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41059-Z
o�gUFF���c Town of Southold 11/2/2016 y P.O.Box 1179 0 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38632 Date: 11/2/2016 THIS CERTIFIES that the building ACCESSORY ALTERATION Location of Property: 10775 Route 25, East Marion SCTM#: 473889 Sec/Block/Lot: 31.4-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/27/2016 pursuant to which Building Permit No. 41059 dated 10/5/2016 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"ALTERATION TO AN EXISTING ACCESSORY BUILDING AS APPLIED FOR The certificate is issued to Fernandes,Anthony of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41059 10-26-2016 PLUMBERS CERTIFICATION DATED 11�40y�-� Autho ' Signature TOWN OF SOUTHOLD o�gUFFOt,rco BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy • o� 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#: 41059 Date: 10/5/2016 Permission is hereby granted to: Fernandes , Anthony 81 Sandy Hollow Rd Port Washington, NY 11050 To: legalize "as built" alterations (window and door replacements) to existing accessory building as applied for. At premises located at: 10775 Route 25, East Marion SCTM # 473889 Sec/Block/Lot# 31.-4-18 Pursuant to application dated 9/27/2016 and approved by the Building Inspector. To expire on 4/6/2018. Fees: AS BUILT-ACCESSORY $200.00 CO -ACCESSORY BUILDING $50.00 Total: $250.00 Bui din spector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 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$15.000 New Construction: Old or Prr4xnj13u mg: e eXef (check one) Location of Property: A977,5� E RiVAI /� A_ yd//��J House No. Street Hamlet Owner or Owners of Property. G�p��/ i�� s�,�.��✓1 �e ���'��' �.r Suffolk County Tax Map No 1000, Section Z1,73999 Block J5l _ /� Lot Subdivision ✓ Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: �X Underwriters Approval: Planning Board Approval: /-/I Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature soUryol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road C Fax(631)765-9502 P.O.Box 1179 a � roper.riche rtC)_town.southoId.ny.us Southold,NY 11971-0959 ,011 'n.UNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Anthony Fernandes Address: 10775 Route 25 City: East Marion St: New York Zip: 11939 Building Permit#: 41059 Section: 31 Block- 4 Lot. 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: "AS BUILT" DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 1 Ceding Fixtures 4 HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 3 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks Disconnect 11 Switches F]6 Twist Lock Exit Fixtures TVSS Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS" Notes: "STORAGE BUILDING" - 1- GFCI Circuit Breakers Inspector Signature: Date: October 26, 2016 0-81-Cert Electrical Compliance Form.xls SOUIyo� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I LATION [ ] FRAMING / STRAPPING [Vof FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 4 C.) • t DATE A6 INSPECTOR OF SO6' UTyolo UOUM'�,N TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: r-f 44�� d� f �C DATE �� 140 INSPECTOR ' FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (18T) j ------------------------------------ C FOUNDATION (2ND) O ROUGH FRAMING& PLUMBING 9 � r INSULATION PER N.Y. H STATE ENERGY CODE o `d FINAL ADDITIONAL COMMENTS W -Fc& L - -2�- v �� z m • Q � z H KC d t4 b H 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 r4-s is of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 /� (Survey Sou tholdTown.NorthFork.net PERMIT NO. q u Check Septic Form N.Y.S.D.E.C. stees ���0 V ZO.Application D[�(J- Flood Permit Examined JS 2& D Single&Separate I R SEP 2 7 2016 Storm-Water Assessment Form Contact: Approved -5 ,_W_ 20� - I ��l/�G'd�J JyOyoy � WII,DING DEMDisapproved a/c 'TOWN OF SO OLD Phone: Expiration ,20 t ' t Building nspector (--VP APPLICATION FOR BUILDING PERMI Date � Z� , 201,4— 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. (Signature of applicant or name,if a corporation) (Mailing address of applicant) t,!f 11677,0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder O ley Name of owner of premises ,/�'e�j�D�L/ Al�/� ✓�/lllcl1��� `�/�/U✓���� (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builde License No. Plumbers icense No. Electricians ense No. Other Trade's Li rise No. 1. Location of land on which proposed work will be done: ' Ll 14921 a House Number Street !° ; ' "' Hamlet " ,1', ' is� .. ,. ', ; '•,,, — County Tax Map No. 1000 Section Block 0T Lot CoQ 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 (0/47/c b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work rCCAnr i o fq r5 (Description)E V.)ir1o0uJ5 4. Estimated Cost ; t Abe aid on filing this plication � 5. If dwelh' g number of dwelling units \ ,..-I b Number of dwelling u}it- n each floor If garage;° , tuber of cars ` ` `{ t' `- Q� 6. If business, comme tial or mixed occupancy, specifnquof each type of use. U 1/1 11L 7. Dimensions of existiXslt� qtures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure��vi alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction�Ft Rear Depth Height Number d"&Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Oyu er 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regula ' ? Y NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? Y S NO Zao 14.Names of Owner of premises��/� /yJ9/'���5 Address'/s'0jq'e//�'" Phone No:-I/� ?,&'7 S7d Name of Architect Address Phone No Name of Contractor Z,i 9 �el? Address Phone No. ,<�41- lo,f'�;r �rssz 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 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 OFSU'.G(+ .S II/I A 11 1 � --!�)P X20 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Contractor, ent, 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 t before me this TRAGBY L-� 6WYM }� day of S 20 MY P UO,IC,STXTB�t OP��C1ti � V Y1111IC OUALIP11.0 IN SUPPOLK CO UN- dOMMISSION 9XPIA8S ad t?�- otary Public Signature of Applicant - N SURVEY OF PROPERTY AT EAST MARION TOWN OF SO UTHOLD SUFFOLK COUNTY, N. Y. 1000-31-04-18 • CERI7FIED T0: SCALE- V=20' SEPTEMBER 2, 2003 POTH177 SIGALAS APRIL 14, 2005 (UPDATE) 7HE NEW YOK MORTGAGE COMPANY, LLC ITS SUCCESSORS AND/OR ASSIGNS CENTURION ABSTRACT, LLC (CEN — 1461) UNITED GENERAL 717LE INSURANCE COMPANY N/0/F KENNETH M. KETCHAM & WIFE N/0/F KENNETH M. KETCHAM FE �j FE 0.5'5 0.2E N8738'50"E 4.28' 0.7E AA — WRE 0 FEN FEEL. 25.1' � ^ _ 3'S CAR. I.JE e; t. .<,. - - —\ 0.2'W 2.2E l --- 94 EL 25.3' r F17 I irl 1 GAR. it CAR. 1.6E rn O � I n.6 m ! N FR. N GAR. c Ix1 t` FE x2 FE 22E LX 11.6' s.a 0.2'W f*� EL 2s EL. 24.'g,k oi'w D rk lie. rij c22i (J1 0 0 4' O 4 � 2 c) M Ix �4 = 00 LX_� SMCKAD£fFNC£ a X`X~x X--xu 6.0 '^ 2.2' U1 z STr, 2.2' 14.e ' h y 64 EL 264• w P. 65 2,5.0' 2.7fL. 231. Ln £L 8, - `� cd EL. 25 0 FF 0 1'W OGRES CONCR£I£SIDEWALK 6178-20�w _� Ec z4.r V EL. 23> 84.87'' T APRON M .R jO�.LI L,>r POLE- F 14Ew � =MONUMENT , �5� EL 2.s ,CEO ,• O,Q ,<P ,M E TZ,r, AREA=11, 198 SQ. FT. ��' ELEVA TIONS REFERS CSD TO N.G. V.D. ANY ALTERA770N OR ADDITION`TO-THIS--SUZVEl' OLA TION NO. 49618 OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. P CONIC EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CER77FICA77ONS (631) 765- 31) 765-1797 HEREON ARE VALID FOR WS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. 1230 TRAVELER STREET SOUTHOLO, MY 11971 03--237 *APPOVEDAS NOTEDCOMPLY WITH ALL CODES OF DATE: P.# NEW YORK STATE & TOWN CODES FEE: Y: AS REQUIRED AND CONDITIONS f �.� u.AY NOTIFY BUILDI 4G DEPARTMENT AT7RA r QRS . 765-1802 8 AMT 4 PM FOR THEol FOLLOWING INSPECTIONS: (MRD-- -•w �, "-""" s-s^ 5' 9" 1. FOUNDATION - WO REQUIRED ' EES FOR POURECONCRETE 2. ROUGH - F ING & PLUMBING 3. INSULATION C0 4. FINAL - CO ST UCTION MUST OCCUPANCY OR k� �Tt 3/�" Plywood Floor ALL B CONSTRU TIN SHALL MEET THE USE IS UNLAWF REQUIREMENT FTHE CODES OF NEW �� 4 YORK STATE. NO RESPONSIBLE FOR WITHOUT CERTIFICATE DESIGN OR CONSTRUCTION ERRORS. OF OCCUPANCY LO RETAIN STORM N TER RUNOFF PURSUANT TO H ,pTER 236 OF THE TOWN CODE. Site Plan Image 1 N N A3 ELECTRIC L INSPECTION REQUIRED u - 1 'r 0 Per View 5.-9 5'-9" First Floor OMoMllI 11'-6" 1/4"= 1'-0rr 11'-6" 10775 Main Road East Marion NY No. Description Date co First Floor Plan co r Project number PH-001 C. �': ,•• �s-� , �- �;• Date 09/25/2016 /y ercfitoxtm , ,a�aedrO� architectural drafting Storage/Garage 8 design Drawn by FLL N Checked by WES Scale 1/4"=1'-0" N rn r- CO 111111111 N (V \ 00 IIIII Jill" 11111 111111 11111111111 111111 11 i OEast O South 1 3/16"= 1'-0" 3/16" = 1'-0" Ixro Rough Sawn Pine Antique painted white Reclaimed Barn Sash Typ. Top Plate _ _ Top Plate n 7'-43/ 7'-43/4" 7 ®B � / N t\ lllt First Flood _ First Floor -0'- 10" V -0'- 1 ONorth 4 West 3/16"= 1'-0" O 3/16" = 1'-0" 10775 Main Road East Marion NY No. Description Date a :z., .«... Elevationsco Project number PH-001 A o Date 09/25/2016CD itoxt®, .o-aa Storage/Garagey architectural drafting&claalgn Drawn b Author N !� Checked by Checker Scale 3/16"=1'-0" N m lx5 Ridge beam Asphalt Shingles Tar Paper Auminun Sutter 1x10 Rough Sawn Board _ _To Plap ten 12 T 4 3/4" V 2x8 Collar Beams 7 9 12" O.G. 2x4 l=ull Sawn Rafter 2-2x4 Full Sawn 24" O.C. CO Top Plat 7'-4 3/4" 0'-6" 2x4 Full Sawn Studs 24" O.C. 3/4" 1=xterior Plywood 2x4 2 Wood Shakes Full Sawn Sill 3/4" Plywood As I weather1e axaxl(o Block 2x10 P.T. Floor Joist _ _ _ First Floor =III I=�I 1, Emil =1 I I=1 I I=I I ISI I - - - - - - 11=III=III=1 I I=1 I I-0'- 10 I I— Polyethlene I�—I I I—I I I—I I —I I a' I —I I I—I I I—I I —I I MI I I=III (— Footing Typ. =III ° I=11I Barrier =III=I I 1=11 I-III 1-1, =III=I I I=I I=III=I I I=III= .: III=III=III=III=III= -I III— I I—III—III—I I U—I . I ISI I I—III—III—III—III—III—I I ` I—III—III—III—I I I- -I I I I I -I I I-I I I—I I I�I I I I'I I=1 11=1 11=1 11=1 I I—I 11=I I I I I I=I 11=I 11=1 I I=I I I- 1=1 11=1 11=1 II ' I I 1=1 1 11 1 11 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11 —II1=1I1=1 1=1 I—III—II1=1I1=1I1=1I1=1I1=III—III=1I1-III=1I1=1II=II1=III-= 1=1 11=1 11-1 I I-1 11-1 I I-1 I I-1 11=1 11=1 11=1 11=1 11=1 11-1 11-1 11=1 11-1 11-1 I I- OSection 1 -Callout 1 O Section 1 2 1/2"= 1'-0" 3/8"= 1'-0" 10775 Main Road East Marion NY No. Description Date a :��--,�F;,;s�y�- —;F•:,�:.-_-�;�;,:t:�-- Building Sections N Project number PH-001 0 ~/•- i -r '' - Date 09/25/2016 A ®ealu7 Storage/Garage y drafting cl I 8 Drawn b FLL —hit—t—1 N Checked by WES Scale As indicated N rn L _Top Plate 7' -4 3/4" ' I I ❑❑❑ o00 0©0 ❑❑❑ ©oo aa© ❑❑❑ orQo 000 ❑❑❑ E1111:1 ❑❑❑ 2 A4 First Floor 1 -01- 10 -_ =1II _ - �=1 , ————————————_� ' . III : I -1 11❑ I ❑I 11 :_. I I=1 1=1 I I–III–III–I 11-1 I I I I–I I I–I 1 I–III–I i 1–I I I–I 11=1 I–III–III-1 I I I I-1 I I I I- 1I–I -1 I I-1 I I=1 I 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 I M I 1=1 I11=1 ;..: IEll I Ed -III -•a III =111=1�1=1 I °. .°� 1=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1 11=1�ISI�I : ; I I S I–I I I- �= 11= 1=111=11 I III 1 I I❑ I Ed 11-1 I ❑I 11=1 I ❑I 11=1 1=1 11=1 I I❑ I Ed 11❑ 11=1 I I❑ I I–I 'I– =11I==1 I =1I1=1I1=1I I 1=1I1=1I1=1I1=1I1=1I1=1I1=1 1=1I1=1I1=111=1I1=1I1=1I1=1I1=111=1 ISII1=1I1=1I1=1 1= 1 1 1 1 1 1 1 I-1 11=1 11=1 11=1 11=1 I I I I I I I I I I I I 11-1 I I I I I I I I I I I I I I I I 1=1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IM I I 1 I��1� El ,111, , ,111, ,111, ,111, IW , ,– I I I- O Section 2 OSection 2-Callout 1 13/8"= 1'-0" 1/2"= 1'-0" No. Description Date Q ,� ;�, .;�tr ,z�. Tom..•-�•<s• 10775 Main Road East Marion NY Building Sections CS`-.r'y�:�JJr i�_:;,:�•�t�/i�i PH 001 Project number g ,. Date 09/25/2016 A4 f Storage/Garage oraF�itaccuro�a�omn9 s doaign DfaWn by FLL N Checked by W ES Scale As indicated N m i