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39565-Z
Town of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY 4/10/2015 No: 37507 Date: 4/10/2015 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: SCTM #: 473889 1330 Gillette Dr, East Marion Sec/Block/Lot: 38.-2-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/3/2015 pursuant to which Building Permit No. 39565 dated 3/3/2015 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: CELLAR ENTRANCE DOOR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Malley, John & Malley, Valerie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Au 0 ' ed ignatu e =L� Off 04 TOWN OF SOUTHOLD � BUILDING DEPARTMENT ; TOWN CLERK'S OFFICE SOUTHOLD, NY 40 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 #: 39565 Date: 3/3/2015 Permission is hereby granted to: Malley, John & Malley, Valerie 4 Rope Ct Melville. NY 11747 To: cellar entrance door as applied for. Replaces 36451 At premises located at: 1330 Gillette Dr. East Marion SCTM # 473889 Sec/Block/Lot # 38.-2-14 Pursuant to application dated To expire on Fees: 9/1/2016. 3/3/2015 and approved by the Building Inspector. PERMIT RENEWAL $200.00 Total: $200.00 Building Inspector (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36451 Date: 6/7/2011 Permission is hereby granted to: Malley, John & Valerie 4 Rope Ct Melville. NY 11747 To: Addition to a Single Family Dwelling; Cellar Entrance Door, as applied for. At premises located at: 1330 Gillette Drive, East Marion SCTM # 473889 Sec/Block/Lot # 38.-2-14 Pursuant to application dated 5/31/2011 To expire on 12/6/2012. Fees: and approved by the Building Inspector. CO - ADDITION TO DWELLING SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: Building Inspector $50.00 $200.00 $250.00 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 #: 36451 Date: 6/7/2011 Permission is hereby granted to: Malley, John & Valerie 4 Rope Ct Melville. NY 11747 To: Addition to a Single Family Dwelling; Cellar Entrance Door, as applied for. At premises located at: 1330 Gillette Drive, East Marion SCTM # 473889 Sec/Block/Lot # 38.-2-14 Pursuant to application dated 5/31/2011 To expire on 12/6/2012. Fees: and approved by the Building Inspector. CO - ADDITION TO DWELLING SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: Building Inspector $50.00 $200.00 $250.00 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 $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 $15.00, Commercial $15.00 Date. M A R New Construction: Old or Pre-existing Building: '✓ (check one) Location of Property: 13'3 & 6-1 in" . 1 f z- M4 it i b d House No. Street Hamlet Owner or Owners of Property: :10(40 A `. L. 9-y Suffolk County Tax Map No 1000, Section —3 � Block o` Lot Subdivision Permit No. .� �� S Date of Permit. Health Dept. Approval: Planning Board Approval: Filed Map. Applicant: Underwriters Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ r,-5() 00 Lot: (check one) R Appli, ant Sig,. ature _ pf SOUryo�o l,`�oUNt'�,�► TOWN OF SOUTHOLD BUILDING DEPT. 76S-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING/ STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ELECTRICAL (ROUGH) [ ] CODE VIOLATION RFMORKS! [ ] ROUGH PLUMBING [ ] INS TION [ NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ ] CAULKING DATE � INSPECTOR L FOUNDATION (1ST) . TMMMMA1rN FOUNDATION (2ND) ROUGH FItAM1 Q & PLUMING INSULATION PER N. Y. STATE ENERGY CODE FINAL G Q i I Mill 'Z m r 4- O z d TOWN OF SOPTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. Examined 20 1 Approved 120 ` a/c Expiration S 20 DECE"E MAY 272011 BLDG. DEPT. TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST 355�� 3 Building Inspector Do you have or need the following, before applying? Board of Health �--�4 sets of Building Plans Planning Board approval - y Survey Check !� 0c)� Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm -Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date!" \ a-1 . 120 1 I 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 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. /&') ignature A applicant or name, if a corporation) (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder O W iJ`wL Name of owner of premises b� �) A.N-!� y 4 LI lLi t, M A- I- t" (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. 1. Location of Ian House Number on which proposed work will be done: i I -A , -%')a . %I G Ci -1 S M A R. ► o i A )l U 1 I 3 Street County Tax Map No. 1000 Subdivision Section P Block �— Filed Map No. Lot / 7 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Rff ►j'&'4C4/ b. Intended use and occupancy P_f's ►1 �'0C,C_ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work AZ o 16AS E ME WT `L. WRA 4C C, (Description) 4. Estimated Cost q 0 u 0 Fee $ 'Lov (To be paid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front (o�, Rear (Q Depth 30 Height `log Number of Stories 1 Dimensions of same structure with alterations or additions: Front �b� Rear (61 Depth �' % Height �� Number of Stories t ^; 8. Dimensions of entire new construction: Front Rear Height 9. Size of lot: Front 1 o d Number of Stories Depth t o " 10. Date of Purchase Name of Former Owner la t i-S'brJ 11. Zone or use district in which premises are situated�n�_,�z Depth 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V1 13. Will lot be re -graded? YES NO ✓ Will excess fill be removed from premises? YES NO ✓ I-:,- C, . 63I -$C>7 14. Names of Owner of premises x, Lt - Address ) 334 r,4,17 f '�L Phone No. Name of Architect Address Phone No Name of Contractor �g I�Pe-vl �ezr c Address �7W . w V Phone No. 63 l 1Sf�i - Do QM yv 1"�'N 15 a. Is this property within 100 feet of a tidal wetland or a freshwater vdetland? *�ES 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 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) CONNIE D. BUNCH Notary Public, State d New York No. 01 BU6i $5060 %4ua1111Ou If vuInnn VVYIuy Commission E)Ires April 14, i91 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 4h pefore y e this -ida of 2011 C Notary Public Town of Southold Erosion, Sedimentation :& Storn i -Water Run-off ASSESSMIRR[T FORM PROPERLY t OCATIofI s.c T wt ax . iE FOUAWINg. ACTIOkS MAY-ReQU11RE T419SUGM1 06" OF A . . MO &!I O A. G' E AN. O— N L 3 — FIED gY P O . io . IN E . ATE C o YORfC. Oistrtct Sb�tiQn . 8kck lel - — - — — —. — — -- — —— -- — — — — — — for each Qt�iesUcn is Requited ft KO Complete Complete AppCieat Yes Itelti Numbed (NOTE: ACheck Mark (4) — VVaI Retain All Stam -Water Mn -Off @e to by a. Two (2") Inch. Rainfall on Site? S this Project attd/cr conSVUc odac(i km as wel as.all (This item_wNkinduile all run-0fFcreated by. site,deadng . (mprovefrter>rts and he the pemianentcreativn of ittpervious surfaces•) floes the:Sike Plaut andltx Survey Show Alt.Propo&ed pralnage Suudures Indicating Size & Location? s Control Surtwe Waterfk;Wvl ` Ul 2 This Item shal(indwde.all Proposed Grede Chengesand.Slope ... / VYia`fhis Prb)ect Require any Land Filling. Grading Or.Excava*Where'there Is a change to the Natural U Existing Grade Involving more than 200 l,ubicYards of MigedW within any. Parcel? catiat RQquire Land Distrarbinq Act�tit:s Encompassing an.Area in Excess of Wia this A. Five Thousand (5,000) Square Feet of Ground Suftce UL/ El5 Is there a NatUrat Water Course Running through the Site? Y Is. this f'roject..within the Trustees jurisdiction. or Within One Hundred (100') feet of a. Wetland Beach? S Will there be Slte preparation on Existing Grade Slopes which Ezccied Fifteen (15) feet of Vertical fuse to . One Hundred ('100) of Horizontal Distance? 7 X11 tJrivPe eways,'r g Areas or.other impervious Surfaces be Sloped to Direct Storm -Water Run -Off. : into and/or in the direction of a i'own right of-way3 8 Will this Project Require.lhe Placement of Material; Remover of C/egetation and/or the: Construction of IE . any Iterri.thin the Town Rig ht�0f :Way -or Road Shoulder Area? (This item wilt NOT include the Installation of Driveway °Aprons.} 9 Will this Project Require Site Preparation within the One Hundred (1U0)'Year Floodplain of any Watercourse? NOTEi If Ahy Answer -to Questions One through.Mne is Answered with a Check Mark in the Box; a Storm: Water, Grading, Drainage &Erosion Contrril Plan is. Required and Must be Submitted for Review priorto Issuance of:Any Building Permit! — - -------- -- -- Yes: Ifo EXEMPTION Ooe. this project meet the minimum standards for classification as an. ncultucal Project? - Note: If Yqu 4 answered Yesto this Question, a.Storm-Water, Grading, O.raiinage 8 Erosion. Control Pian is -NOT Required! — — — — 7 7— STATE Oft NEW YORK, CON`OF:.::,FOLK .. ...........SS. f"Y .... air y q being duly sworn deposes acrd saysthat h�/ she is.die a�pGcactt for Permit, .. is tU�1nVrC. That I, _.... CONNIE D. B (Name of kidiv(dual sigAing ooaament)Notary Public,. State of NQw.York C) (xsN I io. Ot BU61 And that he/she is. the; eo�ora� ofr�er �ualifted art 3uffoYk i � (owner contraaor Agent Commission E>�ires April '14, -2LL pwner and/or representative of the Owner of.Ownees, and is dWy authorized to perform or have performed. the said work and to . make and file this application;; that all statements contained in d* appfication are true to the best of his knowledge and beGeE and El that the work witl. be performed in the manner set forth in the applicAtion filed It Sworn to before me this; . 1 ! .......................... . 20A'� `day of ......&XN ......................................... ...:..•...... igvc(ay Public: ..---•--:...._, .........................:c tureofAprscnt) L.. FORM - 06107 G I L L ET7"E flR/VE� � ,iC..esrnan 0 FaoPosm DECK AODITI ON - . 2s--,or>B,, w"As'. 1DD.o0 1-o 7L 2 a Pbrcl-� � ZO -+ /slay.{rh0� _ 1520 sf DF.GKSu4Roo AtidtttoK IOD tyD sf 32d Sf � "ace /y, a5',00815,00w• /00.00 C --Grepow/Cz 14AImo' C>P- .L.©-T- SURv&y,9,o PWM 140 G,G4 fW;�y rAN A N ,iwNRIcrr,A A. Mc G;ARRY AT rfl 5"r M ,-gi Kj o" NEW ,Kae w sca/c .3©"M=/" ,�r`a � dat:nNmbvru ria ,dr to /YIA o f G/crk's o� f iao -.ts 1 MSP Na • 20.38. O f % V/ Y7 d/ Al? .iii: 6Py'w trueindim �ie' � h Gerson f d hereon s: sd, and on hl bE°m," any, $eV-rnmenta� `�"t'4n Rst6d h, PROPOSLO OWLLL1NG► AbO1TiOF1, 61, iron P�f'c s Guararr feC,-/ 7`2v Horr7 c 7/-7/c Di v%-rion CA;cQgo 77Wc /nsa,-,a ceCamloorly and Soutf,old Savin�,r B'dnh os surveyed 5mepterm hp c r 2 9, /966 V,4N %ll YL r 5 o � i��rrs�LandSwrvaeRyvrs G�rCcrrlvorf� N. � S-1 BUILDING PERMIT EXAMINER CHECKLIST *Date Submitted: S 22-7-11 Date Reviewed. 6404 Applicant: Owner: ��%� /� Architect/Engineer: Estimated Cost: T K SCTM# 1000 — 3 Subdivision: A/wu �/�ak-'LZone: Conforming? Property Address. 133n City: Ea4t/t't0-11►- Pre COs? Building Permits (Open/Expired): BP -Z / C/o Z- , info: BP -Z / C/0 Z- , Info: BP . -Z / C/0 Z- , Info: BP -Z / C/0 Z- , Info: BP -Z / C/0 Z- , Info: Single & Separate Search Required? Y or N Determination: REQ. Lot Size: REQ. Front_ REQ. Height_ STORM 4,MP,_ R -it M F, ACT. Lot Size: REQ. Lot Cov. ACT: Lot (;ov. ACT. Front RVQ Side ACT. Side REQ. Rear PROP. Rear ACT. Height . REQ. BOTH SI DSS A CT Project Description:�_''�G"`�"``� Waterfront? Y or(, If yes, water body: Panel# Flood Zone: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED PLAN S (4f) SIGNED, SEALED SuRVey Suffolk County Health: Y ottPC - If yes, *Bed#: *Date: _/_/_ *Permit#: - If no, certification required: Y or N Received: Y or N By: ,DR STYE PLAN Town Septic: Y- N NYS DEC: PRE -DEC 9n/75 Y or - Date: / / Permit #: or NJ Letter — Notes: Southold Trustees: Y or 6)-D ate: —/—/ Permit #: or NJ Letter — Notes: Southold ZBA: Y or 19- Date: _/_/ Permit #: _ Southold Planning: Y o49- Date: / / Permit M — Notes: — Notes: Town Landmark C of A: Y oraTE: _/_/_ *NYS CODE compliance (page 2) Y N C0NTR+CT-4R IICENSt DIS�4BtLITy LI/4BILITy U/41eICMENS COMPeVS47-16W� Notes: Fee Structure: Calculation: Foundation: ,^ SF %SF First Floor: Second Floor: SF Other: SF Total: SF X$. =$ + Initial Fee: $ c'�-0 0 , 00 + Additional Fee (: $ SFX$. =$ + Initial Fee: $ + Additional Fee : U $ C of o FEE -3 0 00 AS BUILT FEE TOTAL:$ 04C 00 NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC I)ESIGN CRITERIA: Ground Snow Load: 20 Wind Speed: 12OMPH Seismic Design Category: B Weathering: Severe -Frost Depth: 36" Termite: M-H Decay: S-M Design Temp: 11 -lee Shield Underlay: YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: YIN HEADERS: YIN WALL STUDS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N LUMBER SPECIES AND GRADE: YM WINDOW AND DOOR SCHEDULE: -MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N `'ANT 4%: YIN NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: YIN PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N (RESCNECK) TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) ;, GIRDERS: Y/N ROOF RAFTERS: Y/N LaLl 0 . "ED AS NOTED B.P. # �' Op BY )ING DEPARTMENT AT ANI TO 4 PM FOR THE J INSPECTIONS: 1TION - TWO REOUIRED -'OURED CONCRETE _)H - FRAMING, PLUMBING, APPING, ELECTRICAL 9 CAULKING HAT" L - CONSTRICTION & ELECTRICAL P BE COMPLETE FOR C.O. ISTRUCTION SNAII MEET THE EMENTS OF THE CODES OF NEW 'ATE. NOT RESPCN SW FOR OR CONSTRUCTION ERRM,