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�o�o UFF t Town of Southold 6/21/2019 P.O.Box 1179 H 53095 Main Rd ©4 � Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40458 Date: 6/21/2019 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 5925 Nassau Point Rd, Cutchogue SCTM#: 473889 Sec/Block/Lot: 111.43-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/5/2019 pursuant to which Building Permit No. 43865 dated 6/14/2019 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"alterations to an existing single family dwelling as applied for. The certificate is issued to Emery Ellen F 1999 Rev Tr of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43695 5/8/2019 PLUMBERS CERTIFICATION DATED 6/21/2019 APPoints East PIUMI#9 ut o ' d ignature -" TOWN OF SOUTHOLD Q�gOFFO�,��pG� BUILDING DEPARTMENT ' rn a TOWN CLERK'S OFFICE o SOUTHOLD, NY l ,s 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#: 43865 ' Date: 6/14/2019 Permission is hereby granted to: Emery Ellen F 1999 Rev Tr 121 Somerset Ave Garden City, NY 11530 To: legalize "as built" alterations to an existing single family'dwelling as applied for. At premises located at: 5925 Nassau Point Rd, Cutchogue SCTM # 473889 Sec/Block/Lot# 111.-13-6 Pursuant to application dated 6/5/2019 and approved by the Building Inspector. To expire on 12/13/2020. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $624.00 CO -ALTERATION TO DWELLING $50.00 Total: $674.00 Building Inspector Form No.6 TORN OF SOUTHOLD BUILDING DEPARTMENT TORN HALL � 765-1502 D ��(� APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must,be filled in by typewriter or ink and submitted to the Building Department with the foil w)JZ This A. For new building or new use: ADD d.' 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusuzWkwamr s® v- �' P to o a hic features. ✓`�J P 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$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,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$15.00 Date. March 22, 2019 New Construction: Old or Pre-existing Building: X (check one) Location of Property: 5925 Nassau Point Road Cutchogue House No. Street Hamlet Ellen F. Emery and Mark J. Brosnan, as Trustees of the Ellen F. Owner or Owners of Property: Emery 1999 Revocable Trust under agreement dated June 3. 1999 Suffolk County Tax Map No 1000, Section 111 Block 13 Lot 6 Map of Proposed Subdivision Section A, Nassau Point Club Properties Inc. and Subdivision Amended Map A, Nassau Point Filed Map. 745 & 156 Lot: 41 Permit No. ��& Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted:$! �'a� ll �' -' 11 Applicant Signa e Richard F. Lark, as attorney pF SOpT�,olo Town Hall Annex Telephone(631)765-1802 54375 Main Road C Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 roger.riche rt cRtown.southold.ny.us O1��0 Unl►e BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Ellen F Emery Address: 5925 Nassau Point Rd City: Cutchogue St: New York Zip: 11935 Building Permit#: 43695 Section: 1 1 1 Block: 13 Lot: 6 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph 150a Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel 150a A/C Condenser 1 Single Recpt Recessed Fixtures 3 CO Detectors Sub Panel A/C Blower 1 Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect 150a Switches 6 Twist Lock Exit Fixtures �] TVSS Other Equipment: "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS" Notes: 150a overhead service, 1-central airconditioner (condenser and air handler),2-bathrooms,2-bath fans,lights,GFCI,s, And switches UJIVAj fly IL pT Inspector Signature: Date: May 8 2019 17 81-Cert Electrical Compliance Form.xls ii Town ffih Annex: 54375 ME&irIE6ad 765=9502, Box.,1 179, �qRt�h�o�, i197i-(W54 TOWN OF TOWN OF SOUTHOLD DL P52 JUN 2 12019 r`IMDMG,D]LI,FE Building Fermif 14' 43865 13 Ellen F. 'E!&iry-'Tnd Mark J. Brosnan, as Trustees rustees Owner;: of the Ellen F. Emery 1999 Revocable Trust A1.1_PokrktsLj;astPlumbing--�&. Ikeqtin I certify that-the soiderused iff-&dlffater-supplysystem contains less1hin 210-',d£1--%' I&ifd" Brad Plecuch SiKoMlto hpfqMme,=this 21st day--of June s 20, 19 N6taryPubIi0,-.,-------Suffo1 BARBARA DIACHUN Notary Public, State of New York No 01 D14635190-Suffolk County Commission Expires Oct.31,20 91' C&M Contracting Corp. P.O. Box 142 Cutchogue, N.Y. 11935 June 1, 2019 Southold Town Building Dept. Re: Emery Residence 5925 Nassau Point Road Cutchogue, NY 11935 This certifies that smoke and carbon monoxide/smoke detectors were installed as per the latest NYS Building Code. One carbon monoxide/smoke detector with 10 yr. lithium battery was installed in basement boiler room. At bottom of basement stairs, a hard-wired with 10 yr. lithium battery smoke detector was installed, replacing existing smoke detector. In 1st floor bedroom area hallway, the existing hard-wired smoke detector was replaced with new carbon monoxide/smoke detector with 10 yr. lithium battery. In each of the three bedrooms, a smoke detector with 10 yr. lithium battery was installed on ceiling above entry door. � r Christopher Mauceri President /FIELD INSPECTION REPORT DATE COMMENTS ' }d to FOUNDATION (15T) .................---------......... . FOUNDATION (2ND) col O ROUGH FRAMING& PLUMBING y INSULATION PER N.Y; STATE ENERGY CODE H FINAL ADDITIONS COMMENTS K6 c • o • � rn z d ,H 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: 631 765-9502Q�/,(� Surve Southoldt wnny.gov PERMIT NO. ✓()(J Check Septic Form i N.Y.S.D.E.C. Trustees C.O.Application t Flood Permit Examined ,20 Single&Separate Truss Identification Form Storm-Water Assessment Form tact: Approved "J ,20 Mail to: Richard F. Lark, Esq. Disapproved a/ Cuttchogue;ANY 11935 Phone: (631) 734-6807 E Building Inspector JUN - 52019 • APPLICATION FOR BUILDING RMIT Da June 4, , 2019 TOWN OF SOIITflO,;13 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Buildin spector with 4 sets of plans, accurate plot plan to scale. Fee according to s6hedule. 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 onhas 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. X�6 �g�7 (Signature o tei-rramz;if a�erparatierr) agent — Richard F. Lark P.O. Box 973, Cutchogue, NY 11935. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder agent Ellen F. Emery and Mark J. Brosnan, as Trustees of the Ellen F. Name of owner of premises Emery 1999 Revocable Trust under agreement dated June 3, 1999 (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. 'f Other Trade's License No. 1. Location of land on which proposed work will be done: 5925 Nassau Point Road Cutchogue House Number Street Hamlet County Tax Map No. 1000 Section 111 Block, "13 Lot 6 Map of Proposed Subdivision Section A, Subdivision Nassau Point Club Properties Inc.Filed Map No. 745 Lot 41 and Amended Map A, Nassau Point Filed Map No. 156 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy one family residence b. Intended use and occupancy -one family\residence 3. Nature of work(check which applicable): New Building Addition Alteration X Repair Removal Demolition Other Work (See below) (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 1` If garage, number of cars 2 N/A 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 65.9' Rear 65.8' Depth 28.0' Height Number of Stories 1 - N/A Dimensions of same structure with alterations or additions: Front r Rear Depth Height Number of SF tor"ies N/A 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front- 100.04' j Rear 100.08' Depth 304.49' 10. Date of Purchase 1/10/96 Name of Former Owner Florence L. Emery 11. Zone or use district in which premises are situated R-40 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 X 121 Somerset Avg �g0 14. Names gof Owner of premises Ellen F. Emery Address Garden City, NY '°hone No.516-746-4038 Name oT�1�James J. Deerkoski Address L' rar A enu ne Nco 631-774-7355 Name of Contractor C&M Contracting Corp. AddressP.O. Box 2_'1976 Phone No. 631-734-7428 Cutchogue, NY 11935 15 a. Is this property within 100"feet of a tidal wetland or a freshwater wetland? *YES NO X * 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 X * 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. N/A 18. Are there any covenants and restrictions with respect to this property? * YES NO X * IF YES, PROVIDE A COPY. 3. (CONTINUED) "as built" alterations for air conditioning, new windows, front entry, deck, stairs, electrical work, bathrooms ,STATE OF NEW YORK) and kitchen SS: COUNTY OF SUFFOLK) RICHARD F. LARK being duly sworn, deposes and says that(S)he is the applicant (Name of individual signing contract)above named, AD (S)He is the agent (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 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 4th day of June 20 19 � RD "HUN Notary Public Notary Public, StatIAe of New York Signature of Appiieant Agent No 01D146090-Suffolk County Richard F. Lark Commission Expires Oct.31,20 -?-�'_ LARK& FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele.No.(631)734-6807 RICHARD F.LARK Fax No. (631)734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com June 5, 2019 Michael J. Verity, Chief Building Inspector Southold Town Building Department 54375 Route 25 - P.O. Box 1179 Southold, NY 11971 RE: Ellen F. Emery and Mark J. Brosnan, as Trustees of the Ellen F. Emery 1999 Revocable Trust (SCTM #1000-111-13-6) Dear Mr. Verity: In connection with the above-captioned matter, I am enclosing the following: 1 . Application for Building Permit for "as built" alterations 2 . Copy of Certificate of Electrical Compliance issued by the Southold Town Building Department on May 8, 2019 3 . Letter from Christopher Mauceri of C&M Contracting Corp. dated June 1, 2019 regarding installation of carbon monoxide/smoke detectors 4 . Survey of John C. Ehlers Land Surveyor last revised 11-20-2013 S . Four copies of Plans of "as built" alterations of James J. Deerkoski, P.E. dated 5/24/2019 If all is in order, please schedule an inspection so that a Certificate of Occupancy for the "as built" alterations can be issued. Thank you for your assistance in this matter. Very truly yours, LZ Richard F. Lar RFL/bd Enclosures LARK&FOLTS Attorneys at Law JUN 21 2019 28785 MAIN ROAD PO BOX 973 �.y,.meq-Qi�,r�1 CUTCHOGUE,NEW YORK 11935 �'aI("'f'''� Tele.No. (631)734-6807 Tramup Fax No. (631)734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com June 21, 2019 Michael J. Verity, Chief Building Inspector Southold Town Building Department 54375 Route 25 - P.O. Box 1179 Southold, NY 11971 RE: Ellen F. Emery and Mark J. Brosnan, as Trustees of the Ellen F—Emery 1999 Revocable Trust (SCTM #1000-111-13-6) Dear Mr. Verity: In connection with the above-captioned matter, I am enclosing the Certification of All Points East Plumbing & Heating. Very truly yours, Richard F. Lark RFL/bd Enclosure 5U RVEY OF LOT 41 MAP OF PROPOSED SUBDIVISION SECTION A, NASSAU POINT CLUB PROPERTIES INC., N SITUATED ON NASSAU POINT, SUFFOLK COUNTY, NEW YORK. SAID LOT ALSO SHOWN ON "AMENDED MAP A, NASSAU POINT", FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON 8-1 G-22 AS MAP NO. 15G e 51TUATE: CUTCHOGUE W E TOWN: 5OUTHOLD 5UFFOLK COUNTY, NY S SURVEYED 05-14-2013 REVISED 10-23-2013, 11-20-2013 SUFFOLK COUNTY TAX# 1000- I I I - 13 - G CERTIFIED T0= LOT A0 ELLEN EMERY I OCA PROPERTY ADDRESS 30, ,�9 o 5925 NASSAU POINT ROAD PENOti0.55 1 N CUTCHOGUE, NEW YORK 11935r GLS¢OF?(LOPER�UtdE W 1 O ctl M 03 I 036��0»� NL1L OOA 7 .� 14 Z 0 5100rn 0 o -� LlL 30)( D r p1 �� 03 0 I _ LI4.5- --------- ------- � 4 ENDINGS ' M LAWN —5.6 ---- --._ FRAME 5TA1R5 O (S c FRAME M r c� 0 I STOOP _ V' 9y o W I 22'k Q c S 1 0 0 L56,z ASPHALT 30 DRIVEWAY - S1- O o� 036,`20 4 O 57 8 LO- �2 NOTES: BURIED RETAING WALL LOCATION PROVIDED BY CONTRACTOR NOTES: 1 �� 'Unauthorized alteration or addition to o survey �{ jg� mop Dearing o licensed land surveyors seal is a ■ Y(� wololian of section 7209•sub—dmson 2.of the MONUMENT FOUND JOHN C E N LE R5 LAND 5 U RV EYO R ���� E"� ® New York Stale original this Law- --� WOOD FENCE 2 O 'only copies fro ig nal ftheof this surs V- marked wdh al e I of of the be surveyors clamped seal shall be considered to be whd Uae C copies' Area = 30 379 Sc{. Ft. ;1 'certifications indicated hereon signify that Ihis 6 EAST MAIN 5TREET N.Y.S. LIC. NO. 50202 sting M prepared in accordance Surveys the ted Area = 0.6974 Acres 4 ' y the Code of Practice for Land Surveys adopted Dy the New York Slate Association of Professional GRAPHIC SCALE I "= 30' RIVERNEAD N.Y. 1 I 3�9-8288 Fax 369-8287 ° and Surveyors Sod .mcerthe survionsey shall run only to the person for whom the survey is prepared• s r Lv and on his behalf to the title company,governmen— `` ,5020 W agency and lending institution listed hereon.and Iong151andland5urveyor.com ti`SFo LAND `°`bons are not transferable additional msiiwtons PLAN CONTENTS: OCCUPANCY CLASSIFICATION R3 RESIDENTIAL BUILDING USE RESIDENTIAL DWELLING BUILDING HEIGHT (SEE PLANS) TOTAL SQ. FT.OF CONSTRUCTION (SEE PLANS) DESIGN CRITERIA CODE:2015 IRC,2016 NYS UNIFORM SUPPLEMENT FRAMING ELEMENTS AS PER FLOOR PLANS,CROSS SECTION AND GENERAL NOTES EXT.BALCONIES 60 DECKS 40 ATTICS w/o STORAGE 10 ATTICS w/STORAGE 20 DESIGN LOAD CALCULATIONS ROOF (GROUND SNOW LOAD) 20 (LIVE LOADS PSF) ROOMS(OTHER THAN SLEEPING) 40 JIM D E E RKOS KI i PE ROOMS(SLEEPING) 30 phone: (631) 298-7116 TW210310 TW210310 G55 G55 GS5 STAIRS 40 3'-0" GAURDRAILS ANY DIRECTION 200 EXPOSURE CATAGORY (DESIGNED FOR CAT.C) 7 LOAD PATH SEE CONSTRUCTION ANDWIND PATH CONNECTION ROOF-FOUNDATION DETAIL PAGE&GENERAL NOTE PAGE NAILING SCHEDULE SEE GENERAL NOTE PAGE EGRESS SEE FLOOR PLANS AND WINDOW SCHEDULE FIRE PROTECTION Sym.' SMOKE ALARMS TO COMPLY WITH NFPA 72 AND NYS R314 IRC. TW26310-2 SMOKE&CO2 DETECTORS CARBON MONIXIDE ALARMS TO COMPLY WITH R315 IRC. \ \ TRUSS DESIGN N/A-STANDARD STICK FRAME CONSTRUCTION BEDROOM \\ \��� ENERGY CALCULATIONS 2015 IECC BEDROOM LIVING ROOM N CLIMATIC & GEOGRAPHIC DESIGN CRITERIA GROUND WIND SEISMIC FROST WINTER ICESHIELD FLOOD SNOW SPEED DESIGN WEATHERING LINE TERMITE DECAY DESIGN UNDERLAYMENT HAZARDS LOAD (MPH) CATEGORY DEPTH TEMP. REQUIRED MODERATE SLIGHT TO \\ 20 PSF 130 6 SEVERE 3 FT. TO HEAVY MODERATE 11 YES 9'-10" r o _ m M WIC 1'-6" -'a" F 7'-3" � DEN 00 e e - ' T-4 BEDROOM DINING O KITCHEN - 13'-S%" C) O°' Vol BATH Q, A O O TEMPERED O O O O O O 2'-8" � 1 '-1 I i TW210310 CN135 CN135 CXW135 TW2631 TW26310-2 ' C) P4 AS-BUILT DECK - U �••. F"I m P i m O I zn 4X4 POST o i CD -_----_ -`_-----_=� _- - 00 (TMP' ----� I , I I - I I Lij 1-4 Cn O I I , FLOOR P LAN —_----_— m SCALE: 1/4" = 1'-0•. - - ti' .�J W N er r rI , � E"', 6' 11" 3' 9,r 6-11 3 -9 TE,�/If�/( r'' `._.,., ...... 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