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Home My WebLink About36016-ZTown of Southold Annex 54375 Main Road Southoid, New York 11971 7/27/2011 CERTIFICATE OF OCCUPANCY No: 35088 THIS CERTIFIES that the building Location of Property: Date: AS BUILT DECK 7/27/2011 11365 SOUND AVE MATTITUCK, SCTM #: 473889 Sec/Block/Lot: 141.-3-6.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated 8/30/2010 pursuant to which Building Permit No. 36016 dated 11/9/2010 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" deck addition to an existing one family dwelling as applied for. The certificate is issued to O'shea, Tara (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERi, IT NO. 36016 Z Date NOVEMBER 9, 2010 Permission is hereby granted to: TARA P O'SHEA 1533 YALE ST - APT D SANTA MONICA, CA 90404 for : "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 11365 County Tax Map No. 473889 Section 141 pursuant to application dated AUGUST Building Inspector to e~ire on MAY SOUND AVE MATTITUCK Block 0003 Lot No. 006.002 30, 2010 and approved by the 9, 2012. Fee $ 400.00 AutHorized 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 preperty with accurate location of all buildings, p~-operty 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 PI .a~ng 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 $ l 5.00, Commercial $15.00 New Construction: Location of Property: Date. II- / 0 Old or Pre-existing Building: House No. Street Owner or Owners ofProperty: '-~.~.~,_ 0~ ~C.~,.~ ~/~ Suffolk County Tax Map No 1000, Section [ ~t ] Block Subdivision 3 6o! Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted:$ _~'"0 , ~I~r~P DateofPermit. ti- ~ ~' (check one) Hamlet Lot ~. ,~ Filed Map. Lot: 1~) Applicant: ~ ~V~ Underwriters Approval: Final Certificate: ~/(check one) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY ] ROUGH PLBG. ]Ii~~AL TION ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT ~ONSTRUCTION ] FIRE RESISTANT PENETRATION []ELECTRICAL (ROUG/H~.~ ~LEC~AL (FINAL) REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined /'/ ~,20 /tO Approved fl/~'{' , 20 J 0 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 Disapproved a/c BLDG. I}[~I. q 11~, OF S0UlH0tl~ Expiration S / ~7, 20 / ~ 4 Building Inspector :t: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date 20 INSTRUCTIONS 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 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 a~er 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. ~~~ (Signature of appl~ant or name, ifa corporation) (Mailing address of applicant)~_7[ State whether applicant is owner, ~ agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises '-"'~'~, (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 LicenseNo. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Subdivision Section Block Filed Map No. \qt-3-g'- Hamlet Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~,~M~_. ~/x" \~ '~D~YK b. Intended use andoccupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work L~LC) ~f~K ~ r ....7-~' ...... · 7-7. (Description) 117 ............ ~-~'!)-. i (To be paid on filing this a~plication) 5. If dwelling, number of dwelling units,~umD.erl of~4~etling units on each floor_ Ifgarage, number of cars fda1 ~ bi; ~ ?J l,! ' .]- ]l -J f h f 6. Ifbus~ness, commercial or mixea {)ccupancy_, ,s, pe~i~'y]jb.TtTreande>ltento' I - e"~. ' ~r eac typeo use. 7. Dimensions of existing structures, if any: Front ~:~ " Rear I ~:~ Depth /'~CI l Height ~"~ ~ ~'~ p;;?k,~ Number of Stories ~ ~."~or.~ Dimensions of same structure with alterations or additions: Front ~ Rear Depth ,..~ Height ~.*'~ Number of Stories 8. Dimensions of entire new construction: Front ~ O. k .~ l R~e2r X~)td~ .Depth Height 1~ x Number of Stories Size oflot: Front \ \k / Rear 11~ Depth I?~' ~q(::, 10. Date of Purchase ~,OO '~- 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. WilI lot be re-graded? YES (~_Will fill be removed from YES excess premise's? 14~ Names of Owner ofprem~ses~'PX~'~ C~o,~5 Address -'~0 ~O~,q:~ Phone No. ~,O Name of Architect *-'r'o¥,, Pkoq.~e-%~-~ ~ Address ~11 ~~ Phone No lb~ Name ofContractor-~_ ~ .lv~.~'P lb \~G ~ Address' ' ~l~~:t:~hone No. ~ ~ '~q~.~ '~'~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *Y~S * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS M,.~BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES * 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 NI~W YORK) COUNTY O F~l, t3~k ~--)S: T(&.I~ (~1 ~_~ ~ ~ r ~'-~ O/") " being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~']t~ ,1~ ~ (Conu:~or, A~eni, Corporate Officer, etc.) of said owner or owners, and is duly author/zed 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. Sw ° (~t ;be f°~ea~noe ;his .~. fi/.1 JW Notary Public Notary Public, St~_ ~ _N_ew ~/,/~''~¢; ' S i~ture ~f/A~(ant . ..N,.o..01T0~6!,9.0.626 . t~ UUalifioo in ~IJITOIK UOUnlY ...? Commission Expires My ~8, 21:1 [_~ TOwn of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOR..q PROPERTY LOCATION. S.C.T.M, #: . STORM-WATER~ GRADING~ DRAINAGE AND EROSION CONTROL pip"' DIsbict ~ Block ~ CERTIFIED BY A DESIGN ~A~r=~IONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CON&'I'IIUCHON ITEM///WORKA,q,q¥.q,~MENT 1 Yes No a. Y'~at iS t~ Tofa[ Area of the Project Parcels? (In.clude Total Area of all Parcels located within I Will this Project Retath All Stom~Water Ran-Off ~ScopeofWorkforprOpesed~)~ , GenemtedbyaTwo(2")thchRaJnfallonSite? b. Wh~ is the Total~ea of Land Cledl~ (s~=' I ,~es) (This item will include, all mn-off created by site and/or Ground Disturbance for the proposed clearing and/or construction acfi~ties as well as all constructien acUVRy? Site Improvements and the permanent creation of Impervious surfaces,) (S.F.I~) 2 Does the Site Plan and/or Survey Show NI Proposed PRO¥~DE BRIEF PROJEC]' DESCrY[ION (P,w~Pq~a~N~3 r~ Drainage Simctures Indicating Size & Location? This '~' Item shall Include all Proposed Grade Changes and i 33 ~' I ~ ' '~) ~ Slopes Controlling Surface Water Flow. ~"-Y-*'~ %C=~-'.~ ~ ~.C:~%~ 3 D°esthesitePisnand/orSurvaydesoribetheerosion and sediment control practices that will be used to /- cenb'ol site ereslon end storm weter discharges. This ~ item must be mathteined throughout the EnUm ~ r~ ~n ~'~ I{ ~// r~ ~.~ construcitonPeriod. ~L~,~ - - 4 Will this Project Require any Land Filling, Gmdlog or Excavation where there is a change to the Nateml J U ~ ~0 ~ ~_~ Existing Grade Involving mora than 200 Cubic Yards of Material within any Parcel? 5 Will this Appllcation Require Land Disturbing AcUvities E~ X Encompassing an Area in ExCess of Five Thousand BLDG. DEPT. (5,000 S,F.) Square Feet of Ground Surface? TOWN 0F $0{JT~,~ , 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdic~on General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or S ubl~ission o{ a SWPPP is required for all ConstTucfietl activities invofving sctt Beach? disturbances of one (1) or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Exisitng Grade Sl(q)es are part of a isrger common pisn that will ultimately disturb one or mOmoneaCreS(1)Ofac~eland;where which Exceed Fifteen (15) feet of Vertical Rise to including C~Aseuction activlUes iflvoivleg soil distu,'bances of less than the DEC has determined that a SPDE$ permit is reqatmd fo~ store3 wate~ discharges. One Hundred (100') of Horizontal DistanCe? SvvPPP*s Shall meet the Minimum Requivemeofs oftae SPDE$ General Per/nE : 8 Wll!~Drlveways, Parking Areas or other Impervious 1,~°rTheStermswPppWater Dlecharges from Consb'ucUon aativ~ty - Permit No. GP-O-1O-001.) Surfaces be Sloped to Direct Storm-Water Rur~ff shall be prepared prior to the submittal of the NOr, The NOI shall beL~ submitted fo the Department prior to the commencemeof of ~onsmJatkm aatJvlty, o into and/or in the direction of a Town right-of-way? ,. ~ sw,~ ~, ~,~ th. ~. ~,.~at ~..~ ~,~ ~ ..~ 9 Will this Project Require the Placement of Material, co~stmctedrequimd' POat'ccessuction atmm water management pmndces that wia be used mxj/cx,to reduce the polluteatu is storm water discharges and to assure Removal of Vegetetipn end/or the ConstrucUon of any compllerme with the terms and conditions of this barrett. In addition, the SWPPP shall Item Wi~ln the Town Right-of-Way or Road Shoulder } r- COUNTY OF .~)....~... ............ : ......... SS ............... i~.~ at ~.~ih~_~.~ii ....... u~ng y m, aepese~ aha say~ mt t~e~sne is the applicant for Permit, And that he/she is the ..........~'~'~ ~o~,~ . ...... co~:~i~'~. ~i ........................................................ Owner and/or representative of the Owner or Owners, and i~ duly authofi2ed to perform or have performed the said work and to make and £de this application; that all statemenB con,tined in thi~ application are I~ue 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. wnr to me ; ........ : ........ ......... ............ ..... ...... Commissi01 res July 28, TOWN OF SOUTHOLD PROPERTY-. RECORD CARD /~oo-/y/- ~- ~,.~. OWNER FORMER OWNER 8:'(2o ~ log VL. STREET /13 X~ C' FARM VILLAGE 17' E ACR. J W J ~PE OF BUILDING COM/& CB. MICS. Mkt. Value TOTAl. DATE REMARKS LOT Tillable Woodland /~eadow~at~d House Plot Total FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD 'TRIM /0'7 Extension _F.~ ension ~reezewQy G~roge ~atio ~:- B. ~]-~__.~ Tota~ Foundation Basement Ext. Walls ,=ire Ptace Type Roof Bm"h Floors Interior Finish Heat ~ooms 1st Floor Recreation ROOm Rooms 2nd Floor '-- /'d O' ,Dormer Driveway iDinette: DR. ' FIN. B AUG 3 0 2010 BLDG. DEPT. TOWN OF SOUTHOLD /; $OU~ID r~1 YOUNG a YOUNG 2,0 ~5~o' FOLLOWING I~ISPECTION S. 1. FOUNOATION - TWO REQUIRED FOR ~ CONCRL TE 2. ~ CAULKING 4. FINAL - CONST.q!'"' .... ~, ~'CTRICN. MU~T BE COMF.ET~. ~CO. ALL CONSTRUCTION Sh,~L MEET THE REQUIREMENTS O1: [HE CODES OFNEW YORKSTATE NOT RESPONSIBLE FO~ I]I~(]N OR CONSTRUCTION ERROR~. IFICATE 3Y