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HomeMy WebLinkAbout37844-Z �gUFfOI TOWN OF SOUTHOLD moo oy BUILDING DEPARTMENT CO TOWN CLERK'S OFFICE oy • 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#: 37844 Date: 3/5/2013 Permission is hereby granted to: Cal, Jing Shari 62-11 Asquith Cres Rego Park, NY 11375 To: construct an accessory nonhabitable two car garage as applied for At premises located at: 380 Midway Rd, Southold SCTM # 473889 Sec/Block/Lot# 90.-2-4 Pursuant to application dated 2/28/2013 and approved by the Building Inspector. To expire on 9/4/2014. Fees: ALTERATION OF ACCESSORY BUILDINGS $580.00 CO -ACCESSORY BUILDING $50.00 Total: $630.00 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: Ar 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 7110 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 eompleted 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 $15.00 Date- CD New Construction: Old or Pre-existing Building: (check one) Location of Property: 3 /6�1A Y k(J� U l� House No. Street Hamlet Owner or Owners of Property: J C Suffolk County Tax Map No 1000, Section 19b Block C7Lot 0 Subdivision Filed Map. Lot: Permit No. Date of Permit. 3-5 Applicant: Applicant: Health Dept.Approval: " Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted- s 5-6 Applicant Signature • �t, FIELD INSPECT REPORT DATE COMMENTS b m FOUNDATION(1ST) ------------------------------------ • FOUNDATION(2ND) � all z CA E� ROUGH FRAMING& y PLUMBING LVp INSUL•ATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS A-k 1, ll m 19 if Al _ Vn .7i b 4 r7 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying9 TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval _ FAX: (631)°765-9502 ,� Survey SoutholdTown.NorthFork.net PERMIT NO. � `` - Check Septic Foran N.Y.S.D.E.0 f� L (� E �,/] r Trustees � U v C.O Application _ I Flood Permit Examined S ,20j F-M 201" Single&Separate Storm-Water Assessment Form BLDG DEPT. Contact: PP A roved 220-0-- _TOWN OF SOUTki-D J Mail to: > Disapproved a/c 4757 `Q L W, !�^ .Palo sem,:�D0`T-L-,JMV Expiration 2014— /,I1� `(I � tJ(3 5�7t'D—(— 6 43T Building Inspector E PLICATION FOR BUILDING PERMIT . , FEB 2 Date 20 7 2Q13 INSTRUCTIONS a. Tl is appli6al'N,%$T be corn letely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of lans, accu an o scale. Fee according to schedule. gs on premises, relationship to adjoining premises or public streets or lot plan showing location of lot and of buildin 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, i orporation) +—(15' !'l!LL_.- GL&— 5, 0 L-l? tit� 1117-( (Mailing address of applicant) State whether applicant is owner, lessee, ag t, architect, ngineer, general contractor, electrician,plumber or builder Name of owner of premises CA ( (As on the tax roll or latest deed) If applicant is a corporation, signature of dLdy 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 Block 0-7— Lot C9 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 �� b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work A6&65--'zV XL el, (Description) 4. Estimated Cost Fe cj�j (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 Rear Depth 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_KWill excess fill be removed from premises? YES NO 14. Names of Owner of premises '70,62—k Address (246"1 Phone NC. 7 l$' 3S 3 " 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) J SS: COUNTY OF ) HL AP Ot,) &A- being duly sworn, deposes and says that(s)he is the applicant (Naine of individual signing contract) a ve named; CONNIE D. BUNCH Notary Public,State of New York (S)He is the No.01BU6185050 Quaffied Agen or orate Officer, etc. ' `Suffolk (Contract r C P � ) Coanrro's�alore Expires April 14,20,�2 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 _day of � � 20 1310y) L 8-Lxr'-'j , - Notary Public Signature of Applicant Town of Southold - Chapter 236 - Stormwater Management SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPLICANT NAME: Owner-Agent-Consultant-Contractor or Other(Circle One) Property OWNER:(if Different than Applicant) Address: Address: Telephone#: Fez p: Telephone tf: Fax A E-MaiL, E-Mail: Properly Address: rf 2 D a t A ) v Brief Description of Construction Activity,Proposed Structural BMPs,Soft I i S.C.T.M.N: 1000 p,n�(/ u�l n/yVV StabaUmtion BMPs,Project Scope and/or Sequence of Construction Activity E OE —aedio�n oslo Logit I�vidO Addloonel Pepes as Neetleo) Name of Contractor and/or Contact Person Responsible for Implementation of SWPPP: Address: /� __�sl --5--------------------------- E Telephone#: Faztk _`` L s-6-_� �T` .-----___-_------ W C t_ `z..g,, f. Name of Persons Responsible for Installation 8 Maintenance of Erosion Control Practice: ------------ Address:Teleph --•-----------------•'---------___...______..,____ I i E-Maona# Fazfk --------------------- ---------------------- E-Mail. Total Area of All /�/ Total Area of Land Clearing �� ' ________ ___________________ ___ ____ _ __- Pro)ectParcela: S1 060 andlorGround Miurbance. r --_--_ (9F-fhcres] (S.F.fAaasl ._.__..,_...._.-__..-_--___.-__........._...__•.___-__...__._. ' Pro)ectDuratloil ___.______________.----_--_---_,-_--_---I-__---- { ' Start End (Anticipated) �(' c Date: Date: I tMrmbar of Carendoreya1 1 VVIII this Project Disturbe five(5)or More Acres at Q Any One Time During the Proposed Development? Yes No -------------------------------------------- If -------------_---__----__.--------------------If YES:Please Answer theFollowingl --•--•-------.-••_-.-.---------, ...-_----.-..__---- a. Does the Applicant have a Qualified Inspector On Q Q I Staff To Conduct the Required Inspections? Yes No b. Does the SWPPP Indicate How Frequently the Site O 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 I c. Does the SWPPP Adequately Identify All Temporary Q U -- -----_ _--- - ---------------------------.--- I I, and/or Permanent Soil 5tabalization Measures 7 Yes No __----------------------------- d. Does the SWPPP Adequately identify a Complete Project Phasing Plan? ^Yes No Status of Impacted Ovaterbody:(eg.TMDL,303(d)listed Impaired_) e. Does the SWPPP Indicate Additional Site Specific Practices that Will be Utilized to Protect Water Quality? Yes No f. Has the Applicant Submitted a Completed DEC Notice Type of Impacted Waterbody.(eq.Lake,Creek,Day,Pond,sound,Freshwater Wetland...) Of Intent and SWPPP Acceptance Form for Review Q ! by the Town of Southold? Yes No Y i STATE OF NEW YORK, rr � COUNTY OF..7.S�Cr Lk-<..........ss ,r� j That I,.,�iU G� �........�i,�... j.....................................being duly sworn,deposes and says that lie/she is the applicant for Permit, (Name of individual signing Dacumatt) - And that he/she is the ....................................... .. .. ..... ..........................................................._... ............ . .... ....................... ..... . (owner, tractor;Agent,Corporate office,eta) Owner and/or representative of the Owner or O ,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 herewith. Swom to before me this; .....cls of.... ?l .(1.� 1k .. 20. J ..................................... y �{............. Notary Public: ............. ........ ..................... p���•' SWPPP Assessment FORM: 03-12 LIC.#02HU6196298 QUEENS COUNTY MYC ISSION EXPIRES 11-10.201 T.C.S. "SWPPP" Preparation - Chapter 236 For Department Use Only: Storm Water Pollution Prevention Plan S.C.T.M.#: Property Address: Review Checklist Checklist # 11000 13I5hict Section 61ock [at REQUIRED PLAN INFORMATION AND IMPLEMENTATION DETAILS: j + 'Explanation for NO or N.A. Plan Sheet (Does the SWPPP Adequate/ Provide for and/or Indicate the Following.) i YES; NO ;N A., (pg 4) I r � I Location 1. Dratnage a cu of ons&Stormwater BMPs Designs to contain a Two Inch Rainfall On-Site 2._b____ _Construction Phasing plan Indicating- Sequence of ProposadConstructlon Activltfes. --- (1+=1©1 3. General Location Map,_•-•.___ "- - , i[�101 Draiange Slte Plan Drawn to Scale at Sixty(fi0'�feet to the Inch or larger indicating the Following-• C]i 0,0, a Lacatlon and Descrlptfon of Property Boundaries ••, ,•,•, - -_ _ _,• -•• _ _ , " . - .0;[^];�;_ - -_-_• •• -.--- _____ _._.-_..__._______,_._ _ . •- • c. AIf Existin Natural and/or Man Made Features on and within 50'of the Property-gqutrjdpry, d Test Hole Data Indicating Soil Characterlstics&De th to Seasonal High Water Table e. Contours Indicating PropertyjElevapqijs f. Spot Grade&Finish Floor Elevations for Gdsting and Proposed Structures; iC1'Q'=I - - g. Location of Wooded Areas&Isolated Trees with a mum Dimension of 18"Diameter; --- - Sail�anseriiatfon i5rsiric[Soi)•$uivey.�-------__-•• ----"`•----- I ; I I -- ---- - - 5. Background Information about the Scope of the Project,Locatlon&Description of the Site, Proposed Chanes to itis Site and All Exlstlnq.Development on the site including the Following• I i L ---.. a, AIL ImBC9yerrio1;17R0.40l09 Totat Area of Land_Dlsfur4ancQ b. All Excavation,Filling,Stn g Aping&Grading Proposed and Identified as to depth,Volume ur N & Nature.of M ---__-_f__Materials Involved;_-___•___._ _. ......_---_ ------- + c All Areas Re ulnn Cleann and ' .__- __g__ /orGrubbfngi ��;©i©y,_ . .__ _. .----•---- - • - - -_--- - ----_. d. All Areas Where Topsoil Is to be Removed,Stockpiled and where Topsoil will ultimately _,_•e._ -gelation to be Placed on Slte; - ----- - - f. All Temporary&Permanent Storm Water Runoff BMP Control Measures Proposed; g. The Writcipated Pattem of Surface Drainage During Periods of Peak Runoff; ' ' r- -- h. The Location of all'ifoads,Drlvewa s,Sidewalks,Patios,Sfivctures,Otfifrles&Other - "" '-impro`vemefi fnctudfng TemporaryAccess&Coristructiori Stagg Areas; - _-- i - - -- - t, lie Existing Final Confours aria-oi Spot�levatior„s of the site: 6. A Schedule of the Sequence for the Installation of All Planned Soll Erosion,Sedimeniatlon &Stormwater Runoff Control Measures, 7, Description of Pollution Prevention Measures that will be Implemented. B. A Description of the Minimum Erosion&Sediment Control Pradlces to be Installed and/or + , + __-Implemented for Each Construction Activity that will result in Sol[Disturbance 9. Description of Construction&Waste materials Expected to be Stored On Site Q°Q r" _-••--•_._._______,_,__-,_...__ _ ___. .•.•" 10. Temporary&Permanent Soil Stabilization Plan that meets the Current Version of the r New York State Storm Water Design Manual Technical Standard 0 0 i0 11, General Sfte Plan and Construction brawm s for the Pro'ect. I ""_"'-"" ' •` ' -" ` 12. Dimensions,Material Specifications_8,installation Details for Al Erosion&Sediment Control Practices. I 13, Temparary_Practices that will be Converted to Permanent control Measures. J 14, Imp ementation Schedule for Staging Temporary_Erosion Control Practice or BMP. __-••_____{©�0;O�,_".__,_ _•_,____,_,•,_•- 15, Main'ten'ance Schedule to Ensure Continuous&Effective Operation of Erosion& i I c I -" ' • - Sediment Control Practices. 16. Names oF 15'Aitw;r Surface Waters of the Staie of New York and/or VEWthat may be - Impactedby_Development. -� i�10101 17. Delineation of Storm Water Control PI_an Imelementatlon Resconsibilities for Each art of the ,. ._..__.,truci ._. Pro ect Construction Site. 18. All other -__-nF...............•._,.______..•.._.........__.._.__.___,.„,..,.,..,,, „___ _ 19. Id'entlflcationofAllt:onlractor(s}%Stib-Contractor(sj Responslbleforinstalling,-Constnicfing, E�;Q�Q� Re alrin ,Replacing,Inspecting and Maintainin the Erosion&Sediment Control Practices Storm I ; Sm Water Management Control Plan Checklist#1 : 03-12 C' baa, DEC "SWPPP" Preparation - Chapter 236-19 For Department Use Only: -- Storm Water Pollution Prevention Plan s.c.T.M.M Property Address: X61 , Review Checklist Checklist # 2 1000 (Additional Items to be Included with Checklist##1 when Article I II is trigered.) 01611'°t s0cto^ arcek �� REQUIRED PLAN INFORMATION AND IMPLEMENTATION DETAILS: i r i Plan Sheet YES, NO ,N.A., Explanation for NO or N.A.Must be Approved by SMO {pg #) Does the SVVPPP Adequately Provide for and/or Indicate the Following:) , , Location oes t e Ian Indicate and/or Show all Items Require by 'Clid-cKlist 9 V in this Packet? 2. Does the Plan Indicate and/or Show a Description of Each Post-Construction Stormwater _ManaBementPractice? 3. Does the Site Plan/Construction Drawing(s)Indicate andlor Show the Location&Size of I al�rl�r Each Post-Construction Stormwater Mana ement Practice 4. Does the Site PIaNConetruc-Uon Drawings)Indicate andlor Show Hydrologic&Hydraulic Analysis - For All Structural Components of the Stormwater Management System,for Applicable Storms_? 5. Does the Slte Plan/Constnrction Orawing(s)Indicate and/or Provide a Comparison of Post- i Q I O rte, Development Stormwater Runoff Conditions with Pre-Development Conditions? 6. Does the Site PIaNConstruction Drawings)Indicate andlor Show Aft Dimensions,Material Specifications&Installation Details for Each Post-Constructlon Stormwater Practice? lei Iii 7. Does the Site Plan/Construction Orawing(s)Indicate a Maintenance Schedule Provided by r i r i -- -"' " the Constractor(s)to Ensure Continuous&Effective Operation of Each Post-Construction Stormwater Management Practice? 8. Does the Site Plan/Construction Drawings)Indicate andlor Show Maintenance Easements to Ensure Access to All Stormwater Management Practices at the Site for the Purpose of Inspection and Re air? r1 i I l 9. Does the Site PlanlConstruction Drawing(s)Indicate andlor Show inspection and Maintenance r , I ; Agreements) that are Binding on All Subsequent Landowners? 101 O1I�r 10. For All Activities meeting the Threshold in 236-19(B)(1),the SWPPP shall be Prepared&Signed By a Professional in the Principles and Practices of Stormwater Management&Treatment Who Who Shap Certify thatt he Design Meets the Re uiremeats of Chapter 236. ; 11. Does the Plan Indicate and/or Idenkify Ail Potential Sources of Pollution vN(:Kmay affect the Quality of Stormwater Discharges? 12. Does the Plar P.ravide Documentation Supporting the Determination of Approval with Regard i ? to Historic Places or Archeological Resources that Includes the Followli r---j! i a. Information whether the stormwater discharge or land development activities would have I a r r an effect on a property that Is listed or eligible for listing or eligible for listing on the State or National Register of Historic Places�,.________________`_-______ ` ' ` ' ---•--------"-----_'.. --- i + 1 -_.......---•-----_---.._._--------------- ----.....-._•_-_.•_ ______ b. The Results of Historic Resources Screening Determinations that have been Conducted`__ID+OI�r _--"'_'_"'-- -------__-----__""-_". 1 I 1 r--------------------------.•____'"_'""______.____.... _.. c. Description of Measures Necessary to Avoid or Minimize Adverse Impacts on Places Listed, s Imo,01 Q, or Eligible for Listing,on the State or National Resister of Historic Places;and ______,- d. Where Adverse Effects May Occur,Amy Written Agreements in Place with the NYS Office � � I E of Parks,Recreation and Historic Places(OPRHP)or other Governmental Agency to Mitigate Those Effects. ___....W..__..-_-._-_____________-__..__... ..__.._.__..__....__....._-----,------- 13. A Description of the Soli{s)Present at the Site,Including an Identification of the , , � 1 H�draulicSoilGrOup-------------------------------.__-----_-..-- ___ ©i�i�i__ _._ _ _____.-_- ------------------ 14.�Ide-ntification of Any Elements of the Design that are not in Conformance with the - --•- --- Design manual,Including Reasons for the Deviation or Alternative Design and a Description of the Equlvalenc with technical Standards. 16. A Hydrologic and Hydraulic Analysis for All Structural Components of the, StormwaterManagementControlSystem______________ All Post-Construction Stormwater Management Practices. 1T�An Operations and Maintenance Plarithat Includes Inspection and Maintenance V-- --_; ; -------------'-------------'____W..,.._-....__-_ Schedules and Action to Ensure Continuous and Effective Operation of Each Post-Construction Storm Water management Practice. + I + + Storm Water Management Control Plan Checklist#2.- 03-12 Southold Town Building Department P.O.Box 1179 � Permit#: 37844 - 53095 Main Rd Southold,New York 11971 Permit Date: 3/5/2013 (631) 765-1802 Expiration Date: 9/4/2014 Parcel ID: 90.-2-4 BUILDING PERMIT RENEWAL LETTER Dated: 12/9/2016 Applicant: Mladen Bay Location: 380 Midway Rd, Southold Work Description: ACCESSORY GARAGE construct an accessory nonhabitable two car garage as applied for A FEE OF $580.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Cai, Jing Shari Address: 62-11 Asquith Cres Rego Park,NY 11375 The permit listed above has expired.No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. CGO / r J #63 Certificate of Attestation of Exemption From New York State Workers' Compensation and/or Disability Benefits Insurance Coverage Y CL51�R ' "This form cannot be used to waive the workers'compensation rights or obligations of any party." The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers' compensation and/or disability benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit .TING SHARI CAI 380 MIDWAY ROAD From:BUILDING DEPARTMENT OF SOUTHOLD SOUTHOLD,NY 11971 PHONE:718-353-4388 FEIN:XXXXX4874 The location of where work will be performed is 380 MIDWAY ROAD,SOUTHOLD,NY 11971. Estimated dates necessary to complete work associated with the building permit are from March 18,2013 to February 28,2014. The estimated dollar amount of project is $25,001-$50,000 s Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The applicant is a homeowner serving as the general contractor for his/her primary/secondary personal residence. The homeowner has no employees,day labor,leased employees,borrowed employees,part-time employees or subcontractors. The homeowner ONLY has uncompensated friends and family working on his/her residence. Disability Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY BENEFITS INSURANCE COVERAGE for the following reason: The applicant is a homeowner serving as the general contractor for his/her primary/secondary personal residence. The homeowner has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability Benefits Law.) I,SHARI CAI,am the Homeowner with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers'compensation insurance and/or disability benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. 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Y. 1000-90-02-04 SCALE. 1'=30' SEP TEMBER 4, 2012 1,0 O nog � X66' IV \` 401, c� R �Or N ° l 116 ol / `Or 11 �,r 4 -- , N 77.6, 3J 0 0 � h 23 .2 TOR m vi o• Y s.9 � Il e,v �2.� �o v sse, N W ORi CANDSOAp f n f O£or 0-%PPI y GRq te't N69-58' scApf of LOT NUMBERS REFER TO "CEDAR BEACH PARK" 11 W000 GRA�fC of FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE (ALO ev�``HfA0 ON DECEMBER 20, 1927 AS FILE NO. 90 M NG of�x9.96 H w lj� ACO Z� NG CkH f �l� e� Ab CER.,F/F g .fbt % J,) JJNo,;'SL I�R1 C�1 -r HSBC A, K,- USA,-\N.A. I T SUCCESSORS AND/OR ASSIGNS AREA-2� 65� SCS. FT. FID Ll TY /IAt,Tt �lALt �TI'�LE INSURANCE COMPANY TO TIE LINE - r N. Y.S. LIC. NO. 49618 ANY AL TERA TION OR ADDITION TO THIS SURVEY lS A VIOLA 77ON �= `--.' t f;;, , ^_' :~ ECON/C S YORS, P.C. OF SEC77ON 7209OF THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77FICATIONS �- ` J<,.F ,r->4,r (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IFL`'°'� P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET WHOSE SIGNA7URE APPEARS HEREON. SOUTHOLD, N. Y. 11971 12-e41 -.mak 'wl,��'_ *.:'. ,.-_,'-- .,., i s�. `',-fr:: s%,+ :li:•, 'ii „F;!" 'irk',,'•"�'��';5.%; ,+,"'iia, _ S;� - .'d 1 _s,.a«,. _,,.:... ' y.. .pm k2TIF:i S"n✓_ •,iii'%= .. to -., ,4.[J . , - - - -., ..y. _ f.A'.?.......W-l•Ftt.. "u'9'F44"1WI,'�uL'u%'..'.°t .f.L3.tiu 1 A 11 .364 1 1 3 (TYPICAL ROOF SLOPE) _ 2X6 TIES 2X8 RAFTERS 1 2X8 RAFTERS I� _ 32" O.C. �® 16" O.C. © 16" O.C. 8'-6" 8 -6 O-) 7FF4I � o CD 2 2'-2'X3'_ » 3'-0), Q _ f r�` I 2 2 -2X3 10 O 10 O 0 WINDOWS ,.._._......._.__.._____ m 0' - ' d I I o I El 00 WINDOWS J 0 — N i _ z o I o o , `n i Io N�` I HANDRAIL ! I I LINE OF 0 3' 0" HIGH Q � � W FLOOR Q J I\ o -fi-_ --- ---- --- 0 Z 00 x x 0 B —-- N cn o CV to o O 2X2 I I 1 --- t o I i _I ��RED AR i I d- 0 3/4" T&G PLY. WD. FLOOR 0 00 0 0 5 NO 2X2 BALUSTERS I I o o ? Z / z @ 4 0.C. I I - I N q�,. -, 100 00 ` i I i EXISTING GRADE I o P NF_Z ESN �i Ov........._ -----_._._... ... I O O I I - - 3 Q SECTION _ _____ 2 SECTION ____ ---____-___ _- __-___ 30,_0„ -___ .......................... ._.......................___-______-__-------------____ Scale: 1 /4 = 1 —0z Scale: 1 /4 = 1 ' -0 " A 1 Q 3: C) 11 .364 1 1 4 ATTIC FLOOR PLAN o f (TYPICAL ROOF SLOPE) (TYPICAL ROOF SLOPE 0 Z 3 < >1 3 � AT DORMERS) A Scale : 1 /4'— ' - 0 " 0 8' 6" 1 g' 6" W U 00 O 4" CONC. ui1�19 of APRON � � I I+ I o00 00 1 Ll El 11_� - I 1�_ (2) 2'-2'X3'-10" o / 1 '-0" I WINDOWS UP 14 R. LINE OF - ' FLOOR _a� - o '/ ---- --- ---- ---- I 4„ CONC. o APRON X w GARAG E E:1 o o o < R NOT Ul"CILD tr,'ITF I FLAMING L'`; IL r I 00 < OF FOUNDA T I0I'n LO" J � � O _ � � 'HAS BEEN APPROVED. 4" CONC. SLAB O 00 00 . I B RST! '"I STO�'P: trJJ�,TER FL'r:^�I 0000 D �- ON GRADE W/ 1 Fl��'a,�l„^.[ T TO CHAPTER 2135 10X10X10 WWM OF TETE TOV�IN CODE. 0 . _. 0 o SIMILAR NO B I 0 WINDOWS z 0 20'-0” 30'-0" 1 x w AT 1st FI. thw 2X4 STUDS @ 16" O00 0 .C. 2" PLY.WD. SHEATHING AND VINYL SIDING (TYP.) u� I z SIDE ELEVATIONS FRONT ELEVATIONS g A BARN DOORS » » 6,_0„ X 7'-10" ,� 9 -0 � Z � 0 U Scale: 1 /4 = 1 —0 Scale: 1 /4' _ 1 — 0 4" CONC. F 1�:� �� - W 30 _0" APRON N TIFY BUILDINc,, r n S A'11 TO < v J FOLLOVVING INSPECTI" `. \ 1. FOUNDATION A /W 2 n . LEGEND 1 FOR POU"ED CC' CR` i E �J . ROUGH-FRAMING,PLUAIEIN3, � Z STRAPPING, ELECTRI'CF,L&CAl!L ;' Lij 3. INSULATION 4 FINAL-CONSTRUCTION & ELECTRICA'� GARAGE FLOOR PLAN MUST BE COMPLETE FOR C.O NEW WALL ASSEMBLY ALL CONSTRUCTION SHALL MEET THE (� — 2X4 STUDS ® 16" O.C. 1/2 PLY WOOD » > » REQUIREMENTS OF THE CODES OF NF'V' SHEATHING, FELT PAPER, AND VINYL SIDING. Scale: 1 /4 = 1 — 0 YORK STATE. NOT RESPONSIBLE FOR Z �r-� DESIGN OR CONSTRUCTION ERRORS. ~ W F= Q CD C ELEVATION NUMBER 9 DETAIL (AREA) 3:: �1 OTE : < Q- 2 4 DRAWING NUMBER ARCHITECT V V /-1 J � 2 SECTION NUMBER ' DWG NO: 3 1 NOT RETAINED DRAWING NUMBER _ 3 DETAIL (SECTION) FOR FIELD OBSERVATION SERVICES SHEETS IN CONTRACT 3 2X12' (TYP. AT ALL SIDES) 0) oz 3' 0" EAR Q ry ., m LINE OF WALL 2X1 2's AT I � BELOW -- OPENING Z �_ o (2) 2X 12's ABOVE C) I=-- GARAGE DOORS w Q L O 02X12's © 16" O.C. (TYP.) u 0 z (� I I 0L (2) 2X12's � OPENING � o `V 1 /2" PLY. WD. SHEATHING, FELT o PAPER, ICE AND WATER SHIELD 2'-0" �S� L WIDE AT PERIMETER AND VALYS, AND MLAD ADEN9Q�y ARCHITECTURAL SHINGLES (TYP.) STAIR ` OPENING TO BELOW ~ w 1� 0 EW d- 30,_0„ r- 6'-0„ 0 op 30'-0" Z ATTIC FLOOR FRAMING PLAN Q Scale: 1 /4"= 1 ' -0 " ROOF PLAN - 0 0 50z Scale: 1 /4"= 1 ' - 0" W 0 U Z 00 0 W D NV / W CK 8" CONCRETE FOUNDATION 8„ WALL (TYPICAL) I 00 . _ i I CONCRETE FOOTING 2'-6" X 10" (TYPICAL) E X6 RAFTERS @ 2 g16" O.C. (TYP.) oZ o _o N N N � 2X8 RAFTERS @ 16" O.C. (TYP.) z Q CD = z_ p _ I N - � z © .. ...._._...._ 30,_o„ 0 L— � O V-0" TYP. OVERHANG Z FOUNDATION PLAN NOTE : z 0 z 2 ARCHITECT WAS Q - ROOF FRAMING PLAN Scale: 1 /4 = 1 —0 NOT RETAINED Scale: 1 /4,) FOR FIELD = 1 — 0 OBSERVATION SERVICES SHEETS IN SNTRACT DESCRIPTION OF BUILDING ELEMENTS NUMBER OF COMMON NAILS NAIL SPACING ROOF FRAMING TABLE R301.2(1)CLIMATE AND GEOGRAPHIC DESIGN CRITERIA RAFTER TO TOP PLATE (TOE—NAILED) 3-8d PER RAFTER SUBJECT TO DAMAGE FROM ICE SHIELD GROUND SNOW WIND SPEED SEISMIC DESIGN WEATHERING FROST LINE TERMITE DECAY WINTER DESIGN FLOOD HAZARD UNDERLAYMENT 1 /2" PLY. WD. CEILING JOIST TO TO PLATE (TOE—NAILED) 3-8d PER JOIST LOAD (MPH) CATEGORY DEPTH "TEMP ABOVE WALL SHEATHING FELT r__CEILING JOIST TO PARALLEL RAFTER (FACE—NAILED 6-16d PER LAP MODERATE TO SLIGHT TO ' CEILING JOIST LAPS OVER PARTITION (FACE—NAILED) 6-16d PER LEP 45 PSF 110 C SEVERE 3'-0" HEAVY MODERATE 13• F NA 2'—p" PAPER, ICE AND WATER SHIELD COLLAR TIE TO RAFTER (FACE—NAILED) 2-1 Od PER TIE 2'-0" WIDE AT Q BLOCKING TO RAFTER (TOE—NAILED) 2-8d EACH END DESIGN CALCULATIONS ' RIM BOARD TO RAFTER (END—NAILED) 2-16d EACH END DEAD LOAD PERIMETER AND Q WALL FRAMING ROOF = 10 PSF VALIES, z �ooR= 1 o PSF ARCHITECTURAL Q � TOP PLATE TO TOP PLATE (FACE—NAILED) 2-16d PER FOOT WALL = 11 PSF SHINGLES (TYP.) M TOP PLATES AT INTERSECTIONS (FACE—NAILED) 4-16d JOINTS EACH SIDE LNE LOAD (TABLE R301.5) J STUD TO STUD (FACE—NAILED) 2-16d 24" O.C. ROOF = 20 PSF z 'J O HEADER TO HEADER (FACE—NAILED) 16d 16" O.C. ALONG EDGES FLOOR (LMNG AREA) = 40 PSF Ll__I TOP PLATE OR BOTTOM PLATE TO STUD (END—NAILED) 2-16d PER 2X4 STUD DEFLECTION LIMITS (TABLE R301.7) 2X8 RAFTERS © p F— RAFTERS HAVING SLOPES GREATER 3-16d PER 2X6 STUD THAN 3/12 WITH NO FINISHES 16" O.C. (TYP.) LLJ CEILING ATTACHED TO RAFTERS = L/180 M o 4-16d PER 2X8 STUD INTERIOR WALLS AND PARTITIONS = H/180 Z BOTTOM PLATE TO FLOOR JOTS f, BAND JOIST 2-16d 1,2 PER FOOT FLOORS AND PLASTERED CEILINGS = L/360 ALL OTHER STRUCTURAL MEMBERS = L/240 END JOIST OR BLOCKING (FACE:—NAILED) EXTERIOR WALLS WIND LOADS WITH /240 FLOOR FRAMING WIND LOADS WITH FLEXIBLE FINISHES =RITTLE FINISHES LL/120 (2) 2X4'S _ 3/4' SOLID WOOD G�S�EREo JOIST TO SILL, TOP PLATE OR GIRDER (TOE—NAILED) 4-8d PER JOIST SHEET METAL HEADDER (TYP.) - MLADF '9.p BRIDGING TO JOIST (TOE—NAILED) 2-8d EACH END /moi i�/T\� RTRAP NAILED SOFFIT & FASCIA BLOCKING TO JOIST (TOE—NAILED) 2-8d EACH END / L TO RAFTER @ (TYP.) BLOCKING TO SILL OR TOP PVATE (TOE—NAILED) 3-16d EACH JOIST <�; ^�`y� ` 16" O.C. >, LEDGER STRIP TO BEAM (FACE—NAILED) 3-16d 24" O.C. Ill ,�� �i�� ,� °I �> I \��� "x_ Ln JOIST ON LEDGER TO BEAM (TDE—NAILED) 3-8d PER JOISTi �1(/ 'IO o� N Y4 `� °� /�� � i� Mfr `N� I � BAND JOIST TO JOIST (END—NAILED) 3-16d PER JOIST N I BAND JOIST TO SILL OR TOP PLATE (TOE—NAILED) 2-16d' PER FOOT `j j °lj / ROOF FRAMINGII I� �f/i � i� I I 1 I J �' STRUCTURAL PANELS 8d %—,z i ' \� i i 11j -- < 6- EDGE/ 12- FIELD DIAGONAL BOARD SHEATHING , to » V J I ,I I •. ; `, ;� 11 HANGERS NOT I 3/4 T.G. 1"X6" OR 1"X8" 2-8d PER SUPPORT I ',+I-°of I SIMPSON STRONG ��� � SHOWN j PLY. WD. FLOOR 0 1"X10" OR WIDER 3-8d PER SUPPORT TIE H2 @ 16 O.C. Q �- CEILING SHEATHING OR EQUAL 0 GYPSUM WALLBOARD 5d COOLERS 7" EDGE/ 10" FIELD ROOF RIDGE 2x12 BAND BEAM EK_WALL SHEATHING ROOF D I A P H R A G M (TYP.) z STRUCTURAL PANELS 8d 6" EDGE/ 12" FIELD UPLIFT STRAPS _00 � >_6d3 PERIMETER DETAIL FIBERBOARD PANELS o Q 7/16" 3 "EDGE/ 6" FIELD I C) 25/32" 8d 3 3" EDGE/ 6" FIELD O GYPSUM WALLBOARD 5d COOLERS 7" EDGE/ 10" FIELD HARDBOARD 8d 6" EDGE/ 12" FIELD PARTICLE BOARD PANELS 8d 6" EDGE/ 12" FIELD WALL STUD o DIAGONAL BOARD SHEATHING 2-16d PER FOOTFRAMING (2) 2X4's HEADDER z 0M Ld 1"X6" OR 1"X8" 2-8d 6" EDGE/ 12" FIELD (TYP.) p W O 1"X10" OR WIDER 3-8d PER SUPPORT r10 ,Uj (� FLOiOR SHEATHING STRUCTURAL PANELS PLY. WOOD °° 1" OR LESS 8d 6" EDGE/ 12" FIELD SUB FLOOR ° 00 GREATER THAN 1" 1 O 6" EDGE/ 6" FIELD ° DIAGONAL BOARD SHEATHING °o NOTE : i 1"X6" OR 1"X8" 2-8d PER SUPPORT °0B AN ARCHITECT WAS 1"X10" OR WIDER 3-8d PER SUPPORT 0o BEAM I 1. NAILING REQUIREMENTS ARE BASED ON WALL SHEATHING NAILED 6 INCHES ON CENTER AT THE PANEL ° NOT RETAINED EDGE. IF WALL SHEATHING IS NAILED 3 INCHES ON CENTER AT THE PANEL EDGE TO OBTAIN HIGHER SHEAR o CAPACITIES, NAILING REQUIREMENTS FOR STRUCTURAL MEMBERS SHALL BE DOUBLED, OR ALTERNATE ° FORFIELD CONNECTORS, SUCH AS SHEAR PLATES, SHALL BE USED TO MAINTAIN THE LOAD PATH. o 2. WHEN WALL SHEATHING IS CONTINUOUS OVER CONNECTED MEMBERS, THE TABULATED NUMBER OF NAILS SHALL BE PERMITTED TO BE REDUCED TO 1-16D NAIL PER FOOT. 2X4 WALL FRAMING 3. CORROSION RESISTANT 11 GAGE ROOFING NAILS AND 16 GAGE STAPLES ARE PERMITTED, CHECK IBC FOR OBSERVATION ADDITIONAL REQUIREMENTS. ® 16" O,C., 1" PLY _ 2 WD. SHEATHING, J o FELT PAPER & SERVICES VINYL SIDING (TYP.) FOUNDATION NOTES SIMPSON SSP o METAL COIL © 16" O.C. STRAPPING, 1) All footings to rest on undisturbed soil. �-A J OR EQUAL (2) 2X4 s °o EXTEND 8" THICKENED 6" SLAB HEADDER ° OVER WALL 2) New 8" CMU block wall) shall be attached to existing concrete wall with #5 re-bar, 18" long at 12" O.C.. Use approved (TYP.) STUD FRAMING 4" CONCRETE AT FOUNDATION o epoxy for installation into existing wall. All voids in CMU wall shall be filled solid with grout. SLAB WITH WALL (TYP.) v' 10x 1 OX 10 WW EK 3) Vertical #5 reinforcing bars shall be embedded in footing at 4'-0" O.C. maximum, and shall extend the full height of the � RADE foundation wall. Reinforcing bar joints shall be overlapped 18" minimum. 3) All concrete shall be 4,000 PSI minimum. STUD TO TOE STUD TO STUD rE 0 ' - 0 " FRAMING NOTES PLATE TIE 1) All framing techniques and methods to be as per prescriptive design of 2006 SBC High Wind Edition Wood Framing AT BAN D BEAM Construction Manual. 2) Unless otherwise noted, all framing and structural wood material to be Douglas Fir #1. (� 3) Floors, walls, ceilings, rafters to be spaced at 16" O.C. with blocking at 8'-0" max. O.C., unless othervise noted. 8" C.M.U. BLOCK z 4) All bearing wall headers to be (2) 2X4 headers, (1) 2X4 sill plate, with 2X4 studs spaced at 16" O.C., unless otherwise FILLED SOLID 0 noted. W/CONC. W/#5 5 All bearingwall openings to 2 jack studs and 2 full length studs on each side of the opening. LVL headers shall have i`�'f�? I �� r SILL. BEARING = BARS AT 4'-0"OC ( ) j ( ) 9 P g• CORNER � , o (3) jack studs and (2) full length studs on each side of the opening. Bearing wall window sill shall also have (2) 2X4 POST 1 1 i ' i PLATE „ , , , SIMPSON I window sill plates for openings between 4 1 and 6'0", and 2X6 wall openings between 5'11" and 8'9". �` -�, U I , ,r HOLD DOWN 2'-0" Q x.31- ;+ SII HDSA @ ALL �� = I ' I CONCRETE 6) Provide blocking/bridging In floor joists and roof rafters at 8'0" O.C. maximum. CORNER 1 '� ` i I 1 y.__ _.__..___.....__ _..._—_-____ • ___- , -� FOOTING OVER •• W t L,--It— ----- ° + w 7) Roof and exterior wall sheathing to be 1/2" thick (4) ply CDX exterior grade plywood. Plywood to cover over plates and I I I i I POSTS OR i I i I °� VIRGIN SOIL ►J- U headers. i i 1, I ( , II LINE OF CONCRETE -� �1 - -- ------ �`. I,� EQUAL) ; " FOUNDATION " �' -''�.�.�'` �;� � I ;; �� ���` � al ---'"1, CONTINUOUS a � 8) Plywood sub floor to be 3/4 T&G PTS Fir or Advantech adhered with PL400 and screwed to floor joists. Finished floor to , � ��N ��, I I I ����,---'' o U� be Installed over sub floor as per manufacturers Instructions/recomendatlons. �•��\�' `�I ,���� i I i #4 REBAR `'� _— #5 BAR (TYP) ` { �_ SIMPSON SSP 9) All sill plates in contact with concrete to be pressure treated. Sill plates to be installed with foam sill gaskets. I I , X 12 ANCHOR @ 16, DWG No:O.C. ___ ANCHOR BOLT ---y-II BOLT @ 4'-0" O.C. OR EQUAL 10) The contractor shall furnish and install all angles, brackets, toggles, eye bolts, etc. as necessary to properly support, U brace or reinforce all construction materials. ROOF SYSTEM CORNER POST SILL PLATE STUD TO SILL TYPICAL SECTION DETAIL Roof shall be Architectural shingles installed with 60# felt paper base sheet, and 2'-0" wide ice & water shield at gable and HOLD D 0 W N ANCHOR B 0 LT PLATE TIE Scale: 1 1 /2 _ V - 0 " eve side, as per manufacturers Instructions/recomendatlons. SHEETS IN CONTRACT 3