HomeMy WebLinkAbout40661-Z �O.�OS�pfO�,�-CpG Town of Southold 7/26/2016
� y� P.O.Box 1179
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w, ,� 53095 Main Rd
��.�y0� �ao��� Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 38410 Date: 7/26/2016
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
Location of Properiy: 3600 Pequash Ave, Cutchogue
SCTM#: 473889 SecBlocWLot: 103.-14-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this of�ce dated
4/25/2016 pursuant to which Building Permit No. 40661 dated 5/2/2016
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:
INTERIOR ALTERATION(CONVERT EXISTING ACCESSORY APARTMENT TO BEDROOM)IN AN
EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Ninfo,Matthew
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUIVIBERS CERTIFICATION DATED
Autho ' Signatur
�S��Fot�c TOWN OF SOUTHOLD
�,�o O�y BUILDING DEPARTMENT
' � TOWN CLERK'S OFFICE
P • � SOUTHOLD, NY
�.p��l � �ao�-ss
BUILDING PEFdIVIIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 40661 Date: 5/2/2016
Permission is hereby granted to:
Ninfo, Matthew
3600 Pequash Ave
Cutchogue, NY 11935
To: alter interior(convert existing accessory apartment to bedroom) of existing
single-family dwelling as applied for.
At premises located at:
3600 Pequash Ave, Cutchogue
SCTM # 473889
Sec/Block/Lot# 103.-14-2
Pursuant to application dated 4/25/2016 and approved by the Building Inspector.
To expire on 11/1/2017.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
Total: $250.00
i ' g Ins or-
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 Apri19, 1957)non-conforming uses,or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all properiy 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
l. 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. �(ZLC� ��, 7i0(,�,
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property:_3�OD� ��(�LJ f��'�- f��,J� (J'j����
House No. Street Hamlet
Owner or Owners ofProperty: VI�I��TZN� � � � ��Zl O �U CCI.a ,
Suffolk County Tax Map No 1000, Section � Q 3 Block �� Lot 2
Subdivision Filed Map. Lot:
Permit No. V Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Elpproval:
Request for: Temporary Certificate Final Certificate: � (check one)
Fee Submitted: $ ��
A plicant Signature
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f�� �O��OF SOUTy��
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_ TOWN-OF SOUTHOLD BUILDING DEP'�.
765-1802
_INSPECTION -
[ ] FOUNDATION�1 ST [ ] ROUGN PLUMBING �
[ ] FOUNDATION 2ND [ ] IN ULATION
[ ] FRAMING / STRAPPING [ FINAL
- [ ] FIREPLACE & CHIMNEY [ - ] FIRE SAFETY INSPECTIOId
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] EI.ECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REIVIARKS: �`� C. �,
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DATE �� � �� INSPECTOR � ` �
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL ' Board of Health
SOUTHOLD, NY 11971 � _ , . 4 sets of Building Plans
TEL: (631) 765=1802 .� � Plamm�g Board approval
FAX: (631) 765=9502 > ' . � . , Survey
SoutlioldTown.NorthFork.net ' PERMIT NO. 7� Check
, Septic Form
` � N.Y.S.D.E.C.
� Trustees
C.O.Application
/ , Flood Permit
Examined � ,20 L_1� Single&Separate
C'
, , Storm-Water Assessment Form
Contact:
Approved � � ,20� Mail to: �� ��x �- l
Disapproved a/c � � ���_� c���
.f, Phone: �� —�,q'���
Expiration I ,20__L__7 , ,
�
- � ; � � �'0� c' uilding pector
�P� 2 � ���„AP , ATION FOR BUILDING PERMIT
0 ,
Date � . !i� ' � , 20�
Bi1�DING DF,�T. INSTRUCTIONS
TOWNi O�SO�p�D .
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 lcept on the preinises 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�een 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 adinit
authorized inspectors on premises and in building for necessary inspections.
� �
(Sig tu e of applicant or name,if a corporation)
�o ��x �������
, (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
' �"�Y���'
Name of owner of premises �/��/�(1�1 Pf � �� �N�k2)� P� �c�o
(As on the tax roll or latest deed) � - � � �
If ap}�licant 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.
' �'' ;w��;i '� 'i_�_ a'���1 t'
l. Location of land on which proposed work will be�done:� � '`''�f=;�`,- :`��
36�0 � ��Qu �s��;��F: � �v��,� °".�� ;:;,,., C u-tcr�c�-� .
House Number Street . ._ � �''- �', . J~��;.;,`= '� _�_ -�!� ,"��„ Hamlet
County Tax Map No: 1000 Section � � 3 Block l �- Lot 2
Subdivision � Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ��1� G-l� ��YYL . R�'o W/ �CC�cS�s . f4-�T'.
b. Intended use and occupancy ��1�1G'-C� . �I�(l . (Z,�c� � � eo�v E(�'T /�(-'C��S //�""�'t'
3. Nature of work(checic which applicable): New Building Addition Alteration i�
Repair Removal Demolition Other Work
(Description)
4. Estiinated Cost Fee '
(To be paid on filing this application)
5. If dwelling, number of dwelling units �P� Number of dwelling units on each floor /U �
If garage, number of cars �u.�
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. /`1�
�
7. Dimensions of existin� structures, if any: Front (p�,(� Rear ��►(� � Depth �'� • D �
Height 16E-'-b' Number of Stories I
t , .___, . --- - �
Dimensions of same structure with alterations or additions: Front ,�"�S'��ri�,�-.(o�(U ,`'�=R'ear-�S'�rrtG �o�
Depth �,�Y�E �2� Height SQ.t�n Q (�`-O' Num'b'er of-Storie's ���si�,l�'� — /
8. Dimensions of entire new construction: Front N O N� , Rear 'lU-O Nw� ;� De�f�� �O N �
Height N alld � Number of Stories /�c�N � ������� ��
9. Size of lot: Front L��� Rear ( (�� ` Depth -�:�' ��`�.�'°�'-�'T'.�`
I �� ( � .l. 'fN^l
�4�i.1�i�t..i1�1�4..;'.t... Sk.,d �F.�S'��A.1'�
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 �
13. Will lot be re-graded? YES NO �Will excess fill be removed from premises? YES NO
���-�Ni$� lGiv�Z(� PvCCc �• 2�8� � 330•
14. Names of Owner of premises Address �?1�8 ���M�E phone No.
Name of Architect Address ��1'�+v�i� Phone No
Name of Contractor Address 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 3,00 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� ,
�(�T�Iv ���� g�-S 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.)
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 worlc will be
perfonned in the manner set forth in the application filed therewith.
TRACEY L. DWYER
Sworn to before me this NOTARY PUBLIC,STATE OF NEW YORK
�5+� day of ��ri I , 20 �� N0.01DW6306900 ,
(�UALIFIED IN SUFFOLK COUNTY '
COMMISSION EXPIRES JUNE 30,
Notary Publ'c gna re of Applicant
1
'.il�� '�
� w��-" .- t'{-��'
, �L'rF['� � 2-
Scott A. Russell ��'�°�-��` �� ��C'�0�]E���Jt\��A\�C')E)E�
SUPERVISOR �� ( �� I��CA\1�A\�G��EI��JC)E1�`7C'
� -
SOUTHOLD TOWN I-IALL-P.O.Box 1179 �p � $
53095 Main Road-SOUTHOLD,NE1N YORK 11971 �l��a- Town of,S`o u th o l d
1 '����� ,
CHAPTER 236 - ST�OR:MWATER l��.NAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
. _ - �-- - - -- -- - -� - . . . - -- - ...-- � -- --- �-�
�o� ��� ������' ����.,�� �� �� �� �'��..�.o�a��: _
� (CHECK ALL 'fHAT APPLYI
Yes No .
; ❑[�], A. Clearing, grubbing, grading or stripping of land which affects more �
� than 5,000 square feet of ground surface. �
� ❑[� B. Excavation or filling involving more than 200 cubic yards of material
� within any parcel or any contiguous area.
; ❑�] C_ Site preparation on slopes which exceed 10 feet vertica] rise to
; � 100 feet of horizontal distance_
= ❑4 D. Site preparation within 100 feet of wetlands, beach, bluff or coastal :
� \ erosion hazard area. •
: [) E. Site preparation within the one-hundred-year floodpIain as depicted :
.`- _ . . . . on-�'IR1bI-�I-a��of-arry� �vatercourse: � � - - �-._ .. . .- -- - .. . ;
. []�F. Instailation of new or resurfaced impervious surfaces of 1,000 square :
. feet or more, unless prior approval of a Stormwater Management -
: Control Plan was received by the Town and the proposal includes
- in-kind repJacement of impervious surfaces.
� If you answered NO to a]I of ihe questions above, 570P! Complete the AppJicant seciion beIow with your Name,
Signature, Coniact Information, Aate & Connty Tax Map Number! Chapier 236 does not apply to your project.
� lf yov answered YES to one or more of the above, please submit Two copies of a Siormwater Managemenl Control Plan
and a completed Check List Form to the Building Department with your Bui)ding Permit Applica(ion.
APPLICANT (Property Owner,Des�gn Profess�onal,Agent.Contr�ctor,Other) S.C.T_M. �: 1000 Date
Dutnc t /
NnME �v/\�v ��l �1Y�.BT�1�'S L�-✓ � � �•�S��I� .
� , ,,,,� Section Block Lot
.,5��,.�3� Z�l,� ��2�C . F= :�c�R Ft�,t_„`;�t:a I�i_:�.:�'.�r�::��-rt:��: �:��:�_.�� ..:
� C�YP
Cuntact Informatiore
f.�r�iaw���nxi
P,eviewed By-
— — -- — — — — — -- — — — — — — — — — Date T � I�
Property Address / Location of Consli uct ion Work: — — — — — — — — — — — — — — — — —
3/ �/� Approved for proce��ing Bwld�ng Perm�t
�J�� GC.1i(J���JE - Stormwa�er I��lanagement Conirol Pl�n Not Requ�red
_ C(� C'��Z�j'_U �� __ (� Storm�v�ter Nl�n�eement Coni�ol Plaii ,�Rcyu�red
U (For���rJ to Lng�ue�r�n; llep�rimeni (or }�e�iew)
r��i;n� " �MC f' - "1-C)�ti1 �.`r �c�i-�
SUR�Y O� i�ROi��i�TY
51TU,�T�: GUTGHOGU� -
TOY�l1�l: SOUT�-�OLD N
SU��OL�G GOU1�tTY, 1�1Y W e � E
SURVEYED OI - 06 - 03 � �
SUF�OLK GOUNTY TAX # _
1000-103-14-2 �
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AREA = 15,000 sf or 0.34 acrea ���� �m '�'d����� ��� �����'°���
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIG SGALE I"= 20' RIVERHEAD,N.Y. 11901
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NO CHANGES ��
3600 PEQUASH AVENUE
I EXI RM. EXIST anTHRM. CUTCHOGUE N.Y.
, REMOVE DW NO S NO CHANGES
p , EXISTING: SINGLE FAMILY RESIDENCE
� SCTM# 1000-103-14-2
���������� ����� I � ZONE R-40 .37 ACRES
/ I � PROPOSED:
,{ �-�1 �1 �i� �
DATE: � CS.P.# �a � (� I 1�II REMOVE COOKTOP � O TO REMOVE KITCHEN APPLIANCES AND FACILITIES
IN ORDER TO CONVERT THE LEGAL ACCESSORY
�l I ��II AND HOOD VEM EXISTING BEDROOM APARTMENT TO A BEDROOM THAT IS PART OF
FEE: � BY: �l� �� NO CHANGES THE SINGLE FAMILY DWELLING
NOTIFY BUILDING DEPART AT
765-1802 8 AM TO 4 PM FOR THE I EXIST. CLOSEf
FOLLOWING INSPECTIOI�S: I REMOVE NO CHANGES
\ WALL OVEN
1. FOUNQATION - 1W0 REQUiRE� ;
FOR POURED CONCRETE '
' EXISTING PROPOSED
75T FL 2440 S�.FT. INCLUDING 760 SQ FT APT.
2. ROUGH - FRAMlNG & PLUiNBING OPEN , APT.TO CONVERTED - NO SIZE CHANGE
2ND FL NA (�q
3. INSULA i ION
nrric NA NA
4. FINAL � CONSTr�UCTION MUST °E`�' "A "A
cr+au.GE 0 C
BE CONIPLE7E FOR C.O. �
ALL CONSTRUCTIOt� SHALL �iEEf THE
JOAN CHAMBERS - 631-294-4241
REQUIREIti9ENTS CF THE C�DES OF h1E1N ,
YOR!< STATE. NOT RESPONSIBL� FOR EXIST.ONE BEDRM ACCESSORY APARTMENT � W
DESIGN OR CONSTRUCTIOh! ERF�ORS, o TO BE CONVERTED TO NASTER BEDRM.SUITE
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COMPLY WITH ALL CODES OF W
NEW YORK STATE & TOWN CODE �n s�B 1 W > �
AS REQUIRED AND CONDITIONS Q� Q Q z
�7ppT�pCp'fQy4ipt'�lR.� S�D� � �� EXIST CLOSEf - NO CHANGES' EXIST
� FLUE
�.,2-��-'�b,�S �,Q�— � Z W
� ' �� S C� �� , EXIST. KITCHEN � � �/// ��'[[
N.� O NO CHPNGES � Q [ ' J
o � � `.�
�3 � 0
OCCUPA. CY 0 �� y~ C� Z
N � ��, W
us� ��- u�u�Fu�. 0 U
WITHOUT C�l�'l�IGATE Q,� � �
OF OCGUPI�{�Clf' 3 , 0 �
oc U v
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• WU I . ' , - �� , ' , ��y� ,
,-\� J �
RETAIN STORM WATER RUNOFF , • .
PURSUANT TO C�APTER 236 �, - • } � '�� ' ' ' � � ' �
OF THE TOWN CODE. � APRIL 22, zo,s-�� �' � � � Y �� �
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