HomeMy WebLinkAbout29548-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30163 Date: 04/30/04
THIS CERTIFIES that the building ADDITION
Location of Property: 3275 SKUNK LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 9 Lot 10.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 2, 2003 pursuant to which
Building Permit No. 29548-Z dated JULY 3, 2003
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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ELEANOR & BRENDA TRAMALONI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
tho 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. 29548 Z Date JULY 3 , 2003
Permission is hereby granted to:
ELEANOR TRAMALONI
3275 SKUNK LANE
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR. MAINTAIN PROPER
FRONT YARD SETBACKS (50 FEET) AS APPLIED FOR
at premises located at 3275 SKUNK LA CUTCHOGUE
County Tax Map No. 473889 Section 097 Block 0009 Lot No. 010 . 003
pursuant to application dated JULY 2 , 2003 and approved by the
Building Inspector to expire on JANUARY 3 , 2005 .
Fee $ 150 . 00
ho ized Signa
i
ORIGINAL
Rev. 5/8/02
i Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
Wg APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
I. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses:
1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied,the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees //�
1. Certificate of Occupancy-New'd� elling$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 Bgj:ding- $100.00
3. Copy of Certificate of Occupancy-$.25 /
4. Updated Certificate of Occupancy- $50100
5. Temporary Certificate of Occupancy-Ro-sidential $15.00,Commercial$15.00
Date. 14 �- o `0
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 3 a75 S K V rl h Cu f cil(9 614
House No. 2 Street 0 Hamlet
Owner or Owners of Property: E Ie4 rVY + 8Ye r-da, ra MCiAlOVI 1
Suffolk County Tax Map No 1000, SectionBlock q 7. 9 Lot / 3
Subdivision Filed Map. Lot:
Permit No. � q S 4g Z- Date of Permit. I 3' �%J Applicant: t)ei noY,Tyn vri DVl ,
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ ~ a,
N0 ,3° b3
uL Applicant Signature
BUILDING PERMIT EXAMINER CHECKLIST
DATE REVIEWED: -if-/!-/03/3/03
APPLICANT: R "P ,oN► DATE SUBMITTED: i /2 /03
SCTM#DISTRICT: 1,000, SECTION: 9 , BLOCK: I LOT: 10.3 SUBDIVISION: J> #
ADDRESS:3al S"6AC_CITY: CyTr,�Aneu£ ZONING DISTRICT: _Rq0 CONFORMING? YES
BUILDING PERMITS OPEN/EXPIRED: PRE CO:(3)OR N oKs-
BP `1 6513 -Z/C/0 Z-1l°I S , INFO /BP -Z/C/0 Z- , INFO
BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO
SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES:
LATS 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 7/1/82
REQ. LOT SIZE:10,860 ACT. LOT SIZE: rte-0,% t' EQ. LOT COV. CIA-04' ACT. LOT COV.
REQ. FRONT--_.TPROP. FRONT-,I REQ SIDE I'S 3s ACT. SIDE ✓
REQ. REAR M BROP. REAR ,/ REQ. REIGHT PROP. HEIGHT
l oG�.•h'�•
PROJECT DESCRIPTION: ►A&
ESTIMATED PROJECT COST: ARCHITECTfB% :fp'D& 9yc6 C'A
WATERFRONT? _DESCRIPTION: L # FLOOD ZONE:
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES orgo (BED #): DTE: _/_/_ PERMIT#:
TOWN SEPTIC RECEIPT: Y o1G N/A
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or DTE: PERMIT#:
SOUTHOLD TOWN TRUSTEES: YES o DTE__/_/_ PERMIT#:
TOWN ZONING BOARD APPROVAL: YES orfiD DTE: PERMIT#:
TOWN PLAN. BOARD APPROVAL: YES or DTE__/_/_ PERMIT #:
TOWN HISTORICAL PRE (SPLIA):, YES or /
NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): or NO ✓
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: _ SF INIT OTHER TOTAL
TOTAL: 5Q SF FEE FEE FEE
1. ASF)- ( SF)= SFX $ =$ +$ +$ =$
2. ( SF)- (_ SF)= SFX $ =$ +$ +$ = $
3. ( SF)- ( SF)= SFX $ =$ +$ +$ _
FINAL TOTAL ��
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
Ground Snow Load:45 Wind Speed: 120MPH Seismic Design Category:B
Weathering: Severe Frost Depth:36" Termite:M-H Decay: S-M
Design Temp: 11 Ice Shield Underlay:YES Flood Hazards:
USE/OCCUPANCY CLASSIFICATION:
HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE
FULL FRAMING DESIGN ELEMENTS: Y/N
hEADERS: Y/N WALL STUDS:Y/N GIRDERS: Y/N
CEILING JOISTS: Y/N FLOOR JOISTS:Y/N ROOF RAFTERS:Y/N
LUMBER SPECIES AND GRADE:Y/N
DESIGN LOAD CALCULATIONS: Y/N
LIVE: Y/N DEAD:Y/N SNOW: Y/N SEISMIC:Y/N WIND:Y/N
WINDOW AND DOOR SCHEDULE:
MISSLE TEST REQUIREMENTS: Y/N
EGRESS 5.7 S.F.: Y/N
LIGHT 8%: Y/N
VENT 4%: Y/N
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: Y/N
PLUMBING RISER DIAGRAM: Y/N
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: Y/N
TOTAL COMPLIENCE? Y/N(RETURN TO PAGE ONE)
76s-iso2
suaoiNc DEPT.
SPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: �L�/
DATE
ass-isox
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FO�lNDATION 2ND [ ] 1 TION
[ � FRAMING [> FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
A//()
DATE OJ INSPECTOR
�T,n•INSkECTION REPORT DATE CONIlYIENTS
b
FOUNDATION(1ST)
C
FOUNDATION(2ND)
C
�3
ROUGH FRAMING&
PLUMBING a
3
INSULATION PER N.Y.
STATE ENERGY CODE
r '
FINAL
ADDITIONAL COMMENTS 'S
Z-
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TOWN OF SOUTHOLD BUILDING PERMIT APPLI .ATION CHECKLIST
BUILDING DEPARTMENT 2 2003 Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 - - = ' 3 sets of Building Plans
TEL: (631) 765-1802 _•_r_y _•_ r� Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 3 120 3 Contact:
Approved ,20 3 Mail to:
Disapproved a/c �
Phone: 7(�S—�(�5 4e
Expiration ( 3 ,20-5—
f
Building Inspec or
APPLICATION FOR BUILDING PERMIT
Date-0,
� D ' , 20 e_5INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to thBuilding 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 streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances,building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(S' a e ofhppKcant or name,if a corporation)
(Mailing address of applicant)
State whether a licant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location f land on w ich proposed ork will be done.-
House
one:House Number Street Hamlet
' Lot
County Tax Map No. 1000 Section G� Block �� ( �
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of pre ses and intpded.use and occupancy of proposed construction:
a. Existing use and occupancy -
b. Intended use and occupancy��
3. Nature of work(check which applicable): New Building Addition �� Alteration
Repair Removal Demolition Other Work
,.� (Description)
4. Estimated Cost- /V--V I Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any:--FronLL—C-1 'Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
kS:
COUNTY 6FA
bu n ne-
being duly sworn, deposes and says that(s)he is the applicant
e of individual signing contract)above named,
(S)He is the
(ContractAgent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this•"
y of Cj 20
i'
Notary ublic a o Applican
Claire L. Glow
.'ubiic, State of New York
No.OIGL4879505
:ualified in Suffolk Coun
uunimission Expires Dec.8, (
t.
� pls �S'C�oE S,5 M1S
SURVEY OF PROPERTY
SITUATED AT
ZZCUTCHOGUE
o,
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C . TAX No. 1000-97-09 - 10.3
so o'
SCALE 1 "=30'
WB.
� 'I6 0) JUNE 5, 2003
0 ELS O
. tea °y° miy A AREA = 50,888.11 sq. ff.
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ON OR
TO THIS SURVEY LIS A VIOLATION OFTION
• �,� 5� �Io I4Q4Q4�, �'��$�'p ¢�0 EDUCAParv'I°nw OF THE NEW YORK STATE
�j �yP 7oEIEs oF'URVEYORSE INKED SEAL ORrelrvc
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EMBOSSED
o eF aDVA EALT SHALL
HA L NOT BE CONSIDERED
L a .1
J LUYV Qt,` FY
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE� OE SURVEY
6% S PREPARED, AND ON MS BEHALF TTO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
QP FENDING INSPIDnON LISTED HEREON. AND
TO 7NE ASSIGNEES OF THE LENDING IMI
MCI SER➢FlCATIONS ARE NOT TFANSFERAOLE
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
PREPARED IN ACCORDANCE WITH _ MINIMUM
By
FAL FOR AND S°RVEYE " E5AA0`I T Joseph A. Ingegno
DY THE H USE
AND E NEWvTO O ADOPTED
FOR SUCH USE BY THE NEW TO STATE FANO
TITLE ASSOCIATION
Land Surveyor
1'L Ntle Surveys — S1bdIVI6,OO5 — SU, PION — (D,,RtFBd,C, LOyNLt
PHONE (631)727-2090 Fax (631)727-1727
OFFICES LOCATED AT MAILING ADDRESS
S. Llc. No, 49668 1380 ROANONE AVENUE P.O 9Yc 1931
RIVERHEAD, New Vork 11901 RiverhVa
eNtl, New rk 11901-0965
65
- -- 29-151
4C"i"It�,".;�Mg11SA1P.; 5a'��Flc(��F�T� A5�z�•12L—p
ALL CONSTRUCTION SHALL
/y MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.
WIND RESISTANT CONSTRUCTION CONNECTORS " 24 -6 0
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ALL CONSTRUCTION- SHALL MEET THE N U
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