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HomeMy WebLinkAbout37401-Z �`SUFFO(,f 8/13/2013 Town of Southold Annex P.O.Box 1179 cm 54375 Main Road co v • Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36441 Date: 8/13/2013 THIS CERTIFIES that the building DECK Location of Property: 560 Kenneys Rd, Southold, SCTM#: 473889 Sec/Block/Lot: 59.-3-35 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/13/2012 pursuant to which Building Permit No. 37401 dated 7/27/2012 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: deck addition to existing one family dwelling as applied for. The certificate is issued to Schultz,Thomas&Schultz,Karleen (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED X A ed ignat re �gl� TOWN OF SOUTHOLD BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE �y • 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#: 37401 Date: 7/27/2012- Permission is hereby granted to: Schultz, Thomas & Schultz, Karleen PO BOX 2 Southold, NY 11971 To: construct a 20' X 32' deck addition to an existing single family dwelling as applied for At premises located at: 560 Kenneys Rd, Southold SCTM # 473889 Sec/Block/Lot# 59.-3-35 Pursuant to application dated 7/13/2012 and approved by the Building Inspector. To expire on 1/26/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $456.00 CO -ADDITION TO DWELLING $50.00 Total: $506.00 Building Inspector Form No.6 TOWN OF SOUTHOLD. 6 .a �.r( L BUILDING DEPARTMENT ? ' 3 TOWN HALT, 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 follow' ng: A.. For new building or neiv-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_ "Sw.orn statement from plumber certifying that the solder used.in system contains less than 2.110 of 1% lead. - 5. Commercial building,industrial building, multiple residences and similar buildings and installations,a certificate of Code Compliauce-from architect or engineer responsible for the building-. .6: Submit Planning Board Approval of completed site plan requirements. 13. 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 natura features. h or topographic 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$50.1)0,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 $1 5.00,Commercial$15.00 Date. V3 ho2 New Construction: Old or Pre-existing Building: check one) ) Location of Property: © ItEv fJ Soo L?,w 0 z D House No. Street Hamlet Ownir or O wners of Property:_ Teya yn ,q,s- qt X� �,L-622 M, S'��,!U Z,TZ Suffolk Eounty Tax Map No"1000,Section-�- -J dock 3 Lot Subdivision Filed Map. Lot: Permit No. 3? /0 1 Date of Permit. . Applicant:_ T}�D y✓I 4-S ��°,1�[�27 Z Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Subilutted: $ Applicant Signatu e oy� you � o �o coulm, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTI [ ] FOUNDATION 1ST [ ] RO H PLBG. [ ] FOUNDATION 2ND [ ] SULATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ` .�--' �� INSPECTOR pF SO(/T�O • iQ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 -----ANSPECTION [ 'FOUNDATION 1 ST [ ] ROUGH PLBG. [ ]IF DATION 2ND [ ] INSULATION [ RAMING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL ( UGH) [ ] ELECTRIC L (FINAL) REMARKS: �- DATE INSPECTOR FIELD INSPECT ON REPORT DATE COMMENTS _ .. C5e) ro eorl FOUNDATION(1ST) VJ FOUNDATION(2ND) -- o ROUGH FRAMINCr& y, PLUMBING (t V% a p� INSULATION PER N.Y. H STATE ENERGY CODE y r.� FINAL 8 p ADDITIONAL COMMENTS �5�1 o,, 6C d -7 . o rz N 2 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.net PERMIT NO. 3 �� Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined 71Y7 ,20 Single&Separate Stone-Water Assessment Form Contact: Approved 7 �7 120 Mail to: 7HOmA1 ' S�NUL7� Disapproved a/c PO Phone: &3/ 60,3 6(,&(, Expiration IJA7 ,20_�f � A J' Building Inspector APPLICATION FOR BUILDING PERMIT Date , 20 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. L , (Signature of applicant or nam a corporation) so 7- L W l/ (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises T»jo- , 41S W D ���}IZL� 701� 1 2 e"L) 0 ,.>Z (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) i L; l�P �_i_ �l_ `U Builders License No. � Plumbers License No. JUL 1 2 2012 � Electricians License No. Other Trade's License No. BLDG.DEPT, 1. Location of land on which proposed work will be done: TOWN OF SOUTHOLD House Number Street Q Hamlet County Tax Map No. 1000 Section,, .°S% _Block 3 Lo' �`� 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 41712IT)ox) DFLGr I)y 01= L'/Si I1?✓� Na»? b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work D ,9DDY�J/Jyy (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 Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front 3 c'? ` Rear IF ` Depth o2D Height Number of Stories 9. Size of lot: Front /a y' Rear /1)�) Depth 3 5a' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 0 / 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 r 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 WSS/ & ) COUNTY O . YV�Q`� C- �Q �� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, r-A -. (S)He is the n D (Contrac r, 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 1 day of 20 Vic TOTH \(���� '�' Notary Public Staff@ of New York y No 91`f06190696 Notary Public Qualified in suffolk County Signature of Appl' ant Commission rxni pF, July 28.201 1 ~ Town of Southold - Chapter 236 - Stormwater Management SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) I APPLICANT' NAME: Owner-Agent-Consultant-Contractor or Other (Circle One) Property OWNER:(If Different than Applicant) i Address: a l Address: i I Telephonre Telephone#: pax I a E-Mail: ,�O E-Mail: T19 s 6-0a4x2J22 A)) Property Address: S �S�U� Brief Description of Construction Activity,Proposed Structural BMN Sort��iU7'I/1 p t9, Pos I S.C.T.M.# Sfabalization BMPs,Project Scope and/or Sequence of Construction Activity 1000 Ti.Mkt S. n 9G.k Lot (Provide A"idaral Pagel as Needed) Name of Contractor and/or Contact Person Responsible for Implementation of SWPPP: I --HQ �-"----------------- Address: ---• /p Telephone#: Fax#: ---/CL �LL�c_��t!i�s_L� J o E-Mail: -- 7C>_-TLC _ .- 111L- t_44zze�TWA 00-1--H-------------------- Name of Persons Responsible for Installation&M Intenance of Erosion Control Practice: =---=------ f Address: Telephone#: Fax#: _L���J�!.���`�y.�•>_�_�TLyL'-�_lYO��/-�z-✓Zf�/�-' ;..i E-Mail: _��_LSLt� �i� /✓__-W_�✓_ _ � AjJ ��� ---- Total Area of All - �0 LS� Total Area of Land G __�� Zav----------------------------- clearing ProjectParcels: and/or Ground Disturbance: __•L=�2y��j{�` '3�/_�_11/�/ --1- ,J-R-%Ae------ (S.F./A—) (S.F./A—) - Project Duration: (Anticipated)- (Number of calendar Days) -E.. 1 / S.•121 — Will this Project Disturbe five(5)or More Acres at 0 __ _ __`_ ""`_________ _____________ ____ i Any One Time During the Proposed Development? Yes No - --•---'--------------.------.------------------- If YES:Please Answer theFollowingl _.,_-_--.----------- ---------_-------_-------- a. Does the Applicant have a Qualified Inspector On = II Staff To Conduct the F3equired 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 - i i c. Does the SWPPP Adequately Identify All Temporary Q Q --------- ----------------- --------------- ; and/or Permanent Soil Stabalization Measures? Yes Na -`"-`-`--- '----------------=----- i d. Does the SWPPP Adequately Identify a Complete - --------------- -- - - -------------------- Project Phasing Plan 7 Yes No Status of Impact d Walerbody:(eg.TMDL,303(d)Listed,Impaired...) e. Does the SWPPP Indicate Additional Site Specific [� Practices that Will be Utilized to Protec(Water Quality? Yes No f. Has the Applicant Submitted a Completed DEC Notice Ty j pe of Impacted aterbo ` Of Intent and SWPPP Acceptance Form for Review �� Q dr (eq.Lake,creek,Bay,Pond,found,Freshwaterwetland_) ; by the Town of Southold? Yes No - ---------- -----=---- ------------------ STATE OF NF,W YORK, OUN1'Y OF... .................... ....-..........-.SS .'1hatI, ...:1..".""".`. ......... i being duly sworn,deposes says that he/she is the applicant for Permit,..(Name of individual s•niitg Document)And that he/she is the ................................................. Contracior,Age t rporate 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 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 herewith. I f Sworn to before me this; I.. ..................day of....... ,201..4— Notary Public ............ ...-.... ................................ (Signature of Applicant) SWPPP Assessment FORM: 03-12 Notary Public Sta e o eW YOMrk No.01`f06190696 Qualified in Suffolk County Commission Fxpires July 28,?. S UR VEY OF CERTIFIED T0:THOMAS H. SCHULTz KARLEEN M. SCHULTZ DESCRIBED PROPERTY FIDELITY NATIONAL TITLE INSURANCE CO. SITUA TE A T SOUTHOLD JOB N0, 2007-115 TOWN OF SOUTHOLD MAP NO. SUFFOLK COUNTY, NEW YORK FILED: �p LAND S� S.C.T.M. DIST. 1000 SEC. 059 BLK. 03 LOT 35 REViSONS: LOC. FOUNDATION 4120107 FINAL SURVEY FOR C.O.'S 9119107 0 25 13 0 25 50 75 100 125 150 175 200 225 RELOCATE DRIVEWAY 10119107 - SCALE.• 1"=50' DATE.•FEBRUARY 23, 2007 REVISE CERTIFICATIONS TO NEW OWE 9/20/2009 � LOT AREA:37,700 SQ.FT. =0.866 ACREQUO 050363 CLEARED AREA(LOCATED 9/19/2007):23,389 SQ.FT. OF NENN�O� LICENSE NO. 050363 HANDS ON SURVEYING 26 SILVER BROOK DRIVE N FLANDERS, NEW YORK w E 11901 TEL:(631)-723-1954-FAX.•(631)-723-1329 MARTIN D.HAND L.S sG �9 T 2 O l�C16 o� �G• � T -- 10, - - - _ 01 . OF O�QyQ' 3 Fo�FOF � 3h�6•O. 60 .�y� 5 •'-. ___-�, / pis 9 �4�Q 1s s i ��� o• �(�O J�� n,-lot �`S�Y�i •O "r 5. � ` ' 2 C ' L °? C � . Q. STRLCp RES REC SLOSIRFACE STRI.CTIAES RECOROEDOR t"EC01t10EDARE NOiG WRA rTHE WFSSMY&UY. EYIDEI/fA7THE TWEOFSIR13l. 7/Q:OFi3ET IOR DIMENSIONS)SNO WN NEREDN UNESESiRLCASE3RC - PROPERTYUNLWA PMASPECWC PI6U°SEANO USEANDnIOETNEE ARENoiIMENDEDroGIODETNE WALLAONORPEA77 FLANnINO WALLA POOL$PATS V N GS AREAS•YOTHE NS N TRL T)ON. AND ANroTNEn ca+smwnoN. LWAUTHORREO ALTERAnO ORADOInW . roiWSSfNEYISAWOLA ONOF SEon ,Mq OP THENEW YDRN9iATE EDUunoNLAW. COKES OPTINS SURVEYYAPNorEEAWND THELANDSWVT-"I SENOR EMBOSSED dEALSIIAIl NDi SECONSIDERED TOBEA VAUDnTLECOPY. CERMCATIONSUX C TE'CNERONSNALLRLW OMYTO TNERFRSOTYSIPoR WNW iNESUNEY ISFY✓FPAREDAND ofI SBEILAlFT01NE TIREC ANY•OOVFJWYFMALAGENCYAND LENOINGRMnTV"WLl$m NEREOIy AND TOnMASSIGNEES OR THE LENdNOINM MIOIT.0 uTMN3ARErroTT SRNARLE TO ADWRONAL WSnTUnONS OR SLUSEOLW ' onxERs '�Scc-au rL- C6 ZQ 014L tit APPROVED AS NOTED .. GATE' 7404 B.P.# 3T o f ` FEE: BY NOTIFY BUILDING DEPARTMENT AT ' 765-1802 8 AM TO 4 PM FOR THE j I • ' �. FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIREDs -�'"�~ r i FOR POURED CONCRETE "�'� 2. ROUGH-FRAMING,PLUMBING, STRAPPING, ELECTRICAL&CAULKING 3. INSULATION f a . 4. FINAL-CONSTRUCTION&ELECTRICAL MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE ,. .� � • c��,� � pf'J ';�; {+ i " � u � � � i" REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR 1 DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR 1 ( D U i g �U-'l'-3'LE I S UNLAWF L t ¢s ;` as , OL(C'tW` G=r y 11 Vi 17 - � wsC-L�zec �