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Home My WebLink About43457-Z 'f Town of Southold 2/14/2019 P.O. Box 1179 53095 Main Rd # Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 40205 Date: 2/14/2019 THIS CERTIFIES that the building WINDOWS Location of Property: 8745 Oregon Rd Cutchogue SCTM#: 473889 Sec/Block/Lot: 95.-1-12 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/7/2019 pursuant to which Building Permit No. 43457 dated 2/8/2019 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"window replacements to existing single-family dwelling as applied for. The certificate is issued to Domaleski HI Revoc Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED tho ' d Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT j TOWN CLERK'S OFFICE SOUTHOLD, NY f 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#: 43457 Date: 2/8/2019 Permission is hereby granted to: Domaleski HI Revoc Trt 8745 Oregon Rd PO BOX 92 Cutchogue, NY 11935 To: legalize "as built" window replacements to existing single-family dwelling as applied for. At premises located at: 8745 Oregon Rd SCTM #473889 Sec/Block/Lot# 95.-1-12 Pursuant to application dated 2/7/2019 and approved by the Building Inspector. To expire on 8/9/2020. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 (4 Building 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. 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 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 Date. New Construction: ND Old or Pre-existing Building: (check one) Location of Property: �� - C:)vfzGah `Q�� -��ny�,i j C/ House No. Str et Hainlet Owner or Owners of Property- Q nkLi, Suffolk County Tax Map No 1000, Section 95 Block ► Lot Subdivision Filed Map Lot: Permit No Date of Permit. Applicant, Health Dept. Approval- Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted. $ 5o A plic t Signture FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) Z\ ------------------------------------ C 'FOUNDATION (ZND) �- z 0 cn ROUGH FRAMING& I � PLUMBING y 000, . INSULATION PER N.Y: y r STATE ENERGY CODE wt- FINAL ADDITIONAL COMMENTS 5 O z _ c d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined '20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved a/c Phone: Expiration RM '20 ALI V Bu' di pector D FEB - 7 201�P ATION FOR BUILDING PERMIT Date , 20 " INSTRUCTIONS TOWN OF SOUTHOLD a. This application MUST be completely 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 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 authorized inspectors on premises and in building for necessary inspections. (Siji4ature of hplLtjr name,if a corporation) &,_4 a,,M ,,,- IV V (Mailing address of applicat) `[� - State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 0 Ytie/ Name of owner of premises �w�� (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 lid on which proposed work will be done: 2-7 Lis 4G House Number Street amlet County Tax Map No. 1000 Section 95 Block I Lot a Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy �I VnF �,y��_�Qsi 6,qV1 c C'- b. Intended use and occupancy Sam Cl 3. Nature of work(check which applicable): New Building Addition Alteration X Repair Removal Demolition Other Work ( Notj UdW -er- (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars O 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 Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 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--X- 13. Will lot be re-graded? YES NO__X Will excess fill be removed from premises?YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 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 NOS(_ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF 5( being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notari Public,State of New York (S)He is the No.01BU6185050 (Contractor,Agent,Corporate Officer,etc.) Qualified in Suffolk County Commission Expires April 14,2-CD4j 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 o before me th��O��20 v�day of Notary Public AignUre of Applicant Oregon Rd, Cutchogue, NY Owner: Domaleski s cb rre c$ Replacement Windows Anderson Casements 1 - E-Series French Casement 48"x36" 3 - E-Series French Casement 40"x36" 2- E-Series Casement 20'x31" Silver Line Double Hung 5 - Double Hung. 36"x52" 3 - Double Hung. 24"x52" COMPLY ALL CODES Gt APP OV D AS NOTED NEW YORK STIATE & OWN CODE DATE: B.P.# Z4345-7AS REQUIRED AND CONDITIONS O, FEE: D gv ~S9 +f6 ^ ^ NOTIFY BUILDING; :tPART ~y AT S07�H8 �64,A} $OAED 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: S=HG6@ T;W�EES 1. FOUNDATION - TWO REQUIRED tY.S DEG FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3 INSULATION 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR CO. OCCUPANCY OR ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW USE IS UNLAWFUL YORK NOTFOR DESIGN ORECONSTRUCTIONSIBLE ERRORS. WITHOUT CERTIFICATE OF OCCUPANCY RETAIN STORM WATER RUP,10 . PURSUANT TO CHAPTER OF THE TOWN CODE. 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