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34790-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA~qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33996 Date: 10/07/09 THIS CERTIFIES that the building ACCESSORY SHED Location of Property: 350 PARK AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 123 Block 7 I~t 8 Subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 9, 2009 pursuant to which Building ~ermit No. 34790-Z dated JLFNE 16, 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 ACCESSORY 12 X 16 SHED IN FRONT YARD WITH 25' SIDE YARD SET BACK AS PER CODE. q~ne certificate is issued to BUD GEORGE HOLMAN ( OWNER ) of the aforesaid building. SUFFOLK CO~]~TY DEPART~NT OF ELEC~TRICAL CERTIFICATH NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP~ ,, $~? 2~ 2009 BLDG. DEPT. TOWN OF SOUTHOLD 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 o f electrical iustallation 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: 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 1. Certificate of Occupancy - New dwelling $25.00, Additious 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. New Construction: / Old or Pre-existing Building: Location of Property: ~ 5~'0 ~9/°~0( ]q~(/~/Ou'~. HOuse No. Street Owner or Owners of Property: 6° ~ C~ 0 g-~ ~"] 0 {~ Pt ~t} _.?~g Suffolk County Tax Map No 1000, Section /~7~ i'b'J' Block Subdivision Filed Map. PermitNo. ~tT~/0- 7~ DateofPermit. ~ 2~,c] Applicant:~,j> Underwriters Approval: Health Dept. Approval: Planning Board Approval: (check one) Lot Hamlet Request for: Temporary Certificate Fee Submitted: $ '~5'~ ~' __ Final Certificate: (check one) 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. 34790 Z Date JUNE 16, 2009 Permission is hereby granted to: BUD GEORGE HOLM-AN 101 PARK AVE NEW YORK,NY 10t78 for : CONSTRUCTION OF ACCY SHED 12X16 IN FRONT YARD WITH 25' SIDE YARD SETBACK PER CODE. WATERFRONT PROPERTY. at premises located at County Tax Map No. 473889 Section 123 pursuant to application dated JUNE Building Inspector to expire on DECEMBER 350 PARK AVE M3kTTITUCK Block 0007 Lot NO. 008 9, 2009 and approved by the 16, 2010. Fee $ 100.00 Authorized Signature ORIGINAL Rev. 5/8/02 CHARLES M. THDMAS, R.A. 7. OF, LINCDLN ST RIVERHEAD, NY '1 '1 c20"1 --FAX (~,?, 1) 727-BQ33 October 6, 2009 Town of Southold Department of Building Southold, NY RE: Holman Residence 350 Park Ave., Mattituck Shed strapping certification To the Building Department, This letter shall serve to certify that I have inspected the shed on the above referenced property and with have found it is constructed (including both the footing and the strapping) in full conformance with NYS building code requirements Please contact our office with any questions. Charles M. Thomas, R.A. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]RRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION [~]~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: INSPECTOR~~-- I~'t~-;LD ]NSPE('*£ION REPORT'I DATE { COUNTS FO~ATION (lST) : FO~ATION (2~) ~ ROUG~ ~G & ~ ~ ~S~ATION PER N.Y. ~ STATE E~RGY CODE ~ ~DITION~ CO~ENTS ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ~: c.~ ,20 ,":17' Approved d' ,/.Q i' ,20 d'f Disapproved a/c Expiration sets ofpl PERMIT NO. 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: Phone: Building Inspector LICATION FOR BUILDING PERMIT INSTRUCTIONS 23 ,20 rely filled in by typewriter or in ink and submitted to the Buildhig Inspector with 4 :ccording 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 codt~axousing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections._\ ~ (Signature of applicant or t/amc, if a corporation) State whether applicant is owner, lesse~ agent,j{rchitect, /-)e.w ,5a. /-lc (Mailing addt:ess of applicant) engineer, general contractor, electrician, plumber or builder Name of owner of premises ~'~U C~ ~---~ e._. 0 r-"-?2,~ ~ ~011~ (As on the tatatatatatatatatat~t roil 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. House Number Street CountyTax Map No. 1000 Section Subdivision Hamlet Block Filed MapNo. Lot Lot State existing use and occupancy ofpremises, j}nd intended use and a. Existing use and occupancy b. Intended use and occupancy occupancy of proposed construction: Nature of work (check which applicable): New Building. x~ Addition Repair Removal Demolition Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Alteration 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 Height Number of Stories Rear ~Depth .,,,~ Dimensions of same structure with alterations or additions: Front ! , i ~i,, !1: i ,Rear Depth Height_ Number o~ Sto~- ~-.= 8. Dimensions of entire new construction: Front / 7~- ~ Rear ' [ ~_~ ~ Depth, / Height Number of Stories ~ ~ 9. Size oflot: Front ]~. O' Rear / Z ~, ~ ]' Depth ,!i ~)?_5~' 10. Date of Purchase Name of Former Owner ll. Zoneorusedistrictinwhichpremisesaresituated ~" qO 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 bo 3_ I-\ 6}/~ p, rl Address Phone No. ~- ~ ~ - ~ ~ ~-5 NameofArchitectC-kl~ Tl~0r~$ Address~0~ L~o tv~ ~PhoneNo 7z'7-7qq 5 Name of Contractor 7- /_~ L"~)__.~ Address /~:,/t/¼t ~ ~ .Phone/b~o. ./ 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. PERM~TS2MAY BE REQUIRED. b. Is this property within 300 feet ora 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. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF 5~-',-~'{'~ ~l~ (Name of individual signing contract) above named, (S)He is the ~ (Contractor~Co¢orate Officer, etc.) NO CONNIE D. BUNCH No. 01§06185050 O, ua!ifi~ in. Suffolk Countv uommlsslon ~oqmres April 14, being duly sworn, deposes and says that (s)he is the applicant Signature of Applicant Sworn to before me this day of ~J-4-x~ > 20 ~) t~ Notary Public 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. '~, WASHINGTON, DC CHICAGO, IL STAMFORD, CT PARSIPpANy, NJ BRUSSELS, BELGIUM KELLEY DRYE & WARREN LLP 101 PARK AVENUE NEW YORK, NEW YORK 10178 (212) 808-7800 DIRECT LINE: (212) 808-7729 EMAIL: bholman~keHeydrye corn September 9, 2009 By Regular Mail Charles Thomas Architect 206 Lincoln Street Riverhead, NY 11901 Re: Dear Chuck: Certificate of Occupancy h~ed~L for Garden hed _ t~t~ , Holman - Mattituck ~0?~f}~'n,,, ~ I Herewith copies of(l) Town of Southold letter dated 5 August 2009, just delivered, requesting (1) a survey (2) application for a Certificate of Occupancy for the garden shed and (3) $25. (2) the form of application which I have signed applying for a certificate of occupancy for the shed; (3) copy of the survey of 6 Nov 2000 by Joseph A. Ingegno showing everything except the garden shed; and (4) my check for $25. payable to the Town of Southold, Building Dept. Chuck - per my phone call with your secretary just now, please, if Southold insists on punishing its otherwise uncomplaining taxpayer with this additional expense, obtain for me an updated survey, submit it all and let me know. With a copy of this letter, I am asking the Southold Town Building Dept. to please make note to send mail to me at P.O. Box 978, Mattituck, N.Y. 11952 (except, as I have asked, for tax bills which please need to include c/o Kelley Drye & Warren before 101 Park Avenue, NY, NY 10178 for the best chance of reaching me in this 31 story office building with 3000 people still employed here). KELLEY DRYE & WARREN LI.P Charles Thomas September 9, 2009 Page Two Meanwhile, as I promised your secretary, nobody in my family will sleep, cook, eat or bathe in the garden shed, as best as I can prevent it, at least until we have a certificate of occupancy. My thanks. Sincerely, BGH:pag Enclosures (4) cc: w/encl. Tom Gabrielsen Builder P.O. Box 317 Jamesport, NY 11947 cc: w/out encl:Building Dept. Town of Southold 54375 Main Road, P.O. Box 1179 Southold, NY 11971-0959 Tow____? o__f $outhold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM O PROPERTYo~ ~ ~..~ILOCATION: ~C,T.M. #:~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMIS$10N OF A Distrlc! Section alock Lot STORM-WATER, GRADING~ DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK, Item Number: (NOTE: A Check Mark (,~) for each Question is Required for a Complete Application) Yes No I Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? L"/ ii (This item will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? ~'/ r~ This Item shall include all Proposed Grade Changes and Slopes Controlling Sudace WaterFIowl -- 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural r~ V Existing Grade Involving more than 200 Cubic Yards of Matedal wi(hin any Parcel? ~ -- 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of m"~ Five Thousand (5,000) Square Feet of Ground Surface? ~ -- 5 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Seach? I~1 -- 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise [o r~ one Hundred (100') of Horizontal Distance? I~1 -- 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off r~ into and/or in the direction of a Town dghEof-way? I~1 -- 8 Will this Project Require the Piacemenl of Material, Removal of Vegetation aud/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? ~ -- (This item will NOT include the Installation of DriYeway Aprons.) 9 Will Ihis Project Require Site Preparation within Ilia One Hundred (10{)) Year Floodplain of any Watercourse? NOTE: tfAnyAnswertoQuestionsOnethroughNineisAnsweredwithaCheckMarkintheBox, aStorm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit[ EXEMPTION: Ye~s Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Required! STATF, OF NEW YORK, ~ - > ~. N~ Public, ~ N~A (:()l ~N'I%: { )l7 ..... ~ ~ g~ No. 01BU6185050 A..6 ......................................................................... c- ,,,/r . ...... ()~r C ; il/ >r r I)I 'scutalJvc ;[ flit )~ 'ncr J ( ~,] "s, ~ s duly aufll,~lizcd ti, I,Ctl!)lB~ OI' have peHorulcd ~c smd work and to make and file this al)pli{ ation; fl~ai ;dl statcmenLs conmmcd in ~is application iue sxm Io thc best of his bmwledge and beliet; ~d FORM - 06/07 TOWN OF SOUTHOLD PROPERTY RECORD CARD W WPE OF BUILDING ~s. ~/,~ ~s. w 7 ~ co~. c~. ~,sc. ~ND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION ~~'~ ~- ~.~ ~ N~ NOR~L BELOW ABOVE FARM Acre Value Per Value ~re 'ilbble 1 illoble 3 /oodlond ~ampl~nd FRONTAGE ON WATER rushl*nd FRONTAGE ON ROAD louse Plot DEPTH ~ ~ BUkKH~D ot~l ~OCK M. BIdg· Extension Extension ·Extension Porch Porch Breezewe,~ COLOR Foundotion ~ ~ ~[~ment 7 0 IExt' Walls IFire Place Type Roof Recreation Room Dormer Driveway Bath Floors nterior Finish Heat Rooms ]st Floor Rooms 2nd Floor Dinette ,K. DR. BR. FIN. 8. " '" ,-N 85' · '125.00 667.00' © © SURVEY OF PROPERTY SITUA T£ MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-123-07-08 SCALE 1"=30' NOVEMBER 6, 2000 APRIL 9, 2001 ADDED TOPOGRAPHY OF BLUFF SEPTEMBER 12, 2009 UPDATE SURVEY AREA = 77,758 sq. ft. (TO TIE LINE) 1.785 aC. NOTE: 1. THIS PROPERTY IS SHOWN AS PlO LOT(~ MAP OF MARRATOOKA PARK FILE IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON NOVEMBER 1, 1905 AS FILE No, 450 2, FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No, 56103C0482 G ZONE VE: COASTAL FLOOD WITH VELOCI~( HAZARD (WAVE ACTION); BASE FLOOD ELEVATIONS DETERMINED ZONE X' AREAS DETERMINED TO BE OUTSIDE 500 YEAR FLOODPLAIN, 1. ELEVATIONS ARE REFERENCED TO N.G.V.D, 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS: ~ EXISTING CONTOUR LINES ARE SHOWN THUS: ..... 5-- FFL FIRST FLOOR 50467 Nathan Taft Corwln III Land Surveyor PHONE (631)727-2090 OFFICES LOCATEQ AT Fox (631)727 1727 THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, iF ANY, NOT SHOWN ARE NOT GUARANTEED ZONE ~ONC 0 9'W gO-604t pAR~-- AVENUE ' "W 125.0~,,,,~ ~ APROXIMATELY 210'~ LINE ~ 150'~ BACKFROM TOP OF BULKHEAD N 89 48' 00"W HICH WAmR LINE 126.69' (~E LINE) GREAT pEGoN/G BAY S'--Y P_AN ~CA~E: ~" = 30' SCTM~ 1000 - 123- 07- 008 D A T E: JUNE 2009 REVISIONS D E Charles M Thomas PROPOSED SHED: HOLUAN ESIDENCE 8" POURED CONCRETE FOUNDATION WALL ON 8"X16' POURED CONCREIE FOOTINO OVER ~. MIL. POLYETHLENE VAPOR CARRIER ON WELL COMPACTED POROUS FILL PHD 4 /I~P, EACH OVER 4 MiL. POLYETHLENE VAPOR CA !RIER ON WELL COMPACTED POROUS 2"xB" RIDGE BOARD - ? OCCUPANCYOR USEIS UNLAWFUL WITHOUT CERTIFICATi: OFOCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YOR,~ STATE. APPROVED AS NOTED FEE' NOTiFy BUILDIhO DEPARTMENT AT 0 F 0 /U,.N _DcA T I 0 N P L A N C sF'cl R S T F L O O R P L A N FOLLOW,NG'BS-'HO2HAMTO"P'"FORTHE,~,,SPECT,ONB, SCALE: 1 "= 1'-" A E: 1/4" = 1'-0" I. FOUNDATfON - TWO REQUIRED RETAIN STORM WATER RUNOFF FOR POUREB CO"~CRETE PURSUANTTO 6HAPTER 236 2 ROUGH - FRAMING & PLUMBING OF THE ]'OWN [;ODE, 3. INSULATION 4. FINAL - CONrCrRUCTrON MUST DE COMPLETE FOR CO. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK ST/~FE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. TYPiCAl,- ROOF CONSTRUCTION ASPHALT SHINGLE 12 ATTIC 4 MILL VAPOR BARRIER X 12" RIDGE BEAM LING CTION SHIR~J~S 15~ FELT I/2" CD X PLW~O ; O 15' O,C, & DOOR SUF~SHND~ HEIGHT j},_o, ~ HAUNSH (~ CROSS SECTION SCALE: 1/4" = 1'-0" C SIDE ELEVATION SCALE: 1/4" = 1' 0" F R 0 NrTo,, E L E V A T I 0 N ~SIDE ELEVATION SCALE: 1/4" = - ~ SCALE: 1/4" = 1'-0" LU ,,°W 0 SHEET NO, 1