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Home My WebLink About26998-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27510 Date: 01/10/01 THIS CERTIFIES that the building ALTERATION Location of Property: 7215 SOUNDVIEW AVE SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 59 Block 6 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 26, 2000 pursuant to which Building Permit No. 26998-Z dated JANUARY 4, 2001 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" CONVERSION OF GARAGE INTO LIVING SPACE IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER ZBA APPROVAL #3286 . The certificate is issued to JOHN A & JENNIFER GRASSO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-069060 08/30/00 PLUMBERS CERTIFICATION DATED N/A Authorized Signa e Rev. 1/81 �I FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26998 Z Date JANUARY 4 , 2001 Permission is hereby granted to : JOHN A GRASSO 7145 SOUNDVIEW AVE SOUTHOLD,NY 11971 for AS BUILT ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR WITH TOWN ZBA #3286 APPROVAL. FLOOD PMT. INCLUDED at premises located at 7215 SOUNDVIEW AVE SOUTHOLD County Tax Map No. 473889 Section 059 Block 0006 Lot No. 003 pursuant to application dated SEPTEMBER 26, 2000 and approved by the Building Inspector. Fee $ 175 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 f Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT T014N HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 a 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . .. . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . ..:'. . . . . . . . Location of Property. . . . .72/S�A/Ca 7if� I SvdivOdi&ai 4ue.Ude. . . . . . . . . . . . . SwTt/d�� House No. �Y Street Hamlet Onwer or Owners of Property. . . . . . . . :T J. . .��Asso County Tax Map No 1000, Section. .. . . S. .C, . . . . .Block. . . . .6. . . . . . . . . .Lot. . . .3. . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . ,�f . . . . . Permit No. . . . . . . . Date Of Permit. . !/V./°!. . . . . .Applicant. . ...C. �.. . . . GE ✓: . Health Dept. Approval. . . . . . . . V��. . . . . . . . . . . . . .Underwriters Approval. . . . 9 6e2 N A . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . X . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . .. �,o� APPLICANT• 765.18®2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: - 42��& ,DATE d INSPECTO THE NEW YORK BOARD OF FJ.RE UNDERWRITERS PAGE 1 8081160 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK,.NY 100,36 , Date AUGUST 30,20M Application No. on jlle 11390/00 H 069060 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of JOHN GRASSO, 7145 SOUNDVIEW AVENUE, SOUTWLD, NY in the following location; 11I� Basement till 1st FL ❑ 2nd FL GAR Seetton Block Lot was examined on AUGUST 24,2000 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES 9VVITCHEB FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS FIUOROCSNT I OTHER AMT. I K.W. AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS ALL UNIT HEATERS MuLTTII-OEC DIMMERS AMT. K.W. OIL N.P. GAS N.P. AMT. NO. A.W.Q. AMT. AMP. AMT.' AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATT$ SERVICE DISCONNECT M TEOF R S E R V 1 C E AMT. AMP. TIRE EQUIP. T•41A T E SW 36 SW 30 4W No' Felt OF CC W. NO.OF MAIG OF H1.LIG' 140.OF N$WRALS OF M�L OTHER APPARATUS: QWGF4 CON EASION-1 o00 VISUAL DEFECTS: "An electrical sUrvey has been made of the exposed eIertrical equipment in the presisels indicated." "No obvious unsatisfactory condition was found. L L JOHN GRASSO 7145 SOUNDVIEW AVENUE GENERAL MANAGER SOUTHOLD, NY, 11971 Per This coMeate m*not aftred In any manner;return to tho oi11cG of th*Scard N incorrect.IfISMatot!rtigy bo HMMWby their credslrTltal$. e PY FOR BUILDING •D MENT.-THtS Y -OP CERTIFICATE MUST NOT art ALTERED IN ANY MANNER. NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE PAPERWORK REDUCTION ACT NOTICE Public reporting burden for the Elevation Certificate is estimated to average 2.25 hours per response. Burden means the time, effort, or financial resources expended by persons to generate, maintain, retain, disclose, or provide information to the Federal Emergency Management Agency(FEMA). You are not required to respond to the collection of information unless a valid OMB control number is displayed in the upper right corner of each form. You may send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management,Federal Emergency Management Agency, 500 C Street, SW,Washington, DC 20472, Paperwork Reduction Project(3067-0077). Do not send completed form(s)to the above address. To obtain or retain benefits under the National Flood Insurance Program(NFIP),you must respond to this collection of information. PURPOSE OF THE ELEVATION CERTIFICATE The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be used to provide elevation information necessary to ensure compliance with community floodplain management ordinances, to determine the proper insurance premium rate, and to support a request for a Letter of Map Amendment or Revision(LOMA or LOMR-F). The Elevation Certificate is required in order to properly rate post-FIRM buildings, which are buildings constructed after publication of the Flood Insurance Rate Map (FIRM), for flood insurance Zones Al-A30, AE, AH, A (with BFE), VE, VI-V30, V(with BFE), AR, AR/A,AR/AE,AR/Al-A30, AR/AH, and AR/AO. The Elevation Certificate is not required for pre-FIRM buildings unless the building is being rated under the optional post-FIRM flood insurance rules. As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt a floodplain management ordinance that specifies minimum requirements for reducing flood losses. One such requirement is that the community obtain the elevation of the lowest floor(including basement)of all new and substantially improved buildings, and maintain a record of such information. The Elevation Certificate provides a way for a community to comply with this requirement. Use of this certificate does not provide a waiver of the flood insurance purchase requirement. Only a LOMA or LOMR-F from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal mandate for a lending institution to require the purchase of flood insurance. However,the lending institution has the option of requiring flood insurance even if a LOMA/LOMR-F has been issued by FEMA. The Elevation Certificate may be used to support a LOMA or LOMR-F request. Lowest floor and lowest adjacent ground elevations certified by a surveyor or engineer will be required if the certificate is used to support a LOMA or LOMR-F request. This certificate is used only to certify building elevations. A separate certificate is required for floodproofing. Under the NFIP, non-residential buildings can be floodproofed up to or above the Base Flood Elevation (BFE). A floodproofed building is a building that has been designed and constructed to be watertight(substantially impermeable to floodwaters) below the BFE. Floodproofing of residential buildings is not permitted under the NFIP unless FEMA has granted the community an exception for residential floodproofed basements. The community must adopt standards for design and construction of floodproofed basements before FEMA will grant a basement exception. For both floodproofed non- residential buildings and residential floodproofed basements in communities that have been granted an exception by FEMA, a floodproofing certificate is required. FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM LEVATION CERTIFICATE AND INSTRUCTIONS I� FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Inauinilq Cortlpany Use BUILDING OWNER'S NAME Jennifer & John Grasso BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O. ROUTE AND BOX NO. C'.ditips'dy NptC NUtVib¢r CITYSouthold STATE NY ZIP CODE 11971 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 1000-59-06-03 BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) Residential LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_I GPS(Type): ##.W or ##.#glkMp°) 1_1 NAD 1927 1_1 NAD 1983 1_1 USGS Quad Map 1_1 Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME63.STATE Southold 360813 Suffolk New York B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL I B8.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE I ZONE(S) (Zone AO,use depth of flooding) 36103CO154 G 05/04/98 JAE & X El . 11 BID. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. 1_1 FIS Profile 1X 1 FIRM 1_1 Community Determined 1_1 Other(Describe): B11. Indicate the elevation datum used for the BFE in B9:j_Lj NGVD 1929 1_1 NAVD 1988 1_1 Other(Describe): B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)7 1_1 Yes 1 X1 No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings* LlBuilding Under Construction* IX1Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 3 (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations—Zones Al-A30,AE,AH,A(with BFE),VE,V1430,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2.State the datum used. If the datum is different from the datum used for the BFE in Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion. Datum Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM. —1 Yes 12LI No ❑ a)Top of bottom floor(including basement or enclosure)renovation 12 . 4 ft.(m) v ��DF NEw y ❑ b)Top of next higher floor renovation 13 2 t MST 0� ❑ c) Bottom of lowest horizontal structural member(V zones only) _ft.(m) o ` �N Zai y ❑ d Attachedgarage to of slab) _ft.(m) E '0 s x ( p E A ;; Ai ❑ e)Lowest elevation of machinery and/or equipment servicing the building 13 8 ft.(m) ❑ f)Lowest adjacent grade(LAG) 11 2 ft.(m) z' jA 0 ❑ g)Highest adjacent grade(HAG) 12 2 ft.(m) 496`e Llh)No.of permanent openings(flood vents)within 1 ft.above adjacent grade LAND S� ❑ i)Total area of all permanent openings(flood vents)in C31h sq. in. (sq.cm) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by rine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME John T. Metzger LICENSE NUMBER 49618 TITLE President COMPANY NAME PeConiC Surveyors , P.C. ADDRESS CITY STATE ZIP CODE P.O. Box 909 Southold NY 11971 SIGNATURE n Q Z16:4_4: DATE12/21/00 TELEPHONE ( 63 1 ) 765-5020 Y �- FEMA Form 61-91,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces,copy the corresponding Information from Section A. For Insurance Conipany Use: . BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg. No.)OR P.O. ROUTE AND BOX NO. P41ic9.Nuotber CITY STATE ZIP CODE Company AI,CNambar SECTION D-SU VEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certifica a for(1)community official, (2)insurance agent/company,and(3)building owner. COMMENTS IJ Check here if attachments SECTION E-BUILDING ELEVATIO INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(without BFE), mplete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Sectio i C must be completed. E1. Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed— see pages 6 and 7. If no diagram ace ulrately represents the building,provide a sketch or photograph.) E2.The top of the bottom floor(including basement or enclosure)of the building is 1_1_1 ft•(m) l—l_1in.(cm) 1_I above or 1_1 below (check one)the highest adjacent grade. E3. For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building is 1_1_1 ft•(m) I_I_jin.(cm)above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 1.1 Yes 1_1 No 1_1 Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B,and E for Zone A(without a FEMA-issued or community-issued BFE)or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS 1-1 Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law o ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E),and G of this Eleva,ion Certificate. Complete the applicable item(s)and sign below. G1. 1_1 The information in Section C was Iken from other documentation that has been signed and embossed by a licensed surveyor, engineer,or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. j A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0. G3. I-1 The following information(Items G4-G9)is provided for community floodplain management purposes, G4.PERMIT NUMBER G5. DI TE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7.This permit has been issued for: 1_1 New Construction 1_1 Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building is: _ft.(m)Datum: G9. BFE or(in Zone AO)depth of flooding at the building site is: _fL(m)Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS I_I Check here if attachments FEMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS INSTRUCTIONS FOR COMPLETING THE ELEVATION CERTIFICATE The Elevation Certificate is to be completed by a land surveyor, engineer, or architect who is authorized by law to certify elevation information when elevation information is required for Zones Al-A30,AE, AH,A(with BFE),VE,VI-V30,V(with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, or AR/AO. Community officials who are authorized by law or ordinance to provide floodplain management information may also complete this form. For Zones AO and A (without BFE), a community official, a property owner, or an owner's representative may provide information on this certificate, unless the elevations are intended for use in supporting a LOMA or LOMR-F. Certified elevations must be included if the purpose of completing the Elevation Certificate is to obtain a LOMA or LOMR-F. In Puerto Rico only, elevations for building information and flood hazard information may be entered in meters. SECTION A-PROPERTY OWNER INFORMATION This section identifies the building, its location, and its owner. Enter the name(s) of the building owner(s), the building's complete street address,and the lot and block number. If the building's address is different from the owner's address, enter the address of the building being certified. If the address is a rural route or a Post Office box number, enter the lot and block numbers,the tax parcel number,the legal description,or an abbreviated location description based on distance and direction from a fixed point of reference. For the purposes of this certificate, "building"means both a building and a manufactured (mobile) home. A map may be attached to this certificate to show the location of the building on the property. A tax map, FIRM, or detailed community map is appropriate. If no map is available, provide a sketch of the property location, and the location of the building on the property. Include appropriate landmarks such as nearby roads, intersections, and bodies of water. For building use, indicate whether the building is residential, non-residential, an addition to an existing residential or non-residential building,an accessory building(e.g., garage), or other type of structure. Use the Comments area of Section F if needed. If latitude and longitude data are available, enter them in degrees, minutes, and seconds, or in decimal degrees, taken at the center of the front of the building. Enter arc seconds to two decimal places. Indicate the horizontal datum and the source of the measurement data(for example,taken with GPS, scaled from a USGS Quad Map,etc.). SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Complete the Elevation Certificate on the basis of the FIRM in effect at the time of the certification. The information for Section B is obtained by reviewing the FIRM panel that includes the building's location. Information about the current FIRM, and a pamphlet titled"Guide to Flood Maps,"are available from the Federal Emergency Management Agency (FEMA)website at http://www.fema.gov or by calling 1-800-427-4661. If a Letter of Map Amendment (LOMA) or Letter of Map Revision(LOMR-F)has been issued by FEMA,please provide the letter date and case number in the Comments area. Item Bl. NFIP Community Name & Community Number. Enter the complete name of the community in which the building is located and the associated 6-digit community number. For a building that is in an area that has been annexed by one community but is shown on another community's FIRM, enter the community name and 6-digit number of the annexing community. For a newly incorporated community,use the name and 6-digit number of the new community. Under the NFIP, a "community" is any State or area or political subdivision thereof, or any Indian tribe or authorized native organization, that has authority to adopt and enforce floodplain management regulations for the areas within its jurisdiction. To determine the current community number, see the NFIP Community Status Book,available on FEMA'swebsite at http://www.fema.gov or by calling 1-800-427-4661. Item B2. County Name. Enter the name of the county or counties in which the community is located. For anunincorporated area of a county,enter"unincorporated area." For an independent city,enter"independent city." Item B3. State. Enter the 2-letter state abbreviation(for example,VA, TX,CA). Instructions—Page 1 Item B4. Map and Panel Number. Enter the 10-digit number shown on the FIRM panel where the building or manufactured (mobile) home is located. The first six digits will not match the NFIP community number: 1)when the sixth digit is a"C" in which case the FIRM panel is in a countywide format; or 2) when one community has annexed land from another community but the FIRM panel has not been updated to reflect this annexation.If the sixth digit is a"C,"it is followed by a four-digit map number. For maps not in countywide format, enter the "community panel number"shown on the FIRM. Item B5. Suffix. Enter the suffix letter shown on the FIRM panel that includes the building's location. Item B6. FIRM Index Date. Enter the effective date or map revised date shown on the FIRM Index. Item B7. FIRM Panel Effective/ReVised Date. Enter the map effective date or the map revised date shown on the FIRM panel. This will be the latest of all dates shown on the map. The current FIRM panel effective date can be determined by calling 1-800-427-4661. Item B8. Flood Zone(s). Enter the flood zone,or flood zones, in which the building is located. All flood zones containing the letter"A"or"V"are considered Spec�al Flood Hazard Areas. The flood zones are A,AE, Al-A30, V,VE, VI-V30,AH, AO, AR,AR/A, ARAE, AR/Al-A30, AR/AH, and AR/AO. Each flood zone is defined in the legend of the FIRM panel on which it appears. Item B9. Base Flood Elevation(s). (Using the appropriate Flood Insurance Study (FIS) Profile, Flood Elevation Table, or FIRM panel, locate the property and enter the BFE(or base flood depth)of the building site. If the building is located in more than one flood zone in Item B8, list all appropriateBFEs in Item B9. BFEs are shown on a FIRM or FIS Profile for Zones Al- A30,AE,AH, VI-V30, VE, AR, ARNP,AR/AE,AR/AI-A30,AR/AH, and AR/AO; flood depth numbers are shown for Zone AO. Use the AR BFE if the building1,is located in any of Zones AR/A, ARAE, AR/Al-A30, AR/AH, or AR/AO. In A or V zones where BFEs are not provided on the FIRM,the community may have established BFEs or obtained BFE data from other sources. For subdivisions and other developments of more than 50 lots or 5 acres, establishment of BFEs is required by the community's floodplain management',ordinance. If the BFE is obtained from another source,enter the BFE in Item B9. Item B10. Indicate the source of the PFE that you entered in Item B9. Item B11. Indicate the elevation datum to which the elevations on the applicable FIRM are referenced. Item B12. Indicate whether the build'ng is located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area (OPA). Federal flood insurance is prohibited in designated CBRS areas for buildings or manufactured (mobile) homes built or substantially improved after the date of the CBRS designation. An information sheet explaining CBRS areas may be obtained on FEMA's website at http:/Iwww.fema.gov or by calling 1-800-427-4661. SECTION C-B ILDING ELEVATION INFORMATION(SURVEY REQUIRED) Complete Section C if the building is located in any of Zones Al-A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, AR/A, ARAE, AR/Al-A30, ARI/AH, or AR/AO, or if this certificate is being used to support a LOMA or LOMR-F. If the building is located in Zone AO or iZone A(without BFE), complete Section E instead. Item Cl. Indicate whether the elevations to be entered in this section are based on construction drawings, a building under construction, or finished construction. For either of the first two choices, a post-construction Elevation Certificate will be required when construction is comple e. Item C2. Select the diagram on pages 6 and 7 that best represents the building. Then enter the diagram number and use the diagram to identify and determine tie appropriate elevations requested in Items C3a-g. If you are unsure of the correct diagram, select the diagram that most closely resembles the building being certified, or provide a sketch or photograph of the building and enter all elevations in Items C3a-g. Item C3. Indicate whether the elevation reference mark(benchmark) used during the field survey is an elevation mark on the FIRM. If it is not, indicate the source and datum for the elevation. Vertical control benchmarks other than those shown on the FIRM are acceptable for elevation determinations. Show the conversion from the field survey datum used to the datum used for the BFE(s) entered in Item B9. All elevations for the certificate must be referenced to the datum on which the BFE is Instructions—Page 2 based. Show the datum conversion, if applicable, in this section or in the Comments area of Section D. For property experiencing ground subsidence, the most recently adjusted reference mark elevations must be used for determining building elevations. Enter elevations in Items C3a-g to the nearest tenth of a foot(in Puerto Rico,nearest tenth of a meter). Items C3a-d. Enter the building elevations indicated by the selected building diagram(Item C2)in Items C3a-e. Elevation for top of attached garage slab (d) is self-explanatory and is not illustrated in the diagrams. If the building is located in a V zone on the FIRM, complete Item C3c. If the flood zone cannot be determined, enter elevations for all of Items C3a-g. For buildings in A zones, elevations a, b, d, and a should be measured at the top of the floor. For buildings in V zones, elevation c must be measured at the bottom of the lowest horizontal structural member of the floor(see drawing below). If any item does not apply to the building, enter "NIA"for not applicable. BUILDING ON BUILDING WITH BUILDING ON PILES, SLAB BASEMENT PIERS,OR COLUMNS A ZONES V ZONES B A ZONES - V ZONES A ZONES t a C BASE FLOOD ELEVATION C BASE FLOOD - ADJACENT ELEVATION GRADEOJACENT GRADE Item C3e. Enter the lowest elevation of machinery or equipment in an attached garage, enclosure, or open utility platform that provides utility services for the building. If the machinery or equipment is mounted to a wall, pile, etc., enter the platform elevation of the machinery and/or equipment.If this item does not apply to the building, enter "NIA"for not applicable. Items Cif-g. Adjacent grade is defined as the elevation of the ground, sidewalk, patio, or deck support immediately next to the building. Use the natural grade elevation, if available. This measurement must be to the nearest tenth of a foot if this certificate is being used to support a request for a LOMA or LOMR-F. Items C3h-i. Enter the number of permanent openings (flood vents) in the walls supporting the building that are no higher than 1.0 foot above the adjacent grade. Determine the total area of all such openings in square inches (square cm, in Puerto Rico), and enter the total in Item C3i. If the building has no permanent openings (flood vents)within 1.0 foot above adjacent grade,enter"0"(zero)for each of Items C3h and C3i. SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION Complete as indicated. This section of the Elevation Certificate may be signed by only a land surveyor, engineer, or architect who is authorized by law to certify elevation information. Place embossed seal and signature in the box next to elevations in Section C. A flat stamp is acceptable only in states that do not authorize use of an embossed seal over the signature of a professional. You are certifying that the information in Sections A, B, and C on this certificate represents your best efforts to interpret the data available and that you understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Use the Comments area of Section D, on the back of the certificate,to provide datum, elevation, or other relevant information not specified on the front. Instructions—Page 3 SECTION E-BUILDING LEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO ' & ZONE A (WITHOUT BFE) Complete Section E if the building is(!located in Zone AO or Zone A(without BFE). Otherwise,complete Section C instead. Item El. Select the diagram on pages 6 and 7 that best represents the building; then enter the diagram number. If you are unsure of the correct diagram,select the diagram that most closely resembles the building,or provide a sketch or photograph. Item E2. Enter the height in feet and inches (meters and centimeters, in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram)above or below the highest adjacent grade(HAG). For post-FIRM buildings in ZoneAO, the community's floodplain manag ment ordinance requires that this value equal or exceed the base flood depth on the FIRM. Buildings in Zone A (without BFE) may qualify for a lower insurance rate if an engineered BFE is developed at the site. Item E3, For Building Diagrams 6118 with "proper openings" (see page 7), enter the height in feet and inches (meters and centimeters, in Puerto Rico)of the next higher floor or elevated floor(as indicated in the applicable diagram)above the highest adjacent grade(HAG). Item E4. For those communities where this base flood depth is not available, the community will need to determine whether the top of the bottom floor is elevated in accordance with the community's floodplain management ordinance. SECTION F-PROPE TY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION Complete as indicated. This section is provided for certification of measurements taken by a property owner or property owner's representative when responding to Sections A, B, and E. The address entered in this section must be the actual mailing address of the property owner or property owner's representative who provided the information on the certificate. SECTION G-COMMUNITY INFORMATION(OPTIONAL) Complete as indicated. The community official who is authorized by law or ordinance to administer the community's floodplain management ordinance ca complete Sections A, B, C (or E), and G of this Elevation Certificate. If the authorized community official completes Sections C,E,or G, complete the appropriate item(s)and sign this section. Check Item Gl if Section C is completed with elevation data from other documentation that has been signed and embossed by a licensed surveyor, engineer, or arch4ect who is authorized by law to certify elevation information. Indicate the source of the elevation data and the date obtained in the Comments area of Section G. If you are both a community official and a licensed land surveyor, engineer, or architect authorized by law to certify elevation information, and you performed the actual survey for a building in Zones Al-A30, AE,I1 AH, A (with BFE), VI-V30, V, AR, AR/A, AR/Al-A30, AR/AE, AR/AH, or AR/AO, you must also complete Section D. Check Item G2 if information is entered in Section E by the community for a building in Zone A(withouta FEMA-issued or community-issued BFE)or Zone AO. Check Item G3 if the information irf Items G4-G9 has been completed for community floodplain management purposes to document the as-built lowest floor elevation of the building. Section C of the Elevation Certificate records the elevation of various building components but doenot determine the lowest floor of the building or whether the building, as constructed, complies with the community's floodplain management ordinance. This must be done by the community. Items G4-G9 provide a way to document these detefitimations. Item G4. Permit Number. Enter the(permit number or other identifier to key the Elevation Certificate to the permit issued for the building. Item G5. Date Permit Issued. Enter}he date the permit was issued for the building. ��', Instructions—Page 4 Item G6. Date Certificate of Compliance Issued. Enter the date that the Certificate of Compliance or Occupancy or similar written official documentation of as-built lowest floor elevation was issued by the community as evidence that all work authorized by the floodplain development permit has been completed in accordance with the community's floodplain management laws or ordinances. Item G7. New Construction or Substantial Improvement. Check the applicable box. "Substantial Improvement"means any reconstruction, rehabilitation, addition, or other improvement of a building, the cost of which equals or exceeds 50 percent of the market value of the building before the start of construction of the improvement. The term includes buildings that have incurred substantial damage, regardless of the actual repair work performed. Item G8. As-built lowest floor elevation. Enter the elevation of the lowest floor(including basement)when the construction of the building is completed and a final inspection has been made to confirm that the building is built in accordance with the permit, the approved plans, and the community's floodplain management laws or ordinances. Indicate the elevation datum used. Item G9. BFE. Using the appropriate FIRM panel, FIS, or other data source, locate the property and enter the BFE (or base flood depth)of the building site. Indicate the elevation datum used. Enter your name, title, and telephone number, and the name of the community. Sign and enter the date in the appropriate blanks. Instructions—Page 5 BUILDING DIAGRAMS The following eight diagrams i lustrate various types of buildings. Compare the features of the building being certified with the features at n in the diagrams and select the diagram most applicable. Enter the diagram number in Item C2 and the elevations in Items C3a-C3g. In A zones, the floor elevation lis taken at the top finished surface of the floor indicated; in V zones, the floor elevation is taken at the bottom of the lowest horizontal structural member (see drawing in instructions for Section Q. DIAGRAM DIAGRAM 2 All slab-on-grade single-andmul iple-floor buildings All single.and multiple-floor buildings with basement (other than split-level)and high- 'se buildings,either (other than split-level)and high-rise buildings with detached or row type(e.g.,town ouses);with or basement,either detached or row type(e.g., without attached garage. I townhouses);with or without attached garage. Distinguishing Feature-The bottom floor isl at or above ground level Dlstingulahing Feature-The bottom floor(basement or underground (grade)on at least one side.• garage)is below ground level(grade)on all sides. Buildings constructed above crawl spaces that are below grade on all sides should also use this diagram,* 8 i NEXT HIGHE� a i FLOOR i NEXT HIGHER b FLOOR GRADE BOTTOM FL00R GRADE BOTTOM FLOOR (BASEMENT) i F'y : v . •9 .. (determined by existiE..., ..... .. ... .... ...,..".:�:..,:.;. .:.,..,• ....., :..<,,.�:.;,::�:;.:::.::: ::;,�.,:::.,,r,::: f �Ig grade) f g (determined by existing grade) DIAGRAM DIAGRAM 4 All split-level buildings that are s ab-on-grade,either All split-level buildings(other than slab-on-grade), detached or row type(e.g.,townhouses);with or either detached or row type(e.g.,townhouses);with or without attached garage. without attached garage. Distinguishing Feature—The bottom floor( xcluding garage)is at or Distinguishing Feature—The bottom floor(basement or underground above ground level(grade)on at least one at a.' garage)is below ground level(grade)on all sides. Buildings constructed above crawl spaces that are below grade on all sides should also use this diagram. i II i b a b a HIGHER i i HIGHER IGHER NEXTHIGHER GRADE FLOORS NEXT HIGHER RADE BOTTOM FLOOR BOTTOM FLOOR FLOOR li LOOR BASEMENT •.•y '::j'1i .�y.r.. r f g (determined by elSc!sting grade) f g (determined by existing grade) * A floor that is below ground level(grade)on all sides is considered a basement even if the floor is used for living purposes, or as an office, garage,workshop,etc. Instructions-Page 6 DIAGRAM 5 DIAGRAM 6 All buildings elevated on piers, posts, piles,columns, All buildings elevated on piers, posts, plies,columns, or parallel shear walls. No obstructions below the or parallel shear walls with full or partial enclosure elevated floor. below the elevated floor. Distinguishing Feature—For all zones,the area below the elevated floor is Distinguishing Feature—For all zones,the area below the elevated floor Is open,with no obstruction to flow of flood waters(open lattice work and/or enclosed,either partially or fully In A Zones,the partially or fully enclosed readily removable insect screening is permissible). area below the elevated floor is with or without openings"present in the walls of the enclosure. Indicate information about openings in Section C, NEXT HIGHER b Building Elevation Information(Survey Required). � � FLOOR i I NEXT HIGHER a I a b ELEVATED ELEVATED FLOOR FLOOR GRADE GRADE .., T T "N ENCLOSURE (determined by existing grade) ..:..,,.,.., C,,.. (determined by::i C (For v zones only) existing grade) (Fore zones only) DIAGRAM 7 DIAGRAM 8 All buildings elevated on full-story foundation walls All buildings elevated on a crawl space with the floor of with a partially or fully enclosed area below the the crawl space at or above grade on at least one side. elevated floor. This includes walkout levels,where at least one side is at or above grade. The principal use of this building is located in the elevated floors of the building. Distinguishing Feature—For all zones,the area below the elevated floor is Distinguishing Feature—For all zones,the area below the first floor is enclosed,either partially or fully. In A Zones,the partially or fully enclosed enclosed by solid or partial perimeter walls. In all A zones,the crawl space area below the elevated floor is with or without openings—present in the is with or without openings"present In the walls of the crawl space. walls of the enclosure. Indicate information about openings in Section C, Indicate information about the openings in Section C,Building Elevation Building Elevation Information(Survey Required). Information(Survey Required). I � I r I I I I 1 I NEXT HIGHER O b a FLOOR a NEXT HIGHER FLOOR O f OWALKOUT LEVEL % : ..:.. ..:. .: ...: ......s ,:..;..•.::. ,.: ,. •.. ::.., .,..,. ,::..:. ,�'r,.: .... .. . . ._ ..... CRAwL SPACE _. . ** An"opening"(flood vent) is defined as a permanent opening in a wall that allows for the free passage of water automatically in both directions without human intervention. Under the NFIP,a minimum of two openings is required for enclosures or crawl spaces with a total net area of not less than one square inch for every square foot of area enclosed. Each opening must be on different sides of the enclosed area. If a building has more than one enclosed area,each area must have openings on exterior walls to allow floodwater to directly enter,The bottom of the openings must be no higher than one foot above the grade underneath the flood vents. Alternatively, you may submit a certification by a registered professional engineer or architect that the design will allow for the automatic equalization of hydrostatic flood forces on exterior walls. A window,a door,or a garage door is not considered an opening. Instructions—Page 7 SVF0j/( CD Town Hall,53095 Main Road M Fax(631)765-1823 P.O.Box 1179 Telephone(631)765-1802 Southold,New York 11971-0959 zt. BUILDING DEPARTMENT TOWN OF SOUTHOLD January 9, 2001 Garrett Strang P.O. Box 1412 Southold, NY 11971 RE: 7215 Soundview Ave . , Southold. (&Y-q -sso') To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file . XX The check is (not on file . ) $25 . 00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26998-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 1FIO--INSPECTION REPORT DATE COMMENTS --------- ------------------------=---------------- ------------------ FOUNDATION ( 1ST) �' 11 II II FOUNDATION (2ND) ��-- II ------- ---=-- — — — it I I _ ROUGH FRAME 6 PLUMBING n �� r it n 1 � INSULATION PER N. Y. STATE ENERGY _-1i CODE I� _it II jj ' I II p H Il�y FINALf. II II Ida- ADDITIONAL ti COMMENTS: �-1 HQ N z a ro �� H APPLICATION t1 PAGE 1 a( 4 TOWN OF SOUTHOLD FLOODPLAIN DEN'LLOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1 GENERAL PROVISIONS (APPLICANT to rcad and sien)' 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 reissued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE. (APPLICANT'S SIGf4ATURE) — DATE //`/l°l e - SECIION 2: PROP SED DL ENT 6 be corn Ir-ted by APPLICAIt NAME y ADDRESS TELEPHONE APPLICANT ' �OUN L=��ASSn �I/'/'`S J-oJNOVtPW A✓b�.JCJE Jp�OLp BUILDER ENGINEER 96 Y-s"a'5 (',A2o E'N' � �� C N'�.G//l TELT /230 �.�a✓�Lkn Jr °✓7'1-lOr.a r PRO7ECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify 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 well-known landmark. A sketch attached to this application showing the project location/would be helpful. //5`5� .b.�.J r�✓rt;w �vE,NJe �o✓>"l.-ra c. ��{Z$'� W OF KEnii✓�y` o5 t`nnp Sc, n �,Goo - s9- G-3 FDP(93) • APPLICATION _ PAGE 2 OF 4 DESCRIPTION OF WORK (Check all appticablc boxcs) A STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure N Residential (1-4 Family) ❑ Addition ❑ Residential (Marc than 4 Family) 0 Alteration ❑ Non-residenual (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition r ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S 7 30v B. OTHER DEVELOPMENT ACTIVITIES: O Fill ❑ Mining O Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) Cl Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Improvements,(Including Culvert Work) • Road, Street or hPidge Construction O Subdivision (New or Expansion) O Individual Water or'S*r System 13 Other (Please SpectTy)` vo Js After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. ECTION 3: FLOODPLArN DETERMINATION o be completed by LOCAL ADhfINi TRATOR The proposed development is located on FIRM Panel No. l �T • Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). *Is located in a Special Flood Hazard Area, FIRMzone designation is 100-Year flood elevation at the site is: Fl. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See S n 4 for ittonal instructions. / SIGNED i DATE j .—�--- t • APPLICATION N PAGE 3 OF a SECTION 4: AD01T1 NAL INFORMATION REUIRED To he coin leted by LOCAL ADMINISTRATOR The appbcam must submit (tie documents checked below before the application can be processed: ❑ A site plan shoving the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑ Developmeul plans, drawn to scale, and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor ('including basement), types of water resistant materials used below the first floor,details of floodproofmg of utilities located below the fust floor and details of enclosures 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). PS Flood,proofmg protection level (non-residential only) Ft.NGVD (MSL). For llood(iioofed structures, applicant must attach certification from registered engineer or architect. ❑ Certificationnkfrom a registered engineer that the proposed activity in a regulatory Roadway will not result in any increase in the height. of the 100-year flood. A copy of all data and calculations supportinggthis finding must also be submitted. P7 Other• �e� Co.k •awa AX Ofr C D SEMON 5 PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity: A. ❑ Is B.O Is not in conformance with provisions of Local Law #_. 19_ The permit is issued subject to the conditions attached to and made part of this permit. SIGNED DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. �y a APPLICATION s PAGE 4 Of 4 APPE_A S Appealed to Board of Appeals? D Ycs D No Hearing date: Appeals Board Decision --- Approvcdl O Yes D No Conditions SEMON 6: 65-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 I or 2 below. I. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal Hi¢h Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE AMON (To be completed by LOCAL ADMINISTRATORI The LOCAL ADMINISTRATOR will complete this section as applicable based ou inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES 0 NO DATE BY DEFICIENCIES? ❑ YES 0 NO DATE-BY-DEFICIENCIES? ❑ YES ❑ NO SECTION 8 CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: lrBOARD OF HEALTH . . . . . . . , FORM NO. 1 J SETS OF PL.i is - TOWN OFSOUTHOLD SURVEY . . . . . . . . . • - • • • ' BUILDING DEPARTMENT C11CC1: . . . . . . . - _ TOWN HALL SEPTIC F0 RN _ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:0i iF`f Examined . . / z. . . . . . . . . d CALL . . . . . . . . . . . . . . . . Approved t•IAIL T0 : . .� 3 . . . . . . . o. ai�a �i. ' Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) . . . . . . . . APPLICATION FOR BUILDING PERMIT fJ Date INSTRUCTIONS a. This application must be completely filled;in by Typewriter or in ink and submitted to the Building Inspector, with 3 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 stiects or areas, and giving a detailed description•of layout of property must be drawn on the diagram which is part of this appli- cation. C. _The work covered by this application may'hot'be commenced before issuance of Building Permit. d. Upon approval of this application, the. Building Inspector will issued a Building Permit t shall be kept on the premises available for inspection throughout the work. o the applicant. Such permit e. No building shall be occupied or used in whole or in part.for any Certificate'of Occupancy shall have been granted by the Building Inspector." purpose whatever until a Certi 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, h ing code, a d regulations, and to admit authorized inspectors on premises and in building for necessay inspections. .. ns. .... . . . (Si,na ure of applicant, or name, if a corporation) " �;o• 8dxi�{�2,. .�'+?�>faid by i/9?� . . (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . Aecy� �1 q . . . . . . . . . . . . . . ... . . Vame of owner of premises . . . . . . . . . . . . . . . . .Y'6Htil 7eA_-S0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll orlatest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . . . . . . • /J/A Plumber's License No. Electrician's License No. Other Trade's License No. ocation ofland on whichro osed work will be done. P p . . . . a.�5. � s�N��,� A�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . oust weber goondolz Street . _ Hamlet County Tax Map No, 1000 Section . . . . . . . `�, , , , , ; , . Block . . . a. . . . . . .. . . . . . Lot . . . . . . . Subdivision . . . . . . . . . . . . . . Filed Mapo. . . .N . . (Namo) . . . . . . . . . . Lot . . . . . • Slate existing use and occupancy of premises and intended use and occupancy,of proposed construction: a. Existin.,, use and occupancy . . . . . . . . .. . . ... . . . . . .�G,/-E,r4n/c/. �esl F,t/. . .,. ., 4 Gt . . . . b. Intended use and occupancy . . . . . . . . x1A149 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . , . Alteration . Repair . . . . . . . RcCvn�✓e2Sro� 01- �aea�emoval . . . . . . . . . . .. . . Demolition . . . . : . . . . . . . . . Cher Work X . . , . . . . . . . . ' !'To l ✓/L1Ea.,S�µce (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on tiling this application) 5 1f dwelling, nnumber of ca ser of wellir%g units , , , . �. . . . . . . . . Number of dwelling units on each floor . . . .�. . . . . . . . . . G garage, j. . 6. If business, commercial or mixed occupancy, specify nature and extent of•eacll type of use . . . . N�^ 7. Dimensions of'existing structures, if any: Front . . . . . .... , , , , Rear . . . . Depth Height . . . . ? . . . . . . . Number of Stories . . , . , . �. . , . . . . . Dimensions of same structure with alterations o r additions: Front . .7/;V. , , , • . • , • , . Rear ?eDcpth . 3.� i . Height . . . . .... . . ..f. . : Number of Stories . . . . . . . . . . . : . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . • Rear , , , . . . . . . . . , . . . Depth . . . . . . . . . . . . . . Height , Number of Stories . . . . ... . . . . . . 9, Size of lot: Front . . . . . . . Rear. . . . . . . .%/6 , . . . . . . Depth /Dy w ,loo 10. Date of Purchase . . , . . . � � , Name of Former Owner , . , p,uuC�JDv�!. . . , ` ` ` ` • ` ` ` . 11. Zone or use district in which premises are situated . . . . . . R , , 12. Does proposed construction violate any, oning law, ordinance or regulation: NO 13. .Will lot be regraded . . . . ... . . A-1 A . . . . , . . . , . Will excess fill be removed from premises: Yes No 14. Name of Owner.of premises pN U�', ��s'o , , , Address 7/�5 Soun» ✓/qy.AYe , Phone No. ire—,1357 Name of Archit6ct . ,G,age �',j1, Sr?^!!Cn. , , ;, , , , Address f�p� ! /2S�ou7}lX q, , , Phone No, Name of Contractor . . . . . .. ,'I, Address . Phone No. 15. Is this property within', 300 feet of a tidal wetland? *yes. . X. No. . " " ` . . . . . . . *'If yes, SoutholdiTown Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly a}1 buildings, whether existing or proposed,-and,indicate all setback dimensions-from property lines. Give street and bloc)C number or description according to deed, and show street names and indicate whether interior or corner lot. ' V � j�77�iQCh/E A • STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . . . . . . ¢.S (Name of individual signing being duly sworn, deposes and says that he is the applicant contract) 44ve named. is the . :. . . . . . . . . . . -Tcl� k6jA ,n/r . , . . . . , . . . , . . . , . . , . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and File this Aff!icntion; that all statements conta+ned in this application are true to the best of his knowledge and belief; and that the Wwk will be performed in the manner setforth in the application filed therewith. a"arn to before me this Z5d . , . . . . . . . .day of.I, . `... . .. . .�-. . . . . . . 1,R/2oon Nat'nry Public, . . . . NCI7ARY PUBLI County ,� - --_-- y New YorkNo. 4730095 L : . . , . . . . . . . . . . . . . . . . . Quellfied - SAO County (Signature of applicant) 90MM, explrom July a1,-eoov Southold Town Building Department 53095 Main Road facsimile Southold,N.Y. 11971 Tel# : (631) 765-1802 Fax#: (631)765-1823 tmsniival To: Mrs. Strang Fax: 631-765-5490 From: Bruno Semon Date: January 3,2001 Re: Grasso Residence Permit Pages: 2 CC: Fast track form/waiver ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle 41o Please execute the atta shed form and fax back to Vis. We will need the original at some releasing permit. Bruno Semon Building Inspector I BE . ' r ! t ri!' ,3fa,"+.'lakF rtF 's�ye4l(>ndmu.I • .• • • • • • . • • • . . ! ➢! tY ti t! 3l S ..H3I� 3 6 Y.. �- �4 T_ --- a�•. SUFFOLK CO. HEALTH DEPT. APPROV , 121E C=� T � 0 Cif .., "t H.S. NO. f4-SO-f$ 1f ,lVf 1 fY. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL "LA CONFORM TO THE STANDARDS OF THE x = ffctc a/r5rrtjslrwrxr ( ! 4 �� 4� SUFFOLK CO. DEPT. OF HEALTH SERVICES. (S) APPLICANT 6 SUFFOLK COUNTY DEPT. OF HEALTH SERVICES — FOR APPROVAL OF tj 1p.•- .�s- SJR - 1nC �ga{j Y8 �.�iCONSTRUCTION ONLY �,. DATE: H. S. REF. NO.: 14- 50- IS APPROVED: _S• .. ">-^ rte'-,_ - e _I �k.f'�y•-�`� _i s`i•, '7--- _ - '� _ -----' . SUFFOLK CO. TAX MAP DES#G# 41TOiF SUFFOLK C TY HEALTH DE,PARTMENfi - =�—r -b ��eK 6`;' DIST. SECT. BLOCK PCL. 1000 0159 /o -31 _ SINGL FAMILY DWELLING ONLY g OWNERS ADDRESS: 1726 "e_7duwCare 9 P Ur Egos+ Mi�adcrv, NL'-K 't f `.f'� . 1 DATE OCT 2 4 - Np THE S _(}i OS11t AND 1N-': ? SUPPLY FACILITIES FOR THIS _ .7e 1. LOCATION HAVE ''5 iNSPr ' ED BY THIS DEPARTMENT AND z i FOUND TO BE SAT FA TORY:• GEED: L.-4757 P. t TEST HOLE STAMP- ' -Chief ` -Chief of stewater ManagemeN SSection ---m_ .-__ -_ . �7G.:C�fC/J� y�77'1-, --_�_, _. '� /[aw'• Pf� 1{'rvet4 (tt );=-'L: ,,__-j--— __ ._ e'1 ,�3.._ _ (T• p �/''� E3.8`W" 1" 3TSPs z. - -"_---------.`.--.._ d c{'8 s,M...A101 M 07 sut4n'4u�rn8 t11EC # !_.>:3( bt tT"Y, COY. _ _ # SEAL _. -•—•.C� ._.._ --O,O — OF NE 2evtsed Oc+.14,19,96 C?ew, ��,j �f, i='. Ye ea :Jus °s t s, l ap,•AP� PCK v111 yo9 1 fcxarm 9 olevo4ioPlz eom �ietd`sca ve fare �a!9 RODER#CK VAN TUYL. P.C. `'oo` T > y, " b * a « c a� -�rcocin --06 level . ». �v�''u", �` Jt1/ 3!i"198,4, LICENSED LAND SURV19YORS- : Xtgod zsne fi_to (e1. ft - GREENPORT NEW YORK �GS� <S 256ti�c` 7 :. r ®LANDSil 4 }9y�LA�fi F. "�C i✓Rr�51p I FU'P b '. "fie "^ —� ZONE X �i i Hy 4 �r� CL_ A O Q. ZONE Fti X tiFY 9 oqo �0A1 �P Town of Southold 360813 yo Q �f ik 4a44a_. � ZONE ZONE X X J_ ZONE ZONE AE fl,= (EL 10) X ZONE X iZONE Ni, ---- .i01NS PANEL 0162 a � dFT1 C / JJNGL/ C'oa��/ace NYS,I� a..J CoJ rr�.s./ Ue��•-1/ �•5/� �c�r,a�C�o.-1 e 3 �4"/sr .4D��oxss �5 PIS N.:�n {-pt /=uu �c�a.7 L.orylU.fi+CC, , gel 4��v�{+//« .J o- s n roPe•�ato. U/:�'r. /�� , A • J.�'S/6�I /�+f�f4'SS.a.�.fL On •*-q,�eefq�irS 3�cec ri<.rTc./5. A e s/ at 1—l�Lc.n cv'r Q✓-A Aye/.aL , /.1 /''Fn7 J 8 Fr-,7E c 7��' :Z r. J . Lam- 14 �/' G NV/ - IICD f�,. PT F/+G Eta 171 1' G" - u n rz - 11 // '1 // J'• ' i - "1//L LJ ITN /v�s�C /''A"� 7/.3 � /4'Y[•iie.q. / F"(J'L>lh E.TL— G •n 1=.P'.. - 5,7 F ELT_ _ UP Zz C0111PPINVMCHAPTINt �I.(� t 1� Gt 'Y%'rJr9//w � ' .DadU►4E-EREV�16i1 ------ - - �7 �.t< ,`, • `�• ,:.;%��i�, �� ,� �\ .< � .��' - a OLD' mm Coors z H = Q - � )' _ F- y,. 4- Oz rJ ..'/7,_... .Y47 E-r�T4� y- /A 71LY.L14liY 1/ LH1/A NeJYJ..-„ Z0XB� yl Ips-r. � u-rl tTY r v<a 1f'1v U�l�-IYJ�rY OR -NIPLYWITHCHAPTERu46" YTl '.DOD DAATAOE PREVE,- ON 717 .E /��mwe�o _ PROVIDE f/iMR. FIRE LI�}E I,�j Ifl�"8�_F�ik' F�.�L 'CTH0LD' TGWN r•r�e RATED SEPARATION TO X 1 2 T 1 IrPART. 717.3 (f) (1) OF _.. ----- q?c po , sva � F K t T G. I-II I� �nc //qTL2�1�-cr+n AJD J�j•/ F�1T1f Src>c'`(lT1I([3 clJG' .urc lc,��cu�c,>" /`'tl.S i_��/ -Y STATE BUILDING ) CODE. APPROVED ABSY:NOT�ED DATE: NPROV DE ANTISCALD AND/OR PROVIDE FEE:A/ 2b x 1 G THERMAL SHOCK PREVENTING ALARM DEVICES NOTIFY BUILDING DEPARTMENT AT DEVICES AS TO PART. 902.6(K) AS TO PART.721.1 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: If copper tubing is used N.Y. STATE BUILDING CODE. Ii BUILDING CODE. 1- FOUNDATION - TWO REQUIRED for Water distributing FOR POURED CONCRETE system; piping shall be -d{9 AI i WASTE 2. ROUGH - FRAMING & PLUMBING S. INSULATION of types K or L only TCS.. ,.Ic COVERING PROVIDE OPENINGS FOR 4. FINAL - CONSTRUCTION MUST UNDERWRITERS CERTIFICATE � BE COMPLETE FOR C.O. REQIIIRED EMERGENCY ESCAPE AS ALL CONSTRUCTION SHALL MEET REQUIRED BY PART. 714 OF THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY N.Y. STATE BUILDING CODE PLUMBER CERTIFICATION . Coors. NOT RESPONSIBLE FOR ON LEAD CONTENT BEFORE DESIGN OR CONSTRUCTION ERRORS CERTIFICATE OF OCCUPANCY UNDERWRITERS CERTIFICATE Li ' f SOLDER USED IN WATER ENERGY CONSERVATION NOTES : REQUIRED SUPPLY SYSTEM CANNOT I EXCEED 2/10 OF 1%LEAD, 1. To the best of my knowledge,this alteration had been constructed in compliance with the requirements of Section 7814 of the New York State Energy Code. %of Glass = Area of class In sc.ft. _ 70 = 14% glass Area of sidewall in sq.ft. 558 -, 2. All windows aro insulated glass,thermal break,weatherstrlpped and flashed as required with hf r, r F- pv o a maximum Ni value of.58 (minimum"R"value of 1.7)and a maximum infiltration rate of.37 ' " cfm per linear fool. IT! 6 ^p III I 3. All exterior doom aro Insulated,thermal break,weatherstripped and flashed as required with a maximum "U"value of,40(minimum"R" value of 2,5)and a maximum Infiltration rate of.50 cfm per square foot 4. The existing HVAC equipment was to have been in conformance with Section 7814.11 thou 7814.15 of the New York State Energy Code. �— 4!:; ( 'f7EREu6Rr, TITLE �5 'ICU 1 L_-T- VA //, 1 S illA, T�' i--A, GARRETT A . STRANG LOCATION 14-J�� E!X 1 ti -'r �-� �. ��✓.%L tL'".. ,L� Y:/ �' 1 /,. A. 1 :] �t=' architect J� .JY 1-1,:.7 Ly , N I?— - ' I SGLC NEVISEO OPAWING N^ 1230 Traveler Street Southold N.Y. 11971 A't '_��. — '✓`-1 ti.�V .7 1Z- T L-_ —ie=-c—L� .�I U r= rte- �.,�..�._,o]'. DATE j/qrf 0 15244 of NE I',13 631 - 765 - 5455 NPAWN N. PROJECT Nq C0wLvwMCHAPM%r F — Z� _ - ZE, F .7 jjj i C �✓Ti/h�SG- � A t�-�`'-� F it .S ,� ,� , l_ -r. -- _ X 1Nt1 tGJ �/h • _ µE\�/ IF Z - w � ti Gr L fi C H a GNl/h ti:ET /IPJ JVD _- --. F.-X1SY. � UT1lj-1TY�eJc.�//A I p�/�j _Fln LiIUNP¢r I �iXl � '-r1NG --- " x Lj bAt- 69g," SEftEft ARC ST AH Q�p�RE GARRETT A . STRAIVG — I'D""' 1 45 5c.� :J �x ri \vG' r c � �/nalna architect �a Yv� AWl. �� -F' , Tv, rte. SCAIC flEVIS Efl xPAWING N? 1230 Traveler Street Southold N.Y. 11971 A� Na✓ �v Ile �+ 7/ DATE - ' yT 015244 oR� 631 - 765 - 5455 DRAWN BY Are OF NOy PROJECT M? m4 7 1 t7F y BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: / /,2 /opo APPLICANT NAME: DATE SUBMITTED: 9 / ZZ/oo 'CTA-1# --- DISTRICT: 1,000 SECTION: -:!�7 BLOCK: 6 LOT: 3 PROJECT LOCATION STREET: 2,215 Saw�o�,�.� � CITY: SUBDIV. NAME: ARCHITECT/ENGINEER: S� rc. FAST TRACK: YES RNO SINGLE & SEPARATE CERTIFICATION-REQUIItED: YES o NO OTES: ZONING: PERMIT IMATE AMOUNT:_$ j, .00 ZONING DISTRICT. R4 R80 AC CONFORMING: YES o NO QUIlZED LOT SIZE: ¢O,� SQFT. WHERE ACTUAL LOT SIZE FROM TAX CARD ,.S /3Q6&-s/� ACTUAL LOT SIZE: /3 G168- SQFT. REQUIRED F QUIRED /'' ,K,E REQUIRED FRONT:'PROPOSED;26 ' SIDE YD:/0'/ S ' PROPOSED: /S 'I*C2 ' REAR: �S 'PROPOSED:3S ' LOT COVERAGE: ALLOWED:.6--16 EXISTING: sf % NEW: sf % TOTAL: sf % CORNER? YES OR NO WAT ER FRONTS YES R NO DESCRIPTION: �/� G ne*4 L a 14 LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) PROJECT DESCRIPTION: AD AL ACC OR N/D: ,6u/L G C�-sJcr-s loaf AGENCY PERMITS REQUIRED FOR REVIEW NEEDED TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES c NO (BED #): DTE: / / PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9w75 YES o NO SOUTHOLD TOWN TRUSTEES: YE or !G TOWN ZONING BOARD APPROVAL&E or N ZD w < 328K TOWN PLAN. BOARD APPROVAL: YES orin FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 L #: FLOOD ZONE: ,4,��/, I-ewc� e a ,.u.J NYS ENER Y YE OR NO NOTES: ...,s 5�14 Air 4C FEE STRUCTURE: �UNDATION: SF FIRST FLOOR SF SECOND FLR SF INIT OTHER TOTAL TOTAL: 42.6 SF FEE �� FEE TOT( `,49:� SF)- �SF)= SFX $ _$_�+$ ��S +$ /OG =$ s ��-� ��9 ad l�s,.� / � �/y � S/'��'1 _' �� ,rrrp q f Gpo n / V � 'v A�L r•..� � � � k,-� � -�//� u V' T,