HomeMy WebLinkAbout43843-Z OFF01tr49, Town of Southold 9/16/2019
y� P.O.Box 1179
0
°' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40696 Date: 9/16/2019
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1175 Haywaters Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 111.4-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
r
6/10/2019 pursuant to which Building Permit No. 43843 dated 6/10/2019
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 INCLUDING SUNROOM TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR
The certificate is issued to Apgar, Sean&Sarah
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43843 08-30-2019
PLUMBERS CERTIFICATION DATED 09-05-2019 Ed King
th e Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
' TOWN CLERK'S OFFICE
CA
o . 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#: 43843 Date: 6/10/2019
Permission is hereby granted to:
Apgar, Sean
104 Washington Ave
Chatham, NJ 07028
To: legalize "as built" alterations to an existing single family dwelling as applied for.
At premises located at:
1175 Haywaters Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 111.-4-11
Pursuant to application dated 6/10/2019 and approved by the Building Inspector.
To expire on 12/9/2020.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $1,008.00
CO -ADDITION TO DWELLING $50.00
Total: $1,058.00
Buil i g Ins or
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 I%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 L{ I 1 h 1 19
New Construction: Old or Pre-existing Building: (check one)'
Location of Proper 1 17 5 Q �t-E-er5 a c)a of C�-k o Q e, kJy
P h'
House No. j Street Hamlet
Owner or Owners'of Property SecUA _+ 1501r'ex 9�
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 Cte Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
r3f so
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 sean.devlin(cD-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To. Sean Apgar
Address: 1175 Haywaters Rd city Cutchogue st: NY zip 11935
Building Permit#: 43843 Section 111 Block 4 Lot 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor. DBA- AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition X Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 6 Ceding Fixtures 2 HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures 1 Smoke Detectors 1
Main Panel 150A A/C Condenser 1 Single Recpt Recessed Fixtures 7 CO Detectors
Sub Panel A/C Blower 1 Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4 Twist Lock Exit Fixtures Combo SD/CO
Other Equipment
Notes "AS BUILT" "NO VISUAL DEFECTS"
-52
Inspector Signature: te: August 30, 2019
S. Devlin-Cert Electrical Compliance Form.xls
o��aF Si?�Tyo{;' ;
Town Hall Annextit Telephone(63 1)765-1802
54375 Main Road Fax(631)765-9502
C13
P.O.Box 1179
Southold,NY 11971-0959
2
BUILDING DEPARTMENT
TOWN OF SOUTHOLD SEP2019
7''TMDni,�_G D1,31T.
E R-T I-F If-A T-1 0-N
Date;
Building Permit No.
Owner: _Sav&�_ 0�bQhV_
(Please print)
(Pleas6print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
lumbers SignaWie)__ - j
Sworn to before me this
day of 20ff_.
1-acw r� 21,w,
0 U
Notary Public, County
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,22.kd,-
$117 �a0f SOUI�o
TOWN OF SOUTHOLD BUILDING DEPT.
s �o
urm,N 765-1802
INSPECTION',,
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] PdULATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
0 qab��;,REMARKS: PVDV ,
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DATE INSPECTOR
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lsl0 1 ;N E E R 1 iN IG
September 3, 2019
Southold Town
Building Department
Main Road
Southold, NY 11971
RE: Existing Patio- 1175 Haywaters Road
The existing foundation is a monolithic slab with turned down footing.The footing depth is
24 inches below grade and sits on granular frost-free soil.
The structure has been standing-for over 10 years and there is no evidence of frost heave.
The foundation has supported the expected loadings and in my professional opinion should
be able to support the expected loadings in the future.
I inspected to roof rafters which are 2x10's 16 inches on center and certify the roof framing
in compliance with Building Codes.
Wind load strap_pings were not visible for inspection.
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052b
® SS1
BOARD CERTIFIED IN STRUCTURAL ENGINEERING
.J OSEPHgQ FISCHETTI.COM FISSCHETTIENS INEER INS.C0M 631 -765-2954
1 725 H O B A R T ROAD S O U T H O L D , N E W YORK 1 1 97 1
FIELD INSPECTION REPORT DATE COMMENTS y'� 7 *'
FOUNDATION (IST)
.....................................
FOUNDATION (2ND)
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clo
ROUGH FRAMING&
PLUMBING y
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INSULATION PER N.Y; y
STATE ENERGY CODE
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FINAL
ADDIT ONAL COMMENTS
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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
tContact:
Approved 20 Mail to:
Disapproved a/c
Phone:
Expiration
'! J;Jlng nspec or
Y, APPLICATION FOR BUILDING PERMIT
q
Date , 20_L
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 Yoother applicable Laws, Ordinances or
Regulations,for the construction of buildings, additions, or alterations or fo removd or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances,building co e,housi code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Sigr a ure of applicant or name,if a corporation)
�4)11 sd)4 U
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises 5&2 '1 q
(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. LocatiolL f land on whit proposed ork will be done:
1175 40*
House Number Str et Hamlet
County Tax Map No. 1000 Section L�� Block l' \"Lot
. .. i ,• '1., .i; ,tet,li;r
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and i ride 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 Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost ,ORDa Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling,units on each floor
If garage, number of cars
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 Nu rrr `der, a f Stories
8. Dimensions of entire new construction: Front Rear 1�: +bepth
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
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address i 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 X
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
i
16. Provide survey, to scale,with accurate foundation plan and distances to property lines. GA 4.1�
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 NOy
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
S:
COUNTY OF )
zbcw y being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above
named,
(S)He is the
(Contractor,Agent, orporat 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 o before me this
day of k UrQ-, 20 el
nn x0ff ff3t jr
Notary Public TRADE tib-•DWYER Signature o licant
TARP PUBLIC,STATE OF N0N y0ft g
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,"has
� FFQIX p BUILDING DEPARTMENT- Electrical Inspector
O
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main,Road - PO Box 1179
Southold, New York 11971-0959
` �y • o� Telephone (63 1) 765-1802 - FAX (631) 765-9502 ,
roger.rich ert(a.town.southoId.ny.us
f t (
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:" - Date: 7
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: CSQY� CLr
Address: .t'
Cross Street: U ; 0d4 ,
Phone No.: q 7
Bldg.Permit#: 3 Zj email: Say-al2c� ar��ofi r�Cc i knl'1
Tax Map District: 1000 Section: Block: Lot: /
BRIEF DESCRIPTI OF WORK (Please Print Clearly) Y
0 '- A -to el � G
Circle All That Apply:
Is job readyfor inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground Laterals 1 , 2 H Frame Pole Work done on Service? YX N
Additional Information:
PAYMENT DUE WITH APPLICATION
10
Request for Inspection Form.xls
37{3-z-
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