HomeMy WebLinkAbout41711-Z � �rp Town of Southold 3/4/2018
P.O.Box 1179
• 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39540 Date: 3/5/2018
THIS CERTIFIES that the building SHED
Location of Property: 205 Brook Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 79.-5-16.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/1/2017 pursuant to which Building Permit No. 41711 dated 6/6/2017
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 Buonaiuto,Richard&Karen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
tho ed Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
• a 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#: 41711 Date: 6/6/2017
Permission is hereby granted to:
Buonaiuto, Richard & Karen
PO BOX 1721
Southold, NY 11971
To: construct accessory shed as applied for.
At premises located at:
205 Brook Ln, Southold
SCTM # 473889
Sec/Block/Lot# 79.-5-16.2
Pursuant to application dated 6/1/2017 and approved by the Building Inspector.
To expire on 12/6/2018.
Fees:
ACCESSORY $156.00
CO -ACCESSORY BUILDING $50.00
Total: $206.00
BInspector
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:
I. 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 Fite 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 $15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: aoj ?S MOG Lh S(xJ�_`�'IO�CA
House No. Street Hamlet
Owner or Owners of Property: k ubard ana kapen �um04
nL Suffolk County Tax Map No 1000, Section Block S Lot
Subdivision Filed Map. Lot:
Permit No. H Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted:$ 50
plicant W nature
I I �Of SOUjy
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING / STRAPPING ( FINAL S fffb
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL
)
P
REMARKS: J*i(
�YW4_ C"kilt ey VeAoei ,who IL/
(o) vOiow Toibir n ' -a �
DATE ! INSPECTORW'U
Of SOUTy�
N O
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I SULATION /�
[ ] FRAMING / STRAPPING [ FINAL J�A
[ ] FIREPLACE & CHIMNEY [ ] FIRE-SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
. NACPAQVMfjQ��
REMARKS.
I�
Ave X
DATE 3 1 INSPECTOR
i
its
E�OLATION-
STATE ENE• • /
MIR
MEN Molmou
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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
SOU•THOLD, NY 11971 Gets of Building Plans
TEL:-- (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 _ +S rvey
SoutholdTown.North,Fork.net PERMIT NO. Check
\Septic Form.
N.Y.S.D.E.C.
ZdodPermit
tees
. pplication w,'
Examined 20. Single&Separate
\
Q�m
-Water Assessment Form41—
Contact: /� ry
Approved ,20-11 Mail to: PO bot�Ip xx
Disapproved a/c
Phone:
Expiration 20 .
D But n I pector
�wICATION FOR BUILDING PERMIT
JUN gm? D,
Date 20 l
TT BUILDING DEPT.' INSTRUCTIONS
a. TMrnpletely`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 ifthe`work authorized has not commended!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.
ct-sluzo .24&4
(Signature of applicant or name,if a corporation)
PO vwx 1113A sMA�,o�4, wv ( [-Cnl
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Wrl er
Name of owner of premises C�n�rd C�nA �C�,(�P.f1 $ ,y4t
(As on the tax roll or latest deed)
If applicant is a corptorat on,,signRq e�of dully authorized officer
(Name and title of corpora";te`�`o`ff'ce`r)
Builders License No:,�►
Plumbers License No. -
Electricians License No.
Other Trade's License No.
1. Location of land on whichproposed work will be done:
a t ,5s- !i wok LC1, � ,tsl�nol
House Number Street Hamlet
G.
County Tax Map No. 1000 Section IVBlock S Lot �`
Subdivision Filed Map No. Lot
2. State existing use and.occupancy_of premises and 'ntended use and occupancy of proposed construction:
a. Existing use and occupancy " �� 'Q� �j„
b.' Intended use and occupancy
3. Nature of work(check which applicable): New Building V Addition Alteration
Repair Removal Demolition Other Work
y (Description)
4.' Estimated Cost. Fee
(To be paid on filing.this ap lication)
5. If dwelling, number of dwelling units W I a' Number of dwelling units on each floor n A.
If garage, number of cars k �.
6. If business; commercial or mixed occupancy, specify nature and extent of each type of use.
7. ;Dimensions<o_,f existing structures, if any: Front Rear Depth
"Height . Number of Stories
Dimensions of same structure with alterations or additions: Front an
Depth Height Numbe
8. Dimensions of entire new construction: Front � .. to Rear Depth
r
Height Number of Stories VIUUw
9. Size of lot: Front . Rear Depth
10. Date of Purchase Name Name of Former Owner 011e IQ, :1Olt✓�if' YxO
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES N04ef�_'
13. Will lot be re-graded? YES - NO Will excess fill be removed from premises? YES NO
��1n ati�lQ,.cn P ,p 11 Qj
14. Names of Owner of premise: & Address�bll•YhdldlyUYIlg11 Phone No. S�l& - 910 49(Pc
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_LC
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide,survey, to sc,'ale, 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: u
-COUNTY OFV_ajCA )
'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
(S)He is the C No.01BU6186050
(Contractor,Agent, Corporate Officer, etc.) Quamw in SOW Cvunty
Commiselon Expires Apra 14,
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
day of �l�l��_ 20 7
AIAMNotary Public Signature o plicant
r'X
Scott A. Russell �0°Su11:0-/rST(0 RIAWA\TIER
SUPERVISOR �
Z AAA\1�A\ G]ENUE1�T
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 h� Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
Yes No (CHECK ALL THAT APPLY)
❑[]rA. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface. ;
El Y13. 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.
❑
[3"D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑OE. 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. ': 1000 Date:
District /�,
NAME. T�\CNA S. � 81�1A�V��Tb 'S
� �W.
Section Block Lot
1"OR.BUILDING DEPAfiTI1ENT U4' 0 L1`
Contact Information:
Reviewed By-
Date:
Property Address / Location of Construction Work — — — — — — — — — — — — — — — — —
2O 5 ��k-- /
Lit ElApproved for processing Building Permit
Stormwater Management Control Plan Not Required.
Soy Tt101-� j-�
Stormwater Manageinneilt Control Plan ;s Required
ILJI (Forward to Engineering Department for Review.)
FORM ' SMCP - TOS MAY 201a
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SURVEY OF
r LOT, 2
omm.TO_ cFssoRs "MAP OF REYDON--COURT"
C
rffCO •AM MACTMCCR
SoUTWLo SAVMS "MC FILED SEPT. 1711 1987 MAP N0. 8393
AND OR A,� . _ .. . .....r.�i
/Al
6aJ
APPROVED AS NOTED
DATE: B.P.#
�6D RETAIN STORM WATER RUNOFF
FEE: BY:
�._IL._ _ PURSUANT TO CHAPTER 236
NOTIFY BUILDING DEPART TAT
765-1802 8 AM TO, 4 PM FOR THE OF THE TOWN CODE.
FOLLOWING INSPE%11ONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRA+%4iNG & PLUMBING
3. INSULATION
4. FINAL - COPS !CTION MUST
BE COMPLETE. C.O. OCCUPANCY OR
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW USE IS UNLAWFUL
YORK STATE. NOT RESPONSIBLE FOR WITHOUT CERTIFICATE
DESIGN OR CONSTRUCTION ERRORS.
OF OCCUPANCY
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODE.
AS REQUIRED AND CONDITIONS Or
ELECTRICAL
SOUTHOLP TQWN R ANNING BOARL- INSPECTION REQUIRED
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