HomeMy WebLinkAbout42910-Z FFOI,I- Town of Southold 8/7/2018
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P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39830 Date: 8/7/2018
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 545 Birch Rd, Southold
SCTM#: 473889 See/Block/Lot: 59.-2-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/1/2018 pursuant to which Building Permit No. 42910 dated 8/1/2018
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"windows and outdoor shower addition to an existing one family dwelling as applied for.
The certificate is issued to Shea,Thomas&Carol-Ann
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A t ed Signature
1
TOWN OF SOUTHOLD
moo �oay BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
o 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#: 42910 Date: 8/1/2018
Permission is hereby granted to:
Shea, Thomas & Carol-Ann
555 Adirondack Ct
Mahwah, NJ 07430
To: "as bit" windows and outdoor shower addition to an existing one family dwelling as
applied for.
At premises located at:
545 Birch Rd, Southold
SCTM # 473889
Sec/Block/Lot# 59.-2-9
Pursuant to application dated 8/1/2018 and approved by the Building Inspector.
To expire on 1/31/2020.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO -ADDITION TO DWELLING $50.00
Total: $450.00
Buildin 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 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.
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: J� rJ 61 re_./YI �(�� ��� d
House No. Street Hamlet
Owner or Owners of Property: s/ )�o
Suffolk County Tax Map No 1000, Section ci9d U Block 1�(110C1 Lot g06[6
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: $
Applicant Signature
i
�y0 SO j�o�i•,•
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
D.11
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BUILDING DEPARTMENT AUG 2 2018 ;
TOWN OF SOUTHOLD
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IBUMDING DEFT.
TOWNT 07'-Z 0017HOLD
CERTIFICATION
Date;
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Building Permit No. ') �/r� � ------S
Owner: _V i � �[���=►� ®� �� � J-6 j
(Please print) n
_Plumber: 'G /���� ✓�� ��� a ��� i{�c� ���y ��f CX
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(Please print) 1
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I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
(Plumbers"Signature)
Sworn to before me this
i
day of 20,4_, CONNIE D.BUNCH
Notary Public,State of Nevv York
L No.P 01 su ftlk co QuaN#ied in Suilalk County
D
Notary Public, J, '(�ount� r i
AUG - 2 2018
i
BUII,DXNG DEPT. i
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q-yg o
OF SOUTyO6
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ''
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] -FRAMING /STRAPPING [FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
owdy"
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DATE INSPECTOR Q§k,�
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION(IST)
H
--------------------------------------
'FOUNDATION (2ND)
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1
ROUGH FRAMING&
PLUMBING j y
INSULATION PER N.Y: y
STATE ENERGY CODE
Avol
FINAL
P 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 Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 /� r�C�Z Survey
Southoldtownny.gov PERMIT NO. ` Check
Septic Form
N.Y.S.D.E.C.• -
Trustees
C.O.Application
Flood Permit
Examined ,.20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:
Disapproved a/c
Phone:
Expiration ,20H50 ' d,)
D
149- --Beq�ijspector 01
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JUL '3 1 2018 -APPLICATION FOR BUILDING PERMIT
BUILDING DEPT. Date- Ju I 20_&_
TO1 frtN`r;,7`,jxJ�OLD INSTRUCTIONS
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 Country,New York,and othe'r 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,housfng,code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,'if a corporation)
P ?57
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
'Ve4 I enLg IC
Name of owner of premises Sky of
(As on the tax roll or latest deed)
If applicant is a corporation, sigiiature•of'duly,authorized officer
(Name and title of corporate officer) ;.+,:i, :.
uilders License No.
lumbers License No.
ectricians License No.
her Trade's License No.
1ocation of land on which proposed work will be done:
5 p t Y cin fe'l 30 vh-)d ►U
Ouse Number Street Hamlet
'Durity Tax Map No. 1000 Section 67966 6U Block 00 Lot Q�
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 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 alt_e_r_ations r additions: Front Rear
Depth Height Number of Stories;
8. Dimensions of entire new construction: Front Rear Depth r I
Height Number of Stories
9. Size of lot: Front Rear Depth
-- . 57
10. Date of Purchase Name of Former Owner `
11. Zone or use district in which premises are situated
r
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NO Will excess fill bexemoved:from•premises? YES NO
14. Names of Owner of premises Address Phone No.
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
* 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
* 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
(Votary Public, State of New York
(S)He is the No p1aHRtR5M
(Contractor,Agent, Corporate Officer, etc.)Qualified in Suffolk County
Commission Expires April 14,2L?,:)JkD
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.
worn to before me this
day o 20_�g
Notary Public Signature of Applicant
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545 Birch Road, Southold, NY 11971
Carol Shea
Information for window replacement permit
They are Simonton Asure vinyl replacement windows. The Simonton website has a section on Asure
windows, however,there are no dimensions listed.
Here is what I can read:
November, 2014 (main house)
Remove 14 D/H, 1 picture and 4 basement windows
Install 14 Simonton D/H Asure gas energy star windows
Install 4 energy star basement windows
Cap all windows aluminum
Install one storm door(front door)
April 2015 (sun room)
Remove 8 windows
Install 2 D/H Simonton Asure double pane windows
Install 6 Simonton sliding windows
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