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Home My WebLink About50649-Z .�r TOWN OF SOUTHOLD BUILDING DEPARTMENT r 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#: 50649 Date: 5/10/2024 Permission is hereby granted to: Mello, ChadITmmmmmmm 3030 Ole Jule Ln Mattituck, NY 11952 To: Legalize an "as built" bathroom to a single-family dwelling as applied for. May require additional information. At premises located at: 19450 Route 25, Mattituck SCTM # 473889 Sec/Block/Lot# 115.-7-12 Pursuant to application dated 3/2 7/2024 and approved by the Building Inspector,. _ To expire on 11/9/2025. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $580.00 CO-ALTERATION TO DWELLING $100.00 Total: $680.00 ....................... .............._...... �_...-.......� Building Inspector wrac TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 tea; Telephone (631) 765-1802 Fax (631) 765-9502 htt s: Pwww.southoldto mU.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only „, !J PERMIT NO. Building Inspector, I A .Ap flic t�onis 'id farms myst be fi1l�d out ir1 their ent�re�y Incomple#e pa !Wd)rfotr✓ c�r�Pci �Alhere th�A�spfiadt is��te ou+iner, n - if�YYne1""�Aut�ior�tat�an Date: OWNERS)OF PROPERTY: Name: �� C l,L 0 SCTM# 1000- Project Address: i�j�'�p �� f�u�/`/ `7 /�C1��✓ Phone#: 63i ` ,b-7 Email: ME u.vTi LEia1ti lMu it, . Mailing Address: `�p'3v cLE� I-� 1,14/,11� Nth fT/ TvGiG A/., CONTACT PERSON: Name: <Aw'w Mailing Address: Phone#: Email: DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address., Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: >60ther L=?�!S �iN-' d-7/1-112100M $ n Will the lot be re-graded? ❑Yes 7No Will excess fill be removed from premises? ❑Yes 1p�1Vo 1 PROPERTY INFORMATION Existing useof 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 VNo IF YES, PROVIDE A COPY. ❑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 Code. 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 deiriolMon as he described.The applicant agrees to comply with all applicable tam,ordinances,building code, housing code and regulations and to admit authorized Inspectors on,premises and In bullding(s)for necessary inspections.False statements made herein are punishable as a Cass A misdemeanor pursuant to Section 216AS of the New York State Penal Law. Application Submitted By(print name). ❑Authorized Agent ❑Owner Signature of Applicant: <L Date: CONNIE D.BUNCH STATE OF NEW YORK Notary Public,State of New York No,01 BU6185050 SS: Qualified in Suffolk County COUNTY OF_ _._ _ ._... ) Commission Expires April 14, 2� C,H+0 A.4 Z being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the O'U"J '2" — (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 p a�� day of "� ( _ _ _ _, 20 a ` " ® �� (�. Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, m_ .. ............ residing at__ w_............w......................_.._.................._www do hereby authorize_ .................._.... 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 TOWN OF SOUTHOLD BUILDINGPT. 631 765-1802 S� u 0, I PH S P E Agn"' T I Ago"' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] h AL [ ] FIREPLACE & CHIMNEY [ lF'IRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: jvt V. "!Ploy (Ad� 'j4 �9.01 �t'Vi Ly OUNPhIMA DATElXP4 INSPECTOR 09/04/2013 13:05 FAX 8312985779 ANDREWSTYPEREALTY IM 002/008 TOWN OF SOZITHOLD Town Clerk'a Office Southold, N. Y. Galrtgicate Of Occupancy ,q ... Date . . .. .. . .. .. . . . . . _ 19, �. THIS CERTIFIES that the bvd1ding Iocated at . . . . . ; . . Street Map No. . . .. . . . Block No . .. .. .Lot No. . i% ,; e. . . .. .. conforms sub stantially ly to the 19.57. pmwmt to which M�,�,��i �� doted .. . . . . . . . . . . ., 19.72., was issued, and conforms to all of the ments of the applicable provifilons of the law. The occupancy for which this certificate is ismedis . . jm ..j . . . ... ... . . ... . .. .. .. .. , I .. . . . . . . . . The certificate is issued to .E . . . . . . . . .. . . . . . . .. . . . (owner, lessee or teriant) of the aforesaid building. S,ifFolk County Department of Health Approval . . . .. .. .. . ... . . . . . . . . .. .. . .. . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . .. . . - . . , ,, . . . . . , ,. , .. . HOUSE NUMBEti. .�, . . . .tiiree�. .. luft . . . . . . . . . .. . . . . .. . . .. . . . . . .. ... F p ��Iftlur� pw�so� for to 'p a My 09/04/2013 13:05 FAX 6312985778 ANDREI'STYPEREALTY 004/008 TOWN C1 SC1l1Tl101. e C) OFFICE OF AiMILD O INSPECTOA TOWN HALL SOUTHOLJ,, NEW YOrtK CERTIFICATE OF oCrC tIpAnCY NONCONFORK= PREA4IS THIS IS TO CERTIFY that the ;$ Land Pre C-0- - Z13335 / suildiwa) /__/ Use(s) Data- 1' locaied at 19450 Rt. 25 (Min Rd.) MattituCk "Street Shawn on County tau uiap as District I000, Section 125 . Block p7 Lot-_ 012 . does(not)aonfOrm to tfae present Building Zone Code of the Town.of Southold for the following ressons; 7Avaffici.ent total area. insul1iCient side & rear yard set- baobcs for a0Ge89=7 sheds. On the basis 0.of information presented to the Building Inspector's Office. it hoe been determined that the above nonconforming CX/Land /_/8uiiding(s) T/Use(s) existed =the effective dabt the present Building Zone Code of the Town of Southold. Md may be continued pursuant to and Subject to the appli- cablc provisions of said Code. rr S FVRTEM CERTmED that, based upon information presented to the Building eotor,8`091a ze occupaucY and use for w clz brio Certifi- cate is issued is a6 hollows: PropeLtly Contains a two story; ones fe!IY :,rood, framed dwelling with two accesecry sheds; a bauu Btid solar pit %zeene . P situates"Property in thetUrall fw-Beet an ew Arm -- Rt. 25,t a Strata #t ta,ingd, KW. The Certificate is iosued to ASS ANI)mgoC s vim G&L—vo owwner, o;the aforesaid building. suffoTK county Departme2{ of Roalth Approval A UNI)ERVMIT$RS CERTIFICATE NO. NIA NOTICE IS IMP-EBY GIVEN that the owner Of the above premises HAS NOT CONSENTED To AN MSPEC:T1014 of the premises by the Building+Inspec- tor to determine 9 the premises comply with all applicable codes atld ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is riot intended to eortify that the premises comply with all other applicable codes sad regula- tions. ctin inspectai . fl BUILDING DEPARTMENT-Electrical Inspector 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 � smash southold'townn . ov- se@nd@southoIdtownnv.gov APPLICATION FOR ELECTRICAL IN 81PECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: A4 eF Address: 1 ifs o 41 ,F.,v 12,X Af f-7 , r'e-,!— /0,9. 7C Cross Street: Phone No.: e�-`- BIdg.Permit#: email: A4Ee-c-G-rt4.e- Tax MaE District: 1000 Section: //,S- Block: -7 Lot: /Z BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clean ): 07rs;-r�5 tull2iiv, 11-oew Square Foots e: Circle All That Apply: Is job ready for inspection?: 0 YES NO E]Rough In Final Do you need a Temp Certificate?: ❑ YES NO Issued On Temp Information: (All information required) Service Size Ell Ph F-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? Y N Additional Information: PAYMENT DUE WITH APPLICATION ()FF(-c V � Y '`^' �I\I'' .r' I � \ 4t J��.,�� .f� -vaf�,s 4 k a r J APPROVED AS NOTED — 4 V TE�2 B.P.Ii 52 ID q MILL CODESOF cel.tiffication (LSD,p0 gyp CODESNEW YORK STATE&TOWN AS RW�IRW AND CONDITIONS OF May Be Required. NOTIFY BUILDING DEPARTMENT AT 631-765-1802 8AM TO 4PM FOR n4E FOLLOWING INSPECTIONS: � - FOUNDATION-TWO REQUIRED M PLUMBING FOR POURED CONCRETE ALL PLUMBING WASTE ROUGH-FRAMING S PLUMBING WATER SINES NEE INSULATION- Sam TESTING FORE COVERING so FINAL-CONSTRUCTION MUST ELECTRICAL BE COMPLETE FOR C.a INSPECTION PIEUIHED ALL CONSTRUCTION SHALL MEET THE .-.,,.-_.._.,:_..f3EQUIBEMENTSOF,_THE NEW YORK STATE NOT RESPONSIBIE FOR DESIGN OR CONSTRUCTION ERRORS tj 6 t DOOR, lyz \IV c i 1 E 1 z mr ' v E r i i E 1 - -f