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Home My WebLink About44753-Z o�g�{EfOi�{(Co�i Town of Southold 5/26/2020 3 P.O.Box 1179 0 C* 53095 Main Rd �'�,, �ao�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41155 Date: 5/26/2020 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 13135 Route 25, East Marion SCTM#: 473889 Sec/Block/Lot: 31.-540.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/2/2020 pursuant to which Building Permit No. 44753 dated 3/2/2020 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: HANDICAP BATHROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Townsend Jr,Joseph of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40822 09-27-2016 PLUMBERS CERTIFICATION DATED 09-12-2016 d King 01 th e Signature TOWN OF SOUTHOLD � BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 44753 Date: 3/2/2020 Permission is hereby granted to: Townsend Jr, Joseph PO BOX 40 Greenport, NY 11944 To: Construct addition to existing single-family dwelling as applied for with flood permit. Must maintain more than 100' from wetland boundary and provide erosion and sediment control as per Town Code. Replaces BP# 40822 At premises located at: 13135 Route 25, East Marion SCTM #473889 Sec/Block/Lot# 31.-5-10.1 Pursuant to application dated 3/2/2020 and approved by the Building Inspector. To expire on 9/1/2021. Fees: ' PERMIT RENEWAL $193.80 Total: $193.80 J r uildi Inspec or ttSUF t,� TOWN OF SOUTHOLD BUILDING DEPARTMENT 10 cn 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#: 40822 Date: 7/7/2016 Permission is hereby granted to: Townsend Jr, Joseph PO BOX 40 Greenport, NY 11944 To: construct addition to existing single-family dwelling as applied for with flood permit. Must maintain more than 100' from wetland boundary and provide erosion and sediment control as per Town Code. At premises located at: 13135 Route 25, East Marion SCTM #473889 Sec/Block/Lot# 31.-5-10.1 Pursuant to application dated 6/27/2016 and approved by the Building Inspector. To expire on 1/6/2018. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $237.60 Flood Permit $100.00 CO -ADDITION TO DWELLING $50.00 otal: $387.60 ding ns ctor 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. 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: 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$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 1 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. j — X'S. New Construction: Old or Pre-existing Building: '� (check one) 19 Location of Property: _ ,� House No. Street / Hamlet Owner or Owners of Property: J� Suffolk County Tax Map No 1000,Section 3 Block _ Lot /y' Subdivision Filed Map. Lot: Permit No. 0 Date of Permit__ Applicant: Health Dept.Approval: __ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ __K(_06 ppilcant Signature Z0/10 39Gd S331Snai (MOHinos Tb9959LT69 8Z:60 V10Z/T0/L0 t �V 7 SO Town Hall Annex Telephone(631)765-1802 54375 Main Road cis Fax(631)765-9502 P.O.Box 1179 ® roger.riche rta-town.southold.ny.us Southold,NY 11971-0959 olyeoum BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Joseph Townsend Address: 13135 Route 25 City: East Marion St: New York Zip: 11939 Building Permit#: 40822 Section: 31 Block. 5 Lot: 10.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: C-CAT Company License No: 953-ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition X Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 1 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 2 Twist Lock ri Exit Fixtures TVSS Other Equipment: Bathroom Addition, 1- Exhaust Fan Notes. Inspector Signature: Date: September 27, 2016 0-81-Cert Electrical Compliance Form.xls t SD6,,�� , Town Hall Annex y Telephone(631)765-1802 54375 Main Road rte; ;;^:, Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 w BUILDING DEPARTMENT TOWN OF SOUTHOLD A CIE RT-LFICA_TION o Ild-I& i Date: i Building Permit No. S 3 Owner: (Please print) cC�J . . ._ ._..___Plumber: i (Please pri I I certify that the solder used in the water supply system contains less than 2/10 of I% lead. i I (Plumbers Signature) Sworn to before me this day of , 20 i NEAR 1 1 2020 j f Notary Public, - :County= j Yv pF SOUIyo! D � � o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ FOUNDATION 1 ST [ ] ROUGH PLBG. [ �UNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH] [ ] ELECTRICAL (FINAL) REMARKS: w t DATE 499 INSPECTOR ` souryo� H O TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . FOUNDATION 1ST [kj/R�OUGH PLBG® [ ] FOUNDATION 2ND INSULATION [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ® Oz /� INSPECTOR 2�01 . � pE SOUryolo . o�ycou TOWN OF-SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: DATE �� INSPECTO ho�aOF SOUK°� TOWN OF SOUTHOLD BUILDING DEPT. - reourm, 765.1802 INSPECTION - FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] --FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ` ] "FIRE-RESISTANT=CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ' - [ ] ELECTRICAL (FINAL) [ ] ,CODE VIOLATION [ ] PRE C/O REMARKS: pc�vwgm - Qm volx PYN-.- Sv _ ctk /07 kgw m/ DATE ANSPECTOR OF SOUTyOIo # f TOWN OF SOUTHOLD-BUILDING- DEPT. 765-1802 A: INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG.- [ j FOUNDATION 2ND :[ ] I LATIOWCAULKING ' = [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE &`CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR - �0v fi t �H—� LEr yr--r o .o E 'NGI EER'1NCa 17 August 2016D �� V D Building Inspector AUG 1 8 2016 Town of Southold ENDING DEPT. Main Road TOWN OF SOUTTHOLD Southold, NY 11971 RE:Joe Townsend- BP#40822 Dear Sir, I have inspected the framing and the strapping for the above referenced Building Permit and to the best of my knowledge and experience all have been completed in accordance with New York State Building Codes. HE ® � 3 05 SSI� BOARD CERTIFIED IN STRUCTURAL ENGINEERING JOSEPH(LD FIS CHETTI.COM FISCHETTIENGINEERING.COM 63 1 -765-2954 1 725 H O B A R T ROAD S O U T H O L D , N E w YORK 1 1 97 1 E N ,G 1 N EIERI S I March 9, 2020 , MAR 1 1 2020 Town of Southold Building Department Main Road Southold, NY 11971 RE: Joseph Townsend-Main Road East Marion BP#44753 I have inspected the foundation and the insulation for the handicapped bathroom and to the best of my knowledge found all in compliance with Building Codes. oF NEy,y Fiseq,�09 ssto�` BOARD CERTIFIED IN STRUCTURAL ENGINEERING JOSEPH@FISCHETTI.COM F15CHETTIENGINEERINo.00M 1531 -76S-2954 1 7 2 5 H O B A R T ROAD S O U T H O L D , N E W YORK 1 1 9 7 1 ' - �~ :tea *+ ti a. �• / i �+, n TWA , .i: .. ..moi y .• .. , i 2 tit <e..z s tf s � �y. u .moa '"--•�- " d i i , • -TIM w4ft r 4:-A A L t� s.AMMMILA . 1 A IF ps r 'r. 1 - ,ry I L ��..,i1•rr a '.. `\. l - 1 it ,ul. r .. +�.. i Y SF i' - I = Q P I � �ill� ��I�,.��1.. ..wr f►,� :�W i � � I i J' iX'� ME�& AF/S/MAMIPA � b a eD��e +v'i►� �T TOWN OF SOUTHO D 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.NorthF rk.net PERMIT NO. 4� Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application n Flood Permit Examined 20 j, Single&Separate ��pp Storm-Water Assessment Form JUO 2 7 2w Contact: CC-T-6 Approved 20 10 Mail toF4��/K� �L'�✓r/IL Disapproved a/c JaMmommTOWN(w Q) ��. Phone: 631-q'77-0971 Expiration ,20 13 Buil nspector APPLICATION FOR BUILDING PERMIT Date , c�yC�� , 20 14 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. (Signature of applicant or name,if a corporation) l70 X 39 �ot�-- ,/>aY /��f/941-f (Mailing address of applicant) State whether applicant is owner, lesse agent, rchitect, engineer, =contractor, electrician, plumber.or builder Name of owner of premises Z-- 7_0w/'756��-W (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer e�,? �)- &d [#0,42 s (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 will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Lot /0 , / 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 b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition !_ Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost � ;° `3 �Nwzo- (� be paid on filing this application) 5. If dwelling, number of dwelling unitsNumber of dwellin, is on each floor bA41 If garage, number of cars 'n f FN 04 6. If business, commercial or mixed occupancy, spec' , 5qX& nt of each type of use. _ n ZA' 7. Dimensions of existing structures, if any: Front Rear 33 Depth Heigt�^s �, � Number of Stories _D4ei5sio6s of same structure with alterations or additions: Front / Rear 33 D69-4) Height 2!K Number of Stories Z 8.'.Dimensions of entire new construction: Front _Rear Depth Height / Number of Stories S 9. Size of lot: Front 1 4) Rear )"0 `e Depth f '� 10. Date of Purchase I l f 9I�9��Name of Former Owner 11. Zone or use district in which premises are situated 45-7 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 S-�-/ Lam`Address ��3 3�oghon No. Name of Architect Address Phone No Name of ContractofECt2i�(-, Address/�o�a K 3 9 Phone No. `k-7-7 r07 Ld —ri�,/Ze Gv-en�,r�y�iq`�y� 15 a. Is this property within 100 feet of a tiflal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS,.l 4AY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES i 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 anv covenants and restrictions with respect to this property? * YES_____NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) S: COUNTY O 6 being duly sworn, deposes and says that(s)he is the applicant (Name oktivis'igmng contract) above named, (S)He is the '- (Contract: ,Agent, orporate 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. Swo fore me this 27 ` day of 2d� CYNTHIA ftp.CUSATI � - Nota Public Notary Public State of N."'IN`yor Signature of Applicant No 01C&M0507 pp Qualified in Suffolk Coun Commission Expires Oct 20 9 Scott A. Russell SUPERVISOR AWA\ A. G lEAWIEN T SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 s O Town of So u th o l d �Qd Safi; CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY of THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ®ff A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. [IE]"B"'. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ETC. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ®Ej"�D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. EJE]""E. Site preparation within the one-hundred-year floodplain as depicted k ,on FIRM Map of any watercourse. ,,,on Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S_C.T.M. 'j: ]000 Date Ir 3 Dtit C9 e NAME: Section Block Lot F""IR Bt--11_Jl1 G DP.P R'r"IEN-F UISE ONUVY Contact Information :rrirvnonr•��,a" � o �) Reviewed By: . - - - - - - - - - - - - - - - - - - �- - Property Address / Location of Construction Work: Date � 'r 7� — — — — — — — — — — — — 2 2-� Approved for proceaztng Building Permit. J n' Stormwater Management Control Pian Not Required. CQ`S w`� ❑ Stormwater Management Control Plan tz,Required (Forward to Engineering Department for Review.) FORM " SMCP - TOS MAY 2014 Mr SO�jy0 "Y' - Ta�� Tdsphone(631)763-1802 34375 Main Road 107 P.O.Baa 1179 fIel:riChe(l _ri1dYE1.SO�J�d.IW. Sourhol LNY 1197140959 BUR DING TOWN OF SOUIMOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY iak Com, (� n -��en Dalle. C) �0 Company Name: C� C drew Llowme No.: Phone No.: 7s JOBSITE INFORMATION: (*Indicates required information) *Name.- n*Addrew s *Croom Stwt *Phone No.: CQ -c ` �-�- - ( t Permit No.: +D--48 W, - Tax Map 1040 Section: Block Lot a 'BRIEF cwcmPTiON OF WOW(pleaft Print Clearly) d (Please Ci de All TIM Apply) *Is job readffor inspecOon: Rough I Final *Do you need a Temp Cerhfic fie: YES , 0 .Tamp Irrfonmdon(if r�deq �' *Service Size: 1 Phase 3PhOse 100 150 200 300 350 400 Otter *New Service: Re-aoruect Underground Number of Meters Charge of Seri m Overhead Additional Information: PAYMENT DUE WITH APPLICATION 02-RoquestiarrroM Farm Town HA AUc � � Telephone(631)763.1802 34375 Main Road _ 07uan u�i` d.r� P.O Boa 1179 °� SamhOK NY 1197149M- BUILDING DF.PART1�lT • TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION FREETED BY. Jt ---5 / Date.- Company ate: Y Name:— c -- No.: �'� ��o.: CAT 7 JOBSITE INFORMATION: (*Indicates required information) - *Name: � *Add gas, - = aiM, �� fir' IW1 v IV P/ *cmsssteet *Phone No.: Permit No.: 0 Tax Map Dbbft 1000 Sechor , „ l_- i- *MEF-DESCRIPTION OF WORK(Please Print Cleariy) e - J (Pl a Chvie All Dud AppW - - *19 job readyforInspection. NO In Fina -- "Do you creed a Temp Certificate: S NO TanfP `x o {If redj f ' 5 to 3Pirase 100 950 200 300 350 400 Other ,- *New Service ' Re'°° Undergmund Number of Metus Clauige of Service Overhead AddMdMl liftrmadon• PAYMENT DUE WITH APPLITIO `off a2for hapecrion Fban pe,c. X91 S OCT, ,2 0 2016 EUILDING DEPT. TOWN OF SOMOLD J o�oSUFIFoc,+r�oG Town Hall Annex �� 7G� Telephone(631-1802 54375 Main Road Fax(631)734-9502 P.O. Box 1179 C 2 Southold, NY 11971-0959 coo BUILDING DEPARTMENT NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION Date: Owner: 7,7o— x)47 1-2-7-o"-7-0- J�• Location of Property: 12va-.4L r:E ,Q Please take notice that the (check applicable line): New residential structure Addition to existing residential structure Rehabilitation to an existing residential structure to be constructed or performed at the subject property reference above will utilize (check applicable line): Truss type construction (TT) Pre-engineered wood construction (PW) Timber construction (TC) in the following location(s) (check applicable line): Floor framing, including girders and beams (F) s Roof'framirig (R) Floor and roof framing (FR) Signature: Name (person submitting this fo ): '�' �� ZZZ Capacity(check applicable line): Owner Owner representative TrussResReg15.docx Effective 1/1/2015 •r.� H T. TERRY <.Icin TOWN CLERK ,}� ��"" Soulhnld. Nc«" 1 tvl 1 1 ILEGISrRAft OF VITAL STATIS"1lCS �� (�� 0�- Fax (5 I Cil 765-I Rel h4ARRIAGf•: OfTIC1:R i, Tcicphonc (S 1 fe) 765. 11 - '. •�0/ �b RECORDS MNIAGEMENT OFFICER 1 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" (FDP(93) ) , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93)) - 4 B-Za GEFT TOWN OF SOUTMOID �Ju T . Terr Y Southold Town Clerk August 25 , 1993 I f APPLICATION >y_ f PAGE Iof4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This Corm is to be filled out in duplicate. SECTION 1 GENERAL PROVISIONS (APPLICANT to read and Sirrnl 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein_ 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. S. The permit will expire if oo work is commenced within Six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and Cederal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. L THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND W ATTACHMENTS TO _ THIS APPLICATION ARE,TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE., .f (APPLICANT'S SIGNATURE) DATE � i SECTION 2 PROPOSED DEVELOPMENT (To be completed by APPLICANTI NAME ADDRESS TELEPHQNE APP LI CANT - BUILDER0 F/-- 7^ ENGINEER PROJECT LOCATION: • To avoid delay in processing the application, please provide enough information to easily ideat4 the project location- Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or wolf-known Landmark A sk-ctcb attached to this application showing (hc project location would be helpful. FDP(93 ) . I APPLICATION PAGE 2 OF d DESCRIPTION OF WORK (Check all applicable boxes) A STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE D ew Structure CglResidential (1-4 Family) Eg Addition O Residential (More than 4 Family) — -- -------- — O—Aeration — El Non-rc-sidentighloodproofg?—❑�'�sj-------------- O Relocation O Combined Use (Residential & Corn cra.al) O Demolition ' O Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park?. O Yes) ESTIMATED COST OF PROJECT S B. OTHER DEVELOPMENT ACTIVITIES: I�V O Fill O Mining O Drilling O Grading O Excavation (Except for Structural Development Checked Above) - O Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction O Subdivision (New or Expansion) O Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION :, APPLICANT should submit form to Local Administrator for review. - - - SECTION 3• FLOODPLAIN DETERMINATION (Tobe completed by LOCAL AD1'4INISTRATOR) The proposcd development is located ou FIRM Paucl No. . Dated The Proposed Development: O Is EQI located in a Special Flood Hazard Arca (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT' IS REQUIRED). ❑ 1s located in a Special Flood Hazard Arca. FIRM wric designation is 100-Year flood elevation at the silt is: Ft. NGVD (MSL) ❑ Unavailable O The proposed development is located to a (loodway. FBFM Pancl No. Datcd O Scc Section A (or additional iostrucuoos SIGNED DATE APPLICATION 4 PAGE 3 OF 4 SECTION 4 ADDfT10NAL INFORMATION REQUIRED (To be completed by LOCAL ADMINISTRATORI The applicant must submit the documents chcckcd below before (be application can be processed: O A site plan showing the location of all casting structures, water bodies, adjacent roads, lot dimensions and proposed devclopmcnt. O Development plans,drawn to scale, and spcczficatipns,including where applicable: details for —_anchoung�txucwres pcnpos-sdsl&v_alion of lowest floor including basement), types of water resistant materials used below the first floor, details of floodproofwg of uti sties locate below the first floor and details of coclosures below the first floor. Also ❑Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). .J - l✓t:NGVD (MSL). For ❑ Floodproo£u,g protection level (non-residential only) ( ) floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-yeas flood. A copy of all data and - -- calculations-supporting_this fin din g_.mus[ also be submitted_ ❑ Other. SECTION 5 PERMIT DETERMINATION fTo be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. ❑ Is B. C1 Is not in conformance with provisions of Local Law if , 19 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED DATE If BOX A is checked, lbe Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is chcckcd, (be Local Admiruslralor will provide a written summary of deGcacnacs. Applicant may revise and resubmit an application to the Local Administrator or may request a bcartng from the Board of Appeals. • ' , APPLICATION ry PAGE 4 OF 4 APPEA1S Appealed to Board of Appeals? ❑ Ycs ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built)Elevation of the top of the lowest floor, including basement Cin Coastal Hizh Hazard Areas bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FL NGVD (MSL). L Actual (As-Built) Elevation of floodproofing protection is Fr_ NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant_ SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as appLicable based oa inspection of the project to ensure compliance with the community's local law for flood damage prevention. 1NSPP-CTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO ,SECTION 8: CERTIFICATE OF QOMPLIANCE(To be completed by LOCAL ADhtiNISTRATOR) Certificate of Compliance issued: DATE BY: r f Attachment B SAMPLE CERTIFICATE OF COMPLIANCE i for Development in a Special Flood Hazard Area 1 f + 1 lr' 1 n TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (0)ANER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: 0 NEW BUILDING 0 EXISTING BUILDING –0 VACANT LAND ,s THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW #—? 19 SIGNED: DATED: B. COMPLIA-NCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C /C ( 93) K � a M•3i.•^. 1 dt' S4 .� •„' err � +I • '��A' •�9 , .M�+j+ , fes+ SWAP 7*1 All ell ,< k `► ; .�I ` ,4 7` ' ``TT''^,,V'+irFF�+ ^ � Sa :^}• fi N r ' 4 -'w�';' :, • : . ' / Jt s. �' i •w...ta z• � rl ELECTRICAL COMPLY WITH ALL CODES & NEW YORK-STATE & TOWN COD, I INSPECTION REQUIRED AS REQUIRED AND CONDITIONS APE-R111VED AS NOTED ' DATE:iRIV 6.P. FEE- D BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE PLUMBER CERTIFICATION - FOLLOWING INSPECTIONS: ON LEAD CONTENT BEFORE 1. FOUNDATION - TWO REQUIRED FOR 'POURED CONCRETE - -CERTIFICATE-OF OCCUPANCY V 2. ROUGH - FRAMING & PLUMBING SOLDER USED IN WATER - 3. INSULATION S•UPPL Y SYSTEM CANNOT 4. FINAL - CONSTRUCTION MUST EXCEED 2/10' OF 1% LEAD. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW PLUM8I�1 7 YORK STATE. NOT RESPONSIBLE FOR ALL PLUMBING WASTE DESIGN OR CONSTRUCTION ERRORS. �-,-&WATER LINES NEED TING BEFORE COVERING • TING OCCUPANCY OR DO NOT PROCEED WITH A FRAM)NG UNTIL SURVEY USE IS UNLAWFUL !.OF FOUNDATION LOCATION; - WITHOUT CERTIFICATE HAS BEEN APPROVED.: _ - . � � , JOSEPH FtscH�o° �� F OCCUPANCY _ - � - PROFESSIONAL EV�9GINE�7 RETAIN STORM WATER RUNOFF ; - - 1795 HOBART RD/PO FC �I6 PURSUANT TO �HAPTER 236 0 9 H®L®° NY ''��, OF THE TOWN QODE. =�°t MOOD Z0_ El— COMPLY � �APr1 ! -- - - FLWD DAMAGE t' �� _ � - r• - — - - - -I— �V €.�'�' ~ ---_- - — — 1'- _�c�TH =luLLjl ITIUN TO code per Cr • To- 't e. - - - . ¢+ � - _�'t�.P1T��►2..4;L.&.SS i 'c�t�leaa�✓ � , 4 �t„ LOS�17_GEL� lZ s 1 1� t w� SIMPSON L5TH8R1 or L.5T11D8 STRAP TIE HOLD , DOWN 12'FROM CORNERS, 2 PER SIDE min. f�— -A + S R ' 2 k �1�' 2 x 8 P.T. 51LL ON SILL SEALER ANCHORED wl 91b' DIA. ANCHOR B0LT5 Q 45'o.c. t 4'min. �12'max. FROM CORNERS Qa NEW-CONSTRUCTION. l* #5 All AROUND ALL OPENINGS. EXTEND 12' M BEYOND OPENING - . y'min. ASPHALTIC EXP.JOINT 4 t FLOOD VENTS PER PLANS AND SPECS. LOCATED 4'CONC. SLAB w/G x G 10/10 WWM OVER G MIL P.V.B."typ.- 3t, NO.MORE THAN 12'ABOVE GRADE. REFER TO ' ELEVATIONS FOR MORE INFO. 4'-G'GRAVEL TYP. OVER,UNDI5TUR5ED _I� 1 \_= opt-��T A,�G�SS i VOR COMPACTED SOIL ®g NES 1 � � — D D D D D O O DD D A.D ; , Y 1111 ��Y .L.t..- _ - � ��a$��a °�� 11 � a uj —ti�� S #5 DOWELS Qa I G'o.c.IT 2-#5 BARS TOP t BOTTOM OF WALLS V �� SSt .l .4 —P� 12"x 24'CONTINUOU5 KEYED '� CONCRETE FOOTING ®SEPH �ISCHE�I, Pd Wa I I Section 3#5 CONT. BARS Q I G'o.c. PrROFESSIONAL ENGINEER 1725 HOBART RD/ PO BOX' 816 SO2.THOLD, NY -119,71 G,07-7-65-2954 1