HomeMy WebLinkAbout44176-Z �Q�UEFOt,fcp�y Town of Southold 6/19/2020
3 P.O.Box 1179
0
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41201 Date: 6/19/2020
THIS CERTIFIES that the building AS BUILT ADDITION
Location of Property: 275 Majors Path, Southold
SCTM#: 473889 Sec/Block/Lot: 54.4-26.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/9/2019 pursuant to which Building Permit No. 44176 dated 9/17/2019
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:
AS BUILT PERGOLAS AND OUTDOOR SHOWER TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR
The certificate is issued to Agrusa,Traulane&McDermott,Marley
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 06-17-2020 N Wal Marcze ki
ut o ' e Signature
SUFEn TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x 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#: 44176 Date: 9/17/2019
Permission is hereby granted to:
Agrusa, Traulane & McDermott, Marley
23-01 150th St
Whitestone, NY 11357
To: legalize "as built" additions and alterations to existing single-family dwelling as applied
for. Additional certification may be required.
At premises located at:
275 Majors Path, Southold
SCTM #473889
Sec/Block/Lot# 54.-1-26.1
Pursuant to application dated 9/9/2019 and approved by the Building Inspector.
To expire on 3/18/2021.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $624.00
CO -ADDITION TO DWELLING $50.00
Total: $674.00
Buildin r
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
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Date. y� �S�pTEJtiJ3EQ 272
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 2.75 f`MAJ!orS &,rI4 SoUIMOLD
House No. Street Hamlet
OwRc"r Owners of Property: 7_"v L-:�+J€ 40AJ .4 MAfLl.F_•-I MC bj IP rtg> r
Suffolk County Tax Map No 1000, Section 0-1-4 Block o 1 Lot 219.00 I
Subdivision ' LFiled Map. Lot:
Permit No. �{ Lf l Date of Permit. Applicant: 1�e!'GL kgg►U'
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted: $ J U
TApp�liica�n�tSignature
Building Department ADDHcatior
AUTHORIZATION
-Where the Applicant is not the Owner)
S�'• "
I, rC.t f6L residing D 3_O J )SO &)�i ts4o te )-Y• 11357
(Print property owner's name) (Mailing Addre-,,,---=
Flo herebv authorize J1)l6 C-L Po(SM—r W l j.�,A HXO
(Agent)
to apply on my behalf to the
Southold Building Department.
711�-Ja4to, 2-2-2 -19
(Owner's Signature) (Date:s
(ale A
(Print Owners Namt;:i-
CONSENT TO INSPECTION
�l dM ,the undersigned,dot es)perebv state-
Owner(s)Name(s)
That the undersigned(is)(are)the owner(s)of the premises in the Town of
Southold,located at 2.76 Mho CS FATh SdLn],WL;o /I 71 "
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 054 ,Block 01 ,Lot :26.001
That the undersigned(has) (have)filed,or cause to be filed,an application in the
Southold Town Building Inspector's Office for the following: s- go1wr O Tpc;o P-
S AO W UL &1 7540 A-f- goli.Ir PEACPL4S
at the undersigned do(es)hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described property,including any and all
buildings located thereon,to conduct such inspections as they may deem necessary with
respect to the aforesaid application,including inspections to determine that said premises
comply with all of the laws,ordinances,rules and regulations of the Town of Southold.
The undersigned,in consenting to,such inspections,do(es)so with the knowledge
and understanding that any information obtained in the conduct of suoh,inspections may
he used in subsequent prosecutions for violations of the laws,ordinances,rules or ;
regulations of the Town of Southold.
Date_ %2 9-1
(Sienaturer
)ignature)
" (P ' t Name)
CONSENT TO INSPECTION
Aq r a s oL ,tier undersigned.dotes)hereby state:
Owner(s)Names) ;
That the undersigned(is)(are)the owner(s)of the premises in the Town of ;
Southold,located at 2-15" 4 _s . 1 Iq?
which is shown and designated on the Suffolk County Tax Map as D strict 1000, -
Section 0- 5-4 ,Block ®) ,Lot 26.oO I
That the undersigned(has) (have)filed,or cause to be filed,an application in thr
Southold Town Building Inspector's Office for the following s_ 81 o Lr QVrD tot.
sgoW Tw'o As- &J o+-rrF-KKGo 1
That the undersigned do(es)hereby give consent to the Building Inspectors of I&
Town of Southold to enter upon the above described property,including any and aL
buildings located thereon,to conduct such inspections as they may deem necessary with.
respect to the aforesaid application,including inspections to determine that said premises
comply with all of the laws,ordinances,rules and regulations of the Town of Southold.
The undersigned,in consenting to such inspections,do(es)so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws,ordinances,rules 0-:-
regulations
rregulations of the Town of Southold.
Dated: �v 2 /v)ocja v A&t-jell-
-
,signature)
—Fra.LZ-1
TAN(Print ne)
(Signature
(Print Name)
APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM.
The Town of Southold's Code of Ethics Prohibits conflicts of interest on the part of town officers and employees.The nummsc
of this form is to grovide information which can alert the town of possible conflicts of interest and allow it to take whatever
action is necessary to avoid same. i�
YOUR�IAME: p ioi� I rrm-r— hn'r-Itil V
(Last name,first name,middle initial,unless tau are applying to the name orsomeone Rise or other entity,such as a
company,if so,indicate the other person's or company's name.)
" TYPE OF APPLICATION:(Check all that apply)
Tax grievance Building Permit
Variance Trustee Permit
Clunge of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer
or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest.`Business
interest"means a business,including a partnership,in which the town officer or employee has even a partial
ownership of(or employment by)a corporation in which the town officer or employee owns more than 51/o of the
snares.
YES NO
ff you answered"YES",complete the balance of this form and date and sign where Indicated.
Name of person employed by the Town of So thole]
Title or Position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.
Either check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply);
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporanon)
8)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
Q an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSEffP
snitmitted this 0 da�of
PrintName Y 1 w'(4l
4
SQUr��f
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 4
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
Building Permit No. H ,-[. ( I G
7-55' hr1�-JiaT--S
Owner: � .�« �O-�-1-
(Please print)
Plumber: jj�c�! e+c-r�,cs�cZew��h tYzc�S-t� vu`��°c-�
(Please print) r"T - Is;*0 `
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead. _
(Plumbers Signature)
Sworn to before me this p t"✓ot4 b-el
day of 1AN , 20 aD _JCJUN
1 7 2020
Notary Public, County
CONNIE D.BUNCH '''� �' i,p •; ;,
Notary Public,State of New York
No.01 BU6185050
Qualified In Suffolk County
Commission Expires April 14,2 da,(D
SOF 50(/ly ---- — -
�o� o�
# # TOWN OF SOUTHOLD BUILDING DEPT.
�`�cou►m��''�� 765-1802
INSPECTION -
[ ] FOUNDATION 1ST [ ]- ROUGH PL13G.
[ ] FOUNDATION 2ND' = [ ]- INSULATION/CAULKING
[ ] FRAMING/STRAPPING [v] FINAL A �vi
[ ] FIREPLACE & CHIMNEY= ' " _ f j FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION' [ ] FIRE-RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
. j
fonIVp
r v U�►
)f\�� lSk"KVA_
r -DATE INSPECTOR.
ho��OF SOUIyo�
* # TOWN OF SOUTHOLD BUILDING DEPT.
�ycoum, 765-1802
JNSPECT-ION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I LATIOWCAULKING
[ ] FRAMING /STRAPPING [ FINAL .I to 1�
[ ] FIREPLACE & CHIMNEY Y [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ]`FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
1_W2DATE INSPECTOR- -
Nigel Robert Williamson
Architect
P.O. Box 1758
Southold, NY 11971
Phone 631.834.9740
June 16, 2020
Mr. John J. Jarski, Senior Bldg. Inspector
Town of Southold Bldg. &Zoning Division
54375 Main Road
P.O. Box 1179
Southold,NY 11971
Re: A2rusa/McDermott residence 275 Majors Path, Southold,N.Y. P.O.#44176
Dear Mr. Jarski:
I have observed the posts to the outdoor shower and pergolas. They meet the original
design criteria to the best of my knowledge.This does not absolve the owners from
performing additional inspections to confirm that there is no deterioration of the wood
structures which are in contract with the earth.
I trust that everything is in order. If additional information is required please do not
hesitate to contact me. I thank you for your assistance in this matter.
Your's faithfully,
Ni obert Williamson
J ,JUN 1 7 2020
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (IST)
y
C
FOUNDATION (2ND)
� z
o
�y� e
ROUGH FRAMING& t�r1
PLUMBING
a
r
INSULATION PER N.Y. ® �3
STATE ENERGY CODE
0
FINAL ld ll-)�
l
ADDITIONAL CO NTS
o
z
� X
� b
o
x
d
r�
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 q174- Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application ✓
I Flood Permit
Examined / ,20L Single&Separate
'Crass Identification Form
Storm-Water Assessment Form
1 Contact: WILL Pi Gk uP.
Approved b 20 Mail to: l�lfL 1�a�SfEQ;f �1tLi�} ��
Disapproved a/c ,
Phone: 631.834. 474-0'
Expiration 20
} f Buil ns
SEP - 9 2019APPLICATION FOR BUILDING PERMIT
PUU DTI�t Dl"PT, Date 9� 56FFEMB 151? ,20 /7
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.
(Si ature of applicant or name,if a corporation)
P-d. 173-8 S0VT1j..L7.-., . Nab' J1971
(Mailing address of applic t)
State whether applicant is owner, lessee,agent, architect, engineer, general contractor, electrician,,plumber or builder
A GE;J r
Name of owner of premises -rP_&&Aa)E A C.Rvs,% �` MaRLE�4 McZV.P_M0TT
(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.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
278 mxyo2s FAr M $o v-'Noce
House Number Street Hamlet
County Tax Map No. 1000 Section' S4 ,Block , 01 Lot 26= 0O
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 SIM&LC R14 i4M bV)6LLI/JC,-
b. Intended use and occupancy SJJGrL s 1 ►d�.l.LI " "
3. Nature of work(check which applicable): New Building Additions 7C Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling unie4—
Number of dwelling units on each floor 11/.4
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 63.4 Rear 6 3,.P Depth
Height Is'- o" ± Number of Stories 7-Wo
Dimensions of same structure with alterations or additions: Front 6 3-.4' Rear 63-Al"
Depth 45 26 ' Height 28 '.-O°' Number of Stories `rw®
_5koo61z 3- Lo" Is1�•tDEjL 3-w` PPD r
Pr,►zr,,,LA- 13'-0/4 p�1z,�ta )3'• I'�4` Ej2(s�a 9-1174
8. Dimensions Qfiptirf,ne onstruction: Front n w /s�,o'%` Rearfo?:�eW is",0 3/j.' Depth p� n II i2
Height o c K w Number of Stories 0
rzPL* 1;'- w 8` '24 6. 9 6 `
9. Size of lot: Front 10 o. 00' Rear Depth
10. Date of Purchase IST`�VLLJ , 2014. ,Name of Former Owner 17A,J d F.L-b6 o 0 4 1_PAy 1_A1,11✓ A CTRuSjv
11. Zone or use district in which premises are situated P —
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO x
13. Will lot be re-graded?YES NO Will excess fill be removed from premises? YES- NO
TPA')LA- F- ACig"A- 23_o1 15011CSMM-
14.Names of Owner of premises MA9141i HODrSE",oTrAddress l)Hrrl sToaE Aq 113S7Phone No.
17YS
Name of Architect N& L►, Qo1369f kJ;"i IM.roJ Address w� a.� .I 71 Phone No 631.8343740
Name of Contractor N A Address ,) Phone No. iJ Fl-
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? * YES NO_X__
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
IJP Gr:4 613152Y 01LL M.fo-) being duly sworn,deposes and says that Xhe is the applicant
(Name of individual signing contract)above named,
�We is the A Gr6 0-t-
(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 tg-before me this
day of SI;fff.K 9&T_ 20 I R
AA DAVID J.JANNUZZ_I
Notary Po li ,Aate of N5 w York —
Notary Public UZ
Qualified ih Suffolk County Signature of Applicant
Commission Expires Dec. 22,6
SURVEY OF PROPERTY v�
�+ .es SCALE: 1 INCH o
H = 30FEET
$O 60
DESCRIBED PROPERTY ,�Gj�• 302
SITUATE
SOUTHOLD
e�P��e a� 0.86 o
TOWN OF SOUTHOLD •�O�E401 0 o
° 116Z p J Z
SUFFOLK COUNTY, N.Y. lti• ��`IP e �' o
< tS
TAX MAP NO.: 1000-054.00-01.00-026.001 • �O ti s z
LOT AREA: 33,779.07 S.F.(0.775 ACRES) l2O •��Ci �"• T N 3 o
DATE SURVEYED:AUG.21,2019 � Z N cl
,�H
CLEARING LIN z a
DEED REFERENCE:LIBER 12785 PAGE 356 °� AO No o ° o
o fA z
of o << 5 a u
N y
EXISTING LOT COVERAGE: RqV +�(p &I (� z w u �i w z
RESIDENCE&PORCH: %926 S.F. $$ ° / F w N F
PERGOLAS: 210 S.F. ROgo ° 6.74 5.07+ w `Z c'n a w �°-
DECK&STAIRS: 651 S.F. o"e °„/ o00 E +27.57 0 i-2s
TOTAL: 2,787 S.F.(8.2%) $°'3 w o j ° o w
N3 P53EENT END Q — , G mz
0 W Q
PROPOSED LOT COVERAGE: �! QPJ I PR oxo oED i UJ� Z
RESIDENCE&PORCH: 1,926 S.F. 5• i IN GROUND PO I o z 5 ° z o
PERGOLAS: 210 S.F. y� +27.68 _ ___ 3 N w z
DECK&STAIRS: 651 S.F. ° /� OZ z o°¢ a q`
SWIMMING POOL: 800 S.F. �O $�/ N Zs AiA Z.�u� Z. w g
TOTAL: 3,567 S.F.(10.6%) ' oJ. > u a o 0 2 -
O a + 3 0 O 43.89+ ❑ � �5
j O 3 +5.66 26. + O =3 a L' v
39.44 S 5 p "V m
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