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42946-Z
�4�gUFF0I,YCpp� Town of Southold 8/22/2018 P.O.Box 1179 P 53095 Main Rd 4, ' �a10, Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39859 Date: 8/22/2018 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 2435 Brigantine Dr., Southold SCTM#: 473889 Sec/Block/Lot: 79.4-64 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/8/2018 pursuant to which Building Permit No. 42946 dated 8/14/2018 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 Motschenbacher,R&Amy of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A th d Signature Sa�n[�reTOWN 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#: 42946 Date: 8/14/2018 Permission is hereby granted to: Motschenbacher, R 2435 Brigantine Dr Southold, NY 11971 To: legalize an "as built" deck addition as applied for. At premises located at: 2435 Brigantine Dr., Southold SCTM # 473889 Sec/Block/Lot# 79.-4-64 Pursuant to application dated 8/8/2018 and approved by the Building Inspector. To expire on 2/13/2020. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $535.20 CO - O LLING $50.00 otal: $585.20 1 Building Inspector a a 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: 7—L'3� ,�� 6-,*AJ rlAl e- —DI—I v`d SO�TIcp House No. / Street amlet Owner or Owners of Property: 12 f CA-O-/d / y 0?. 6&,C,t/f��d G d�fil� Suffolk County Tax Map No 1000, Section_ :79 Block Lot o Subdivision I& [,d 6-H 1-f Cf? A1-6J Filed Map. ! Z Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: L/ (check one) Fee Submitted: $ Applicant Signature r - # * TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ NSULATIO9t1iliJZeo�--FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: ' DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(15T) 'FOUNDATION (2ND) ROUGH FRAMING& PLUMBING y INSULATION PER N.Y. STATE ENERGY CODE � p � Lor j FINAL ADDITIONAL COMMENTS 2-1 S O T z • •N C� _ O O 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 South oldtownny.gov PERMIT NO. 442—Cl Check Septic Form N.Y.S.D.E.C: Trustees C.O.Application Flood Permit Examined 0' Single&Separate D � 1 Truss Identification Form Storm-Water Assessment Form AUG ' 8 2018 Contact: /f� Approved � 0CXAi'/ 1107Ie4444 u/ Disapproved"a/c I . To" , , �� ; lin `'� Phone: l Expiration 20 3(; 2- 7� Z` 3 4?�l nape or APPLICATION FOR BUILDING PERMIT , INSTRUCTIONS Date 20 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 throughouf 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 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. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises c-bar� o /t rnyt Ayre/-joA d Ace-t g-2 (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'i'cense leo: Other Trade',s License No. 1. Location of land on which proposed work will be done: / , House Number Street Hamlet County Tax Map No. 1000 Section Block � Lot Subdivision I`f�2P�/L L,t.� rr EsZ',*-rz r filedMapNo. _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 AsBut' JA"Alteration Repair Removal Demolition Other WorkL;ogs, p� � (Description) 4. Estimated Cost _ _ Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units ;leu be_r`of dwelling.unit� on-each floor If garage,ara e, number of cars f �°� '�--' 6. If business, commercial or mixed occupancy, specify each'type of use. 7. Dimensions of existing structures, if any: Front Rear- , Depth Height Number of Stories g•. Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Sforios' . 9. Size of lot: Front i `� Rear Depth 2-oz) 10. Date of Purchase Name of Former Owner /N 1)A? '17 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO t 13. Will lot be re-graded? YES NO Will excess fill be removed.frozn premises? YES NO 14. Names of Owner of premises '� Address Phone No. 7��Name of 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 k"'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) �((yyam� SS: COUNTY OFS LSO r Q hQ nLDC. her being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the \ xle e (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 tYii trW'1'-il1DWYER performed in the manner set forth in the application filed therewith. NOTARY PUBLIC,STATE OF NEW YORK No.01 D W6306900 QUALIFIED IN SUFFOLK COUNTY Swo n to before me thisCOMMISSION EXPIRES JUNE 3U, (o 4L1 day o r 20 jp.) . OW U rotary - ubli Signature of Applicant Scott A. Russell ,� °Su m STO>KN[WA\TEK SUPERVISOR � �. IWA\NA\GIENUEN'7C' SOUTHOLD TOWN HALL-P.O.Box 1179 u' 53095 Main Road-SOUTHOLD,NEW YORK 11971 STown of Southold 1 `� CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) ---------- ----------- —----- - - DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: A�'�A. (CHECK ALL THAT APPLYesY Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑ B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ', ❑�. 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. ❑ E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square f eet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes 1 ; 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 Cheek 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: 4 Ny jp � IA4e (Po —I� Section Block Lot FOR BUILDING DEPARTMENT USE O\L Y Contact Information 76.5--- 3 rawnanc N—t„ Reviewed By: 4a" — — — — — — — — — — — Date: 7-1G —/5 Property Address /Location of Construction Work: —d — — — — — — — — — — — — — — Approved for processing Building Permit. 3�J I�&(4.AAJ!'w1l9 / rl VL Stormwater Management Control Plan Not Required. TVA �� ! f 7 -7F] Stormwater Management Control Plan is Required (Forward to Engineering Department for Review) FORM 11 SMCP-TOS MAY 2014 ;•'�• ;_`��;�„�r�s�t• .,, , .,-: . ;.; ',,.,-�, : � '' " 'suFr•.co.H ovw 1 r�'a.��o: DATEDEC 12 1978 H. D. REF.' # $-$O-.$A1 �; :til�l�,rfZ• 4 r ' .' , - .�6e. 7r'/-loL © A X 7/ T Tni0.sewage di e p oset end rrit er >1Tpp Pac i 1:'.;es f r t,?'li^ lnc'T' :n have been". in.;aoctcd by this CAG'? ?'t and found + ARm^: ti�,��n �;�LG!?i�cr � 7 Y to be satisfactory.i� Chief of General Engineering DRUM LNLA Services VC�Ct�t►if9 �Y�1t3YS, ' - $(1r ' � `D 141 I z O / <5"g `1 Uy' Trail in cdk ,._ .., I>.. •J -,[.•, •'�,•`� - ,-•¢4 i,¢y"• , 45i2{tt`' t,�5•II3 F .,t..' - .t x v-.:c'R,Pnt'f¢�•.$.%-.,y-• ,Ait ri-.�:t`.b`?s^. '•''ri,l,?�`.1�C.�4, '+K. ..r, ,+i='.' �✓.: S.Y �_' � 1,`I`°'• i�l�'� A:L*,-, F L - - — 0 e _ L.. � Q 11� A: SCALE: ?� �hX071 63 �vel � 6¢( a W"UFNORRED ALTERATION OR'ADDIT" nos 1Lw"16 A pt C Q 9 OF THE NEW YORK STATE EDUCATION COPIES OF THIS SURVEY MAP NOT BEARIN 0 THE LAND SURVEYOR'S 1N',.D SEAL OR • -� Q^J IMIOSSED SEAL S!IALL NCT EE COUSICUM rte"' TO R A VALID T:.UF CCPV, ■ - Q*VAxIT7r's 4K7-AT-0 Y:4::'?,�.SlIA44 Yft'N Im THE>P:5t9N far,sI•:.,A fm ,9• p Ti%"SAM,A.,D O,1 rt:.,C_I ALF 4p tr;W n'FitE=COMPAKY, G0Wr.:.pi:4.--*L/,rrL'�eyV a UNDING 41,S74=31I 1!Sl:;,H.H p 1,A" TO THE•YLSSIGKM Of TI?:1;E,IM,-*114411- TUTION.GuARANI".S,Y{,",NQTj TITLE CAUMF. ro'rD�nroNAL:ncsTlrurl�?t 9p ,WNER$. -�-` �owri�r, ;TAMP =�' Z-,,'-1-e- /�41e Insar kic SEAL ' "A/.G1ROO!Zahc! /M,0,47 /�/a. -5`/4 7) Sanik As s�{r vee e d Nov.71" ' , RODER'ICK VAN YL. R •G. ve.- .... .�► """' ' ' ` LIC.LAND SURWYORE>T-GRS6N RT, N.Y. 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'•f , ,�+t�! ..;T p..'Jit "x�1:'xt. �•,' .Y c, ^'1�' rrMfi..�"�' 1' 2.. v. - F' •.+•, ,. •'f 't .d. i' "+;`. ,,", .5 a�'6 G' �`'r;e L.,.f" 3,., r'.',.. '''' " '4``''+'r ., • „ '•r 1- ' N Z V Y CL 42 'o Go ori_ o c w Z . 0% W g N � M IX so . 01 LL? L0 I L. I - .. ... - - • O� m o � I r ff i N ��p ~1 I Tfi" �•. V) � 2/4'x 6P11 Qf,*&KI U4NO w - �� i FST' �'' x u 2yIo pr u G+ ��J-Cv ► ,r I 0,& , _ = l�p�� DATE IMA � B.P.�#�Z� A 2 X10 4 XA FF Po!�- I FEE:§5,662 B •� ► '��r{LI i?G►���J� ` NOTIFY F3UILDING. DEPARTMENT T 'p 765-1302 8 AM TO 4 PM FOR THS FOLLOWING INSPECTIONS: • 1. TWO REQUIRED FOR POURED CONCRETE J7�1 • I I 2. ROUGH - FRAMING & PLUMBING T � 'v 3. INSULATION N 4. FINAL - CONSTRUCTION MUST �� �k BE COMPLETE FOR C.O. FXI�T! I P ALL CONSTRUCTION SHALL MEET THE I al #?(„ GjTr _ _ ,O 4X4 I REQUIREMENTS OF THE CODES OF NEW - MrS I 'r it I Lj— YORK STATE. 'IPT RESPONSIBLE FOR�� � x « - (� �)UC- 'P r CONSTRUCTION ERRORS. j i COMPLY WITH ALL CODES OFI I »x NEW YORK STATE & TOWN CODES E ` .�� u_ oil 'p 2X1 , N EOUIRED — �• ASH . A SO !� �-"X4-• ��',f�D`aT1t" O� '� _ cXrr11wrEES _ -- - - N.Y`S:fic�— if l 8ti� i I - _ '��l _ �' �f _ Cert , cored- M � I10�. FFIu-a,a90 r H ��H r-� e e - - OCCUPANCY OR T—t) r;",f r—,.---57A 4 USE IS UNLAWFUL r�;itJU � VI T { BOUT OLFfIFIO T ZD. OF OOCU AINCY HA{ �Qi �v -Tt I -3 FL/–" J5r7