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Home My WebLink About42277-Z 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 ........... NX.S'D.E.C.7.......................... Trustees C.O.Application Flood Permit Examined— 2J Single&Separate--—------ Truss Identification Form—--....., Storm-Water Assessment Form Contact: Approved 12019 Mail to:LL-&,t..V lE&xke l Disapproved ale_ d"14-g-,P) C C to .................. 20_ Expiration ector MPLICATION FOR BUILDING PERMIT Date 20 BUILDING DEPT, INSTRUCTIONS a.MWN LIPI)Ii9aFti"O)P�WkeDcotiipletely filled,in by typewriter or in ink and submitted to the BuiMng 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) St ;�whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises BILh&,��-A ................ (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. t& Plumbers License No, Electricians License No. Other Trade's License No. Location of land on wh* h propo d work will be d e� 1c se '_7 LLL-t2l:cm 1:) - -1 t —4- J t,4 l!41 House Number Street Hamlet County Tax Map No. 1000 Section—ft5--Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of pr anises and intended use and oFcupancy of proposed construction: a. Existing use and occupancy .24 t b. Intended use and occupancy��`AnaA-t � / 3. Nature ofwork(ch k wti°hich applicable):New Building Addition Alteration_ Repair ,� Removal Demolition Other Work_ (Description) 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 A. If business,commercial or mixed occupancy,specify nature and extent of each type of use. /`• 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 ydf Sfories`Ej * ADimensions of entire new construction:Front Rear .a ' Depth Height Number of Stories 9 Size of lot:Front Rear Depth hfl.Date of Purchase Name of Former Owner I 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 J Will excess fill be removed from premises?YES___—NO rn� d— i �- ddress 0 lrtw.�a�4 tol,�, P� h (+5-r l 3 b 14.Names of Owner of premises` ��--�-r�-^� A o¢7e No. &51-q Name of Architect Address Phone No Name of Contractor o Address 301!r 9U-1&xA-s ,4l"o-phone No.03)•LA(P-to d C;51,6n,t3,. .....t I S 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 V * 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, CONNIE D.BUNCH Notary Public,State of New York No.01BU5186050 (S)He is the _ ....,..f3wralilledOin- n ry (Contractor,Agent,Corporate Officer,etc.) Commission Expires April 14, AZO 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 inethis day 20�_ Notary Public Signature of Applic� 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 I%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. OIB- or existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and "pre-existing"land uses: . 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: a.„yy _Old or Pre-existing Building: (check one) Location of Property:-2 qv.-L �o,.t,�°� .:i.... 2 r,�. . mm....... t 1 . . House No, Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section � Block ` Lot Subdivision Filed Map._ Lot: Permit No. Date of Permit. . Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary CertificateFinal Certificate: ll� (check one) Fee Submitted: $ 50. 0 � � Mn A ic, ' ature t Michael J.Domino,President X¢ � Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. Sanders „ Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski x ,a .1'" Fax(631) 765-6641 4 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9127A Date of Receipt of Application: September 27, 2017 Applicant: Michael & Elizabeth Sweeney SCTM#: 1000-115-11-22 Project Location: 280 Luptons Point Road, Mattituck Date of Resolution/Issuance: December 13, 2017 Date of Expiration: December 13, 2019 Reviewed by: Board of Trustees Project Description: Remove and reconstruct in-place existing 69"x17.5" front entry steps; remove and reconstruct in-place existing 124"x24" seaward side platform with one step to ground off screened porch; remove and replace in-place existing 189"x24" seaward side platform with steps to ground and handrails at sliding glass door; install an 8'x10' shed in rear yard; remove 4' high chain-link fencing and install a 15'x28' paver patio within location of chain-link fence; install a sprinkler system onto the property; and to remove three (3) dead trees located in the rear yard. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the project plan prepared by Michael Sweeney, received on September 27, 2017, and stamped approved on December 13, 2017. Special Conditions: Sprinkler system limited to landward of the retaining wall; revegetate area of disturbance with native plantings, i.e., high tide bush, blueberries or Eastern red cedars, allowing for a 4' wide path to Deep Hole Creek. Inspections: Final Inspection If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees Scott A. Russell � � � �� ksTIEIK w , � a "rr SUPERVISOR: _ I\\1A\_AG]EAMIEN T SOUTHOLD TOWN HALL-P.O.Box 1179 `-� 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PRQ:JE C'T' INVOLVE ANY GF `]['REE FOLLOWING: INN: Yes No KFIECK. ALL "MA.1' APPLE) 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. El E. 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 withyourBuilding Permit Application. Dn t APPLICANT (t'ro rC O�wne,Design Professional,Agent„trontractor,Other'} S.C.�.�. 1000 ID Section Block L_ot Q:roV;G�t p'ufrantArtmu .m'r�.m"L Reviewed By: Date: PropeNy Address l L.oCation of Construction Word: _ � _ �. or (processing BmIding Perrnd. , + 4 ... �. 1�Yairagerrtertt Control Plan Not Ftea�uired. Approved rrovcd GG — I m"�� Stormwater . � 9 �......... .. ',., `_itorrinvater Management Control Flan is Ret.Inired.. BLi (Forward to Engineering Depmlrneril l'or Review.) FORM t SSCP- TOS MAY 2014 O w s Rome LL co LU o am dam* ui ti LL , - , ti LU ccl LU LmLJI LU ce tu now 0 o TME EXISTENCE OF RIGHTS OF WAY U;qA4JT"QMZED ALTERATION OR ADDITION AND/OR EASEMENTS OF RECORD IF TO THIS SURVEY IS A VIOLATION OF ANY, NOT SHOWN ARE NOT SECTION 7209 OF THE NEW YORK STATE GUARANTEED. EDUCATION LAW. COPES OF THIS SURVEY MAP NOT-BEARWG THE LAND AL OR Area= 17,691 s.f. Premises known as: EMBOSSED SEAL SHALLSURVEYOR's NOTINKED BE SECONSIDERED TO BE A VALID TRUE COPY. # 280 Lupton Point Road, Mottituck GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY Is PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND L040ING INSTFFUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION. GUARANTEES ARE NOT TRANSFERABLE. 20 Point Wid, p 25a S73-28,50 app e POOdway 6 "Ott 2. zr 10000, W3 0 Cnfi ults VD 106C garag, 140, ng 27�6' Mcf r4.1, 41-1 1- Rykr ff f ------------ lQ' �'o 6S Certified to: WCHAEL SWEENEY AND ELIZABETH SWEENEY Survey of Described Property EMINENT ABSTRACT, INC. (EA1867—S) situate at FIDELITY NATIONAL TITLE INSURANCE COMPANY Mattituck Town of So-uthold Michael W. Mento, L.S.P.C. Suffolk County, New York LICENSED PROFESSIONAL LAND SURVEYOR District 1000 Section 115 Block 11 Lot 22 NEW YORK STATE LICENSE NUMBER 050871 87 Woodview Lane Scate V= 30' SUeyed May 23, 2017 Centereach, N.Y. 11720 GRAPHIC SCALE PHONE/FAX: (631) 580-1202 CELLULAR: (631) 766-9774 30 0 is 3b 6 1 0 120 EMAIL: mikemintolspcOgmail.com ( IN FEET