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HomeMy WebLinkAbout37276-Z Q�Qg1fF0 N Town of Southold Annex 8/2/2012 _ y P.O.Box 1179 c 54375 Main Road 'i �� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35854 Date: 8/2/2012 THIS CERTIFIES that the building DECK Location of Property: 5500 Rocky Point Rd, East Marion, SCTM#: 473889 Sec/Block/Lot: 21.-3-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/29/2012 pursuant to which Building Permit No. 37276 dated 6/5/2012 - - 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: repairs to existing deck and"as built"deck addition to an existing one family dwelling as applied for. The certificate is issued to Skulikidis,Michael&Ploum (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A ed Signature . o�g'3FFoj/.co TOWN OF SOUTHOLD �a ay BUILDING DEPARTMENT y i TOWN CLERK'S OFFICE lob • 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#: 37276 Date: 6/5/2012 Permission is hereby granted to: Skulikidis, Michael & Skulikidis, Ploum 40-15155th St Flushing, NY 11358 To: repair an existing deck as applied for At premises located at: 5500 Rocky Point Rd, East Marion SCTM # 473889 Sec/Block/Lot# 21.-3-1 Pursuant to application dated 5/29/2012 and approved by the Building Inspector. To expire on 12/5/2013. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 41tV�Cjjl_-' Building Inspector Y91 ? 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: Ar For new building or aneW.11 e. 1. Final survey of property with accurate-location of all buildings,property fines, 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 2110 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$50.00, Alterations to dwelling.S50.00, Swimming pool$.50.00,Accessory building$50.00, Additions to accessory building$50.00,Businesses$50.00_ 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate o€.Occupancy-$_25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy -Residential$1..00,Commercial$15.00 Date. �— New Construction: Old or Pre-existing Building: (check one) Location of Property: _—so AQUA A V� ��S%�A4.fJ�d� House No. Street Hamlet Owner or Owners of Property: 0 ff ` S Kv L/K'I bl s Suffolk County Tax Map No 1000, Section © Z/ Block o 3 Lot © o*1 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: /V Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ ] SULATION [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL ( QGH) [ ] ELECTRICAL (FINAL) REMARKSaxi a r L DATE l INSPECTOR FIELD INSPECTXON REPORT DATE 7 COMMENTS FOUNDATION(187) - ------.•.-..---- ------------ FOUNDATION(2ND) . � z ROUGH FRAMINQ& �y PLUMBING INSULATION PER N.Y. , H STATE ENERGY CODE . 4 OR 000l .. 1 FINAL ADDITIONAL COMMENTS U\ W t4 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 Survey SoutholdTown.NorthFork.nct PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees n n � C.O.Application U Flood Permit Examined 20_ Single&Separate Contact:Storm-Water Assessment Form Approved /,20_,a BLDG.DEPT. Mail to: 26 ^ 19 Disapproved a/c TOWN OF SOUTHOLD �/ Phone: Expiration IO �,20 73 Building Inspector APPLICATION FOR BUILDING PERMIT Date 2— , 20 / 2- 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 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. OCCUPAI1CY OR A1 A/ A 9 (Signature of applicant or name, iT a corporation) I""" fT4'5_ ieo C K CaVc C--r 6�e5ii-Ploole5r Y (Mailing address of applicant) m a � _.I 0 - State whether applicant is owner, lessee, agent, architect, engineer, general cpVtlActor, electrician, plumber or builder A10T(Fy BUILDING DEPARTMENT AT Name of owner of premises 76�51802 8 AM TO 4 PM FOWTHEn (As on the tax, o MVPSI�TIONS: If applicant is a corporation, signature of duly authorized officer � r OUNDATION-TWO REQUIRED FOR POURED CONCRETE 2 ROUGH-FRAMING,PLUMBING, (Name and title of corporate officer) WRAPPING,ELECTRICAL 8 CAULKING Builders License No. 3 INSULATION Plumbers License No. 4. F1NAL-CONSTRUCTION 8 ELECTRICAL MGST BE COMPLETE FOR C.O. Electricians License No. ALL.CONSTRUCTION.SHALL MEET THE Other Trade's License No. RE,)UIPEMENTS OF THE CODES OF NEW YORK STATE. NOT kESP*IBLE FOR DESIGN OR CQNSTRTION ERRORS. 1. Location of land on which proposed work will be done: �.:,,., . House Number Street Hamlet County Tax Map No. 1000 Section 0 2/ Block 0-3 Lot 0 m l Subdivision Filed Map No. Lot 2. State existing use and occupancy of premi es and intended use and occupancy of proposed construction: a. Existing use and occupancy S_S 1 p 2 N71 4 I- b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair V11- Removal Demolition_- _ _ _ Other Work (Description) 4. Estimated Cost f 0 0 C" O Fee (To-:be paid on filing this application) 5. If dwelling, number of dwelling units Nut"* " ,< g hits on each floor er'A'o d��in u If garage, number of cars 6. If business, commercial or mixed occupancy specify mature arid 0x'tent 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 Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front /_570 Rear / 5--fl Depth / SQ 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 V Will excess fill be removed from premises? YES NO 14. Names of Owner of premises 5k ya krJ Is Address 5V A NW PVC- 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 t/ * IF YES, PROVIDE A COPY. STATE OF NEW Y0W' ' , COUNTY O u Fa s-i"I.! ;J� i r"`i_d i'1P`i iA 1.01 f, being duly sworn, deposes and says that(s)he is the applicant (Name of individual„s ^""ncQ,ljjt vet)a ove flamed, (S)He is the �'� T,' ,,�tii'-'t';3 t,;; •;a�:'_:,.. (Contractor`3'Agent, Corporate Officer, etc.) of said owner or owners, and is, uly.,-u-thof ed to,perform or have performed the said work and to make and file this application; that all statements contained�i tliis!aplicaYo ,are,true to the best of his knowledge and belief; and that the work will be _." '' `' ' `j li'' ion file t a ��SCAN®ISH performed in the manner set o� h inxlie, p , . © rll u C,State of New York d 1ST6164008 Sworn to before me this Qualiff .I Suffolk Count{yy (;oFtiFrii siot# ii 5 April 91 day of ` 20/ Notary Public Signature of Applicant Town of Southold - Chapter 236 - Stormwater Management ors SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPLICANT NAME: Owner-Agent-Consultant-Contractor or Other(Circle One) Property OWNER:(If Different than Applicant) i e Oa-£L v ra, 1 bl s Address vA, Address: n i Telephone# Fax# �15 �,v Telephone# Fax E-Mail: E-Mail: Property Address: Brief Description of Construction Activity,Proposed Structural BMPs,Soil S.C.T.M.#: l000 Stabalim ion BMPs,Project Scope and/or Sequence of Construction Activity Dbtr Wtrfct Section Block Lo! (Provide Additional Pages as Needed) Name of Contractor and/or Contact Person Responsible for Implementation of SWPPP: -------------------------------------------- Address: -------------------------------------------- TelephoneFax#: -------------------------------------------- E-Mail: ----------------------------------------------- Ii Name of Persons Responsible for Installation 8 M�Intenance of Erosion Control Practice: -------------------------------------------- Address: 4 -_------•-------------------------- ------------- - it Telephone#: Fax#: -----------_----------------------•--------=--- t E-Mail: Total Area ofAll Total Area of Land Clearing ------------------------------µ------- —+-- Project Parcels: and/or Ground Disturbance: (S.F./Acres) —-_....., —._—.___ _ (S.F./A—) Project Duration: Start End -- — ____.______ __._ _ _„ _________ _______„ (Anticipated) Date: Date: -------------------------------------------- of Ca —__-----.,_.....-......._—_..---------.-.-----__--_.-__---- (Nu lendar Days) Will this Project Disturbe five(5)or More Acres at Q Q -- - -- ------ ------------------------ ---- i Any One Time During the Proposed Development? Yes No ----------------------------------------------- If YES:Please Answer the Followingl -------------------------------------------- 1 a. Does the Applicant have a Qualified Inspector On Q Q Staff To Conduct the Required Inspections? Yes No b. Does the SWPPP Indicate How Frequently the Site O List the NAMES or description of all Potentially Impacted Waterbodies and/or Wetlands: Inspections will Occur and for What Period of Time? Yes No c. Does the SWPPP Adequately Identify All Temporary Q Q ---------------- ------------------------------- and/or Permanent Soil Stabalization Measures? Yes No ---___.____-__---_--__--__.__.---------------------- d. Does the SWPPP Adequately Identify a Complete Q Q __......._.._._.._...._...__.._...................................._.....____._____._________ Project Phasing Plan? Yes NO Status of Impacted Waterbody:(eg.TMDL,303(d)Listed,Impalred...) j e. Does the SWPPP Indicate Additional Site Specific Q Q i Practices that Will be Utilized to Protect Water Quality? Yes No .................................................................................._....................................._......._................._......... f. Has the Applicant Submitted a Completed DEC Notice Type of Impacted Waterbody.leg.Lake,Creek,Bay,Pond,Sound,Freshwater Wetland...) Of Intent and SWPPP Acceptance Form for Review j by the Town of Southold? Yes No ! STATF,OF NFW YORK, rr�, I COUNTY OF..J T".............................SS ! That I,.. . R�?. � �` !-� ing duly sworn,deposes and says that he/she is the applicant for Permit, l (Name of individual signing Document) And that he/she is the ..A4.(.,6L-1-�.L:.......Si<L)-L-t !� `...... .... ... (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to I make and file this application;that all statements contained in this application are trlFt� wledge and belief;and that the work will be performed in the manner set forth in the application filed I�ttpU IIC,State of eW irk Sworn to before Ise this; �!q 01ST6164008 tl� QOA fled in Suffolk Coun{{yy� 4i14� rbtl Eltpires April 9;20 F .....................day of...R ......... --..............,2012 ; au Notary Public .- - ... .................. .. ......... ......... �.......... ............... (Signature of Applicnt) � SWPPP Assessment FORM: 03-12 pF SO�jyol Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �Q July 17, 2012 BUILDING DEPARTMENT TOWN OF SOUTHOLD Michael Skulikidis 40-15 155" St. Flushing, NY 11358 Re: BP 37276 — Repair Deck- 5500 Rocky Point Rd, East Marion Dear Mr. Skulikidis: In order for us to issue a Certificate of Occupancy for the above referenced building permit, you will need to submit 4 sets of"As Built" stamped plans for the additional decking. Once we receive those, we will amend your permit and notify you of the additional fee. If you have any questions, please feel free to call our office. Sincerely, Gary Fish Southold Town Building Department 'i® S .WHO `,PW PE��Y RECORD I�� IF: OWNER STREET. 'VILLAGE ;DISTRICT. SUB:. LOT - Is - rr A r'r . L-S FORMER OWNER c N� E , '.. ACREAGE �'r A GLAR'K W r ,,or r v,,iy� e.�n✓ � G ; �. S _T �A -�} s, b , TYPE OF BUILDING - RES. 6 SEAS. VL. FARM COMM. I IND. I CB. I MISC. Est. Mkt. Value i LAND.. IMP. TOTAL DATE. REMARKS:' 8.7 j nncintJ :lfG� r rSo S oG/�� P U qWtx Y ��t r4 /:.0 cJ �/ !>-(/ ,A'r �✓� - 6)!LYl�1i, .�ir "f� i✓c �', i90 �'tr�f.. �� I — fr t) f �' Deep 5.�. r73 �, To K Z, ju-.w ILDING CON[by', 7 r - p1­97AO O - . NEW 5�10. L. j QELOW ABOVE FRONTAGE ON WATER rm p e r A V�{u/e FRONTAGE ON ROAD / -D X1�0 a Tillable '1 BULKHEAD: Tillable 2 DOCK: Tillable. 3. Woodland Swampland .... i I Brushland.. .. -House Plot. f Total _ _. i �Q U.�J Y/E L✓ f1 YEit/UE- IV 77%9-540 /Jfo,ob' MON, +j Cd.a/C kl Q Q n oNE sroeY I V Q' � . Nr� O \� \, .r Jam//7-N.e r.✓ co..ic MoN n„ S 77%9 So ;,V 130-op' ' �/MA-2oiKOS ET ux i� f o�sc.�i<sEa �.�'a.pE•,ery .EAS 7- - Toy✓.c/ o.� 5oclryOL o, E SUFFOG.'C CaU,vr'Y i(/.EJ-S/ y0,2K I } P.ECO.c/iC ABST,PyGT /NG, FORTUNE Mo-�TGAG�BAN.eE,e S- /,�/�. of NEW B,ec/c� ¢SNie L.EYA S/E✓E.�MA� �(F- �YO� ,�PPv\,I CA i 1 ti SURYF,-��� �f.: : % 1•<<';/'� L.S. 371:c 1 PHUL T, CA.C/.yL/L�sp .SU.PY E>'O,e o/sr. i000 sEc, 02/ o�.r. 03 LoTOo/ /ygMoTON B�9yS t/.Y. �Q C.iA Y/L� L✓ /9 YEit/C/E- - ' _ �i9di"✓,4GT SURFACE, . iV 77 ♦9-so E /moo:oo' i oo c taut.i i ` N e +� c � qj -�n -)ALf ° . n ir�. ok� 'A'' 3 ` X • 77 /9 50"W MR,e/ice! t i I J-MA,2oieoS�ET I - roy✓.v oc S4:;?eZ7;-104.v, i S�/FFOG fc COCuc•/r y, .v�W yo,�K P�CO:t/iC ABST.PfjC.T /NG, ' FORTY/.VE-Mo,¢'T6+A4,E BA.VK.E.QS,/.t/c: of NEW y . BA?'G/CC-/C SN/�G,EYA S/B✓,EQMA-v - �Q4;`I.CA I. SURV�O ' oiST. /pp0 SEC 02/, BLK, 03 6o7-OG/ .SrgNlProN .�iYs .J Y. . _ • t � `�ilia I AUG - 2 Q12 . BLDG. EP TOWN OF OL'T;OLD EAS D .4 op '9 �0 dam••O Ilk BP 37276mRe air Dick _ - = 1000-021-03700.1 . - - 1-75*51 _ DATE' " � 2 1'2 LIKIDIS RESIDENCE, 1� _ 0 ROCKY POINT RD.NOTE Decksbuilt in.accordan* t® the AST MARION•.: NY Codes of•the titre of constructionCHORNO ASSOCIATES architects. SOUTHOLD,NEW YO K