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HomeMy WebLinkAbout34841-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34048 Date: 10/18/09 THIS CERTIFIES that the building DECK ADDITION Location of Property: 725 SCHOOLHOUSE RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 102 Block 1 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 29, 2009 pursuant to which Building Permit No. 34841-Z dated JULY 8, 2009 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 MICHAEL & KELLY EVERS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r i AA riz d Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 � APPLICATION FOR CERTIFICATE OF OCCUPANCY CD c-) This application must be filled in by typewriter or ink and submitted to the Building Department with t owing: c� r� !�T 00 co o A. For new building or new use: _ N 1. Final survey of property with accurate location of all buildings,property lines,streets, and unus �l n ituraSr 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 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 I. Certificate of Occupancy-New dwelling$25.00, Additions to dwelling$25.00, Alterations to dwelling$25.00, Swimming pool $25,00, Accessory building$25.00,.Additions to accessory building$25.00,Businesses$50.60. 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 �eC'K Date. © O 0 New Construction: Old or/Pre-existing Building: �* (check one) Location of Property: House No. Street Hamlet Owner.or Owners of Property: ,` Suffolk County Tax Map No 1000, Section/-d, Block__ Lot Subdivision Filed Map. Lot: Permit No. 6 yam_Date of Permit.--A Applicant: dielde 4. Health Dept.Approval: Underwriters Approval: Planning Board Approval: .Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Z Go � 3q So lv` Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. '134841 Z Date JULY 8, 2009 Permission is hereby granted to: MICHAEL & KELLY EVERS PO BOX 274 CUTCHOGUE,NY 11935 for CONSTRUCT DECK ADDITION TO REAR OF EXISTING SFD PER APPROVED PLANS AS APPLIED FOR at premises located at 725 SCHOOLHOUSE RD CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0001 Lot No. 025 pursuant to application dated JUNE 29, 2009 and approved by the Building Inspector to expire on JANUARY 8, 2011. Fee $ 200 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 SOUlyo�o cout `r,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION KFOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: - � v S DATE � '�� 0 INSPECTOR �. �� 3 OF SOUTy��o CcOUMV C1c� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUND ION 1ST [ ] ROUGH PLOG. [ IF NDATION 2ND [ ] INSULATION [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: �S i� DATE INSPECTOR OF S0Ur9 o �o to OOUM`I TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: fl Q DATE INSPECTOR i FIz' D INSPECTION REPORT DATE COMMENTS o j FOUNDATION(IST) FOUNDATION(2ND) AT . z Ll ROUGH FRAMING& y PLUMBING INSULATION PER N.Y. y STATE ENERGY CODE Y FINAL ADDITIONAL COMMENTS O • �rn • H - O Z m t7 �roi 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 J 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. �� Check �a.� Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined ,20 relF1 Storm-Water Assessment Form Contact: Approved 120--0-9 Mail to: Disapproved a/c II II Phone--T I> 1 n Expiration 120 11 D EC 29-E , Building Inspector 1PLICATION FOR BUILDING PERMIT JON Date 11 n� a q , 2005 INSTRUCTIONS BLDGTOWN OFa. T is app ispletely 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 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) 80X aig Mchoq ue /V Y III (Mailing address of ap cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ICh Le., Q,a tl J�e.i 14 E Ye-�S (As on the tax roll 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 proposed work w' 1 be done. a 5 0)oolljou e' Kd . Cu 4C60 Uc, House Number Street HamleiQ County Tax Map No. 1000 Section O Block 1 Lot 5 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of posed construction: a. Existing use and occupancy - `X. Intended use and occupancy heLe 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 alterations or additions: Front 1 N'�j �!_-.' {Rear'-�- ; Depth Height Number of';Sto' nes Dimensions of entire new construction: Front Rear 9 ep�li I i Height Number of Stories 9. Size of lot: Front Rear Depth '" ^1 ="M'�'I'-1 -­ ""A " 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed 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 REf�LTIRED. 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. CONNIE D.BUNCH STATE OF NEW YORK) Nary P bOc State e50NW York SS: 50 Qualified in Suffolk Coun COUNTY Commission Expires April 14, 0 j being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (�G (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 to before me this C1 day of 2000 ���71►�^-o ram. ��/ « - Notary Public Signature of Applicant N/F GRA TTAN FD N 46' 57' JO E 100.0' M CM Lo L d' � � Y N/F McCAFFERTY N/F DIACUN. CELLAR 72' ENT. v 18.8 1 .STORY " WOOD FRAME IJA7 RESIDENCE CHIMNEY � o 25.5' 16.8' 2B.7' W CONC. PLANTER 41 Q STOOP � O BRICK C W L Q � J N N � �7 0 FD FD W FD CM CM TIE= 351.70' S 46' 57' 30" W 100.0, SCHOOL HOUSE.. ROAD SURVEY OF TAX MAP NO, DESCRIBED PROPERTY SURVEYED 08 DECEMBER, 2000 1000-102-01-25 SI TUA TE GUARANTEES INDICATED HERE SHALL RUN TOWN OF SOU THOL D ONLY TO THE PERSON FOR WHO0 CU TCHOGUE, SCALE 1"=20' M 'THE SURVEY AREA= 1S;000 SF IS PREPARED, AND'ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY, SUFFOL K COUNTY N. Y. OR LENDING INS77TU77ON, IF LISTED HEREON, AND TO THE ASSIGNEES OF 7HE LENDING /NS77TU770N. 0.344 ACRES GUARAN7EES ARE NOT TRANSFERABLE TO ADD177ONAL INS7I7U77ONS OR SUBSEQUENT OWNERS SURVEYED FOR MICHAEL A. EVERS UNAU7HORIZ£D AL7ERA770N OR ADDIRON TO THIS SURVEY IS A WOLA7101V OF SEC77ON 7209 OF THE NEW YORK STA7E EDUCA71ON•LAW. SURVEYED BY COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS.EMBOSSED SEAL SHALL STANLEY J. ISAKSEN, JR. NOT BE CONSIDERED TO BE A VALID 7RUE.COPY. P.O. BOX 294' NEW UFFOLK, NY 11956 GUARANTEED TO 631. 73' 5 5 MICHAEL- A. EVERS SAFE HARBOR TITLE AGENCY, LTD. ' FIRST AMERICAN TITLE INS. CO., OF.NY LICENS > LAND S I jR4EYOR SUFFOLK COUNTY FEDERAL CREDIT UNION NYS LIC. NO. 49273 0OR970 doss Town of Southold o g Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM o PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE-SUBMISSION OF A Q =�S' STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. ------------------------------------------------- Item Number: (NOTE: A Check Mark(4)for each Question is Required for a Complete Application), Yes No ------------------------------------------ ------------ Will this Project Retain All-Storm-Water Run-Off Generated by a Two(2")Inch Rainfall on Site? (This item will include all run-off created by site clearing and/or construction activities as well as all Site — Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaierFlowl — $ Will this.Project Require any Land Filling,Grading or Excavation where there Is a change to the Natural ❑ Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? / 4 Will this Application Require Land Disturbing- ctivities Encompassing an Area in Excess of Five Thousand(5,000)Square Feet of Ground Surface? a 5 Is there'a Natural Water Course Running.through the Site? a Is this Project within the Trustees jurisdiction or within One Hundred(100')feet of a Wetland or Beach? IV 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen(15)feet of Vertical Rise to One Hundred(100')of Horizontal Distance? \/ 7 Will Driveways,Parking Areas or other.Impervious Surfaces be Sloped to`Direct Storm-Water Run-Off J( into and/or in the direction of a Town right-of-way? 8 Will this Project Require the.Placement of Material,Removal of Vegetation and/or the Construction of ❑ 1� any Item Within the Town Right-of-Way or Road Shoulder Area? L� (This item will NOT include the Installation-of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred(100)Year Floodplain of any Watercourse? — 1 I NOTE: If Any Answer to'Questions One through Nine.is Answered with a Check Mark in the Box, a Storm-Water,Grading, Drainage&Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! EXEMPTION•. Yes No Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question;a Storm-Water,Grading,Drainage&Erosion Control Plan Is NOT Required! — STATE OF NEW YORK, CONNIE U.'OUNCh COUNTY OF ......SS Notary Public State of New York .....U.... .................. No.010185050 jG/ �. Qualified in Suffolk Coun d That I,.�......4'll.�.. -J..... ..... U /L.S...:...............being duly sworn,deposes and say�r4 ►1f�gabpafl� � Tllt, ( signing Document)Name of individual si•nin �� �P Andthat he/she is the .......................... .......................................................................................................................... (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner of 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 perfonned in the manner set forth in the application filed herewith. Sworn to before me this; ..... ...................... day of.... u .................. ,20.00 ` :. 9TT�Notary Public: ............. .. �....:. �,'�.............. ................. . . . (Signature of Applicant) FORM =06/07 -.".I1�,-II ,�.-I�.I,-1I1--- --I -_�.�1 1-III- - I -1'"-- -_�-I.-�I.� ­ 7.. , - - 7-1 .�­_1 ,?­,� % ,. -�.%,� ft - I I I.I, - . I� , _..,._*� .II ,­ _ . ­ ., a- �, --­. - - �- - --; �; . � - � C,* - ,_ N� I -- v ­­ -0 ,� — i , �" - ". - ,- r ,1 ..� )!� �, , L"f.-.,p �, 1 ,� �,� ,,�, ,4"'k- , "�,--, v� 't" ,j' - -: 4�"-7., K 7,s--- -.��, ,,..�­- � ,,4 , ll j , . 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' I 6- • - a, !T , - e 6.- j IV ,-, ­. , I , _ " . I o � :, � , J ,i : . -',_n ­ - _A ' ' 6- , �f c j . ;�� 1* 1 C .I I - ,, : " .1 11. ,­ . . USE IS UNLA­I 'tJL . o11 � I WITHOUT C )I ILATE ,,, . , I , / x` I , , , J . p& cw, 4,cv . . , - . I ,, - . I OF ,` "i: ,�� " ," , .I _ , " M RETAIN STORM WATER RUNOFF ,. *� 23v*�, ER" - HAPT , C 1 . �- PRSUANTO 1, , ; " - . '� ,�- � i .. fjHTN . *r _" �_ ; _ I I1. � . _ I _ AP R VED AS NOTED .. ,�-<.I, - �,D 2 -k c 0 , I. 0rIiVs - N , . I - ., . , .. . :, . I I I . . , I . DATE: B.P.# - I . - i 1. I FEE BY: , , .1 BUILD!t— T. AT L .l- NOTIFY 'i 1 . I . � - o I i - 765-1802 '8 AM TO 4 PM FOR THE I �*;.0 40 ��f �", � V <-( 0-6t.e%c vf ri ml,&S � FOLLOWING INSPECTIONS: , 1 .�� , .1. I. - � � , _� - . 1. FO UNDATION - TWO REQUIRED .., . 1 . I :,� .i I I . FOR POURED,CONCRETE "' , • . 2. ROUGH - FRAMING & PLUMBING 1 , _ 3. INSULATION ,I . - - 4. FINAL - CONSTRUCTION MUST , : - - _, _ � �- ,. BE COMPLETE FOR C.O. , , 1 4 1 - I I �­. , I - ALL CONSTRUCTION SHALL'MEET THE' I •. REQUIREMENTS OF THE CODES OF NEW . I - I . I YORK STATE. NOT RESPONSIBLE FOR I . ­ , , I ALL CONSTRUCT'ON SHALL DESIGN OR CONSTRUCTION ERRORS. � �4 E REQUIREMENTS OF THE : . � I, � I ,EET TH I CODES O N y T5 I �, � , . . . . . .- I Y f1 .. i I - I. . � . . I �A I � pI �� ,6 A /. . . � I . - , � , , . � I a .` . I1�1I� :1..� I,1 .I. , I' .i I ,. I I . -, , � , � - ' I , �k � . L 1, �I I � , ­ �I �� ;', �, - � , � ­ ' ' .I I , I - . J " I 11 L . I .1 � - . � " I . � � ­• I I . I - 1� I . I , _7 - . � � I . ­ I . . I . � 1. . 11. � I, I . - - L � I -.1 � 1� - . , . ��, I,I . I.,��) I ­ I . I I �. �. I I . �e. .. I � I . �� 1, �, " ., I � . � I 0�,­� % .1 �L� , _. -, , —, � ��­ . - I I , : .1 . I. . ... -� .- L� I I . I I . : - .1 .1 1�., - ll,*� L I ,� - I ". "L .' .- . �,t * ; �- . .,,- I . e,•.�v, kl� _. - � - , I _ . . I � I1. 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