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Home My WebLink About36809-Z Town of Southold Annex 8/27/2012 °Gym P.O.Box 1179 54375 Main Road co oy rat Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35918 Date: 8/27/2012 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 495 JACKSON ST. NEW SUFFOLK, SCTM#: 473889 Sec/Block/Lot: ' 117.-9-4.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/17/2011 pursuant to which Building Permit No. 36809 dated 11/14/2011 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: front porch addition to one family dwelling as applied for The certificate is issued to JOHN&ANDREA SPIEGEL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A o ' ed S' ature TOWN OF SOUTHOLD �gUFFO(,�co ` `moo ay BUILDING DEPARTMENT y TOWN CLERK'S OFFICE 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#: 36809 Date: 11/14/2011 Permission is hereby granted to: Spiegel, John & Spiegel, Andrea 2681 N Burlington St Chicago, IL *60614 To: front porch addition,to dwelling At premises located at: 495 Jackson St, New Suffolk SCTM #.473889 Sec/Block/Lot# 117.-9-4.1 Pursuant to application dated 10/17/2011 and approved by the Building Inspector. To expire on 5/15/2013. Fees: CO -ALTERATION TO DWELLING $50.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $212.00 Total: $262.00 Building Inspector 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. 'Swom 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 cpmpleted 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. /.D1I?-�!( New Construction: Old or Pre-existing Building: (check one) Location of Property: A 15 --yActsot-4 S+ House No.. Street Hamlet Owner or Owners of Property. LL J P L�G 1=L Suffolk County Tax Map No 1000,Section_ / ` Block "1 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. — A l- Applicant: Health Dept.Approval: Underwriter's Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ � Applicant ignature • Q r_ SO(/j�olo TOWN.OFSOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION P�EUCTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE t/ 6� !� INSPECTOR pF S0(/T�o TOWN OF. SOUTHOLD -BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) REMARKS: r a� DATE `� �� INSPECTOR �U oF soar - - - -- �y�OUNiV,�� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLB [ ] FOUNDATION 2ND [ ] INSU [ ] FRAMING/STRAPPING 1 AL �� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE �� INSPECTOR i FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION(1ST) cJ - --------- -------------------- O FOUNDATION(2ND) l�O vl ROUGH FRAMING& y PLUMBING dt . tq INSULATION PER N.Y. STATE ENERGY CODE Qzy�n co - • 1 .. FINAL ADDITIONAL COMMENTS z 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. Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined ,20 Single&Separate Storm-Water Assessment Form Contact: Approved 120 Mail to: Disapproved a/c ��0 Phone: (as Expiration ,20 1:1 Building Inspector LICATION FOR BUILDING PERMIT Date 20INSTRUCTIONS 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-i-ionths-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 addit-ion 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 remov r demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, ho si �Y,—,— g code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,ff— (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 G-e N C r ak CO N��c-1-v i?� Name of owner of premises � I E: eL (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. ''.14$81`1..^ti: Plumbers License No. Electricians License No. I-CC.T:c— Other Trade's License No. 1. Location of land on which pro osed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block 9 Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of r s and intended use and occupancy of proposed construction: a. Existing use and occupancy ��E 5 I b. Intended use and occupanc S 3. Nature of work(check which applicable): New Building Addition Alteration Repair X Removal Demolition Other Work'; (Description) 4. Estimated Cost C) 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 pC to 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of'existiilg structures, if any: Front Rear Ip Depth S Height Number of Stories 9 Dimensions of same structure with alterations or additions: Front Rear Depth S ' Height Number,of Stories 1 P � � 8. Dimensions of entire new construction: Front Rear (n Depth" S Height Number of Stories 9. Size of lot: Front Rear Depth 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 NCI 14. Names of Owner of premises SPi EgLrL Address 495 To►tlkyoi+ Phone No. ►► \\ Name of Architect Address Phone No Name of Contractor 0oC})!s Cot k wooa woc1.S Address U-1 p fj}+!�jc k Phone No.&SI 255 Yo 2 S Z.? 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NOS_ * 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? .k YES NO 4- * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) 5 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D.BUNCH ^ Notary Public,State of New York (S)He is the �O N AG No.01BU6185050 .,.._, WUty%ii%C___. (Contractor, Agent, Corporate Officer, etc.) Commission Expires April 14,2Ql)a, 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 dre 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. S olrim before me this day of 20_L�__ Notary Public 0 SignatLirelof Applicant . r y, Town of Southold: :Erosion, Sedimentation & Storm-Water Run-oft ASSESSMENT FORM _ PROPERTY LOCATION; s.c.T M. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A �j STORM-tNATER,GRADIN DRAINAGE AND EROSIQN G __ OL PLAN b�tr eTc 3eawn aTo k'- —C-ot"�' CERTIFIED BY A DESIGN P IONAL Ii1 THE ST ATE OF NEW YORK SCOPE OF WORK - PROPOSED CONSTRUCTION rffM#-/ WORKASSESSMErn' Yes9FM a. What is fhe Total Area of the Project Parcels? Will this (Include Total Area of all Parcels boated within Project Retain An Stomi-Water Run-Off the Scope of Work for Proposed Construction) meted by a Two Cn Inch Rainfall on Sfte? fS..rAm s) (This.1teln will include all ntn:oif mated by site b. What is the Total Area of Land Clearing clearing �p� atx)/or Ground Disturbance for the proposed m construction anit the permanent creationwellImprovements of construction activtity1 impervious surfaces.) • (?F rAQes) . PROVIDE BR)FF PROJECr Dwau IZON t—w. v�,w Pis as r 2 Does into She Plan arxl/or Survey Show AN proposed Dralnage Structures Indicating Size a Location?This / Item•shallinclude all Proposed Grade Changes and • a — c7 r a N 4•- Slopes Controlling Surface Water Flow. .3 Does the Site Plan and/or Survey describe the erosion and sediment control pracBces that vnll be used to N e 11 control' erosion and storm water discharges. This -t= (J l to G t'h5 item must be maintained throughout the Entire Construction Period. fl M�-G Q IN O O 4 Will thi;i Project Require any Land Filling,Grading or r C /�t htCt �,�j J Excavation.where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards ` 7`q 7( of Material within-any Parcel? I 5 Will this ApPlicatlon Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square 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(1001 feet of a Wetland or- Submission of a SWPPP is required for all Construction activities involving so0 Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that , •7' -Will there be Site preparation on Existing Grade Slopes f are part of a larger common plan that will ultimately disturb one or more acres of land; I including Construction activities involving soil disturbances of less than one(1)acre where which Exceed Fifteen(15)fleet of Vertical Rise to the DEC has determined that a SPDES permit Is required for storm water discharges. One Hundred(100')of Horizontal Distance? (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 YOFDriveways,Parking Areas or other Impervious for Storm Water bischarges from Construction activity-Permit No.GP-0-10-0o1.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the Not.The im shag be into and/or in the direction of a Town right-of-way? ` submitted to the Departmentprlor to the commeneementof construction activity. El 2.The SWPPP shag describe the erosion and sediment control pracf)cei and where 9 Will this Project Require the Placement of Material, required,.post-construction storm water management practices that will be used and/or Removal Of Vegetation.and/or file Constnlctiorl of any constructed to reduce the Pofiutants in storm water discharges and to assure Item Within the Town Right o�Way or Road shoulder compliance With the terms and conditions of this permit.In add0lon,the SWPPP.shaA Area?(rhts item wTow inciud�Right-of-Way a y or a< F-1 tdenUly.potenIW sources of pogution which may reasonably be w"ded to affect the edveway Aproru) quality of storm water discharges. .. NOTE: If Any Answer to Questions.00a through Nine is Answered with a Check Mark 3.All SWPPPs that require the post construction storm water management practice in a Box and the construction site disturbance Is between 5,m.s.F.d 1 Acre in area, I component steal be prepared by a qualiW Design Professional Uowm d In New York a StomrWater.Grddin%Drainage&Erosion Control Plan is Required by the Town of f that is knowledgeable in the principles and practices of storm Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. (NOTE ACheckMwk(W)mxttg mwlorearhQuesUonbRequlmdforaCompleteApprcaLon) SIATE OF NEW YORK, CONNIE D.'BUNCH COUNTY OF...........................................SS Notary Public,State of New York r SCO`� Ea {-N- No.01 BU6185050 fiat I,........................g................................................ �}� �}1Pi`Fl�d in ttffolk County ®1 (Name of individual signing Dowmerrq ...being duly sworn,deposes and says mf�1u98tt3tt��C� tGfA�Plrur»t, (i� And that he/she is the ..................................... { (owner,eoritrector,Agent.Corporate officer,etc) , Owner and/or representative of the Owner or Owners,and is duly authorized to perfonn or have performed the said work and to make and file this applica4on;that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be i performed in the manner set forth in the application filed herelvith. � Swum to befi�ort;rzae this; � r .............._......................_.. day of. ,201. J Notary Public_ -_CLTy.--,.-r--P-.-. ..... .. ............. ------------------------------- (Signature of Applicant) FORM - 06/10 oF so[/Tz,o Town Hall Annex Telephone(631)765-1802 54375 Main Road cia ax(631)765-,95Q2 P.O.Box 1179 • �Q roger.richert own.sou5b95 d.nMms Southold,NY 11971-0959 COU�'�^.� BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: KAr l rr Date: 1`7- Company Name: -�-� �- Name: - License No.: Address: - it Phone No.: J _ JOBSITE INFORMATION: (*Indicates required information) *Name: aZy S Pr C'4�C *Address: 9r_,J A C_t Sc,ti Sly *Cross Street: S U 1-� `« *Phone No.: Permit No.: Tax Map District: 1000 Section: �1�_ Block: Lot: _ *BRIEF DESCRIPTION OF WORK(Please Print Clearly) /06 Scr lit 141&t, L, ce- (Please Circle.All That Apply) *Is job ready for inspection: E O Rough In Final *Do you need a Temp Certificate: / NO Temp Information.(If ed) *Service Size: 1 Phase 3Phase 100 150 <. "o 300 350 400 Other *New Service: a-tonne Underground mber of Meters, Change of Service , Overhead . Additional Information: P YMENT DUE WITH APPLICATION T-- 82-Request for Inspection Form �t ,fly:.T 1 Fpsv . _J FFNcF `F� o Ci, or D ,i 0 V t'~�D 1` k •�Q �� LA I y� �� t o�ooir , ON,y '7r�q .J II R!v'A.I h � Sr 1 MAP OF CER rYF/EO TO., OESCRlBEO PROPERTY COMMONWEALTH LAND TITLE INSURANCE COMPANY AT NEW SUFFOLK ROBERT J. a JOAN G. KIRSCH TOWN OF SOUTNOLD SUFFOLIIC CO, N,Y. AREA J 34,179 SO.FT or NEivto donaCk associates OR 0.7833 ACR yoW•°oryi Rr 313 west main street * '-`-`'°rr * riverhead ,new york 11901 (516) 369-1717 1 D. 492bb ��' APRIL 12, 1964 Job No.e4- 496 ! fo LAND a�P 1000-117-09.03 B04 Scale:ft, 40' I 1 LFd -e r m N;z viz x LA'95 �f c 6- eck�'N 51y A q ��E fl '�a5 h e c-`S @ I'(o �+ r �1�'d�e►� oaf APPROVED AS NOTED PIL r DATE10 ' FEE: -li�- _ BY -�------- 11 NOTIFY BUILDING b PART it i"'�� {R�'`� �'� Q•� Foc�-�n�� ! 765-1802 8 AM - a Prv1 -to Neakaec �— INSPECTIONS 1. FOUNDATION TWA ='SQUIRED FOR POURED 2. ROUGH-FRAMING.PLUIMS=NG, STRAPPING, ELECTRICAL & CAULK'NG 4. FINAL-CONSTRUCTION & EL ECTP' ;L MUST BE COMPLETE -^R ' REQUIREMENTS OF THE CC)L*)ES NEW AJN r0�(, YORK STATE. .NOT RESPONSIRI F . -� k pQ DESIGN OR CONSTRUCTION ERRORS. �'� =� s" kii .VLA ii F� _ l P L y �`•�C�` E n \E 1� c� f n lEL�� - �� 5I'��'-t�LE- . � P �e,rA ct, N : 1�.eP tact Eve t,,\ y I��A i I►�r �la" � --�v M f��-C� �� S�;►�� w� Zoe S� ;N�1� 61L A SV F- L K S+ f- 1 H E 7�i`5�-i r► Ro o r-i (Dt n1 4-a b e Qe.w i r--e-d 41 E Nc._1 uk8�,., � C�� C,obl e --v yff 1 1 t tit A ra•�11a �� -/ �yY ;F .rd -