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Home My WebLink About32349-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32491 Date: 07/30/07 THIS CERTIFIES that the building ACCESSORY Location of Property: 1640 NINTH (HOUSE NO.) County Tax Map No. 473889 Section 49 ST (STREET) Block 1 GREENPORT (HAMLET) Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 5, 2006 pursuant to which Building Permit NO. 32349-Z dated SEPTEMBER 11, 2006 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 NON-HABITABLE ACCESSORY GARAGE WITH ATTIC STORAGE AS APPLIED FOR. The certificate is issued to ARTHUR & MARCIA KARMEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A 07/06/07 ELECTRICAL CERTIFICATE NO. 3020658 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ~ . Form No.6 TOWN OJ;' SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 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: I. 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 I. 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 - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 7/2-0/0 r; v Old or Pre-existing Building: q-/t...')(- r trkclft Lfj Block ----.1 (check one) New Construction: / ~ ";0 House No. Owner or Owners of Property: An 17fV 11.. Street ~Wfl)1L1 Hamlet kll-f<h~A) Location of Property: Suffolk County Tax Map No 1000, Section Lot :ll Subdivision Filed Map. Lot: Permit No. 5?-?> L/ I Health Oept. Approval: Date of Permit. Applicant: Underwriters Approval: Plmming Board Approval: Request for: Temporary Certificate oz> Fee Submitted: $ .; S'...:::-- Final Certificate: ./ k/~ ( check one) Co "'3?~ t; I ~ c.:"'b-~~ '6 x Applicant Signature 1iI.1iI I > BY THIS CERTIFICATE OF COMPLIANCE THE I ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~ ~ CERTIFIES THAT ~ ~ ~ ~ Upon the application of upon premises owned by ~ ~ ~ ~ JIM SAGE ELEC. INC. ARTHUR KARMEN ~ ~ PO BOX 38 1640 9TH ST ~ I GREENPORT, NY 11944-0038, GREEN PORT, NY 11944 I ~ Located at 1640 9TH ST GREEN PORT, NY 11944 ~ ~ ~ ~ Application Number: 3020658 Certificate Number: 3020658 ~ ~ Section: Block: Lot: Building Permit: 32349 BDC: NS37 ~ ~ ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ First Floor, Second Floor, garage w/2nd fl, Detached Garage, Outside, ~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~ ! authority having Jurisdiction, and found to be in compliance therewith on the 6th Day of July,2007. ! ~ Name OTY Rate RatinQ Circuit ~ ~ ~ P~~ ~ ~ I 40 5 ~ ~ Wiring and Devices ~ F.!l Outlet 14 0 Fixture F.!l ~ Fixture 12 0 Incandescent ~ ~ Fixture 2 0 Flourescent ~ ~ Outlet 22 0 General Purpose ~ ~ Receptacle 10 0 General Purpose ~ ~ Switch 10 0 General Purpose ~ ~ Receptacle 4 0 GFCI ~ ~ S~~ ~ ~ I Phase 3 W Service Rating 200 Amperes ~ F.!l Service Disconnect: I 200 cb F.!l ~ Meters: I ~ ~ ~ I Defects previously reported, as items of non-compliance, have been corrected. A visual inspection made of the exposed e161lfleal equipment in I mJ the premises indicated found no obvious unsatisfactory condition. r.!J ~ I of I ~ ~ ~ I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I 1iI~.1iI " BY THIS NOTICE OF DEFECT THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 on the application of upon premises of JIM SAGE ELEC. INC. PO BOX 38 GREENPORT, NY 11944-0038 ARTHUR KARMEN 1640 9TH ST GREENPORT, NY 11944 Application Number: 3020658 Located at 1640 9TH ST GREENPORT, NY 11944 Section: Block: Lot: Building Permit Number: 32349 Regrets to advise that the electrical installation of the stated premises is not in compliance with requirements of the reference standard as set forth below: Item Location device boxes 1 st Floor Description boxes to deep in wainscoating-exposed wood Reference Std. 370-20 This notice of defect is issued by: ROGER RICHERT on the 5th day of July, 2007. NS37 GREENPORT, VILL VILLAGE OF GREENPORT 236 THIRD STREET GREENPORT, NY 11944 Pace 1 of 1 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. 32349 Z Date SEPTEMBER 11, 2006 permission is hereby granted to: ARTHUR & WF KARMEN 110 COLONIAL PKWY MANHASSET,NY 11030 for : CONSTRUCTION OF A NON-HABITABLE ACCESSORY GARAGE WITH ATTIC STORAGE AS APPLIED FOR WITH FLOOD PERMIT at premises located at 1640 NINTH ST GREENPORT County Tax Map No. 473889 Section 049 Block 0001 Lot No. 021 pursuant to application dated SEPTEMBER 5, 2006 and approved by the Building Inspector to expire on MARCH 11, 2008. Fee $ 565.00 \ Authori Signature ,/ ORIGINAL Rev. 5/8/02 t; ~ f;} f$ ~ ~ + .......,.... "'~ ~ .......~s >Y-f<'r .;:;" " " '~ , , " " Unu Poc, ;., ". ~ t !i2 ~ -s i;j l (j ~ ~ ~ ." "' ~, . < " 18,6' " " 10.0 <5" 0."1. 'C UTIliTy 'l; POLE ~ ;:g ~ ~ . C ."J ~ IJi 4I.klY.4( Pjp.e:s-. SU'" ~.8'W ~ 8Ull<(HE"4D C'Oi-'e SURVEY OF PROPERTY AT GREENPORT TOWN OF SOUTHOLD SUFFOLK COUNTY, NY. 1000-49-01-21 SCALE: 1'=40' MARCH 29, 2005 4'/0/,1' -ftICIt. '4cz </. ~1f>1l)- P,->, !?..,~ ~ ... , <> iil I:j Ii! ~ '" ..., olf ." ~ ~ u ~ ..., CER YIFIED TO ' DR. AND MRS. ARTHUR KARMEN ~ ~ AREA=45,050 SQ. FT. TO TIE LINE . =PIPE ANY AL1ERAllON OR ADomON TO THIS OF SEClICW 72090F mE NEW 'rORK~ EXCEPT AS PCR SCC7ION 7209- .~ HEREON ARE VALID fOR THIS SAID MAP OR COPIES BEAR m ImOSE SIGNA TURE APPEARS HE ;; [TONIC (631) 765-5020 P.O BOX 909 1230 TRA VELER STREET SOUTHOLD, N. Y. 11971 3),,5 ~ 9" Z;- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] IN ATION FINAL [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT PENElRATION C;rL. DATE 'Iff; INSPECTOR 32--3 sL7C TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] R H PLBG. [ ] FOUNDATION 2ND [INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRATION REMARKS: ~~~ J1f. DATE I INSPECTOR ... ---.-- 3J.-3Y-1-6- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] ~DATION 2ND [] INSULATION [v(FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ~. REMARK~ Ej..,~~ ~~~j -: (J(~ (~ DATE I i 5-/0t; I INSPECTOR 3~3cr9t: TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [~NDATION 1ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: h, - e", -:e-;, ot::- /0 r:tiL2. J , ' ( ~ DATE (~~/O~ I FIELD INSPECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N, y, STATE ENERGY CODE FINAL COMMENTS " ~ - , ..~J;~ ~J_.70 M;d ~ ~.J'~_O'.'C-~ ~~ ....j/~ 1/ )..4'} . fr;.&~. - . , \}.l... ~~ ~::J ...s>.. t\J Ql~ > ~~ ~ z -, ~p~ C; ~ [;; ?--~ i: lJ.' '+ == > ~ l"l .., Q: ((2... . D ~~ rnU-h~1L- t;. ~~. ~. -~---- l'L"/'r_ -4........~). . ?7~ ADDITIONAL COMMENTS 1 ./1'~"~~ . '/1(#/11'. if ^ ~ ~~ z - m ;tI f f l"l w~ - ..:..~ ........., g~ == L-~ .., == I:l l"l ... ~ ,~. 4 \~~. ~ CO TOWN OF SOUTHOLD PROPERTY RECORD CARD . :"- '\ J)1 ~/'i -. STREET VI:lLAGE DIST. . SUB. EN 'i- WI="" 1v~I, S/~ T 61-1- /0 'JJ e, N, ACR. ~. . cNDLlfR 1.049 S W TYPE OF BUILDING LOT VL. I$+-. FARM y- COMM. CB. MICS. Mkt. Value U>~~ &) RES. lP LAND 3 l:,OIJ .3. 0 80 D .3 i't>6 tS?4 b CO IMP. TOTAL , Z, C J(JOO ~~<JO S-700 (p aOQ b Woodland Meadowlal1d House PIQt FRONTAGE ON WATER II y ~ 3 '-I. f ~ -.... _660 r FRONTAGE ON ROAD Tillable DEPTH BULKHEAD r'IV Total c 1 --- .. I. .' I ' , M. Bldg. . C. ~ .,( ;;. ^ ~ I::>" v. a Extension IllI >''''. ~.:oo Extension .;;lox/l./~ I .:< Z.... I 7"" t> Extension x Y bO -:- I" () ~VE'~I( A'V4f -;, 3) <:~ Ltub PereIr'i>~K . '1X!'- '" H') B."~I!i',u"r '9x/(,. ,</ U ->;..;r"" -- ,~ Garage I~ ".l-o .: Ii-/) Patio IttJ{ ~ <!C'{) ~), ~Cf I<:I€~/" ~ 2 5'L Total I / (',/------ "'----j ,.... :-- L . .~ . COLOR Iw A It-#I..,.. L~'" .. IV!"" ." ~ "~ TRIM ,,., IQ /' - , ~ ".~ .\ \ 3.zS' .3~Q lS- ,<;-0 l.,; I'" .2.~ ./J (, to!('I; ~ ,f Zl !foundation I I D Basement Ext. Walls 7 2..i Fire Place 2 () I Type Roof 'f~ Recreation Room 6 3 Dormer ,6,'1S.5'. J' ~,... ~ 6L" Bath 'VlA, Floors V. vr,T. ~"'-.::::- Interior Finish S".. - )., ~ I Heat Rooms 1st Floor Rooms 2nd Floor Driveway 't.,' , .. "'" .J, .,\ 1 IV 1 ~ . " ~ ):i :- L ~ Dinette o~ K K. /1. ,5~ot.k" LR. f-L., DR. BR. FIN. B "'-. FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. a.M.B. No. 3067-0077 Expires July 31,2002 SECTION A. PROPERTY OWNER INFORMATION For I"""""", Coo\lany Use: BUILDING OWNER'S NAME Policy Number DR. ARTHUR & MARCIA KARMEN BUILDING STREET ADDRESS (Induding Apt, Un~ Suoe, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 164 NINTH STREET CITY STATE GREENPCRT NY PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, et,,) 11JOO.49-01-21 BUILDING USE (e.g., Residential, Non-residential, Addition, Ao:2ssory, et" Use a Comments area, if necessary.) RESIDENTIAL LA TITUDElLONGITUDE (OPTIONAL) ( #If - ##' - ##.#If' or ##.###II/f) ZIP CODE 11963 HORIZONTAL DATUM: o NAn 1927 0 NAD 1983 SOURCE: 0 GPS (Type):_ o USGS Quad Map o Other_ SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP COMM.JNrrY NAIIE & COIIMJNrrY NUWBER SOUTHaD, TO\VN OF 360813 82. COUNTY NAME SUFFctK B3.STATE NY 64. MAP AND PANEL 85. SUFFIX 87. FIRM PANEL 89. BASEFLOOO ELEVA1lCl'l(S) NUMEER 86. FIRM INDEX DATE EFFECTIV'ffiEVISED DATE 88. FLOOO ZONE(S) (ZoneAO, ""dei>h ofllorxfng) 36103C0176 G MAY 4,1998 AE EL8 B10.lndicatethe source of the Base Flexxl Elevation (BFE) data or base lexxI depth entered in 89. o FIS ProIiIe cg:J FIRM 0 Community Dete.mned 0 Other (Oesaibe):_ B11.lndk:aletheelevationdatum used forthe BFE in 89: cg:J NGVO 1929 0 NAVO 1988 0 Other(Desaibe):_ B12.lsthetIJilding Med in aCoasta BalTierResources System (CBRS) <rea or Otherv.iseProtededArea (OPA)? 0 Yes cg:J No Desgnation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Buik>ng elevations "'" based on: 0 Conslruclion Drawings' 0 Building Under Construction' cg:J Finished Construclion 'A new Elevation CerIIcate v.ill be required when oons1rucIion of the tlJik>ng ~ axnpIete. C2. Building Diagra-n Number ~ (Select the tlJiklng diagrall rmst simla-to the tlJiklng forwhicl1 this certilicate ~ being ~ed - see pages 6 and 7. W no diagra-n a:ruralely represenls the tlJiklng, provide a sketd1 or ~.) C3. EIevations-ZonesA1-A30,AE,AH,A(v.ith BFE), VE, V1-v&!, V(v.ith BFE), AR, ARIA, ARlAE,ARlA1-A30, ARlAH, ARlAO Com~ Items C3. -&i beIaN occoo:Iing to the tlJilding dagra-n splCiIied in Item C2. State the datum used. W the datum is different from the datum used for the BFE in Section B, oonvert the daum to that used for the BFE. ShaN field measurements and datum oonversioo calaJtatioo. Use the space p-ovlded or the Comments <rea of Section D or Section G, as awqxiate, to document the datum oonversion. Datum NGVO ConI'l3fSior1lCorr Elevation reference mat< used _Does the elevation reference mat< used <we<r on the FIRM? 0 Yes cg:J No o a) Topcibdtoollloor(induclng basementorenclooure) Q llt(m) o b)Topciooxthg.,r1loor ~.Q.It(m) o c) BoIIomcilo,.."stluizontaslruclu.a meniJer(V zones onty) _._It(m) o d)Atta:rejga-age(topofslOO) _' _It(m) o e) lc1Nest elevation of mochinery <ffi/or equiprre1t seMcingthe tlJiklng (Desaibe" a Cornmenls <rea) Q.. [ft.(m) o Q lc1Nestadja;ent(Inished)grail (LAG) L. Q.ft.(m) o g)Highest~(lnished)grail(HAG) Z. ~ft.(m) o h) No. of pemment q:enings (floo:j venls) within 1 It fb:Ne ~ grail_ o i) T ota <rea of all permanent openings (floo:j venIs) in C3.h _sq. in. (sq. em) SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or archilect authorized by law to certily elevation infonnalion. I certify that the infonnation in Sections A, B, and C on this certificate represents my best effotls to interpret the data avaiiab!e. I understand that any faise staternen! may be punishable by fine or imprisonment under 1 B U. S. Code, Section 1001. CERTIFIERS NAME JOHN T. METZGER ' UCENSE NUMBER 49618 " . oo ~ :22 .- 00 D~ Ec w_ ai~ D~ E;; ~c Z.!? .oo . II ::l TITLE PRESIDENT OOMPANY NAME PECONIC SURVEYORS, P.C. ADDRESS P.o. BOX 009 SIGNATURE /ft-.-I>>(r FEMA Fomn 81-31, JUl 00 CITY SOUTHOLD DATE iJ4J05.Q5 SEE REVERSE SIDE FOR CONTINUATION STATE NY TElEPHONE (631) 765<i020 Z1PCOOE 11971 REPLACES ALL PREVIOUS EDITIONS BUILDING PERMIT APPLICA nON CHECKLIST Do you have or need the following, before applying? Board ofRealtb 4 sets of Building Plans /' Planning ~ approval Survey CheeJ.j:r Septic Form NY.S.D.E.C. Trustees Contact: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ PERMIT NO. 3Q '3 Y "l ~ Examined 'f ~ t LJ-II Approved Disapproved ale b ,20_ , 20-t.:>- Mail to: Expiration ,20 Phone:S fc'. (;)7- 005S G.' ~-r~: " I,' -~-r~' .,'; ! 5 Ii . ~ . i j I Date ,20_ APPLICATION FOR BUILDING PERMIT ., --"Ii INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. '. . b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or aree" 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 South old, 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. /) i J (~/~~ (Signature of applicant or name, if a corporation) I/o CD /..otJ I ilL PK./.-()'1 11A-.NHA%P'!jiN,Yr tto3o (Mailing dress of appl1cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder c!:> CU ,v .ElL. Name of owner of premises 1t1fT7lul< KI'Il:I'tt!# f-HMc/ /+ k'ARI'tEJ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: It '10 NI N n-f 51X-EE r House Number Street County Tax Map No.1 000 Section Subdivision 4L9 G;q .6~f'o/ Po R:r 9114AAW~t ..' Ie ~!Gla.l3ildu'l y1&lo~ /' .....,A"IO.Oil Block "'1nvl m :,.,I.I.u; Filed MapNo: "....J.,;; NY ,I"ot ;? ! Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ]) W I~ L " ) /1/ Ii-- b. Intendeduseandoccupancy '11'::..,.-4(,1-1-,,"1.7 c2 CA-I<. ~A-(i..E ,/5'rvl(~ V" 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost l1?3u , Qel 0, , Addition Other Work Alteration (Description) Fee 5. If dwelling, number of dwelling units If garage, number of cars ~ (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Depth Rear Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories I 8. Dimensions of entire new construction: Front ss Rear Height /7 /' t II Number of Stories ~Y.z. "3 S-/ Depth ;z, r I Depth 9. Size oflot: Front Rear 10. Date of Purchase /18' I Name of Former Owner t- II. Zone or use district in which premises are situated J / C; tfif 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 V (nf/1/CI/4- {<.r10"G~ 110 eot-OIV/I~'; flt..U1 {J'-?/ ~ 14. Names of Owner ofpremise~Ar~u..e !(thel7t;A!Address ftA?vt"*S}€T N 'fPhone No. IJ Iv ~ ;;( 7()aJJ 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 V 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) SS: COUNTY OF.~Ffo\l<L- PlI+hIAr \Zc...r"",~", being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the 01 ~c. ( (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ::5 dayof '3'-~~ r 20..s:li..a- ~c -\ Notary Public -.,Zm"1FM Comm.'1!t'C~nl() fka;- /~ / Signature of Applicant ,I 3~~+q ,"h.. . .~ ~. ~'" .' liLCISTnNl or VlTN. STATlSllCS MAnnIAGF. OfFlCr:rl RECO[1.US Ivt.N'lAC€MENT OITICEIl rn.EE:DOM OF INrOfllMnON orrlcm T""',, 1I;i11. .I.lIlY:,> 1.1.'" P.O. 011, 1171) SotJlholtl. Nc\\'.Ynrk , F" IS II" 7<'l'<'IR"' TckfllHH1C (.'i l(q 7(1.~-: . . 'J'tfP'IT'H T . TERRY , tOWN CLERK 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 14, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (1) new forms to be used under tlie Flood Damage Prevent regulations ..1 OJ the Code of the Town of Sou thold: f'pplication" [FDP(93) J. and /Certificate Special Flood Halard Area [(lC(93)]. "Floodplain De,:,elopmenl Pe rmi t i I of Compliance ?j(r Develcpmen t in . / fQli~ I,G 1 ~~-- I~i .... 'l iil ~. BG-3. 02.PT TO,^;~ OF SOlJilWLD ~/,A~~ ~hT.T~ Southold Town Clerk August 15, 1993 ,'" ".', " " .,.., . . ., APPLICATION II rM;E I or 4 - TOWN OF SOUTHOLD FLOODPLAIN DEYELOPMENT PERMIT APPLICATION This form is to be filled auf in duplicate. , SECTION I: GENERAL PROVlSIONS (APPLICANT \0 rcad~): L No work may start llOtil a permit ls issued. 2. The permit may be revoked if any fwe st.temeots are made herein. ], If revoked, all work must cease llOtil permit is re-issued, 4, Development shaJJ not be l1$ed or occupied until. Certu.C<lte o( CompUance ls issued. 5, The permit will expire if DQ work is commenced within six montns 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 complhnce, ' 8, I. THE APPLlCANf, CERTIFY THAT ALL STATEMENTS HEREIN AND IN A TTACHMEJITS TO _ THIS APPLICATION ARE, TO THE~B OF MY Kl'IOIVLEDGE, TRUE AM) ACCURA (APPLICANTS SIGNATURE) '. _~/~DATE ~ ; I / / / //SECTrON 2: PROPOSED DCYELOUhEi'rr rro. (,e comDIc[cJ bv APPLICANT) . NAME AP PLlCANT A~ T1-/u ~ f( ~ ~e1V BUILDER "'7b BE C!'/.fv/ eN ENGINEER It S ~T'+I/~D Of! 73t.u.E,tP I1UNr ADDRESS TELEPHONE 110 Co'-CJN I A-L PkUJ V (Si~{';l7DtJJJ M iI+-A/~:>.5F:II'(YUt>:\o ~.a,ll /7"'T'E]:> PROJECT LOCATION: To a",id delay in processing tbe .ppUcauon, plca.se providc cnough Wormalioo to =sily ideotify the project location. Provide the sueet address, lot number or legal desaiption (at1ach) and, outside urban areas, tbe distance lo the nearest intusccting road or vtCU~k.oOVID Lindmark. A skClch 3llachcd lo lhis application sbowing the project location would be belpfuL Ie.*> Kr..yi'fl" 5T-/'rEET; ~ENPOA'T/' r\ry /t9~~ Prflfce L f 0 <?-73 ?8'9..- / ~:<J;. Ikr:rl'lhr 17 FDP(9J) '.t, It. " .' ;., ',' , v APPL/CA TlON ;; PAGE10Fd DESCRIPTION OF WORK (Check all appuGlblc boxe,) A STRUCfURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE 2 S-r",JOI. y r:;;.;,-~I'r-~(S("l>~ liiil1fesidentjaJ (1-4 ~anilly) o Rosidential (More than 4 Family) o Non-residential (Floodprooflllg? 0 Yes) o Combined U,e (Residential & CommercllJ) p 0 Manufactured (Mobile) Home (In Manu- factured Home Park? 0 Yes) Iil New Struclure o Addition o AJteratioo o Relocation o DemoUtion o Replacement EST[MATED COST OF PROJECT s3o,ot:JO ' . "; , , j B. OTHER DEVELOPMENT AcnVITIES: iil'FUJ 0 Mining 0 Drilling 0 Grading o Excavation (Except (or Structural Development Cbecked Above) o Watercourse Alteration (lndudlng Drodging aod Channel Modiiiulions) o Drainage ImprovemenLs (lnduding Culvert Work) o Roa.}, Street or Bridge Construction o sutivisioo (New or Expausioo) o ~dllal Water or Sewer System o Otber (Please Specify) . -, ! / j AIler completing SECTION 2. APPLICANT should submit form to Loc.a.J Administra[or for review. SEITION); I'LOODPLAlN DElCRM1NATION (To be comnleted bv LOCAL ADMINTSTRATORl The propo~cd dcvelopment ls loclCcd on FIRJy{ Panel No, . Dated Tile Proposed Development: o Is l:!QI located in . Special Flood Hazard Area (Notlly the .ppUcantthat the application review is complete and NO FLOODPlAIN DEVELOPMENT PERMIT [S REQUfRED). o Is 1000led in . Special Flood Hazard Area. FTRM "l.Ortc de..,<:;ignalion is tOO-Year Oood e!cvalioo althe site is; Ft. NOVO (MSL) o UoavaiJablc o Tbc proposed development i~ IOCJ(cd io 3 Ooodway. FBFM Panel No. Daled OSee 5ccllon ~ (or Hlrlilional iOS(rlJ(lio[).~ SICNED DATE '" ~. . ~ '.', ;t . APPLlCA TION ,II PAGE) OF4 - SECTION" ADDITIONAL INFORMATION REOUIRED (To he comnkted bv LOCAL ADMINISTRATORj The appGcant must submit the documents checked below bdore tbe appGca00n can be proee5sed, o A.silt. plan sbov.ring lhe location of aJl c.x:islLog slrUC(UfCS, waler bodies, adj!lCCDI roads, 101 dimensiollS and proposed development. o Developrneol plans, drawn 10 seak, and speciocati(Jns, including wbere appUcable; details for ancboring structures, proposed elevation of lowest noor (including basemeot), tyPes O(WBter resistant materials used below the r..sl noor, details of noodproor<ng of utilities located below the first noor and del ails of eoclosures below the first noor. Also. o Subdivisioo or other developrneol plans (If the subdivision or other development exceeds 50 lots Or 5 acres, whichever is the lesser, the applicant !!Illi! provide tOO-year (load elevations if they are DOt otherwise available). o PI"-!lS showing tbe extent of watercourse relocation and/or landform alterations. o Top of new rill e1evatioo FI. NGVD (MSL). o Floodproofmg protectioo level (oon-resideotial only) Ft.' NOVD (MSL). For noodproofed structures, ';,ppUcaOI must attach certification from r~gistered engineer or _ architect. 'j/ /- o CCrtificatiOll [rom a~regis((:.red engineer thai the proposed actl0.{~ in a regulatory flood way will 001 resull in.mY increase in the. height of tbe l00~ycar Oood. A copy of aU data and caJcuJations supporllng this rLOding mill! aJso be submitted. o Otber. SECTION S: PERMIT DETERMINATION ITa be comoleted bv LOC:AL ADMINISTRATOR) I have detennined tbal the proposed .ctivity. A. 0 Ls B,O Is Dot in conformance with provisions of Local Law t , 19 The p"rmil is issued subject to tbe eoodillnllS attached lo and made part or lhis permil. ~ ~ SIGNED . DATE If BOX A is checked, tbe Loc.aJ Admirllitrator may lsSUC a Dcvdopllleol Pcnnil upoo paymeol of designaled fee. lr ~OX B is checked, tbe Loc.al Adminislrator wiJl provide & YvTl(1co summary of dcrlciencic.s. Applica.nl may reVIse and resubmit all application 10 lhe Local Administrator or may rcqucsl a bcarLng from the Board or Appows ~ - t, H. ! '. " '" APPLICATION # PAGE 4 OF 4 APPEALS: Appealed 10 Board of Appeals' 0 Yes 0 No Hea.ring date: Appeah BUill d D......~;ou .-- ^p.-u Vy...J? 0 Y (,5 0 ~Ia Cooctitions SECTION 6: ;\.S,OUILT ELEVATIONS fTo be submitted bv APPLICANT before ConiJicale of ComDlianee is issued) The foUowiog information mus( be provided for project slructures. This sectioo must be completed ~y a registered professioDal eogineer or a licensed land surveyor (or attach a certification to this application), Complete I or 2 below, L Actual (As-Built) ElevatioD of the top of the lowest noor, including basemeDt Gn C<lastal Hieh HaUl'rd Areas. bottom of lowest structural member of tbe lowest noor, excluding piling and columns) is: FT. NGVD (MSL). ' 2. . " Actual (As-Buut) ElevatioD of noodproorLDg protectioo is FT, NGVD (MSL). / " " ", N7: Any work performed prior to sUbmill~.~f the above informalioo is at tbe ris~:;f the AP~:'~L ..' /1 ___I /' SECTION 7: COMPUANCE ACTION [To be cOOlolcled bv LOCAL ADMINISTRATOR) The. LOCAL ADj\{lNlSTRATOR will cornplclc this section as applicable based 00 inspectioo of the project (0 ensure compliance with the cornrnun.ity's locaJ law for Oaod damage prevention. lNSP~cnONS: DATE DATE DATE DEFICfENOES? 0 YES 0 NO DEFICIENCIES? 0 YES 0 NO DEFICIENOES' 0 YES 0 NO BY BY BY SECTION 8: CERTIFICATE OF COMPLIANCE[To be comnleted bv LOCAL ADMINISTRATOR) ~rtlficale of C<lmpUance mued: DATE: BY: :', fl.: . 1,;. . " " .' Attach:ment El , , / / 8AH~;LE CERT~JICATEjJF COMPLIANCE for Developm~nt in a special Flood Hazard Are~ ,'. '. '... . " I f ~. t ( 'r.". .' " . TOWN OF SOUTHOLD .. .' " CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT [N A SPECIAL FLOOD HAZARD AREA ~MUST REnIN THIS rERTlFICA'fE) PERMIT NO. PERMIT DATE PREMISES LOCATED AT: CHECK ONE: o NEW BUILDING o EXISTING BUILDING o VACANT LAND OWNERS NAME AND ADDRESS: } " , / j I /' j THE LOCAL ADMINISTRATOR IS TO COMPLETE A, OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQmREMENTS OF LOCAL LAW # _,19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CER'TIFIED WITH TIlE REQmREMENTS OF LOCAL LAW # I 19~, AS MODIFIED BY VARIANCE # DATED SIGNED: J DATED: C I C (93) Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD JULY 12,2007 ARTHUR & MARCIA KARMEN 110 COLONIAL PARKWAY MANHASSET, N.Y. 11030 Whom It May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: ~ An application for Certificate of Occupancy is not on file. (Enclosed) (t.C4I'J ~d '111"",10' No Electrical Certificate on file.=- ./ / 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!, 1984) Certificate of Compliance from Southold Town Trustees. Approval ofthe Zoning Board of Appeals Final Planning Board Approval. BP #32349Z (ACCESSORY NON-HABITABLE GARAGE) '~ UNDERWRITERS CERTIFICATE REQUIRED AP R VED AS NOTED DATE: '1 /1 (. B.P. # 3~.3Ljq-6 FEE: ~y. BY:~ NOTI Y BUILDING DEPNmAENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS; t FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRA,VUNG 8, PLUMElING 3. INSULATION 4. FINAL - COW"PUCTION MUST BE COMPlEI;. '~1i1 CO, ALL CONSTRUCTIUN SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. CO~lPL y. W~:~:i\~~~J~gbES NEW YORK~S...,d ," ~ ND!TIONS OF AS REOU:Rcu'\''j ~,O , "0' . Q(: HOLD L__I'\ .0_' . . ~OW 1UN~ PiJ\NNING BOARD S:J", HOLD ,OWN TRUSTEES N,YS, DEe L~'-""'r, OCCUPANQY qR USE IS UNLAwFUL WITHOUT CERTIFICATE OF OCCUPANCY C:r~~~~~~C~FoNS NAill REQUIRED. , ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. FLOOD ZONEAE{~ ) ~ COMPLY WITH CHAPTER 46 FLOOD DAMAGE PREVENTION SOUJ;HOLD TOWN CODE.