HomeMy WebLinkAbout36403-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
6/22/2011
CERTIFICATE OF OCCUPANCY
No: 35011
Date:
6/22/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ADDITION/ALTERATION
910 VANSTON ROAD, CUTCHOGUE, N.Y. 11935,
Sec/Block/Lot: 104.-12-10.2
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/6/2011 pursuant to which Building Permit No. 36403 dated 5/19/201 I
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:
screened porch on existing wood deck on a one family dwelling as applied for.
The certificate is issued to
Samowski, Daniel
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
'~ Authot:~zed Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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 #: 36403
Date: 5/19/2011
Permission is hereby granted to:
DANIEL SARNOWSKI
P.O. BOX 919
CUTCHOGUE, N.Y. 11935
To:
Addition to an Existing Single Family Dwelling;
Screen Porch on Existing Wood Deck, as applied for.
At premises located at:
910 VANSTON ROAD, CUTCHOGUE, N.Y. 11935
SCTM # 473889
Sec/Block/Lot # 104.-12-10.2
Pursuant to application dated
To expireon 11/16/2012.
Fees:
5/6/2011
and approved by the Building Inspector.
CO - ADDITION TO DWELL1NG
SINGLE FAMILY DWELL1NG - ADDITION OR ALTERATION
Total:
$50.00
$248.00
$298.00
~lnspector-~C~
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 Complianee from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
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
I. 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.
Block
(check one)
/Hamlet
New Construction:
Location of Property:
House No.
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
42
PermitNo. ~ CL(~(f'~ 5~ DateofPermit
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Lot
Old or Pre-existing Building:
Street
Filed Map. Lot:
Applicant:
Underwriters Approval:
Final Certificate: ~/
(check one)
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING / STRAPPING ~FINAL
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ]mERES~am'CONSmucnoN [ ]F~RERESm'Am'P~NETRA'noN
REMARKS:
DATE
INSPECTOR
TOWN OF SOUTHOLD
BUILDING DEPARTMENT '
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
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:
Expiration tt ~' /6 . ,20 [o~t'~
Building Inspector
Phone:
APPLICATION FOR BUILDING PERMIT
Date //iq a-/7 4' 20_/]
INSTRUCTIONS '
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets c~f pIans, 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.
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
author/zed inspectors on premises and in building for necessary inspections.
~ corporation)
(Mailing address o~f applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises /9~'.-/~,. / ~ir. llou,,.sk!
(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 LicenseN6.':~ :~ ':
Plumbers License:'Na;. ':'.., ,,":~ ',
Electricians Lleerls~ 1~o.'"., '~
Other Trade's LicenS~ lqo.
1. Location of land on which proposed work will be done:
'S/lO t/n ,, s ,t , .., /dd
House Number Street
Hamlet
County Tax Map No. t000 Section 10.4 Block Iff--- Lot /~, Off-,
Subdivision Filed Map No. Lot
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
Nature of work (check which applicable): New Building
Repair Removal Demolition
4. EstimatedCosr ~ /~9,,, 000
5. If dwelling, number of dwelling units
If garage, number of cars
Addition /~ Alteration
Other Work
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. Dimensmns of existing structures, if any: Front ~"q Rear )"-~ Depth
Height Number of Stories 2_
Yq
9. Size of lot: Front
10. Date of Purchase
Dimensions of same structure with alterations or additions: Front
Depth ~'~ Height Number of Stories
Dimensions of entire new construction: Front.. fl'~ Rear ~'~
Height Number of Stories
3.2.
Depth
Rear ~ !"4',~ aT'- Depth. ~. ~?, ~.~.
Rear
Name of Former Owner
11. Zone or use district in which premises are situated ]~-- ~[ 1~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
13. Will lot be re-graded? YES
NO 2(
NO ~X Will excess filI be removed from premises? YBS
NO ,K
14. Names
Name of Architect
Name of
Address
Address
Address
Phone No.
Phone No
Phone No.
15 a. Is this property within 100 feet afa tidal wetland or a freshwater wetland? *YES
* 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 2{
* IF YES, D.E.C. PERMIT8 MAY BE REQUIRED.
NO 2(
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)
SS:
COUNTY OF )
ROb¢/~'~ tl~t~t'/'~" being duly swam, deposes and says that (s)he is the applicant
(Name of individual s~gning contract) above named.
(S)He is the
(Contractor, Agent, Corporate Officen etc.) _ ~ I~ ~ ~ ~ .
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 ali statements centained 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.
Lwol-r! to before me this,~,^
"~ day of ,11'~ 20 l
Notary ~blic
Town of Southold
Erosion, Sedimentation & Sto~fii-Water Run-off ASSESSMENT FORM
PROPERTY L ATION: S.C.TJL #: THE FOLLOWING ACTIONS RIAY REQUIRE THE SUBMISSION OF A
Se~A STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN
SCOPE OF WORK - PROPOSED CONSTRUCTION I'I'EM# / WORKASSESSMliNT I Yes No
(Inc/ude Tofal Ama ol MI Parcels iscatad within 2~! /P~' C-eneratad by a Two (2") Inch Raisfa, on Site?
the Scope of Work for Proposed Consbuc~on)
I-I
is
Total
of
La~
Cisa~g
imperious surfaces.)
{s.F./Acres) 2 Does the Site Plan and/or Survey Show Ail Proposed
PRO'V'I]:)[; BI~,.IY.~ PROJ~'TT DESC~uJ'I'.ION
3 Does the Site Plan and/or Survey describe the erosion
and sediment control praclJces that will be used
I--I
Excavation where there is a change lo the Natura~
are Prat efa ;arger commm Wn Ihat MI ul~metelY dtsluF° me ~ m°m ac~es ~f land; which Exceed Fifl,,e~, n (15) feet of Vedfcal Rise to
S']'A']~ OF NEW ¥OILK,
COUNTY OF ........................................... 55
( , c,m~c~. Agem. co, p0m, oa;~r. ;,~:i ....................................................
Owocr ;Lrtd/or representative oJ'~c Owner or Owners, ;Lud
make and file this application; that all statements contained in fids application are true to the best of his lu]owlcdge and belief; and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
............................................... day of ............................................ ,90 .....~~~~'
Notary Public: ............................................................................................ . ......
FORM - 06/10
BUILDING PERMIT EXAMINER CItECKLIST
Applicant:
*Date Submitted: _~--6-~ I Date Reviewed:
Owner:
Estimated Cost:
SCTM# 1000-- I Ot~
Property Address: q [ O V~/'~- ~
!
Subdivision:/I/~'~-/p~-~ Zone: /~--~-0 Conforming?
City: ~ Pre COs?__
' Building Permits (Open/Expired): BP ~-z / c/0 z- , Info:
BP __ -Z / C/0 Z-__, Info: BP __ -Z / C/0 Z-
BP__-Z / C/O Z-__, Info:
,Info: BP -Z / C/O Z-__, Info: __
Single & Separate Search Required? Y or~ Determination:
REQ. LotSize: I~_.. ACT. LotSize: R'-5'-~/o! ~.ST{o) REQ. LotCov
REQ. Front ~ ACT. Front ~ REQ Side
REQ. Height 75'- ACT, Height
Project DeScription: ~
Waterfront? y oM '
If yes, water body: '------" Panel# ~ Flood Zone: ~ Bulkhead/Bluff Distance: -
ADDITIONAL APPROVALS I~QUIRED
Suffolk County Health: Y or~- If yes, *Bed#: *Date: / / *Permit#:
- If no, certification required: Y or N Received: Y or N By:
NYS DEC: eR~-o~c 9nn$ Y or~- Date:
Southold Trustees: Y 0r~- Date: ~/
Southold ZBA: Y or~ - Date: /
Southold Planning: Y or~- Date:
Town Landmark C of A: Y o~DTE:
/ / Permit #:
/ Permit #:
Permit #:
/ Permit #:
/ /
Town Septic: Y o~(~
or NJ Letter - Notes:
or NJ Letter - Notes:
- Notes:
- Notes:
*NYS CODE Compliance (page 2): Y or N
.Fee Structure:
Calculation:
Foundation: SF 1¢9-0 X $ , ~ .=$ 1~-~. 00
First Floor: l/,~-O SF +InitialFee:$ ~00~ 00
Second Floor: SF + Additional Fee ( ): $
Other: SF SF X $ :$
Total: /~ SF + Initial Fee: $
+ Additional Fee ( ): $
TOT~:$ ~ff~' oo
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
· Ground Snow Load: ~0
Weathering: Severe __ .Frost Depth: 36" __
Design Temp: 11 __ ·Iee Shield Underlay: YFJ~ .
USE/OCCUPANCY CLASSIFICATION:
' HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/pREScRIPTIVE
FULL FRAMING DESIGN ELEMENTS: YfN
HEADERS: Y/N WALL sTUDS:
CEILING JOISTS: Yf~ FLOOR JOISTS:
LUiM[BER SPECIES AND GRAJ)E:
Wind Speed; IZ0MPH __ Seismic Design Category." B ,
Termite: M~H Decay:
Flood Haza~'ds:
GLRDERS: Y/N
ROOF IC, kFrERS:
WINDOW AND DOOR SCHEDULE:
,MISSLE TEST REQUIRES{ENTS: Y/N
EGRESS 5.7 S.F.: Y/N
LIGHT 8%:
VENT 4%: YflN
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: Y/Il
PLUMBING RISER DIAGILAid: Y/N
LOCATION OF FI?RE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: Y/N
TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE)
E:,LJRVEY' OF LOT ICI8~
A~ 5HOI,"J,I ON "AI'XL=NIDEID HAP "A" OF NA...G~AU POINT"
I=1! I=r) IN THE ,.G~=FOLK CO. C,,LERI~.G ~:F:I~,E ~ I,.IAP NO.
51TUATE~ NA55~ POINT
TOP, IN.. .50UTHOLD
5LFF:OLK COUNTY, NY
5UP-.VEYED' HAT' 2, 2011
E~UFFOLK GOUNTY TAX
IOO0 - I04 - 12 - t0.2
N
E
C~RT~IF.D '~I~:
DAlql~.., PAUL SARIqOWS~
NOTES:
HONU~IENT FOUND
Area To Tie Line = 2,5,101 .Gq,. Ff,. o¢' 0.,5-/&2 Ac. cos
®F;~APHIC SCALE I"= :~O'
6 EAST MAIN STREET N.Y.$. LIC. NO. 50202
RIVERI4EAD, N.Y. 11901 369-8288 Fax 369-8287
REF.C:\Usem~John~Docmnents~ly Droplmx\11\ll-122.pro
JOHN C. EHLERS LAND SURVEYOR
~ I / A 0'7' COMPLY WITH ALL CODES Of PROPOSED
G"- ,3' '7" .2LO'' '- I O" ,, I ~ ~ NEW YORK STATE & TOWN CODES
- ,3-V" /' ?l N ~ ~ X AS REQUIRED~'ON~'t~'2~ SCREENED PORCH
4x4 POSTTO KESTON ~ ~ , ~ ~ , '~'Ot~IOLDTOWNZBA
~ ~ SARNOWSKI
' = - " ¢~'~ 5 '~5 ,o o' RESIDENCE
(~ VANSTON RO~
/~ ~ ~o~o5~o a q ~ CUTCHOG~,
~ S.C.T.M. ~ I000-
..o,o~ , ~o ~, AbPROVED AS NOTED
ffLOOR ~N ,o~,¢ ¥ Bi Jr[ DING DEPARTaENT AT
? ~ ~ PPING ELECTRICAL ~ CAULKING
4 hflAL - CONSTRUCTION & E~CTRIC~
ALL CONS~UCTIO~
~ YORK STATE. NOT
DESIGN OR C~ E~S.
NAILING & CONNECTIbNS
REQUIRED.
RETAIN STORM'
PLOT PLAN
?' '~ ..... ,OF T~E TOWN C{
SZTE ~D ZON~G DATA
KEAK ELEVATION ~~ '~'~' ~"~'
~CALE~' = ILO" ~-~=s~ ~ ~o~ ~o~ JOHN E. ~TUMPF K.A. ~.C.
.~t a~e~ ~.~'~ ~.~'~ G47 F~NELIN AVENUE
~~ Tlfl~P~A~NOG~DEC"AI'IG~51~CAVAT[ON, rlLLIHG, AND/ORCLEARIN*DON~TOT"JSP~OPE~ GARDEN CI~, N.Y. I 1530
TO BE MECHANICALLY "~ ' K PECONIC PERMIT
~PiCAL ROOF CONSTRUCTION WALLaTU~5 ., EXPEDITING
ow~ 2x¢ ~oo~ ~ ¢ m" o c. PHONE: G3 I .734.83G2
FIN. 2n~ ~L~.
SOUTH ELEVATION BUILDING $ECTION A-1
~CALE E' = ILO" .,,
SCALE
~ '-0"
ER RUNOFF
'~TER 236
SITE AND ZONING DATA