HomeMy WebLinkAbout48590-Z ��o��s�}FfOLKcpG Town of Southold 8/5/2023
a P.O.Box 1179
o _ 53095 Main Rd
o ,'fig Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 44390 Date: 8/5/2023
THIS CERTIFIES that the building DECK
Location of Property: 910 Country Club Dr,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.-3-2.12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/13/2022 pursuant to which Building Permit No. 48590 dated 12/13/2022
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"deck addition toexisting single family dwelling as applied for.
The certificate is issued to Gannon SF Living Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Aut oriz d ignature
��o�suF cD TOWN OF SOUTHOLD
BUILDING DEPARTMENT
H 2 ' TOWN CLERK'S OFFICE
"may • oma+ 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#: 48590 Date: 12/13/2022
Permission is hereby granted to:
Gannon SF Living Trt
910 Country Club Dr
PO BOX 1186
Cutchogue, NY 11935
To: Legalize as built deck at existing single family dwelling as applied for.
Additional certification may be required.
At premises located at:
910 Country Club Dr, Cutchogue
SCTM #473889
Sec/Block/Lot# 109.-3-2.12
Pursuant to application dated 10/13/2022 and approved by the Building Inspector.
To expire on 6/13/2024.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $886.40
CO-ADDITION TO DWELLING $50.00
Total: $936.40
Building Inspector
souTyolo
I # # TOWN OF SOUTHOLD BUILDING DEPT.
�ycou631-765-1802
INSPECTION
[XFODATION 1ST [ ] ROUGH PLBG.�-
DATION 2ND [ ] INSULATION/CAULKING
ING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
0
REMARKS:
DATE Y v INSPECTOR
ho�aoF souryo�
* TOWN OF SOUTHOLD BUILDING DEPT.
`'cou631-765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [FINAL De k—
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
DATE INSPECTOR
OF SOblyo�
# # TOWN OF SOUTHOLD BUILDING DEPT.
courm?'�' 631-765-1802
#,510
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL beZ�.-
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS: t)te//L— Cm�p&k-
DATE INSPECTOR
'IELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST) O
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FOUNDATION (2ND)
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PLUMBING
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INSULATION PER N. Y-. y
STATE ENERGY CODE
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ADDITIONAL COMMENTS S
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=�o�g�fFO(,tcoG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
oy�01 �ao�� Telephone(631) 765-1802 Fax (631) 765-9502 https://www.southoldtownny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only OCTI. 3 2��2 •- �, .�i
PERMIT NO. 0 Building Inspector: „ .
E'`ILf...� .
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an,.
Owner's Authorization form(Page 2)'shall be completed.
Date:
OWNER(S)OF-PROPERTY:',
Name: SCTM #1000-
Project Address:
Phone#!J,,-l�o - -- -- S —_ _ ...- ------- Email: N�1CQ _ �PJ�L./Ncr
Mailing Address:
CONTACT"PERSON:
Name:
-Mailing Address: 4 U )C e617el_14,. _ ------._-.---__-__-
Phone# LG�-/-�l--� ��- ---------- Email:-
DESIGN PROFESSIONAL INFORMATION: ;
Name:
Mailing Address:
Phone#: Email:
_CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF'PROPOSED CONSTRUCTION
❑New Structure El Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
1KOther 16 AGK $
Will the lot be re-graded? ❑YeKNo Will excess fill be removed from premises? ❑Yes)<N'o
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 No IF YES, PROVIDE A COPY.
❑ Check Bo'k 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'BuildineDepartment 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 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
punishable as a Class A misdemeanor,pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name): < ❑Authorized Agent ,Owner
AA-
Signature of Applicant: Date: Q
STATE OF NEW YORK) CONNIE D.BUNCH
Notary Public,State of New York
SS: No.01 BU 6185050
COUNTY OF ) Qualified in Suffolk County
Commission Expires April 14,20,�`
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 n /
4h day of c) ��t" I 20�
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
)ew-011
APPROVED AS NOTED OCCUPANCY OR
USE IS UNLAWFUL
DATE:1��,"a�-B.P# �� WITHOUT CERTIFI
FEE BY: CATF
NOTIFY BUILDING DEPARTM NTAT OF OCCUPANCY
631-765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH-FRAMING&PLUMBING.
3. INSULATION lik,f� L,;, 111f1 l-I ��
4. FINAL-CONSTRUCTION MUST fel„ �d�� YO r ALL C,CCyaS OF
BE COMPLETE FOR C.O. YORK ST ATE & TOWN CODES
'�'S REQUIR D
ALL CONSTRUCTION SHALL MEET THE AND CONDITIONS OF
REQUIREMENTS OFTHE CODES OF NEW SOUTHOLD TOWN ZBA
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUC ON ERRORS SOUTHOLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
N.'r'.S.DEC
Additional
Certification
.May Be Required.
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE,
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TOWN OF SGUTHoLD
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