDICAT,D H:P,EOV SHALL RUN
ONLY TO 7H2-PimA(N FOR%'/,,-CM THE SURVEY
15 PREFACED,A:.D O."NII L:iALF TO THE
TITLE COMPANY. GOVS Qi,cR'Ai.AGtNCY AND
LENDING INSTITUTION L STtD h.6_O i;AND
4'. ..
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION.GUARANTEES Arc NOT Ta(ANSFiRABLE +\
TO ADDITIONAL INSi1TUTIONS OR SUBSEQUENT
OWNERS.
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FOUNDATION PLAN
SCALE: .1/4" = 1'
Eul
APPROVED AS NOTED OCCUPANCY OR
DATE: B.P. .,.1' USE IS UNLAWFUL v1
BY: O
NOTIFY BUIL�,iNG DDEPAR1 AT WITHOUT CERTIFICATE 4 765-1802 8 AM TO 4 PM FOR THE
OF OCCUPANCY
FOLLOWING INSPECTIONS: f O � Z
EXISTING GARAGE
1. FOUNDATION - TWO REQUIRED O
EXISTING HOUSE FOR POURED CONCRETE �J w -
2. ROUGH - FPAk1ii•:'< ;3< PLUMBING i`'" o O
3. INSULATVC• • Q� U
4. FINAL - MUST N a
BE COMJ'. C.G. RETAIN STORM WATER RUNOFF
ALL CONST: .A SHALL MEET THE PURSUANT TO CHAPTER 236
REQUIREMEN.*i� OF THE CODES OF NEW OF THE TOWN CODE.
YORK STATE. NOT RESPONSIBLE FOR `�,��FZED ARC
DESIGN OR CONSTRUCTION ERRORS.
�
NDRAWN: MH/MS
COMPLY WITH ALL CODES OF * SCALE: 1/4°=r-O^
NEW YORK STATE & TOWN CODES jl,d ltfonal N JOB#:
AS REQUIRED AND CONDITIONS OF ation '9� 0 39 August T UM
��_ r��e��e� `C`OF N E��O SHEET NUMBER:
FLOOR PLAN - �' • , 4. � to
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