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HomeMy WebLinkAbout37651-Z �q��,11FFat,��AG Town of Southold Annex 11/28/2012 y� P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36062 Date: 11/28/2012 THIS CERTIFIES that the building DECK Location of Property: 3655 Wickham Ave, Mattituck, SCTM#: 473889 See/Block/Lot: 107.-9-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/16/2012 pursuant to which Building Permit No. 37651 dated 11/28/2012 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 as applied for. The certificate is issued to Yousik,Rosemary&Yousik, Sharon Ann (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 00 i Au o ed gnatu e ��SUFFo�Kco TOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE 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#: 37651 Date: 11/28/2012 Permission is hereby granted to: Yousik, Rosemary &Yousik, Sharon Ann 3655 Wickham Ave PO BOX 618 Mattituck, NY 11952 To: construct "As Built" Deck as applied for At premises located at: 3655 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-9-8 Pursuant to application dated 10/16/2012 and approved by the Building Inspector. To expire on 5/30/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $489.60 CO -ADDITION TO DWELLING $50.00 Total: $539.60 Building Inspector 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-digposat(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 2l10 of 1% lead. . 5. Commercial building,industrial building, multiple residences and similar buildings and installations,a certificate of Code Complianee-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 9,19�7) rion-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 l. Certif cafe 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 $15.0%Commercial $15.00 Date. New Construction: Old or re-existing Building: ✓ (check one) Location of Property: ' 3V5_5S WtGIB )qde ma ,�,zf[SIG House No. Street Hamlet Owner or Owners of Property: () e,{')YA�Lj Nouslic. &4,O a.lm V d u s)k, Suffolk County Tax Map No 1000, Section to! Block . Cl Lot g Subdivision /- Filed Map. Lot: Permit No. 3_ Date of Permit. Applicant: Health Dept.Approval! Underwriters Approval: Planning Board Approval: Request for: Temporary, Certificate Final Certificate: v (check one)- Fee Submitted:$ X _�." Applica t ure ' pF SOpT�o`o TOW SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION .- I FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELE TRICAL (FINAL) REMARKS: DATE INSPECTOR 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 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 _ l Survey SoutholdTown.NorthFork.net PERMIT NO. � l 'Check +5D -+—LSD C. ! Septic Form N.Y.S.D.E.C. Trustees C.O. Application _ Flood Permit Examined 20� �'' )� y� Single&Separate Storm-Water Assessment Form C ntact: Approved 20 Mail to: Disapproved a/c `=J -� Phone: l� Expiration 20:� / o -� �Building Inspector APPLICATION FOR BUILDING PERMIT Date , 20 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 fi•om 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Ow�j Name of owner of premisesR05eMA-P-V l,(,Sl kG � O WS I L 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. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section O Bhockt "f Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occ pancy of proposed construction: a. Existing use and occupancy p � /� ,,(y ��,(,��yy�0 ye 44 (BPS b. Intended use and occupancy c, ` y}U Cy C°G k- 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work e 4(c C(p (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 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 —7 5 Rear 7'�'• � • Depth —7o 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 v Will excess fill be removed from premises? YES NO 14. Names of Owner of premises 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 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 Old' sore e A-le-V OS I being duly sworn, deposes and says that(s)he is the applicant (Name of individual sig ing contract) above named, (S)He is the �j /A- (Co tractor, 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 work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ELIZABETH A. FINNE _day of 20__j?q6tery PUbfic, State of New York N o. 4653666 .; Qualified in Suffolk bounty 00. Commission Expires November Notary Public ignature of dp6lnt D. r, :W BUILDING PERMIT EXAMINER CHECKLIST *Date Submitted: �a ��it- Date Reviewed. Applicant: 2-f- 5 r' 0� � Architect/Engineer: �, �►5 -TiLc Estimated Cost: SCTM# 1000- -�j - Subdivision: Zone: Conforming? Property Address: — yJ City: Pre COs? Building Permits (Open/Expired): BP -z/C/o Z- ,Info: BP -Z/C/o Z_ ,Info: BP -Z/C/o Z- , Info: BP -Z/C/o Z------,Info: BP -Z/C/o Z- ,Info: Single& Separate Search Required? Y or N Determination: REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. ACT: Lot Cov. REQ. Front ACT.Front REQ Side ACT. Side REQ. Rear PROP. Rear REQ. Height. ACT. Height RE:62, ,B� SIDES A c T Project Description: S 6 Waterfront? Y or N? If yes, water body: Panel# Flood Zone: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED Suffolk County.Health: Y or N- If yes, *Bed#: _*Date: _/_/_*.Permit#: Town Septic: Y or I�1 - If no, certification required: Y or N Received: Y or N By: NYS DEC: PREPRE-DEQ 9/1�759iii�s Y or N - Date: —/—/ Permit#: ' or NJ Letter-Notes: Southold Trustees: Y or N- Date: / /_ Permit#: or NJ Letter-Notes: Southold ZBA: Y or N- Date: / / Permit#: -Notes: Southold Planning: Y or N- Date: "/ / Permit#: -Notes: Town Landmark C of A: Y or N DTE: / / *NYS CODE Compliance(page 2): Y or N Notes• FF Y AL V Fee Structure: Calculation: Foundation: SF 4 f SF X $ =$ First Floor: SF +Initial Fee: $ Second Floor: SF +Additional Fee $ Other: SF SF X$ =$ Total: SF +Initial Fee: $ +Additional Fee $ TOTAL: $ NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load:ZO . Wind Speed: 120MPH SeismicyDesign.Gategory Weathering: Severe -Frost Depth:36" Termite: M-H" Decay: S-M Design Temp: 11 -lee Shield Underlay: YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGOWIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: YIN HEADERS: YIN WALL STUDS:Y/N GIRDERS: YIN CEILING JOISTS: YIN FLOOR JOISTS:YIN ROOF RAFTERS: YIN LUMBER SPECIES AND GRADE: Y/N WINDOW AND DOOR SCHEDULE: •MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N t LIGHT 8%: Y/N VENT 4%: YIN NAILING/CONSTRUCTION SCHEDULE: YIN MEANS OF EGRESS: Y/N PLUMBING RISER D:IA,GRAM Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: YIN TRUSS DESIGN: Y/N CERTIFICATION: YIN ,... .` -NERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) Town of Southold - Chapter 236. - Stormwater Ma nagement SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Com APP plete Application) UCA NAME ner Agent-CoraU Fit Contractor or Other(Circle One) Property OWNM of Different than Apprtcant) Address1 1) CG ! SS V111 C_ Ma4f ; E Fax#: Telephoraik. Faxi� I E- - E-Mai I 1 _ P� � V_ hid W. I M V 4 alC7 BriefDesmptim.ofConstrad6aActi ty Pro posed Stnuttual BMPs,Soil t ! s.GTj&k 1000 � Stabafimbon BW',Project Soope and/or Sequence of Construction Acgvity tr>:p1et tPrwMe AdAftial Pago es Neater Names of Contractor ante-Contact ---------------- Person Responsible for 1mplementaHon of SWPPP - i -------------------- Addr-- ------------------------------- I is i Tidephorro#: Fax# ------------------------- r , ---- - -- i Mal Name of Persons Responsible forhufallalm d hYritenanu of Eroslm Control Praet1w. --------------------- ------ 1 ---- ------------- t Address- I I -------------------------------------------- I Telephoned Fax#: ------------------- ; E-math e- Trial Area of Aq Total Area of Land clearing ------------------- -------- P eel rcets: and/or Ground Disturbance- (S.F. ,Amy) --____-_-___ IS —) ________________ . Project Duration: Start End .— . (Anticipated) .Date: _-`---- Date: t INumbn o)CaleAdar Derry) - _________________..__ Will this Project Disturbe five(5)or More Acres at � --`�--------'-'---- Any One Time During the Proposed Development? Yes No --------------- ----------------------------- Jt YES;please Answer the Following! -------------------------------------------- a. II Does the Applicant have a Qualified Inspector On Staff To Conduct the F2Qquired Inspections? Yes N b. Does the SWPPPJndicate How frequentiy-the Site List the.NAMES or description of all Potentially Impacted Waterbodies and/or Wetlands: r Inspections will Occur and for What Period of Time? Yes No c. Does-the SWPPP Adequately Identify All Temporary -'-- - --------------------------------------- and/or i i F � 1i Permanent SolStabalization Measures? Yes No �v_----________________ d- Does the SWPPP Adequately Identify a'Complete 1n --------------___ ( j I :Project Phasing Plan? Yes No I' pe Status of Im acted Walerbody fey-rMot,303td Psi,A-) ! e. Does the SWPPP Indicate Additional Site Specific ��. P )Llseed,tan Practices that Will be Utilized to Protect Water Quakily? Yes ,No f. Has the ApplicantSubmitteda Completed DEC Notice -`- '- - ----------.-----_______________ 1 I I Of Intent and SWPPP Acceptance Form for Review Type.o(Impacted waterbody(eg Lake,creek,Bay,pond,,Sound.Freshwater Wetland_) by the Town of Southold? Yes No /v -- ------------------------------------ STATE OF NEW CORK, colnvTY OF......_ f U ss ` That I, Plante.._........ .s�. .! being d � .. indvltlual signi t g WY sworn,deposes and says that she is the••- he1 applicant for Permit, And that hq4heis the _......._. . ......» .�.��,,?— duly orm or ! j Agerd,Corporate olbcer,etFj.»»....»...».........»........................ ..».».. 1 Owner and/or representative of the Owner or Owners and is clot authorized to pert 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 herewith. t I Sworn to re me this; _................ t ' day of. .. .1� . -- lotary Public_ .._... . •... -...__ ✓� � U, s,�, J.__ -- -... .-- ^- i NPPP Assessment FOR 03-12 i ELIZA13ETH A.FINNE Notary Public, State of New York No.4653666 Qualified in Suffolk County Commission Expires November 30,,e-) TOWN OF SOUTHOLD' PROPERTY RECORD CARD OWNER STREET � .� VILLAGE DIST. SUB. LOT FORMER O C`lER N ;Y. ,; E ACR. an S W TYPE OF BUILDING c k ' OEc Wr- . ZES. 9 W SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS ppAlZc -l\1�0 4-Ayo L—Rs•4 o ROOasqR-- c r go3 YlagLd rph 1,r) it 3- t5 AGE BUILDING CONDITION y _ , vq d&easrcl z�i 5 jib NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 _ Tillable 3 Noodland iwampl.and. FRONTAGE ON WATER 3rushland FRONTAGE ON ROAD a _ -louse Plot DEPTH 0 BULKHEAD 'otal 00 DOCK t��1 - � ..-'.. �+�n y f i t� r Fr * `� bf r ':•�y�•I ■■■■■■ ■■■■■■■■■■■■■■■■■■■ � - ■■■■■■■■■■II■■■■■■■■�.�■■■�>■■■ ^.,.�t,� „.--. «�'7M}"+x.r-:` t:'+i+x'.^..�4�-`•�'�o_T`c�a`._c,.:-n-••�:.. a. '.,.. .,. r'r '..i ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ .AV Found tion Basement Interior Finish �_ •' ••• Rooms Floor i• •• ® Recreation ••• ••• • •• i r ormer riveway i olk LU C.) NOV 16 2012 w ® ❑ U cc In BLDG.OEPT. TOWN OF SOUTHOLD 05 ss% !77' 4,"P!"s 140TED L-1117 TE REAR ELEVATION SCALE: 1/4" = V-0" R ARTIVENT- AT R: HE 'w OCCUPANCY F QUIRE-D, U;N! AlAlf—U I i— L cj ik-s? P Cpdo co Os U- 'N TrRUCTF)N&El E �PLETE FOR 0 ON SHALL M E,E-4 THE REQUIREMPhalz b OF THE C002�QF N YORK STATE, NO r RESPONSIBLE FOR W DESIGN OR COME TRUCTION ERRORS, SHEET NO: LEFT ELEVATION RIGHT ELEVATION SCALE: 1/4" = V-0" SCALE: 1/4" = 1d-0-1 f EXISTING HOUSE EXISTING HOUSE W W QZ � � U 00 J �~ 3� m cc Q co Lo ® p 4 N AS-BUILT DECK Y i 6X6 PT POSE ON 6X6 Pf POST ON i ,12'dia CONC PIER 12"dia CONC PIER: :3'BELOW GRADE T BELOW GRADE' i _=� ,2)2R8'Pf GIRDER----------------------- I iv 13'-O° 8'-0" 1�_6" 5_0" '_6t 8'-O" w FLOOR PLAN _ 1 SCALE: 1/411 1= -oII FOUNDATION PLAN `�UZI �WXON EXISTING _ ,_ SCALE: 1/4„ 1 0„ s q °° �dN�fO N LWL 2X8 DJ®16°OC -\� :_ a (2)2X8 _` T GIRDER hP • 6X6 POST EXISTING d• i v �' 2'diaCONC 4L n ]I Iff PIER r'- m (n 0. 1� I NOV 1 6 2012 AIQOF $66NQ� SHEET NO: CROSS SECTION gLDG.DEFT. SCALE: 1/4" = V-0" Certifications indicated hereon signify that this plat of the property depicted hereon was made in accordance with the existing Code of Practice for Land Surveyors adopted by the New York State Association of Professional Land Surveyors. This certification is only for the lands depicted hereon and is not certification of title,zoning or freedom of encumbrances. Said certifications shall run only to the persons and/or entities listed hereon and are not transferable to additional persons,entities or subsequent owners. O►vG' CREEK L LINE) 6•t TIE E 75. _ __ (N 27'1 9 APP oR X M TE HIGH WAR MARK MONUMENT WOOD FOUND 3LL 'S PIE CONCRETE FOUND WALL FE 0.3'N 0.6'S w U , W WALL Q ON LINE CONC. X K GAR w COVERS OQ: 0.2'S r3 „7 (TYP.) PO GAR Q. N �N m .3'S ' 1 STORY 18.5' DWELLING SLOG ' 0.2'N 8M.5' 0 CONC R 12 4UE COw - 8YP) 3.0 Wd a ,J I . a •� LL O CONC. y 18.0': O N e s COVER INE CV (TYP.)Ld ty J� • J Y d I lX Z FE o + N O Q t— 0.VS 22:6 • 2°. 3.,•. W m ~ tf) �O 61' _ 6.1 3.4'W�V) Z _ a O e 10.3' a O> Q O F- Q cwi o� I W) Z W 1 STORY Z w DWELLING 1 j p o� No: ,3655 Q 11.0 J W W > Nd aIPL I • Z MONUMENT Q FOUND WATER® . . ....... �. 301.43 FE 1.1's IRON. VALVE . PIPE W 75.009 O.6'E S 31.05040 W iCKH AM AVENUE vi v: LOT ARE �t 20)371 S.F. The offsets or dimensions shown fronrstru a property lines are for a specific purpose and use,and therefore,are not Intended to guide In the erection of fences,retaining walls, pools,patios,planting areas,additions to buildings and any other construction. Subsurface and environmental conditions were not examined or considered as a part of this survey. Easements,Rightsof=Way of record,if any,are not shown.Property comer monuments were not placed as a part of this survey. © 2012 BBV PC VBarrett Tax Map: DISTRICT 1000 SECTION 107 BLOCK 9 LOT 8 Bonacci .& Ma of DESCRIBED PROPERTY Unauthorized alteration or addition to PC P this survey is a violation of Section Van Weele� 7209 of New York State Education law Civil Engineers 175A Commerce Drive Map Lot: --- Map Block: --- Surveyors Hauppauge, 63 pauge,N1111788 Filed: =-- No.: -- County: SUFFOLK Planners F 631.435.1022 www.b6pc.com Situate: MATTITUCK,TOWN OF SOUTHOLD Certified to: Title No.:381200077 Revision By Date ANTHONY & PATRICIA GALEOTTL n .of this survey map not bear CHICAGO TITLE INSURANCE COMPANY ing the land surveyor's embossed ASTORIA FEDERAL SAVINGS&LOAN ASSOCIATION seal and signature shall not be con- sidered to be a true and valid copy (its successors and/or assigns) Sun by-, A.B. Drafted : G.C. Checked M.A.R. Scale: 1". = 40' Date: SEPTEMBER 14 2012 ProjectNo.: A120463