HomeMy WebLinkAbout46913-Z =o�guFFOIKcoGy Town of Southold 10/9/2021
P.O.Box 1179
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�' ►�. 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42430 Date: 10/9/2021
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 56025 Route 25, Southold
SCTM#: 473889 See/Block/Lot: 63.-3-26
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/24/2020 pursuant to which Building Permit No. 46913 dated 10/1/2021
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"alterations to apartment A in existing building as applied for.
The certificate is issued to Pressler Living Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 3016449 12/4/2006
PLUMBERS CERTIFICATION DATED 11/17/2020 rge Bertj
A
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Signature
S FFQ��c TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
"oy • 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#: 46913 Date: 10/1/2021
Permission is hereby granted to:
Pressler Living Trust
650 Grove Dr
Southold, NY 11971
To: legalize "as built" alterations to existing building as applied for. Additional certification
may be required.
At premises located at:
56025 Route 25, Southold
SCTM # 473889
Sec/Block/Lot# 63.-3-26
Pursuant to application dated 11/24/2020 and approved by the Building Inspector.
To expire on 4/2/2023.
Fees:
AS BUILT-COMMERCIAL ADDITIONS/ALTERATIONS $817.60
CO-COMMERCIAL $50.00
Total: $867.60
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Town Hall,53095 Main Road � ® e � Fax(631)765-9502
P.Q.Boa 1179 * € Telephone(63i)765-iS�
Southold,Now York 11971-0954 �.�,,,
E-UIWING DEPS. 1WMN'I'
TOWN OF SOTLYMOLD.
CERTIFICATION
Dade: 11-7
3uludzng?emwit l\To. 4(AD
Omar �SS'� �I If12L�-� LJOQ�L T��iSG�
(please )
Plumber.
(please pmt)
r cert►&at the solder used is"+e water Supply S em conWm Iess thau 2/10 o€1%
Lead.
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Swom to before me this
day of
UGAIN4694680
ed in SuiiOiit COW
NT4taly Pubis: 1L� �ipass[kzerr
FIELD INSPECTION REPORT DATE COMMENTS
�ro
FOUNDATION(IST)
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PLUMBING y
INSULATION PER N.Y. H
STATE ENERGY CODE
FINAL -
ADDITIONAL COMMENTS
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�o�Og�FFO k�0�� TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtownny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only I�.,,'{-✓rj �`\Se/�(y-�'
PERMIT NO. (!l Building Inspector: I
_ NOV
Applications and forms must be filled out in their entirety. Incomplete _
.applications will not,be accepted.,Where the Applicant,is not the owner,an „LL
Owner's Authorization form Vage',2)shall be completed. : � �s
Date:
--OWNER(S)OF PROPERTY:_', e
Name: L SCTM#1000-
--- - - �_�rn�_�c U/r� Tom-,T�_r�_s_ - -_
Physical Address:5�j(�a�
7/
A _.
Phone#:_ �_j"=l D�7 �_ Email• (x.60M
Mailing Address: _,�oCcthold —� IN -7/
CONTACT PERSON:
Name: wLr6h N LLSZr�I�-U
Mailing Address; O —
Phone#:�3(`qEmail:�Q/�//"1 --
DESIGN_PROFESSIONAL INFORMATION: -
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
d3 _a, _LV_e
Mailing Address:
Phone#: Email:
DESCRIPTION 011PROPOSED CONSTRUCTION -
❑New Structure ❑Addition Iteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other a-5 bvl $
Will the lot be re-graded? ❑Yes Colo Will excess fill be removed from premises? ❑Yes C�-FPd"o
1
PROPERTY INFORMATION
Existing use of property: ��� Intended use of property: r
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property.. DYes ONO IF YES, PROVIDE A COPY.
Q check Box Affair Read'ang: The owner/contractor"/design'professional is responsible for all drainage and storm water issues as provided by
_,Chapter 236 of the Tow6Code.-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,eNew York and other applicable,,,6 s;Ordinances or,Regulations,for,the constructlon of buildings;',_',,'
additions,"altera{tions or for removal-or demolition as hereinAdescribed.The app licant'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
punishable as a Class A misdemeanor pursuant to'Section 216.45 of the Newyork State Penal Law.
Application Submitted By(print name): Laurel-? el - 2Authorized Agent C)owner
QjgDate:
Signature of Applicant: ___`/j
STATE OF NEW YORK)
COUNTY OF
Lct iu cf evq k1y-u wsKj being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 'F_A-eC,+f1 �< c,,,iJ l%U11 1`�--
(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
_23I�,,
� day of �Wem e r 120,2-0
NICOLE STORK Notary Public
Notary Public, State of New Yo*
Commission # 01ST6116690
Qualified in Suffolk County PERTY OWNER AUTHORIZAT fi�9
Commission Expires October 4, 20
ao� (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
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FOR POURED CCAI'VCaETE
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3. INSULATION
- 4. FINAL - CONSTRUCTION MUST
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ALL CONSTRUCTION STRUCTION SH LL MEET T PLUI'11BER CERTIFICATION
HE ON LEAD CONTENT BEFORE:
3,• ;,; ♦ '
-. t �- YORK STAT E T NST RFS CODES OF NEW CERTIFICATE OF OCCUPANC
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I t4di�ional
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OCCUPANCY OR
Certification
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WITHOUT CERTIFICATE
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