HomeMy WebLinkAbout37002-Z �4�s11FFG,1& � Town of Southold Annex 4/27/2012
P.O.Box 1179
y 54375 Main Road
o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35564 Date: 4/27/2012
THIS CERTIFIES that the building WINDOWS
Location of Property: 3650 Ole Jule Ln, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 122.4-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
2/14/2012 pursuant to which Building Permit No. 37002 dated 2/16/2012
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:
replacement of one window as applied for.
The certificate is issued to Munier,Robert S C&Munier,Jan C P
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Autho e Sign ure
o�SV ztv- TOWN OF SOUTHOLD
�� Gy BUILDING DEPARTMENT
y z TOWN CLERK'S OFFICE
oy • 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#: 37002 Date: 2/16/2012
Permission is hereby granted to:
Munier, Robert S C & Munier, Jan C P
114 Old Coach Rd
Basking Ridge, NJ 07920
To: replace an existing window as applied for
At premises located at:
3650 Ole Jule Ln, Mattituck
SCTM # 473889
Sec/Block/Lot# 122.4-23
Pursuant to application dated 2/14/2012 and approved by the Building Inspector.
To expire on 8/17/2013.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
Total: $250.00
Building Inspector
V vv
Form No.6
TOWN OF SOUTHOLD
BUtLDING 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:
l. 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 Occu'pancy is
denied, the Building Inspector shall state the reasons therefor in writing to file applicant.
C. Fees
I. 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 Buildin (check one)
Location of Property: 3 6 S o C/e__
House No. Street Hamlet
Owner or Owners of Property: o�,;Y —(— +
Suffolk County Tax Map No 1000, Section 12 Z Block `/
Lot Z
Sulidivision Filed Map. Lot:
Permit No. 3 ��Oa Date of Permit. fa Applicant:
Health Dept._Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
OF SO�lyo�o
S-1007
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] RO GH PLBG.
[ IF NDATION 2ND [ NSULATION
[ FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [71RERESISTANT
SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION [ PENETRATION
[ ] ELECTRICAL (ROU H) [ ] ELECT CAL (FINAL)
REM KS: �. 1
Cam`
DATE3 /y /�� . G✓
INSPECTOR
3700 2-- —e7— �Atf so(/r�,
�o ono
co ,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ION
[ ] FRAMING/STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE r INSPECTOR
FIELD INSPECT N RtE�ORT DATE COMMENTS
FOUNDATIONZ(1ST)
FOUNDATION(2ND)
ROUGH FRAMING&
PLUMBING O
, M
INSULATION PER N.Y.
H
STATE ENERGY CODE
co
FINAL `
ADDITIONAL COMMENTS
Z
. rn
r� O
m
W
, F
i
TOWN OF SO�YHOLD i UILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health (j `' N0� '^e ,Q
SOUTHOLD,NY 11971 4 sets of Building Plans `e.5
TEL: (631) 765-1802 Planning Board approval ->o fya,f`A/leI-S
FAX: (631) 765-9502 Survey t/ s
SoutholdTown.NorthFork.net PERMIT NO. J 70 Check yc 5
Septic Form ' y Zs /YO'r f ee-cQ
N.Y.S.D.E.C. -�)o rVvl- zee,¢
s% 44�/J W
C.O. Application y,- S
Flood Permit
Examined ,20: Single& Separate
ECE0VD Storm-Water Assessment Form
Contact: C _
Approved / 20ra"� Mail to:
FEB 4 2012 ?n�. c, ,3 x�' s
1
Disapproved a/c /%.-7F /V.Y
BLDG.DEPT. Phone: L 3 c?c)? C Z 3
Expiration D 20 OWN OF SOuTHOLD
Building Inspec or
APPLICATION FOR BUIL ING PERMIT
Date Z -/`/ , 20 /Z
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter o• 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 isIsue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the worl<.
e.No building shall be occupied or used in whole or in part for ally purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has n t commenced within 12 months after the date of
issuance or has not been completed within 18 months front such date. If n zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building inspector may alltlorize, 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 or removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building lode, 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)
�sz �l y 11�'rZ
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor or electrician, plumber or builder
C4 'r
Name of owner of premises
(As on the tax rbll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. .3/ 1 s-- �4
Plumbers License No. Mot- Ne ecQ
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
36.o C) /e- A -,
House Number Street Hamlet
County Tax Map No. 1000 Section 17- z- Block Y Lot 23
Subdivision Filed Map No. Lot,, : S
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 1 rub _
b. Intended use and occupancy l ��v,,� (� �8 s
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost 4e 6 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 S�� Depth Z c
Height Number of Stories %
Dimensions of same structure with alterations or additions: Front Rear
Depth Z P Height Num��ber of Stories f
8. Dimensions of entire new construction: Fronts ���'��; y,-Rear`��°`"y Depth 4
Height Number of Stories
9. Size of lot: Front � ' Rear �-3 Depth 0 C)
10. Date of Purchase o2 d 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 x Will excess fill be removed from premises? YES NO-
R"b+ 114 47r N.Y'
14. Names of Owner of premises f!a� ►'�'^�' �� Address 36` 0 O'�- J�'1'--/Phone No. ��U�3 ��Z V 9 7S�
Name of Architect Address Phone No
Name of Contractor Address V10 & 1'e,44/—%*-�Whone No. 62 6 (Z 3
60A I—(,
`Y
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 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)
COUNTY OFF �" f
'b&4LO—ed being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the �L
(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 pefore me this
�- day of f�o4 7 KI TOTH
agr RuHtic State of New Ynr`k
No.01`fO6i90F96
Qualiried in Suffolk County
Aires July 28,20 g Notary Public Si nature of p licant
-
i
Town of Southold
�o5�k I
two L
Erosion, Sedimentation & Storm-Watery Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.0 T.M-# THE FOLLOViIiNG ACTIONS MAY REQUIRE THE SUBMISSION OF A
41 l�j �C60 I L Z / .22 STORM WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN
�ilric -S on hoc rl— —[Ft— CERTIFIED BY A DESIGN RROFESSIONAL iN THE STATE OF NEW YORK. i
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No F
a. What is the Total Area of the Project Parcels? Will this Project Retain Ali Storm Water Run-Off
(Include Total Area of all Parcels located within �2 8. S r(-
Generated by a Two(2")Inch Rainfall on Site? I
the Scope of Work for Proposed Construction)
(S.F./Acres) (This item will elude all run-off created by site
b. What is the Total Area of Land Clearing clearing and/ construction activities as well as allF-1 '
and/or Ground Disturbance for the proposed (i Site Improver nts and the permanent creation of
construction activity? (s.F.l Hoes) impervious su aces.)
z goes the Site lan andlor Survey Show All Proposed i
PROVIDE BRIEF PROJECT' T)FBt;RIPIZON (PrmvdeAmBle,ralPagesesNaeded) Drainage 5tru rev Indicating Size&Location?This j/ ❑
Item shall include all Proposed Grade Changes and
Slopes Controlling Surface Water Flow.
�C r' Vlny rim. I �
3 Does the Site Rian and/or Survey describe the erosion
1�J O n ��S'� w ,,,-f i� (,,d, and sediment c�ontrol practices that will be used to �� ❑
control site era I*on and storm water discharges. This
item must be mmaintained throughout the Entire
Construction t'tinod.
4 Will this Proje4 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? 1
5 Will this Application Require Land Disturbing Activities , i•
EncompassinglIan Area in Excess of Five Thousand
(5,000 S.F.)Sduare Feet of Ground Surface?
6 Is there a Natural Water Course Running through the /
Site? Is this Project within the Trustees jurisdiction ❑ {`/
General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or j
Submission of a SWPPP is required for all Construction activities involving soil Beach? i disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be S e preparation on Existing Grade Slopes
1
are part of o larger common plan That will ultimately odisturbances
disturb one or more ne(1 of land; Which Exceed FFifteen(15)feet of Vertical Rise to
including Construction activities involving soil disturbances of less than one{i)acre where One Hundred(f Q0')of Horizontal Distance?
E]
the DEC has determined that a SPDES permit is required for storm water discharges. I.
(SWPPP's Shall meet the Minimum Requirements ofthe SPDES General Permit $ Will Driveways,Parking Areas or Other Impervious 1
for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ t
1.The SWPPP shall be prepared prior to the submittal of the NOT,The NOI shall be into andlor in t�e direction of a Town right-of-way? l
submitted to the Department prior to the commencement of construction activity- j..
2 The SWPPP shall describe the erosion and sediment control practices and where Q Will this Project Require the Placement of Material, I
required,post-construction storm water management practices that will be used andlor Removal of Vegetation and/or the Construction of any !.
constructed to reduce the pollutants in storm water discharges and to assure It Within th I Town Right-of-Way or Road Shoulder
compliance with the terms end conditions of this permit In addition,the SWPPP shall Area?(This Item l NOT Include the MstAllatlon of DdvewayApron%)
identify potential sources of pollution which may reasonably be expected to affect the
quality of storm water discharges. NOTE; If Any Answe�to Questions One through Nine is Answered with a Check Mark i
3.All 3WPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.81 Acre in area,
component shall be prepared by a qualified Design Professional Licensed In New York a Stuns-Water,Oradiikg,Drainage&Erosion Control Plan is Required by the Town of
that is knowledgeable In the principles and practices of Storm Water Management, Southold and Must he Submitted for Review Prior to Issuance of Any Building Permit.
(NOTE: A Check Mark ,J)andlor Answer for each Question Is Required for a Complete AWI albn)
t
i
STATE OF NEW PORK, ;
COUNTY OF....aA....... ��...SS
That Zr......� �......
being duly sworn,deposes d says that he/she is the applicant for Permit,
(Name of individual slgting Documefit) ,
And that he/she is the ....................................(- J.l�- .L �................................................... I .
(Ovrrrer,Contractor.Agent.C. orpaate Ofll r,e0c.)
Owner and/or representative of the Owner or Owners,mid is duly authorized to p dorm or have performed the said work and to
make and file this application;that all statements contained in this application are t llue to the best of his knowledge and belief;and
that the work Hall be performed in the manner set forth in the application filed heremvith. i
" Svlrom to before mse this; /�
........................................... .day ti........ .......................... ,20-••-•
NotaryPublic: .... 1....... ......................:..............IVi'Etfli'.0TV L am............,..........
(Signature of Applicant)
FORM - 06/10 No.01T061905 6
Qualified in Suffolk County
Comrnission Expires July 28,20
15URVEY OF PROPS' RTY
51TUATE: MATTITUGK N
TOWN: 5OUTHOLD
5UFFOLK GOUNTY, NY
es
SURVEYED 12/14/07 W E
SUFFOLK COUNTY TAX #
1000 - 122 - 4 - 23 f S
CERTWIM TO:
RO]BERT S.C.MUNIII R
SAN C.IF.Pu UNII a
VMM]FARGO BANK,N.A.
SKYLINE TITLE,LLC
STEWART 3'II7CLE INSURANCE CONPANY
�6 0
sB;S a,
0%
Op,
as 6 S8.9
o ,
AS
. post
O Q DRIVj�VAY
?s. 0
7.7' N
ti coHou FAY FOUND
0, GA GS O
�O
GONG.
�L,DECK i Mall o.6QW�9 Q
J �
XW
/ FOUND l�
' G
\ Q o
FOUND O ..
m
\ o
` \
GO
C
Laitnorlred a mt�
mop baQLiy o Ikeroee Ind eweynb seal Ie o
! vlolotlon or eectbn i xt-ena.bn�of Nis
fbw York
Stafe Fd.cetbn Law!
' •any eaplee r ens nlgwi of we ewey
_ ���W{��,r/ morkee Itn on aguwl or the lord eevoyn5
A lO• ES: 9lunpetl seal Yell is[oer�leeroe to bn valb We
r�l r L✓
'Ceft.V—MI-ted Hereon elyilly Nbt tlJa
MONUMENT FOUND S'l"1.1 Cape
aJ eie New Yak Stoto Oseoelatbn o/PrfeeYmol
Lab sw.,eyon. Sole certl/lcotlone Ynll nn only
.. to Ne penon for venom Ma—.y Ie prepnee,
mtl on nb laehall to tM title campary govertvnen-
- STAKE FOUND .. tal egerry o.,e lenekg r blwnon Iletee M on one
tib melyieee of th.lording metlwtlon.ee rlco-
tw�e ore not trorererotro ro ode¢lorbl NMetlwti"
AREA = 22,373 S.F. OR 0.51315 AGRE JOHN C. EHLERS LAND SURVEYOR
6 EAST l IAIN STREET N.Y.S.LIC.NO.50202
6RAPHIG SGALE 1"= 30' RIVERHEAD,N.Y. 11901
369-8288 Fax 369-8287 REF.\\Compagserver\pros\07\07-236.pro
M C H
Design Services
www.mchdesignservices.com
phone:
(631)298-2250
e-mail:
michael@mchdesignservices.com
30-CW14-CW14-CW14
61 /11 BAY WINDOW 66-411
REPLACE EX.BILCO
GC TO REVIEW 0 0
FOUNDATION &
REPAIR AS REQUIRED
1ST. FLOOR PLAN 1 4
V
SCALE: 1/4" = 1'-0" W 1-4 H
t=. �D
W W H
W
APPROVED AS NOTED .,—i
- DATE. '9 4�, /,z B P #._37�'a
Fcr 1, BYZ
—_- — -- _ N( 3U1,-DING DEPA, ,Mc_N r AT
_ AN" TO 4 PM FUR THE
FUt uVJ!%,. INSPECTIONS:
— — — I. f-OUNDATION-TWO REQUIRED
FOR POURED CONCRETE
_ 2. ROUGH-FRAMING,P0.1E"V;.
STRAPPING. ELECTRICAL & Ca!r
3. INSULATION
I
4. FINAL•C1-'NS-'?';G' ;N 8 F' r i n,
MUST SEC^_t.1F. _'`1
11LALL CONS'K I( !G Hr
I "T
I
c 'EsP'on; h ,, DRAWN BY: MH
lid
JANUARY 26, 2012
UNLAWFU
.. . � ��, � -,
uo ,�a, IT GEC TII�,6VAT
AINI Y
tam >
SHEET NO
REAR ELEVATION
SCALE: 1/4" = 1'-0" ''w
ssl?