HomeMy WebLinkAbout35063-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34565 Date: 09/17/10
THIS U~KTIFIES that the building ACCESSORY GARAGE
Location of Property: 2685 BOISSEAU AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 5 Lot 14
Subdivision FiledMap No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 1, 2009 pursuant to which
Building permit No. 35063-Z dated OCTOBER 8, 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 UNHEATED ACCESSORY BARN WITH NO ELECTRIC AS APPLIED FOR.
T~e certificate is issued to ROBERT G & CAROL A BOHN
( OWNER )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPRO~rAL
E~.R~-rKICAL c~KTIFICATE NO.
pLUMBERS C~K'rIFICATION DA'r~u3
N/A
N/A
N/A
~~~ature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUII/DING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
35063 Z
Date OCTOBER 8, 2009
Permission
is hereby granted to:
ROBERT G & CAROL A BOHN
PO BOX 55
PECONIC,NY 11958
for :
CONSTRUCT ACCY BARN IN REQUIRED REAR YARD, NO HEAT OR ELECTRIC,
PER APPROVED PLA-NS AS APPLIED FOR
at premises located at
County Tax Map NO. 473889 Section 055
pursuant to application dated OCTOBER
Building Inspector to ex]Dire on APRIL
2685 BOISSEAU AVE
SOUTHOLD
Block 0005 Lot No. 014
1, 2009 and approved by the
8, 2011.
Fee $ 668.00
Authorized Signature
Rev. 5/8/02
ORIGINAL
Form No. 6
TOWN OF SOUTHOLD
APPLICATION FOR CERTIFICATE OF OCCUP3 ~ICy
This application mU~t be filled ia by typewrlter or ink and submitted to the Building D pallment ~~ng:
A. For new builrHug or new
"1. Final. ~urv~y of proplm'y with accurate location of all buildings, proPerty lines, streets, and unusual natural or
topographic features.
.2. Final APProval fxom Health Dept. of water aupply and sewerage-disposal (S.9 form).
3. Approval of electrical installatiOa'lSom Board of Fire Underwriters.
: 4. Sworn statemeat from plumber ceitifying that the solder used in system contains less than 2/! 0 of 1% !eacL
'5. C°mmemial building, industrial building, multiple resideneas and Similar buildings and installations, a ~fi~te
· o f Code Compliaace from arohiiect, or engineer responsible for the building.
'6. Submit Plan,i-g Board Approval of~completed site plan requirements.
B..For existingbuildings.(prior to April 9~ 19S7) non-eanforming uses, or buildings and ~'pre..existing- land uses:
1.. Accurate survey of property showing all property lines, s~'eets, building and unusual natural or topographic
features.
2. A properly completed application and consent to tnSpect signed by the applicant. If a Certificate of Occupancy is
denied, thc 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,
Swilnming pool $25.00, ./gecoSsory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of OccupancyonPre~existing Building- $100.00
3. ' Copy ~f'Certificate of Occupancy ~ $.25
4. Updated Certificate of Occupancy - $50.00
5. Tempogary C, ertificate ot~Occupaney - Residential $15.00, Commercial $15.00
'New Comstmction:
Locatign 9f Prope~.
/
Date·
,. L~ Old or Pm?existing Building:
House N& '
..Owlier or owanr~ of property:. ',' .~(~, J~
Subdivision
Health Dept. Approval:
Planning Board ApProval:
Request for: Temporary Certificate
Fee Submitted: $ ,e~ ~-'~,~49 ~
(check One)
Hamlet
' Dat6'0fPermit.
Street
Filed Map.
Applicant:
Lot:
Undmvrit appro :.
Final Certificate: (check one)
CONSPECT ENGINEERING
P.O. Box 162
Pearl River, New York 10965
845-300-0707
9/10/2010
RE: Bohn Garage ~ 2685 Boisseau Avenue, Southold, NY 11971
Permit # 35063
The concrete foundation at the above location has been built according to the approved plans and
to all applicable building codes and standards.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS~JL-~TION
[ ] FRAMING/STRAPPING [/./]"FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION _[ ] RRE RESISTANT PENETRATION
REMARKS: (~'9~ ~ ~. jty-.__.~ ~ ~
INSPECTOR~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAI~L
SOUTItOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined
Approved
Disapproved a/c
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: "7(.~ ~'--- [ I i ~]
['1' ( ~ ,20 [I
Expiration ' ,
~ ] Buil~n~-spector
l~0 A~[CATION FOR BUILDING PERMIT
Date 6) ~,,T \ ,20 O ~
INSTRUCTIONS
a. This application MUST be completely filled in by t~ewriter or in ink and submitted to the Building ~spector 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 wate~ays.
c. The work covered by this application may not be commenced before issuance of Building Pe~it.
d. Upon approval of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such a pemfit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in pa~ for any pu~ose what so ever until the Building Inspector
issues a Ce~ificate of Occupancy.
5 Eve~ building pemit shall expire if the work authohzed 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
prope~y have been enacted in the interim, the Building Inspector may authohze, in writing, the extension of the pe~it for an
addition six months. Thereafter, a new pemit shall be required.
~PLICATION IS HEREBY M~E to the Building Depa~ment for the issuance of a Building Pe~it pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin~ces 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
auth°rized inspect°rs °n premises and in building f°r necessa~ inspecti°ns'C~~ ~
~ignamre of applicant or name, if a co¢oration)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~ (~,.eq- ~-~0 blOk.)
(As on the tax roll or latest deed)
If apj2~icant is a corporation, sigl~ture 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:
House Number Street
County Tax Map No. 1000 Section
Subdivision
Hamlet
Block
Lot
Filed Map No. Lot
State existing use and occupancy of premises and intended use and occugang~ of proposed constructi,,n:
a. Existing use and occupancy
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost /5~o~ o -- Fee
If dwelling, number of dwelling units
If garage, number of cars
t,-~ Addition
Other Work
Alteration
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front
Height~.----------~~ Number of Stories
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height,
8. Dimensions of entire new construction: Front
Height ~ -2~ Number of Stories
9. Size oflot: Front I g~,(~' Rear I~o 5"-
Number of Stories
Rear /4 ~
.Depth ff'-'~g)
.Depth
Rear
L[O
10. Date of Purchase 7.000
Name of Former Owner (/_A 5~-
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zo~ law, ordinance or regulation? YES NO
/
13. Will lot be re-graded? YES NO d,/ Will excess fill be removed from premises? YES NO
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address
Address
Address
Phone No. ray/
Phone No
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 ~UIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO t/'
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO J
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 sm, v'ey.
18. Are there any covenants and restrictions with respect to this property? * YES NO f
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
CO~
( } ("'-.---'~''''k4 ~ 7~ being duly sworn, deposes and says that (s)he is the applicant
'"--4,Ndme of imf~vidual signing c-"~ct) above named,
(S)He is the
(Contractor, Agent, Co,orate Officer, etc.) uommissi0n
of said owner or owners, and is duly authorized to perfo~ or have perfo~ed the said work and to m~e and file this application;
that all statements contained in this application are tree to the best of his ~owledge ~d belief; and that the work will be
perfo~ed in the manner set fo~h in the application filed therewith.
Sworn to before me this . r
1~ day of C)~~ 20 C) c3
Notary Public
TOWn of Sout old
sion, Sedimentation & Storm-Water Run-off ASSESSMENT
PERTY LOCATION: $.C.T.M. ~
THE FOLLOWING ACTIONS MAy REQUIRE THE SUBMt;=;nN OF II
~ ~,r~ED BY A u~ r~ur~lO~L IN ~E STATE OF N~ YO~,
~ Num~n (~: A C~ M~ (~) ~ ea~ O~m Is ~ f~ a ~ta ~i~n) Yee No
1 Will Ihla Project Retain All 8tarrn~Water Run-Off Generated by a Two (2") Inch Rainfi;dl on Sita?
.(This Item will thdude all mn-off c~eated by site cleadng and/or construction activities as well asjll Site
~mprov ,ef~is and the permanent =reatlofl of Imper~,ous surfacas.) ~'~u ~ O~ -~ _~c, k
2 D°es ~he alta Plan and/°r Survey Sh°w NI Pmp°sed Dmtnage Stroct~as 'ndica0ng Size & L°cati°~ ~ ~
This item shall include all Proposed Grade Changes end Slopes Conbollln~ Surface WaterFta~
3 Will ~his Project Require any Land Filling, Grading or Excavation where there is a change to the Natural r'~
Existing Grade Involving moro than 200 Cubic Yacks of Matadal within any Parcel?
Five Thousand (5,000) Square Feet of Ground 8udace?
Is thie Project within the Treateas ledediotion or within One Hundred U00' toot of a Wetland or Se~ch'~
6 OneWill thereHundredbe Siteog0,]preparationof Horizontal°n ~xistingDisthnce?Orado Slopes which Exceed Fifta~n It 5~ tact of Vertical Rise to
7 ~,f'~ll Driveways, Parking Areas or other Impervious Surfaces ~e S~oped to Direct Star'-Water Run-Off r'~
into and/or in the direction eta Town ;ight-:of-way?
8 Will this Project Require the Placement of Material. Removal of Vegetation and/or the Construction of
any Item Within the Town Right-of-Way or Road Shoulck~ Area? ~L~
(This item will NOT include the Installation of Driveway Aprons.)
9 Wtil this Project Re0uire Site Preparation within the One Hundred (100)'Year Floodplain of any Watemourse? r'~
NOTE: If Any Answer to Questions One through Nine is Aeswered with a Check Mark In the Box, a Storm.Water, Grading,
Drainage & Erosion Control Plan Is Required and Must be Subreitted for Review Prior to Issuance of Any Building PermRl
EXEMPTION:
Yes N._.9.o
Does this project meet the minimum standards for cisssitication as an Agricultural Project?
Note: ~fY~uAnsweredYest~thisQuest~n~aSt~rm~ater~Gradtag~Dreth~ge&Er~si~ntr~PianisN~TReq~ired~
STATE OF NEW YORK, z-/-- . C C0~NIE o. BUNCH
oou , ...........
' No. 0i806185050
..................................... C0 Ou~ ~,~,~un~ )~
{Na~ of indMdual s~iag ~tl
Sworn to before mc this;
Notary Public: .%..~ ............ ..% ...........
And that he/she is the
(Owner, Contractor, Agent. Corporate Office~. etc.)
Owner and/or representative of the O ncr of Owner s, and ~s duly authorized to peffom~ 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 herewith.
(Signature of AO01~:a~t}
FORM - 06/07
TMf: 1000-55-5-
GUAK4NTEEO TO:
Robert G. 8ohn
Carol Ann gohn
Chlcogo ~#e ins. Co.
Cendont Mortgoge Corp.
N/F Ouod .
~ CUL~IVATED RELD ~
N/F Miloski
SURVEY OF
DESCRIBED PROPERTY
SITUATE
SOUl'OLD. TO~ O~ SOU~HOLD
SUFFOLK COUNT~, NEW YORK
SURVEYED: '7 Ju~, 1988
SCALE: I '~60'
AREAS, 94,706.82 S.F. or
l ; 7~ ACRES
'l'o~n ltall Annex
51375 Main Road
P.O. Box 1179
Southold, N Y I 1!t71-0959
Telephone (631) 765-1802
I:ax (63 I) 7(;5-9502
131 IILI)ING I)EPARTMENT
TOWN OF SOUTHOLD
August 23, 20'10
Robert Bohn
PO Box 55
Southold, NY 11971
RE: 2685 Boisseau Avenue, Southold
NOTE: Please submit certification of foundation per the Building Inspector's request.
TO WHOM IT MAY CONCERN:
The following items are needed to complete your Certificate of Occupancy:
~ Application of Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
A fee of $25.00.
__ Final Health Department approval.
__ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
__ Trustees Certificate of Compliance. (Town Trustees #765-1892)
__ Final Planning Board approval.
__ Final Fire Inspection from Fire Marshal.
__ Final Inspection from the Building Dept.
__ Final Landmark Preservation approval.
Building Permit: 35063-Z accessory barn
07-30-09;05:51AU;R@S ESTIMATING DEPT
;631 996 3456 # 3/ 4
6.5-7 ' e.~7 7.1~. 1-B-B
07-30-09;05:51AM;RBS ESTIMATING DEPT
;631 996 3456
,, ! ,iii - O! I I~.,_:~ i i, , WIND-BORNE DEBRIS PROTECTION FOR WOOD STRUCTURAL PANEL '"'
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WIND LOAD PATH CONNECTION AND CONSTRUCTION DETAIL DRAWINGS
i · ~iDE WALL FLY,MING
D~
BY:
~ ~' "~ ~J ~'~ ;5~1 SHEET NO:
N E RAL N CT E S W,ND F.AM,NG NOTES I N^.L,.G S..ED.LE, P~..O.TE.TS~
ROOF FRAMING: _o _c _CU.ANCy CLASS,.~C^T,O. R3 RES~D~nA~
CONSTRUCTION NOTES: inelc~e~ld°fthec°~lar,eneedn~exceedlfletal~lated.um~r°fSdll~in~ RAFTERTO 8'WALL:~C~MM~N EACH TOE4~jli
a~ ~ tM~e 3.3. I,~, ~ter ~- ~u do rm~ fall I~1 line wl~ ~uds b~, taffeta DESIGN CRITERIA
,~,,~ s~ =~,..,., ~...~.~,. ~,~... ~ ? ~,.. ~. ,~,.m WALL FRAMING: ST~.S
~1 W~,~..,,,.~,~,~.t.~,"~r~'~.t~.'~'~". ~I.~,~,~'~O.S"~.W~CO..~CT~C~= ~o~rro~ ~.~TO: ~. F~ I CLIMATIC & GEOGRAPHIC DESIGN CRITERIA
FOUNDATION NOTES: r~ll~m~e~l~.¢~e31~btim.~a~ FL~J~ST,~Dj~ 2.1~M~ F~ i~NOTE:I,:
~d~l)~i~e ,) I~RI~S~LC~NEC~ONS: FLOOR F~MING:
I
~n~~.~unh~l~ ~) ~EC~S~OUNOE~R~RW~L~NINGS: SlLLT~ORGI~R 4'~C~M~ I JOinT ~ ROOF SHEATHING REQUIREMENTS FOR WIND LOADS:
s) ~ ~ ~ ~ ~ a ~ 18~4' ~.ln~a, o~ ~e~. ~ JaST ~ NOTES
~"~"'" ~' DECK AND COVERED PORCH NOTES: Jo~LEO~E. ~. T~
F~MING NOTES ~.~,~'~'~"'~'~"~"~ : ~ ~ '
2) U~n~,~l"O~l~l~"2+B~ ~g~.~,~l~di, ~,i,~ ~UC~P~EL ~ ~,~T~,e WALL SHEATHING REQUIREMENTS FOR WIND LOADS:
4~ ~J~= ~ ~' U~ =n O = CEILING SHEATHING:
~1~ L~ h~ ~ h~ (3)~ ~ and (=)~ len~ ~ ~ "~ '"' d WALL SHEATHING: NOTES
.~.~,~m PLUMBING NOTES ?/~ ~U~I ~OC.E~
~ ~. ~ ~,~ ~ ~ ~ ~ ~h~. ELECTRICAL NOTE S: ~ ~ ~ ~' ~ ~'~ ~'
OCCUPANCY OR
USE IS UI,!LAWFUL
WITHOUT CEF;TIF!CATE
OF OCCUPANCY
-'p ~,~ P...
ALL CONSTRUCTION SHALL
MEET TIdE REQUIF;EMENrS OF THE
CODES OF NEW "/O~}K STATE
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE,
APPROVED ~,S NOTED
NOTIFY BUilDiNG D?hRTMENT AT
76548O2 8AM TO 4P'~ FOR THE
FOLLOWING JHSPECT~ONS:
1. FOUNDATION - TWO REQDtRED
FOR POURED CONCRETE
2. ~OUGH - FRAMING &PLUMB[NG
3, INSULAT~ON
4, FINAL * CO[iqTRUCT~ON MUST
BE COMPLETE FOR C 0
ALL CORSTRUCTION SHALL ~EET THE
REQUIREM~NTS OF THE CODES OF NEW
YORK STATE, NOT R~SPONSJBLE FOR
DESIGN OR CONSTRUGTIOA ERRORS.
CERTIF!CATION OF
NAILING & CONNECTIONS
REQUIRED.
L
f-
SCALE: I/Z-I ~'~
DATE:
APPROVED BY
NUMBER
:L