HomeMy WebLinkAbout31836-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31559
Date: 05/04/06
THIS CERTIFIES that the building ADDITION
Location of Property: 2020 DELMAR
(HOUSE NO.)
County Tax Map No. 473889 Section 127
DR
(STREET)
Block L-
LAUREL
(HAMLET)
Lot 21
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 9, 2006 pursuant to which
Building Permit No. 31836-Z
dated
MARCH 9, 2006
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 5'X6' STOOP ENTRY ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to RICHARD E & TARA JERNICK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~z-:f!!!:-
Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
MAR I 5
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 nse:
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 2/1 0 of I % 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 nses, 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
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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.
,3' 15/0((>
}
. Old or Pre-existing Building:
o(D:;)6 J)e \mc.( De.
Street
/'
l~
( check one)
New Construction:
Location of Property:
House No.
Owner or Owners of Property: _____~ II r
Hamlet
Suffolk County Tax Map No 1000, Section
.l-lOrc...
41 3"6'?Q
--:fP r () {ck
b0:.oL(
Lot
0'2- I
Block
Subdivision
Filed Map.
Lot:
Permit No.3 f '3 3 (p
Date of Penn it.
Applicant:
Health Dept. Approval:
Planning Board Approval:
. Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
(check one)
Fee Sublnitted: $
~~..~c
~70107
Co 7=3\ 5$ 9
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
31836 Z
Date MARCH
9, 2006
permission is hereby granted to:
RICHARD E JERNICK
2020 DELMAR DRIVE
LAUREL,NY 11948
for
5 X 6 STOOP/ENTRY ADDITION TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP 29775.
at premises located at
2020 DELMAR DR
LAUREL
County Tax Map No. 473889 Section 127
Block 0004
Lot No. 021
pursuant to application dated MARCH
9, 2006 and approved by the
Building Inspector to expire on SEPTEMBER
Fee $
150.00
ORIGINAL
Rev. 5/8/02
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATIO ;. ''\.
[ ] FRAMING I STRAPPING [)(FINAL ~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ;::~ ~ ~
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DATE ; -I-> ~D k
INSPECTOR ~~
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765-1802
BUILDING DEPT.
INSPECTION
[ ] ROUGH PLBG.
[~ULATION
[ ] FINAL
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS: ---r;.;J-1t-/7:J
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DATE /.2- /10 / () ;; INSPECTOR
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765.1802
BUILDING DEPT.
INSPECTION
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FOUNDATION 1 ST
[ ] ~DATION 2ND
[ aFRAMING
[ ] FIREPLACE & CHIMNEY
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REMARKS: ~ U-
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DATE
INSPECTOR
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OWNER
TOWN OF SOUTHOLD PROPERTY RECORD CARD
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VILLAGE
DIST.
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LOT # f$"
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TYPE OF BUILDING
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DATE
MICS.
LAND
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BUILDING CONDITION
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FRONTAGE ON WATER
FRONTAGE ON ROAD .
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'orch Ext. Walls 1/.)01-,7) S~i,'., i: Interior Finish k//j-L BL; LR.
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~ reezewoy I i Fire Place Iv 0 Heat )(1..5- DR. I
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;arage . ':l, IS- , < I ,:- Type Roof Rooms 1 st Floor
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). B. I I Dormer
-~ .~----_._.- Driveway
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TOWN OF SOUTHOLD
.
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, ~y 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold/
.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
_ 3 sets of Building Plans
Planning Board approval
~ Survey
- Check
Septic Form
N.Y.S.D.E.C. .
Trustees
Contact:
Mailto:f(L(o. A, ~n(\C(c..
JOqD bellYhl Jx la.ure/ Wi'-flJ
J
Phone: {Q31- 7~4"1-- ~llo'f
((QP]J...JJ( ..jJ/J
sH'Y'p r
PERMIT NO. .;J. <'t 7:r ~-r
I'
Examined
Approved
Disapproved alc
)
,20_
O~
Expiration
<-
,20_
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'2 ?(1!'\1
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APPLICATION FOR BUILDING PERMIT
Date
?--
,2003
INSTRUCTIONS
.~.
a. This application MUST be completely filled in by typewriter or in ink and submitted to the'Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee according to schedule. . .
b. Plot plan showing location oflot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or othier 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 South old, Suffolk County, New York, and other applWable Laws, Ordinances or
Regulations, for the construction of building., 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.
,J(lJQ 0
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name, if a corporation)
dOd (; elk/milA IU- J)(Jv.uJ
(Mailing address at applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
C)\ nil !1,~
Name of owner of premises ~ [ .t- IO..rCL. i1. JQ ( n ; ct
(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. !J ~'I"J..... - H
Plumbers License No. p
Electricians License No. '1<)~ -. "^ r
Other Trade's License No. #,){ '"
1. Location ofland on which proposed work will be done:
..}6~o DflllWlr Dr
House Number Street
U0i2-.!:.'-
Hamlet
County Tax Map No. 1000 Section L/7 ~ 81( 9
Subdivision
Block J 2.7 .
Filed Map No.
Lot - Cf-1./
Lot
(Name)
2. State existing use and occupancy of premises ~ntended use and occupancy of proposed construction:
a. Existing use and 'lccupancy -1<~(UE)\l4-
b. Intended use and occupancy !<Es L 9. \:SIVc:..6'"
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
/
Alteration
(Description)
4. Estimated Cost
Sin')
f
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
.--
(To be paid on filing this application)
Number of dwelling units on each floor I
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
f 1,1?"
7. Dimensions of existing structures, if any: Front 55 I"
Height Number of Stories
Rear
\
'~c ' '7 II ,-
'Jc) 12
)_-. i -") it
Depth .:;r (I ..:)
Dimensions of same structure with alterations or additions: Front ;') S '7 '/z
Depth 7 q , 3" Height Number of Stories
,. c.' 7/2
Rear ,).:>
\
8. Dimensions of entire new construction: Front J'd I II "
",'
11 Number of Stories
Height
Rear
I
t0IA
Depth
~.i I 1-/'
9. Size oflot: Front
Rear
Depth
'-Iff) d.
/
II. Zone or use district in which premises are situated
Name of Former Owner
10. Date of Purchase
12. Does proposed construction violate any zoning law, ordinance or regulation? YES ~ NO.....i...
13. Will lot be re-graded? YES~ NO j Will excess fill be removed from premises? YES~NO 1_
14. Nanles of Owner ofpremises~;(h:<.::l '!cu."'- J,r1<ctAddress ,:)c{},(i /}liI+'I' Of U<"'1>hone No.Zei';?' 67lp'-/
NameofArchitect.l(jI,~('eiK( Iu.+h, II AddresstO'~~II.2.. G,fee'1flifjPhoneNo q-')f-!l.?5L
Name of Contractor ('C.{ Af" (}lIJIM c:i1,><.... Address '/'.2,I'i) S"VNIIl AJr Phone No. ,::)9 rf' ~rr'/r-2,
MATT1 TVr-K 1->1
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO 1
* IF YES, SOUTH OLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property witl1in 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.
STATE OF NEW YORK)
SS:
COUNTY OF .5uff1iu:..)
1"0,(( ~, ~ \ l\ I Ct) being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
'')\'tVjE' ('
(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 knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Swom~efore me this
!;;; day of ')ul'T 20Q3...,
~.~Q;:~
Notary Public
DAVID G. CHESHIRE
Notory Public, Stole of N_ York
No. 4783676
Qualified in Suffolk CourttY: _
Commiss.ion Expires Dec. 31;t~
.~
In ~ 0.
o ~M'\lrt
Signatur of Apphcant
---------
ENERGY CODE CALCULATIONS
CHAP1ER5
SECTION 501
Detached One and Two Family
(For Non-Electric Heat)
For; ( ) e y J, I ( j"
Per:
5750 Degree Days
Zone lIB
f~"M I-~" t '"tt2.S
e/l.L/;]
, /
Design Criteria
. . I
S."./h. i J
Dated:
SUBSYSTEM AREA DESIGN CODE DESIGN CODE
"lJ" "tJ" UA UA
Exterior Walls 2-2-9 o. 110' 0.14 2. 7.3'-1 32.0 {,
Ceiling Roof /31... D.03 0.031 3 '1' L/. D ?
I 0.ld7 1-./
Floor Over Unheated Space ,31- 0.05 1.1. 2D t . 0
.f.
Heated Slab On GracIe 6.5
Unheated Slab On Grade 4.5
Basement Wall 0.1
Crawl Space Wall 0.06
42.29 '12..75
NOTES.
Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage
Building Envelope Systems to meet requirements of Section 501
The mechanical systems and equipment including:
HV AC Equipment, HV AC Systems, Duct Systems, Ventilation Systems and Insulation of Piping Systems to meet
requirements of Section 503
Service W ster Heating Systems & Equipment to meet requirements of Section 504
Electrical & Lighting Systems & Equipment to meet requirements of Section 505
To the best of my knowledge,
belief, & professional judgement,
these plans are in compliance
with ,the code.
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Extension ~3)(.:z3 .,. S" Z- f
Extension ,/ n.()
8 \( I~ 0- ,
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Extension I I <I"" :3711
Foundation 1'( Bath 1 ~ Dinette
Porch 13 I? r..V Basement F r.J L Floors -.\"6 ;' K.
(P1t.;!3 ~ S1> L i)4!(
Porch . Ext. Walls Interior Finish lR.
00"", SJI, v~ f,#/,/)L!_ 21)
Breezeway Fire Place No Heat )(L: -.:;:.. DR.
Soroga J~X~/ = ":?/.\ /0 D ';/ I.\" Type Roof Rooms 1 st Floor SR.
Patio Recreation Room Rooms 2nd Floor FIN. B
:>. B. Dormer Driveway
Total '/ () 'I S- /
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TOWN OF SOUTHOLD PROPERTY RECORD' CARD
M-<j
STREET ? !')" 2_
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VILLAGE
DIST.! SUB.v
LOT~. 'd.r"
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TYPE OF BUILDING
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Mkt. Value
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TOTAL
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AGE
NEW
FARM
BUILDING CONDITION
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NORMAL
Acre
Value Per
Acre
Value
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BELOW
ABOVE
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Woodland-t-__ ~--i--.---- . ... __.. F~ONT~~_E. O~!O~~ i___::.~.__.__
Meadowland i ! . I DEPTH ;\ /
Housoo.Pl~-'--- +--.::-:------r;JLKHEAD
1'...----.-,...... . .____m .-,----.-.---...------,- ------------..j-.-- -----.-.-.
Total : ." i ! I DOCK
. . _._.___.1..____.__ ____________.._______._.______.____.. _._.. _ __._.___ _.""_. __ '_"_'_
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L- 40.22'
JOSEPH
ANY AL TERA T/ON OR AODITION TO TIfS SURVEY IS A VIOLA TION
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTF/CA TIONS
HEREON ARE VALID FOR THIS MAP AND COPES THEREOF ONLY F
SAID MAP OR COPES BEAR THE IW'RESSED SEAL OF THE SURVEYOR
WHOSE SIGNA TURE APPEARS HEREON.
AOD/TIONALL Y TO COIIPL Y WITH SAID LA W TERM . AL TERED BY .
MUST BE USED BY ANY AND ALL SURVEYORS UTLIZWG A COPY
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH . IiSPf:CTED . AND
. BROUGHT - TO - OA TE . ARE NOT IN COIIPLIANCE WITH THE LAW.
~
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. SURVEY OF PROPERTY
A T LAUREL
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N y:
1000 - 727 - fU - 27
SCALE: 7" r: 20'
FEB. 25, 2002
MARCH 12, 2002 ICERTlFICA nON)
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CERTFIED TO'
RICHARD E. JERNlCK JR.
TARA A. JERNlCK
FLA TBUSH FEDERAL SA VINGS 8. LOAN ASSOCIA TlON
ALLSTA TE ABSTRACT
NOTE' LOT NUMBERS ARE REFERENCED TO
. MAP OF LAUREL COUNTRY. ESTATES'
FILED IN THE SUFFOLK COUNTY CLERK'S
OFFICE ON JUNE 22,1970 AS MAP NO. 5486
Y.S. LlC. NO. 49618
P.C.
X (630 765 - 1797
02 - 129