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HomeMy WebLinkAbout41729-Z ��p`p��}FFOt,fcoG� Town of Southold 7/9/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39754 Date: 7/9/2018 THIS CERTIFIES that the building DECK Location of Property: 1020 Old North Rd, Southold SCTM#: 473889 Sec/Block/Lot: 55.4-6.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/6/2017 pursuant to which Building Permit No. 41729 dated 6/12/2017 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: DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Haman,William&Carolyn of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED u o ' Signature �OfFat-to oTOWN OF SOUTHOLD BUILDING DEPARTMENT y a 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#: 41729 Date: 6/12/2017 Permission is hereby granted to: Haman, William 1020 Old North Rd Southold, NY 11971 To: construct deck addition to existing single-family dwelling as applied for. At premises located at: 1020 Old North Rd, Southold SCTM # 473889 Sec/Block/Lot# 55.-1-6.1 Pursuant to application dated 6/6/2017 and approved by the Building Inspector. To expire on 12/12/2018. Fees: CO -ADDITION TO DWELLING $50.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $276.80 Total: $326.80 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 Iess 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$15.00 Date. ,.gyp e` New Construction: Old or Pre-existing Building: (check one) Location of Property: lb 6L ® 'Ve k'T k4 L B A 7J �� g-r p-o Lp House No. Street Hamlet Owner or Owners of Property: Suffolk County'Tax Map No 1000, Section JL BIock Lot _ Subdivision C q Filed Map. Lot: ( Permit No_ 1 � 1' I Date of Permit. Applicant: 0 � � r—A 46® eJ Health Dept.Approval: Underwriters Approval: Planning Board Approval: _ Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ R Applicant tignat �a0f SOUryo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION /] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL) REMARKS: A fit DATE Yl INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1602 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING /STRAPPING [ FINAL 0A60A [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: �dfm\%,Ad, v n(% DATE !.3I INSPECTOR 50 �0 UTy TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] SULAT ON [ ] FRAMING /STRAPPING [ FINAL VAC4k [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL�(FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: 1ov� DATE ?J' S INSPECTOR r: r r •: o •� • ano war* r - ' 1: 1 r mm_ - r A / AV WMIX �..- Y u M '.. t1 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 ,q Survey SoutholdTown.NorthFork.net PERMIT NO. d � Check Septic Form N.Y.S.b.E.C. Trustees " C.O.Application Flood Permit Examined ,20 Single&Separate Storm-Water Assessment Form Contact: Approved ,2011 Mail to: Disapproved a/c 31 Phone: Expiration ,20 Add ' nspector D C D PLICATION FOR BUILDING PERMIT JUN 6 2017 Date 6 , 20—LI INSTRUCTIONS a. S ST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of tSG%jrjftLDcaIe.Fee according to schedule.,: "Ttplanshowing 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 shal l 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,anew 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,.Sutfolk'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: (Signature of applicant or name,if a corporation) O1--0 UIZT#177, , d L,(Tffae:;,p (Mailing address of app cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder v�T c7-De- Name of owner of premises (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 whichpro osed workM11be done: House Number Street Hamlet County Tax Map No. 1000 Section Block — Lot 0 Subdivision ; I Filed Map No. J�'S ^ Lot ( . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use,and occupancy 0 L-- N K t-t /,L b. Intended use and occupancy LF S b 42- Al T t, ",g-L_ , 3. Nature of work(check which applicable):New Building Addition Alteration 5 Repair 'Removal Demolition Other WorkZp LQ v- (Description) 4. Estimated Cost ! app , v� Fee t (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 existiing structures, if any: Front 5 © � Rear Sy Depth Height I. 3 ' Numberlof Stories l Dimensions of same structure with alfieraiions or-additions: Front Se�_�. _ _Rear S O Depth Height_' L 3 ` Number of'Sto'ries i C Imo_,},,•____1117 - f 8. Dimensions of entire new construction: FtonC fol Rear �e �t� ` Depth Height a NumbE:r of Stories +- '�r 9. Size of lot: Front ( 30, y Rear r••D 1"0 Depth L -34 ,_ g'Jc 10. Date of Purchase OL 2 Ndme of Former Owner L1 c(A-M 'A A-� 1 I . Zone or use district yin which premises are situated 2 Lf-s k r0 c�N`r U_* * ' 12. Does proposed construction viola te'any,'zoning 14*, orditi4Ace-or regulation?YES NO! 'K 1 . Will lot be re-graded? YES_N X,, Will'excess fill.be removed from premises?YES NO� X I � E 14. Names of Owner of`premises L0,;urA x.A--�~� Address• t'-6&-6 .n�0 Ind rk-whone;.No., 7&0 - .5 5 2( Name of Architect i:! :,. r Address Contractor( PhoneNo Name of ' h CQ�rcflG� t� I I Address"�i4a����> Q�» Phone+I?1o':Co�i=�5 3 "07 1 a. Is this property within 100 feet of a tidal!We'tlako'r•a;fresYiwater wetlan�? *YES NO, 'x IF YES, SOUTHOL6T*OWN'`TRUSTEE� &-�'lD•.E.C. PER1VIMTS§IiIAY 13E�REQUIRED. b. Is this property within 300 feet of a;tidal'wetarid? *'YE'S NO' IF YES, D.E.C. PERMITS MAY BE REQUIY2.E6 ! . 1 . Provide survey, to scale, with accurate founddi.ion plan and distances to property lines. 1 . If elevation at any point on property is at 110 feet or below, must provide topographical data on survey. 1 . Are there any covenants and restrictions With respect to this property? * YES NO X IF YES, PROVIDE A COPY. S ATE OF NEW YORK) SS: COUNTY OF ) o � le ,c1 LS i 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; th t all statements contained in this application are,true,to the best of his knowledge and belief; and that the work;wil l be performed in the manner s4et forth in the application filed therewith. ' I S or to before me this day of 20 j ROSKI NotaryPdblicU Notary Public,State Of New York Si na u r e plicar No.01D06095328,Suffo / 1 Term Expires July 7,20 I"7 X01- 00, ST(0 R IM[\�V.A\T)E R, Scott A. Russell � SUPERVISOR - IWANA,(G IE1\\41EN T SOUTHOLD TOWN HALL-P.O.Box 1179 "' ? 53095 Main Road-SOUTHOLD,NEW YORK 11971 �O Town of,Southold CHTAPTER 236 - STORM'WATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT) --- ---1DOES--TJHIS•— 0JEr_T Yes 3`10 (CHECK ALL THAT APPLY [I® A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. E]] B. 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. ❑® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. t ❑© E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse.. ®[A 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 DepartmenLwW_your Building Permit Application. APPLICANT. (Property Owner,Design Professional,Agent.Contractor,Other) - S.C.T M. 1000 Date. DDIrICt NAME b LP ( e3 l`J 1 r Section Block Lot / t` Gr.u,. z FOR BUILDING DEPARTMENT LSL: 0-INT.); Contact In(ormatiort .fan�..r vo.�n.,• - Reviewed By: — — — — — — — — — — — — — — — — — — Date: Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — Approved for processing Building Permit 16 L "O?)A'i`�� is F1 Stormwater Management Control Plan Not Required. Stcrmwater Maaagcime i; Ccrtrol P!at- •J Rcqu•ed. Li (Forward to Engineering Deparimenl for Review) FORM SMCP - TOS MAY 2014 Sr - { -74 ":•1 /°t>Ftr r� - e� d tfisrJ; r v v. Ilk 41 Vt 7�� �''f ' l r�y/_!•.l�`r� l! .14f �J -' }rte�' 'f Y �� ��'�•'' '�i �' 0 - ��''•'-� - Yet t..� +�'� `..-'�:..y�l , ._ A�1g�'� D AS NOTEDDATB.P.FEE: BY: COMPLY WITH ALL CODES OF NOTIFY BUILDING AT 765-1802 8AM 'TO 4 "M FOR THE NEW YORK STATE & TOWN CODE, FOLLOWING INS"ECTIC tiS: AS REQUIRED AND CONDITIONS OF 1. FOUNDATION - TG,'(,) PEQU'qED FoPOUR70 ROUGH - FRAI,�i;N-G & PLU%'3ING 2. P -rjtX-AT 3. INSULATION �i,7 BOARD 4. FINAL - CON;TRLICITION MUST . ,9,4 BE COMPLETE r-nR C.O. HS A ALL CONSTRUCTION SMALL MEET THE N.Y. AtA 7 REQUIREMENTS OF THE CODES OF NEW - YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR RETAIN STORM WATER RUNOFF USE IS UNLAWFUL PURSUANT TO CHAPTER 236 OF THE TOVIN CODE. I't'ITHOUT CERTIFICATE 07 OCCUPANCY -T70A-VA qT y- ild 0 Ir o-c 14A r—T— JP 4 4 it m,,0,- AW 4I,2-) V ii r4-- _ __ r" I— -- _L Fcl T I _� k4, Co ts u t;7 r� PLIAI( LOC l<I JAI J A, f r s. SCALE: APPROVED BY: DRAWN BY 1,7 -4 DAT C-.'-- T REVISED j. L DRAWITO NUMBER