HomeMy WebLinkAbout44097-Z �q�gUffOtk o Town of Southold 6/22/2020
0
• P.O.Box 1179
v' rh 53095 Main Rd
oy�o® �a°� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41203 Date: 6/22/2020
THIS CERTIFIES that the building ACCESSORY ALTERATION
Location of Property: 11325 Great Peconic Bay Blvd, Mattituck
SCTM#: 473889 Sec/Block/Lot: 144.-3-19
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore fled in this office dated
7/8/2019 pursuant to which Building Permit No. 44097 dated 8/26/2019
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:
interior alterations, including half bath, to existing accessorygarage as applied for.
The certificate is issued to LaGinestra,Gina&Lisa
i
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-12-0095 4/3/2020
ELECTRICAL CERTIFICATE NO. 44097 12/12/2019
PLUMBERS CERTIFICATION DATED 2/6/2020 Killiarn Gjqer
th d Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a TOWN CLERK'S OFFICE
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#: 44097 Date: 8/26/2019
Permission is hereby granted to:
LaGinestra, Gina
43 High St E
Williston, NY 11596
1
To: construct interior alterations to existing accessory garage as applied for per SCHD
approval.
At premises located at:
11325 Great Peconic Bay Blvd, Mattituck
SCTM # 473889
Sec/Block/Lot# 144.-3-19
Pursuant to application dated 7/8/2019 and approved by the Building Inspector.
To expire on 2/24/2021.
Fees:
ACCESSORY $182.80
CO -ACCESSORY BUILDING $50.00
Total: $232.80
Buil ngnspector
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. `::)W� \(::�
New Construction: Old or Pre-existing Building. (check one) (�
Location of Property: ' \\
House No. Street Hamlet
Owner or Owners of Property: �_� e-C�b&=,
Suffolk County Tax Map No 1000, Section I ( Block Lot
Subdivision Filed Map. Lot:
Permit No. q— ®171 Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ �(
Applicant Signatur
rjv so
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 � roger.richert@town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To LaGinestra
Address. 11325 Peconic Bay Blvd City: Mattituck St: New York Zip: 11952
Budding Permit#: 44097 Section 144 Block. 3 Lot* 19
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Roslak Electric License No: 3677-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt 12 Ceding Fixtures HID Fixtures
Service 3 ph Hot Water elec GFCI Recpt Wall Fixtures 1 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 5 CO Detectors
Sub Panel AIC Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks
Disconnect Switches 3 Twist Lock Exit Fixtures TVSS
Other Equipment. 1-bath fan, electric hot water (30 A), 3-combination smoke / co detectors,
4-combination GFCI/ARC fault circuit breakers, 1-Arc fault circuit breaker
Notes.
DETACHED GARAGE
Inspector Signature: Date: December 12 2019
81-Cert Electrical Compliance Form.xls
Town Hall Annex Telephone(631)765-1802
54375 Main Road I, Fax(631)765-9502
cri
P.O.Box 1179 G•�.! may, _ ; ,�;"
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
F E B - 6 2020
C E R T IFI-C A-T-I.O-N
Data:
Building Permit No.
Owner:
lease print)
_Plumber: W- -.—--
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
(Plumbers Signature)-
tt
Sworn to before me this G
day of F-Cjor 2020
Notary Public,519e �T `outy
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO 01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2.Q2,
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# TOWN OF SOUTHOLD BUILDING DEPT.
°`ycourm N�' 765-1802
INSPEC ION -
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FOUNDATION 1ST ROUGH PLBG.
[ ] OUNDATION 2ND [ ] INSULATION
[ FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: Of
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INSPECTION
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[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
] CODE VIOLATION [ ] CAULKING
REMARKS:
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765-1802
INSPECTION
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FOUNDATION 2ND ATIOWCAULKING
FRAMING /STRAPPING FINAL
FIREPLACE& CHIMNEY FIRE SAFETY-INSPECTION
FIRE RESISTANT CONSTRUCTION- FIRERESISTANT PENETRATION
-ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
CODE VIOLATION E C/O
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JNSPECTION ,�Np
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[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY ,[ ] 'FIRE-SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION . [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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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
South oldtownny.gov PERMIT NO. Check
Septic Form
N Y.S.D.E C.
Trustees
C.O.Application
Flood Permit
Examined 20 ` �-`� y Single&Separate
t ......e Truss Identification Form
AUG ® 9 2019 Storm-water Assessment Form
Contact:
Approved20 ti ��y__D Mail to: '
Disapprov4a/c
Phone��',,,z,
Expiration _,20F
p
i Bu ns ec r
'
APPLICATION FOR BUILDING PERMIT
Date I� , 20�
7kT ,�DW:C,DEPT`. 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.
(SighaNture 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 .
(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 proposed.workit be done:
House Number Street Hamlet
County Tax Map No. 1000 Section LC / Block �.,_ Lot 17
Subdivision Filed Map No. Lot
2. State existing use and occupancy of prejuisesi and intended use and occu ancy of pro osed 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 Worl.
(Description)
4. EstA\umber
Fee
(Td& aid on filing this application)
5. If dwof dwelling units Number of dwelling units,"on each floor
If garof cars
6. If buscial or mixed occupancy,!specify natureand extent of each type of use.
7. Dimeng structures, if any: Front Rear Depth
HeighNumber of Stories
Dimensions of same tructure with alterations or additions: Front - „ Rear
Depth Height Number of Stories" F`
8. Dimensions of entire new co truction: Front i 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 ar situated
I
12. Does proposed construction violate any zoni law, ordinance or regulation? YES NO
i
13. Will lot be re-graded? YES NO Will e ,cess fill be removed from premises?YES NO
i
14. Names of Owner of premises ! 'ddress Phone No.
Name of Architect A dress Phone No
Name of Contractor Ad ess Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a fr hwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PE TS 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 distan es to property lines.
17. If elevation at any point on property is at 10 feet or below, must provi e topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * S NO
* IF YES, PROVIDE A COPY.
�I
STATE OF NEW YORK)
SS:
COUNTY OF,S )
being duly sworn, deposes and says that(s)he is the applicant
(Name of indi ' al signing contract) above named,
I
(S)He is the D
(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
-ti= day of 0 1 NJ 20
NotaryP is TRA L. DWYER Signature of App is nt
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2a
�g�ffQL,r BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
°�y • Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert cnr.town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.: email:
Address:
Phone No.: 31V 70
JOB SITE INFORMATION: (All Information Required)
Name:"
Address: / 16-
' N ��
Cross Street:
Phone No.:
Bldg.Permit #: " Q q 7 email:
Tax Map District: 1000 Section: Block: Lot: j
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YE O Rough In Final
Do you need a Temp Certificate?: YES LVO - 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? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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V fa
Iv I PVC PICKET PAVERS * N - �•
NOTE: MEASUREMENTS FROM BUILDING O FEN. * rq
CORNERS TO ACCESS COVERS I / g STEPS
z
OUT
j� O SHOWER
- rte•
�� * ROW OF EVERGREENS r ' Fh
�. GEN. WOOD DECK
PAD AC
47.7' Y
08 N/O/F
N/O/Fa o R.J. ENDERLE JR.
"'_ & D.A. CONRAD
M. ERGULEC "' 2 STY. FR. • .3
DWELLING PVC PICKET "� HOUSE "' 12 m m DWELLING
PUBLIC WATER FEN.
E GATE FF=13.1' ow m m * PUBLIC WATER
* 47.7' 47.7' N o C C
FE.COR. ' ' '6 m m * z
1.5'W * o
6.0 7.3' 11.1 * m
* 19.1' T
2ND FLR. WOOD W
V * DECK OVER 1ST
* FLR. WOOD DECKS D
w * ST
4: * LP i --
* LP LP D
* C
* P T
ROW OF SPRUCE TREES * L LP PAVERS 1 ' 1
* I
COLUMN
ELECT. METER--,,,,
FE. 0.3'E 100.00'
H2O METERIV
COLUMN
CMF EL 8.1' EL 6.2'
S76'18,00"W 103.68'j
0
AREA
INLET
EDGE OF PAVEMENT
CL PUBLIC WATER IN STREET CL
EL 7.8' EL 6.4'
PECONIC BAY BOULEVARD
TEST HOLE DATA TOWN PARK
WDONVAW 0fosaENCE
KEY
EL 11.5' ar DARK SROM LOAM OL
Q = REBAR SUFFOLK COUNTY DES'ARY?J!`s:T OF HEALT'ri SERVICES
® = WELL BROW s1Lr SAND SW
APPROVAL OF CONSTRUCTED WORKS FOR
A = STAKE 3' A SINGLE FAMILY RIESIDEw,CE AND
= TEST HOLE bL`u— L
PALE BROWN RNE SAND SP p v !--
• = PIPE Date piPR Q ��120 .,, R, r-'c. I
■ = MONUMENT EL. 1.8' 9 9' and T :.;,s Iocabon have been
its sa�Yags divpesal waster supplyfac?e:�c:`.
= WETLAND FLAG WA1ER/N PALE BROWN RNE SAND SP Inspected and/or csartned by this Department or4�;�er agencies and found to
bg saastar�'FORT L M OF �-) BEDROOMS.
= UTILITY POLE n5'
= HYDRANT N01E WAW?ENCOUN7ERERED 9.9'BELOW SURFACE , Chief
Craig l<r�Lrp�.d,
� F ice of Was'evjater Management
ELEVATIONS REFERENCED TO NAVD 88
THE LOCATIONS OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS-- of NE
AND OR FROM DATA OBTAINED FROM OTHERS 7HEREFORE THEIR LOCA77ONS AND OR EXISTENCE �C�''` IV,2
IS NOT GUARANTEED. �,'��' ,r f<�'-. '
l am familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE ;
SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions "
set forth therein and on the permit to construct. The location of wells and cesspools shown
hereon are from field observations and or from data obtained from others. { �-
ANY ALTERA77ON OR ADD177ON TO THIS SURVEY IS A VIOLATION OF fy n �� .� 1 LIC, NO. 49618
SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. EXCEPT AS P 0�l'I �V1�Y0'RS, •P.C.
PER SECTION 7209—SUBDIVISION 2. ALL CER7IFICA7)ONS HEREON (631 - 020 FAX (631) 765-1797
OR COPIES BEAR THE IMPRESSEDOPISEAL OFARE VALID FOR 7HIS MAP AND CESE THE SURVEYOR ONLY FREOF AWH SEP AREA= 17,458 SQ. FT. P.0. BOX 909
SIGNATURE APPEARS HEREON. 1230 TRAVELER STREET
SOUTHOLD, MY 11971 01-279
APPROVED AS NOTED
DATE: B.P.#
FEE: BY: ak
NOTIFY BU{LDING [LPaRTMENT AT
765-1802 8 AM TO PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - Tk'V!-- REQUIRED z
FOR POURED CONCRETE z Y
2. ROUGH - FRAMING F_ PLUMBING
3. INSULATION Q a
4. FINAL - CONSTRUCT'DN MUST cu
BE COMPLETE FC-' C.0. -
ALL CONSTRUCTION SHALL MEET THE m >
REQUIREMENTS OF THE CODES OF NEW W w m
YORK STATE. NOT RESPONSIBLE FOR n cU >
ca
DESIGN OR CONSTRUCTION ERRORS. V - in
EXISTING STAIRS TO UNFINISHED LOFT < c v
0
J N
I i COMPLY WITH ALL CODES OFco
00
s I NEW YORK STATE & TOWN CODES o
AS REQUIRED AND CONDITIONS OF
00 UP 4
ISedTt '� ARD
fi�i T '
I PROPOSED STEES I e�` -
UP BATHROOM O -
I � I
I \1JO
I I OCCUPANCY OR
7`0" i USE IS UNLAWFUL
M EXISTING GARAGE i WITHOUT CERTIFICATE
CNCNI I OF OCCUPANCY .
PROPOSED I
STORAGE
LEGEND >-
2X10 F.J. ;
16°O.C. W
- --'' f i PLUMBER CERTIFICATION I— Z
I I ON LEAD CONTENT BEFORI W O
I I CERTIFICATE OF OCCUPAN = z i--
UP
—UP I SOLDER USED IN WATER U W O N
NEW DOOR EXISTING DOORQ 0') L6
I I SUPPLY SYSTEM CANNOT
I EXCEED 2/10 OF 1% LEAD. _ p (0
o I EXISTING WOOD STUD WALLS
LL u) (0 M
w X m
PROPOSED WALLS.2x4 FRAMING WITH PL.UMBIN 01 � m
FO 8"TYP X GYP BOARD BOTH SIDES Al I -PLU��BNIG WASTE;, EL O
❑ • '� T Si IWA TER LINES NEED.= Uj L
I 11-6 1 23-4 1/2 ( r ORE CO'J.-'RING
1 351-2" J NOTE:ALL DIMENSIONS ARE TO FRAMING 0
L — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — --- —
REMOVE DOOR OPERATOR& Fire separation
FIX TO DOOR TO STRUCTURE required as per
NYS Code or-
ELECTRICAL
INSPECTION REQUIRED
,off 0525
NISYZEN
JULY 30, 2019
0r, 2 6
SCALE: AS NOTED
SHEET NO: