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Home My WebLink About33973-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33835 Rte: 07/17/09 THIS CERTIFIES that the building ALTERATIONS Location of Property: 2015 BAY AVE (HOUSE NO.) County Tax Map No. 473889 Section 31 Subdivision Filed Map No. __ EAST MARION (STREET) (HAMLET) Block 17 Lot 2 LOt No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~LAY 29, 2008 pursuant to which Building Pez~nit No. 33973-Z dated JUNE 11, 2008 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 ALTERATIONS, TRELLIS ADDITION AND OUTDOOR SHOWER WITH CHANGING AREA ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JULIETTE VASSILKIOTI (OWNER) of the aforesaid building. SuFMOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R~,RCTRICAL CERTIFICATE NO. PLUMBERS C~u(TIFICATION DA'r~u N/A 125851C 04/17/09 TODD DAWSON ~u~th~ri~ature 02/27/09 Rev. 1/81 MAY 6 2009 BLDG. DEPT. TOWN OF SOUTNOLD Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OFOCCUPANCY This application must be fdled in by typewriter or ink and submitted to the Building Department 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 o~ topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical iustallafien frcm Board of Fire Underwriters. 4. Sworn statement from plumber ceflffying that thc solder used in system contains less than 2/10 of 1% lea& 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. 8ubrait Planning Board Appwval of enmplcted site plan requirements~ B. F~rexistingbul~dings(pri~rt~Apri~9~~957)~~n-~~nf~rminguses~~rbu~dingsand"pre~existing~~anduses: 1. Accurate survey ofprop~ty showing all property lines, streets, building and.unusual natural or topographic ~ features. 2. A pr~per~y c~mpl~tedapptica~n and c~nsent t~ in~pect signed by the applicant. ~f a C¢rti~cate ~f ~ecupancy 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 - $.25 4. Updated Certificate of Occupancy- $50.00 5. Teraporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 5-'/~'/D7 New Construction: Location of Property: Old or Pre-existing BuildinL 6~ (eheck one) House No. Hamlet Owner or Owners ofProperty: VO.~ 5,1k/b'~-7' / ~)0a t4_C//L~t4~'~L/ Suffolk County Tax Map No 1000, Section ~ I Bleck / '-)' ;-3. Subdivision Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ c~ ( Date of Permit. Filed Map. Lot: Underwriters Approval: yf'fl, Final Certificate: J (check one) Applicant Signature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0426C Date June 3, 2009 THIS CERTIFIES that the trellis, outdoor shower, and wood fence At 2015 BayAve., East Marion Suffolk County Tax Map #31-17-2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 2/24/09 pursuant to which Trustees Wetland Permit #7048A Dated 3/18/09 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a trellis, outdoor shower, and wood fence. The certificate is issued to JULIETTE VASSILKIOT! owner of the aforesaid property. Authorized Signature Issue Date 2/27/2009 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 125851C East Patchogue, NewYork 11772 (631) 286-6642 Issued To: Vassilkioti/Bogushevsky Street: 2015 Bay Avenue Village: East Marion Zip: Section: Block: Lot: 11939 Town: Southold Contractor: Shore Power Elec. Cont. Inc. Lic. # 42536-ME Was examined and found to be in compliance with the National Electrical Code. ~ Commercial [] NV Defects I~ Pool [] lstFIoor [] Indoor ~ Basement ~ Hot Tub [] Residential [] Der. Garage [] Attic [] 2nd Floor [] Outdoor IT Addition ~ Survey Switches Receptacles Fixtures 12 20 15 Dishwasher Washer/Amps Dryer/Amps 1/20a Furnace Oil Gas Circulators Meter Amps Phase UG/OH Jacuzzi /[] GFI Heaters A/C Fans 5 Oven Range/Amps Microwaves 1 Gas 1/20a Smoke Detector Bell Transformer 1 Television CO Detector Bldg. Permit: 33973 Other Equipment 1-200 amp M/B Panel/1-Co/Smoke Det. Hugo S. Surdi President Rough 11/13~2008 This ce[tificate must not be altered in any manner. Inspectors may be identified by their credentials. 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 O1~' SOUTHOLD CERTIFICATION Date: ~/- [ '7-0 q Building Permit No. Owner: J li C) (Please print) Plumber: ~ (Please print) I ce~ifythattbe solder used in the watersupply system contains less than 2/10 ofl% lead. Sworn to before me this dayof ~ , 2000x (Plumbers Signature) Notary Public, ~(~-J~ County CONNIE D BUNCh Notary Public. Stata of New Yorl~ No. 018U6185050 Oaalified n Suffo k Cou , Commission Expires April 14n~n/ James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosie, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (6311 765-1892 Fax (6311 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7048A Date of Receipt of Application: February 24, 2009 Applicant: JUliette Vassilkioti SCTM#: 31-17-2 Project Location: 2015 Bay Avenue, East Marion Date of Resolution/Issuance: March 18, 2009 Date of Expiration: March 18, 2011- Reviewed by: Trustee Bob Ghosio, Jr. BLDG. DEPT. TOWN OF SOUTHOLD Project Description: For the as-built trellis, outside shower, and to replace inkind/inplace the existing wood fence. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance'of an Administrative Permit allows for the operations as indicated on the site p!an prepared by Joseph A. Ingegno, last dated October 19, 2006, and received on February 24, 2009. Special Conditions: None. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. James F. King, President Board of Trustees JFK:eac 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. 33973 Z Date JUNE 11, 2008 Permission is hereby granted to: for : JULIETTE VASSILKIOTI 2015 BAY AVENUE EAST MARION,NY 11935 ALTERATIONS TO AN EXISTING SEASONAL RESIDENCE AS APPLIED FOR W/ FLOOD PERMIT AS APPLIED FOR at premises located at 2015 BAY AVE EAST MARION County Tax ~4ap No. 473889 Section 031 Block 0017 Lot No. 002 pursuant to application dated MAY 29, 2008 and approved by the Building Inspector to expire on DECE~I ,~ Fees 300.00 Auth~ri~d Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-t802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ] ROUGH PLBG. [ ] I~LATION [ ~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION[ ] FIRE RESISTANT PENETRATION REMARKS: ¢~ ~'~ ~) DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ) RIlE RF. SlSTANT CONSTRUCTION [ ] RRE RESISTANT PEHETRATION REMARKS: DATE '~' -- / ''/~- ~' ~ INSPECTOR TOWN OF ~LD NG DEPT. 765-1802 I N [ ] FOUNDATION 1ST IGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING !~STRAPPING [ ] FINAL [ ] FIR~E & CHIMNEY [ ] FIRE SAFETY INSPECTION [//]"'~'IRE RESISTANT CONST~_ LJCTION [ ] FIRE RESISTANT PENETRATION REM~K ,~.~~.c~/~ '~ ~"~_ //~/~(~) ? INSPECTOR ~ ~~ DATE ~/(/ · TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION ¶ST [ ] ROU~H~LBG. [ ] FOUNDATION 2ND [~INSULATION [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ]R~GH PLBG. FOUNDATION 2ND [.~/]~ INSULATION []FRAMING/STRAPPING []FINAL []FIREPLACE&CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] .F_IRE RESISTANT PENETRATION REMARKS: ,~~ ~~ DATE INSPECTOR /~/ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ~'~RAMING / STRAPPING [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOViN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ BUILDING PERMIT APPLICATION CHECKLIST Expiration ., 20 Approved / {' ~- Mail to: Disapprov~ k~ ~ ~ Phone: APPI~ICATION FOR BUILDING PERMIT Do you have or need the following, before applying? Board of Health 4 sets of Building Plans planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Date /HaY JZG ,20a INSTRUCTIONS a. This a~plication MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been unacted 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. (Sign~tur~ffapplicant or name, ifa corporation) (Mailing~ddress of aPPlicant) # State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises c~) ~J { i~7~_.~ (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 Tradds License No. Location of land on which proposed ~ork will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block I~' Filed Map No. Lot Lot O2- 2. State existing use and occupancy of premises and inte.,n, ded use and occupancy of proposed cons?uction: a. Existing use and occupancy (-':'-3]N~9[..~ ~'~M[.(.,,~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair k.~ Removal Demolition Other Work 4. Estimated Cost ~ ~O,0OO 5. If dwelling, number of dwelling units If garage, number of cars Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front '"]i~. ~l Rear ~)' "5~'°' Depth Height ['9'3~ Number of Stories ~ Dimensions of same structure with alterations or additions: Front Depth Height Number of Stodes Rear 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size oflot: Front -'~'9"O,'~4'1 Rear ~4~""~51 10. Date of Purchase ~3' '90'O~ 1 I. Zone or use district in which premises are situated Name of Former Owner Rear .Depth Depth ~ 4, (~ I 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 o f Owner o f premises/~_~ NameofArchitect ~l~l~L, ~ Addressl~'laW6~l~::NR~'~neNo 4':~"-~"~ Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 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. NO 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 ) , .~- ~x~/~P~'' being duly sworn, deposes and (Na~n~ of ii~dividu~.l signing contract) above named, says that (s)he is the applicant (S)He is the ~ ' (J (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 tq before me this .., ~ c~Ol'~ day of 0 ~ 20 0 ~ Not~ ~blic CONNIE D BUN~ N~.~blic.~ ~ ~ ~ ~o, 01BU618~50 uommi~ ~ ~ir~ Apfl114, Applicant · j-LFDITH T. TERRY TOWN CLERK Town Hall. 53095 N'lain P.O. Rox Ii $oulhold. New York I IqTI Fax (516) 765-1g33 Tclcpi~onc (S J6J ~65- 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 two (2) new forms to be used under the of the Code of the Town of Southold: Application" [FDP(93)], and "Certificate of Special Flood Hazard Area [C/C(93)]. Town of Southold hereby adopts Flood Damage Prevent regulations "Floodplain Development Permit Compliance for Development in BLDG. D F-. ~... ~ TOW OF I Southold Town Clerk August 25, 1993 TOWN OF SOUTHOLD APPLICATION PAGE 1 of 4 FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION I: GENERAL PROVISIONS (APPLICANT to read and sign): L No work may start until a permit is i&sued. 2. The permit may be revoked if any false statements are 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 ksued. 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 representa6ve to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN A"FI'ACI-LMENTS TO _ THIS APPLICATION ARE, TO TItlE.BEST OF MY KNOWLEDGE, TRUE AND ACCURATE. SECTIq)N 2: PROPOSED DEVELOPMENT (To be completed by APPLICANT) APPLICANT BUILDER NAME ADDRESS TELEPHONF ENGINEER R E N: To avoid delay in proce~ing thc application, please provide enough information to easily ideutify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to thc nearest intersecting road or weil-lmown landmark. A sketch attached to ~ application showing the project location would be helpful. FDP(93) APPLICATION PAGE 2 OF d DESCRIPTION OF WORK (Check all appticable boxes): A. STRUCTURAL DEVELOPMENT STRUCTURE TYPE [] New Structure [] Addition ~'~Alteration [] Relocation FI Demolition [] Replacement [] Residential (1-4 Family) [] Residential (More than 4 Family) [] Non-residential (Floodproofmg? [] Yes) [] Combined Use (Residential & Co-~merdal) [] Manufactured (Mobile) Home (In Manu- factured Home Park? Fl Yes) ESTIMATED COST OF PROJECT $ OO o B. OTHER DEVELOPMENT ACTIVITIES: [] Fill [] Mining [] Drilling [] Grading [] Excavation (Except for Structural Development Checked Above) [] Watercourse Alteration (Including Dredging and Charmel Modifications) [] Drainage Improvements (Including Culvert Work) [] Road, Street or Bridge Construction [] Subdivision (New or Expansion) [] Individual Water or Sewer System [] Other (Please Specify). After completing SECTION 2, APPLICANT should submit form to Local Admkfi.strator for review. SECTION 3: FLOODPLAIN DETERMIN~TION (To be completed bv LOCAL ADIHINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: El la NOT located in a Special Flood HaTard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ~s located in a Special Flood~.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 [] Sec Section 4 for additional instructions. SIGNED DATE APPLICATION PAGE 3 OF a SECTION ~1: ADDITIONAL INFORMATION REQUIRED [To be completed bv LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application c2m 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 spedfications, 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 Ftrst floor and details of enclosures below the tn'st floor. ALso, [] Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acxns, whichever is the lesser, the applicant must provide tOO-year flood elevations if they are not otherwise available). [] Plans showing the extent of watercourse relocation and/or landform alterations. [] Top of new Fall elevation FI. NGVD (MSL). [] Floodproofing protection level (non-residential only) Ft. NGV'D (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 ~ incre~e in the height of the i00-year flood. A copy of all data and calculations supporting this Finding must also be submitted. [] Other: SECTION 5: PERMIT DETERMINATION (To be comoleted by LOCAL ADMINIb-~RATOR) I have determined that the proposed activity:. A. [] Is B, El Is not in conformance with provisions of Local Law # , 19 attached to and made part of tiffs permit. · Thc permit is issued subject to the conditions SIGNED , D~TE [f BOX A is checked tlie Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Admimstrator 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. APPEALS: Appealed to Boaxd of Appeals? [] Yes [3 No Heaxing date: Appeals Board Decision --- Approved7 [3 Yes Conditions [] No APPLICATION # PAGE 4 OF 4 ~;ECTION 6: AS-BUILT ELEVATIONS (To be submitted bv APPLICANT before Certificate of Compliance is issued'~ The following information must be provided for project structures. Thiz section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this appfication). Complete ! or 2 below. 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 bv LQCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on ittapection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES.'? [] YES [] NO DATE BY DEFICIENCIES? [] YES [] NO DATE BY DEFICIENCIES? [] YES [] NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be comnlegnd bv LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAIARD AREA (OWNER MUST PdETAIN 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: Ao COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # ,19 SIGNED: DATED: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19__, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) M E R Y L K R A M E R a r c h i t e c t Mr. Damon Rallis Southold Town Building Dept. Southold Town Hall PO Box :1.179 Sou[hold, NY 11971 February 24t~, 2009 RE: Vassilkioti Bogushevsky Residence Tax Map # 100~31-17-02 Permit # 33973 Dear Damon, I am applying for an amendment to the building permit for the above project. Attached please find 4 copies of .the revised site plan and detail drawing for the trellis located at the above mentioned property. Please note · that the height of the shower enclosure is 6 feet above grade. An administrative permit application is currently on file at the Town Trustees. Please feel free to contact me with any questions or concerns. D ~ AP Cc: Juliette Vassilkioti and George Bogushevsky 455 MAIN STREET P.O. BOX 683 GREENPORT, NY 11944 631-477-8736 631 477 8936 FAX oL_J : NE~ S 79°20'08'' REPLACE EXISTING PICKET FENCE IN KIND~IN PLACE NEW SHOWER/CHANGING AREA ENCLOSURE 6' HIGH NOTES 1. SURVEY OF PROPERTY SITUA 7"£D A T EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-$1-17-02 SCALE 1":10' JANUARY 9, 2006 JUNE 12, 2006 ADDED HEALTII DEPARFMEN1 DATA AUGUST 50, 2006 ADDED PROPOSED 2ad STORY ADDITION OCTOBER 19, 2006 REVISED WETLAND NOTE AREA 4,850.81 sq. (TO TIE lINE) 0.111 Dc. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 BATLIM EXISTING ELEVATIONS ARE SHOWN THUS:~¢ EXISTING CONTOUR LINES ARE SHOWN THUS: PROPOSED CONTOUR LINES ARE SHOWN THUS: FF£ - FIRST FLOOR 6FL GARAGE FLOOR THIS PROPERTY IS IN FLOOD ZONE AE (EL. 9) FLOOD INSURANCE RATE MAP No. 36105C0177 G ZONE AE BASE FLOOD ELEVATIONS DEqERMIRED 3. NO ADDITIONAL FILL SHALL BE NEEDED. LOT COVERAGE DATA (LOT COVERA6E DAfA OF UPLAND LOT AREA) T£'ST HOLE DATA UNAU[HORIZED ALTERATION OR ADDITION lO Till5 SURVEY IS A VIOLATION OF THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED k o n cI PHONE (631)727-2090 Fox (551)727 1727 N.Y.S. Lic, No. 4.9668 8 A1 APPROVED AS NOTED 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMLNG & PLUMBING 3. INSULATION 4, FINAL - CONSTRUCTION GE COMPLETE COMPLY WITH ALL coOES OF bleW YORK STATE & ToWN CODES AS REQUIREMENTS YORK DESIGN 6 bRED AND CONDITiONS OF DTOWNZBA TOWNPLAN~)~GBOARO SOUT~OLDIOWNTRUSTEES NEW CEDAR SHINGLE SIDING (5" EXP,) NEW SLIDING DOOR TO REPLACE EXISTING WINDOW EAST ELEVATION NEW WINDOWS TO REPLACE, EXISTING OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE 8"FLUETHROUGH PV PANELS THIS SIDE REPLACE EXISTING WINDOWS WEST ELEVATION ¼.= SHINGLE SIDING (5" EXp) WINDOW Alternate to 120 MPH Certified Window Installation Plywood Panel Window and Door UNDERWRI~RS CERT[FICA1~,, REQUIRED D DAMA .,~0'~ MOLO TO",N t't CO oE" OF OCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. REpIJ&CE EXlS~I,~ G WINDOWS REPLACE EXISITN G WIN DOWS, REMOVE SHUTTERS NORTH ELEVATION ~-" = 1'-0" 4 REMOVE EXISTING WINDOWS. NEW CEDAR SHINGLE SIDING (5 EXP.) SOUTH ¼._- -- REPLACE EXISTING WINDOW W/NEW CASEMENT WINDOW. REMOVE SHUTTERS, REPLACE EXISTING WIN DOWS. REMOVE SHU~FERS ELEVATION REPLACE EXISTING DOOR NEW CEDAR SHINGLE SIDING 'EXISTING DECK REPLACE EXISTING WINDOW REMOVE CEILING Protection for Wood Framed Buildings REPLACE EXISTING SLIDING ~ REPLACE EXISTING / NEW WINDOW ~WINDOW W/ REMOVE EXISTING WALL EXISTING KITCHEN NEW CEDAR SHINGLE SIDING (5II EXP ) REPLACE EXISTING CLG TILES W/ REPLACE EXISTING REMOVE EXISTING WINDOW & WALL SECTION REPLACE / WINDOWS LIVING AREA NEW DOOR NEW STEP DOWN (5") DINING , SANQUE~FE EXISTING WINDOW TOILET EXISTING / BATH WINDOW IJ SHOWER WINDOWS IN6 FLOOR PLAN ~.-- 1MO, WINDOW LREPLACE EXISTING WINDOW lNG WINDOWS THIS SIDE X WINDOW / DOOR SCHEDULE NAME TYPE RO, SIZE (W x H) COMMENTS EGRESS A WUDH2418 2~-6 ~" x 3~-9 ~" MARVIN WOOD DOUBLE HUNG B WUDH2018 2'- 0 ~/~" x 3~- 9 ~" MARVIN WOOD DOUBLE HUNG C WUDH2416 2'- 6 ~" x 3'-5 ~" MARVIN WOOD DOUBLE HUN( D WCM3248 2'- 9" x 4'- 0 ~" MARVIN WOOD CASEMASTER YES WITH CHECK RAIL~IMULATE DOUBLE HUNG E WUDH2026 2~-2 ~" x 3'-5 ~" MARVIN WOOD DOUBLE HUN( F WUDH2620 2'43 ~" x 4'-1 ~" MARVIN WOOD DOUBLE HUNG G WOM3224 2~- 9" x 2'- 0 ~" MARVIN WOOD CASEMASTER, VERIFY SASH SIZE MATCHES UNIT D 101 6068 6'-1~" x 6u&O ~" WOOD ULTIMATE SLIDING FRENCH DOOR NOTE: CONTRACTOR TO VERIFY EXISITNG WINDOW ROUGH OPENINGS PRIOR TO ORDERING NEW WINDOWS, DISCUSS EXISTING HEADER HEIGHTS WITH ARCHITECT. m \ SITE PLAN 1" = 20'-0" SITE DATA SCTM# %000-31-17-02 PROPERTY ADDRESS 2015 BAY AVENLJE~ EAST MARION~ NY OWNER JULIETTE VA$SILKIOTV GEORGE EOSUSHEVSKY LOT COVERAGE LOT COVERAB E = 20 % ZONING R~O NON-CONFORMING JOSEPH A. INBESNO SURVEYOR 322 ROANOKE AVE, RIVERHEAD, NY, 11901 GENERALNOTES ALL WORK MATERIAL, AND EQUIPMENT SHALL BE IN ACCORDANCE WITH THE NEW YORK STATE UNIFORM BUILDING CODE, AND THE NEW YORK STATE ENERGY CONSERVATION CODE, AND LOCAL AUTHORITIES, 2. PROVIDE FLASHING AT ALL ROOF BREAKS, CHIMNEYS, SKYLIGHTS, EXTERIOR DOORS, WINDOWS AND DECKS ETO,. 3, BO NOT SCALE DRAWINGS. 4. RECORD ARCHITECT IS NOT RESPONSIBLE FOR THE INSPEOTION, SUPERVISION, OR ADMINISTRATION OF THIS OONSTRUCTION PROJECT, FEDERAL, STATE AND LOCAL ZONING AND BUILDING CODE COMPLIANOE SHALL BE THE RESPONSIBILI~/ OF THE CONTRACTOR, S. THIS DRAWING lEAN INSTRUMENT PREPARED TO FACILITATE CONSTRUCTION AND SHALL NOT BE OONSTRUEB AS A OONTRAOT BETWEEN BUILDER AND OWNER, 6. ARCHITECT TO BE NOTIFIEDINWRmNG OF ALL CHANGES PRIOR TO AND DURING CONSTRUCTION, 8. CONTRACTOR SHALL OBTAIN ALL PERMITS AND INSURANCE NEOESSARYTO PROTECTTHE ARCHITECT AND OWNER. Z A