HomeMy WebLinkAbout32142-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33152
Date: 07/15/09
TBIS CERTIFIBS that the building ADDITION
Location of Property: 1505 DELMAR DR LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473899 Section 127 Block 4 Lot 10
SUhd1V181On Filed Map NO. LOt NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 16, 2006 pursuant to vPhich
Building Permit No. 32142-Z dated JUNE 20, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to BERNARD I NIECKO & WF
(OWNER)
of the aforesaid building.
SIIFPOL& CODNTY DBPARTMENT OF HBAI,TH APPROVAI, N/A
BLSCTRICAL CERTIFICATE NO. 4003953 06/24/08
PLDlBSRS CERTIFICATION DATED
~' / i
Rev. 1/81
f
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
.i~9_ I
APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ _~ i~
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This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1 % lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions [o 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. 'I~~JIO
~~
New Construction:
Old or Pre-existing Building: ~ (check one)
Location of Property: )SAS ~~~/p~~ ~ LIQuR~L ~ /(~~ y 119 ~8
House No. Street Hamlet
Owner or Owners of Property: (j~R.u1FM,D °I' ~o~o~C~S lV I EdKo
Suffolk County Tax Map No 1000, Section ~/ 7.3 8 8 9 /~~ Block 00051 Lot /
Subdivision
Permit No. 3 ~` 1 t{,'j Da[e of Permit.
Health Dept. Approval:
Planning Board Approval:
Request for: "temporary Certificate
00
Fee Submitted: $ o'Z.S
~a X33 15 a-
Qe ~ "l`F~`~ O
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Final Certificate: / (check one)
Applicant Signature
FORM N0. 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. 32142 Z Date JUNE 20, 2006
Permission is hereby granted to:
B & D NIECKO
1505 DELMAR DR
LAUREL,NY 11948
for
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY
AS APPLIED FOR
at premises located at 1505 DELMAR DR LAUREL
County Tax Map No. 473889 Section 127 Block 0004 Lot No. 010
pursuant to application dated JUNE 16, 2006 and approved by the
Building Inspector to expire on DECEMBER 20, 2007.
Fee $
150.00
u!.
Authorized Signature
ORIGINAL
Rev. 5/8/02
.; - I ~
BY THIS CERTIFICATE OF COMPLIANCE THE '. '
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
~.~I~l~-
CERTIFIES THAT
Upon the application of upon premises owned by
KEITH NIECKO
1505 DELMAR DR
LAUREL, NY 11949
Located at 1505 DELMAR DR LAUREL, NY 11948
Application Number: 4003953
Section: Block:
Lot:
BERNARD NIECKO
1505 DELMAR DR
LAUREL, NY 11948
Certificate Number:
Building Permit:
4003953
BDC: ns11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Outside, Porch/Deck,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the zath Day of Juae, Zoos.
Name ~ Rate Retine ~r i Tie
AddidoaalCharges
2 GFCI recptiGes on rear deck
Wiriog Aod Devices
ReceptaGe 2 0
1 oe 1
GFCI
seal
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
3z~~a. ~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1 NSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING /STRAPPING
[ ]FIREPLACE 8~ CHIMNEY
[ ]FIRE RESISTANT CONSTRUCT
[ ]ROUGH PLBG.
[ ] 1 CATION
[ FINAL~~,G~~-~J
[ ]FIRE SAFI ETY INSPECTION
[ ]FIRE RESISTANT PENETRATION
~/ OV
DATE ~~j`l dQ INSPECTOR v~
3 z l s~z.
TOWN OF
1 NSP
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING /STRAPPING
[ ]FIREPLACE 8~ CHIMNEY
[ ] FIRE RESIST~CONSTRUCI
l `
REMARKS: !~
DATE ~ 4 INSPECTOR
DEPT.
ON
[ ]ROUGH PLBG.
[ ] INSU ION
[ INAL
[ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT PENETRATION
~~ ~~~
~~
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TOWN OF SOUTNOLD BUILDING DEPT.
765.1802
C~~~K~ INSPECTION
[~ FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION
REMARKSe
0
DATE ~ ^ oZ ~ INSPECTOR ~~
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION (1ST) - ~ H
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FOUNDATION (2ND) ~
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INSULATION PER N. Y.
STATE ENERGY CODE
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FINAL $ (., G, ,
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ADDTITONAL COMMENTS
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ~,
SOUTHOLD, NY 11971 i '
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
/<,A sets of Building Plans
Planning Board approval
t?.Survey
PERMIT NO. J,1 ~ `f !}-~i Check
Examined /~~~p, 20~
Approved- /~~~j , 20~
Disapproved a/c
Expiration ~, 20~
Septic Form_
N.Y.S.D.E.C.
Trustees~
Contact:
Mail to:
Phone:
~2~
Building Inspector
~6
APPLICATION FOR BUILDING PERMIT
r_.. _ _ __ _ ~ Date , 20 O I9
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.
£ Every building permit shall expire if the work authorized has not commenced within 12 months afrer 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 permi*, for an
addition six months. Thereafrer, 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)
/.5'oS,~clmR~ ~R • ~f}uREI; ~~ 1198
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~ ER/U i~1°. t~ ` ~^~L ~p~o f~l;S ~ /lj 1 FG l(D
(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. j
Electricians License No.
Other Trade's License No.
L. __`
1. Location of land on which proposed work will be done:
ISos a~c~,9-~ .bR . L-a-uREL
House Number Street
Hamlet
County Tax Map No. 1000 Section ~7/a g g 4 Block / ~ 7 . - '~ Lot - ! O
Subdivision Filed Map No. Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ,.
.i
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition ~ E ~K Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost
Fee
(To be paid on filing this application)
If dwelling, number of dwelling units
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear
Height Number of Stories
Depth
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 Will excess fill be removed from premises? YES NO
1
14. Names of Owner cf premises Address Phone N 3 ~ 98 -~ ~ ]
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.
STATE OF NEW YORK)
COUNTYOFSu~'~lK) .
tz R~ ~ ~ ~- IV 1 ~ C-Ka being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
Number of dwelling units on each floor
(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.
Swore llefore me this
J 'r /1 day of ~U~.Y
(,~.Q~
-- Notary Public
JEMJ hiAiSE'ff
11DURY PUBLIC • STATE OF NEW YdM
NO.U1HA6048b64
aIALIF~D IN SUFFOLK COUNTY
~MCOMt'MSSION FJtPIkES 09.25.1f01.o
t
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Signature of Applicant
o a a- ~.~ 7- ~- . d TOWN
OF SOUTHOLD PROPERTY ,~E~ORD CARD
/~/ - 9
~..,
OWNER
FORMER OWNER brFtEET ~
N VILLAGE
E DIST. SUB.Y~ LOT ~!
// «.~t.. ~~.~ . :~~1 ~~~~~,-w
ACR, ~ r
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LL~ //
~fi ~d ~~`" -17orn~ eS ~.e C S W TYPE OF BUILDING
RES. '~ ~ SEAS. VL. - FARM COMM. CB. MICS. Mkt. Value
LAND
0 ~
/6 q
I o+~ IMP.
3 o a
440~~ TOTAL
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55oc~ ~ DATE
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5~ rsC~S REMARKS l~ f /ql /,L a DD LoJ~- *// ;~d 'Yy nay F F~. ~ e
S/ o~ !fie '~ ~S Z ~ C. ~ a
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z 7 S"a/~ SS`0a. ~'h/aKd ate
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~, ~1~.~~ 3 0 V-~. 4ao, ~ /
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fillabie FRONTAGE ON WATER
Noodland FRONTAGE ON ROAD '
i'r
~eadowluid DEPTH ~ 90
loin PIS BULKHEAD
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Foundation ~ ~ .Bath ~ Dinette
Poeoh Basement F V ~ Floors ~ K.
porch Ext. Walls w o o ~ S F+~ N anterior Finish 4 c ~ LR.
B~~,ay Fire Place c Hoot S DR.
~~ _ ~ s ~ o a ~ ~s/ TyPe ~{ Rooms 1st Floor BR.
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. ,.,~ o ~ p ~ pp ~ Don++ef Driveway
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NOTE
^= MONUMENT REVISIONS
,. SUBO/V/SA7NMAPF/LED
.
. MAY 9 y 1972
/NTNEOFF/CEOFTNECIfgK JUNEI6,19T2
OFSUFFOLKON/UNEPP,/9T0 JULY 13, 1972
ASNAPN0.5~B6. AUG.14,19T2
'AUTXORIIFD AtT'"ATN)N Ot ADDITION AUG.ZZ,I9TZ
C PJIS SURV[Y IS A vl'I ATION OE
ECIh ):C9 O! TX! NFW YORK SGTE
JUGD..N :A.I.
^r TXIS SukVaT MAP NOT BEATING
!'-YOR'3 INK.D 5. Al OR '
E UI NOE D WNSIDE4FD
.. BF A YAd. INE CGPY.
E'A4AKTER iNDICAIID IIEf.PON SXALE lUN
EY i0 iXE iER30N EO0. WfiV.N 41E SUAVFY
AID. A~o oN HIS elnAD IJ TnE
, ~ :OVERNM[NI AI AGENCY AND
,~ E STFD Ni4EON, AND
I • A ~ 'S Of Ld BENDING INST4
1 A AhIIES AAI hell TAANSflBAtlE
~O ADU. u..,•~L INSIIIUilON3 Ok SUBSECIUENr
WNERS.
'w.A,-
b~~
S.n°230 w Lot to
'~4{.I e„ f
YOUNG &~~YOUNG"A ~,~ :, ';
400 OSTRANDER AVENUE,~RIVERHEAD NEW YORK ...- ,..,,.-
ALDEN W. YOUNG HOWARD W.YOUNG
FROFEeEIONAL ENGINEER AND GLAND BURVlYOR ,~ ,
LAND SURVEYOR, N.Y.3. LTC. NO, 12846' 'N, T. B. LICP NO. ASt1Y9
SURVEY FOR:
BERNARD F. NIECKO 8E DOLORES NIECKO to of NE
LOTN0.11, LAUREL COUNTRY ESTATF,~st" ~+
/ ~PpD W Y ~~*
Q
~~ .siQ- G
,,. LAUREL v~1+1.K'Enl ~ IVE ,,, B
RIVERHEA INOS •`'
TOWN OF SECURITY IT E6 ~ YCO. :'
SUFFOLK CO., N. Y. ev~ ~N
SCALE n E DATE.: ~^V ~RI~ ', NO. ~ '
Young 4 Yount'
4G0 Gat~sn0e- Avcnue. RveeneM. Nc.. YOn 11901
63149-2303
>c w. ray. ;ono Sselw
rro~x. c waP~rt. r,a~a fyK..
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0 IB'-p BY OWNER SELECTED BY OWNER
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SIZEt SPACING
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1 J L JJ 1JJJ J 1 CONCRETE fOUNDATION
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1 FOOTING TO REST JN
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OELK JOIST REFER
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45PACING
NIECKO RESIDENCE
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AT LAUREL, TOWN OF SOUTFtOLD
~ I~ ? `"II I 2x10 SKIRT SUFFOLK COUNTY, NEW YORK
I~ ® I-,
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HEADER REFER TO SIMPSON
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P05T BASE
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CONCRETE FOOTING
REFER TO PLPNS FOR SIZE
DECK FRAMING AND FOOTING PLAN 2 POST/JOIST CONNECTION
SCALE : I /4'= I'-O' A- SCALE : I /2' = I'-0' iMr v. zaoc
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