HomeMy WebLinkAbout44589-Z 0�2=
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P.O.Box 1179
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o 53095 Main Rd
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CERTIFICATE OF OCCUPANCY
No: 42331 Date: 9/14/2021
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 9525 Route 25,Mattituck
SCTM#: 473889 Sec/Block/Lot: 122.-6-13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/6/2020 pursuant to which Building Permit No. 44589 dated 1/13/2020
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 built"decks additions to existing singley dwelling as applied for.
The certificate is issued to Hughes,Michael&Therese
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Autri ed S' n tore
o�SOFFoi�. TOWN OF SOUTHOLD
�� ay BUILDING DEPARTMENT
z TOWN CLERK'S OFFICE
o • 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#: 44589 Date: 1/13/2020
Permission is hereby granted to:
Hughes, Michael
PO BOX 1282
Mattituck, NY 11952
To: legalize "as built" decks as applied for.
At premises located at:
9525 Route 25, Mattituck
SCTM #473889
Sec/Block/Lot# 122.-6-13
Pursuant to application dated 1/6/2020 and approved by the Building Inspector.
To expire on 7/14/2021.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $588.80
CO-ADDITION TO DWELLING $50.00
Total: $638.80
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. 1/2/2020
New Construction: X Old or Pre-existing Building: (check one)
Location of Property: 9525 Main Road, Mattituck, NY 11952
House No. Street Hamlet
Owner or Owners of Property: Micheal Hughes
Suffolk County Tax Map No 1000, Section 122 Block 6 Lot 13
Subdivision �j Filed Map. Lot:
Permit No. y� O Date of Permit. Applicant: Eileen Wingate
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: X (check one)
Fee Submitted: $ 5�
A icant Signature
Building Department Application
AUTHORIZATION
(Where the Applicant is not the Owner)
1, Micheal Hughes residing at 9475 Main Rd.
(Print property owner's name) (Mailing Address)
do hereby authorize Eileen Wingate
(Agent)
to apply on my behalf to the
Southold Building Department.
1/2/2020
(Owner's ignatu ___---- -��- -(Date)
K 1+Lj
(Print Owner's Name)
q09 �pF SOUTy
# ��# TOWN OF SOUTHOLD BUILDING DEPT.
�ycou765-1802
" INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION/�CAULKING
[ ] FRAMING /STRAPPING [ ] FINALD� PO, &Z q
[ '] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
.01
DATE /l 0 INSPECTOR
FIELD INSPECTION REPOR:7' -DATE COMMENTS ,
FOUNDATION (IST)
H
-------------------------------------
FOUNDATION (2ND)
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ROUGH FRAMING & 9
PLUMBING
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INSULATION PER N.Y.
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STATE ENERGY CODE
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FINAL
ADDITIONAL CO MENTS -
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TOWN OF SOUTHQLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARIIENT 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
Southoldtownny.gov PERMIT NO. j Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
v Contact:
Approved ,20 Mail to:
Disapproved a/c (ZJ
Phone:
Expiration 20 7
Buildi g Inspec R
APPLICATION FOR BUILDING PER
Date 12/27/2019 1 20
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.
(Sig re of applicant or name, if a corporation)
2805 west miii rd,mattituck,ny 11952
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
AGENT FOR OWNER
Name of owner of premises 9525 Main Road, Mattituck, NY 11952
(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. BUILT DECKS
.Other Trade''-s License No.
1. Location of land on which proposed work will be done:
9525 Main Road, Mattituck, NY 11952
House Number Street Hamlet
County Tax Map No. 1000 Section 122 Block 6 Lot 13
Filed Map No. Lot
Subdivision
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
2. g single family cottage and mobile home
a. Existing use and occupancy g
b Intended use,and occupancy single.farrxrly cottage and.mnbde bnme vnth entry decks
Addition X Alteration_
3. Nature of work(check which applicable):New Building Other Wo-k -
Repair Removal_ Demolition (Description)
4. Estimated Cost Fee (To be paid on filing this application)
5. If dwelling,number of dwelling units
2 Number of dwelling units on each floor separate buildings
If garage, number of cars.
6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. .4'
house 22.5' house 23
mobile home 56.1 Rear Depth mobile home 13.7
7. Dimensions of existing structures, if any: Front 1 STORY
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
same with decks L'+ Rear
Depth Height -Number,of Stories
8. Dimensions of entire new construction: Front
Rear Depth-
Height Number of Stories
53.15' Depth 790.19
9. Size of lot:Front 50.0' Rear P
10.Date of Purchase Name of Former Owner
11. Zone or use district in which premises are-situated R-40
12.Does proposed construction violate any zoning law, ordinance or regulation?YES NO X
13. Will lot be re-graded? YES NO X Will excess fill be removed from premises?YES NO
Micheal Hughes Address 9475 Main Rd Phone No. 631 495.6350
14.Names of Owner of premises Address Phone No
Name of Architect APhone No.
Name of Contractor Address
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X
* 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)
S;.
COUNTY O A
being duly sworn,deposes and says that(s)he is the applicant
(Name of indh idu signing contract)above named,
(S)He is the AGENT FOR OWNER
(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.
Sworrr�before me tl
day of 20 a.C�
(p ✓1\.L
L. DVVYER 4-ficanture of App
otary ubli OTARY PUBLIC,STATE OF NES ,/0
NO.01 DW6306900
QUALIFIED IN SUFFOLK C(- ,NTY
COMMISSION EXPIRES JUNE 30,2 i�
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EXISTINP -HOUSE CondoneFpgin,eering, P.C.
. a - A � �l AS NOTED ED 1755 �igsbee Road
----- — _° \ \ Mattitupk, NY 11952
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FEE ��
i NOTIFY BUILDING CDEFAR T kAIENT AT
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--3(j765-1802 o v 8 AM TO 4 P%4 FOR THE
0 ° I � N FOLLOWING INSPECTIONS:
X X 1. FOUNDATION - TWO REQUIRED
`" "' I FOR POURED CO�NCRETE
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2. ROUGH - FRAMING & PLUMBING Z
3. INSULATION
FRONT DECD i --- [� II 4. FE NAL - CONSTRUCTION MUST I'
OR
24- EN-® BE COMPLETE1 s^ p
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW u- d O }
YORK STATE. NOT RESPONSIBLE FOR ❑ O of
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AS-BUILT FOUNDATIONPLAN C��4��PLY WITH ALL CODESCODES w
NEW YORK STATE � TOWS! ❑
AS REQUIRED -
EXISTIN, HOUSE SOTHOI.DTOWNZBA Z
SOUTHOL LANNING BOARD
---- _ 14-- ----- --_- SOUT QLD TOWN TRUSTEES
O C SAN C�( OR w .
- ---- --AS-BUILT i� K-------Y - N USEI U LAW UL �� � C .
- --_____� _-_------_-- - ----_- -_-- WITHOUT CERTIFICATE �� "N � .
FRONT DECK _— _— I OF OCCUPANCY °
DATE: D 2019
RETAIN STORM VVAT ER RUNOFF
PURSUANT TO CHAPTER 236 REVISION§—.
OF THE TOVVN CODE. -
Additional
Certification
AS-BUILT DECK PLAN May Be Required. SCALE:4" 't 1'01.
DWG. NO. 300,01
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Condon Engineering, P.C.
EXISTING HOUSE
o• -• y � _ • - 1755 Sigsbee Road
j ----- __ - _- Mattituck, ICY 11952
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---- ---------- _ -- ---- -- _ --- RAR DECK
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DATE: DSC. 12,2019
REVISIOb1�:
AS-BUILT DECK PLAN SCALE:d'� 1 .0
j DWG. NO, 300.02