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HomeMy WebLinkAbout37651-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 11/28/2012 CERTIFICATE OF OCCUPANCY No: 36062 Date: 11/28/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: DECK 3655 Wickham Ave, Mattituck, Sec/Block/Lot: 107.-9-8 Filed Map No. conforms substantially to the Application for Building Permit heretofore 10/16/2012 pursuant to which Building Permit No. was issucd, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: Lot No. filed in this ofliced dated 37651 dated 11/28/2012 "As Built" Deck as applied for. The certificate is issued to Yousik, Rosemary & Yousik, Sharon Ann (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 37651 Permission is hereby granted to: Yousik, Rosemary & Yousik, Sharon Ann 3655 Wickham Ave Date: 11/28/2012 PO BOX 618 Mattituck, NY 11952 mo~ construct "As Built" Deck as applied for At premises located at: 3655 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot # 107.-9-8 Pursuant to application dated To expire on 5/3012014. Fees: 10/16/2012 and approved by the Building Inspector. SINGLE FAMILY DWELL1NG - ADDITION OR ALTERATION CO - ADDITION TO DWELLING Total: $489.60 $50.00 $539.60 Building Inspector Form No. 6 TOWN OF SOUTHOLD. BUILDING DEPARTMENT TOWH 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 sm'wy of propeaty with accurate'location of all buildings, property lines, streets, and unusual natural or topographic featur6s. 2, Final Approval from Health D0pt. of water supply and sewerage-disposal (8-9 form). 3.. Approval of electrical installation from Board 0f Fire Undenvriters. 4. Sw. om statement from plumb~ certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commemial 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-elisting" land uses:' 1. Accurate surw~y of proPerty showing all property lines, streets, building and. unusual natural or topographic features. 2. A properly ~mpleted application and cor~sent 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 I. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimmilig pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00,. New Construction:. Old or ~e/~-existing Building: x,/ Location of Property: ~{~5-~' [.&) t C I.~[~l~//~ Hous~ No. Street Owner or Owners of Property: gOSe~r)t'E~,l .~I)U~IC. Suffolk County Tax Map No 1000, Section l O ~] Block 8ubdivisi0n 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. lb. Zot 2., Polmitlqo. 3 ~'~'~-"~/ Health Dept. Approval: Planning Board Approval: · (check one) Hamlet [ Request for: Temporary Certificate Foe Submitted: $ ~ 0 ~'~ Date of Permit. Filed Map. Applicant:. Underwriters Approval: Final Certificate: (check one) Applica~igl~ure 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELE(~I'RICAL (FINAL) REMARKS: ~ /cyE_ /~ ~-~. ~f~>~, ,~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined Approved Disapproved a/c Expiration 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 Septic Form N.Y.S.D.E.C. Trustees ~ C.O. Application k K~"/~ ~ C,..~ ~ Storm-Water Assessment Form. ~ _ ~' 11 ~-- ~ C~ntact: ,1 Ma'to:__ APPLICATION FOR BUILBING PERMIT Date 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building luspector 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, relatioaship to adjoining premises or public streets or areas, and waterways. c. The work covered by this applicatioa may not be commeaced before issuance of Buildiug Permit. d. Upon approval of this application, the Building luspector 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 ao zoning amendments or other regulations affecting the property have been enacted in the interim, the Building luspector may authorize, in writing, the extensiou of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Buildiag Depamnent for the issuauce of a Building Permit pursuant to the Buildiug Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildiugs, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildiug code, housing code, and regulations, and to admit authorized inspectors on premises and in building for uecessary inspections. (Signature of applicant or name, if a corporation) (Mailing address &applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises .~,(¥> .~_Ar~?a[7 ~Jt.~lAstl(.. cLrx~ ~g~o~ ~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: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occgpancy of proposed construction: 47m,¢, or, Existing use and occupancy ...... _ _.l b. lntended use and occupancy '~l%'hlrl~ deC/dc- / 3. Nature of work (check which applicable): New Building Addition Repair Removal Demolition Other Work Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars Alteration · - (D~cr~Ptio~) (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 Depth_ Height. Number of Stories Rear 8. Dimensions of entire nexv construction: Front Rear Height Number of Stories 9. Size of lot: Front ~ 5' Rear "']~", t° . Depth Depth 10. Date of Purchase 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 NO v/ 13. Will lot be re-graded? YES NO v/Will excess fill be removed t'rom premises? YES NO ''/ 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet eta tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERM1TS MAY BE REQUIRED. b. Is this propgrty within 300 feet ora tidal wetland? * YES__ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO v/ 16. Provide survey, to scale, with accurate tbundation 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. l 8. Are there any covenants and restrictions with respect to this property? * YES NO · IF YES, PROVIDE A COPY. STATE OF NEW YORK) .~O~ ~fx ~--- "/ ~x](.} O ~ { ]~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual sig~ling contract) above named, (S)He is the i,,D/]85 (Cohtractor, Agent,, 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 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 therewith. Sworn to before me this ELIZABETH A. FINNE Public Ugnatu~e or ~p~nt ! ~'~/ Town ofSouthold-Chapter 236-Stormwater Management ~/ SWPPP - Storm Water Pollution Prevention Plan Assessment Form G~ ~_I~ORMAT~ON: (All Requested/nformation is Required for a Complete Application) o~wP..~..,.~...~ ~ ili~-~-~i~i ................................ ~ ~e S~P ~le~ ~ a C~ ~ ~ ................................................ ~ecl P~ ~n ? Yes No Has ~e A~l~a SU~N a ~1~ DEC No~ ................................................. Oflntenta~P~F~R~ ~ T~eot ~ed Wa~l~ ~ke. C.~ a~. pon~. ~.d. Fm~~ by~T~ol~? Yes ' NO ~ ~o~ o~........~dkL~.~ ~ ~ ~ a ~ ............ :i_~.~.~.~ .... · _ ......................... . ............ ...... , /~ -'~"~--'~ .......................... ~;~:i; .......................... ELIZABETH A. FINNE Notary Public, State of New YO~ No. 4653666 aualitie~ in Su"o~k Coumy ~}~::~ Commillion E~ir~ ~r ~ BUILDING PERMIT EXAMINER CHECKLIST Applicant: ~_ ~. ~ Architect/Engineer: *Date Submitted: Estimated Cost: SCT # iooo- 7~ 9 Subdivision: City: BP BP Zone: -Z / C/0 Z- -Z / C/0 Z- Property Address: ~b~C'~ 0Qi~ ~_ PA.a~ Building Permits (Open/Expired): BP__-Z / C/0 Z- , Info: BP~-Z / ~0 Z-~., Into: BP -Z/~0 ~ Single & Separate Search Required? Y or N Determination: ~Q. ~t Size: ACT. ~t Size: ~Q. Front ACT. Front ~Q Sid~ ACT. Sid~ ~Q. Height. ACT. Height. R~. ~ 5lb~S ProjectD~cription: 9~ ~" ~_ ~ REQ. Lot Cov. __ REQ. Rear ACT Conforming? ~ Pre COs? , Info: , Info: ... ACT: Lot Cov. PROP. Rear Waterfront? Y or N? If yes, water body: Panel// Flood Zone: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y or N - If yes, *Bed#: *Date: / / *Permit#i Town Septic: Y or N - If no, certification required: Y or N Received: Y or N By: NYS DEC: Par-D~c 9ar~$ Y or N - Date: / / · Permit #: or NJ Letter - Notes: Southold Trustees: Y or N - Date: / Permit #: or NJ Letter - Notes: Southold ZBA: Y or N - Date: / / Permit #: - Notes: Southoid Planning: Y or N - Date: / Town Landmark C of A: Y or N DTE: Notes: Foundation: SF Calc~,..~ First Floor: SF ~ Second Floor: SF Other: SF Total: SF Permit #: - Notes: __/ *NYS CODE Compliance (page 2): Y or N Structure: SF X * + Initial Fee: $ Addition.al Fee ( ): $ SF X $ =$ + Initial Fee: $ Additional Fee ( ): $ TOTAL: $ NEW YORK STATE CODE COMrLIANCE CItECKLiST CLIMATIC/GEOGRAPHIC DESIGN CR/TERIA: · Grolmd Snow Load: ~0. Wind Speed; i20MPH.. Seismic Design Category." Weathering: Severe __ . ·Frost Depth: 36"__ Termite: M~H ' ' Decay: Design Temp: 11 - Ice Shield Underlay: YES ~ Flood Hazai'ds: USE/OCCUPANCY CLASSIFICATION: · HBIGt:IT/FIKE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGIN:BBRED/pREscRIPTiVE FULL FR/AMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STUDS: YfN CEILING JOISTS: Y/IX/ FLOOR JOISTS: Y/N LUiM[BER SPECIES AND GRADE: YfN GI/iD ERS: Y/lq ROOF 1L4AVrERS: Y/N WEqDOW AND DOOR SCHEDULE: · MISSLE TEST RIgQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT8% :y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N 'TRUSS DESIGN: Y/N CERTIFICATION: ¥/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) /~ oo _/~ ?. ?_ ~ TOWN OF SOUTHOLD' PROPERTY RECORD CARD OWNER STREET ~,'~,. &,~ v,~GE SUB. Di'~ ~ ~O · S W ~PE OF BUILDING RES.~ ~ O~ S~S. VL FA~ )COMM. CB. MISC. Mkt. Value ~ND IMP. TOTAL DATE REMARKS ' ' /I , AGE BUILDING CONDITION N~ NOR~L BELOW ABOVE j FARM Acre Value Per Value Acre Tillable Tillable 2 ~illable 3 Woodland ~wampland FRONTAGE ON WATER 3rus~lond ON ROAD ~ou~e Plot DEPTH BULKH~D fot~l ~ ~ D~K ;,' IIIIIIII IIIIL.III i M. Bldg. ~-~x,Z J~ '- (~ /~ 3,~0 l,~z~olF°undati°n___ <~o~J¢--- Bath / Dinette Extension ? x' t ~ ~, ,~ z. ~ / t ~- Basement ,/--~/L L_~ Floors /~_ / ~ K. Extension Ext. Walls /:) ~./~ . Interior Finish 6c/~ t. c (5 .'.) ' LR. Extension /,P X & ~ ~ ~' ~ ~ /,s-o ~-~z ~j Fire Place /v/ ~ . Heat ~ ~ % DR. Type Roof H i 'p Rooms 1st Floor BR. Porch ~? ~ :- /~ o 5 ~' ~/~ Recreation Room Rooms 2nd Floor FIN. B. Porch , Dormer Breezeway Driveway Patio O.B. Total Cerdflcafloos Indicated hereon signify that this pJat of the property doptatad hereon was made in o~cardance with the existing Code of Pracltae for Land ,Surveyors adopted by the New Yod¢ State .6,.~x:lation of Profe..~ional Land Surmyors. 11~is certification Is only for the lands deplctad hereon and Is not certification of tille, zoning or freedom of encumbcances. Said certiflcation~ shall run only to the persons and/or entities listed hereon and are not hansferable to additional persons, entities or sub,sequent owners. ~).3~ ) PIPE CONCRETE u I ~- 0 ~ f"'~- , ~,,~ ~ · ~.~ § ~ o.,, tX F_ t",r,~yyk'''' ~. '-~ 12 ~ ~, ~, E '.,~ / I~i ._. .J;;t~ O 0 z ~ '~° ~P / ~,~4. o< x ~, IE) zo, //jel STORY I i',, z Z ~ /.," / DWE:LLING .1'3 r~ .~, ,~// No. 365.5 m . :' ///// I ~o~d~' ,7~ _ °~'~e~['"~' 31"05'40" W 75.0~ wIcKHAM AVENUE The ~ or dimension ~'~hown'"'"{-,c~T., ~. ;~.;;.'-..~ ~opefly lines are for a spedflc puqx~e and use, and therefore, are no{ Inlended 1o guide in I~e credo0 of fl~rlCea, rek31nlng wal~s, Paola, patios, planting areas, addltio~a to buildings and any olher construction. Subsur[ace and environmental condlflor~ were not examined or considered m a part of this ~uwey. Eot, en',enla, Righla.d. VVay of reoo~d, if any, are noi' shown. Prope~ corner monument~ ware n~ placed os a part d this sun, ey. © 2012 BBV PC ~ !~V~ Barrett Tax Map: DISTRICT 1000 SECTION 107 BLOCK 9 LOT 8 Unauthorlz~d a~alta~ o~ nd8~!o~ lo Bona¢ci & Map of:. DESCRIBED PROPERLY fn~. ~u~,/~ a ~ d .m Van Weele, PC Civil Engineers 175A Commerce ~ive MaP ~ -o- Map BIo~k: o-- Hauppauge, NY 11788 SUI~I"~ T 631.435.1111 Filed: ooo No.: County: SUFFOLK Planners ~ 631.435.1022 www.bl~c.cam Situate: MAumJCK, TOWN OF SOUTHOLD Certifind te: Tille N~.:381200077 Rmd~ion By Dale~p ANTHONY & PATRICIA GALEOl11 iesd~is,u~ymap~beo~ lng the land sur,~eyo~'s CHICAGO 1TI1.E INSURANCE COMPANY *cai and *~ue zhdl r~ be co~ ASTORIA FEDERAL SAVINGS & LOAN ASSOCIATION ~ to be a t~e and ~lld copy (its successors and/or assigns) Sm~dblc. A.B. Dmfmlb}c. G.C. CIm:tmdbic. MA.IL ProiectNo.: A120463 Sca~: I"~ 40' Dais: SEPTEMBER14r 2012 ' ;'~':~/~S NOTED R~R EL~A~ON ' ¥~~ ~LE: 1/4" = 1'~" '; ~: .8 ; . · ............ ~ -. -~- YORKSTA~. N( 'RES~NSIBL~. -- DE$1GN ~ OON~ ~ON ERROR& LE~ EL~ATZON ~GHT EL~AT~ON ~LE: ~/4" = t,.O,, S~LE: ~/4" = t,_O,, ~SmN~ HOU__.SE ~ EXlSmNG ~ous~ . AS-BUILT DECK I : ,, ,- ~ .... -. ,.~ ~_: ....................... 8'.-0" FLOOR PLAN SCALE: u4,,_- ~,_o. FOUNDATION PLAN --~ : ~ SCALE: 1/4"--1'-0" ~[ CROSS SE~ION W,~,[ n, q ~ S~LE: 1/4" = ~'-0"