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36382-Z
Town of Southold Annex P.O. Box 1179 54375 Main Road Southoid, New York 11971 11/7/2012 CERTIFICATE OF OCCUPANCY No: 36038 Date: 11/7/2012 THIS CERTIFIES that the building DECK Location of Property: 205 Private Rd #3, Southold, SCTM #: 473889 Sec/Block/Lot: 70.-6-9 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 4/27/2011 pursuant to which Building Permit No. 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. Lot No. filed in this officed dated 36382 dated 5/13/2011 The certificate is issued to Starcic, Renato & Carla (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 #: 36382 Permission is hereby granted to: Starcic, Carla Date: 5/13/2011 243 Morningside Ave Cliffside Park, NJ 07010 To: construct a deck addition to an existing dwelling as applied for At premises located at: 205 Private Rd #3, Southold, NY 11971 SCTM # 473889 Sec/Block/Lot # 70.-6-9 Pursuant to application dated To expire on 11111/2012. Fees: 4/27/2011 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ADDITION TO DWELLING Total: $327.20 $50.00 $377.20 Building Inspector Fo~m 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: Ae 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 2110 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~ Submit Planning Board Approval of completed site plan requirements. .6. Be 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 $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 New Construction: Location of Property: House No. Owner or Owners of Property: /~ [& LfC,L Date. ~' -. / ~'~ ,_ Old or Pre-existing Building: (check one) Street Suffolk County Tax Map No 1000, Section SubdivisiOn Date of Permit. Hamlet Applicant: Underwriters Approval: Final Certificate: L~~(c i~'i'i ne) Permit No. r.~ ff_,,, ..~ ~ ~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~5..0. ,vO/~,,~ Block f-~ Lot Filed Map. Lot: TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [j/] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING / STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT ~II~UCTION [ ]FIRE RESISTANT PENETRATION REMARKS. ~/~ ,/~-~~ _/~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG, [ ]FOUNDATION 2ND [ ]/~NSULAT~),N~_. [ ] FRAMING / STRAPPING [/J FINAL ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION[ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) .[ ] ELECTRICAL (FINAL) REMARKS:, ~ ~ DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdT own. NorthF o rk. net Examined ~7/~ ,20 )l Approved Disapproved a/c Expiration PERMIT NO. ,~g 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 Single & Separate Storm-Water Assessment Form Contact: Mail to: Phone: ~ APIq 26 BLDg. [~ ~.~ ~_ ¢ Building Inspector tPPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This pletely filled in by typewriter or ill ink and sublnitted 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. 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 amendnlents 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 issnance ora 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 coustmction 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, ifa corporation) (Mailing address of a~licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~/z7,~,/._~7 ~-,.~,/~,,~__. ,/c~' (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. Location of land on which proposed work will be done: z o / House Number Street Hamlet County Tax Map No. 1000 Section 7'(--.Q Subdivision Block 0 ~ Filed Map No. Lot Oq Lot 2. 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 Addition Repair Removal Demolition Other Work Estimated Cost o~t O O O, o o Fee If dwelling, number of dwelling units If garage, number of cars Alteration (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 Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories imensions of entire new construction: Front ~ / Rear eight Number of Stories Depth Rear 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 14. Names of Owner of premises Name of Architect Name of Contractor 0 c*-w'l%0-'T Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet cfa 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 cfa tidal wetland? * YES ~ NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide survey, to scale, with accurate tbundation 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__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH (S)He is the Notary Public, State of New York (Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk County _ 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. Sworn to before me this ~ ~,{/~3 day of ~ 20 ]] Notary Public Signature of Applicant PROPERTY ADDRESS: 205 PRIVATE RD. #3~ SOUTHOLD Pursuant to the provisions of'Chapter 275 and/or Cha~[~ Southold and in accordance with the Resolution of the Board of Trustees adopted at ~e me~fi~ h~ld bn ject to the following: the survey prepared by John approved on March 23, 2011. ' !~ ~' ~-. - ,i- , ' ' = : " '' i, IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and, these4~es~, to~ ~ab.,s~fih~ !~Y, a~aj~ .~jty o[the said. lloyd asa.of this.~d~ ,~,. ~ New York State Department of Environmental Conservation Division of Environmental Permits, Region 1 SUNY @ Stony Brook 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0365 · Fax: (631) 444-0360 Website: www.dec.ny.,qov February 9, 2011 PERMIT MODIFICATION Carla Starcic 243 Morningside Ave Cliffside-Park, NJ 07010 Re: Permit # 1-4738-00272/00005 Dear Permittee: The Department of Environmental:Oonservation (DEC) has reviewed your request to modify the above referenced permit in accordance with the Uniform Procedures Regulations (6NYCRR Part 62!). It has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore,. the permit is hereby modified to authorize: - Addition of second story deck as shown on the plan prepared by John Metzger, last revised 1/20/11, and stamped NYSDEC approved on 2/8/11. This letter is a modification to the original permit and must be available at the job site whenever authorized work is in progress. All other terms and conditions remain as written in the original permit: Please note, it has been determined that the portion of the property located landward of the 10 foot elevation contour as shown on the survey by John Metzger last revised 9/22/06, is beyOnd Tidal Wetlands Act (Article 25) jurisdiction. CC:. Suffolk Environmental Consulting, .Inc. BOH;TW File Sincerely, Mark Carrara Permit Administrator O Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M. ~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A /~ ~0 ~ ~ _.~ STORM-WATEI~ GRADING, DRAINAGE AND EROSION CONTROL PLAN District Section CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW.. YORK. SCOPE OF WORK* - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT [ Yes N_2o a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within 1 Will this Project Retain Al Storm-Water Run-Off the Scope of Work for Proposed Constmclion) Generated by a Two (2") Inch Rainfall on Site? '/~ (Thisttem will include all run-off created by site b. What Is the Total Area of Land Cleadng (S.F. ! ~) clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Site Improvements and the permanent ~eation of construction activity? impen/ious surfaces.) · (='~"~") 2 Does the Site Plan and/or Survey Show Ail Proposed PRO~v'[DE B]{ZF_,F PROJECT DF_.SC-']~ON (P.~ ~ Pug.. ~ Drainage Structures Indicating Size & Location? This\/ r'~ Item shall Include all Proposed Grade Changes and · / X / co. o, .g Sur c ~ 3 Does the Site Plan and/or Survey describe the erosion ..~~ and sediment control practices that will be used to control Site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. 4 W/il 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 within any Parcel? 5 Will this ApPlication Require Land Disturbing Activities F""'l Encompassing an Area in Excess of Five Thousand I I (5,000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the I-'---1 .- Site? Is this Project within the Trustees jurisdiction I-I General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or. · Submission of a SWPPP is required for all Construction activities involving soil Beach? distud)ances of one (1) or mo~ acres; including disturbances of less than one acre that i. 7 Will there be Site preparation on Existing Grade Slopes am pad of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to r~ including Construction activities involving soil disturbances of less than one (1) acm where One Hundred (100') of Horizontal Distance'~ .._/__ the DEC has determined that a SPDES permit is required for storm water discharges. · ( SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious for Storm Water Discharges from Construction activl~ - Permit No. GP-0-10-O01.) Sur[aces be Sloped to Direct Storm-Water Run-Off . 1. The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department p~or to the commencement of construction activity. 2. The SWPPP shall des~ibe the erosion and sediment control practices and where 9Will this Project Require the Placement of Material, requ!red, post-constmctlon storm water management practices ~mt will be used and/or Removal of Vegetation.and/or Ihe Construction of any constructed to reduce the pollutants In storm water discharges and to assure Item VVithln the Town Right-of-Way or Road Shoulder comlfllance with the terms and conditions of this permit. In addition, the SWPPP shall ' Area? ghl= I~m wi. NO~ In~'lu~ ~e I~talla. o. ~ ~y Apm~) . identify potenllel sources of pollution which may reasonably be expected to affect the . quallly of storm water discharges. NOTE: If Any Answer to Questions one through Nine Is Answered with · Check Ma~k 3. All SWPPPs thai require the post-construction storm water management practice In a Box and the construction site distuCeance Is between 5,0~O$.F. & t Acre in area, component shall be prepared by a quali~ed Design Professional Licensed in New York a Storm-Water, Grading, Drainage & Erosion Control Plan is Requtmd by the Town of that is knowledgeable in the I~inclples and practices of Storm Water Management. $outhold and Must be Submitted for Review PHor to Issuance of.any Building Permit. (NOTE: A Chad( Ma~ (~1') and/or/mswer fa' each c~,,,~ _~. is Required fo~ a STATE OF NEW ¥O]~, Notary Public, State of New York COUN']~ OF ........................................... SS No. 01BU6185050 Qualified in Suffolk County ,., {~o o~ ~o~ ~/~i~'~t'i ................... And that he/she is the ....................................... ,' ..... (~-,~2'~;~ij'~il; ~.';i;2i ................................................................ Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be performed in the manner set forfla in the application filed herewith. Sworn to be/fore me this; ] , ...... t~(Z2:'4~ ........ '7I .................. qa_y of..~...1.~~ ' [~ ...................... N°tary Public: ~....V~......'~.. ...... /.~,:.,~...'L/d.L ~ .................. ~....~~.:.,.:=, ...... " (Signalure of Applicant) FORM - 06/10 SCDHS Ref. # R10-05-0208 N joCKEY _.~o,¢'~,~ N. 7'6' N/O,/F H. & I~. MURPHY .~. '5t 05 ©aklawn Ave. r cREEK DOCE 16' RIGHT OF wAY ~. 112 STY. . k' ~-'~t~r~ ~ 5145 ~ 83.34'40~ E ~ 7.4 97.5.7' ~ S. oF w~?' pRIVA ~ 4¢' 220 NIO/F Oakla~n, Ave. LYNN ,.. CHARLES 0.' HARD Y ~sr~.,. SURVEY OF 0 101~0157~1 I$ ' ' - - ,. Izq?. ' , PROPERTY A ::N~ Eg, N.~1::Kf, ROAD~ :: ~:ARK BROWN LOAM OL . . A ' T S OUZ~O~ ~ , ROWN SANDY LOAM 8C ' TOWN OF SOUTHOLD to t,~ !i~. , ~ , ~.~, ~::~~~ SUFFOLK COUNT~ LOT COVERAGE I ~r ' $~ 1000-70-06-09 ~4 ~.fugoL6 = zo,~ % ~[~:~'~~ ~ ~ ~ ~ ~.~, ' SCALE: 1'%30' The locations o/ wells and cesspools shown hereon ore from f/eM observations and or from da/a ob/a/ned from o/hers. I am familiar w/Ih /he STANDARD~ FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will ab/de by /he condilions se/ forlh /herein and on /he permll 1o' conslrucl. . ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF T~ ~ Y~K STATE EDUCAT~ LA~. EXCEPT ~ PER SECTION 7209 - S~DIV~ ~. ALL CEETIF~ATIONS HEREON ARE .VALID FOR THIS MAP AND C~ES THERE~ ~LY iF SAID MAP OR COPIES BEAR T~ I~ED SE~ ~ T~ SURVEYOR WHOSE SI6NATURE APPEARS HEREON. ADDITIONALLY TO ~COMPLY WlT~ SAI~LA~.TERM ' ALTERED BY ' MUST BE USED BY ANY AND AL~¢~EYORS. UTIL~IN6 A ~OPY OFf,OTHER SURVEYOR'~ MA~TE~MS SU~ ~SPECTED. A~ ' BROUGHT - TO - DATE :,ARE NOT IN COMPLIANCE WITH THE LAW. ·" STAKE I SEPTIC SYSTEM CROSSECTION ~, ] (6312 765- 5020 FAX'[d3~ 17.97 P. O. BOX 909 1230 TRAVELER STI:fEE"7- SOUTHOLD, N. Y. 11971' , MA Y 1'2~. 2005 ,~ung by McDONALD GEOSC/ENC;£' /~,~ 15, 2ooc (r¢v/~/or~ SEPT. ~8~ EO/O (PROP. DECK APR[ 11~006 (REVI$1ONI NOK ag~ ~OOS ( WELL AU6. ~7, 8008 ffoundation) MA Y 8~ EO09 fFINAL 8~ MA Y ~0~ ~009 (UTIL. EASEMENT) . dAN. 27~ 2010 (BASEMENT ELEVATION) ~ I JUNE 14~ ~0 (fln~lJ IIIInl ~ *~?~',~'~'RIGHT ELEVATION LEFT ELEVATION . ~~?-~.~ ~------~.~~----L.: U~"= z'-o'~- ~oo-~2 8 AM TO 4 PM : ~ ~ ~ ~ FOLLO~NG INSPECTIO FOR THE .~ ~ 1. F~NDATION TWO REQ ~?F~'Y'~'~ ' UIRED .... FOR POURED CONCRETE ~ 2 RO~H-FRAM!NG PLUMBING ~ ~; '....~ STRAPPi~G-ELE~TR ' · ~,,,~,~,~ ~ ~ ~' ~' 3. ~SU~T~O. ~C~ .... ~.,,.~ X ~O~ ~~ MUST BE GuMPLETE FO~' C 0 ~_~ ~ ~~ REQUIREMENTS OF THE CODES OF NEW YORKSTATE NOT ~ESPONSiBLE FOR ~SI6~ OR CONSTRUCTION ERRORS. RETAIN STORM WA,~E;-: ~, ~~~ CHAP'iEi':, L~u o,..~.ow, ~AR E LEVATI 0 N SCALE: 1/8" = 1'-0" Z LLI 03 UJ n, SHEET NO: '- " 1' "~' t' LLI ,.-- ,~o~ ~;I i I I I , ~ I .......................... I ,', ,1'~, ,T, , i m-~ ~--~.-~-, i '. ii ~ ~.! ' I/L , ', ' ii k..' ,,---"~ ~ ,~ , ~ ~, ,~ -+-- , I ~ IH I ~ I ,', ' ~ ~' .... T'[~ ..... T .... t ~ ~z , - _ . . ~ST. FLOOR P~N ~~,, ~'~'~ FOUNDATION P~N S~LE: 1/8" = 1'-0' ' ~,o ,c~ ;~ SCALE: 1/8" = 1'-0' (29 I/2" ~T~ ~.~ ~ FLITC~ PLATE5 I," CON~R~E PIER SE~ION A A SHEETNO: ~ ~/ ~'X2'Xl' CONC. FTC. . ~ ~; S~LE: ~/8" = Z,_0,, WIND LOAD PATH CONNECTION AND CONSTRUCTION DETAIL DRAWINGS LU DEC~O~CH ~AILING ' POST-T~GIRDE~H~ER CONNECTION 4~ ~ST PA~ ~ ~ ~/~ ~H~ ~Y TO ~m F~mO HAND'IL CONNECTION i i ~ ~ ~ ~ ~ ~ ~ ~" POST-T~DECK CONNECTION ~ H~E~GI~ER-T~POST CONNECTION ~ ; ~ ~ *~ ~ UN~I~ ~IL POST-T~GIRDE~ER CONNECTION ~ ~e ,~ .' , ~ ~IN~ TO ~CN ~N~TION ~c~u ~m~ u.c. ~ YTO~H~LUaU DEC.PORCH LEDGER C~NECTION ~ ~ ~ JOIST ~ ~ v ~iST ~l~T -- ~ING CONC. PIER FOO~NG ~ O FLUSH JOISTS WITH HE~E~GIRDER SPLICED JOISTS OVER HE~E~GIRDER ~ ~ ~ct ~o ~.~ ~T~ ~. ~Te ~T~ To A ~ ~ ro ~ ~ ~T~ SPLICED JOISTS O~R H~E~GIRDER DECK & PORCH NOTES: N~LING SCHEDULE ~,~am~ml~d~.~g.~~.~. CLIMATIC & GEOG~PHIC DESIGN CRITERIA ..m~ 2-"~ ~CH T~ ~ ,~ SHEETNO: