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HomeMy WebLinkAbout37853-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 3/19/2013 CERTIFICATE OF OCCUPANCY No: 36174 Date: 3/19/2013 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: AS BUILT DECK 1025 Delmar Dr, Laurel, Sec/Block/Lot: 127.-4-14 Fried Map No. conforms substantially to the Application for Builffmg pern~t heretofore 3/5/2013 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: "AS BUILT" DECK ADDITION TO SiNGLE FAMILY HOME AS APPLIED FOR Lot No. filed in this officed dated 37853 dated 3/7/2013 The certificate is issued to Cibulski, Gerald & Cibulski, Betty (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 #: 37853 Permission is hereby granted to: Cibulski, Gerald & Cibulski, Betty 1025 Delmar Dr Laurel, NY 11948 Date: 31712013 To: "As built" deck addition as applied for. Additional certifications may be required. At premises located at: 1025 Delmar Dr, Laurel SCTM # 473889 Sec/Block/Lot # 127.-4-14 Pursuant to application dated To expire on 9/6/2014. Fees: 3/5/2013 and approved by the Building Inspector. AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $635.20 CO - ADDITION TO DWELLING $50.00 Total: $685.20 Form NO. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy This' applic,;tion must be filled in by typewriter or ink and submitted to the Building Department with the following: For new building or new use: 1. Final survey of property with aceumt¢ location of all buildings, property lines, streets, and unusual natura} or topographic features. 2. Final Approval from Health Dgpt. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board Of Fire Underwriters. 4. Sw.orn 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. 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, streels, building and unusual natural or topographic features. 2. A properly c4~mpleted application and cortscnt to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state thc 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. Ce[tifieate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $:25 4. Updated Certificate of Occupancy- $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / New Construction: -' Old or Pre-existing Building: Location of Property: /~2~ /~3 ~-/.-A4 4k~ ?'~) ~l g'-~- House No. or Owners of Property: '~ ~t-~ ~r ~/-TF~ Owner Suffolk County Tax Map No 1000, Section / 2 7 Subdivision Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Foe Submitted: $ DateofPermit. ~- 7 - /.~ Date. (check one) Street Hamlet Block Filed Map. Lot / ~ Applicant: Undem~ters Approval: Final Certificate: ~/// check one) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [. ] I~t~LATION [ ]FRAMING/STRAPPING [~] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. North Fo rk.net Expiration PERMIT NO. MAR -4 2013 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. Frustees C.O. Application Flood Permit Single & Separate Stol'in-Water Assessment Form Contact: Mail to: Building h~/pector ~ APPLICATION FOR BUILDING PERMIT Date .20 INSTRUCTIONS a. This application MUSF be completely filled in by tSpexx riter or in ink aud submitted to the Building Inspector with 4 sets ~,fplaus. accurate plot plan lo scale. Fee according to schedule. b. Plot plaa showing Iocntion of lot aud of buildings ou premises, relationship to adjoining premises or public streets or areOs, and waterways. c. The work covered by this application may not be commcuced before issuance of Building Permit. d. Upon approval of this applicatiou, lhe Building Inspector x~ ill issue a Building Permit to the applicant. Such a permit shall be kept ou the premises available for iuspection 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 Occupanc3. f. Every buildiug permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 1'8 months from such date. If ilo zoning amendmeats or other regulations affecting the property have beeu enacted iu the iuterim, 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 Departmeut for the issuance ora Building Permit pursuaut to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York. and other applicable Laws, Ordinances or Regulations, for the constructiou 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. housiug code, and regulations, and to admit authorized iuspectors on prelnises and ill buildiug For necessary inspections. (Sig~mture o~app-~i~(nt or name, ifa corp-oration) (Mailing address of applicant) State whether applicaut is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder NameofowneroFpremises ~-~I~=R,,,~t~'.~-FP'/ '~--_J~l.)l-,.%~! ~.g~. (As on the tax roll or Imest deed) If applicant is a corporation, sim~ature ofdulx authorized nfficer (Name and title of corporate of'lice~) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which propose4 work will be done: ! O P..S"' House Number Street Hamlet County Tax Map No. , O00 Section /r~'''') Block q Lot )~ Subdivision l:iled Map No. Lot 2. State existing use and occupancy of premises and intended use and occupanc3 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 Addition Alteration Other Work A-s (Description) Fee (;!~ ';' - '.:"!' (To be paid on filing this application) Nulnber of dwelling units on each floor 6. It' business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, it' an3': Front Height. Number of Stories Real' Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase Name of [:ormer ()wner l 1. 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 V/Will excess lill be relnoved t¥onl prelnises? YES NO__ 14. Names of Owner of premises~,..~/¢~i~OC~r?~/~._ ~..,~ .~ ,. . t,~_,. [P,o~ . ,~,q_ ~.~,~, _ I O,%~' I)~~''- Phone No.~'~l- qlS't ,> ~ ~o Name of Architect Address Phone No Nanle of Contractor Address Phone No. 15 a. Is 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. ls 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 foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or belox~, 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: COUN I'Y OF ) 'x,~'[~.~'"f ~---&~IL'q~S~x [ J~-,- being du'> sworn, deposes and says tim[ (s)lne is tine applicant (Name of individual signing contract) above namecl, CONNIE D. BUNCH ~ --'{- Notary Public, State of New York No, 01 BU6185050 (S)Hc is thc Qualified in ¢hlffflik C~.Ollrll~. __ (Contractor, Agent, Corporate Ol'l]cer, etc.) Commission E,~pires April 14, of said owner or owners, and is duly autlnorized to perform or have performed the said work and to make and file this application; tlnat all statements contaiaed in this application are true to the best of Iris knowledge aad belief: and tlnat tine work will be performed in tine manner set forth ia the applicatioa filed there~Gth. Notary Public aiure Or--cant  Town of Southold - Chapter 236 - Stormwater Management SWPPP - Storm Water Pollution Prevention Plan Ass~sment GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPU NAME: ~-~mlu~nl-Con~raclororO~hlr (Ck~O~) Pmpe~y~R:(~DIl~remtl~n/l~N~l~anl) Staff To ~ndu~ ~e ~ t~ns ? Yes No c. ~es ~e ~PPP A~u~y Ident~ NI Tem~m~ ~ ~ d. D~s ~e ~WPPP ~uately Id~ a Comple~ ~ ~ D~s SWPPP Spec~c Of ]n~t and SWPPP A~e~ Fo~ ~r Re~ ~ ~ Sq'A~ OF NEW YORK, CONNI~ ~. ou,~v, , CO~ OF ........................................... ~ N0ta~ Public, State of New York No. 01BU6185059 ~d ~ h~ ~ ~ ................................ ~..~. ....................................................................................................... (~r, ~, ~~, ~1 ......... ............ ...... 8WPPP Assessment FORM: 03-t2 SURVEYED FOR: HENRY ROMANONSKI 8 KATHIE CIBULSKI PROPERTY LOCATED AT LAUREL LOT No. 7 MAP OF LAUREL COUNTRY ESTATES FILED: JUNE 22. 1970: FILE No. 5486 TONN OF SOUTHOLB SUFFOLK COUNTY. NEW YORK S.C.T,i"I. # 1000-127-4-14 AREA = 23,B13 SF. : 0.5467 ACRES SCALE: 1'=30' NOTE: THE EXISTENCE OF RIGHT OF NAYS. NETL^NDS AND/OR EASEMENTS DF RECORO IF ANY. NOT SHONN ARE NOT GUARANTEED. SURVEYED BY: ~ PAUL BARYLSKI LAND SURVEYING ~, PATCHOGUE NY 11772 ~ PHONE 631-294-6985 ~ FAX 631-627-3186 ~ PAULBARYLSKIoYAHOO.COM LAND N/F CERTIFIED TO: HENRY ROMANOHSKI KATHIE CIBULSKI FIDELITY NATIONAL TITLE INSURANCE COMPANY CHASE BANK 1126 LOT 8 GENERAL NOTE5 ALL MORK PERPORMEE;' SHALL COMPLY MITH THE 2OIO RESIDENTIAL CODE OF HEM T,ORK. STATE. CONTP-.ACTOR SHALL GOORPlNATE ANT' AND ALL INSPECTIONS AS REQIJIRED TO OBTAIN CERTIPICATE OF OC, CUPANC'r' ON BEHALF OF THE OMNER· O!AINER SHALL OBTAIN ANT' ANP ALL REQUIRED VARIANC. ES AND/OR PERMITS PRIOR TO ALLOIAIIN® CONTP-JNCTOP--.S TO PROCEED MITH ANY OF THE !AIORK. ALL MORK SHALL BE PERFORMEI~ BT' LICENSEP CONTRACTORS MHOM ARE EXPERIENCED MITH THE TYPI~ OF MORK BEIN® PERFORMED. ALL C, ONTP. ACTORS SHALL MAINTAIN LIABILI'TT, INSURANCE AND IA!ORKERS COMPENSATION INSURANCE IN CONNECTION MITH ALL MORK BEIN® PERFOP,,MED ON THE PROJECT· ' ANT' SITE MORK INCLUI?IN® SANITART' ST'STEM, UTILITIES, EASEMENTS, SETBACKS, ELEVATIONS, DRAINAGE, RETAININ~ HALLS, ETC. SHALL -- BE IN AGGOP. OANCE kilTH A SITE PLAN PREPAREE) BT' THE OMNERS SURVET'OR. THE ARCHITECT IS NOT P-JESPONSIBLE FOP`` SITE I::)ESI~NS OF ANT' TYPE IN ANT' CAPACITY. : ALL DIMENSIONS AND ®RADE ELEVATIONS ARE TO BE FIELD VERIFIEI:2 ALL CONTRACTOR~ SHALL I,,IARRANT THEIR MORK IN MRITIN~ TO THE OMNER FOR A MINIMUM PERIOD OF ONE T'EAR. THE ARCHITE©T SHALL NOT HAVE'CONTROL OR CHAR®E OP AND SHALL BE P-.ESPONSIBLE FOt~. CONSTRUCTION MEANS, I'dETHOOS, ,lOT TECHNIQUES, SEQUENCES OR PROCEDURES, OR FOR SAFETY' PRO®RAMS IN CONNECTION MITH THE IA!ORK OR FOP`` ACTS OR OMISSIONS OF THE CONTRACTOR, SUBCONTRACTORS; OR ANT' PERSON PERFORNfIN® ANT' OF THE MORK, OR FOP`` THE FAILURE OF ANY OF THEM TO CARRT' OUT THE MORK IN ACCORDANCE MITH ITHE INTENT OF THE CONTRACT :2OCUMENTS IN THAT SAIP RESPONSIBILITY IS THE SOLE RESPONSIBILITY OF THE CONTRACTOR. OONTP-.ACTORS TO FIELD VERIFY ALL CONDITIONS, DIMENSIONS, ®RAISES 8 UTILITIES IF APPLICABLE AS REQUIRED FOR PROPOSED HORK. AND ALLOM FOP`` SAME TY?. FP.,AMING NOTE5 I, ALL EX lERIOR FRAI'41N® SHALL BE STP-.UCTURAL CP-.AIDE CCA TREATED LUMBER. 2. L/BE SOLII2 BLOCKIN~ OR X-BP. AC, IN® BIEThlEEH ALL JOIBT5 TT'PICAL, D, ALL FLUSH HOOD CONNECTIONS TO BE FASTENED IN/ RATED ®ALV, METAL CONNECTORS BT' SIMPSON / TECO (OR EQUAL). JST. (T'(P J (.2) 2"xlO" (..CA (TT'PJ (TYPJ BET'ONC' I,~" 06., (l~FP.) , ' '!1 DETAIL 'A' SCALE: ~,/4" = I'-O" · lb" OG (TYPJ (2) ~/5" PlA. BOLT5 4x4 G~'A POST ~'~ HASHERS .,,_. FAST,HEP TO 12" GONG. FOOTER (T'~ 3 EXIST. DETAIL 'D' SCALE, D/4" : ILO" EXISTING I-STORY RESIPENTIAL STRUCTURE 2"×b" TOP WAIL --TO COPE EXIST. PATIO TO f~EMAIN ~O C, HANC~E) 4"x4" POST DECI I LAN 5GALE: ~/8" = I'-O" TOTAL DECK AP-.EA = 2q4- ~G;L FT. APPROVED AS NOTED 765~1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION · ¢W0 REQUIRED FOR POURED CONCRETE 2. ROUGH - FNAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCT[ON MUST BE COMPLETE FOR C.0. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY W~ITH AL ~ , . L CODES OF NEVV YCRK STATE & TOWN CODES AS REQUIRED ,~¢$~m~=~¢i SOU~ .~LB TOWN PLANNING BOARD / bUU~B~RUSTEES __..z~ .... N.Y.S. DEC EXISTING I-STORT RESIDENTIAL STRUCTURE OF 4"x4" POST III fl) -,,~w: :=:=:=:=:=:=:=: :=:=:=:="=:=:'": -=:=:=:=:=,:=:=:=:--: :=:=:=:=:=t~ N ' l I/ (z~ 2,XlO,, oN TOP ' ~ ~Z I ~ fP. EF. OETAIL 'A') ~ ~ ~ 'N ~'-0" +/- = 6'-0" +1- ~ 5'-~" +1- ~_~. ,,, - THPJJ BOLT 2xlO TO F~A. 51125 I2" PT¢.~ lmm ...... RISE~ HT. = ~ ¼" DECK I=P. AMING PLAN SC, ALE: ~/8" = I'-0" DATE: OD-O4-201~ ISSUEID TO OMNEP,, OCCUPANCY OR USE IS UNLAWFUL WITHOUT r,~-mF-in/~' OF OCCUPANC;Y SEAL: DRAWING#: 0_m vo 3 ~ r~Z rY PROJECT#: I~0~, ) CAD FILE: I'°~ ) A-I PHS.