HomeMy WebLinkAbout39832-Z ��o��UPFOtp��G Town of Southold 3/29/2017
3 y P.O.Box 1179
o -
°" 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38880 Date: 3/29/2017
THIS CERTIFIES that the building OTHER
Location of Property: 3765 Wells Ave, Southold
SCTM#: 473889 Sec/Block/Lot: 70.4-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/26/2015 pursuant to which Building Permit No. 39832 dated 6/3/2015
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:
OUTDOOR SHOWER STALL TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Place,Robert&Place,Jennifer
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
(),,thaed Signature
4�S �KcoTOWN OF SOUTHOLD
BUILDING DEPARTMENT
co TOWN CLERK'S OFFICE
• SOUTHOLD, NY
y�al � dap!
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#: 39832 Date: 6/3/2015
Permission is hereby granted to:
Place, Robert & Place, Jennifer
599 W End Ave
New York, NY 10024
To: Construction of an outdoor shower as applied for.
At premises located at:
3765 Wells Ave, Southold
SCTM # 473889
Sec/Block/Lot# 70.-4-3
Pursuant to application dated 5/26/2015 and approved by the Building Inspector.
To expire on 12/2/2016.
Fees:
CO -ALTERATION TO DWELLING $50.00
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
Total: $250.00
Building Inspec o
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: V (check one)
Location of Property: 57�J `��1\ NV`_ , J_MX �-)1 v7
House No. Stfeet Hamlet
Owner or Owners of Property:qO6,4/i7 �p `� � �C4 Lei
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant._f
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
p•lic t Signature
Iden Robins Custom Renovations
365 Pequash ave Cutchogue,NY 11935 631 484 8931
D
MAR 2 8 2017 d
March 19, 2017
BUILDING DEPT.
Building Department T®"OF S®U'IMGLD
Town of Southold
Town Hall,Box 1179
Southold,NY 11971
RE: Place Residence,Permit#39832
3765 Wells Avenue
Southold,New York
Town of Southold
Dear Mr. Verity
This is to certify that Pex water supply lines were installed in the above
outside shower meets the requirements of the New York State
Construction code.
Yen
rely,Robins Custom Renovations
Owner
qf soUlyolo
OUM`I,�c�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLSG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING / STRAPPING [ FINAL 9VI S/!0t---
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
JeN -REMARKS: [ Pis L Sve4
4 0A 7Tiv&� :6 l
j q wtl- me,,b
4
DATE INSPECTOR PA^
FmT-.p I TS mcnex T�EFOR•T DAT9 CONIlI�E,NTS
' FOUNDOIOX(1ST) Q ,
� ��1����T��.h•w�i�w�TTT�T�Tr��r��
FOUNDAMON(Mb)
ROUGH FRA117M& H
PLUMBING
. H
IN�TJLATION PEA N.Y.
STATE ENERGY COT3E
. ► 'l®Ilii/ i'S ►f'
MAL
AMR= om9ts �
$'�(�•• CGi v 19'x►
m
j { a
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL f1-Board of=Health
SOUTHOLD,NY 11971 4,sets of Building Plans !
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey ,,a
SoutholdTown.NorthFork.nei PERMIT NO(.- Check
..;;Septic,Form
!
{ N.Y.S.D.E.C.
Trustees
= C.O.Application
_Flood Permit
Examined ,20,"r";0 _ -s ;.; Single&Separate
1' '" '• - aj���"f Storm-Water Assessihent Form
- -Contact:
Approved _,20 Mail to:
Disapproved a/c ?/
Phone:, F-�—1 u �73g
Expiration ,20
fir)
- nspor i
APPLICATION FOR BUILDIN 4 T ,
-- Date S 20 5
INSTRUCTIONS t
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`accor'ding 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'aPPlicatiori''&-Buildiig' ' { issued Building lPerinit'to`tlid`aP`6ficani. Suchla permit
shall be kept on the premises available for inspection throughout the work.
e.No building shalPbe occupied`or'used in;1hole of in part for'ariy purpose what so ever'until the Building Inspector
issues a Certificate of Occupancy.
f.Everybuilding permitcsliall 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 mayauthorize, in writing,the extension of the permit for;an
addition six months. Thereafter,a new permit shall be required.
APPLICATION IS HEREBY MADE,toathe Building Department for,the ss,�ance,ofa 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 regulati }s,and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signatur of ppli ant or name,if a corporation)
(Mailing�address lof applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ayn� ( Q_r, (-� I Q f��
• ° (As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer) Y.
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed workill be done.
al(05 L P\�S AV`P lPLJ
House Number Street '. :> Hamlet
County Tax Map No. 1000 Section l. ',;Block' ",,,,. Lot
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•'obcupancy &A.��
b. Intended use and,occupanc Del rvVp-(" C�W\0,11 1IG
3. Nature of work(check Which"'—licable):New Building Addition Alteration_
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(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-miked occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
1'= '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="- Depth
Height Number of Stories
9. Size of lot: Front Rear /K)-? r j:>iTe.;.:Depth
10. Date of Purchase �N'anie of Fo'friief Owner
11. Zone'or u`se'di'strict'iri'which premises•ar'e'`situafed'`"7`
`rG!-' '"° 3'.�I' s ,-j:.t= •-!7 ' 'J' ii'7: .� ;s 3:1 �a.vFz ,at,i-i. ft':; r,. i /r•.
12. Does proposed const'ruction,violatetarry''zoning;la(w, ordxnarice or regulation?YES,, NO „
lr. "�1t} tltts i£;i i.4,' . i '•J� !f;i gist :I. ,
13. Will lot be re-graded? YES , ,NO, - .-Will,excess be removed froni.,premises?YES, NO
14. Names of Owner,ofpremiseg,,�frlm e(r I�C�Q Address�7C'nSr�ll��;l�sa�Y1i.•, ;Phone:No.gI7�(��}
Name-of Architect- r 'Address ✓ Phone;No
Name of Contractor e V1' l i'IJ1'' Address,3K( 1pe4i QtSh `PVe_.."Phorie'No.• I-qB1 —213 l
15 a. Is this property within 106feet of a'ti'd'al'wefladd°o'r"a ffeshwater'wetlarid? *tYES� NO
* IF YES, SOUTHOL'D'TOWN'TRUSTEES &''D.R.C.`PERMITS MAY BE'REQUIRED.
b. Is this prdperty'within'300 feet of a tidal'wetl`and? *'YE'S NO
,i,IRED
* IF YES, D.E.C. PERMITS MAYBE'REQU :
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—L
* 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 confr`act)`above`named, "' '
(S)He is the -
(Contractor,Agent,Corporate Officer, etc.) ""'`'°" PV
`
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'bei
performed in the manner set forth in the application filed therewith.
Sworn to before me this
day of 20 1`�
CONNIE n IN _
Notary Public Notary Public,Stene of Now Y ign ture o pplicant
No.01 BUSI0M
Qualified In Suffolk County
Commission Expires April 14,2
4k-
-� 5T�O R IMIWA\T]E K
Scott A. Russell o �, ���
SUPERVISORU - AWA NA\(G IENUEN T
SOUTHOLD TOWN HALL-P.O.Box 1179 16 rn
53095 Main Road-SOUTHOLD,NEW YORK 11971 I' � Town of Southold
yj0 3
CH"TER 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.
❑M13. Excavation or filling involving more than 200 cubic yards of material ,
❑1dwithin any parcel or any contiguous area.
C. Site preparation on slopes which exceed 10 feet vertical rise to
❑E� 100 feet of horizontal distance.
D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑dE. Site preparation within the one-hundred-year floodplain as depicted ;
❑Eon FIRM Map of any watercourse.
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
DLstmt
NAME Vp������ �(l� Cj_ Section Block Lot
Contact Information
17 s (��� 57 �(� FOR BLILDING D1EP�> _-F 11t�T 1 T ONLY
_
Reviewed
— — — — — — — — — — — — — — — — — —
Date-
Property Address / Location of Construction Work: — — — — — — — — — — — — — —
` 1 Approved for proce5�ing Building PAM.
�76ns VypQ-\�� N��`� Stormwater Management Control Plan Not Required
Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review)
FORM * SMCP-TOS MAY 2014
�pF SO(/T
John M.Bredemeyer III, President �o� y®�® Town Hall Annex
Michael J.Domino,Vice-President
54375 Main Road
P.O. Box 1179
James F.King,Trustee Southold,New York 11971-0959
':D:.
''Dave;Bergen,Trustee Telephone (631) 765-1892
. .a Ol
ChArles.J:'Sanders,Trustee
coU Fax(631) 765-6641
w BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
May 19, 2015
Jennifer Place
PO Box 700
Southold, NY 11971
RE:. 3765 WELLS AVENUE, SOUTHOLD
SCTM# 70-4-3
Dear Ms. Place:
The Southold Town Board of Trustees reviewed the project plan prepared by the
licant ap
' , received on May 2015, and determined that-the proposed construction of
,pan'eri�closed outdoor shower against the seaward side of the garage is out of the
1Netland�urisditicon under Chapter 275 of the Town
Wetland Code and Chapter 111 of
F ::Ther in.;a`ceo arice�` the current Wetlands Code (Chapter 27
� re rtl' with,
Tilt, z. 5 and the
rosio'i Mazarci:Are Cha
y .}� ,- a<(_n y`peter,111) no permit is req ed. P
; r.�,� .however 3 eco uir lease be advised
�W:1r, .,Y; ttatio�._-ns"#ruction; sedimentation or disturb
ance of any kind may take Bea rd of the tidal or',T. fre'shW6ter wetlands jurisdictional boundary or eaward of
place
coastal erosion,hazard`area as indicated
within 10
to of'1he'bt.0 above, or 0 landward from the
p�, , ff;<'wifih`out further authorization from
5..,.. m the Southold Town Board of
pursuant-to'Chapter 275 and/or Chapter 111 the Trustees
to'ensure that all necessaryof e Town Code. It is your responsibility
_z
precautions are taken to prevent any sedimentation or other
alteration or disturbance to the ground surface or vegetation within Tidal Wetlands
jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such
Precautions may include maintaining adequate work area between the tidal wetland
jurisdictional boundary and the coastal erosion hazard area and your project or erecting
a temporary fence, barrier, or hay bale berm.
This determination is not a determination from any other agency.
f
f ,
r'
If you have any further questions, please do not hesitate to call.
Sincerely,
John M. Bredemeyer, III, President
Board of Trustees
JMB:eac
i
I
D E-CIFF
-c.'K Co: f�i9r40
,rpt;; JJ`?a+4 P 3 JH= � o t) � r�LLS /"1
14+11[Tlj•i 'C N, ��' 1J
2%
Fab i'
fi
� asr Ile
�
4
IV
ro
� 4 `
fLnoO ��E ti' PwR Pas-4
- ,�- R 0-JA c.e Y T o c�rl�RS:
�t�Y C'r2. /. ROC.ERS
.�l
APPROVED BY
BOARD OF TRUSTEES
TSV OF SC3UTH®l®
SHcc~T /a F/ ��381g
®ATE liq E
':r�:YSc — _ �• yJ./J qd-- � �`j1'�r.4t--lf't^a:{.�� �- J.
(�0 _ `7Q — � TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER "i STREET .� -gyp -� VILLAGE DIST. SUB LOT
A - O
ACR. REMARKS
4-p Pa rs
TYPE OF BLD. R'
�sr��� va�'��sa 1 r<13 --�-- 12-7& -- r6- 71, � a v- -'14,s 00
s C L ASS
.016
t�
LAND IMP. TOTAL DATE
O
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
TOWN OF SOUTH®L® PROPERTY RECORD CAR®
-
WNEG� � �, -• REET j���1" VILLAGE DIST. SUB. LOT��
1 4,��u
FORMER OWNERA Y- �Z 1-6bp N // E ACR
j� S W TYPE OF BUILDING
RES. 7 �� SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
�-
a
6=� �(c. 1)-fj6z� i-aR 1C r--(-2— I -,C, (xn.-),
Lr r 5
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER �,�o v J oy
Woodland FRONTAGE ON ROAD
Meadowland DEPTHQ
House Plot BULKHEAD
Total DOCK
a
; "=-�=.�.� ., � � i=-'--`� :,� ■ ■■i■■■■■■■■■■■■■■■■ MINI■■■
- _ ,T_-: . _ ■ ■■■■sL7■■■■■■■■■■■■■■■ MINI■■■■
" ■■■■■■�■■■■■■■■■■i■■■■■■ MINI■■■■
- - - ■■■■■■�■■■� �■■■■■■■■■■■MEMO■■■
M MEN
MINI■■■■I■■■ ��€■NI■■■■iNI■■■■■■■■■
MINI■■■■i■ ■ ■■�■■■a■
MINI■ii■I■moi■■■ii�►7i■■■i■i■■■■■
MINI■=■�i��■������■NI■i■■■i■■a■■■
■MI■ i■�...G ■®®�■■i■■i■■■■■■■■■
■MI■■NI■im■■NIi_NINI®i■i■ii■■MEN■■
: . ■■MINI■■■■■■■■■■NI■■■■■i■■■NI■■■■■■■NINI■NI■NI■ ■■■■■■■■■■■ MINI■■■
NI■■■■■■■■■■NI■�C■■■■■
NINI■mommommom MEMO
■■■■■NI■■■NI■■i■■i■NI■■■■■
MINI■■■■
.• / . Walls OEM
JC UPANCY OR
USE IS UNLAWFUL
g WITHOUT CERTIFICATE APPRIO ED S NOTI-D
OF OCCUPANCY DATE: z ���
t FEE: Z�t� BY:
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 Phfi FOR THE
FOLLOWING INSPECTIONS:
1 1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. OUG' FLAMING & PLUMBING
I��SULATION
4. FILIAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL. MEET THE
REQUIREMENTS OF THE CODES OF NEW
r � --Y6 NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
1 PLf1r"+/IBER CERTIFICATION
} ON LEAD CONTENT BEFORE
CERTIOCATE OF OCCUPANCY COMP LY WITH ALL CODES OF
SOLDER-USED IN WATER NEW YORK STATE & TOWN CODES
SUPpLY'SYSTEMbAN-NO.T AS REQUIRED AND CONDITIONS OF
J XXCEED 2/10 OF 1%LEAD. S BA
a.c._...�_
J SOUTFiOttfi MM-CANNING BOARD
SOUTHOLD TOWN TRUSTEES
PLUMBING -
ALL PLUMBING WASTE
&VVATER LINES NEED
TESTING BEFORE COVERING