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Home My WebLink About33931-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34100 Date: 11/25/09 T~IS c~TIFIES that the building HOT TUB Location of Property: 65 AUGUST LANE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 53 Block 4 Subdivision Filed Map No. Lot NO. GREENPORT (HAMLET) Lot 44 . 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 2008 pursuant to which Building Permit No. 33931-Z dated MAY 23, 2008 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 HOT TUB AS APPLIED FOR. The certificate is issued to GERALD M & MELANIE DOROSKI (OWNER) of the aforesaid building. SUF~OI~K CO~N~YDEP~T~NT OF }~%LTH~PRO~-AL N/A ~[~lrK~fa~ Cq~RTIFICAT~NO. 11091 08/28/09 PLU~ERS c~KTIFICATION ~A'£~U N/A ure Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34099 Date: 11/25/09 THIS ~TIFIES that the building DECK ADDITION Location of Property: 65 AUGUST LANE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 53 Block 4 subdivision Filed Map NO. __ Lot NO. __ GREENPORT (HAMLET) Lot 44.13 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 2008 purs,,~-t to which Build/ng Permit No. 33931-Z dated MAY 23, 2008 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 GER3%LD M & MELANIE DOROSKI (OWNER) of the aforesaid building. SUFFOLK COUN/~f DEPART~Fr OF HF-;kLTH APPRO~rAL RT.RCTRIC~L CERTIFICATE NO. PLD~ERS C~KTIFICATION DA'r.{~u N/A N/A N/A //or~ed Signature Rev. 1/81 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-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, thc 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 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 Deck New Construction: Location of Property: X Old or Pre-existing Building: 65 August Lane (check one) Greenport House No. Street Hamlet Owner or Owners of Property: Gerald M. & Melanie Doroski Suffolk County Tax Map No 1000, Section 53 Block 4 Lot 44.13 Subdivision Auqust Acres Filed Map. Lot: Permit No. 33931 Date of Permit. Health Dept. Approval: Planning Board Approval: Applicant: Gerald & Melanie Doroski Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ 25.00 Final Certificate: X (check one) ~ - Applicant ~g~ure- Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 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-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 masons 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 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. it[17.-Ioc] Hot tub New Construction: Location of Property: X Old or Pre-existing Building: 65 Auqust Lane (check one) Greenport House No. Street Owner or Owners of Property: Gerald M. g Melanie Doroski Suffolk County Tax Map No 1000, Section 53 Subdivision Auqust Acres Permit No. 33931 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 25.00 Date of Permit. Hamlet Block 4 Lot 44.13 Filed Map. Lot: Applicant: Gerald & Melanie Doroski Underwriters Approval: Certificate No. 11091 Final Certificate:l ~ (ch, eck one) Applic~atum + SUFFOLK 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough ]n [nspection Date: Application No.: County Tax Nap No.: 3erry Doroski August 28,2009 11091 Certificate No.: Final Inspection Date: Building Permit No.: 11091 August 28,2009 This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: Jerry Doroski Site Location: 65 August Road, Greenport, NY 11944 Owner's Address (if different): ~ Residential [] Indoor ~ Basement [] Commercial [FI Outdoor [] First Floor [] New l--1 Renovation [] Second Floor [] Addition ~ Survey Other: INVENTORY Single Phase Heat Duplex Recpt Ceiling Fixture Three Phase Hot Water GFCI Recpt Wa~l Fixture Main Panel AC Cond Single Recpt Recessed Fixture Sub Panel AC Blower Range Recpt Flourescent Transformer Appliances Dryer Recpt Emergency Disconnect 1 Switches Twist Lock Exit Fixtures GFCl Breaker Heat Pump Electric Heat Pool Luminaire Other Equipment: 1-Self Contained Spa Pack GFI Protected [] Service [] Shed ~ Pool [] Hottub [] Attic [] Garage HID Fixtures Smoke CO Detect Pumps Time Clock TVSS Exhaust Fan Applicant: Jerry Doroski Inspected By: Gene Surdi ~'.~ j Signature: ~~ License No.: Homeowner Date Of Certificate: Oct 06,2009 The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEP~LRTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PEP,MIT NO. 33931 Z Date MAY 23, 2008 Permission is hereby granted to: GERALD M DOROSKI 65 AUGUST LANE GREENPORT,NY 11944 for : CONSTRUCTION OF a DECK ADDITION & HOT TUB AS APPLIED FOR at premises located at 65 AUGUST LANE GREENPORT County Tax ~ap No. 473889 Section 053 Block 0004 Lot No. 044.013 pursuant to application dated MAY 23, 2008 and approved by the Building Inspector to expire on NOVEMBER 23, 2009. Fee $ 450.00 / Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ]IN~ [//]'I~NAL [ ] FIRE SAi-,-, ~/' INSFECTION [ ]FIRERESISTANTCONS'TRIJCTI0N [ ] FIRE RESISTANT PENETRATION REMARKS:__ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION y FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ [ ] ROUGH PLBG. [ ]INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~"~ ~FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE#,-,.ATION REMARKS: ~~ ~ DATE ~) ~ INSPECTOR FI:ELff~NSPECTION REPORT I DATE i COMSM~NTS , ...................................... FOUNDATION (2ND) . ROUGH F~G & ......... LNS~ATION PER N. Y. STATE ENERGY CODE y~ ~/ 7'~ ~'~, ~ ' .' ~DI~ON~ CO~S TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20 Approved -~'~, 20 t~d~ Disapproved a/c PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 2008/ a. This application MUST be con~pletely 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 propose 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 al2er 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. ~$LtL. ~//Xf0 ~f (Signatu.r~f applicant or name, if a corporation) (05 . 6ret noor . AN/Itqqq · 't9 (Mailing'address of~pplicdnt) ! ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises erald o Uci 3 /}O¢la~ or sl i (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 propos, ed work will be done: House Number 'Street Hamlet County Tax Map N~. 1000 Section Subdivision ~p. lo~ ~kres Block /7L Filed Map No. Lot ~J' 1~ Lot ! ! 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~'~g~; d/.14~/~.t~ /41~4A.f, b. Intended use and occupancy/~ dl[~c. ~ ~/i[o~l.~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work 4. Estimated Cost ff4rt~. 5. If dwelling, number of dwelling units If garage, number of cars 3( g0/Jc~ Alteration Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~q. 7 Height Number of Stories / / Dimensions of same structure with alterations or additions: Front ,.,ff~/. 7 Depth ~(o .O ' Height do r/,t~q~ Number of Stories 8. Dimensions' of entire new construction: Front ,1~ Height Number of Stories 9. Size oflot: Front 0/ Rear I31' Depth ~)/ ¢, 10. Date o[t~-'urchase Name of Former Owner Depth ~.~l Rear Depth c~[ 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO )~ L/3¢/ 13. Will lot be re-graded? YES__ NO ~ Will excess fill be removed from premises? YES NO )( 14. Names of Owner ofpremises~trl~[d}l * t~d~lqd~rt~ddress (o[]~tt~tllP[.at4t.~t~P Phone No. 417"3~013 Name of Architect ~]'~t~l ~},~[¢14Po' , Address 70f~?.~/~/- PhoneNo_ NameofContractor ~Pra ld Itt, ht'rg ~[O Address (~f /bu~.ttl~ G~. tS?r Phone No. d~7'7-~191~ 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 X · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF~0F~-0L~. ) ~4 [[0[~ (e b 0'~ ~ ~-d' being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE O. BUNCH Notary ~blic, St~t~ d New York (S)He is the ff~t ~/dJ~t/ No. 01BU6185050 (Contractor, Agent, Corporate Officer, etc.) Oual$~l m ~/~IK Commissi0~ F. xpires April 14, 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 tree 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 .~ r~'~"~( dayof ]~,-6~ 20d:~o¢ Notary Public Signa(m~ of Applicant Tow n of Southold Erosion, Sedimentation ~ S--~o~ Ru---~-o. ASSE$8MENT FORM PROPERTY LOCATION: 8.C,T.M. #: Ileum Number: (NOTE: A Check Mark (~') for each Quesiion is Required tore CompleJe Application) 1 Wifl Ihis Project Retain All S[orm-Waler Run-Off Generaled hy a two (2") inch Rainfall on Site? (This item will include all run-off created by site clearing and/er construction a0tivities as well as afl 81te Improvements and Ihe permanent creation of impervious surfaces) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Slmcnlres Indicagng 81ze & Location? This Ilem.shalt include all Proposed Grade Changes and Slopes Conlrolling Surface WaterEIowl 3 Will thls. Pi'oJect Require any Land Filling, Grading or Excavation where there Is a change to the Natural Existing Grade Involving more Ihan 200 Cubic Yards of Matehal within any Parcel? 4 V~ll this Application Require Land Oislurbing Activities Encompassing an Area In Excess of Five Thousand (5,000) Square Peet of Ground Surface? 5 6 THE FOLLOWING ACTIONS MAY REQUIRE THE 8UBMI8810N OFA STORM-WATER, GRADiNG~ DRAtHAGE'AND EROSION ~ON'I'ROL PbAH CERTIFIED aY A DESIGN PROFESSIONAL IN THE STATE OF NEW ¥~RK. Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred 100') feet of a Wel and or Beach9 7 8 9 Will there be Sile preparation on Existing Glade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Horizontal Distanced Will Driveways, Parking Areas or other Impervious Surfaces be Sloped Io Direct Storm-Water Run-Off into and/or in the direction of a Town dght-oPway? Will Ihis Proiect Require lhe Placemenl of Malarial, Removal of Vegelalion and/or the Construction of any Item Within the Town Righl-of Way or Road Shoulde~ Area? (This item will NOT include the Installation of Driveway Aprons.) Yes No this Project Require Silo F'lepar alion wilhiu die Cue I{u~ldred (100) Year Floodplain of any Wa e course? NOTE: If Any Answer to Questions One through Nine is Answered wi(h a Check Mark in the Sox, aStorm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of An}' Building Permitf EXEMPTION; Yes No Does this project meet the minimum standards for classificanon as an Agricultural Project? Note: IfYouAnsweredYes(olhls Question, aStorm-Water, Grading, Drainage&E~oslonControiPlantsNOTRequired~ ~ATE O1' N~W YORK, Aud d~;d hc,zh~ i; th~ ~ ~ ¢ ~.01BU61~050 make ~d file tJds application; d~at alt sb~(em~mt.s cont uued m iJlis apl~iicatJon am tree to the best of iris knowledge ~d belial; ~d d~at fl~e work will be pelfurmed in die m~mncl set foHb m d~e applicaOoa filed hcrc~d~h, Notary Public: ........ ~:~ ........... 0. ,.~,,~ ................... FORM. 06/07 Lot numbers refer to "Map of August Acres" filed in the Suffolk County Clerk's Office on June .3, lg91 as File No. 9107. $CDH$ Ref.~ R10-99,.0169 ~/o/r RumOred N 79'54'00" 5 ANY ALTERATION OR ADDITION TO THiS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION 7209-$UeOIVISION 2. ALL CERTIFICATIONS ~ON ~ VALIO FOR THIS MAP AND C~tE5 THEREOF ONLY IF ~AtD MAP' ~ COP)ES BEAR ~E IMPRESTO SEAL OF ~E. SUR~YOR ~$E $~RE APPEARS HEREON, -Amended ~ of pecenlc ~oy Es{at~ suffolk County File Ne., 1124 SURVEY OF PROPERTY A T ARSItAMOMA QUF~ TO~N OF $OUTHOLD SUFFOLK COUNTY, N~ YORK 1000-53-04-44.13 SCAL~,: 1'=40' DEC. 8, 1999 Jon. 27, 2000 (fndtn loc.) JAN, 25, 2002 (FINAL) · =PIPE AREA = 1,1391 ac SORF/~OF¢ ' ~ (551) 765 - 5020 F~ 797 BOX 9O9 sOu'~H~;~ N,~[. 11971 / / ,/ ~ ;V~THO~ CERTIFICATE ' ~FP~,O~i~D AS NOTED . .~ c~t~/, none ~: ~:3EZN MUST ~' I ~ = ~s.~' · ~o~ ~ ~ SE COt,~-,~ ' -- zs~ ~ ~ ALL CONS', ~tUC'7,':?'. :~-~LL Mc. ET THE ~ YORK STATE. NOT ;{ES~O:4SiBLE FOR / ~ DESIGN OR CO~STR.~ ,O ERRORS. / /''~''~ ~__ , reSTING.., , RE.fORM WATER RUNOFF , ~_ ,N ~.~ ~1 ~ PURSUANT TO CHAPTER 236 /, ,,/ ~,, ~ '~;~~ ,, SITE PLAN ~ 4'-4' .L 4'-~' ,k 3'-9' L 2'-v : ~ / ~ ~ I PROVmE 2- 1~" Dlmeter I ~ ] i ~ ~ ~ / ~ // ~ i ~1) JOISTS ~D DEC~G ~ ~QUI~D / NEW CONC~E '~ ; / ~ / ~ ~ ~/ FOUNDATION & FRAMING PLAN ~2 EC TYPICAL ~ DECK PLAN