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Home My WebLink About35210-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34574 Date: 09/20/10 THIS U~TIFIES that the building ADDITION Location of Property: 2855 BAY SHORE RD (HOUSE NO.) (STREET) County Tax Map NO. 473889 Section 53 Block 6 subdivision Filed Map No. __ Lot No. __ GREENPORT Lot 3 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 7, 2009 purs,,mnt to which Building Permit No. 35210-Z dated DECEMBER 11, 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 COVERED FRONT ENTRY AS APPLIED FOR. The certificate is issued to 2855 GREENPORT CORP. (OWNER) of the aforesaid building. COUNTY DEPARTMENT OF HEALTH APPROVAL RT.Rt-rKICAL C~aTIFICATE NO. PLI~BERS CERTIFICATION DA'i'~43 Rev. 1/81 r~/A N/A N/A th/ized/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. 35210 Z Date DECEMBER 11, 2009 Permission is hereby granted to: 2855 GREENPORT CORP. 2855 BAYSHORE RD GREENPORT,NY 11944 for : CONSTRUCTION OF A COVERED FRONT ENTRY AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 053 pursuant to application dated DECEMBER Building Inspector to expire on JUNE 2855 BAY SHORE RD GREENPORT Block 0006 Lot NO. 003 7, 2009 and approved by the 11, 2011. Fee $ 200.00 / Aut hori~d Signature ORIGINAL Rev. 5/8/02 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. 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: 1. 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, Alterations to dwelling $25.00, Temporary Certificate ~ Occupancy - Residential New Construction: Old or Pre-existing Building: LocationofProperty: ~-- ~2X4 ~.~'~ ~ House No. ~ * '~'~' Street Owner or Owners of Property: 2 ~.~'~.~- t/q~ .g' ~ ~ ~,~ ,De9 ~---q5- Subdivision 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. $15.00, Commercial $15.00 Date. (check one) Ham~let - Permit No. 35~10 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Suffolk County Tax Map No 1000, Section ~' ?) Block (o Lot ~.~ Filed Map. Lot: Date of Permit. t ~ - ti - O~Applicant: ~J/~ Underwriters Approval: Final Certificate: (check one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~I~MING / STRAPPING [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ,~ ~ · DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FIREPLAC [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~/~.) ~'~S /v~-/4~ DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 [ ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING INSPECTION I [_ I~S~]LATION [ ~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT COflSTRUCTION [ ]FIRERESISTANTPENETRATIOfl REMARKS: DATE INSPECTOR ~:~D I~$P~TION I~PORT DATE, ~ CO~TS rO~ATION (1S~ ~ ~ ~o~o~ (~) ~ ~ . g .. . _. ~ ~$~ON PER N, Y. ~ STATE E~R~ CODE ~ ~ /f/~ ~ . ~~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined {¢/ , 20 O ~ Approved /¢! , 20~ ~ Disapproved a/c Expiration ~/l i , 20 l/ DEC 7 BLDG. DEPI. }OWN OF SOUTHOLD a. lhlS apphcation MUST be co: PERMIT NO. ~5~0'~ DEC BLDG. DEPT. TOWN OF SOUTHOLD ~tor BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health ---~ 4 sets of Building Plans Planning Board approval "--..A Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: PPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS /9-/o 7 ,200~ tpletely 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 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. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~II'ff-.AM(~-~ g/4Ag~O ~p,g~.~' 8~ya~r)t/~ (As on the tax roll or latest deed) If afi"b-l'~ant i~/]a corpp~a~ig(0, signature of duly authorized officer ~"(Nam¢ and title of corporat~offic/er) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on w_hich pro, posed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block O000 Filed Map No. Lot 00~ Lot 2. State existing use and occupancy ofpremises_,and intended use and occt~pancy of proposed construction: a. Existing use and occupancy ~6,' ./rid, r~4. ~_ t2_ b. Intended use and occupancy .~'Ca,vq~ ,v]//C~ ~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal D fm 6 ii~i-qn-i.~ ;i "i~ ~7~ ,~ i~i~ib~t~ w~ rk t, i.''i, ;~ \'7 !t q ,. ~ilc~"I t (D~scription) 4. Estimated Cost~t_~~''OO' 0 t) i ! t: Fee , I i;;. t" -, ~ (~.olb, b paid on filing this application) If dwelling, number of dwelling units ~ Number of dweiiing!t~n~s~ on each floor , 6. If business, commercial or mixed occupanc~,'g~-e&ffy-nattire and extenvof'eath type of use. 7. Dimensions of~e:~isting~slructures, if any: Front ~ Rear _Depth Height ¥ ~-~ ~ ' Numberof Stories Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories 8. Dimensions of entire new construction: Front !/.p t Rear Height [o~. ~ ~ q Number of Stories 9. Size 0riot: Front Rear Depth 10. Date of Purchase .~,/.2. o O I~ Name of Former Owner Rear _Depth 11. Zone or use district in which premises are situated 12. Does proposed consiruction violate any zoning law, ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES__ NO X Will excess fill be removed from premises? YES NO 'X 14. Names of Owner of premises t~;(_/4 ~4 ~zoO Name of Architect d2ALO ~/O/~rl0q, F'~t Address2~ ~fl~i~oq SFO¥$t'o,P, hone No Name of Contractor Address t~/4-v/ tf,'~ Phone 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 cfa tidal wetland? * YES __ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Address ~ 7,/J~ i~ b~/~ Phone No.'-~/&' 3 ~'/~.ZO3~ 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 NO X · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF h~,,.-~i'ta~ ) ~l~ ~, ¢,,~ ,~ ~ ~. being duly sworn, deposes and says that (s)he is the applicant (Nmne of individual signing contract) above named, (S)He is the ¢~'t' t .O, t,..,~ ~4 Z.o¢ &'-~ ~- _~ .~1~, ~~ (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have pedbrmed 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 perfbnned in the manner set forth in the application filed therewith. Sworn to before me this ~_ ~,,a~ day of .~ ;,;otaryP-ut:~, State of New York ........... 76741 Notary Public Qualified in Nassau County Commission Expires Signature of Applicant /660-5'~-( '-,~ TOWN OF SOUTHOLD PROPERTY RE¢:ORD CARD OWNER STREET ~.< <~7,.~5 VILLAGE DIST~. SUB. LOT ~..,,~ ' FORMEJR~..W~NEI~5'I_)hte~O~/i~ ~'N / E ' ' ACR. ~.L~ ~ lit ' -' N~ NOR~L BELOW ABOVE , F~RM Acre Volue Per Volue ' Acre Tilloble 1 Tillable 3 Woodlond Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH / ~ ~' ~ ~ BULKH~D Totol D~K COLOR Extension Extension Porch Porch Breezeway Garage Patio Total Foundation / ~ ~-~ Basement Ext. Walls Fire Place Type Roof ROOIT Dormer Driveway F ,II Bath Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd FIo~ KDinette DR. ' BR. FIN. B. 53.-6-3 3/08 COLOR TRIM r~M;..B~ld4-~ Z3'~2-~~ 5~"2~',/ ~'~ 5~ ~5~ Foundation ~ Bath Dinette Extension $ X [~ = ~ [ Basement SL*S Floors Kit. ~n~ ~~ 7~ ~ ~le Ext. Walls ~ ~,~, Interior Finish ~. L.R. Extension Fire Place ~ Heat ~ D.R. Patio Woodstove o ~k ~ BR. ~-~ ~ ~ Z~ ~ ~ ~ Ze~ ~?~ Dormer Fin. B. Deck ?~2~ = ~ ,~ ~ Attic Breezeway Rooms 1st Floor Garage I~ ~1~ = ~ tS~ /7/ Driveway Rooms2nd Floor OmB. / Pool ~ 1 7~ // ,/// / I . ,.Town o_ f Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M. ~: TNB FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A -- (~'-~ (~0~)~:~ ~ ..~TORM-W.,A¥.-~, GRADING, DRAINAGE AND EROSION CONTROL PLAN District $~'flon Block Lot ¢-F.R¥iFIED 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-Watar Run-Off Generated by a Two (2") Inch Rainfall on Site? ~1~ r~ (This item will include all mn-off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 2 D°es the Sita Plan and/or Survey Show All Praposed Drainage Structures Indicating Size & Location? ~ r~ This Item shall include all Proposed Grade Changes and Slopes Controlling Suffaca WatarFIowl 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural ~'~ Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet ora Wetland or Beach? 6 oneWill there be Site Preparation on Extsfing Grade Slopes which Exceed Fiftaen (15) feet of VerUcal Rise tOHundred (100') of Horizontal Distance? r~ ,~ 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct StomvWater Run-Off into and/or in the direction of a Town dght..of-way? any Item Within the Tow~ Right-of-Way or Road Shoulder Ama?~L~ (This item will NOT Include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100)Year Floodplain of any Watemourse? NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark In the Box, a Storm-Water, Gradtag, Drainage & Erosion Control Plan is Required and Must be Submlffed for Review Prior to Issuance of Any Building Permit! 9 EXEMPTION: Does this project meet the minimum standards for classification ss an Agricultural Projec~ Note: If You Answered Yes to this Question, a Storm.Water, Gradthg, Drainage & Erosion Control p an is NOT Required! Yes No STATE OF NEW YORK, COUNTY OF ..~.~ ....................... SS ThatI 2kC-~ ~o, ~./Z4..t,tO be' .................................................................... mg duly sworn, deposes and says that be/she Is the applicant for Permit, (Name of Individual signing Occdme~) (Owner, Contractor, Agenl, Coqx~cate Officer. e~c.) Owner and/or representative of the Owner of Owner's, 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 herewith. Sworn to before rne this; .......... ~.....-~.-- ......................... day of ..~....~.....O'..,~...C ............ 20..0...~ molary Public' .Z~~O~! · ..].. ................................... ~IG.**02 H Lt4ffFt~?4t ............. / Qualified in Na,ssau County (Signature Of Applicact) FORM - Og/07 Commission Expires ~/fl , GENERAL NOTES GENERAL CONDITIONS AND NOTES FRAMING & ROUGH CARPENTRY ELECTRICAL GYPSUM WALLBOARD ROOFING CONCRETE PWI LLIN5 / / ,/ --A PLAN BXBTIN 12 2X4 C,T, 16'O,C, ..,~.~6"FORCHPOST / POU~P CON& FOOTiN~ 2×8 HOUSB PI[~BR~AS5 ~OOf :BLT '£PY, PLYWOOD R,R, 16" O,d, Z) ~ I.BAPgBR ALL cONST~ ? ." TH= REO-,, cODES OF NT,~ .........:' B(BT1N~ CONE, POO~N~ ~--~P ~HiTHOL:%,' "" RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OATE:~-~ Al~ QOF[5}fRUC]lO'q SHAtL MEET THE PgOPOSgD POgC UNDERWRI~R8 OE~FIOATE , REQUIRED FOR: 2855 Bayshore Road GreenpoR, ~ Drawn by: Date: BLADYKAS & PANETTA MJR 11/23/2009 L.S. & P.E., P.C. Oyster Bay, N.Y. SCALE: 1/4"= 1'-0" (516) 922-3031 ~kOOl~ JOBT CUT LENGTH Sl~mpson Strong Tie H3 Simpson Strong-Tic HGAt0 NAILING SCHEDULF ROOF FRAMIN(~ FtDOR_.~ GENERAL NOTES GENERAL CONDITIONS AND NOTES NEW YORK STATE ENERGY CODE FRAMING & ROUGH CARPENTRY ELECTRICAL GYPSUM WALLBOARD ROOFING BONCRETE Edges, 6rI On center Field, 12" on center ROOF SHEATHING AND WALL SHEATHING ATTACHMENT DIAGRAblR PI,ANS OF PROPOSED PORCH FOR: 2855 Bayshore Road Greenport, NY by: Date: BLADYKAS & PANETTA Drawn M JR 10/29/2009 L.S. & P.E., P.C. Oyster Bay, N.Y. SCALE: 1/4"= 1'-0' (516) 922-3031