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HomeMy WebLinkAbout41631-Z �FFot,r. TOWN OF SOUTHOLD �q� cad 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#: 41631 Date: 5/12/2017 Permission is hereby granted to: Willow Pond Lane LLC 1089 Rockaway Ave Valley Stream, NY 11581 To: construct accessory in-ground swimming pool, fenced to code, as applied for. At premises located at: NOID 435 Willow Pond Ln, Southold SCTM # 4738890 Off,( Sec/Block/Lot# 78.-1-45 Pursuant to application dated 3/27/2017 and approved by the Building Inspector. To expire on 11/11/2018. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Building Inspector 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$15.00 / Date. e4arc�-`- i"_, 201-7 New Construction: - — Old or Pre-existing Building: _ p (check one) Location of Property: �f3 5 W I (,AW PoyVot- �a hR- 0,0umo la House No. Street Hamlet Owner or Owners of Property: W K ow Pbrt.& G Suffolk County Tax Map No 1000, Section 7$ Block ' Lot Subdivision- Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ppl' an ignature FIELD lNS1'E 4 R- B1.Qar DATA C©442,,,3 'Su • FOUNDA'ftON(1ST) ............. ............. OUNDATxON'i(zrm) CA' c z CAL o UN ROUGH FRADMQ& INSULATION PEA N.Y. , STATE ENBROY Coln rTl i 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 Suryey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 5 20 H Single&Separate Storm-Water Assessment Form Contact: ,,,�a f Approved ,20 Mail to: ola" v wnek'a, Disapproved a/c toyet pacf;G2.G�Ct,(, A't -eA'I ve- Phone: (StO �25 0-85-0 Expiration '201 \,/" (��� IE[D it nspector D, MAR 7 207 APPLICATION FOR BUILDING PERMIT Date GeGL' 20 V7 BUILDING DLT- INSTRUCTIONS `SOWN OE-SOUTHOLD 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-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 building's, 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' (Signatu e of pp cant or name,if a corporation) (Mailing address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder d w�-� Cze�.•e�E Ce�I.�-�.cf�o� Name of owner of premises • Vyao W ran& `afte, �'C, (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 pr posed work wCm�ld, 435 W4CCW `P Va,fe, GM's` LcgZ House Number Street Hamlet County Tax Map No. 1000 Sectionor � 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 b. Intended use and occupancy 3. Nature of work-(check which applicable):New Building Addition Alteration Repair Removal ,• Demolition Other Work (Description) 4. Estimated Cost ®n d - ® D 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 ,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° :a Depth Height Number of Stories, "� ;j j a� dd r t 8. Dimensions of entire,new construction: Front,, Rear Depth Height Number ofStories 9. Size of lot: Front Rear Depth 1 . Date of Purchase Name of Former Owner 1 I . Zone or use district in which premises are situated 12. Does proposed construction Violate any zoning law, ordinance or regulation?YES NO 1'. . Will lot be re-graded? YES , :NO 'Will excess fill be•removed from premises? YES NO 1 Zr. Names of Owner of premises = Address Phone No. Name of Architect Address ' Phone No Name of Contractor Address- -Phone No. 1 a. Is this property within'100 feet of a tidal wetland or a fressfiwater wetland? *YES NO( IF YES, SOUTHOMTOWN 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. 1 . Are there any covenants'and restrictions with respect to this property? * YES NO IF YES, PROVIDE A COPY. STATE OF NEW YORK), �,t SS: COUNTY OF C�as5a. 'JWC'4k/ ® being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S He is the (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. Sworn t efore me this p L day of Gfi _c'Yl 20 C7 14—ek OjA_W / E'Ef.�o. iU� . Notary Public0v atm Of NOW Signa re o Ap icant 110.01 MAMI140 ftaiified in Nomp Comissim Expires Juiy e . ' Scott-.A. Russell 1 fr Fco>RIM(WA�T�E� hKA NA\(Gr]ENUEN7[' SOUTHOLD;T.OWN-"A4-'P.0,Dox,1179 Town of Southold '53095 mai i twid•SOUTtidW NDW YORK 11101 '( CHAPTER,236 - 'STORMWATER:MANAGEMENT�WORI{ SHEET (TO BE,COMPLETED BY THE APPLICANT) ;WES^'THIS PROJECT.INVOLVE• ANY OF TME .rOLIbWING: (CHECK ALL THAT-APPLY) 'z Yes �'a=°•. 0 '.'A.,CI'earing, grubbing,.,grading,or stripping of land which affects more than-5;000 square feet of ground surface. , 11 13: -Excavation-or filling `involving more than 200 cubic yards of material 1 within any parcel or. any contiguous area, Q C, Si'W dparatiion;on slopes,which exceed,.10 feet vertical rise to 100 feet-of;liorl•2ontal.aistance. Q D..Site;preparation'within 160 feet of wetlands, beach, bluff-or coastal erosion'hazard area. xa`l,,,Site,preparation within the one-hundred-year floodplain as depicted cin'FIRM,Map of•anyvatercourse, 0 rF..l'nstallation-of'new,or resurfaced}impervious surfaces of 1,000 square feet 61 more, unless,prior approval-of�a Stormwater Management 4 Contirol;Plan:was-received"by the Town,and the proposal includes 'in-kind-replacement-of impervious-surfaces. ]i',you.answercd NO to all,of the queslions;above,STOP) Complete the-Applleantsiellon`below with your Name, Siidk6rei,,Conlact,lnformatlon,;Date:&County,Tax Map Numberl Chapter m docs not apply'to your project: lf�youanswered•-Y1:5 to-ono°or inore`,of tho,;aliove;•pleasc subinlCTwo eoples,of a�Sforinwater Management Control Plnn ' �tiiiil=�conipleted_CheokLisC•Fornrto the`Bullding�Doparlmenl,ivltfi your BuildingPerniltApplicatton. 40 tCANT;(Property Oi wr,Deign Prort4lor .AIIent,dntr`ector,Otheil S'C.l�'M' �' 1000 Daly. - -a l� ,Q '"JQ )�_ a 0 - NAME l `"try `'0 K 1• , r[C�_ _ 45 �J-a Scelbn Block, p°!I nit=f3[JII.DINGfiLPAR�'MCNTaUS1:,nNI'.Y-"*'? Coolacltnrertnatlon G�� � Revlewed l3yrjq Date: — Prdberly Address/'Location of.C664ruction Work -- — — _ — — — — -- — — — — — Approved'Por'pr6cessing Building Pemilt. l ayr� _Slormw_mer; .ns c - AP ROVED AS NOTED DATE:s B.P.# ELECTRICAL FEE: BY: INSPECTION REQUIRED NOTIFY BUILDING; DEPART ENT AT 765-1802 SAM TO 4 f'M FOR THE FOL LO!NIG INSPECT!3NS: 1. F;'71UINDAiiON - TWO REOU!RED F" i=, °CURED CONCREl c 2. HOUGH - FRAMING & PLUMBING 3. INSULATION � �" ° � 4. FINAL - CONS!F-iCTION MUST ?#Kt ;3`�c�''" " 7 �`" BE COMPLETEC.O. ENCLOSE P3-"L TO CODE UPON GGMPLETION ALL CONSTRUCTION SHALL MEET THE BEFORE"WATER-", REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF RETAIN STORM WATER RUNOFF NEW YORK STATE & TOWN CODES PURSUANT TO CHAPTER 236 AS REQUIRED AND CONDITIONS OF OF THE TOWN CODE. 60pqFNwZ8L, SOUTH G BOARD S9�48L-B�9�1I��18IEES MrA OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY INE ARfA'OF INS PRLWERTY tS��0.1B1 Sr 24 S.F. 67-ox)y 7111S PROPERTY HAS BEEN 6LEARED pJ 26O ,F.(67.01y ACL EIEVARONS 57IORN REF70 NAW'08 VAIUAI VOW �( $ ��r��r� �B 4. 00 C gi .$°, 3 ' 49, sat, 68,0•. _ - •�t!fuW,, �_ 1 � ,y ` - ' ' .. .S��P,Y ,,,x,, , :" •`200,00 ;�F' ' AIR- j 1"1{t0/C'I�tU/ (Ilf Gnit,'W�f��016d//1Qn �il a ve •sj .4 4,• J' ri`.,}1 ipAllflann�]m>�i46s1�sact,tCo�p: (I(tleJNa.fAlA�Z9f4'" .. ,, + �Eiu A t �ld�l1 l�+dtroxol brlae:'/nau anae EcoMaan!' 4 '` i .= o ' y SF 1'p EY nON,S�3/9%�'Qt6) tfiG4p11�LE�SfA� `C_deT�/�,L//°SrJ�tLN'AMLYYq l51h^lt>AINQ ARNOTt11tAN5fEltA9iE;, �i ��SiQlT��9,,`NO,�, t1WV� " (f�16� �' �,�'���i'4t" , •` A��l/� ' J,ti;F'1 SUI VEY 16h IDEVI,B,EDr � !,'' { 'S1'7l'lta�TEO�EI►Vc 'SOLI �� ". 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