HomeMy WebLinkAbout48683-Z =o��g11FFOl�-cOGy� Town of Southold 5/3/2024
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P.O.Box 1179
o • � 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45156 Date: 5/3/2024
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 40 Oriole Dr, Southold
SCTM#: 473889 Sec/Block/Lot: 55.-6-15.15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/7/2022 pursuant to which Building Permit No. 48683 dated 1/3/2023
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"alterations, including finished second floor,finished basement and HVAC,to an existing single family
dwelling with 4 bedrooms total.
The certificate is issued to Roslak,Maureen&John
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48683 3/6/2024
PLUMBERS CERTIFICATION DATED 10/5/2022 Georg erry Jk.
Authori ed 6knature
�SUFFotK TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y. z TOWN CLERK'S OFFICE
SOUTHOLD, NY
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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 #: 48683 Date: 1/3/2023
Permission is hereby granted to:
Roslak, Maureen
40 Oriole Dr
Southold, NY _11971
To: Legalize.as built second floor, finished basement and HVAC unit at existing single
family dwelling as applied for. *4 bedrooms max. within dwelling.
Additional certification may be required.
At premises located at:
40 Oriole Dr, Southold
SCTM # 473889
Sec/Block/Lot# 55.-6-15.15
Pursuant to application dated 11/7/2022 and approved by the Building Inspector.
To expire on 7/4/2024.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $1,360.00
ACCESSORY $200.00
CO-RESIDENTIAL $50.00
Total: $1,610.00
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Building Inspector
OF SOUr�,QI
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Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q. Sean.deviin(&-town.southold.ny.us
Southold,NY 11971-0959 Q�yeOIUNTI,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Maureen Roslak
Address: 40 Oriole Dr city:Southold st: NY zip: 11971
Building Permit#: 48683 Section: 55 Block: 6 Lot: 15.15
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: Roslak Electric License No: 43977ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic X Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 35 Ceiling Fixtures 7 Bath Exhaust Fan 1
Service 3 ph Hot Water GFCI Recpt 5 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser 2 Single Recpt Recessed Fixtures 22 CO Detectors 1
Sub Panel A/C Blower 2 Range Recpt Ceiling Fan 3 Combo Smoke/CO 5
Transfer Switch UC Lights Dryer Recpt 30A Emergency Strobe Heat Detectors
Disconnect 2 Switches 4'LED Exit Fixtures Sump Pump
Other Equipment: Jacuzzi Tub, W/D
Notes: " AS BUILT NO VISUAL DEFECTS " Second Floor, Basement and HVAC
Inspector Signature: Date: March 6, 2024
S.Devlin-Cert Electrical Compliance Form
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Pax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959Q�� a�
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date: 10
Building Permit No.
Owner: V ILL I
(Please print)
Plumber: 7�0 �sT
lease print)
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I certify'tha_t the solder used in the water supply system contains less than 2/I0 of I%
lead.
m ers Sodium)
tum)
Swom'to beford me this
day of 06-L 20 —
1 VICKI-t BERRY
Notary Public, ,(_ --� )►-County Notary.Public - State of New York
No. 01 BE6070081
Qualified in Suffolk Cou, y
Commission Expires_
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# # TOWN PSOUTHOLD BUILDING DEPT.
cou 631-765-1802
INSPECTION ,
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] -INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[. ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION_
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION -
[" ] ELECTRICAL (ROUGH) .ELECTRICAL (FINAL)
[ . ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS: tit L� �� �✓
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DATE -INSPECTOR
pF SOGTyolo
TOWN OF SOUTHOLD BUILDING DEPT.
c-um, 631-765-1802
no� INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IWLATIOWCAULKING
[ ] FRAMING/STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
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DATE 7O INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
cou 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I ULATIOWCAULKING
[ ] FRAMING/STRAPPING' [ FINAL i&- I f'l-` 2
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
I [ ] RENTAL
REMARKS: O O /� !�v! "te
DATE ' o? -a INSPECTOR
FIELD INSPECTION REPORT. DATE COMMENTS
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INSULATION PER N.Y-, �H
STATE ENERGY CODE
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FINAL
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ADDITIONAL COMMENTS
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TOWN.OF SOU'1'HOLD—BU1LDOG DEPAKTMEN'1-
Town Hall Amex 54375 Main RoadP. 0.B6x 1179 Southold, NY 11971-0959
'Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtowmy.go
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 3 Building Inspector: ' NOV _
��. 0 7 2022
Applications and forms must be filled out in their entirety.,lncomplete ILD
-applicationswill,not be accepted. Where:the•Applicant is not the owner;an
Owner's Authorization-form(Page,2)shall be completed:'
Date: /i r.f I Zv
OWNERS)OF PROPERTY:
Name: o J l`oS L-A- FSCTM#1000- sS 4 S /.S-
Project Address: zq0 p „`IL �K lv,E -r►*O / I 1 Q f
Phone#: S/G q 7 y Email:
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Mailing Address: LIP OR 1 9 1
CONTACT PERSON::
Name:
Mailing Address: L1 0 O o�� i�� So - + �D ,.� 9 `7/
Phone#: S/G yg9_a7 147 Email: ct�0 , e.�
DESIGN.PROFESSIONAL INFORMATION:
Name:
Mailing Address: 3 ow 933 I- I933' f
Phone#: OJ - Email: m e—J op or\sre
CONTRACTOR INFORMATION:.
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF.PROPOSED CONSTRUCTION:
❑New Structure ❑Addition . Alteration ❑Repair ❑Demolition d kj44t ZG Estimated Cost of Project:
❑Other r4 Ress W.W133-J I -J'I' A-14y'" ,a °Z r'G�d $ 7-.4 0,0,
Will the lot be re-graded? ❑Yes 21<lo Ir— Will excess fill be removed from premises? ❑Yes CR<o
1
PROPERTY INFORM�4TION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
IN Check Box'A- er Reading:, The owner/contractor/design professional Is,responsibie'for all drainage and storm water issues as'provided by, • '
Chapter M of tlu Town Code.=APPLICATION IS HEREBY MADE to,the BuildiogZapartment for the'issuanee of p Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicafle'Laws,Ordinances or Regulations,for tfie constnicfion of.buildings; t
additions;alterations or'for.removal'or demolition as hereindescrr'bed.Tlie-applicant agrees to'compiy with all applicable laws,ordinances;building code,
-housinj coda and reolatioris and to admit authorized inspector 'on.primtses,and in buildini{s)foi.n4cessary'inspalmons.False statements made herein are -
punishable a's'a Class-A misdemeanor pursuant to Section 210:45,of the+New.York State P.ena6Law:
Application Submitted By(print name): J ¢D�A r•f C-2 o S GA-k_ ❑Authorized Agent Mlowner
Signature of Applicant: ONNIE D.BUNCH Date: 7 I I l LL
Notary Public,State of New York
No.01 BU6185050
STATE OF NEW YORK) Qualified in Suffolk County
SS: Commission Expires April 14,2 b
COUNTY OF }
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;that all statements contained in this application are true to the best of his/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
C64dayof ✓��y ,20 /"�a C� j—
Notary Public
PROPERTY OWNER,AUTHORIZATION
(Where the applicant is not the owner)
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
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rrj uFFQL BUILDING DEPARTMENT- Electrical Inspect y
r SSS' � TOWN OF SOUTHOLD
Town Hall Annex.- 54375 Main Road - PO Box 1179
u' Southold, New York 11971-0959
�✓x Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(a southoldtownny.gov - seand(Dsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: J z�
Company Name:
Electrician's Name: �a
License No.: Elec. email:
Elec. Phone No: S1G yy 9 o-7y ,7 EI 1 request an email copy of dertificate of Compliance
Elec. Address.: , Cv Tr_i
JOB SITE INFORMATION (All Information Required)
Name:
Address: O ®p�io
Cross Street:
Phone No.: y 7
Bldg.Permit#:q8 c�33cw email e,,�as _ c,4►�
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK-, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
�L 4e_ u,�)� 5e�✓S I l c.�er�z. t"��.z Ar�vi.t�! I A�nc_,/-,r-4,je,�j �k� ��02_ ivwk SO4-43-
Square Footage.
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO []Rough In- ❑ Final
Do you need a Temp Certificate?: ❑ YES [E-110 Issued On
Temp Information: (All information required)
Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 H Frame D Pole Work done on Service? 0 Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
T e. c I o3 S-014
1 p _JA E---s
1
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$ ¢ pL ,�,.` BUILDING DEPARTMENT- Electrical Inspecto
TOWN OF SOUTHOLD
o Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (6.3.1) 765-9502
rogerr(a�southoldtownny.gov'— seand(cr_southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: ���--
Electrician's Name:
License No.: Jn4 y 39� '7 Elec. email:
Elec. Phone No: S1G yy 9 wn 7 Ef I request an email copy of ertificate of Compliance
Elec. Address.: *Z� Co-rc-1-1, ,—) /0
JOB SITE INFORMATION (All Information Required)
Name: tit er 'r- lz�°+�tJ o . .
Address: q0 OR,10
Cross Street: �j ,,� A
Phone No.: 5ic. u, L( 7
Bldg.Permit #: �f�?c C33� email: �� C �,�,•.oa _ r�
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
�- c-
Square Footage:
Circle All That Apply:
Is job ready for inspection?: El"YES NO Rough In 11 Final
Do you need a Temp Certificate?: YES � O Issued On
Temp Information: (All information required)
Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire ReconnectOFlood ReconnectOService ReconnectQUnderground❑Overhead
# Underground Laterals M 1 2 H Frame E Pole Work done on Service? Y DN
Additional Information:
PAYMENT DUE WITH APPLICATION I
e. c :tj I 03 Sc�to
PERMIT # Address:
Switches l r
Outlets
r
GFI's s,
Surface .7
Sconces
H H'soi�rw�
2ti .
UC its
Fans I 75 Fridge HW
Exhaust I Oven WAD
1
Smokes DW Mini
Carbon Micro Generator
Combo s ' Cooktop Transfer
AC AH I Hood Service
l Amps Have Used
Special:
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�CUJTIFICATION OF ORIGIN
These Plans Have Been Prepared From Plans r1c,"QP' IF,0. -31 gaF-VM-ZMd4VtS3U1 MNsT,11�,
And Specifications Previously I'levievved And
Approved 13Y The S;ato Of New York,0j.fR,
Westchester Modular Homes Inc
P.O. Box 900 Dover Plai�, NY 12522
THIRD PARTY INSPECTION AGENCY ARCH ENG 1 REMSION/DRN IDA ITel(914)832-9400 F=(914)832-6698_
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Approved By The State Of New York,DHCR, "-1 58_
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NOTIFY BUILDING DEPARTMENT AT ® `'uPA1�1r+�
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85.1802 8AM TO 4PM FOR THE OCCUPANCY
FOLLOWING INSPECTIONS:
1. FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE r
2 ROUGH-FRAMING&PLUMBING °
3. INSULATION
4. FINAL-CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE C010PLY WI 1'H ALL CODES oil-
REQUIREMENTS OFTHE CODES OF NEW NEW YORK STATE & TOWN CODES
YORK STATE. NOT RESPONSIBLE FOR AS REQUIRED AND CONDITIONS OF
DESIGN OR CONSTRUCTON ERRORS
--L SOUTHOLD TOWN ZBA
SOUTHOLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
,Additional N.Y.S.DEC
Certification
May Be Required.
PLUMBER CERTIFICATION
RETAIN STORM WATER RUNOFF ON LEAD CONTENT BEFORE
PURSUANT TO CHAPTER 236 CERTIFICATE OF OCCUPANCY
OF THE TOWN CODE. SOLDER USED IN WATER
SUPPLY SYSTEM CANNOT
EXCEED 2110 OF 1% L-EAD,
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Project ROSLAK HOUSE ® ® ® ® T.
Energy Code: 2018 IECC
Location: Southold,New York
Construction Type: Single-family
Projectlype: Alteration FASTENER TYPE: SPACING:
Climate Zone: 4 (5572 HDD) NaBw000-srNEw
Permit Date: BASED ANCHOR WITH 16'OC
Permit Number: bn.EMBEDMENT LENGTH
No.10 WOOD-SCR ® ® Q
Construction Site: Owner/Agent: Designer/Contractor: RBASEED ANCH RWITHK.1N 16.0E
40 OREO DIVE
SOUTHOLD,NY 1/4,n.din.LAGSCREW
BasEo ANaoR WITH 16'OC
2m.EMBEDMENT LENGTH
......................,..........,..........�...........w.,..«",...-..,..J SHEATHINGYWOOD N
GRA-1 L CE
PLYWOOD RATED SHEATHRIG N
GLTERNA r ,
(ALTERNATMVE:7/16'O.S B) O L�✓�
Slab-on-ur v)e tndenffs are no longer eans,d,red in the OA or performance compliance path in RESrherk Each slob-on-grade ® 1/2'APA RATEDSHFATHING
assembly;n the sp—fled climate zone m—t meet them iinnni,energy code in-!1t;nn R-value and depth requirerr eW^ LL GRADE PLYwoo
(ALTERNATMVF.7/16'O S 6)
O O
Envelope Assemblies 10 1
J FASTENER TYPE: SPACING: Dn DFk]
No.6 NCHOR WO STUDS 1 y J
{ BASED MBEDMEN WITH ID'OC
s j
•,.AA. li .. 7 e :6q 2m.EMBEDMENT IENGR V
WINDOW SILL
TYPICAL WINDOW OPENING
Wall;Wood ._.., ... .. .... . ... .._..,.....�..._... ,..._..._...... ._._._ ...�.. ...._ _... .� No.10 WOOD-SCREWS �✓
pod Frame,16"D.C. 757 13.0 0.0 0.082 0.060 61 45 BASED ANCHOR WITH 12'OC I
PANEL SPAN EQUAL OR SMALLER 2;n.EMBEDMENT LENGn
Window:Wood Frame THAN 4 FEET
7 0.300 0.320 2 Z BASE.ANCHOR WITH
SHGC:0.40 BASSO ANCHOR WITH 16.OC
Window 1:Wood Frame 7 0270 0320 2 2 zm.EneErnENr LEnGR
. . o 0
SHGC:0.34 TYPICAL DOOR OPENING
Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other PANEL SPAN GREATER THAN 4 FEET 2ULUX4 PLYWOOD CONNECTED
LIE6 FASTENER TYPE' SPACING:
2-]%4 R WITH
STUDS CONNECTED
calculations submitted with the permit application.The proposed building has been designed to meet the 2018 IECC requirements in AND EQUAL OR SMALLER TOGETFIER wmtsratNLEss STEEL N°.8 WOOD-SaEW
REScheck Version:REScheck-Web and to comply with the mandatory requirements listed in the RES check Inspection Checklist. OR GALWN¢ED Bars w/WASHERS RASED ANCHOR WITH e'oc
THAN6FEET AND NUTS O2•-VO.c 2In.EMBEDMENT LENGTH
WOOD-S
REWS
Name-Title signature Date TYPICAL MULTIPLE OPENINGS No.10 MCHOR WITH
RASE ANCHOR WITH 9'OC
2In.EMBEDMENT LENGTH
PANEL SPAN GREATER THAN 6 FEET
AND EQUAL OR SMALLER 1/Mn.di..LAGSCAEW
&SED ANCHHOR Wmi 16'OC
THAN 8 FEET tin.EMBEDMENT LENGTH
WIND-BORNE DEBRIS PROTECTION FOR WOOD STRUCTURAL PANEL DRAWN:
AS PER SEC.R301.2.1.2 NYS CODE: PROTECTION OF OPENING :' ��i� s ` `� SCALE:
WINDBORNE DEBRIS PROTECTION FASTENING SCHEDULE FOR WOOD STRUCTURAL PANELS WOOD STRUCTURAL PANELS WITH A MINIMUM THICKNESS OF 7/16"
AND MAXIMUM PANEL SPAN OF 8 FEET SHALL EE PERMITTED FOR OPENING PROTECTION IN ONE-AND TWO-STORY BUILDINGS.PANELS SHALL BE PRECUT TO �� t r4 JOB#'
COVER GLAZED OPENINGS WITH ATTACHMENTHARDWARE PROVIDED.(REFER TO SECTION 1609.1.4,1609.6.5 AND TABLE 1609.1.4 OF N.Y.S.RESIDENTIAL r '• �• �,
- 10/24/2022
CONSTRUCTION CODE).THIS IS NOT A SUBSTITUTION FOR DESIGN-PRESSURE.ALL OPENINGS MUST HAVE DESIGN-PRESSURE UPGRADES WHERE APPLICABLE.
ALL PANELS MUST BE CUT TO SIZE AND READYTO USE ON ANY NEW WINDOWS AND DOORS.SHUTTERS MUST BE MARKED FOR WHAT OPENING IT IS TO COVER. SHEET NUMBER:
HARDWARE MUST ACCOMPANY SHUTTERS FORINSTALLATION. k 1 fE
Project Title:ROSLAK HOUSE Report date: 10/18/22
Data filename: Page 1 of 1A- 1