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t�g�EFQt� Town of Southold 8/29/2020 'G� P.O.Box 1179 C* 4, 53095 Main Rd ads ` Southold,New York 11971 ra,.�.2XLPr�. CERTIFICATE OF OCCUPANCY No: 41399 Date: 8/29/2020 THIS CERTIFIES that the building ALTERATION Location of Property: 475 Youngs Ave., Southold SCTM#: 473889 Sec/Block/Lot: 61.-4-28 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/9/2019 pursuant to which Building Permit No. 44299 dated 10/16/2019 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: roof repairs (in-place)to existing dwelling as applied for. The certificate is issued to Horton Charles House LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Autor ignature �g�FFOI,�c TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S'OFFICE o . SOUTHOLD, NY y�ol � �aoRh 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#: 44299 Date: 10/16/2019 Permission is hereby granted to: Horton Charles House LLC 7160 Horton's Ln Southold, NY 11971 To: construct roof repairs (in-place) to existing dwelling as applied for. At premises located at: 475 Youngs Ave., Southold SCTM # 473889 Sec/Block/Lot# 61.-4-28 _ Pursuant to application dated 10/9/2019 and approved by the Building Inspector. To expire on 4/16/2021. Fees: ` SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $250.00 CO -ALTERATION TO DWELLING $50.00 Total: $300.00 Buildin spector 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. Och�v 9 2-1D1 0 New Construction: Old or Pre-existing Building: (check one) Location of Property: '1 QPAA 01 C bnLnLL LP I C� +"� L House No treet Hamlet C l Owner or Owners of Property. r •t�—C C1b� r /D (,� enter A ax Suffolk County Tax Map No 1000, Section ( Block Lot Subdivision � Filed Map. Lot: Permit No. 't c Ij Date of Pert-nit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval- Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Sign ture 0��LA)r LJ-C- - # # TOWN, OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ -] SULATIOWCAULKING [ ] FRAMING/STRAPPING [ FINAL [ " ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ( ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE )* INSPECTOR FIELD INSPECTION REPORT -DATE COMMENTS FOUNDATION 1ST ►= -------------------------------- CIO FOUNDATION (2ND) z o H ROUGH FRAMING& q PLUMBING I r INSULATION PER N.Y. STATE ENERGY CODE r � FINAL ADDITIONAL COMMENTS 0 3rz rn . lb O ® z d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL hoard of Health 4SOtiTIiOLD,NY 11971Vets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 Su ey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Application Prood Permit Exammed .0 t f`_e `,, '�+U \,f r-� ` Single&Separate 7 , =f ��-•t� Tmss Identificarion Form Storm-Water Assessment Form 10//6,20UT � j1 ' �® Contact: Approved ��y �� ail-to• F a✓\6,MC'tx Disapproved a/c �K -^�1•�; "�: _.� Phone 99DW2 ,� Expiration 20 But dmg pector APPLICATION FOR BUILDING PERMIT Date 2011(9 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 inspection k I�D 0-441f) (Signature of applicant or name,if a corlibration) (Mailing address of applicant) St to whether a plicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owoerof premises (UA AU-hV) OL (As on the tax roll or latest deed) I Wta oration,signature of duly aut rized officer Tffa e d—t—NeVoY corporate fficer) Builders is se No. Plumbers is rise No. Electricians icense No. Other Trade's License No. 1. Location of land o which proposed w rk will be done: e, r HJusiNumber S f ( Hamlet County Tax Map No. 1000 Section—W� Block �" Lot Subdivision Filed Map No. Lot �. State existing use and occupancy of pr ses and i tgnded use and occupancy of proposed construction- a. Existing use and occupancy J ' s�' It b. Intended use and occupancy 3. Nature of work eck which applicable):New Building Addition Alteration Repair Removal Demolition Other Work �, (Description) 4. Estimated Cost t „ cx�o,"�' Fee (To be paid on filing this lication) 5. If dwelling,number of dwelling units_,�>Number of dwelling units on each floor e, ala.. If garage, number of cars l a� 6 If business,commercial or mixed occupancy,specify nature and extent off each type o/lff®use. ;�) 7. Dimensions of 7stmg structures,if any:Front S � `Rear \� �� r0 Depth ® -3/q/I Height i I Number of Stories I Dimensions of same structure with alterations or additions: Front �j, M, Rear Sq4%._ Depth 60n+,,, Height So C10— Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height VqNun ber of Stories 9. Size of lot:Front Rear 17 -Depth 9 /.00, Q 10.Date of Purchase 67 vO Name of Former Owner 11.Zone or use district in which premises are situated 9, 'G 12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO 13.Will lot be re-graded?YES NO &^ill excess fill be removed from p remises9 YES NO ✓ o 14.Names of Owner o& e%mise "�1Hdte�s°s � �mIN� t. 41� ` S r Name of Architect ' ' ddress 0/�9ye 01q3 Name of Contractor aAd gess p• h©pe�No. 15 a.Is this property within 100 feet of a tidal wetlandr a freshwater wetland?*YES NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.0 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. "a 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 *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: g COUNTY F l being duly swom,deposes and says that(s)he is the applicant ame of individua signing contract)above named, (S)He is the h GS.t i (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 tg_before me th' U day of 200— � n AaCW Notary Public Signature of Applicant 1 ' l. -, TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2( � 51 1k. Car./rdy rax Mala MAi-> C.l = f• OPI +'1'!� 4r C.40UPolf's N,. - , N.7844&'1019- _ ��~ /� - - _ 1. �..�� • ALM 1Z4'1-i c • � � Ijr j ly 87.29YTIMRNORf>]1 EMAT10t OR�A9011Mk t �O TNB SUR IS,A.VIO�t►iil�!OF � EKr!ON 7Z0fi F THE NEyV YIRK STATI I T�UGITION �'. � I / f e COAITS'OF T' SU. A,;_ NOT YEARM' I TH!LAND SUR lYOG'S UAL OA fYS, :� , . s �i�� '•t` (Y r. Qf NI / Nri�'"'Gr�! EMIOSSFO S 53MA Is7 'N$IDFRtO To EF A Y¢It r:U:c,ir; E ig�� It ' GUATWWS�PG"•A:0 1":-A NAIL RUN i•r/�diY ONLT TO TI=I1:._.. 1.,.,:• i8f SURYit' is.rREPA:[D, 0 u,, :%f Ta rHE !_Y•r�...�, '� Y ti; ?` ,; . .a TME cc r,G;•�.•/• ..,zhA A.T XY Alio • =�• �� LENDING,Ir rilii, :,: h_WN,Aho Ll��=� a '• --�+- - = TO 709 AUSI ',::.,:i l l:t ItDlilG mu- 61"WOW 4pri . .. TUTIOK G4ANTLtYXX NOT TRtVISUAILI M, ",:I •s, TO ADWIO#IAL INS RRK*4 OR SUSSLOUOP ' AWuerae iiiiii '. •', CLIMATIC AND GEOGRAPHIC DESIGN CRITERIA AS PER 112015 INTERNA'T'IONAL RESIDENTIAL CODE.ICC",TABLE R301.2(1) APP. 0. ED AS NOTE OCCUPANCY OR ORGUND WMD'PnsiCN seismic HUDJLrfTTODAMAGEFROM WINTER (CesI11eLD 1 USE I S UNLAWFUL SNOW si ELU 6 pEst(iN DSSIip. UNDERL REQUIRED HAZARDS lAflp r r Hnp) TO � i1C SPEcTs NEgI HIND De01DlISJONe CA7epORY WL'A111E1tINQ IrRQLITlfNE TaRMITa TEMP. REQUInEp DATE: - d � B.P.# _ � MODSRATBTC 19 y� ZONE r%f FEE: ��� BY: WITHOUT CERTIFICA�, �� Ps� Isa vev vas E savane 3 t�"[eta i1nAVY NOTIFY BUILDING DEPARTMENT AT OF OCCUPANCY I 765-1802 8 A TO 4 PM FOR THE �---- FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED SIW rLE PLY EPDIH MDF'IIJCr FOR POURED CONCRETE 00 2-3/32" ADv&fd•1'Ec44 zip r 2: s%I.smM s•I E4TH I I.IG ROUGH-- & PLUMBING - ou 2"rc4 R.12 Ca /(o" 4 tap E 3.- INSULATION o.c. + 4.-FINAL - CONSTRUCTION MUST j�` r-'BE COMPLETE FOR C.O. slnPs��1 STRDN�r-Ti� /"6_II 2"c 4' Ll:1�Gre CL BD. wl ALL CONSTRUCT'CN SHALL MEET THE N2.5A POP-ElOAQ15 G-IpS, LO k 5CatJ5 1:SrUfl. REQUIREMENTS OF THE CODES OF NEWWNEJF_H.1 DOF Is Tt,tpA YORK STATE. NOT RESPONSIBLE FOR I? ov CONTP-6c. 2, 1 DJ1. DESIGN OR CONSTRUCTION ERRORS. Tb ccOpp-m Ti4&T- F�'fG, 3",c S" G-IRDEPPAS F..NCLOSED TapOI:Ti� 'rULL '61EE&P-10 r, ;I. pop-c'" iT IS AVOLPMM LAW 1 3 ANY PERSON, DERTI•IE COMPLY WITH ALL CODES OF m 11NLEss NOr-G DIRECTIOII OF A LICENSED NEW YORK STATE & TOWN CODES ARCHITECT,TO AI-TER AN AS REQUIRED AND CONDITIONS OF ; 5'-13i�" IT14Y AY a�f DRAWING U AUTHORIZED Ald ° ALTERATION MUST BE gyp,SEALED.AND DAI\ICE DESCRIBED IN ACCD i �t}IE IVY. SOI7HOLDTOWNTRUSTEES '>Jss-r ELEV&T1oN 5ouTH .Ew--vA-nolJ. Se--c.Tto Q. NXS.DEC o►Z i LEV�r-ioN.-SI Ml u4Q,u BaTN p.M, 1too-J). k.t TC'H eo' Wc-r-E -&'LGHITE•GT Is To BI=. IIJ�R-� OF A0V 5TI?VLTU94L � �• IQc0ws157-6t�c,'&s WHFd ROOF 1s OPW. L FLP,,- VLL 4'-113,W cI LL •- Rb 1 3 r2-„ - -- �- I IJST4LL -TO14Q.5 Mb4.V I LLQ o R=21 kRAFT FAcED .k)SUL., &TH fl -d ED-OH FABov1: ro .�a-trt1RM . ) ��03 r 4 CLDSED POP-rH (FYrc,) M� d_ sl u klcv- w H X1.1 ILm-F IS cm0m- N MAT-F-yo RF-MON/ti-D. INSTALL lULAT'IOIJ ' BaFFLES @ EAdS. n D W ao �G� p J o �' w _ RETAIN STORM WATER RUNOFF ' o c!) 0 PURSUANT TO CHAPTER 236 OF THE TOWN CODE. LT7 PL 4N4,1 4 Pp-O pos ED A L"f'11R-A, w `T'O ROOF �,'i- 475 You Q c,s AvF-o uF. I SourHoL-D, N.Y. 11971 S.C.T- H 1000 ' 4-- 2 sc&L_I✓: V4: - 1`-0" D&T-E. 7C0cTTogEP- aOlct