HomeMy WebLinkAbout34916-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33924
Rte: 08/28/09
THIS CERTIFIES that the building HANDICAP RAMP
Location of Property: 2555 YOUNGS AVE
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 63 .2 Block 1
Subdivision
Filed Map No. __ Lot NO. __
SOUTHOLD
Lot 44
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 7, 2009 pursuant to which
Building Permit NO. 34916-Z dated AUGUST 10, 2009
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 HA/qDICAP RAMP ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
(CONDO UNIT 14B)
The certificate is issued to JOAN SCOTT
of the aforesaid building.
(OWNER)
S~FOI~K t~D[~Y DEPAR~)~qT OF ~TH APPRO~
ELECTRIC~%L ~KTIFIC2%TH NO.
~ c~KTIFIC3%TION DA'r~D
N/A
N/a
N/A
th/rized/Signature
Rev. 1/81
Form [No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
APPLICATION FOR CERTIFICATE OF OCCUPA
This application must be filled in by typewriter or ink and submitted to the Building D~
A. For new building or new use: TOWn OF S0UT~0t0 1. Final survey °f pr°perry with accurate location of all buildings, property lines, streets, and unnsual 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:
t. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
feamres.
2. A pr°perly c°mpleted application and consent to inspect signed bythe applieant, if a Certifieate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2 Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction: J Old or Pre-existing Building (check one)
Location of Property: .~q~t~V,~,,jr~f.~
.ouseNo. FY Iq
Owner or Owners of Property: L~/fir 0o ~'r__ O 'qD4- Hamlet
Suffolk County Tax Map No 1000, Section
Subdivision
Permit NO. ~:~/~ ~ / 6 ~-~ Date of Permit.
Health Dept. Approval:
Planning Board Approval:
.Request for: Temporary Certificate
Fee Submitted: $ ~' C' ~' ~
Filed Map. Lot:
Underwriters Approval:
Final Certificate:
(check one)
,ApPlicant Signatur~e~
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. 34916 Z Date AUGUST 10, 2009
Permission is hereby granted to:
JOAN SCOTT
2555 YOUNGS AVE UNIT 14B
SOUTHOLD,NY 11971
for :
CONSTRUCTION HANDICAP PJkMP ADDIITON PER APPROVED PLANS AS APPLIED
FOR
at premises located at 2555 YOUNGS AVE SOUTHOLD
County Tax Map No. 473889 Section 063.002 Block 0001 Lot No. 044
pursuant to application dated AUGUST 7, 2009 and approved by the
Building Inspector to expire on FEBRUARY 10, 2011.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ] Fo~ATION 2ND
[ ~/FRAMING / STRAPPING
ROUGH PLBG.
INSULATION
FINAL
[ ] FIREPLACE & CHIMNEY ( ) FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENEI'RATION
REMARKS: ~~ ~
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS: '~/~% )/-~
[ ] ROUGH PLBG.
[ ] INSU.~.ATION
[ ~J~AL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE (~/~/~? INSPECTOR
FH~LD INSPECTION REPORT I DATE I ' COMMENTS
FOUNDATION (1ST)
FOUNDATION (2ND)
· ROUGH FRAMING &
PLUM~ING
INSULATION PER N. Y.
STATE ENERGY CODE
ADDITIONAL COIVIMENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SontholdTown.NorthFork.net
PERMIT NO.
Disapproved a~c
AU¢ 7 2009
BLDG. DEP[
TOWN OF SOUTHOLD
BUILDING PERMIT APPLICATION CHECKLIST
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
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to: ~tO [/. L~ }-c ~]n. Jo/~
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
Phone: b'TGI- 7~'""~0~
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
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 tbr 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
issuanc~ or has not been completed witbin 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 ora 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.
ature of applicant or name, if a corporation)
(Mailing address of ap~lica~)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises ~'~r ~o ~'~0 p~l.-
(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.
Location of land on which proposed work will be done:
}louse Nfimber I ' Street
County Tax Map No. 1000 Section
Subdivision
2. State existing use and occupancy of premises and intended use and occupancy ofpro~pose~ construction:
a. Existing use and occupancy
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost -~ ) ~-oo ~ Fee
If dwelling, number of dwelling units
If garage, number of cars ~
Addition Alteration
OtherWork flattop, c~,
f (Descfiptic~n)
(To be paid on filing this application)
Number ofdwelling 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
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height. Number of Stories
Rear
8. Dimensions of entire new construction: Front Rear
Height Number of Stories
Depth
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
13. Will lot be re-graded? YES__ NO /Will excess fill be removed from premises? YES__
~",er~o 5¢,4-Jf Addressafq'ff' ¥,,o~-e~/~,~PhoneNo.
Address / ~ ' Phone No
14. Names of Owner of premises
Name of Architect
Name of Contractor~O I/. LiJc~,lk¢ol~(
Address ~o i~*g 5?F ,5o,41,*10 Phone No.
NO,,,'/
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 tbundation 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.
18. Are there any covenants and restrictions with respect to this property? * YES v/ NO__
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY OF
M~O~,*'.~ V' L.t' ~-x.~x~ua (,J~ being duly swom, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the 0 bo ta 6~ / (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 tree 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
Signature of Applicant
Town of Southold
Erosion, Sedimentation & Storm'Water Run-off ASSESSMENT FORM,,
'* STORI4~WATE GRADIHG; DRAINAGE AND EKU~IV ' . _~.
~ Numl~c.
1
2
3
4
5
6
7
8
9
(NOTt~: AChask M~d~ (~)f~' eac~ {~°n Is Re(~ired f°r a ~I:~qete AI;~4i~U'c~) Yes
~ ~ p~ R~ln ~ ~r ~ ~ ~ 8 T~ ~) t~ ~n~ ~ ~?
im~ a~ ~e ~ ~.~'~'')
~ Item s~lt I~de afl p~s~ Gm~ ~s ~ S~s ~ Su~ Wat~
~sflng Grade I~ ~ ~ 2~b~Ya~ ~ ~te~ ~ a~ P~
Is ~ a NaOmi ~at~ ~me R~ ~ ~e SEe?
Is ~is Pmle~ ~in ~e Trust. s ludsdi~on ~ ~in ~e H~ (1~) f~t of a Wet. nd ~ Bea~? --
~ll ~em ~ Site pmpamflon on E~sttng Gmde SIop~ ~i~ ~ Fi~een (15) f~t °f Ve~l ~se t° ~
One Hu~r~ (100') of Ho~l ~n~?
~11 Ddveways, Pang ~as ~ o~er Im~s Su~s ~ ~o~d to Dim~ Stoa-Water Run~
into ~dlor in ~e dir~ of a T~ flght~-~y?
Will ~is Pried R~m ~e Placement of Material. Re~l of v~etat~ a~or the ~s~ of ~
NOTE: IfAny Answer to Questions One through Nine Is Answered with a Check MaX In the Bex, a Storm-Water. Grading,
Drainage & Erosion Control Plan IS. Required and Must be Submitted for Review Prior to Issuance of Any Building Permltl
Yes N._.~o
EXEMPTION,'
Does. this project meet the minimum standards for classification as an Agd~Jltural project?
cOUnTY .............................ss
qr~t[, ..~ok~ ~' g;..3cdm~/r being duly sworn, deposes and says that he/she is d'e applicant f°r Pennit'
~d tha~ hdshe is thc ............................ -~ ..... ~' ~
Owner and/or represen~.Uve of the Owner of Owner's, and is ~luly authorized to peffornl or have performed the said work and to
m~ke and file ~his applicafon; that all statemen~ contained in this application are ~ue to the best of his knowledge and beliefi and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before nte this;
7 ............
Notary Public: ................... I~rN~ I~g~-~- ~TATE 'OF*~ ~11~ .......
NO, 01HY618~
FORM - 06/07
CERT F'CAT/ON OF
NAILING ,r; -)NNECTIONS
O~L~ '~-REQUIRED.
_1
-.!'? I, -
!,!SE U~,~LAWFUL
WiTH CERTIFICATE
OF O(;0.. UPANCY
AS NOTED
3.
4
COMF
RE
RK
Di SIGN OR
tNG DEPARTMENT AT
TO 4PM FOR THE
- TWO REQUIRED
/~¢UR :-D CONCRETE
& PLUMBING
- C( qSTRUCTION MUST.
FOR C.C.
SHALL MEET THE
OF THE CODES OF NEW
NOT RESPONSIBLE FOR
.~TION ERRORS.
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
Founders Village
2555 ¥oungs Avenue
Southotd New York
SITE
FLOOR PLAN
MODEL B
5/4" FACIA BOARD TO B
"TRIM BOARD_BY AZEK"
5/4" NON-SLIP DECKING TO BE~
"LAKESHORE_BY BLUELINX"~
2 X 8 ACQ FRAMING @ 16" O.C.-
OCCUPANCYOR
USEtS UNLAWFUL
NITHOUTCERTIFI(
3F OCCUPANCY
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
II1/
/ I/// .
/
SOUTHOLD TOWN ZBA
SOUT~OLD TOWN P~NNING BOARD
SOU~'H~D TOWN TRUSTEES
N.Y.S. DEC
6'-6" 9'-6"
('"'~ P~N VIEW OF RAMP
~..~ SCALE:
APPROVED AS NOTED
DATE. ~_BP #
1 FOUNDATION TWO REQUIRED
.- ~ · - 1. HEIGHT UNDER 30 RISE DOES NOT
5/~ NON-SLIP DECKING TO BE-~ FOR POURED CONCRETE REQUIRE GAURDRAIL AS PER NY STATE
~KESHORE_BY BLUELINX" ~ 2. ROUGH - FRAMING & PLUMBING CODE: ~R316.1
~ ~ 3. INSULATION ~
~ ~ 4 FINAL - CON-~H~T ON MUST 2. RAMP SLOPE UNDER 1:12 SLOPE
~ ~ ' BE COMPLETe ~R C 0 DOES NOT REQUIRE HAND,ILS AS PER
NY STATE CODE ~R313 2
~ ~ REQUIREMENTS OF THE CODES OF NEW
, ... % . ~. ~ORE RTATF NOT RESPONSIBLE FOR 14
; ~SiGN ~R ~51 I1
4'-7" 16'-0"
CONCRETE SIDEWALK
LEFT SIDE ELEVATION
SCALE: 1/2'=1'-0"
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.