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Home My WebLink About41039-Z o�ASUMire TOWN OF SOUTHOLD aye 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#: 41039 Date: 9/29/2016 Permission is hereby granted to: Cabral, Douglas PO BOX 96 Cutchogue, NY 11935 To: construct accessory in-ground vinyl swimming pool as applied for. � D ID W At premises located at: 1530 New Suffolk Rd, Cutchogue SCTM # 473889 Sec/Block/Lot# 109.-6-13 Pursuant to application dated 9/20/2016 and approved by the Building Inspector. To expire on 3/31/2018. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 it in .spector 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, Ji;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. Ag/i4 New Construction: Old or Pre-existing Building: (check one) Location of Property: 7n New $ /L, /zr,-0 &�Cj 4 M //?TT— House No. Street Hamlet Owner or Owners of Property: 1/Ove/P C6 5^zca 66".4 Suffolk County Tax Map No 1000, Section to -1 Block ( Lot Subdivision /Inn Filed Map. Lot: Permit No. LfV Date of Permit. Applicant: -r Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted:$ �O App ' t Signature IULD 1NSPF Flog RE1''ORl' �`pUNDA.�'SON(1ST) w rr Yrs wYF ....YM.YY.Y��Y•IY FOtM- A ON(2N'D) ROUGE YRABItINQ PLUNMING , , I TNSUS.ATXON•PEA N.Y. STATE ENERGY GpS)E 1 1 ANAL 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 n `� Survey SoutholdTown.NorthFork.net PERMIT NO. V ✓ Check Septic Form L N.Y.S.D.E.C. Trustees C.O.Application-• Flood Permit-', Examined (/� ,20__J� Single&Separate Storm-Water Assessment Form Contact: Approved ,20_L� Mail to: Disapproved a/c Phone: i Expiration ,20 i ding In ector A DING PERMIT Date , 20 Sip I�T$,TRUCTI UU 2016 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 as ule. b. Plot plan showing location of loth Diiffy ises,relationship to adjoining premises or public streets or areas, and waterways. OLD 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 ®uvrier Narne of owner of premises Daw 0.2 56 9.,16'ka G 60 re (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 be done: I Ir , v House Number Street amlet County Tax Map No. 1000 Section V Mock- _� Lot "•pi} t ..I I i 1 • 1 ' C t _ p - i 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 02e p�se�e_ b. Intended use and occupancy &&2kehZ4= 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work A6 L (Description) 4. Estimated Cost 24 o9Z Fee On, (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 �-�«�r �1 =� `Rear `, r "! 1, Depth Height Number Of Stries 9. Size of lot: Front Rear ? ` Depth 10. Date of Purchase 7-110 Name of Former Owner G�.�� V'V_ e�lJ;4+ 11. Zone or use district in which premises are situated :T1 ` Ya fi" ;:So 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 OFSf �Ljq[Q3being duly-sworn',deposes and says that(s)he is the applicant (NamekQjndividual signing contract) above named, (S)He is the 01-1X)(2 R- (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. Swore before y e this Y da of mbc& - 20� , (Notary Public TRACEY L. DW Sign ture of Applicant NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,26)B 4 Scott A. Russell SUPERVISOR W IMA A,G 1EAW1EN T 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 T INVOLV1E ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) E] A. Clearing, grubbing, grading or stripping of land which affects more " than 5,000 square feet of ground surface. ❑ 0B. xcavation 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 0 feet of horizontal distance. ❑ Site preparation within 100 feet of wetlands, beach, bluff or coastal osion hazard area. ❑ Site preparation within the one-hundred-year floodplain as depicted j on FIRM Map of any watercourse. ❑ 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. APPLICANT (Property Owner,Design Professional,Agent.Contractor,Other) S-C T.M. # 1000 Date n DisUict lao NAME- �J / r v 11)"" Section Block [Lot 6.news - *k;r FOR BU'1L1Dl.Nc'T 1✓t_:;�^I17%l[N-r t.Z (>l: ]-' . Contact Information &1j 76-7— /® �9 :rdiplwn.N—NI. {/ Reviewed By: Date- Property Address /Location of Construction Work. d/Approved - - - - - - - - -for processing B rPermit Stormwater Management ContControlol Plan Not Required ❑ Stormwater Managcrnciit Control Plan a Required (Forward to Engineer ing Department for Review) FORM � SMCP-TOS MAY 2014 Scott A. Russell , SUF " STORtM WA.TIE]E, SUPERVISOR IMIANA(G!)EMUEN T SOUTHOLD TOWN HALL-P.O.Box 1179 �a 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 OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ® A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑LI �. xcavation 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 0 feet of horizontal distance. ❑ Site preparation within 100 feet of wetlands, beach, bluff or coastal osion hazard area. ❑ 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 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. #: 1 000 Date- Dist nct q r NAME. �� / 1 v Section Block Lot � � 1'Oi�.BUILDING 1;F�:P;�1:'1'�,"s�'lv"F ["Sl: Contact Information O�il 76�`" r,Aplw Y..nbr, p I Reviewed By: — — — -- — — — — — — — — — — — — — — Date Property Address /Location of Construction WorkdApproved - - - - - - - - — — — — for processing Building Permit. tormwater Management Control Plan Not Required Storrnwater Management, Control Piaci i_')Required 7i (Forward to Engineei ing Department for Review) FORM " SMCP-TOS MAY 2014 4 1 *of so�lyolo Town Hall Annex Telephone(631)765-1802 54375 Main Road max(631)765..-9512 P.O.Box 1179 Q roger.richert(au_town.souod.ny.us • �O Southold,NY 11971-0959 O CQUNTI,� BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: ��,� /7 Company Name: Zia0.7 C ) CK Name: 12 i License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: �f�QJ i L"A *Address: 14 Etc,' Sc) FFdLK UC' *Cross Street: *Phone No.: ?/— S I3 — 7633 Permit No.: Tax Map District: 1000 Section: Block: Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: YES / O Rough In Final *Do you need a Temp Certificate: YES / O Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service OverheaI54 Additional Information: PAYMENT DUE WITH APPLICATION 0CJCP 82-Request for Inspection Form NAppl'M. ppb NT o C t:u>rINGi srO�r 'Ni t'�Ot'O G 2Nn %ow�plV t FWM PDGI ON _( 2NG FL00F iM G A K o A�" CNE�tM1G i b 2+ 1 d 0 0 1 Q 1 , 1 STORY FRA q'+' ' HOUSE/ & GAR GE LANs NOW OF, K POI?MI;I3.Y 0r RICW12 K. CA5�, 1 f - N 4QIy�` b NOW OF, ----- �Qo �� pMILY OF TI OTW KSI I.Y C) s Lrriqti- Pak 3T 6s P6 C i s l 2 X ELECTRICAL INSPECTION REQU R COMPLY WITH ALL CODS OF NEW YORK STATE & TOW CODE AS REQUIRED AND CONDI IO S C y �57 APRO ED AS NOTED DATE: b.p.# OA; FEE: �Dv FY: NOTIFY BUI DI-4C; L=F_,ART. . AT 765-1 '02 8 VO 4 G��q FOR THE ! f' FOL!_(,WING IN 1. FOU DATOi T- J R;-OU9ED 2. FG-1 ROUGHPOU 1- Fi &' � F. OCCUPANCY OR 3. INSULATI1 USE IS UNLI-AWFI pL 4. FINAL - OP`\S-'!T!i�rl; A� ,;T BE COMP E_` F'}r _ C WITHOUT CERT(r; A E ION SI-IAL' MEET THE REQU REi�E TSiO THE CODES OF NEW OF OCCUPANCY - CY _ YORK STAT . NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. RETAIN STORM WATER RUNOFF CLOSEQ OOL Tp COIDE Glut 5,10, PURSUANT TO CHAPTER 236 -UPON COMPL8TION OF THE TOWN CODE. i �1 E,FORE�"WA' � m,in incl c(k A st_4O CE u LA r lines � P � �