HomeMy WebLinkAbout41054-Z EFQI,I-�p�� Town of Southold 10/13/2016
a
P.O.Box 1179
53095 Main Rd
�'�.ljo• ��o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38575 Date: 10/13/2016
THIS CERTIFIES that the building AS BUILT ADDITION
Location of Property: 625 (aka 48)Wilmarth Ave, Greenport
SCTM#: 473889 Sec/Block/Lot: 41.4-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/22/2016 pursuant to which Building Permit No. 41054 dated 10/3/2016
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:
"as built"deck addition to existing one family dwelling as applied for.
The certificate is issued to Diaz,Irene
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
u rized Signature
o�SUFFot,r�oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
ti 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#: 41054 Date: 10/3/2016
Permission is hereby granted to:
Diaz, Irene
48 Wilmarth Ave
Greenport, NY 11944
To: legalize "as built" deck addition to existing single-family dwelling as applied for.
Additional certification may be required.
At premises located at:
625 (aka 48) Wilmarth Ave, Greenport
SCTM # 473889
Sec/Block/Lot#41.-1-5
Pursuant to application dated 9/23/2016 and approved by the Building Inspector.
To expire on 4/4/2018.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $784.00
CO -ADDITION TO DWELLING $50.00
Total: $834.00
,Building Inspector
f
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.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 518162.5 Wit-1-64 AVE jiZe 90EC-mo
Hol e No. Street IHamlet
Owner or Owners of Property: —2SF,D w /l�, �1A7- �� SOVM DIAZ_ KQ;RT9 0F,
Suffolk County Tax Map No 1000, Section �`//��B��ll�occk / Lot
Subdivision _ff�, IVILWA rj?J /7'�i A Map. �/ Lot:
Permit No. // '' Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (che
Fee Submitted: $
he ature
ID F SopTyO
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o�yooUNi'1,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] �- LATION
[ ] FRAMING / STRAPPING [ FINAL j �
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECT CAL (FINAL)
REMARKS:
DATE I'DI IL 00
INSPECTOR
FIELD INSPECTION REPORT I DATE COMMENTS
_ b
FOUNDATION(1ST)
--------------------------------------
FOUNDATION(2ND) M
z
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ROUGH FRAMING&
PLUMBING y
INSULATION PER N.Y:
STATE ENERGY CODE
� a
FINAL
ADDITIONAL COMMENTS -
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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 Planning Board approval
FAX:(631)765-9502 �,� Survey
SoutholdTown.NorthForkxet PERMIT NO. Check
Septic Form
N Y S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 single&Separate
Storm-Water Assessment Form
Contact:
Approved ,3 20 Mail to-
Disapproved a/c jj Q
Phone:�/t�F�Cr � /
Expiration 20
uilding pector
(
U
UDDAPPLICATION FOR BUILDING PERMIT
S E P 2 2 2016 Date 20
INSTRUCTIONS
$ %))a o dVIUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
lto 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 perinit 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 o s,and to admit
authorized inspectors on premises and in building for necessary inspections.
( ign a of applicant or name orporation)
Ifs E.4sr atatrm Denw- &sT ON Aly
(Mailing address of applicant) I
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
PA
vx-mco ,,2 ®F
Name of owner of premises ( k4 4 �1
(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. Locatio of land on which proposed work will be done: All
House Number StreetHamlet
County Tax Map No. 1000 Section Block Lot S
F SubdivisionlHfl OF �� X221 6iV QS Filed Map No. J Lot 3� P 0 �� 3Z
WA90,04YON i6GOT5
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy SI N&L.>E. F M 16u_9>%&19UAi1q&
b. Intended use and occupancy /t4ae (-
3. Nature of work(check which applicable):New Building Addition Al4tiRepair Removal Demolition OtherWork (D
4. Estimated Cost A11A Fee
I (To be paid on filing this application)
5. If dwelling,number of dwelling units 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 Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height Number of Stories
9. Size of lot:Front X60 -Rear--/&O—Depth !�t'• 4d
10.Date of Purchase A 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_Z
13.Will lot be re-graded?YES_N0-A('—'*'W6I excess fill be removed from premises?YES_NO_
Tre or-
14.Names of Owner of premise�5t � %'T A. Address Phone No.
Name of Architect Address 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 )lr 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__,V"
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OFA AA f�
�O 4�tV A. Iil�•Z. being duly sworn,deposes ajsS bare�� York
(Name of individual signing contract)above named, No, 01 f3U6185050
(S)He is the
Qualified in Suffolk County
(Contractor,Agent,Corporate Officer,etc.) Gemmi`'
sion Expires Apifl 14,
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.
S:�onm_to/before me th' �p y
day o11
f 1 20
r'---P r-'-
Notary Public
t
Scott A. Russell 0°Sum/rl,>� STO]E IM[WA T]EIK
SUPERVISOR 0 1� \\NAG]E1\M[]EN`]F
SOUTHOLD TOWN HALL-P.O.Box 1179 6
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
- - --- -- -- -- - -- - - - - - - ---- ------ -- - --- ----- - - -
DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑�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.
❑ rc. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑�D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑go E. Site preparation within the one-hundred-year f loodplain as depicted
on FIRM Map of any watercourse.
❑W F. Installation 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 replacement of impervious surfaces.
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project.
If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan
and a completed Check List Form to the Building Department with your Building Permit Application.
APPLICANT (Property Owner,Design Professional,Agent Contractor,Other) S.C.T.M. #: 1000 Date:
AA Disc ict
NAME-
�- A
Section Block Lot
2 FOR BUILDING DEPARTNIENT USE ONLY "tz
Contact Information ((p3�/ �LP� rg /V r
�
Reviewed By: U' ^l v"4
— — — — — — — — — — — — — — — — — — Date.
Property Address / Location of Construction Work. — — — — — — — — — — — — — — — — —
® Approved for processing Building Permit
Stormwater Management Control Plan Not Required
�-- — — — — — — — — — — — — — — — — —
❑ Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review.)
FORM * SMCP-TOS MAY 2014
Yr
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` TOWN OF SOUTHOLD PROPERTY RECORD CARD ? <<
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OWNER STREET VILLAGE DIST. SUB. LOTZV— G� 2
cFORMER•OWNER N E ACR.
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RES. fa SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
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LAND IMP. TOTAL DATE REMARKS �qsP I— Wq 3
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Total
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5 U RV EY Of LOT 3 G * P/O 35 * 3 7 N
AS SHOWN ON A CERTAIN SUBDIVISION MAP ENTITLED "MAP OF PROPERTY KNOWN AS WASHINGTON HEIGHTS"
FILED IN THE OFFICE OF THE CLERK OF THE COUNTY OF SUFFOLK ON DECEMBER 29, 1927 AS MAP NO. G51
51TUATE : GREENPOIZT w E
TOWN : 5OUTHOLD
5UFFOLK COUNTY, NY s
SURVEYED 08- 1 1 -201 G
SUFFOLK COUNTY TAX #
1000 - 41 - I - 5
CERTIFIED TO:
ESTATE OF IRENE DIAZ
LAND NOW OR FORMERLY OF:
TOWN OF 5OUTHOLD
N87048'30"E 10t 0.00'
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NOTES P �k `Unauthorized alteration or addition to a survey
,.`'w�•�" ;, mop beonng o licensed land surveyor's seal is a
p PIPE FOUND JOHN C. E H LE�5 LAND 5 U�VEYO ' aN G-Eli �: violation of sealiNn 72or sub-division Education
2, of the
v New York Stale Education Law"
❑ o- STOCKADE FENCE �O <C 'p N
� Only copies from the original of this survey
-o-o- WIRE FENCE N marked with an original of the land surveyor's
,",-,"„-'j�i�i • F stomped seal shall be considered to be valid true
copies"
G EAST MAIN STREET N.Y.S. LIC. NO. 50202 'F" J..g f�
�f'�'`_,�,}�^`f" Yg "Certifications indicated hereon signify that this
survey was prepared in accordance with the ex-
Area = 15,172 Sq. Ft. RIVERHEAD N.Y. 1 1901 3G9-8255 Fax 3G9-8287 �'� u 3 a� sting code of practise for Land Surveys adopted
s A� G' � by the New York Stole Assoclallon of Professional
Area = 0.34 Acres �5� 5L�Z02 , Land Surveyors Said certifications shall run only
Ion�Ilslandlandsurve or.com �o'�---- •;� a� to the person for whom the survey Is prepared,
GRAPHIC SCALE I"= 20 J �1'��;vU 4tj� and on his behalf to the title company,governmen-
K K-" tol agency and lending institution listed hereon, and
to the assignees of the lending institution. Certifica-
J. Mons are not transferable to additional institutions
V�
r
APPROVED S NOTEDq1 f OCCUPANCY OR
DATE: 61�h5 FUSE IS UNLAWFU_
FEE: 7 E _ Ep� WITHOUT r ,TI F<<�'
ljC P.OTIFY BUILDi�t : 7tidENr AT v r1i
765-1802 6 A TO FOR THE OF OCCUPANCY
FOLLOW iNG INS DEC5:
1. FOUNDATION T`y` ! =+EOUIRRED
§
r f 1 FOR POURED CC'
2. ROUGH - FRAViiN, u PLUkl2iNG
3. INSULATION RETAIN STORM WATER RUNOFF
k 4. FINAL - CONSTRU T?CN MUST PURSUANT TO CHAPTER 236
BE COMPLETE C G.O. OF THE TOWN CODE..
ALL CONSTRUCTION SMALL MEET THE
REQUIREMENTS OF- CODES OF NEW
YORK STATE. NOT ES PONSGLE FOR
DESIGN OR CONSTf JCTION ERRORS.IAo
I
COMPLY WI ALL CODES OF �e_ r-etu ,•r
NEW YORK STS TE & TOWN CODES
AS REQUIRED A JD CONDITIONS OF
i
19"114-
Vill or /I\�♦:/tom'
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