HomeMy WebLinkAbout48087-Z 4`o�OgBFFQIkCpG Town of Southold 9/1/2022
P.O.Box 1179
® 53095 Main Rd
fi
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43392 Date: 9/1/2022
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 505 Bungalow Ln,Mattituck
SCTM#: 473889 Sec/Block/Lot: 123.-3-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/24/2022 pursuant to which Building Permit No. 48087 dated 7/19/2022
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"outdoor shower as applied for. .
The certificate is issued to Maloney James A Rev Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 8/26/2022 fi Nam"aloney
A ize gnature
�o�soFFnc TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y z TOWN CLERK'S OFFICE
"oy • SOUTHOLD, NY
hod � Sao
s 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#: 48087 Date: 7/19/2022
Permission is hereby granted to:
Maloney James A Rev Trust
505 Bungalow Ln
Mattituck, NY 11952
To: Legalize as-built outdoor shower at existing single family dwelling as applied for.
Additional certification may be required.
At premises located at:
505 Bungalow Ln, Mattituck
SCTM # 473889
Sec/Block/Lot# 123.-3-7
Pursuant to application dated 7/19/2022 and approved by the Building Inspector.
To expire on 1/18/2024.
Fees:
AS BUILT-ACCESSORY $200.00
CO-RESIDENTIAL $50.00
Total: $250.00
Building Inspector
dF
Town Hall Annex Telephone(631)765-1802
54375 Main Road ° Fax(631)765-9502
P.O.Box 1179 '.
Southold,NY 11971-0959 `'
BUILDING DEPARTMENT .
TOWN OF SOUTHOLD AUG 2
2022
BUILbligG vtrl
TOWN OF SO(JTH6 D
CERT-IFICA.3jaN
Date:
Building Permit No. oQ
Owner: jo M e-�; Aa A-
(Please print)
Plumber:.-.
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
(Plumbers Signature)
Sworn to before me this C A
day ofkJA 20 a�
CONNIE D.BUNCH
Notary Public,State of New York
No.01BU6185050
Qualified in Suffolk County
Notary Public, Commission Expires April 14,3q
qql%
��arg SO# # TOWN OF SOUTHOLD BUILDING DEPT.
Comm 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATIOWCAULKING
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] -FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ "] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
6(0 Kq -� -
DATE 1/ INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
®
FOUNDATION (IST) a�
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------------------------------------
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FOUNDATION (2ND)
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ROUGH FRAMING&
PLUMBING
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INSULATION PER N.Y. H
STATE ENERGY CODE
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FINAL Ili
ADDITIONAL COMMENTS
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O��S=3FfOL��oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
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y x 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
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Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only ® v E v E
PERMIT NO. VBuilding Inspector: JUN 2.4 2022 DD
BUILDING DEPT.
Applications and forms must be filled out in their entirety. Incomplete TOWN OFSOUTHOLD
applications will not be accepted. Where the Applicant isnot the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name
TCTM#1000
Project
Address:
Phone#: � �_'� Email: C<l7
Mailing Address: 'ov
CONTACT-PERSON:
Name: 6�`
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION: =
Name:
Mailing A ress:
Phone#: Email:
CONTRACTOR INFORMATION:
Ni e.
Mailing A ess:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
El New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other 6� QaY�l-adl�t/fi� $
Will the lot be re-graded? []Yes ]No Will excess fill be removed from premises? ❑Yes []No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ONO IF YES, PROVIDE A COPY.
E]'Check Box After Reading:- The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by -
Chapter 236 of the Town,c de'. 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;alterations or for removal or demolition ash erein 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
punishable as a Class A misdemeanorpursuant to Section 210.45 of the New York State Penal Law;
Application Submitted By(print name): lne5 / a,16,v ❑Authorized Agent No"wner
Signature of Applicant: �i Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01 BU6185050
COUNTY OF ) Qualified in Suffolk County
Commission Expires April 14,
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(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
ay of lit , 20 a�1- yj
Notary Public
PROPERTY OWNER AUTHORIZATION
(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
• ,I
I '
M AR R A -TOOK A ROA D
7 N / 0/ F BERNARD TURCHIANO
o RR he
I PUBLIC WATER I
.t �, 279.93 a N
EL 22J E POST a Rat FEWE '— -
N. 49 °15�00�� mon _
`von. ', /k
f ' `� cn TEST HOLE
�`y• - L;��s- - - 250 . 34' Lffr _i b__ J . ret'wajl }E �1 cT -p b AkDondd Geosclence•
o_ E OUT" WATER iH1wc W � ON—Cam yy
EL 22.3 Z �—W �W TIME SCAB ro 05,60VI)eyyro ro P�niT� 8/�I/Q7.. EL 18.2
P s s te�� 4 I° o i N f Z Dark Br..Sandy.
o se p IC sT Y 2 STY, o t D I 0 Loam OL.
EL I17X — FR. HOUSE d cy o 0.5'
\ J � •
rRE� �P_ za GARAGE 3 p i Br. S#1y Sand
O rr; Fin Fir..EL 18.1 3 a 1 \ I` to C n R F,OAT 3 SM
rq �G) 0, L o Z 1 –
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C. CI O o M !` pocx
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a furn
�< q�,` ex. Q14.o ` � � tD �I Sandto SP
v 15.9 ECS 2.3
C+ A 7.4' o WOOD D% Edr
4 'p v ro �! cp a sT , 0? m Wafer In Pole
��► z `"• 2a z F 1 cp �, ` Br. Fine to Med.
r&2 e; I �' ' 17' Sand SP
c" < O WALK
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'7 'HEDGE / t
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�� � ��-"� 253.70' �
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EL 2 �
1-2 0 �
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EL 21.9 �/� N 0 F DALE BERGEN a EILEEN BERGEN
EXISTING SEPTIC SYSTEM TO BE �� r PUBLIC wATER
PUMPED OUT AND REMOVED OR
FILLED IN SURVEY OF PROPERTY
NEW SEPTIC SYSTEM
(4 BEDROOMS MAX.) � T
1 - 1000 GAL PRECAST SEPTIC TANK
" � `��`��
2 - LEACHING POOLS 8'4 X 6.5' DEPTH _
WITH 3' SAND COLLAR (SW) 3' ABOVE TOWN OF SOUTf-�OL®
GROUND WATER SUFFOLK COUINTY, N.Y
AREA = 23,784 sq.ft. to tie line CER SOU THOD D �AV/NGS BANK 1000 - 123 - 03 - 07
• - Scale: 1"= 30'
PECONIC ABSTRACT
JAMES MAL ONE 4 Dec. 31, 2008..
f am_ familiar with the STANDARDS FOR APPROVAL JANET HUGHES - MALONEY O "'=='� E
AND CONS TR UC TION OF SUBSURFACE SEWAGE ~
DISPOSAL SYSTEMS FOR SINGLE FA MIL Y RESIDENCES
and will abide by the conditions set forth therein and on the -
permit to construct.
N.Y S. LIC. NO. 49618
ANY AL TERA TION OR ADDITION TO THIS SURVEY ISA VIOLATION
a -ye
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS 'CONIC"S YDOS, P.C.
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF OHL Y IF
The locations of we//s and cesspools (. (LyS ` S2aFAX (63/1 765 1787 `
P SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR FLOOD ZONES FROM FIRM
shown
shown hereon are from field observations WHOSE SIGNATURE APPEARS HEREON. 36103CO479 G 5/04/98 /230't� RA LER STREET
and or from-.dafa obtained from others. ELEVATIONS AND CONTOUR LINES ARE REFERENCE TO NGVD. SOUTHOLD, N.Y. 11971 87:°°-16.0
OCCUPANCY OR
USE IS UNLAWFUL
APPROVED AS NOTED WITHOUT CERTIFICATE
DATE: 'I/ as B.P.# OF OCCUPANCY
FEE: epS o•ODBY:
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTION&
TING REQUIRED
i"gAMING & PLUMBING COfAPLY WITH ALL CODES OF
3. hq:z ELATION NEW YORK,STATE.& TOWN CODES
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O. AS REQUIRED-AND=CONDITIONS OF
ALL CONSTRUCTION SHALL BEET
THE REQUIREMENTS OF THE N.Y. SOLTHOLDTO.WNZBA
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR SOC1I DTOWNPLANNINGBOARD
DESIGN OR CONSTRUCTION ERRORS SOUTHOLDTOWPITRUSTEES
N.Y;S-DEC
,Additional
Certification RETAIN STORM WATER RUNOFF
May Be Required. PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANC'r
x SOLDER USED IN WATER
SUPPLY SYSTEM'CANNOT
EXCEED 2/10 OF 1% LEAD.
BUILDING DEPT
TOWN OF SOUTHOLC
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BUILDING DEPT:
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