HomeMy WebLinkAbout42283-Z Town of Southold 2/27/2018
P.O.Box 1179
.-D) _ 53095 Main Rd
y0 ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39581 Date: 2/27/2018
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 1750 Evergreen Dr, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 102.4-4.8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/27/2017 pursuant to which Building Permit No. 42283 dated 1/8/2018
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 Burns,Douglas&Lydia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
th ed Signature
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#: 42283 Date: 1/8/2018
Permission is hereby granted to:
Burns, Douglas & Lydia
1750 Evergreen Dr
Cutchogue, NY 11935
To: legalize "as built" deck addition to existing single-family dwelling as applied for.
Additional certification may be required.
At premises located at:
1750 Evergreen Dr, Cutchogue
SCTM # 473889
Sec/Block/Lot# 102.-1-4.8
Pursuant to application dated 12/27/2017 and approved by the Building Inspector.
To expire on 7/10/2019.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $784.00
CO -ADDITION TO DWELLING $50.00
Total: $834.00
BLVdiI ector
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
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 1"� 5 0 Cy�a r2 r
House No. Street H mlet
Owner or Owners of Property: W4�)a S L-Yd ; Ru ryi S
�L Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. 0)_a iDate of Permit. Applicant:
Health Dept. Approval: 1\1I or Underwriters Approval. N l f►
Planning Board Approval-
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
cL 11 Nl �
I IF
Applicant Signature
titig�
SOU�yo
courm
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATIO/N pul,FRAMING / STRAPPING [ FINAL 6d�1
2-
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
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DATE -kl kk S INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] I LATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE 'g INSPECTOR
CHITECT �
MARK SCHWARTZ & ASSOCIATES 2849511T(fr'i;6T—o-M33\�•Cutchu , '1' 11935
631.734.4185 1 mvw.m LAltect com '
FEB 262018
February 26,2018
TOWN OF SOU'L'SpLD
Southold Town Building Department
Main Road
Southold,New York 11971
Re: Douglas Burns Residence
1750 Evergreen Drive ('
Cutchogue,New York
To whom it may concern,
Y
I have been on site to review the as-built construction and I have obs ed photos for the
aforementioned project. To the best of my knowledge,the strapping d footings/foundation for the
rear deck,meets or exceeds New York State Code.
Please call this office with any questions you may have.
Sincerely,
— :.
Oft
Mark Schwartz
AIA
\4ember American Institute of Architecture
FIELD INSPECTION REPORT 7 DATE COMMENTS
FOUNDATION (IST) 9J �
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FOUNDATION (2ND)
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ROUGH FRAMING&
PLUMBING '� H
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INSULATION PER N.Y. y
STATE ENERGY CODE
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FINAL
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ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Buartl-ofHealth
SOUTHOLD, NY 1.1971 ,4'se of Building Plans.
TEL: (631) 765-1802 Tanning Board approval
FAX: (631) 765-9502 �I u ey
SoutholdTown'.NorthFork.net PERMIT NO. U heck
C.O.Application
r Flood Permit
Examined 20 Single&Separate
.Sterm—Water Assessment Form
Contact:
Approved ,20L� Mail to: ,
Disapproved a/c
Phone: G 51 `(6G.1 7 Z.(_
Expiration ,20
noBui�_Idi' ector
DDAPPLICATION 7201 FOR BUILDING PERMIT
DEC 2
Date , 20.
INSTRUCTIONS
TQ 4�o ion 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 Ins.pector 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 forjany 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 Southpld,.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 ousing code,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
( nature of applicant or name,if a corporation)
1-76-o het (e H Dr. Cu iso .re
(Mailing address of applica
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
0QJAtr
Name of owner of premises . —U00 5
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 propose work will be done:
11 0 Fycrcireeo ✓
House Number Street 1 Hamlet
County Tax'Map No. 1000 Section Block ' Lot
I -
Subdivision
i Filed Map No.
Lot-
2 State existing use ano occupancy of premiises;and intended use and occupancy of proposed construction:
a. Existing used-and occupancy
b. Intended use-and occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal . Demolition Other!Workgr
,
(Description)
4. Estimated Cost Fee
(To be paid on'filing this application)
5. If dwelling, number of dwelling units I11, _Number of dwelling units on each floor,'
If garage, number of cars
i
-6. If business, commercial-or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions ofexisfing structures, if any:IFront Rear Depth
Height Number lof Stot'ies
. �-,..� r.+.afT7, - •�. `^T per_
/ ..7
Dimensions of sarme structure with alt;erations.or-additions: Front Rear, ;
Depth Height Number of Stories r I
8. Dimensions of entire new construction: Fiont'. Rear Depth
Height I Number of;Stories
9. Size of lot: Front Rear '' Depth
1 . Date of Purchase :' N i e,of Former.Owner
1 . Zone or use district lin which premises are,'situated i I
I' ? „!
12. Does proposed construction violate any;zoning l4w, inarice:oregµlatiori?YES--NES= r
y l
13. Will lot be re=graded? YES NO YV' Will`excess fill.-be-removed from.premises?YES NO� �
14. Names of Owner...of premises Address. Phone,No.
Name of Architect;' ! Address ' Phpne;l*10
Name of Contractor,! i ' Address KPhone+No:
1 a. Is this.pro e -'withm�l00 feet of a tidal wetlako'r a'fresliwaterwetland? *YES NO`�
p p rh'., .. .
IF YES, SOUTHOLD'.TOWN`TRUSTEES'&'D.E.C: PERIVI)�TS'`1vIAY BVREQ2JIRED. ! `
�.
b. Is this,property within 300 feet of a;tidal wet ai}d. *`'YE'S;': NO
IF YES, D.E.C. PERMITS MAY BE REQ�UIRI , i
1 . Provide.survey; to scale,-with accurate foundation plan and distances to property lines.
1 . If elevation at-any point on property is at 10 feet or below, must provide topographical data on survey.
L& Are there any covenlants and restrictions�ith res ect to thisproperty? * YES
IF YES, PROVIDE A COPY. p
S ATE OF NEW YORK) ;
I
-SS:
COUNTY OF )�
I being duly: swore,deposes and says that(s)he is.the applicant
(Name of individual iigning contract)above nair e'd, i I
CONNIE D. BUNCH '
(S)He is the ;
Notary Public,State,of New York
(Contractor,Agent, Corporate Officer, etc.) Ouahio- in Suffolk County,
Commission E
I i xpires April 14,2n�O I
of said owner or owners, and is duly authorized to perform or have performed the said work and to make.and filejthis application;
th t'all statements contained in this application aretrue,to.the best of his knowledge and belief; and that the work will be
performed in the manner siet forth in the application filed therewith.
I
Sworn to before me his !
day of 20 '
Notary Public Signature of Applicant!
{
-' Scott A. Russell S�FFa� STO)E MMA\T)E)E,
SUPERVISOR -� I��J[A\-A\(G��EMUENT
z
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEIN YORK 11971 'Jlj �d'
Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED_BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
(CHECK ALL THAT APPLY)
Yes No
❑[� A. Clearing, grubbing, grading or stripping of land which affects more i
than 5,000 square feet of ground surface.
❑�13. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑[dC. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑a 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
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,
ignatuFe,-Contact�Int'or-mation,-Date-&-Count-y-T.ax-Map-Number!--Chapter-236-does-noLapply--to-3tour-Pro ec
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.C.T.M. 1000 Date:APPLICANT. (Property Owner,Design Professional,Agent,Contractor,Other)
District
NAME. 1&U!S'\ by rV Section Block Lot
ta,�o
FOR/ �s^•'°q66 - 1 -7Z-d"_
../'/66 J� 0(l.BUILDING DE:P�,t?TI�fLN"I' t �l�
Contact Informanorn t`31 '1 - 1 � �" }�� May/, )\
Reviewed By- ll
— — — — — — — — — — — — — — — — — — Date: 1�•�I1�7� •
Property Address / Location of Construction Work. — — — — — — — — — — — — —
17-1 Approved for processing Building Permit — — —
Stormwater Management Control Plan Not Required
❑ Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review.)
FORM ' SMICP - TOS MAY 2014
FO(,�coG
Town Hall Annex �� y� Telephone(631)765-1802
54375 Main Road _-� - Fax(631)765-9502
P O Box 1179 0 '
co Z
Southold, NY 11971-0959
411
p�
01 � �a
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION, PRE-ENGINEERED
WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION
Date: . (Z-(411
Owner: N",L, L d���, G+f K7 1
Location'of Property: � e�Q !2-8-Po-7 p/� ('.i /��DP Vl�n-
Please.take notice that the(check applicable-lihe):
` New commercial:cir residential::structure
Ad to
exi fin j--dib merciat Qr residential strua..0
'u. il� habilitatioh o4 existirig'eo t iercial or residerit{eltstructure
to be .constfu4t �pTpefformec! at the subject�pl'operty referenceaabdve will-util ze
(check appliceb�f� .(r3e}: _
Trus -pezonstruction (TT)
Pre-eng+ne-?ed Wpod construction (PW)
` 1% Timber constr dtibfi*(TC)••-,.
in the following location(s) (check appliaatle.line):
Floor framing, including girders and beams (F)
Roof framing (R)
FI or nd roof framing (FR)
Signature:
Name (person submitting this form):
Capacity
(check applicable line):
V -Owner
Owner representative
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