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Home My WebLink About37172-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southoid, New York 11971 CERTIFICATE OF OCCUPANCY 5/3/2012 No: 35575 Date: 5/3/2012 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 675 Maier PI, Southold, SCTM #: 473889 Sec/Block/Lot: 55.-6-28 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 4/20/2012 pursuant to which Building Permit No. Lot No. filed in this officed dated 37172 dated 4/26/2012 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" 326 sq ft deck addition to an existing one family dwelling as applied for. The certificate is issued to Jelenkovic, Bruno & Jelenkovic, Laura (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 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 #: 37172 Date: 4/26/2012 Permission is hereby granted to: Jelenkovic, Bruno & Jelenkovic, Laura 675 Maier PI PO BOX 683 Southold, NY 11971 To: construct a 326 sq. ft. "As Built" Deck as applied for At premises located at: 675 Maier PI, Southold SCTM # 473889 Sec/Block/Lot # 55.-6-28 Pursuant to application dated To expire on 10/26/2013. Fees: 4/20/2012 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ADDITION TO DWELLING Total: $660.80 $50.00 $710.80 t~'~ ' ~uilding Inspector 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. FiuaI Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fi'om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. 5. Commercial building, iudustrial building, multiple residences and similar buildings and installations, a certificate of Code Co~npliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existiug 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 iuspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspecto~ shall state the reasons therefor m writing to the applicant C. Fees I. Certificate ofOccupano/- New dwelling $5000, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $5000, Accessory building $50.00, Additions to accessory building $50.00, Busiuesses $50.00 2. Certificate ofOccupancy on Pre-existing Building $100.00 3. Copy of Certificate of Occupaucy- $.25 4. UpdatedCel~ificateofOccupancy $50.00 5. Temporary Certificate of Occupancy - Residential $15 00, Commercial $15.00 New Construction: Locatiou of Property: Owner or Owners of Property: ~_~Ot25/ Suffolk County Tax Map No 1000, Section House No. Street mook d, Date. ~-.,°-.-7-/~.O, Old or Pre existing Building: (check one) Hamlet Lot c~2 ~3~ SulSdivision Permit No. ~ ~ / '7 o~ Filed Map. Date of Permit. q~ 20 - [ ~ Applican!: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate_ Fee Submitted: $ Fiual Certificate: v/ (check one) ApplicmWSiguature TOWN OF SOUTHOLD BUILDING DEPT. 765- t 802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING/STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] IN~JL~TION [/] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ~O~A~ON (2~) ~ ~ ~ PL~G . ~ TO~'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net PERMIT NO. Examined Approved ]]~, 20 le%' Disapproved a/c Expiration BLI)G DEPT. _a. Thru a i ' T k ..... BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ~'q 4 sets of Builcjing Plans+ I--~3c~ Cry:W{-, Planning Board approval O-~oF~-%q-~, N Survey '~\ C/ocR Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector 'PLICATION FOR BUILDING PERMIT Date /_)/9 ..~ 2~,/ INSTRUCTIONS '// ~letely filled in by typewriter or in ink and submitted to the Building Inspector with d sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relatiouship to adjoining premises or public streets or areas, and waterways. c. Tile work covered by this applicatioo may not be commenced before issuance of Building Permit. d. Upon approval of this application, tile 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 bnilding 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 amendmeuts or other regulations affecting the property have been enacted in the interim, tile Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be reqaired. APPLICATION IS HEREBY MADE to the Building Department for tile issuance ora Building Permit pursuant to tile Buildiug Zone Ordinance ol'the Town of Soothold, Suffolk County. New York, and other applicable Laws, Ordinances or Regulations, for the construction of boildings, additions, or alterations or for removal or demolition as herein described. Tile applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit attthorized inspectors on premises and in building for necessary inspections. C_ (Signa~'e of applicant or name, ifa corporation) (Mailing address of applicant) 119'71 State whether applicant is owner, lessee, agent, architect, engineer,, general, contractor, electrician, plumber or builder 0 vv iv C-& Nameofownerofpremises ~ l~ q l',) O '--)'-~ £ E t~/x. O ~O I C '~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer ~-E LC./t,~KO VI Cb (?,Tame and title of corporate ofricer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street ot THo Hamlet Lot 7z:~, ~;~ County Tax Map No. 1000 Section ,~-~-- Block 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_ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work t~,)( I ST/tV' ¢-" __ ~i~ .~ q l ~ T (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 ~ Rear ~' .Depth P/~ ,t-- Height. Number of Stories Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories ?'8: ~,~,.ensions,ofentirenewconstruc,,,~: ,-5-'t Rear aW'¢,W" .Depth ~i~ht ~ ~ Numberof Stories ~ 9. Sizeoflot:FronI /~O ] Rear ]~ I .Depth i~1 Rear / 10. Date of Purchase ] t~oQ ~' ~ ~_5" Name of Former Owner 1 l. 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 14. Names of Owner of premises Name of Architect Name of Contractor NO )('Will excess fill be removed from premises? YES__ ~a~]<OUlO Address ~b)~ PhoneNo. Address Phone No Address Phone No. NO )x/ '7OS--9. qV7 15 a. ls this property within 100 feet of a 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 ora tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO )< 16. Provide survey, to scale, with accurate foundation plan and distances to property lioes. 17. If elevation at any point on property is at l 0 feet or below, mast provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO X · 1F YES, PROV1DE A COPY. STATE OF NEW YORK) SS: COUNTY OF Sq C----F-Ot~ /-,, I,q- tq ,o,, t~- ~-'~' I.,-~--tq ],:LO V / ~being duly sworn, deposes and says that (s)be is tbe 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 tbis application are true to the best of his knowledge and beliefi and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me tbis [ t'7 dayof /:Fro/4-//.,-- 20 ]~ ( o Notary Public ~4o~r~ Public, 8tai~ u[ 14~, Yu¢~ ~gnatnre of A~icant ' - No. 4982528 Oualified in 8u~olk · Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATJOH: S.C.T,M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PL~ District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUC'rION rr-~M# / WORKASSF_~q~ a. What is the Total Area of the Project ;'ai~;~? (Include Total Area of all Parcels located wilhin I Will this Project Retain AIl Stoma-Water Rea. Off the Scope of Work for Proposed Construction) Generated by a Two (2") Inch Rainfall on Site? b. What is the Total Area of Land Clearing (S.F./~cres) (This item will include all run-off created by site clearing and/or construction activities as well as a# and/or Ground Dislu~bance for the proposed Site Improvements and the pennansnt creation of constmcgen activity? Impervious surfaces.) (S.F. I PROVIDE BP, I~ PROJECt DF.~31IFFION O'.~k~'~P-~.~e~0.d! 2 Does the Site Plan end/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall Include all Proposed Grade Changas and Slopes Controlling Surface Water Flow. 3 ones the site Plan end/or survey desedbe the erosion and sediment control practices that will be used to I~ I control site erosion and storm water discharges. This item must be maintained throughout the EnUm Construction Pedod. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural ~ Existing Grade Involving more than 200 Cubic Yards of Material with n any Parcel? -- 5 Will this Application Require Land Disturbing AcUviUes Encompassing an Area in Excess of Five Thousand~L~ (5,000 S.F.) Square Feet of Ground Surface? 6 is there a Natural Water Course Running through the Site? is this Project within the Trustees jurisdicUon ~ ~ General DEC SWPpp Requirements: or within One Hundred (t00') feet of a WeUand orI,~ Submisskm of a SWPPP is required for att Construction activities involving soil Beach? dk~turbaoces of one (!) or mom acres; includb~g disturbances of less than one acre that 7 Wilt there be Site preparation on Exist/ng Grade Slopes ~ are part of a larger common pisa thai witi ultirrote~y distorb or~e or more acres of land; which Exceed Fifteen (15) feet of verUcel pjse ta ~ ! including Construction activities involving so~ disturbances of less than one (1) acta where One Hundred (1 Off) of Horizontal Distance? ~ -- the DEC bas determined theft a SPDES permit is requ&ed for storm water discharges. . SWPPP'$ Shall meet the Minimum Requirements of the SPDES General Permit , 8 Will Driveways, Parking Areas or other Impervious let Storm Water Discharges from Constmctton activity - Permit No. GP-O-10-00t.) 1. The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shati be Surfaces be Sloped to Direct Storm-Water Rutt-Off submitted Io the Deqartment prfor to Iba commencement of construction activity, into and/or in the direcUon of a Town right-of-way?~ : 2. The SWPPP shall describe the erosfo~ and sediment control practices and where 9 Will this Project Require the Placement of Matedal, required, post-consbucflon storm water management practices that wgl be used and/or Removal of Vegetation and/or the construction of any n STATE OF NEW YORK, CO[.TN']~tr OF .................. SS NotaBt Public, State of New York ......... No. 01BU6185050 Qualified in Suffolk County / _ That 1 ................. 0,~'fi~'~7~'~hi~'~'~i~;fi;'~;j ........... .?..... being duly sa, om, deposes and sa¢(~-~ne iEsx~er°aSppA~fic~nl ltal~r2~'t, And that he/she is the ./~...Z~.(.~(/~O ...~....~'..~~'C-~/;'/~''~''~c/! Q "'. .............................. i~;.'FAh'~; ~"/Ai~ ~,'~' ~.' ;'G. j ................................................................ Owner md/or representative of the 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 txue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; .................. ....................... ............... . 7~_~' ~I~, :ill ~ ~ ' · F( L[ )W,NG INSPECTIONS: 1 F( UNt ATION ..... 2 ~UGH'FRA~NG, 4, FIlIAL-CONSTRUCTION&ELECTRICAL % MI ,ST BE COMPLETE F~ C:O G & CONNECTION~ REQUIRED. ¥-~ lISTING DECK ~1/4.-1 -0 SCALE; ' "- ' " '# 100~55-6-28 · JELENKOVIC RESIDERCE 675 Maier'Pl~Ce Southold NY. CHORN0 ASSOCIATES ' · &mhltect~. DATE: 4-16-12