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Home My WebLink About42263-Z h f••k�" �SupFat/( r Town of Southold 9/14/2020 $ P.O.Box 1179 o 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41442 Date: 9/14/2020 THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 150 Meadow Ln.,Mattituck SCTM#: 473889 Sec/Block/Lot: 115.4-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/18/2017 pursuant to which Building Permit No. 42263 dated 12/26/2017 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: Bathroom alteration to an existing single family dwelling as applied for. r The certificate is issued to Simmons,Gregory of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42263 08/18/2020 PLUMBERS CERTIFICATION DATED 08/12/20 B 11 emler Jr A 'z gnature �uFfat TOWN OF SOUTHOLD jo`p °may BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • y� SOUTHOLDs NY ol � ��. 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#: 42263 Date: 12/26/2017 Permission is hereby granted to: Simmons, Gregory PO BOX 1029 Mattituck, NY 11952 To: bathroom alteration to an existing single family dwelling as applied for. At premises located at: 150 Meadow Ln., Mattituck SCTM # 473889 Sec/Block/Lot# 115.-4-22 Pursuant to application dated 12/18/2017 and approved by the Building Inspector. To expire on 6/27/2019. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $224.00 CO -ALTERATION TO DWELLING $50.00 Total: $274.00 Building Inspector 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$15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: So 1LIE )OW U49 /M*JT1 I Lx'/e House No. + cStreet Hamlet Cs Owner or Owners of Property: V-EGDV J. JIM�►•.o�� Suffolk County Tax Map No 1000, Section f 15 Block Lt Lot �- Subdivision Filed Map. Lot: Permit No. o Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: / Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓✓ (check one) Fee Submitted:$ Ap lic nt n ture ®��OF SO(/lyOl Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G Q sean.deviin(cD-town.southold.n us Southold,NY 11971-0959 y' BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Gregory Simmons Address: 150 Meadow Ln city:Mattituck st: NY zip. 11952 Building Permit#: 42263 Section: 115 Block: 4 Lot- 22 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Custom Lighting of Suffolk License No: 38893ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor 1st Floor X Pool New Renovation X 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 1 Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 4 CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 3 4'LED Exit Fixtures Pump Other Equipment: Notes. AS BUILT, NO VISUAL DEFECTS " Did Not See The Rough - Bath Renovation Inspector Signature: Date: August 18, 2020 S.Devlin-Cert Electrical Compliance Form.xls o�o�Soly Town Hall Annex 1 Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ' BUILDING DEPARTMENT TOWN OF SOUTHOLD SEP 1 4 2020 EUMMTG DEPT. TOI7''I C.Ti'`s�'I17_'L"OLD C•ERTIFICA3:3M Date: 1� Building Permit No. 1-2 j Owner: —/'-7-- /1. 7 leases print) Plumber: (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. l (Plumbers Signature) Sworn to before me this day of 20-0Z) x Notary Public, 1 Nom►Pub�l►c,45tate INw Nxlc , �pF SOUjy �V �o� opo N o ��ly TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLSG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: <� -�✓ fA 3 vi LLIX . DATE INSPECTOR �vv�0� BOE SO(/ry how o� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ /ROUGH PLEIG. [ ] FOUNDATION 2ND [INSULATION [VJ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) 7MARKS: P)Ga, 0vvv6,V-ltA ) L-vl 1fo 0[,V, ul014VI DATE 6 ANSPECTOR SOUlyolo 2� J �yoourm,N�' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE '— / / /�` INSPECTORz:Zc ho�apF SOUTyolo Li 2,2, W M eon'ct � ln.4, # TOWN OF SOUTHOLD BUILDING DEPT. `�cou►m,aF'` 765-1802 INSPECTION [ - I FOUNDATION 1 ST [ ] ROUGH PL13G. [ ]: FOUNDATION 2ND j j INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O s REMARKS: l M ZC4&T?�4p Gam l AIXF6 l aAf DATE INSPECTOR �y I FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(IST) -------------------------------------- FOUNDATION -----------------------------------FOUNDATION (2ND) 1 1Y.,Oyqln q NuolDinn IPAV w "1 .® z • rhi ROUGH FRAMING& Vt PLUMBING S n fci y 1 K. ,r INSULATION PER N.Y. y STATE ENERGY CODE i FINAL ADDITIONAL COMM NTS Qj a ►� - 2d e d e� Cf-r-- 191P o l. 00 �p s � � z d b y TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING D'EPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,INI' 11971 i •-... ,. _ _ �,l• 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 , y Surve Southoldtownny.gov PERMIT NO. � Check Septic Form I iN.Y.S.D.E.C. Trustees C.O.Application D Flood Permit Examined _,20 D Single&Separate Truss Identification Form DEC 1 D 2017 Storm-Water Assessment Form Conitact: Approved '� ��(� ,20 $�1�TN� I Mail to: ?0,60,4 Disapproved a/c TOWN OF SOUTHOLD ' /gRTfit-TuLc, 0,1 B 1q 5 Phone: +—Bea-8�i3� Expiration `� ,20 j r � BuildingInspecto1*1111 i lll APPLICATION FOR BUILDING PERI IT Date 1'a�9� 11 , 2011 INSTRUCTIONS i 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. Uponlapproval 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. I 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 wr�iting,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 o�her 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. ( ign re,6rf applican name,if a corporation) (Mailing address-of applicant) I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Wm+t✓e Name of owner of premises l�► �ao�`� - 51M.+�c,r'S i (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer)A Builders License No._ __ Plumbers License No. 5003—MP Electricians License No. 3MS-Mb Other Trade's License No. I 1. Location of land on which proposed work will be done: { House Number Street Hamlet County Tax Map No. 1000 Section )-��l X881 Block 11S Lot i 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 S1a6L& F4PAtLY USiD&JC6, b. Intended use and occupancy SING%I.S FA,4ILY US08IJCC 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work Mew 6tKamn (Description) 4. Estimated Cost 1 , 1 t Fee, i b`e,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'` b Depth Height Number of Stories Dimensions of same structure with 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 1 l. 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 N0j-,_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 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 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) SS: COUNTY OFC, �1 {(my) n being duly sworn, deposes and says Wthat(s)he is the applicant c�re �r LA o S (Name nd' ' ual signing contract) above named, (S)He is the 0Wne_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 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 1 e)th day of_00-_2yy)1o_ , 2T I f7� Notary Public Signatu f li ant ��S�ffol�coGy BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD o • Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 roger.richert(cD-town.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: 6ge4oZy Stn4n10t45 Date: lab /S Company Name: Cu5-rbA4 L CHTI,jG, ®j= SUCK_ Name: License No.: 3$ 99 3 email: Address: S-1-70 6 CL)r-,iy Phone No.: 6S)- 'F7g- 69 sI JOB SITE INFORMATION: (All Information Required) Name: C c.'el Address: /So Nt = Vw 0-)c m l-Uck Ny ��- Cross Street: C t a�L D2tuC Phone No.: ^(x,31-$'la 'N2j Bldg.Permit#: YQ Q (03 email: �,H,,,pv�SC�.T��,+�A,�.CU•e,, Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly) pec..-04c- 67- 8A-�Rt A- Circle All That Apply: Is job ready for inspection?: ES / NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# New Service - Fire Reconnect - Flood Reconnect- Service Reconnected - Underground - Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form.As ��Q, BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 xylol Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 roger.richertP-town.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: a?-e-400 SIM^,o^'S Date: lab /S Company Name: Ct,S A4 L GHT(,-iG ot= SoFF�IK Name: License No.: 3$ 3 M6 email: Address: S^1'70 C ��,�� Y� �uc.lL ,.,� I1�S.a Phone No.: s1- g?a.- 5131 JOB SITE INFORMATION: (All Information Required) Name: C-3P6co2q 5101"M01-3 Address: /SL) m — acw 44.oe. M M fyc< PyS�- Cross Street: �' �aL D2tuC Phone No.: Bldg.Permit#: Lta a 63 email: ,,;t,,�o�SC�`�Gn,,�t-i�.Co�►., Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly) LL-ec--4c. 6n-cz 8 � Circle All That Apply: Is job ready for inspection?: ES / 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? Y N Additional Information: PAYMENT DUE WITH APPLICATION 0O 82-Request for Inspection Form.xls ��e,l✓ OF SOUry®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ® aQ August 18, 2020 BUILDING DEPARTMENT TOWN OF SOUTHOLD Gregory Simmons P.O. Box 1029 Mattituck, New York 11952 RE: 150 Meadow Lane, Mattituck Please note your Building Permit has expired and must be renewed. 41_0 2-®The fee due is$137.00. Upon renewal and the items checked off below we can issue your Certificate of Occupancy for this permit. TO WHOM IT MAY CONCERN: The items marked below are required to obtain your Certificate of Occupancy Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificatd---*C Id 18�A fee of$50.00. Final Board of Health survey. Plumbers Solder Certificate or Pex Affidavit Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. (631-765-1802) Storm Shutters required for all glazing Energy Test Results and Manuals required Final elevation certificate from surveyor. Spray Foam Insulation Certification from a NYS licensed architect or Engineer BUILDING PERMIT: 44478-Z addition/alteration APPROVED AS NO TED, DATJ, --t.-L GC-,DES OF !--14A- :� t & TOWN CODES FEE i�; %ZZ- - r-, r S REQUIFiLED , F��MT!QhaQF NOTIFY BUILDING DF-PARTHENT AT 765-1802 8 AM TO 4 PM, FOR THE C'M IT-1111-1m,�1111 FOLLOWING INSPECTIONS: st�ljlullul�7111 1. FOUNDATION - TWO REQUiRED hull�tt 7p 117-2 FOR POURED CONCRETE 2. ROUGH - FRAMING 8,, PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE OCCUPANCY OR REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOF RESPONSIBLE FOR USE IS UNLAWFUL DESIGN OR CONSTRUCTION ERRORS. WITHOUT CER71 IFICATE OF OCCUPANCY PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE Cr TIFICATE OF OCCUPANCY R S PLUMBING ,- OLDER USED IN WATER SU[)PLY SYSTEM CANNOT ALL PLUMBING WASTE EXCEED 2110 OF 1% LEAD. 8,WATER LINiFs NEED TEST,ING BEFORE COVERING t17'-0 3/4' 9'-9 1/4" 6'-1' 2'-0' 3'-0' 2'-8' n 0 EXISTING CLOS. N MOP05�p 6ATNf;00M GEEING Nf.95" N i tV 2'-6"16.51. 6' 10'-1 3/4' X15-Wi MA5V 6 WOOM LELING Hf.95" i 0051M WALL WW Wl.L 51MMON5 F�51MNC� 50 MM20W M - MAMTUCK, NY 11952 MA5V 6AHOOM An121ION .� x S L N z r�