HomeMy WebLinkAbout44245-Z �pgUfFat,f��' Town of Southold 10/3/2019
, P.O.Box 1179
53095 Main Rd
�� �,� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40745 Date: 10/3/2019
THIS CERTIFIES that the building WINDOWS
Location of Property: 595 Middleton Rd., Greenport
SCTM#: 473889 Sec/Block/Lot: 40.-5-15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/25/2019 pursuant to which Building Permit No. 44245 dated 10/2/2019
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 replacement as applied for..
The certificate is issued to Mccafferty,Mary
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
0
ut riz Fa ure
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
•moo
' TOWN CLERK'S OFFICE
o SOUTHOLD,,NY
y�Ol�r���O�f4
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#: 44245 . Date: 10/2/2019
Permission is hereby granted to:
Mccafferty, Mary
c/o Gerald Doroski
65 August Rd
Greenport, NY 11944
To: legalize an "as built" window replacement as applied for..
At premises located at:
595 Middleton Rd., Greenport
SCTM # 473889
Sec/Block/Lot# 40.-5-15
Pursuant to application dated 9/25/2019 and approved by the Building Inspector.
To expire on 4/2/2021.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00
CO -ALTERATION TO DWELLING $50.00
Tot • $450.00
uilding In ector
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
L 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. August 26, 2019
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: 16 (aka 595) Middleton Road Greenport
House No. Street Hamlet
Owner or Owners of Property: Doroski — John S..�Jr. , Gary D. & Gerald M.
Suffolk County Tax Map No 1000, Section 40 Block 5 Lot 15
Subdivision Map of Fleetfield, -Section 2 Filed Map. 1351 Lot: 8
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
pplicant ignature
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 (,�rl _ Survey
Southo_ldtownny.gov -PERMIT No.. . ( �I'o�Z�� Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined '20 Single&Separate
2019 Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20
Disapproved a/c >>
Phone:.Co J �d� -701 1
Expiration '20
Building Inspector
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,purpo_se what so ever until the Building Inspector
issues a Certificate of Occupancy. " - , - 1 1 - '
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.
(Signa re o applicant or name,if a corporation)
(Mailing address of applicant)
Cu � �--rr A � � 3�
State whether applicant is owner, lessee, agent, architect, engineer, general contract?, electrician, plumber or builder
Name of owner of premises o ' - o`rn r.1 Sa Sr . a..v' a- e\r CK 2�
(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 land on which pro o ed work vill be done:
-5 17 S fY1
House Number Street Hamlet
County Tax Map No. 1000 Section L(Cr -Block,.: $,, Lot
- ,,:
Subdivision Filed Map No. Lot
X 2. State existing use and occupancy of premises ad intended use and occupancy of proposed construction:
a. Existing use and occupancy �-eS ►'sJ�
b. Intended use and occupancy Yee St 0e. V34
X3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work�w'."'voc,5 Y e P� - e til
'p (Description)
Estimated Cost Fee
t= To be a'd on filing this application)
5. If lling, number of dwelling units Number of dwellin"u' nits on each floor
If gara number of cars
6. If business, co' rcial or mixed occupancy, specify n re and extent of each type of use.
7. Dimensions of existing s ctures, if any: Front Rear Depth
Height Number of ories
Dimensions of same structure W Iterations or additions: Front Rear
Depth H g Number of Stories
8. Dimensions of entire new co truction: Front Rear Depth
Height Number of S ies
9. Size of lot: Front Rear Depth
10. Date of Pu. lase Name of Former Owner
11. Zo or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
v13. Will lot be re-graded? YES NO X Will excess fill be removed from premises?YES NO X
Go_ Dov- skx- (. 2,k-:5(P&-761a.
14ames of Owner oof 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 f6 feet or below,must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO 4, ns
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF�)
GG.r- r atr t9 being duly sworn, deposes and says that(s)he is the applicant
(Name of incividual signing contract) above named,
(S)He is the Ow K eu-
(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 thi
day of t�� 20-_ _
DWYER
Notary Pub i NOTARY PUBLIC,STATE OF NEW YORK Signature of Applicant
N0.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,X01.
1
S `
APP 0 VED AS NOTED
DATE:�0'LZ BP #f m "��a-���
SEL ��.. ,,,1, NEW
�' � _ �IR� COMPLY WITH ALL CODES Or
T NEW Y
"C. U's!_Jli�,. i;"'PAR;K4,ENT A� YORK STATE & TOWN CODES
765-1802 8 AMI TO' 4 I-VI FOR THE AS REQUIRED OF
FOLLOWING !NSFECTIONS:
1. FOUNDATION — iVlJO REQUIRED
FOR POURED C(X;C,RETE S
2. ROUGH ,- FRAMING & PLUMBING S
3. INSULATION
4. FINAL - CONSTRUCTION-MUST l
BE COMPLETE FOR CO,
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR & a�
DESIGN OR CONSTRUCTION ERRORS. U O U PAN
NC
OEli
USE IS UNLAWFUL
WITHOUT C RTIACATE
OFCCUPACS
certific�t1°n
May
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