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HomeMy WebLinkAbout27057-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28059 Date: 11/13/01 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 3745 MILL RD PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 67 Block 2 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 6, 2000 pursuant to which Building Permit No. 27057-Z dated FEBRUARY 12, 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 ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT BERNARD & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 570890 09/28/01 PLUMBERS CERTIFICATION DATED N/A utho ized gnature Rev. 1/81 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. 27057 Z Date FEBRUARY 12 , 2001 Permission is hereby granted to: ROBERT & ABBY BERNARD 2543 MILL LANE PECONIC„NY 11958 for ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR WITH FLOOD PERMIT. at premises located at 3745 MILL RD SOUTH/PEC County Tax Map No. 473889 Section 067 Block 0002 Lot No. 010 pursuant to application dated NOVEMBER 6, 2000 and approved by the Building Inspector. Fee $ 75 . 00 FLOOD DEV.PMT 100.00 FEE DUE $175.00 Authorized Signature ORIGINAL Rev. 2/19/98 fs Fork No. 6 ' TOWN OF SOUTHOLD j BUILDING DEPARTMENT Q TOWN HALL '';;. I 765-1.802 9 APPLICATION FOR:CERTIFICATEOF OCCUPANCY toC� pT A. This application must be filled in by typewriter OR ink and submitted *to 'tau ding inspector withthe 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 buildin; and installations, a certificate of Code Complianoe from architect -or engineer responsible for the building. 6. Submit Planning Board'Approval of completed site plan requirements. i B. For existing buildings (prior to April 9; 1957) non-conforming uses, or buildings an( "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� Occgpancy is denied, ,the Building Inspector,.shall state.the reasons therefor 1n. 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 $25.100, Businesses $50.00. 2. Certificate of Occupancy on Pre-•existing; Buildine - $100.00 3. Copy of Certificate of Occupancy - .2ft 4: Updated Certificate of Occupancy - $50.00 ' 5: Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ... . . .... :.... . .. .... . . . .. . .. pew Construction. . ..... . .*.. Old Or P_re-existing Building. . .. .. . . . . ... . Location of Property.YC2... .>..7. r�.. �?L-� ..1% .. .., . �. ... ......,. . . . . ..... ' House No. Sheet Hamlet Onwer or . Owners of Property...L4w2.,.. .'. . . . . . . . . . .. . . ... . . . . . . . . . . County Tak Map No 1000, Section. . . 6.. .. . . . .Block. . . . . . . .. .. . .Lot. . .L.� .. . . . . . . . .. . Subdivision. . .. . . . .. . . . . . . . . . . . . .. . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . l z Permit No. :': ��,1..Z .Date.Of Permit.. .. . . .. 4 . . ... . .Applicant. . 1 Health Dept. Approval. . .. . . .. .. . .. .. . . . .. . .Underwriters Approval. . . . . . . . . .. . . . . . . . . . . Planning Board Approval. ,'. .. . .. .. .. .. .. . pproval. .'. .. . . .. .. .. .. . : . Request for: Temporary Certificate. .. .. . . . . . . Final Certicate. . . . . . . . . . . Pee ubmitted: $... . ... . . . . . . . . . . . . . . . .. . . . . . : THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1045095 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date SEPTEMBER 28,2001 A location No. on f1e 12441.401/0]. N 570890 THIS CERTIFIES THAT ERMIFP NO. -70597 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of MANZI HOMES, 175 KOKE DRIVE, SOUTHOLD, NY in the following location; ® Basement ® 1st Fl. ® 2nd Fl. GAR/O1.TY Section 078mock07 Lot 047 was examined on SEPTEMBER 06,2001 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCEPO FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 54 43 45 52 2 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 2 F 1 DW 12/ - 1 7 600 SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A.W.G. A.W.G. A.W.O. AMT. AMP. TYPE EQUIP. 1•2W 1 0 3W 3 0 3W 3 0 4W PER 0 Of CC.COND. NO.OF HI-LEG OF HI NO.OF NEUTRAL$ OF NEUTRAL 1 200 CB 1 X 2 2/0 1 2/0 OTHER APPARATUS: CO DETECTOR-1 WHIRLPOOL BATH-1 G.F.C.I:-7 SMOKE DETECTOR:-6 FULTON ELECTRIC INC. LIC.#3910E L 77-7 WINDSOR PLACE ISLANDIA, NY, 11722 GENERAL MANAGER it Per This ceredcate must not be altered In any manner;return to the office of the Board If Incorrect.Inspectors may be Identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. UL ' Town Hall, 51095 Mill, ilia l X KITH T. 1 � ' '� .a TERRY ('.O. R(rx 117() TOWN CLERK Southold, Nc\x 1'(irk I I')71 y (cbL: Fax (5I6) 7(,5-IV1 REGISTRAR OF VITAL STAIISIICS �i� � MARRIAGE OFFICER _ J / T cicRhnnc (5 I 6! 7(,5- I HO I fZEr_ORI)S M/WACEMEN7-OFFICER JOl FREEDOM OF INFORM ION 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) ] . TOWN OF SOUT(NOLD /-Jh T. Terry Southold Town Clerk August 25, 1993 APPLICATION # PAGE I of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and siu): 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements arc 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. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is he' &y 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 TATEMENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE, TO THE B OF Y KNO«'LEDGE,TRUE AND ACCURATE. (APPLICANT'S SIGNATURE) DATE SECTION 2• PROPOSED DEVELOPMENT (To be completed by APPLICANT) NAME ADDRESSTELEPH NE APPLICANTI j / ' �_� v BUILDER ENGINEER PROJECT LOCATION: • To avoid delay in processing the application, please provide enough information to easily identify the project 4 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. C- Wt V.o- .�( K t 4 for Acv,*5 G.✓ y.T L. leL a p v FDP(93) APPLICATION PAGE 2 OF 4 DESCRIPTION OF WORK (Check all appGcablc boxes) A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure Id Residential (1-4 Family) P Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residcntial (Floodproofing? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECTS /O ppD B. OTHER DEVELOPMENT ACITVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) a-s w After completing SECTION 2, APPLICANT' should submit form to Local Administrator for review. ,SECTION 3 FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. 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. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION PAGE 3 OF 4 SECTION 4 ADDITIONAL INFORMATION REQUIRED (To be completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑ Development 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 floodproofing 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 ,O'lif they arc not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofmg protection level (non-residential only) Ft. NGVD (MSL). For 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-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A- ❑ Is B. ❑ 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 Tf 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 appfication to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? O Yes ❑ 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 in Coastal High 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 ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ONO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? OYES ONO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE BY: y _ Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area i r' TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND 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. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) a 577�--, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY I!� REMARKS: ,DATE L-113101 INSPECTOR /� M-1802 BUILDING DEPT. INSPECTION [ j FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ar�L DATE /49///? INSPECTOR FIELD INSPECTION REPORT DATE _COMMENTS ax=ss=aaa�==a3aoasx=xx=airxvx==x=ot' N V1 FOUNDATION ( IST) N n H " N I�— Q FOUNDATION (2ND) n a 14 ----- — ------_------_-- ------------- ROUGH FRAM & n f o v PLUMBING , u �I I ----- --------- jI�II to INSULATION PER N. Y. t p STATE ENERGY ��------ p CODE 1 t �I u �1 A it H 11 1 FINAL aaasaa=--c-=- -_ -- H F ADDITIONAL C S: O H� H Q ---- tv BOARD OF HEALTH . . . . . .. . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . .. ... . . . . . SOUTHOLD, N.Y. 11971 DEC . .. . S . . . .. .. ....... ... . TEL: 765-1802 TRUSTEE . . . . .. . .. . . . . . . . . NOTIFY: ALL u Examined..... .. . �# Z �S /�+- . // ., 2 .4�1. MAIL TO: . . . . . . . . .. . . . . . . . . . . Approved...��l sl......,2 .�. Permit No. !��.7. �.� ..... Disapproved a/c .................................. .r� ..�r. ...,............ . ............................................ ... NOV -6 2000 ding. •••-•.-. (BuilInspector) APPLICATION FOR BUILDING PERMIT Date. &.4N.. . . . . ... 2C;X9. . INSTRUCTIONS a. This application must be completely filled in by typewriter or- 'in ink and submitted to the Building Inspector wi 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 permit shall bekept 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS UMM MALE 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, bui ing code, housing code, and regulations, and to admit authorized inspectors on premises and in building for Z-OGOel ti S. •(Sture of or name, if a.corporation) (Mailing address of applicant) State wbe r applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..... .:L .................................................................................................. Name of owner of premises ......,�/ .. ` ?:......................................... (as on the tax 11 or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nam and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Incation of land on which proposed work will be done.... �!Z........... House Number Street Hamlet Canty Tax Map No. 1000 Section ....1 7...... Block ..... ........ Lot .....1.0....... Subdivision ...................................... Filed Map No. ....Z.......... Lot .,o?- (Nam) 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 aihichapplicable _ // ilding ...... Addition Alteration Repair ............ Removal ...`... Detrioliti .. Other Work......... .......... 4. Estimated Cost .... ?............ fee ..:! `.��............................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ Number of dwelling units on each floor ................ Ifgarage, number of cars ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... Nudger of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ...... Depth .................... Height Number of Stories ............... ......... 8. Dimensions of entire new construction: Front .....l..4...... Rear ..... .... Depth .. Height ...... .5F............... Number of Stories ..../................. 9. Size of lot: Front ...f19�l. ...... Rear ...lli,F!.:l�.Z':.... Depth ...��?!.!q ..... 10. Date of Purchase ..................... Name of Former Owner ........................................ II. Zone or use district in which premises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ......<e / ..... Will excess fill b e�� r3ni YES gem4i 14. Names of ..�l��R ..., Z,':'titi✓!!l� re4�• Owner of premises ...... Address Phone No. Name of Architect .................................... Address ....................l...R Name of Contractor ..................................... Address ...............................Phone No. ............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... ND .......... *IF YES, SQTMD TUA TR[MMS FM41T MAY HE MQMRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions from property lines. Give street and block ember or description according to deed, and show street names and indicate whether interior or corner lot. S'C/1.IT Or Nil , ODUNIY or .. � d.I1.� SS ...... . iC.��c .....�e .�'y1 R v. :........... • .being duly sworn, deposes and says that he is Use applicant (Name o individual signing contract) above named, Lieis Clie ............ .. .......................................................................... (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 by�lief;-and that the work will be performed in the manner set forth in the application filed therewith-; Sworn to before me this /,,, .........I ...day o .Q.ciek ...... . .!.. Notary Publi � ����,�......... ....... .. S SANKTOOKER / ••••••. NOTARY PUBLIC,State of New York Signature of i.cant) No.01TOso7a120 Qualified in Suffolk County Commission Expires May/g Z d D f rt 1 f` 1 • 1 l�irx/C�G 4-5 G.irrter Foliofro 1/0 to arra lc�`' C t y atev X•":h � �es�' a i"off ' .d✓'.� i-ic� /GADO' J�r�•� w.�S'� ' pit,�qh , r �i r_ 4 - Y r {� �{a D�- r1 • t 216 I� I i g A34 22 P18 b� 18 83R q'S"Nyw f' 64 �� 7530 30 330 0 630 �w 21 W21 DISH � - 24 30R , 24" r- 1687'It t t -. -- 160 t-3336-- 3-3- - 33 0 15 DB W27 15 67i 27 30 � 52� -- _ 36 D S\RB15L 2Af�G,E B18L 0L REFRIG t 24 DW2430R! W2730 W3p15 W1830 W3015 S�','"r ��✓ 36 15 f- 3'0 18 f- 310 - 87 1 1 _ 24_' 27 -r`- 3,0 �- 18 -'_ �0 - 86 132 - -I---- f . 84 66 r- 48 -- -- - 102 216 i I I i I I i i BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: i /.29/o/ APPLICANT NAME: l3e'rnarri DATE SUBMITTED: /i / /00 SCTM# --- DISTRICT: 1,000 SECTION: 6 7 BLOCK: 2 LOT: /© PROJECT LOCATION AND TYPE OF PROPOSED WORK: PROJECT DESCRIPTIONALT,ACC OR N/D: uop /�r.», - -/z�_., / " �o "'�• �•C X/�..� STREET: 3746 /N'LL Z2o.4d CITY: Re-CCAYC SUBDIV. NAME: llcoait �hoNs ARCHITECT/ENGINEER: �c.,r- jjpa t B �'^'�y FAST TRACK: YES 4NQ SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: 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 7/1/83 ZONING: PERMIT ESTIMATE AMOUNT:—$—10 X — .00 PERMIT USE: EXISTING: INTENDED: ZONING DISTRICT R4 R80 AC CONFORMING: YES O �,,. REQUIRED LOT SIZE: 10K SQFT. WHERE ACTUAL LOT SIZE FROM?(Ec:A:jD ACTUAL LOT SIZE: //67V SQFT. REQUIRED rd rc REQUIRED REQUIRED FRONT:'PROPOSED:/0/0� SIDE YD: /O '/ ' PROPOSED:3.5 '/ REAR:V 'PROPOSED:#8 ' LOT COVE GE: ALLOWED:% EXISTING: sf % NEW: //2 sf % TOTAL:/G36 1'¢ CORNER? YE OR NO WAT ER FRONT? YES N DESCRIPTION: FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: J i / FLOOD ZONE: r AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN AP CATION TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES or (BED #): DTE:—/—/ PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES oN TOWN PLAN. BOARD APPROVAL: YES o O NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT: NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR Z3 9' SF SECOND FLR SF ESIIT OTHER TOTAL TOTAL: SF FEE FEE FEE T( SF)- ( SF)= SF X $ =$ +$ >� +$ /b1/ = $ J>"!�-ar- struction; no base flood elevations deter mined. ZONE VE (EL 13) ZONE V Coastal flood with velocity hazard (wav t action); no base flood elevations determine( Town of Southold a 36U013 �5` ZONE VE Coastal flood with velocity hazard (wav action); base flood elevations determined �S i Iz� z FLOODWAY AREAS IN ZONE AE OTHER FLOOD AREAS ZONE X Areas of 500-year flood; areas of 100-yea WISE PROTECTED AREA flood with average depths of less than 1 foo )ENTIFIED 11-16-91 or with drainage areas less than 1 square mil( )ASTAL BARRIER LEGEND) 'x � � S q andareas protected by levees from 100-yea 2Tq yf' ZONE AE • _„yr � ' S �\ OTHER AREAS • ,� �/ (EL 10) ZONE X Areas determined to be outside 500-year floodplain. \ •�'� • ” ,,`�;, � ZONED Areas in which flood hazards are undeter- \ • • « '` '� g mined. ZONE X UNDEVELOPED COASTAL BARRIERS" 310M V1a Identified Identified Otherwise • 1983 1990 or Later Protected Areas (ELL 11) * `` "N 7N � Identified . � 1991 or Later ZONE X Q , Coastal barrier areas are no,mally located within or adjacent to Special Flood Hazard Areas. ZONE ZONE AE 4 Floodplain X o iEL 10) p Boundary — — — — — — — Floodway Boundary - - Zone D Boundary b ` 7 7M Boundary Dividing Special Flood Hazard Zones, and Boundary Dividing Areas of Dif- ZONE ferent Coastal Base Flood Elevations Within Special Flood Hazard Zones. X FaStiR�NDFR _513— Base Flood Elevation Line; Elevation in Feet" ZONE ZONE X X A A Cross Section Line ZONE AE (EL 987) Base Flood Elevation in Feet Where Uniform ,E aEL 101 .. Within Zone" ZONE X s No RM7 X Elevation Reference Mark •M1.5 River Mile "Referenced to the National Geodetic Vertical Datum of 1929 MAP REPOSITORY Refer to Repository Listing on Map Index J ZONE z X a EFFECTIVE DATE OF COUNTYWIDE FLOOD INSURANCE RATE MAP Z MAY 4,1998 EFFECTIVE DATEIS)OF REVISION(S)TO THIS PANEL Refer to the FLOOD INSURANCE RATE MAP effective date shown on this map to determine when actuarial rates apply to structures in the zones where eleva- tions or depths have been established. To determine' if flood insurance is available in this community, contact your insurance agent or call the National Flood Insurance Program at(800)638-6620. APPROXIMATE SCALE 500 0 500 FEET v a I COdIP1YWfTFLCHAPTEft 46 ` _ _ $16 18 INSt�F APPR VEDAS NOTED 00D 0AMA0E PREVENTI0t1 - _- - -T— _ I { EOUTHOLD. TOWN COLEEt 5y 'NOTIFY BUILDING .DEPARTMENT AT - - - _ - - - - CN3D1 _irk— 9trt5 W 786-1802 9 AM TO`4 PM FOR THE _.� - - - FOLLAIANG INSPECTIONS: I- FOUNDATION _ TWO REQUIRED' - -` = _ _ FOR POURED CONCRETE PLUMBER CERTIFICATIOP! I( G 2. ROUGH . FRAMING & PLUMBING -ON LEAD CONTENT BEFORE _ � }. - - _ - - - - _ ". 6v E'icy :' ,'�,DNkk�l'�T:d2•(� . 4 wtt +.y , t fM ' ' 'T`!_lti4k Y Fesi..73�°F -c15�a - a. iNsuLdnON- CERTIF/CATEOFO_CCUPAPICY } " 4. FINAL -BE COMPLETE FOR C.O.ION MUST SOLDER USED IN WATE : - - - aSOLDER USED R- - ALL CONSTRUCTION SHALL MEETSUPPLY SYSTEM CANRIOT THE REQUIREMENTS OF THE N.Y EXCEED 2/70 OF F°� % r; - - _ -- - STATE CONSTRUCTION & ENERGY - CODES. NOT RESPONSIBLE FOR -.. `' _ DESIGN OR CONSTRUCTION ERFCI"- _ - f { _� •" j _ ' k T _ - , { PROVIDE ANTI-SCALD AND/OR � f tsSP NAt pf" y £I THERMAL SHOCK PREVENTINGp-- �° = I ( v{ DEVICES AS TO PART.902.6(K) 0SiCUPANC`� OR N.Y. STATE BUILDING CODE. �� wa ` It:tt t+ttt UsF IS UNLAWFUL _ �, T CERTIFICATE p-y- PLUMBING �f?� THOU ) CERTIFICATE ALL PLUMBING WASTE _ � - - .-g (jt. - 4_ [ tI- P3F°p�)�D�'�RIr &WATER LINES NEED -�-, 1 - - f6 ,. ii . - , _t -. - - - .I _ 'L` = I AM TESTING BEF3RECOVERING - - I rt T / . " .�.- -�_ { 1 _ _:f' _ . _ _ - ..f PROVIDE SMOKE-DETEETING If copper tubing is used ALARM DEVICES - [ AS TO PART. 721.1 for water distributing system;Piping shall be N.Y.S.BUILDING CODE. - _ of typesKorLonly - _ - - - - - Q. w. • ' ppc�' ':� UNDERWRITERS CERTIFICATE - Q,0"f4t 7 - _ tJ Y- ` Y t _ ' - - x 8s - _ - 0381RD38 - REQUIRED -- - _ HG"E�S >�laT fv '/ d kn"%'.t.3rtbFi NEW $' -�}' cc REQUIRED - 310HIL833 S11311BMR30N0 ��f# L 1�1---�-AD 1) t `z�'i D : LOQ7L= kht ' 11I �1 'n' _ T—T yfiilFY &KC&ITiONS �' cAelnlrT WIN DAW SIZE � - i 7Nf'7TH L : - - - �Tk a - Ga _ ' - - _ -7Vt7✓ Aim ...+�+.....-_..� .., ._, - f( - - _ _ =1 _ . Ex+s-r r9uutt.'rr r.N - - - _ Xf94 FOtiJdAATt - '� , Esr . 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