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44088-Z
�iiFFoc�� 15 cow Town of Southold 8/23/2019 P.O.Box 1179 p + �4 53095 Main Rd % 'ol Southold,New York 11971 ®1 •la tis' CERTIFICATE OF OCCUPANCY No: 40653 Date: 8/22/2019 THIS CERTIFIES that the building WINDOWS Location of Property: 915 (aka 35) Sound Rd., Greenport SCTM#: 473889 Sec/Block/Lot: 33.4-72 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/12/2019 pursuant to which Building Permit No. 44088 dated 8/22/2019 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Sheiffer,Kathleen&Ors of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED tho e i ature ,fi'ggEo�� TOWN OF SOUTHOLD '�� tisoo� may KM BUILDING DEPARTMENT 0 " TOWN CLERK'S OFFICE o _ {i 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#: 44088 Date: 8/22/2019 Permission is hereby granted to: Sheiffer, Kathleen PO BOX 736 Quogue, NY 11959 To: legalize "as built" window replacements to existing single-family dwelling as applied for. At premises located at: 915 Sound Rd., Greenport SCTM # 473889 Sec/Block/Lot# 33.-4-72 Pursuant to application dated 8/12/2019 and approved by the Building Inspector. To expire on 2/20/2021. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 Buildi ctor 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. Loy —� New Construction: Old or Pre-existing Building: V (check one) So Location of Property: House No. Street Hamlet ` Owner or Owners of Property: 11�e�tl S�,e� �e��y _Dr -c�h'� \a_V_S Suffolk County Tax Map No 1000 Section 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: (check one) Fee Submitted: $ Applicant Signature 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 �ltiiing-Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 J�e --Sey Southoldtownny.gov PERMIT NO. Check Septic Form •�, N.Y.S.D.E.C. tees C.O. pplication r ood Permit Examined ,20 019 �" Single&Separate pUG 1 2 2 Truss Identification Form Storm-Water Assessment Form �Ail 0 'y y Contact: Appioved �f' ,20 Mail-to: 4 �` r► �t� ���Y� Disapproved a/c �w Expiration 20 Bui pector APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS 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. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder — Name of owner of premises ��r r (As on the tax roll or 1—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 land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section 5 ) Block 1-} Lot ��— 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 vv-,— b. Intended use and occupancy — 3. Nature of work(check which applicable): New Building ��Iteration Repair Removal Demolition Other Wo"r 1 ©UJ (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dw lling, number of dwelling units Number of dwelling units on each floor ra If gae, number of cars 6. If business, co mercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existtn ructures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure wi 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 13. Will lot be re-graded? YES NO ~ Will excess fill be removed from premises?YES NO 'v 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Naive 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 PQUIRED. 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 NO V * IF YES, PROVIDE A COPY. STATE OF NEW YORK) S: COUNTY OF& SS � �> being duly sworn, deposes and says that(s)he is the applicant K Ah is S (Naive of individual signing contract) above named, (S)He is the \j\)r�-c (Contractor,Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to snake 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 1"�^ day of 20 I9 rww Nota Public ACEY D Signature of A licant n' NOTARY PUBLIC,STATE OF NEW YORK g pP NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2— i j cVO c-e-SO14�—' h.vvA cam. cw. I � x COMPLY WITH ALL CODES OF 1I NEW YORK-STATE-4-Ml 1 C-$0D 1 , AS REQUIRED AND CONDITIONS C AF' APPR_ OVED-aNOT-Ev ' €� ^ATE- j.p # DO eFEE: � Y' NOTIFY BUILDING GCP�RTNIE -A 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPI=G TOTlB: 1:JFOUNDATION - TWO REQUIRED FOR 2,IROUGH -FRAMINCC E & PLUMBING OCCUPANCY OR 31 j INSULATION U 41, FINAL - CONSTRUCTION MUST IE COMPLETE-FO-R o. �T - T C E F��I ALL CONSTRUCTION SHALL MEET THE FTATE Et1UIREMENTS-OF-THECORE--S OF-NEy' OFOCCUANOY Y©RK STATE. NOT RESPONSIBLE FOR ESIGN-OR-CONST-RUCTION-ERROR. rr 1� fl I {l {i Ill tee GA-LCO 4NDUST,;jRIES INC . � y �✓1 -a I r PATIO AWNINGS esT�eusfEo,a REPLACEMENT WINDOWS PATIO ENCLOSURES BOWS - BAYS -'GARDENS RETRACTABLE AWNINGS 375 JERICHO TURNPIKE ENTRANCE DOORS VINYL SIDING FLORAL PAR STORM DOORS (516) 352-81 8 718 ) 347-4422 Nassau Lic. #H1800640000 N.Y,c. LIC.#674632 : Suffolk Lic. #24;_228-HI Customer's Name ...... .._._. . .Phone No. '/777 ... n N° 21374 Addrgisl.. - ...— D..Ltie .It . ----.._ city.: :. / jt�d+Pr]!'�' .. ._..... - Zip 1.f. 9Y7.. .. _..- . .. OUANTITY� -- -- -A)Y/ Q��rZ✓ - %!�_/'h l ii'�`t%I_ A_��1�_=` � _~ _ r->%t ,^--'=�L,sL_�.:r. ~ ' - _ ��� •111� -G7./fhQ2a%LP.. � �iU�%f.� ---�%�Gs/�.[�-z,�s-- =%C..�i1'�:r/�i/� ���( - _�����r.1�( - - �/1�:�.' �- •G'lr.Hfr'ii.._ _ ..,�- _YOU✓ir -�l�_�./lt�. _/rF�,�.d✓�t�— _._.G�^�..o_ _,_�rl ,�al(- 'f/�.'4�� j _ � �•�~�+_-':.--- �- -_-- -- -_-+-+.rr--r, -1 __�r_ _ _-�1 M TMS,-.-+�,r_ -- f A,J ✓ -- - CONTRACTOR WILL PROVIDE CERTIFICATE OF WORKMEN'S`CdMPENSATION PRIOR TO' COM/vIENGEtv1ENT OF WORK. CONTRACTOR TO PROCURE ALL PERMITS REQUIRED BY LOCAL- LAW: r A"GR EE'AIENT _ r THE UNDERSIGNED;kiFiaG(ii Ball die'Owriei;iiquiiii the Toidl AmoiiFif .:.....- GALCO INDUSTRIES'INCORPORATED (30.. Deposit i'erewith �.. ,� ,�Q�t. ....... 6.f.viafter called the Contractor to make tmtalldtic_'s m occardance wdh Wi ab`-e- ciricationi; which f (he) (they) hereby approve• and ., which (he) (they) agree (o pay It tum o( S YQ r',�. •BalUrlce Pa Oble -in accoidanci with the terms &hewn to the right of this ogree'inent, The Ownei-Kie y authorises ttii&Atracttii y ; - r to.make changes necessary to accomplish thi above work. Contractor Iholl not be held respenuble for delays On Delivery •• .P'.' cdua.d by -or conddions„Fre, dcudent or any [aura biyond their nintrot. It it ecpressly' ogieed that no stcfement, warranty, arrarpemenf or understandirg': oral or ritnen, ixprested oc ;m lied. not contained heisiri -- 'well be reiogntsed. Thi Owner iepresents,that,(he is) (tliy are) the owners) of Ihi property where initallotion Payd6le ori Completigli':. 3., is to be• made If is further underafoad that Ih,a' agreement is not subiict io cancellation except by the -_ - - Written consint of both-parties. The buyer cgreei-to pay liquidated damages ,n the amount of 50% of ,the Check an. above quoted purchase prize plus legal fees should chi buyer refusi to accept delivery of the above mentioned ❑ F.H. A Finonied ;r LL/ items provided the same,conform to thi sample. - ash an Complefian L•t7 G,r -CERTIFICATE OF WARRANTYao, Iv Fai,o period of one year offer purchase, we hereby warrant l0 1he purchaser of Galco Products, that any par( or parts theriof; which'rprove to be directive In workmanship or,nater,o(i will be replaced or repaired w,lhout charge to the original purchaser p - --Should defects ,n workmanship or matir,ols occur in our products, such defects should be promptly idoorfid. Ariongimenti will be made for iep(acemeni or repair within thi terms of this warranty. - ' Thii ii a limited warranty; it does not cover consequential domagei, condensation,, domage_6y fire, vinds(oim, of damage mucid by circunsituncns beyond oui conlrcil This warranty is in lieu of all other warranties, implied or ixpressid, and rvo wit( neither asiumi nor cuthorlxo bnY person to assume in our name any other liability or obligutiori. - nYOUi THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER'-THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION,OF THIS RIGHT:" Accepted: GALCO INDUSTRIES INCORPORATED Receipt of cancellatit- 'notice acknowledged. By .. - - - -- -- - -- -- :% OWrier ._ ! � OWfier Date: - _ - ,-r - - - -- - -- - - - - - - - - - _ Salesman: '>"✓!0,7dC fj? t�'I/" __ - _ Address L - -- - License# - �t�7 / d- - -- - - I 4 ALL BALANCES MUST BE PAID IN CASH,CASHIERS,OR CERTIFIED CHECK ONLY.