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Home My WebLink About45319-Z �O�guFF04ea Town of Southold 10/9/2020 P.O.Box 1179 0 C* T 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41508 Date: 10/9/2020 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 1295 Sigsbee Rd, Laurel - SCTM#: 473889 Sec/Block/Lot: 144.-2-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/18/2020 pursuant to which Building Permit No. 45319 dated 10/9/2020 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 blt"alterations (front door and sliding glass door)to an existing dwelling as applied for. The certificate is issued to Mule,Linda&Ors. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Oh(7-Signature �o�SUF�ot�c TOWN OF SOUTHOLD ay BUILDING DEPARTMENT x 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 #: 45319 Date: 10/9/2020 Permission is hereby granted to: Mule, Linda 251-42 61st Ave Little Neck, NY 11362 To: legalize "as bit" alterations to an existing dwelling as applied for. At premises located at: 1295 Sigsbee Rd, Laurel SCTM # 473889 Sec/Block/Lot# 144.-2-5 Pursuant to application dated 9/18/2020 and approved by the Building Inspector. To expire on 4/10/2022. Fees: . AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO-ALTERATION TO DWELLING $50.00 Total: $450.00 cr f -- - - Buil a 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 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: ii Old or Pre-existing Building: I✓ (check one) I Location of Property: 1 a c�-5— House No. Street Hamlet M / Owner or Owners of Property: I ,,cL A , / I ut t o Suffolk County Tax Map No 1000, Section ) q y, O Block Lot Subdivision l Filed Map. Lot: Permit No. I Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 44 Applicant Signature ee (fir() .gyp 3-- FIELD INSPECTION REPORT DATE GUtT3' FOUNDATION(1ST) y FOUNDATION (ZND) ROUGH FRAMING PLUMBING A INSLLATION PER N.Y. r77y . STATE ENERGY CODE; FINAL O m X zz 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)765-9502 ` Survey Board approval FAX: 631 765-9502 Il Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees i{° 1�°a � 1 C.O.Application U 6 J �- s Flood Permit Examined 1 20p �� y �VSingle&Separate UN- � & -�n� ��us1sI�dentification Form 9 6 Storm-Water Assessment Form 2--o p Contact: �, � Approved 20 , , r Mail to: L Disapproved a/c /o2-a0 ft SJ'et P,J 14o-#,+&ck Phone: h n IP Building Inspector 1 SEP 20 20 APPLICATION FOR BUILDING PERMIT i Date 20 r70TC ;,!r o INSTRUCTIONS a.This application e 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,relationslup 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 prenuses 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 Pemiit pursuant to the Building Zone Ordinance of the Town of Southo ,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of bu' dditions,or alterations or for removal or demolition as herein described.The applicant agrees to complywitht 1 li a laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on a .m ilding for necessary inspections. (Signature of applicant or name,if a corporation) ging address of applicant) Stat h ther`applicant.is,owndr`,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name(g,,6 ner,of premises,;;L I r\ � !c,1 lit 3 ��U`'` AAs on the tax roll or latest dee t, `<! ``�`° Cd�C�i�;t i_Y WITH ALL CODES OF If applicagt(i's a cot n,signatuie ofiiuly`anth nae�dt officer .� _;, PJ'EW YORK STATE & TOWIN CODES am and''fitle of cor' orate;officer. c`� ' `(��'° - S OF BuildersLicen c�No_r-,1A%' _, ;`'' "`.^r'� >�\ r4tiE AS hLG�IJIREG A Plumbers LicenseVo ��;� , f ` ;�"�`�'`. SOUTHOLD TOWN ZD Electricians Licen eN, 6 ,�Z f':. '\""r�`^''� Other Trade's Liee se :�'''�'0`" SOUTHOLD 'PLANNING BOARD \� �� SO ' ; LG TOWN TRUSTEES 1. Lo ation of lana on,-vyhi`c proposed work will be done: M E� o0.d I 1tdt' ' U`C x,ivC; (' House Number Stf t Haml ' ' County Tax Map No. 1000 Section49 Block a- Lot S�_- 0.0 O Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occu ancy of proposed construction: a. Existing use and occupancy re S CL r ir,r b. Intended use and occupancy fC m C'_ 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work. ¢i ➢ Q X'i'e r 1 or -doorf — ACI- (Description) P 4. Estimated Cost 0 Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units--4—Number of dwelling units on each floor i If garage, number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. �j I R 7. Dimensions of existing structures,if any:Front Rear Depth Height Number of Stories 1 Dimensionso' + ►e tructure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories r 9. Size of lot:Front 1 �a Rear I f®!� t Depth f 10.Date of Purchase ) 9 g Name of Former Owner �S_, A r, 'A r h p 11.Zone or use district in which premises are situated ��f► dC I-f) � 12.Does proposed construction violate any/zoning law,ordinance or regulation?YES NO 13.Will lot be re-graded?YES NO y Will excess fill be removed from premises?YES_NO_ 14.Names of Owner of premises Li A n. Mt&(i Address 0-w rryt"�Z of Phone No. 6 x'031-3 YY 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 10 *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 NO IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: en COUNTY/OF rn f_,6 L If-, r= A I-I k.,r 16 being duty-sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, CJ 0 rn y (S)He is the CD W h er •t" (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 i performed in the manner set forth in the application filed therewith. ;0 it,Cq Sworn to before me this ® G q day of 02 �' 20 O Z ;2 Notary P ubtrc Signature of Applicant WOLF 1-171 pt AN, t 1 I �A b 0 Q T � Q MANUFACTURER STIPULATES CONFORMANCE TO CODE: THC RATING: NFRC NERC 100/200 PRODUCT:Fbergtass Entrance Dx• NERC THC-10-5 MST 32610 M_06 y�y� t n ,. 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