HomeMy WebLinkAbout35075-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPABTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-35051
Date: 11/04/09
THIS CERTIFIES that the building RAMP ADDITION
Location of Property: 18075 SOUNDVIEW AVE
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 51 Block 1
Subdivision
Filed Map NO. __ Lot NO. __
SOUTHOLD
Lot 8
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 23, 2009 purs,,ant to which
Building Permit No. 35075-Z dated OCTOBER 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 "AS BUILT" RAMP ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to ELIZABETH P & ROY I MARTIN QPRT
( OWNER )
of the aforesaid building.
SuFfOLK CO~TY DEPART~FT OF HEALTH APPROVAL
ELEL-rKICAL CERTIFICATE NO.
PLUMBERS c~KTIFICATION
N/A
N/A
N/A
uhizeignature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTEOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-35050
Date: 11/04/09
THIS CERTIFIES that the building ALTER ACCESSORY BUILDING
Location of Property: 18075 SOUNDVIEW AVE SOUTHOLD
(HOUSE NO.) (STREET)
County Tax ~ap No. 473889 Section 51 Block 1
subdivision
Filed ~4ap No. __ Lot No. __
Lot 8
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 23, 2009 purs%u~nt to which
Building Permit No. 35075-Z dated OCTOBER 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 "AS BUILT" ALTERATION OF ACCESSORY GAPQ%GE TO NON-HABITABLE ACCESSORY
BUILDING AS APPLIED FOR.
· ~ne certificate is issued to ELIZABETH P & ROY I MARTIN QPRT
(OWNER)
of the aforesaid building.
SUFFOLK COU1FrYDEPART~TOF}~ALTHAPPROlr~-L
ELBC~rKIC~J~ u~KTIFICATE NO.
PLUMBERS ~KTIFICATION DA'r~u
11/03/09
N/A
Fed S~gnature
Rev. 1/81
Form No. 6
TOWN OF 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. Fhial Approval from Health Dept. of water supply and sewerage-disposal (S-9 £orm).
3. Approval of electrical installation f~om 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:
! 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, Additions to dwelling $25.00, Altarations to dwellhig $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
LocationofFrope.y: / ::7
House No. Street Hamlet
~ ~ ~Bloek ~ c~ , ~t
Suffolk County T~ Map No lO00, Sechon & S / ~& ~
Subdivision Filed Map. ~3:
Health Dept, Approval: Unde~te~ Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate: [.// (check one)
.j~ ~/ ~Apl~icant Signature
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. 35075 Z
Date OCTOBER 16, 2009
Permission is hereby granted to:
ELIZABETH P & ROY I MARTIN QPR
18075 SOUNDVIEW AVE
SOUTHOLD,NY 11971
for :
AS BLT R3~4P ADDITION TO EXISTING SFD & ALTERATION OF ACCY GARAGE
TO NONHABILTABLE ACCY BLDG WITH TOILET & SINK PER APPROVED PLANS AS APPL'D FOR
at premises located at 18075 SOUNDVIEW AVE SOUTHOLD
County Tax Map No. 473889 Section 051 Block 0001 Lot No. 008
pursuant to application dated SEPTEMBER 23, 2009 and approved by the
Building Inspector to expire on APRIL 16, 2011.
Fee $ 600.00
Authorized Signature
COPY
Rev. 5/8/02
11/03/2009 22:34 6317652752 RBRUER PAGE 02/02
SBEI NYBT8
SUFFOLK
BUREAU
ELECTRICAL
40 Noltingham Ddve. Ml~lle Island, NY 119,~3
Telephonel: 8,31 49~ 813~ * Fax; 0~1 9~0 ~ ' E-MMI: $~.ElG$~gmail.o~m
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant:
Rough In Inspection Date:
Application No,:
RudOlph Bruer Esq
Now~mber 3.2009
11~B
Certificate No.;
Final Inspection Date:
Building Permit NO.:
~AO06
November 3,3~lOg
Count/Tax Hap No.: 10OO $1 O1 08
This Certificate of Electrical Compliance ts limlted to the inmpectlofl and compliance Of electrical equipment and/or
work described below, installed by the aOplicant named above, Ioca~ed at the premise of and not after the final
inspection ~ate above;
Owner: Roy Hal'tln
Si~e Location: ~8075 ~oundvi~w Ave~ Seuthold~ NY 11971
Owner's Address (if different):
[] Resi~lentlal [] Indoor ~ Basemem [] Service [] Shed
[] Commercial [] Outdoor [] First Roor [] Pool [] Hottub
[] New [] Re,ovation rq Sece~d Floot' [] AltJc [] Gal'age
[] Addition [] ~u~ey Other. i :
Three Pl~e Het lt,~er : ....
INVENTORY
Duple~ Re;pt
Ol~CI Re~p~ "3 :
~.~ R~
~n~ R~
T~t L~
The electrical' work and/or equipment described above were inspected and appear t= ~ in compriance
wRh local, state and national electrical code requirements anti this office.
Applicant Rudolph IBruer Esq
Inspected By: RooerRichere
License No.:
Date Of Cedtficate: Nov 03,2009
tKCHITECT
' MARK SGHWARTZ & ASSOGIATES
28493 Main R~a(I · PO Box 933 · Cu.'howl.' NY 119%
631,73~,4183 I ~ ~. mk~u'chil('cl,c,
October 9, 2009
Southoid Town Building Department
Main Road
Southold, New York 11971
Re'
Martin House
18075 Soundview Avenue
Southold, New York
(SCTM# 1000-51-01-08)
(]lOHbqOS l0 N,N~0I
'Id30 ~(]18
To Whom This May Concern:
I have been to the site, inspected the as-built work and submitted plans depicting the existing accessory
building and ramps.
The accessory building, built around 1962 and altered in 2000, has no heat and no cooking appliances.
It has been used as a Sitting Room with a half bath for convenience. The bathroom has waste piping
underground to the house waste line and ties into the existing septic system. I hereby cerl~y, to the
best of my knowledge, the framing and plumbing work have been completed as shown on plans and
meets or exceeds NYS code requirements when constructed.
Please call this office if you have any questions or require additional information.
Very truly yours,,,~ vc ~,
Mark ~hwa~
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 35075 Z
Date OCTOBER 16, 2009
Permission is hereby granted to:
ELIZABETH P & ROY I MARTIN QPR
18075 SOUNDVIEW AVE
SOUTHOLD,NY 11971
for :
AS BLT RAMP ADDITION TO EXISTING SFD & ALTERATION OF ACCY GARAGE
TO NONHABILTABLE ACCY BLDG WITH TOILET & SINK PER APPROVED PLANS AS APPL'D FOR
at premises located at 18075 SOUNDVIEW AVE SOUTHOLD
County Tax Map No. 473889 Section 051 Block 0001 Lot No. 008
pursuant to application dated SEPTEMBER 23, 2009 and approved by the
Building Inspector to exq~ire on APRIL 16, 2011.
Fee $ 600.00
ORIGINAL
Rev. 5/8/02
Town $outhold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOR~,~
PROPERTY LOCATION: S.C.T.M. I~.
Item Number.
THE FOM.OWING ACTION8 MAY REQUIRE THE SUBMISSION 0
· ~ ...... ~T~ ~DING~ D~INAGE ~D ~,~,n~ ~n~n~ m -.,
Ols~ ~on B~ --~ C~"I lel~O BY A D~t~ PROFESSI~L iN ~E ~A'~F N" ' "~ ~
(NO~: R Che~ M~ (~) ~ oe~ O~ Is R~~ f~ a ~p~te ~Uon) Yes Ho
I W'dl this ProJeof Re(ale .aJI Storm-Water Run4~f ~enerated by a Two (2') Inch Ra nlall on Sile?
(This Item will laclude all mn-off c~eated by site cleadng and/or construction a~vitlas as well as all Site
Improvernants and the permanent creaeon of ~ suffaoes.)
2 ThisD°eSitemthe Site Plan and/or Suwey Show .NI Proposed Dminnge Stmcturas Indicaling Size & LocaUon?
Proposed Grade Changes and Slopes Controlling Sudace Waten~lowl ~'/
shall
include
3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural r~
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel?
4 Will this Applicatfan Require Land Disturbing A~lvtfles Encompassing an Area In Excess of r~
Five Thousand (5,000) Square Feet of Ground Sulface?
5 Is there a Natural Water Course Running through the Site? r'~
is this Project within the Trustees jurisdiction or within One Hundred (100'1 (eet of a Wetland or Beach? ~ ~L~
6 Will there be Site preparation on Exisling Grade Slopes which Exceed F[ltee~ (15) (eel of Vertical Rise to
One Hundred (100') of Horizcatal Distance?
7 ~/lil Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Sit'tm-Water Run4Dff
into and/or in the direction of a Town right-of-way?
8 Will this Project Require the Placement of Material; Removal of Vegetatio~ and/or the Conslr~clion of r~
any Item Within the Town PJght-of-Way or Road Shoulder Area?
(This ilem will NOT include the Ins{alia(Ion of Driveway Aprons.) ~ --
9 Will this Project Require Site Preparation within the One Hundre¢ (lO0}'Year Floodplain of any Walemourse?
NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 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 Permifi
EXEMPTION:
Yes
Does this project meet the minimum standards for classlficalion as an Agricultural Project?
Note: If You Answered Yes to this Question, a Storm.Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl
Nc,
COUN O -9 ss
'""~"v'/'~'J~'"'~'Z:"'"'.~ ~..~.-~/~..L~... ~ duly s~m, de~s~ ~d says fl~t h~sh~ ~ ~c app~t for Penni~
I,
(Name ~ ~dMdua[ ~lng
..................
~d
~at
hdshe
~c
(~r~'~"~ .... :':'""': ................ ~'P~Jc;'~-~& .....
..... o~[e umw, em.) NO. 01BU6185050
O~cr ~or mp~enmdvc of~e Owner of O~cr's
..........
m~c ~ me ~s app,caUon; ~at ~1 s~cmen~ ~n~ned in fils appli~on am ~c to ~e ~st offs ~wle~ ~d ~ef; ~d
~t ~c work ~11 ~ performed in ~e intoner set fo~ ~n ~e appl~fion fi]cd hemM~.
S~m to before me ~s;
FORM - 06/07
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWel HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined
Approved
Disapproved a/c
Expiration
Ic'l 10,20 cq
U.
SEP 2 3 2009
81.OG. DEPI,
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:
ail,o: 4,e/C. ro'tWd Z Fz
Building Inspector
LICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
,20
:tely 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 enacted in the interim, the Building Inspector may authoi'ize, 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, Suffblk 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 regulaf~:~ and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applica~t~r name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, les engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises gO~ /f~d} ~ '7" /At/
(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:
R a c,
House Number Street
s-/
Hamlet
County Tax Map No. 1000 Section Block O [ Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises_an~djot~nde~u~se and occupancy ofl2roposed construction: a. Existing use and occupancy ~
b. Intendeduseandoccupancy -" /'-" '"'~'~/'lor~hff b/'-~b/ff'
3. Nature of work (check which applicable): New Building '~n
Repair Removal Demolition Q~her W~ork~
(Description)
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, _commercial or mixed occuEancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height. Number of Stories
Dimensions of same structure with alterations or additions: Front ~
Depth. Height Number of Stories
· ,Rear
8. Dimensions of entire new construction: Front
Height ~ Number of Stories
9. Size of'lot: Fron~t~' "~'6/t~' O' ~'~ear
Rear .Depth
.13enth~,._ , ,,, ~ ....
11. Zone or use district in which premises are situated ~r--aJll~rO ~'
12. Does proposed construction violate any zoning law, or~(n~anc~e or regulation? YES
13. Will lot be re-graded? YES__ NOXWill excess
14. Names of Owner of premises t/~,q/~ ~'(t~/ Address
Name of Architect 0'C/4&'~,~/g~ t ~ Address
Name of Contractor Address
NO
fill be removed from premises? YES__
Phone No.
Phone No
Phone 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 foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 f~et 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.
NO ~
STATE OF NEW YORK)
COUNTY OF5 k~l~S:
~/~/4/~ ~ ~/tl~-~r~g FF._ being duly swom, deposes and says that ($~l~t~l~DtSU~gttlicant
(Name of individual signing contract) above named, Notai7 Public.State of New ¥or~
No. 01BU6185050
Qualified in Suffolk County ~.-,
(S)He is the ,/~/~ C./-7t7 '7~//~e ~./y Commission Expires April 14, 202~L
(ContractOr, Age~t, 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 .
g~2~ d a y o f ~2.,.,.,.,.,.,.,.,~'~~ 200~
Notary Public
OWNER
TOWN OF SOUTHOLD ~OPERTY RECORD CARD
STRE.'r / 0¥5
VI LLAGE
DISTRICT SUB.
LOT
~dP~MER oWNE~P,', , - .
RES. ,,.~/.ai\~l SFAS. I VL.
TYPE OF BUILDING.
LAND
IMP. TOTAL
:~q oo
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total
~ e~ o
?/0 a //~ o
FARM
DATE
COMM.
REMARKS
IND. CB. J MISC.
Garage
.3/
Eoundation
Basement
Ext. Walls
Bath
Floors
Interior Finish
Fire Place Heart
Porch Attic
Porch Rooms 1st Floor
Patio Rooms 2nd Floor
Drivewgy
I~/~- '- 30#/
7'-0" 14'-0"
PLd~I
2N LE
, n.
~, :
UN. :..~ RITERS (
,./'
~N HABITABLE ACCESSORY BUILDING
(UNHEATED)
COVERED PO~CH x__ ~
4'-4V~"
3fill CEZ TIFIOA TION
~D CONTENT BEFORE
0
tCA TE OF OCCUPANC ~ALF BATH
~ER USED IN WATER~
~ SYSTEM CANNC ?'
II II
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
-
5URVET' OF PROPERTY
.GtTUA"I~.' .GOUTHOLP
TOINN, 50UTHOLO
.%IPT::OLK GOUN'I'Y, NY
~URV'EX'ED: AUC~UST 26, 200q
COMPANY OF
9.-<3
N89°54'30"E '100.00'
Sound