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46128-Z
�oSUFEot co° Town of Southold 6/22/2021 a P.O.Box 1179 o - �' x 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42107 Date: 6/22/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 58315 CR 48, Greenport SCTM#: 473889 Sec/Block/Lot: 44.-2-12 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/6/2021 pursuant to which Building Permit No. 46128 dated 4/26/2021 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 bathroom alteration in existing single family dwelling as applied for. The certificate is issued to Michael Piccirillo&Alana Anacreaonte of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46128 6/11/2021 PLUMBERS CERTIFICATION DATED 6/9/2021 an Vill�? 0 A ori Signature �o�SUEfat�,co ` TOWN OF SOUTHOLD ay BUILDING DEPARTMENT C* TOWN CLERK'S OFFICE SOUTHOLD, NY 4/pl � 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#: 46128 Date: 4/26/2021 Permission is hereby granted to: Long Is One Real Est Inc 58315 CR 48 Greenport, NY 11944 To: Legalize as-built bathroom alteration in existing single family dwelling as applied for with flood permit. At premises located at: 58315 CR 48, Greenport SCTM #473889 Sec/Block/Lot# 44.-2-12 Pursuant to application dated 4/6/2021 and approved by the Building Inspector. To expire on 10/26/2022. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $470.40 CO-ALTERATION TO DWELLING $50.00 Flood Permit $100.00 Total: $620.40 Budding Inspector OF SO(/��! Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502' P.O.Box 1179 ® sean.devlin(a?town.southold.ny.us Southold,NY 11971-0959 ®l�C®UNrI,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Michael Piccirillo Address: 58315 CR 48 city Greenport st: NY zip: 11944 Building Permit#: 46128 Section: 44 Block: 2 Lot: 12 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: AS BUILT License No: 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 X Heat Duplec Recpt Ceiling Fixtures 1 Bath Exhaust Fan 1 Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 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 5 4'LED Exit Fixtures Pump Other Equipment* Notes " AS BUILT NO VISUAL DEFECTS " Bath Inspector Signature: - Date: June 11, 2021 S.Devlin-Cert Electrical Compliance Form.xls o��pf SO(/Tyol - Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q Southold,NY 11971-0959 � �� COUron��, BUILDING DEPARTMENT _ TOWN OF SOUTHOLD Y JUN 1 p � - CERTIFICATION Date: Building Permit No. Owner: L-9PJ-jf )p-- 0 el (Please print) Plumber:- , orj \/ 1 �L_ lease print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. .9 _e� J r (Plumbers Signature) Sworn to before me this day of)�� 20,Q L Notary Public, I County _6 ffoTRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2ba;, of SObI l 3! � ✓.�it/1�� # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 . ...INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. ] FOUNDATION 2ND [ ] SULATION/C AULKING h [ ] FRAMING/STRAPPING [vf FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ]PPRE C/O REMARKS: 142kLl" C kl' ca+6 DATE INSPECTOR V4v s 0 L) * # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm N 765-1802 INSPECTION [ ] FOUNDATION 18T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [. ] ELECTRICAL (ROUGH) M ELECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O REMARKS: i L,-r DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) ' FOUNDATION(2ND) 4 , v10 OQ ROUGH FRAMING& y PLUMBING INSULATION PER N.Y. H STATE ENERGY CODE VM 6 --- Sol FINAL'------------- '� Q7✓ ADDITIONAL CO ' NTS (�A -1 pa o d � z • rn O Z . H o�°$u4F0�'too TOWN OF SOUTHOLD—BUILDING DEPARTMENT CO Gym Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 °yea• ��o�� Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtowm.%Zov Date Received APPLICATION FOR BUILDING PERMIT =� r Rye t For Office Use Only PERMIT NO. Building Inspector: APR — 6 20Zr L21 Applications end,forms,must be-f out in-their-entiretyr Incomplete ,.u ' ,r sappL-'ons will-not be-accepted. ,Where the Applican is not t t he owner;an o ° _ .,�.._.«,.�, ;�;... .3q ., „, c$, '", r °Owner's Authorization form(Page`if shall 6e'completed. Date: f L11-24 'OWN"ER(S)-OF_PROPERTlf:;; "1=- Name' _ _G?�+ _ __®dam+ __fZ �d`�I I_ CTM #1000- -- _4 - Project Address: Phone#: f _-�— Email: n,y+>r ti6 .V, Mailing Address: _ fCON, TACT'PERSONi .,, 11 21 n, a Name: Mailing Address: Phone#: ly"7 7 ly ? L Email: 3 DESIGN PROFESSIONAL INFORMATION: 'i ,LLf Name: Mai Iing,,Address:� Phone,#:, . ,;`; `` Email: `CONTRACTOR{INFORNIATION: Name: Mailing Address: Phone#: Email: _ — s} Jv _ — _ --'l .,C.4z •_~�.�`C 'T'"Y�'k,` W}~- I`,�.. Yw._—_.,A�a� •I ��'li 1r2. ��sN St.Ii }X �}n pESfCRI"PTION OF PROPOSE'V'CONSTRUCTI'ONK' ' ;;.• ❑New Structure ❑Addition ❑AI eration ❑Repair ❑Demolition Estimated Cost of Project: _Other , -------__ $Will the lot be re-graded? ❑Yes &0 Will excess fill be removed from premises? ❑Yes Lo 1 PROPERTY INFORMATION'' - - - Existing use of property: j Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Dyes ij9No IF YES, PROVIDE A COPY. Check B'oic After Reading: The'owner/contractor/design professional is responsible for all drainage and storm water.issues as provided by' - Chapter 236 of the,Town Code. 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,'NeIW York and other applicable Laws,1)4nances okegulations,for t'he construction of buildings,, additions,alterations or for removal or,demblition 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(s),for necessary inspections.False statements made herein are , pun a Class A misdemeanor pursuantuto Section 210.45 of`theAive YorkState Penal Law., = 4= Application Submitted By(prin ame): �7(t�( � V Y ISL f� Authorized Agent 17GOwner Signature of Applicant Date: STATE OF NEW YORK) SS: l COUNTY OF Lbeing duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, s ' (S)he is the Ca (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/her knowledge and belief; and that the work will be,'performed in the manner set forth in the application file`therewith: Sworn before me this � " k U(� day of ' 1 , 20 Notary Public SABRINA M BORN Notary,No lic,State OG31of New wYork PROPERTY OW 14ER AU fHO R(ZAITIQ mission in Suffolk county �` Commission in Dec.22,20 (Where the applicant is not the owner) I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 Glenn Goldsmith, President �Q� ����° Town Hall Annex A.Nicholas Krupski,Vice President ®� , ~ .m ®�® 54375 Route 25 John M. Bredemeyer III . " * P.O. Box 1179 Southold,New York 11971 Michael J. Domino CATelephone(631) 765-1892 Greg Williams ® a® Fax(631) 765-6641 ®I�COW v ,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL, EROSION MANAGEMENT PERMIT COASTAL EROSION PERMIT#99790 Applicant/Agent: Michael A. Kimack Permittee: Long Island One Real Estate, Inc. SCTM#: 1000-44-2-12 Project Location: 58315 C.R. 48, Greenport ®ate of Resolution/Issuance: May 19, 2021 ®ate of Expiration: May 19, 2023 Reviewed by: Board of Trustees DESCRIPTION OF ACTIVITY: For the existing 36.3'x24.3' (882.09sq.ft.) one story dwelling on concrete piers; 138.5sq.ft. easterly wood deck with 11.4sq.ft. staircase; 196.83sq.ft. westerly wood deck with 6sq ft. and 16sq.ft. staircases; a 55.5sq.ft. wood walkway; and for the as-built non-structural wood skirt(36' in length by 5' in height: 180s.ft.)with drain cutouts at bottom of skirt every four feet to cover cement pilings on seaward side of dwelling; and as depicted on the site plan prepared by Philip R. Ferrantello, RA, dated March 5, 2021, and stamped approved on May 19, 2021. INSPECTIONS: Final Inspection SPECIAL CONDITIONS: None In accordance with Chapter 111-15 Erosion Protection Structures: N/A A maintenance agreement is attached hereto and is a necessary special condition of this permit. By: Glenn Goldsmith, President Board of Trustees M BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 9879&9879C DATE: MAY 19,2021 ISSUED TO: LONG ISLAND ONE REAL ESTATE,INC. PROPERTY ADDRESS: 58315 C.R. 48,GREENPORT SCTM#1000-44-2-12 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees Mopted at the meeting held on May 19,2021 and in consideration of application fee in the sum of$500.00 pak-,by LI One Real Estate,Inc. and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: xjt is A Wetland Permit for the existing 36.3'x24.3' (882.09sq.ft.) one story dwelling on concrete piers; 138.5sq.ft. easterly wood deck with 11.4sq.ft.staircase; 196.83sq.ft.westerly wood deck with 6sq.ft. and 16sq.ft. staircases; a 55.5sq.ft.wood walkway; and for the as-built non-structural wood skirt(361 in length by 51 in height: 180s.ft.)with drain cutouts at bottom of skirt every four feet to cover cement pilings on seaward side of dwelling; and as depicted on the site plan prepared by Philip R. Ferrantello, RA, dated March 5, 2021, r, d stamped approved on May 19, txr 2021. IN WITNESS WIIEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of the 19th da of May,2021. Ca AA'p J MON qViL TERMS AND CONDI'T'IONS The Permittee Long Island One Peal Estate Inc residing-a,58315 C.R48, Greenport, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is-considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Glenn Goldsmith,President �QF so(/jy Town Hall Annex A. Nicholas Krupski,Vice President ,`o ��� 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III l [ Southold, New York 11971 Michael J. Domino G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 OUNT`1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1823C Date: June 15, 2021 THIS CERTIFIES that the existing 36.3'x24.3'(882.09sq.ft.)one story dwelling on concrete piers; 138.5sq.ft. easterly wood deck with 11.4sq.ft.staircase; 196.83sq.ft. westerly wood deck with 6sq.ft.-and 16sq.ft. staircases; a 55.5sq.ft.wood walkway: and for the as-built non-structural wood skirt(36' in length by 5' in height: 180s.ft.)with drain cutouts at bottom of skirt every four feet to cover cement pilings on seaward side of dwelling, At 58315 C.R.48, Greenport Suffolk County Tax Map#1000-44-2-12 Conforms to the application for a Trustees Permit heretofore filed in this office Dated January 5,2021 pursuant to which Trustees Wetland Permit#9879 Dated May 19,2021, and Coastal Erosion Permit#9879C Dated May 19,2021 was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being.issued is for the existing 36.3'x24.3' (882.09sq.ft.)one story dwelling on concrete piers; 138.5sq.ft. easterly wood deck with 11.4sq.ft. staircase; 196.83sq.ft. westerly wood deck with 6sq.ft. and 16sq.ft. staircases;a 55.5sq.ft. wood walkway;and for the as-built non-structural wood skirt(36' in length by 5' in height: 180s.ft.)with drain cutouts at bottom of skirt every four feet to cover cement pilings on seaward side of dwelling. The certificate is issued to Long Island One Real Estate,Inc. owner of the aforesaid property. IL 4" "t - Authorized Signature JUN 1 7 2021 I'Mil -TOWN OF SMJTllO1.f? FUDODPIAIN DE'VEIL,01.)NIENT PERMIT APPLI-CAT1,0N This [of III is to be filled out in duplicate. IE( - I CAV'Lt 1 " "2' 8 2021 71U.J: GENFRAL P.ROV S10ta-LAEf�L,_1 No work, may starund a permit LS issued32� 2 The permit may be revoked if any false statem,-:vs arc made bcrcw 3 If revoked, all work must cease until permit is n: issued. 4 Development shall not be used or occupied uu:il a Ccrtiflcatc of Compliance- v; usucd 5 The permit will expire if no work is commenced mthin sLx ulou(bs of issuance. 6 Applicant is hereby informcd that other permits way he required to fulfill local, state and fcdc-ral itgulaLory re.quiraments. 7 Applicant hereby gives consent to the Local AdiriixL�trator or hu/her representative to make rcasoaablc . inspections required to verify compliance. 8 1, THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACH-ME-NTS TO THIS APPLICATION ARE, TO THE BEST OF MY KNMVLEDGE, TRUE AND ACCURATE (APPLICANT'S SR3�1ATURF_-'__._ n' DATE 4/28/21 SF,C,',T1QN_2: PRO _QSILRf DFftUDPMENTLJ10 IL(I—SiOni lctcdt by kP1`1_lC&=N 'S T*F.WF__MjQHI*t APPLICANT' BUILDER AMZ IC4A17— ENGINEER AJIW PROJECT LOCATOR To avoid delay in processing the application, plc&se provide enough information to easily identify the project location. Provide the stmet address, lot cumber Ot' legal description (attach) and,'outside urban are-as, the distance to the nearest int,=ccting road or well-knownL-wdmark. A sketch attached to this application showing the project locauon would be helpful. 41R. /PV A1_-Ys 17 C CR 446* UJ FDP(93) APPLICATION PAGE 2 OF n ---- DESCRIPTION OF WORK (Check all appbcablc boxes) A STRUCTURAL DEVELOPMENT ACTIVTTY STRUCTURI TYPE ❑ New Structure X Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) YAlteration Cl Non-resideaual (Floodproofing? ❑ yes) ❑ Relocation ❑ Combined Use (Residenual & Commercial) ❑ Demolition P ❑ Manufactured (Mobile) Home (la Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S B. OTHER DEVELOPMENT ACTIVITIES. ❑ Fill ❑ Mining ❑ Drilling O Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Impro�vements (including Culvert Work) 0 Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Witer or Sar System Cl Other (Please SpectTy) After completing SECTION-2, APPLICANX should submit form to Local Administrator for review. E=ON 3: FLOQDPLATN DETERMINATION o be com leted by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel NO. ' Dated The Proposed Development: ❑ Is hM located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERJAIT IS REQUIRED)- 0 Is located is a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Pt. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional iastructtons S1G,NED DATE APPLICATION u PAGE 3 OF 4 SECTION 4. ADDITI NAL INFORMATION REQUIRED fTo he cornl2leted by LOCAL ADMINISTRATQR The applicant must submit (tie documents checked below before the application can be processed ❑ A site plan showing the location of all c�astmg structures, water bodies, adjacent roads, lo[ dimensions and proposed development. ❑ Development plans, drawn to scale, and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor (including basement), types of water resistant materials used below the first floor,detwis of floodprooftng of u(ihtics located below the first floor and details of enclosures below the first floor, Also ❑Subdivision or other dcvelopmcn( plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft.'NGVD (MSL). For G . floddl�roo[ed structures, applicant must attach certification from registered engineer or architect. ❑ Certificati`o from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the heigh( of the 100-year flood. A copy of all data and calculations supporting<this finding must also be submitted. ❑ Other: SECTION 5 PERMIT DETERMINATION (To be comvleted by LnrAL ADMINISTRATOR) I have determined that the proposed activity. A- 11 Is B.O Is not • in conformance with provisions of Local Law , 19 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOXA 4s chcckcd, the Local Administrator may issue a Development Permit upon payment of designated fee. if BOX Bins checked, the Local Admirustrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals APPLICATION a PAGE a OF a APPE-Al.S Appealed to Board of Appcals'7 ❑ Ycs ❑ No Hcarmg date- Appeals Board Decision --- Approvcdl ❑ Yes ❑ No Cow:bbO[LS SECTION G AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is tssued The following information must be provided for project structures. This section must be completed by a registered profcssional engineer or a Licensed land surveyor (or attach a certiCicauon to this application) Complete I or 2 below 1. Actual (As-Built) Elevation of the top of the lowest floor, including basetaent (in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodprooftng protection is FI'. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. ¢pi SECTION 7 COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ONO DATE BY DEFICIENCIES? O YES © NO DATE BY DEFICIENCIES? ❑ YES O NO SECTION $ CERTIFICATE OF COMPLIANCE(To br. completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD ARCA (OWNER MUST RETAIN THIS ( ERTIFICATE) PREMISES LOCATED AT: PERMIT NO. C48 PERMIT DATE iv. . /?,4' OWNERS NAME AND ADDRESS: CHECK ONE: L / OAV� Af&�-6V"4rg 0 NEW BUILDING //048 1& e011 P60R A _ EXISTING BUILDING C,QO �?l�,�Q FL. 4q2 O VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19-1 AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) Q�gUFI:Ot,��oG BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 o Southold, New York 11971-0959 4�. Telephone (631) 765-1802 - FAX (631) 765-9502 Ol - rogerrCaD-southoldtownny gov - seand(&-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Name: 8(=� 0 i License No.: email.- Phone mail:Phone No: F]l request an email copy of Certificate of Compliance Address.: JOB SITE INFORMATION (Alt Information Required) !► Name: .r Address: , y J-Z Cross Street: (,.��d- Phone No.: jV-112 ® 1,, B1dg.Permit#: 9 email: g V, Tax Map District: 1000 Section: Block: °� Lot: Z BRIEFESCRI TION OF O Please Print Clearly} Check All That Apply: Is job ready for inspection?: �'ES ❑NO ORough In ERFinal Do you need a Temp Certificate?: ❑YES ❑NO Issued On Temp Information: (All information required) Service Size Q1 Ph 03 Ph Size: A #Meters Old Meter# ❑New Service ❑Service Reconnect n Underground ❑Overhead #Underground Laterals D QH Frame[Pole Work done on Service? Ely N Additional Information: PAYMENT DUE WITH APPLICATION CP Sq Electrical inspection Form 2020.x1sx 1 PERMIT# Address: - Switches - ---- ------------------------------------ ----------------------------------- ---------------------------- Outlets CFI's 1 Surface Sconces I H H's UC Lts Fans Fridge i HW Exhaust Oven Dryer Smokes PW Service - erreratar Combo - 06ktop Trgns#er AC AH Mini Special: Comments erg �'-�1' a-o• • f iAp4ILROVIEED A NOTED00, V(l D TE: B.P.# tea'' L 4� ,= . r Ay v.`B.�• x q SI DUZ FEE: P BY: sr 'b N TIFY BUIL l G P t; 7(5-1802 8 AM TO 4 PM FOR THE e F LL.OWING INSPECTIONS: 1. FOUNDATION - TWO'REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING COMPLY WITH All CODES F 3. INSULATION NEW YORK STATE 'TOWN (, 4. FINAL - CONSTRUCTION MUST AS REQUIRED ND ONDITICI )Ifs F BE COMPLETE FOR C.O. A REQUIREMENTS OF THE CODES OF NEW ZBA ' ° YORK STATE. NOT RESPONSIBLE FOR ©asrn�o wnou a�as V� L PLAry,,NG80ARD DESIGN OR CONSTRUCTION',ERRORS. SOUTH4! TRE'EES PLUMBER CERTIFICATION0 N.Y.S.DEC NTENT BEFORE ',w- e ' OCCUPANCY O SOLDER USED IN WATER SUPPLY SYSTEM CANNOT USE � UNLAWFUL EMCEED 2/90 OF 1% LEAj WITH UT CERTIFICATE NGY - m �- Addifional Ceification b May Be Requir J. I fr iHEd LIMNG ROOM�+ b A [ , DUSTING FLOOR PLAN sura,/V-,•-o• B r , 1 2 3 4 5 6 7 8 9 10 PHIL FERRANTELLO ARCHITECT, P.C. I& WHICH COMES IN NOTE: ALL LUMBER CONTACT WITH CONCRETE IS PRESSURE 14 PUMPKIN STREET E. NORTHPORT, NY 11731 TREATED WOOD TEL: 1 (631 )860-4373 —0" 4 WHICH 36'-81" 8'–O" VAI.'IARE GALVANIZED OR STAINLESS STEEL INOTE: ALL FAS E: phil@ferrontellodesign.com COME IN CONTACT WITH PRESSURE TREATED NOTE: ALL FOOTINGS -PLACED AT SAME F LEVEL ti {B 3 IZ APPROVED BY BOARD OF I RUSTEES TOWN OF SOUTHOLD D E BUILDING I q Ys • yrs, Sr EXISTING EXISTING IIFOOTPRINT SIDE DECK SIDE DECK(890 S I1 1 CN E It4 II.........IItIItIttWr ID PLYWOOD SKIRTING AT REAR OF HOUSE EXISTING WOOD STAIRS TO BEACH itUNDERNEATH DECKING IS FOR COSMETIC AND VISUAL PURPOSES ONLY. NOT INTENDED FOR STRUCTURAL PURPOSES. � L,% -1 IIIED EXISTING OVERHEAD SITE PLAN SCALE- 1/4" f-0" \9 41,CC 135 E N C 35'-10" APR I 2021 AOR SEAL / SIGNATURE 13'-10" 8'-10" Southold 1bwn—---------—----- Board of Trustees IT IS A VIOLATION OF LAW FOR ANY PERSON UNLESS THEY ARE 0Ll ACTING UNDER, THE DIRECTION OF A LICENSED PROFESSIONAL EXISTING ELECTRICAL ARCHITECT, TO ALTER AN ITEM LIGHTING LEGEND � IN ANY WAY ON THIS DRAWING BATH J1 OR SPECIFICATION (DOCUMENT). LO 3'–6" 2'-6" co co DECT DECT IF A DOCUMENT BEARING THE C) CD SEAL OF AN ARCHITECT IS I -1 pj��E GOUND FAULT DUPLEX OUTLET EXISTING -co 00 GFI DEDICATED OUTLET 20 AMP. ALTERED THE ALTERING C�l EXISTING ARCHITECT SHALL AFFIX TO THE BEDROOM #1- DOCUMENT THEIR SEAL AND THE DUPLEX OUTLET' NOTIFICATION "ALTERED BY" FOLLOWED BY THEIR SIGNATURE EXISTIN49 ALTERATION AND A SPECIFIC BATH #2 6' RECESSED LIGHT 120 V, 15.2 WATT AND THE DATE OF SUCH C) DESCRIPTION OF THE I -1 ALTERATION.2'–O" 5'-7�16'–O"B L LO CEILING FAN WITH , LIGHT 'FIXTURE — 120 V, 17 WALL, LIGHT FIXTURE 58315 ROUTE 48 GREENPORT co N E W YORK , 11944 DECT SINGLE POLE WALL SWITCH W/ DIMMER C) i3 THREE—WAY WALL SWITCH W/ DIMMER EXISTING EXISTING ISSUED FOR KITCHEN LIVING ROOM AS – BUILT Is.d. INDICATES HARDWIRED INTERCONNECTED to SMOKE DETECTORNo. ISSUED / REVISEDDATE 00 i 1 ISSUED FOR AS-BUILT 2021.03.05 I XIDE DETECTOR 35'-10" r-XISTING LIGHTING AND POWER PLAN PROJECT No. 20-000.14 EXISTING FLOOR PLAN B A SCALE: 1/4" SCA[f: I AS BUILT FLOOR PLANS AI milli 111119