HomeMy WebLinkAbout44596-Z i
�SUEFOL�-�oGy Town of Southold 3/21/2024
o
o� P.O.Box 1179
o • g, 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45063 Date: 3/21/2024
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 795 Oyster Ponds Ln, Orient
SCTM#: 473889 Sec/Block/Lot: 25.4-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this.office dated
1/9/2020 pursuant to which Building Permit No. 44596 dated 1/15/2020
_ 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"bathroom to'existing single-family dwelling as applied for.
The certificate is issued to Lewis,Evan&Lynn
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44596 10/30/2020
PLUMBERS CERTIFICATION DATED 3/21/2024 t omane
0 Au ri d ignature
�g11FF01/( TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a TOWN CLERK'S OFFICE
_o • SOUTHOLD, NY
'y Off'.1�p1 .....a
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#: 44596 Date: 1/15/2020
Permission is hereby granted to:
Lewis, Evan
40 W 24th St Apt 9E
New York, NY 10010
To: legalize "as built" bathroom to existing single-family dwelling as applied for.
Certification may be required.
At premises located at:
795 Oyster Ponds Ln, Orient
SCTM #473889
Sec/Block/Lot#25.-1-2
Pursuant to application dated 1/10/2020 and approved by the Building Inspector.
To expire on 7/16/2021.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $432.00
CO -ALTERATION TO DWELLING $50.00
Total: $482.00
Building Inspector
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. . I GUVM IGI/NUO 2020
New Construction: Old or Pre-existing Building: I (check one)
Location of Property: �qts 0US} TO VA l a h e, 06
House No. Street Hamlet
Owner or Owners of Property: v m LeANIS
Suffolk County Tax Map No 1000, Section Block ` Lot
Subdivision Filed Map. Lot:
Permit No. Lf �J��P Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: c (check one)
Fee Submitted: $ C)
Applicant Signature
Town Hall Annex Telephone(631)765-1802
54375 Main Road :
P.O. Box 1179
Southold,NY 11971-0959 j°+r
* .
BUILDING DEPARTMENT --y, r °r '`,°`, 'fir 7 1 ,�`•
TOWN OF SOUTHOLD i ; `� ^' i V`
MAR 21 2024
CERTIFICATION
Date:
Building Permit No. !+• Z4 5
Owner: y Le u- S
(Please print)
Plumber: (Zom~ill h1 P—z q
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1% lead.
(Plumbers Signature)
Sworn to before me this
day of MOA Vn 20A
CONNIE D.BUNCH
�p Notary Public,State of New York
No.01BU6185050
Qualified In Suffolk County /
Notary Public, County Commission(Expires April 14,2
1
OF SO �l
Town Hall Annex ~ O Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G Q sean.deviin(aD-town.southold.n us
Southold,NY 11971-0959 y'
coUNT`I,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Evan Lewis
Address: 795 Oyster Pond Ln city:Orient st: NY zip: 11957
Building Permit#: 44596 section: 25 Block: 1 Lot: 2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Home Owner License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey 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
Main Panel A/C Condenser Single Recpt Recessed Fixtures 1 CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO 1
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4 4'LED Exit Fixtures Pump
Other Equipment:
Notes: Bath Renovation Wiring
Inspector Signature: w Date: October 30, 2020
S. Devlin-Cert Electrical Compliance Form.xls
1 ✓ 1 �aOF SOpJ�O
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPE7RkG-
ON , .
[ ] FOUNDATION 1ST [ H PLBG.
[ ] FOUNDATION 2ND [ ANSULATION
[ ] FRAMING /STRAPPING [ l
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
f ] CODE VIOLATION [ ] CAULKING
R MARKS:
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r�s�Jl�o�u i� top-✓
DATE INSPECTOR
�o�aOF SOUIyO� 1 -1 7ats'
am/�`P
# TOWN OF SOUTHOLD BUILDING DEPT:-
°`�cnuHn 765-1802
INSPECTION
[ ] FOUNDATION' 1 ST. [ ] ROUGH PL13G.
] FOUNDATION°2ND [ ] INSULATION/CAULKING-
[ ] FRAMING%STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ]° FIRE SAFETY INSPECTION"
[ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
.REMARKS:
DATE -INSPECTOR
Of so
* # TOWN OF SOUTHOLD BUILDING DEPT:-
`ycourm, 765-1802
INSPECTION
=
[. ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ -] .-FOUNDATION 2ND [ " rSLATIOWCAULKING
U] FRAMING /STRAPPING [ NAL #,ff"An
[y. ] -,FIREPLACE'&CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT.PENETRATION
-[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: L �0
1 S 0Vl>> 7
DATE INSPECTOR
l H �Y UE SO�Tyo
T1 TOWN OF SOUTHOLD BUILDING DEPT.
`yco 765-1802
- INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
-[ ] FOUNDATION 2ND [ ] SULATION/C HULKING
[ ] FRAMING /STRAPPING [ FINAL e#g14
[ ] . FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE°RESISTANT=CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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DATE INSPECTOR
ho�*OF SOGIyo�
# TOWN OF SOUTHOLD UILDING"DEPT.
° ourm, 765 1802
INSPECTIO
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ( ] PRE C/O
REMARKS:
DATE. INSPECTOR o l—
FIELD PtOEC 110N REPORT DATE COMMENTS
►o
FOUNDATION (IST)
---------------------------------
FOUNDATION (2ND)
ROUGH FRAMING& 0 7'
PLUMBING 'y
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INSULATION PER N.Y.
STATE ENERGY CODE O
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FINAL (�� a
ADDITIONAL COMMENTS
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;OWN 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)7654802 Planning Board approval
FAX:(631)765-9502 q�nSurvey
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
Contact:
Approved 2026 Mail to:
Disapproved a/c
Phone: 01?—
Expiration
�:) E
>` BkOng spector
JAN - 9 2020 APPLICATION FOR BUILDING PERMIT
_ Date 20 20
INSTRUCTIONS
a.This application MUST"lie 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 the work authorized has not commenced within 12 months 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.
q*� `xz)�,
(Signature of applicant or name,if a corporation)
�y yv t 2411" _ NY�Y Ioola
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
O Wh21K
Name of owner of premises f��`w ►-e�S
(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.
Other Trade's License No.
1. Location of land on w ich pr posed work will be done:
'7a S 0v s.�- yVia ta,vlP O.1&,AT
House Numb r Street /J Hamlet
County Tax Map No. 1000 Section C/� Block I Lot
Subdivision Filed Map No. Lot
€ ' 2. State existing use and occupancy of premises and in nded u e and occup cy of proposed construction:
a. Existing use and occupancy G I VIA46, AAAW A V G
b. Intended use and occupancy Gf
3. Nature of work(check which applicable):New Building Addition Alteration ✓ �-{ 1 (YI01 r"
Repair ✓ Removal Demolition Other Work �J
(Description)
4. Estimated Cost 'rj, 0 b Fee
(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 L5� Rear �S� Depth 3$'5�
Height - Number of Stories 1
Dimensions of same structure with alterations or additions: Front Rear
Depth Height S tiV U Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height — Number of Stories
9. Size of lot:Front toil 5 Rear j Oct � Depth I0 1
10.Date of Purchase Ol 23 i ZV(q I Name of Former Owner 1 Y► em e, -Raevn
11.Zone or use district in which premises are situated
12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO )C
13.Will lot be re-graded?YES NO_X\,WiII excess fill be removed from premises?YES NO
14.Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO X
*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 X
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
S:
V
COUNTY 01�7 d
a�/ � Lme w l S being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the 0 LoC( 'e 0—
(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 workT)RJ�e`EY L. DWYER
performed in the manner set forth in the application filed therewith. KOTARY PUBLIC,STATE OF NEW YORK
NO.01 D W6306900
Sworn to�before me th' QUALIFIED IN SUFFOLK COUNTY
day of f 20,Q COMMISSION EXPIRES JUNE 30,2Q&P,
,JA laq aR wt.-Y-A—
otary Public Signature of Applicant
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
o Town Hall Annex - 54375 Main Road - PO Box 1179
o - Southold, New York 11971-0959
4,- p� Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(a).southoldtownny.gov seand(a-),southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION (All Information Required)
Name: �fxw �emi�
Address: E59Y1
Cross Street:
Phone No.:9i I t7 S g 02_
Bldg.Permit#: L�(f 57 j email: ah 'L47M
Tax Map District: 1000 Section: Z�j Block: ( Lot: 2.
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
�Pratie�r0., �' a� � if �tic�G►�-d e'V�
Circle All That Apply:
Is job ready for inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect - Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection Form.xls
d0
0 ,lam
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
o Town Hall Annex - 54375 Main Road - PO Box 1179
W Southold, New York 1 1 971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(a)_southoldtownny.gov - seand(a�southoldtownnV.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ali Information Required) Date:
Company Name:
Name:
License No.: email:
Address:
Phone No.-
JOB SITE INFORMATION (All Information Required)
Name,
Address: pY�
Cross Street:
Phone No.:.9 .
Bldg.PermitA7'. % o - - _.....- ..
email a
Tax Map District: 1000 . Section: ^.7ra Block: utok . 2-
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
P�Itie'V'ave�ln o�' a� tt Itfid 'I�k
Circle All That Apply:
Is job ready for inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground.Laterals 1 2 H Frame Pole Work done on Service? Y . N
Additional information:
�AY--MENT--DUEW4T-H-ARP-L CAT4 t�
Request for Inspection FormAs
d0
0 J
PERMIT# Address:
Switches i JJ
Outlets
GFI's R
Surface
Sconces
HH's 1 .
UC Lts
Fans Fridge HW
Exhaust Oven Dryer
Smokes. DW Service
Carbon Micro , Genefator.
Combo Cookto .__. Transfer
AC AH Mini
Special: 1
Comments:
pF SO�lyol
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
July 27, 2020
Evan Lewis
40 W. 24th St. Apt. 9E
New York, New York 10010
RE: 795 Oyster Ponds Lane, Orient
TO WHOM IT MAY CONCERN:
The items marked below are required to obtain your Certificate of Occupancy
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate.
A fee of$50.00.
Final Board of Health survey
Plumbers Solder Certificate or Pex Affidavit
Trustees Certificate of Compliance. (Town Trustees # 765-1892)
Final Planning Board Approval. (Planning # 765-1938)
Final Fire Inspection from Fire Marshall. (631-765-1802)
Storm Shutters required for all glazing
Energy Test Results and Manuals required
Final elevation certificate
Spray Foam Insulation Certification from a NYS licensed architect or
Engineer
BUILDING PERMIT: 44596-Z "as built" bathroom
: ; 1 ser"dia s rar- for:
;r .�yter.;ponds: fan•e
N (It 1 r
,1xtetlt.: 1°97 LUMBER CERTIFICATION
LEAD,CONTENT BEFORE
C RTIFICAT,E.OF OCCUPANT
�•s SOLDER USED IN WATER
SUPPLY SYSTEM CANNO
' r, R EXCEED'2110 OF 1% L E4 n
"a �r..
;1w.irt;
CU,P OR ELECTRICAL a :
REQUIRED
A ... ECl'ION
UNLAWF U l ��,sl�
I:OUT.CERTIFIC' i
GUPANCY ,
` AP RO�fED Addi
n;° h{ AS NOT tional :`
Cert>< ication .
B.P.#
:FEE: 6 : COMPLY WITH ALL CODES OF Male Required.
DE NEW YORK STATE & TOWN CODES
� . NOTIFY BUILDING DEPARTMENT AT AS REQUIRED AND CONDITIONS OF
.765-1802 8 AM TO d PM FOR THE
FOLLOWING INSPECTIONS: W A
1..FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE SOl4�#6tEfi8�PL-�PlI�IGBOARD
2. ROUGH - FRAMING & PLUMBING $Q� JSTEES
8. *INSULATION
4. .FINAL - CONSTRUCTON MUST •-...........
-�
-BE COMPLETE FOR C.C.
ALL CONSTRUCTION SHALL MEET THE PLUMBJNG .
REQUIREMENTS OF THE CODES OF NEW ALL OMBING WASTE
YO.RK STATE. NOT RESPONSIBLE FOR � �r�1l"TE'R LINES NEED
DESIGN OR CONSTRUCTION ERRORS. _,: �t~O,k3E.COVERING
795 Oyster Pond Lane
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Contact: Evan Lewis evanlewisl@gmail.com 917.848.5702
795 Oyster Pond lane
Orient, NY
rental floorplan
75'
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BEDROOM 1 KITCHEN SCREENED PORCH
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LIVING ROOM
BEDROOM 2 BEDROOM 3
GARAGE
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Contact: Evan Lewis 1 91Z848.5702 ( evanlewisl@gmail.com