HomeMy WebLinkAbout48915-Z �S�l:FoiK��
Town of Southold 3/10/2023
a <t P.O.Box 1179
o _ 53095 Main Rd
Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 43909 Date: 3/10/2023
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 1790 Sigsbee Rd,Laurel
SCTM#: 473889 . See/Block/Lot: 144.-1-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/16/2019 pursuant to which Building Permit No. 48915 dated 2/15/2023
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"additions and alterations, including outdoor shower,to existing single-family dwellin ags applied for.
The certificate is issued to Maltese,George
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48915 2/10/2023
PLUMBERS CERTIFICATION DATED
uth ri d ignature
�o�S�FFni,� . TOWN OF SOUTHOLD
�
ay BUILDING DEPARTMENT
y 2 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#: 48915 Date: 2/15/2023
Permission is hereby granted to:
Maltese, George
1790 Sigsbee Rd
Mattituck, NY 11952
To: Legalize "as-built" additions and alterations to existing single-family dwelling as
applied for. Additional certification will be required. Replaces BP #44137
At premises located at:
1790 Sigsbee Rd, Laurel
SCTM #473889
Sec/Block/Lot# 144.-1-11
Pursuant to application dated 2/15/2023 and approved by the Building Inspector.
To expire on 8/16/2024.
Fees:
PERMIT RENEWAL $449.40
Total: $449.40
Building Inspector
r
TOWN OF SOUTHOLD
,,t,�gVfFOt�CQ BUILDING DEPARTMENT
" TOWN CLERK'S OFFICE
4vy�• ao� , 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#: 44137 Date: 9/9/2019
Permission is hereby granted to:
Maltese, George
1790 Sigsbee Rd
Mattituck, NY 11952
To: legalize "as-built" additions and alterations to existing single-family dwelling as applied
for. Additional certification will be required.
At premises located at:
1790 Sigsbee Rd, Laurel
SCTM #473889
Sec/Block/Lot# 144.-1-11
Pursuant to application dated 7/16/2019 and approved by the Building Inspector.
To expire on 3/10/2021.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $668.80
CO -ADDITION TO DWELLING $50.00
Total: $718.80
Bu ing Inspector
pF SOUjyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlina-town.southold.ny.us
Southold,NY 11971-0959
�yCOUNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: George Maltese
Address: 1790 Sisgbee Rd city:Laurel st: NY zip: 11948
Building Permit#: 48915 Section: 144 Block: 1 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors 2
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO 1
Transfer Switch UC Lights Dryer Recpt Emergency StrobeHeat Detectors
Disconnect Switches 4'LED Exit Fixtures Sump Pump
Other Equipment:
Notes: " AS BUILT NO VISUAL DEFECTS " Smokes and Outdoor GFI
Inspector Signature: Date: February 10, 2023
S.Devlin-Cert Electrical Compliance Form
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: Old or Pre-existing Building: (check one)
Location of Property: J 7 �� -- �l 4S L'� nl TT��I�C�C 11g`�
�C h /C
House No. y�,Street Hamlet
'k-Owner or Owners of Property: � r�/ �/
Suffolk County Tax Map No 1000, Section `7 q Block Lot
Subdivision Filed Map. Lot:
Permit No. �� Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: S _
Appli ant Signature
CONSENT TO INSPECTION
Gltorcu Ma a 4-ec�- the undersigned, do(es) hereby state:
O er(s)Name(s)
That the undersigned (is) (are)the owner(s) of the premises in the Town of
Southold, located at 1-4-q n e21 A S h l_,,
which is shown, and designated on thc; Suffolk County Tari Map as District 1000,
Section [u ,Block , Lot I
That the undersigned(has) (have)filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
That the undersigned do(es)hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described property, including any and all
buildings located thereon,to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all of the laws, ordinances, rules and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: J Z9 Iag
(Si nature)
tx
rint Name)
(Signature)
(Print Name)
q �q Is ( 7qO sil Sbc%,r
rg SOUTWl:Glt�
yO�
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
1 NSPECTION
- '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) &A ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING *x�'
REMARKS: rr I
C_Awe�n do 0 V4 IX
OAJ
IL62��
DATE t l INSPECTOR
I �'OF SOUTyO
# f TOWN OF SOUTHOLD BUILDING DEPT.
�yco 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] NSULATION/C�A/_ULKING-
[ ] FRAMING /STRAPPING [ FINAL A 6f/!/T 4d4;619 hi
] FIREPLACE & CHIMNEY [ ] FIRE SAFETY"INSPECTION
[ ] FIRE`RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
oorv` -
DATE INSPECTOR
l V V oy�OrjF 50(/lyO -- -
* # TOWN OF SOUTHOLD BUILDING DEPT.
cou631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ULATION/CAULKING
[ ] 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:
VO4.&
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DATE ?1 ?DY� INSPECTO
. a
FIELD INSPECTION REPORT DATE COMMENTS _
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FOUNDATION(1ST)
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FOUNDATION
-----------------------------------FOUNDATION (2ND)
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PLUMBING
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ADDITIONAL COMMENTS
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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) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Southoldtownny.gov PERMIT NO. 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
I� Contact:
Approved 20 f Mail to:- _
Disapproved a/c
Phone: 1J 1 08 -3
at*n.� '}'fir;
3Build r
JUL 1 6 2019
APPLICATION FOR BUILDING PERMIT
ww-,i"I�'S^�U-s�.����..� Date , 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 ffie}vlork authorized has not comme-aced—*tilil1 l.2 nionths 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.
As
(S
- ignature of plicant or name,if a corporation)
194-10 56asbee, Pd MatH ucl�
(Mailing address of applicant)
State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises
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. ___ �-�'��GU/1�G
Other Trade's License No.
1. Location of land on which proposed work will be done: 1�
House Number J Street I hamlet
County Tax Map No. 1000 Section __I `�1�1 Block � _ Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy �5 FQ.rYI
b. Intended use and occupancy
S
3. Nature of work(check which applicable):New Building _Addition Alteration
Repair Removal _Demolition_ Other Work
4. Estimated Cost Fee (Description)
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded?YES NO /Will excess fill be removed from premises?YES NO
14.Names of Owner ofremises GO(W MOA4M Address b 51S ( —Phone No.
Name of Architect 'mm&hLol `i'ehn A-dd Address M57 U6641 2d Phone No �3r d4a-31gy
Name of Contractor_ 1'Y10.'-M Q I,r) Address 6" S F' Phone No.
IIS
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO V
* 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:
COUNTY OF )
Glow m6u tets& being duly sworn,deposes and says that(s)he is the applicant
(Name of indi ' ual signing contract)above named,
(S)He is the oyiWil—
(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.
Sworn to before me this
1!^ da 20j_9
NEATHER L" SANDERSON
otary Public Notary Public, State of New York Signature of Applicant
No. 01 SA6133734
Qualified in Nassau County
')mmission Expires September 19,20d
; =SOF04 BUILDING DEPARTMENT- Electrical'Inspector
`O�0- -f,
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
� Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(c_southoldtownny.gov seand(p�southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name:
Address: 1
Cross Street:
Phone No.:
Bldg.Permit #: q li�q email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
�
(� f C�s
Square Footage:
Circle All That Apply:
Is job ready for inspection?: ❑ YES ❑ NO ❑Rough In
1:1 Final
Do you need a Temp Certificate?: ❑ YES ❑ NO. Issued On
Temp Information: (All information required)
Service Size❑1 Ph 1-13 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals D 1 2 H Frame Pole Work done on Service? FI Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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6318887319 L.Bennett Design 10:51:55a.m, 10-17-2019 1 /3
JAM Design Services
1257 Udall Rd., Bay Shore NY11706
Phone:(631) 888-7318 Fax.(631) 888-7319
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UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL
NOT BE CONSIDERED A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR
WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY, OR LENDING
INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. '
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A- 06-28-2019 OUTLINE SURVEY
REV. DATE DESCRIPTION
SURVEYED BY: SUFFOLK COUNTY TAX MAP LOT #36 N \\N
FRANCIS X. KARL L.S. ON THE "AMENDED MAP OF �O
DISTRICT 1000
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(631) 363-2891 PHONE LOT O 1 1.000 SITUATED AT
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