HomeMy WebLinkAbout41017-Z �� StlFFaIK�aG� Town of Southold 12/28/2016
a
A P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38733 Date: 12/28/2016
THIS CERTIFIES that the building DECK
Location of Property: 60125 North Rd Unit 3D, Greenport
SCTM#: 473889 Sec/Block/Lot: 44.1-1-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/16/2016 pursuant to which Building Permit No. 41017 dated 9/26/2016
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:
DECK ADDITION TO AN EXISTING CONDO (UNIT 3D)AS APPLIED FOR
The certificate is issued to Aquino Teresa J Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ed Signature
�5v OLIr TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x 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#: 41017 Date: 9/26/2016
Permission is hereby granted to:
Aquino Teresa J Trust
36 Adelhaide Ln
East Islip, NY 11730
To: replace existing deck addition as applied for with flood permit per Trustees.
At premises located at:
60125 North Rd Unit 3D, Greenport
SCTM # 473889
Sec/Block/Lot# 44.1-1-12
Pursuant to application dated 9/16/2016 and approved by the Building Inspector.
To expire on 3/28/2018.
Fees:
Flood Permit $100.00
CO -ADDITION TO DWELLING $50.00
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $288.00
Total: $438.00
ing Inspector
Fos rn two 6
TOWN OF SOUTH0Lf)
BUC MNG DEPARTMENT
TOWN [-CALL
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.
S. 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 OTC
ofOccupancy
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
Date. �cnT�w.UCr 5� �U(G
-T- ,
New Construction:` Old or Pre-existing Building: (check one)
Location of Property:Ino l al- -3 d CR `1 Gni/T
House No. Street Hamlet
Owner or Owners of Property. A(awk-)o Te lrf`S R
Suffolk County Tax Map No 1000, Section !f4.1 Block. L Lot 1
Subdivision Filed Map. Lot:
Lf
Permit No. -I (0� Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ —_-�-- --�----_-•------------
62
App i ant Signature
5f SO(/ly�
N O
boy cou M'1,��a
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] RO GH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
( ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
III lf'"D MIA
�k
DATE INSPECTOR
FIELD II�SI?� 'x�l� E 'OT�x A C011? E�N'x'S .
F UID TION 1S
AII
. _w_ , .. ...........
LA �.
ROUGH Y;Et4NmgQ&
PLUMBING
TNSULATZON PBA N.Y.
STATE ENE-ROY 603
FINAL ,
c
rn
�L>d
Subdivision 5Fa 6 rce*o V (laa a Cee c6w.t,n;urns Filed Map No. Lot Q
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Candd 444111 DECK
b. Intended use and occupancy Car,de Wilk n cptaced D GcK
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work R ep la ce D aac K.i r, k"+,d
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units A11A- Number of dwelling units on each floor Adtr
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 � '- '1 ���.� Rear? - `Sa Depth SU'
Height Number of Stories /Vk
Dimensions of same structure with alterations o�additions: Front �} —1 c1" Rear 17'-lo'�
Depth �j'-1 l `Ay" Height V-004x_ Number of Stories
8. Dimensions of entire new construction: Front ���-(U" Rear 04-71-IU'' Depth
Height 71-1`®s" Number of Stories N/A-
9. Size of lot: FrontG ,G�' '—Rear-311.�`I , Depth 3 •(y U
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated (4 196 D rras7X Reii agr i s 1
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 t/
14. Names of Owner of premises Ao vh d Trvsr Address 60MT CR ut 6lyftawrr Phone No. (SM�'IU-TOM
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 NO I/
* 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_j1
* 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.
CONNIE D.HUNCH
STATE OF NEW YORK Notary Public,State of Now York
No.01 BU6185050
SS: Qualified in Suffolk County '
COUNTY OF §Ufa[.(!!- Commission Expires April 14,2A=0
TOAV Ctll"6E�g 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;
�'L'nat 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
J 64—day o 20_1�
Notary Public Signature of Applicant
TbWN`OV 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 fi Survey
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined l(J 20 j__ Single&Separate
Storm-Water Assessment Form
Contact:
�
Approved ,20 Mail to: VrD17\J e ft'
Disapproved a/c
lirl Phone: 6P3(-2A4- /
Expiration 20 M
g1b) L�ObL�
DB ldmg nspector
SEP 16 2016APP CATION FOR BUILDING PERMIT
BUILDING DEPT. Date SQnTem r 1r� , 20A_TOWN OF SOUTHOLD 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.
(Signat b1f applicant or name,if a corporation)
P.U. R a y 4 a SoyrL,Q 10 W17-1
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer$ general contractor, electrician,plumber or builder
Ace nt
Name of owner of premises ¢1aw-Aa 1 rusr
(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. 3 D
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done: /
Cno 115- C R G
4q rec^porn
House Number Street Hamlet
County Tax Map No. 1000 Section 41t.1 Block I Lot 101
J
Subdivision 5ca b rcc*o V:I laG a cdnduwjn;urns Filed Map No. Lot in
& r-"
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy COridd 1A/11h D ec K
b. Intended use and occupancy Cards cof®ced h ac K
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work R a la ca D cr K.;. k�w d
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units IVIA- Number of dwelling units on each floor /NIA.
If garage, number of cars Ad&
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
o Ia 1)
7. Dimensions of existing structures,if any: Front ` j - �I 41Rear is Depth 10'
Height Number of Stories /V/h
Dimensions of same structure with alterations ok additions: Front 17' -10 Rear 371 to"
Depth �j'—1 1 %1] Height �'-q�ii Number of Stories A#A-
8. Dimensions of entire new,construction: Front 3�-lU" Rear ����1UDepth 9 -lI Yt �
Height V-J' " Number of Stories AVIA- °
9. Size of lot: Front-166 .671 Rear 3 41.S 1 Depth °'f 35.d U
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated 0 N 14196 Irns 1 y 45 i 4ew-1 a 1
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO a1
O✓_1413. Will lot be re-graded?YES NO Will excess fill be removed from premises? YES -NOV--
14.
. Names of Owner of premises Ao vied Trus r Address(7013T CR "t Gryecarr Phone No. CSIQ ft-T013
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 NO I/
* 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--,/—
.F
* 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 ✓SNO
* IF YES, PROVIDE A COPY.
CONNIE D.BUNCH
STATE OF NEW YORK Notary Public,State of New York
No.01 BU6185050
SS: Qualified in Suffolk County
COUNTY OF 1SUFMe— Commission Expires April 14,2-=C)
;�S—OAV CttATA6E-S being duly sworn,deposes and says that(s)he is the applicant
(Dame 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;
Alhat 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
W+)—day o6wka _20�
-�TV .�
Notary Public Signature of Applicant
sTown Hall Annex
John M.Bredemeyer III,President .
Michael J.Domino,Vice-President P, 54375 Route 25
Aq E ^` ` P.O.Box 1179
Glenn Goldsmith Southold New York 11971
A.Nicholas Krupskir.$ ` r �;`'f
���_"'�' Telephone(631) 765-1892
Charles J.Sandersc Fax(631) 765-6641
5
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 8846A
Date of Receipt of Application: June 17, 2016
Applicant: Sea Breeze Village Condominiums c/o Edmund John Tiedemann
SCTM#: 1000-44.1-1 (Lots 1 — 16)
Project Location: 60125 Route 48, Greenport
Date of ResolutionlIssuance: July 20, 2016
Date of Expiration: July 20, 2018
Reviewed by: Board of Trustees
Project Description: Replace the existing seaside decks on all 16 condominium
units; for Units 1A, 1 B, 1 C, 2A, 213, 2C, 3A, 313, 3C, 4A, 413, and 4C construct a
proposed 139sq.ft. upper deck with a 13.7sq.ft. stair landing, and 41.69sq.ft.
staircase to ground; Unit 1 D construct a proposed 240sq.ft. upper deck, a
13.7sq.ft. stair landing and a 41.69sq.ft. staircase to ground; Units 213, 3D and
4D construct a proposed 205.8sq.ft. upper deck, a 13.7sq.ft. stair landing, and a
41.69sq.ft. staircase to ground.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
project plan submitted by Joan Chambers, received June 17, 2016, and stamped
approved on July 20, 2016.
Special Conditions: None,
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
John M. Bredemeyer, III
President Board of Trustees
John M.Bredemeyer 1I1,President SO
Town Hall Annex
Michael J.Domino,Vice-President ,r`O l0 54375 Route 25
P.O.Box 1
Glenn Goldsmith t t
Southold,New York
11971
A.Nicholas Krupski G
Telephone(631) 765-1892
Charles J.Sanders �O Fax(631)765-6641
�ycDUNI`(,�
13OARI? OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 1297C Date: December 14,2016
THIS CERTIFIES that replacement of the existing seaside decks on all 15 condominium units;
for Units lA 1B 1C 2A,2B 2C 3A 3B 3C 4A,4B, and 4C construct a proposed 139sq.ft.
;aper deck with a 13 7sq_ft stair landing, and 41 69sg ft. staircase to around;Units 2D,-31)-and
.,.4D construct a proposed 205 $sq ft upper deck. a 13 7sq_ft stair landing, slid a 41.69sq.ft.
staircase to ground,Unit 1D SCTM4441-14 (no construction performed that was-=Red for):
At 60125 Route 48, Greenport
Suffolk County Tax Map#1000-44.1-1-2-16
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated June 17,2016 pursuant to which Trustees Administrative Permit#8846A
Dated July 20,2016,was issued and conforms to all of the
requirements.and conditions of the applicable provisions of law. The project
for which this certificate is being issued is
for the replacement of the existing seaside decks on all 15 condominium.units;for Units
MIB, 1C,2A,2B, 2C, 3A 3B,3C,4A 4B and 4C construct a proposed•139sq ft under deck
with a 117s ft stair landing, and 4169sc1 ft staircase to ground; Units 2D 3D and 4D construct
a uropased"205'8sq ft upper deck, a 13 7sq ft stair landing,and a 41.69sq.i1._•sfaueese.to kaund,,
Unit LD,SQTM:#44.1-1-1 (no-construction performed that was pp'll f r) , "-"' `� " -� '' ►
The certificate is issued to SEA BREEZE VILLAGE CONDOMINI[JN owngrs of the "
aforesaid property.
Authorized Signature
Scott A. Fussell �a°������ S��'���)���1C���A\�C'lE)E�
SUPERVISOR V) ��/1[A\NA\G)EM1EN1F
SOUTHOLD TOWN HALL-P.O-Box 1179
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)
E ffA. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
®E3"'B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
13/c. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
i ®dD. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
®EJ/E. Site preparation within the one-hundred-year floodplain as depicted
- - - - -ori-FIRM-Map-of-any watereourrse:
E dF. 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
r ��� District
NAME 70 6% 9..kC1�n he �,�.( ►—
rs � i Ll_ i
W,.„i Section Block Lot
FOR.BUILDING DEPARTMENT USE OINLY
Contact Information. C(,
Tdrylrox Nwnnttt
Reviewed By: ///
- - - - - - - - - - - - - - - - - - Date: �' � —4
Date:
Property Address/ Location of Construction Work: — I(Approved
- - - - - - - - - - - - - -� for processing Building Permit.
ln('J la-1� 3 — ormwater Management Control Plan Not Required.
Goren ppYT AIV ® Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review)
FORM " SMCP-TOS MAY 2014
o�osu�i:ack`�,�
Town Hall Annex Telephone(631-1802
54375 Main Road Z:) t Fax(631)734-9502
P. O. Box 1179
Southold, NY 11971-095 ,9. a�
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED
WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION
Date: _September I T6 RAG
G
Owner. &t4iAQ TruST
Location of Property: GO I a6' C tk. Wf Gram„Hort
Please take notice that the (check applicable line):
New residential structure
Addition to existing residential structure
Rehabilitation to an existing residential structure
' M
to be constructed or performed at the subject property reference above will utilize
(check applicable line):
Truss type construction (TT)
Pre-engineered wood construction (PW)
V Timber construction (TC)
in the following location(s) (check applicable line):
Dec k Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof framing (FR)
Signature:-
Name
ignature:Name (person submitting this form): '00korr B,✓_ls�,,,�
Capacity(check applicable line):
Owner
Owner representative
TrussResReo15.d0cx Effective 1/1/2015
r
APPLICATION W
- PAGE 1 of a --
TOWN OF SOUTHOLD
FLOODPLAIN DEVELOPMENT PERMIT APPLICATION
This form is to be filled out in duplicate-
SECTI N I: GENERAL PROVISIONS APPLICANT to read and i
1. No work may start until a permit is issued.
2 The permit may be revoked if any false statements are made herein_
3. If revoked, all work must cease until permit is're-issued.
4. Development shall not be, used or occupied until a Certificate of Compliance is issued.
5. The permit will expire if,no work is commenced within six months of issuance.
b. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory
requirements.
7, Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable
inspections required to verify compliance.
B. i,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO
THIS APPLICATION ARE.TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE.
(APPLICANT'S SfbRATURE) DATE
ECI'TON 2: PROPQSED DELOPME IT(To be completed by APPLICAND -
_ NAME DR TEL PH NE
APPLICANT V��
BUILDER ��CS (J6��Qt�� e>tSo,�C�GQPSurt a C,Q-e . Crim'
ENGINEER
PROJECT_LOCATION:
• To avoid delay in processing the application, please provide enough information to easily identify the project
location. Provide the street address, lot number or legal'description (attach) and, outside urban areas, the
distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing
the project location would be helpful.
FDP(93)
APPLICATION
PAGE 2 OF- 4 ---
DESCRIPTION OF WORK (Check all appGcablc boxes):
A. STRUCTURAL DEVELOPMENT
ACTIVTT'l( STRUCTURE_ TYPO
❑ New Structure ❑ Residential (1-4 Family)
-- — ❑ Addition — -- ❑-RcsidcnCj�j-{Mcorz tban-A-FamUy)-
❑ Alteration O Non-residential (Floodproofing? ❑ Yes)
❑ Relocation D Combined Use (Residential & Commercial)
❑ Demdlition ❑ Manufactured (Mobile) Home (In Manu-
,%Replacement factured Home Park? D Yes)
TA5aL-s
ESTIMATED COST OF PROJECT S
B. OTHER DEVELOPMENT ACTIVITIES:
O Fill 0 Mining ❑ Drilling ❑ Grading
❑ Excavation (Except for Structural Development Checked Above)
❑ Watercourse Alteration (Including Dredging and Channel Modifications)
❑ Drainage Improvements.(Including Culvert Work)
p Road. Street or Bridge Construction
❑ Subdivision (New or Expansion)
❑ Individual Water or Sc r System
0 Other (Please Specify)`
After completing SECTION 2, APPLICANT should submit form to Local Administrator for review-
' E IN DP
LAIN DETERMINATION o e eom lei d v CAI. ADMINI RATOR
The proposed development is located on FIRM Panel No._ . Datcd
The Proposed Development:
O TS Tj►Q'l_located in a Spccial Flood Hazard Area (Notify the applicant that the application
review is complete.and NO FLOODPLAIN/ DEVELOPMENT'PERMIT IS RE ED
0 Is located in a Special Flood Hazard Area.
FIRM zone designation is
loo-Year flood elevation at the site is: Ft. NGVD (MSL)
O Unavailable
O The proposed development is located in a floodway.
FBFM Panel No. Dated
0 See Section 4 for additional instructions.
SIGNED DATE
APPLICATION a
• PAGE 3 OE 4
SECTION' 4: ADDITi NAL INFORMATION RE UiRED To be completed by LOCAL ADMINISTRATOR)
The applicant must submit the documents checked below before the application can be processed:
❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot
dimensions and proposed development.
— ------ —�- ---fl-Devclop=nt-plans.-drawn-toscalc;-and-specifications,-including-where-applicable:-details-for--.—
anehoring structures, proposed elevation of lowest floor(including basement),types of water
resistant materials used below the first floor,details of floodproofing of utilities located below
the first floor and details of enclosures below the first floor.
Also
❑Subdivision or other development plans(If the subdivision or other development exceeds 50
lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations
if they are not otherwise available).
❑ Plans showing the extent of watercourse relocation and/or landform alterations.
❑Top of new fill elevation Ft. NGVD (MSL).
❑ Floodproofing protection level (non-residcutial only) Ft:NGVD (MSL). For
floMi-oofed structures, applicant must attach certification from registered engineer or
architect-
way❑ Certification from a registered engineer that the proposed activity in a regulatory flood
will not result in Any increase in the height of the 100-year flood. A copy of all data andd
calculations supporting his finding must also be submitted.
❑ Other:
E : PE 1T RMINATi N completed by INT 11
I have determined that the proposed activity.A.❑Is
B.❑ Is not
in conformance with provisions of Local Law IF-, 19 The permit is issued subject to the conditions
attached to and made part of this permit.
SIGNED , DATE
gf BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated
fee.
If BO}t B is ch�ekcd, the Local Administrator will provide a written summary of deficiencies. Applicant may
revise and resubmit an application to the Local Administrator or may request a bearing from the Board of
Appeals.
J
APPLICATION ov _
PAGE 4 OF 4
APPEALS Appealed to Board of Appeals') ❑ Yes O No
Hearing date:
Appeals Board Decisiou --- Approved? ❑ Ycs ❑ NO
Conditions
SECTION 6: AS BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance
is issued
The following information must be provided for project structures. This section must be completed by a
registered professional engineer or a licensed land surveyor (or attach a certification to this application).
Complete I or 2 below.
I_ Actual (As-Built) Elevation of the top of the lowest floor, including basetuent(in Coastal High Hazard
cas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is:
Fr. NGVD (MSL).
2. Actual (As-Bui3t) Elevation of floodproofmg protection is F3'. NGVD (MSL).
NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant.
ECTI Id 7: COMPLIANCE ACTI N o be com leted v CAL AD INT TRAT R
The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to
ensure compliance with the community's local law for flood damage prevention.
INSPECTIONS: DATE BY DEFICIENCIES? 0 YES O NO
DATE BY DEFICIENCIES? O YES ONO
DATE BY DEFICIENCIES? ❑ YES ❑ NO
SECTION $ CERTIFICATE QF CQMPLIANCE(3:o be completed by LOCAL ADNIINISTRATQR)
Certificate of Compliance issued: DATE: BY:
Attachment B
SAMPLE
CERTIFICATE OF COMPLIANCE
for Development in a Special Flood Hazard Area
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
F•OR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA
(O"WER MUST RETAIN THIS CERTIFICATE)
PREMISES LOCATED AT: PERMIT NO.
PERMIT DATE
OWNERS NAME AND ADDRESS: CHECK ONE:
17 NEW BUILDING
O EXISTING BUILDING
O VACANT LAND
THE LOCM, ADMINIS'T'RATOR IS TO COMPLETE A. OR B. BELOW:
•K•
A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # $ 19
SIGNED: DATED:
B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # , 19-,'AS MODIFIED BY VARIANCE # ,
DATED
SIGNED: DATED:
C/C(93)
ENERGY CONS- 1eA�4 _ ANALYt�1
X15 PER N IY'5, E.t1JC-R4Y CONSERVATION CONST. COPS
77106-
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SEABREEZE VILLAGE
OCCUPANCY OR 60126 ROUTE 48
USE IS UNLAWFUL �9 SOUTHOLD N .Y.
WITHOUT CERTIFICATE afl °gig
ANDNED AS NOTED OF OCCUPANCY �..�..w ...._��.._ . .n�.-
UNIT 3 D
DATE: .P. '
FEE: t BY: — —
rr � 000 - 44 . 01 1 12
NOTIFY BUILDING D' RTM TAT RETAIN STO,'-.M V'��`ATER RU^dOFF — — — —
765-1602 8 AM TO 41"M FOR THE PURSUANT TO CHAPTER 2Jo
FOLLOWNG INISPE TIONS:
1. FOUNDATION T'^,'O P OF THE TOWN CODE.
AQ U I N O TRUST
g EXISTING
FOR POURED C: SITE KE
:"dCRETE
2. ROUGH - FRAMING & PLUMBING 1 / 16" _ V-0"
3. INSULATION I
4. FINAL
CONSTRUCTION MUST �--00DZO�' �'l� oE.a � --p�.�_ E.T. .a ..•. -'w 205 . 8 SQ.FT. UPPER DECK
BE CC)^1,PL -r'' COMPLY ..._,._.._.,,.._,,.r, mow•
ET. C.O. '• LYWITMr,+1A.a�'Fri 9 .4 SQ.FT. STAIR LANDING
ALL CONSTRUCTION SHALL MEET THE �i � `
REQUIREMENTS CCDES t .�-;,,6��:1>,r;f'
T OF THE v E�Or NEW E.4 ,;, ; . ,, =
2 6 . 8 SQ.FT. STAIRCASE
YORI< STA E. NOT RES, ONSi6LE FOR
DESIGN OR CONSTRUCTION ERRORS.
_ . ._. .. 4wE: � ' PROPOSED REPLACEMENT
COMPLY WITH ALL CODES OF
205 . 8 SQ.FT. UPPER DECK
NEW YORK STATE & TOWN CODES
AS BEQUIRED AND !TI F
T ^! 17% 13 . 7 SQ.FT. STAIR LANDING
S " . ' OARD
41 . 69 SQ.FT. STAIRCASE
SOUTHOLD TOWN T RUSTEES
GENERAL NOTES
9 ^ x EXIST. POURED CONCRETE FOUNDATION WALL.' j _ ` EXIST. POURED CONCRETE FOUNDATION WALL-
_ _ _ _ _ _ _ _ _ _ _ _ _ 1. All work shall conform to the requirements of the Residental Code of New York
REPLACE EXIST. 2X10 LEDGER w/ NEW 2x10 LEDGER �— 2x10 LEDGER State, County and Town Department Regulations, Utility Company requirements and
N FASTEN w/ 2-1/2" HILTI HIT-Z BOLTS & HIT-HY-200a EPDXY" best trade practises.
N N STAGGERED @ 16OC MIN. a 23
I 2. Before commencing work the Contractor shall file all documents required by the
N III NEW 6X6 POST ON - TREX TRANSCEND WHITE II w Building Department, a all fees required b local agencies and obtain all required
— —I 0 0 0 9 P pay q Y 9 q
N NEW PIER & FTG. 8 COMPOSITE POSTS & RAIL F
a I 1 ILU permits.
2 2X12 00 TREX "GRAVEL PATH" DECKING
X a o 0 3. The Contractor shall visit the site and verify all dimensions and the existing
L@ W/ HIDDEN FASTENERS III
conditions affecting the work prior to construction. Any discrepancies which would
—Q QZ� " o o interfere with the satisfactory completetion of the work described herein shall be
UJ o reported to the designer or property owner. Do not start work until such conditions
@ II NEW 6X6 POST ON EXIST. 6X6 POST NEW 6X6 POST ON II
NEW PIER & FTG. TO BE REMOVED NEW PIER & FTG. w have been examined and a course of action mutually agreed upon. Failure to notify
IL I LEAVE FTG. IN PLACE @ o o the owner or designer Of unsatisfactory conditions will be construed as an acceptance
NEW sxs AGO POST LLIX W� of the conditions to properly perform the required work.
ANCHORED To NE
I m z tea, 4. All work is to conform to the drawings and specifications of the designer and
10" DIA. POUR. CONC. PIER
Z o engineer consultants.
0 o TO 24"X24" POUR. CONC. FTG. —
2-2X10 GIRDER 5. The Contractor is to maintain a complete and up to date set of plans on the
job site at all times
J NEW 3-2X12 GIRDER 6x6 POST ON 12•• DIA. 6. The drawings are not to be scaled under any circumstances.
POUR. CONC. PIER TYP. 7. It shall be the Contractor's responsibility to ascertain all prevailing procedures
10'-0' 10-0' 3-sz.. -2z., including storage and toilet facilities,protection of existing work to remain,access to
20'-s4' work area, hours of permitted work,availability of water and electric power and all
z•-1o'
other conditions and restrictions for this particular location in order to execute the
LINE OF EXIST. GRADE LEVEL WOOD DECK BELOW work in a careful and orderly manner with the least possible disturbance to the public.
8. The Contractor shall make the neccesary arrangements to utilities and services
3•-0temporarily disconnected while performing the work as required.
EXISTING DECK PLAN 9. The Contractor shall provide all dimensions and cut-outs for other trades.
L-3'-91., 1 10. The Contractor shall provide proper shoring and bracing for all remaining structure
prior to removal of existing structure.
2 PROPOSED DECK PLAN 11. Plumbing, electrical, HVAC and similar work shall be performed by licensed
NOTE: ALL LEDGER BOLTS TO BE 1/2" X 4-1/2"
persons who shall arrange for and obtain all required Inspections.
HILTI HIT-Z W/HIT-HY-200a EPDXY
Contractor shall be responsible for scheduling all other inspections as required.
NOTE: ALL FOOTINGS TO BE NEW
24•• x 24" X 8" POUR. CONC. FTG. 12. The Contractor is solely responsible for construction safety and shall hold the
W/ 10" DIA. CONC. PIERS owner and designer harmless from litigation arising out of the Contractor's failure to
provide construction safety means and methods.
TREX TRANSCEND WHITE CONSTRUCTION NOTES
COMPOSITE POSTS & RAIL 1
1. All footings shall rest on undisturbed soil at a minimum of 36" below fin. grade
and where existing footings are to be utilized they must be inspected and verified to
meet standard criteria and building code requirements.
:i TREX TRANSCEND WHITE 2. Poured concrete shall have a minimum psi of 2800 at 28 days unless noted.
i COMPOSITE POSTS & RAIL
3. Unless otherwise noted all framing and structural wood components shall be
TREX "GRAVEL PATH" DECKING #2 Or better Douglas Fir.
a w/ HIDDEN FASTENERS HEADER
HEADER 4. All framing techniques and methods shall be as prescriptive design based on
TREX FASCIA I AF&P Wood Frame Construction Manual for One and two Family Dwellings (WFCM)
TREX FASCIA or as specified in R301.2.1.1
TREX TRANSCEND WHITE
NEW 2X8 DECK JOISTS @ 16" OC 3-202 GIRDER ASSEMBLED W/ COMPOSITE POSTS & RAIL 5. All portions of the new structure are designed to comply with local geographic
TECO TO GIRDER & LEDGER 2 STAGGERED ROWS OF 3" SCREWS TREX "GRAVEL PATH" DECKING and climatic criteria as stated In the following table.
SPLICES @ POSTS ONLY. ION TREADS
_
NEW 2X10 LEDGER GIRDER TO BEAR_ FULLY ON NOTCH GEOGRAPHIC & CLIMATE DESIGN CRITERIA
FASTEN W/ 2-1/2" HILTI HIT-Z BOLTS ANCHOR GIRDER TO POST W/ _ _- TREX FASCIA
NEW 6X6 ACQ POST W/ HIT-HY-220a EPDXY SIMPSON BCS STRAP OR EQUAL. li TOE KICKKSS
GROUND SNOW LOAD 45 pM
120 M
ANCHORED TO NEW STAGGERED @ 16" OC �- WIND SPEED PH
2 12 ACO STRINGERS SEISMIC DESIGN CATATGORY B
10" DIA. POUR. CONC. PIER EXIST. VINYL SIDING @ 16" OC _z_�
TO 24"X24" POUR. CONC. FTG. 6X6 ACO. POST I WEATHERING SEVERE
NEW
NEW 6X6 POST ON NEW 6X6 AGO POST ON NEW PCFROST LINE DEPTH 36"
R & FTG.Q POST
NEW PIER & FTG. NEW PIER & FTG. I OF NEW TERMITE THREAT MODERATE TO HEAVY
D,cDECAY SLIGHT TO MODERATE
�7- WINTER DESIGN TEMPERATURE 1 1
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REV. 9.7. 16
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