HomeMy WebLinkAbout51717-Z �o��OF SO//TyOlo Town of Southold
* P.O. Box 1179
r �o�c 53095 Main Rd
courm H Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 46056 J Date: 03/24/2025
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 110 Sleepy Hollow Ln Southold, NY 11971
Sec/Block/Lot: 7 8.-1-10.6
Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 02/28/2024
Pursuant to which Building Permit No. 51717 and dated: 03/06/2025
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 to include finished room above garage and rear,
covered porch.
The certificate is issued to: Christopher Doman , Jocelyn Doman
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL:
ELECTRICAL CERTIFICATE: 51717 3/18/2025
PLUMBERS CERTIFICATION:
tho ' e Si ature
0
4
��OFSOU TOWN OF SOUTHOLD
BUILDING DEPARTMENT
' 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#: 51717 Date: 03/06/2025
Permission is hereby granted to:
Christopher R Doman
154 W 70th St Unit 31R
New York, NY 10023
To:
legalize"as built"additions and alterations to existing single-family dwelling as applied for. Additional
certification may be required.
Premises Located at:
110 Sleepy Hollow Ln,Southold, NY 11971
SCTM#78.-1-10.6
Pursuant to application dated 02/28/2024 and approved by the Building Inspector.
To expire on 03/06/2027.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $1,190.00
CO-RESIDENTIAL $100.00
Total S1,290.00
Building Inspector
oE so�ryol
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 G • Q
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Neville Robert F Rev Trust
Address: 110 Sleepy Hollow Ln City:Southold St: NY Zip: 11971
Building Permit#: 51717 Section: 78 Block: 1 Lot: 10.6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: PKJ Electric License No: 60122ME
SITE DETAILS
Office Use Only
Indoor 170 Basement F Service F Solar F
Outdoor r 1 st Floor W Pool F Spa r
Renovation 2nd Floor ly—, Hot Tub r Generator r
Survey rivi
Attic I— Garage Battery Storage I—
INVENTORY
Service 1 ph (! Heat Duplec Recpt 5 Ceiling Fixtures Bath Exhaust Fan
Service 3 ph r Hot Water GFCI Recpt 3 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors
Disconnect 1 Switches 4 4'LED Exit Fixtures
Other Equipment: 8' Track Lights, Minisplit w/ (1) Blowerhead
Notes: AS BUILT NO VISUAL DEFECTS " Finished Room Over Garage & Back Porch
& Mini S[plit
Inspector Signature: X L Date: March 18, 2025
Sean Devlin
Electrical Inspector sean.devlin(cD-town.south;old.ny.us
110SleepyHollowFROG
%f SO(/Ty�
�# TOWN OF SOUTHO.LD BUILDING -DEPT.
cou 631-765-1802
I.-N'SPECTION
[ FOUNDATION 1ST/ REBAR [ ] 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 [ ] RENTAL.
REMARKS:
DATE '�� INSPECTOR
of souryo
# # TOWN SOUTHOLD BUILDING 13E4T.
°ycou 631-765-1802
FNSPECTIO-N
[ ] FOUNDATION 1ST/ REBAR [ ] 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 [ ] RENTAL
REMARKS: S r I� 01
Neel -;5 -
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he �_Cor ou' 44et- qz�p_
,P, v Ll -A- FAlVV A 2-6
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DATE - INSPECTOR
OE SOUTyo�
# # TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
sn-P- ., -INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [X.FINAL
PLBG.
[ ] FOUNDATION 2ND [ TION/CAULKING
[ ] FRAMING-/STRAPPING [
[ ] FIREPLACE: & CHIMNEY [ ]`FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION- [ ] FIRE-RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
DATE 70 'INSPECTOR
J EFFREY T. B UTLE R9 P. E., P. C .
206 LINCOLN STREET
RIVERHEADy NEW YORK 1 1 901
63 1 -208-8850
1
LICENSED PROFESSIONAL ENGINEER
u 1 -
February 7, 2025
Building Department
Town of Southold
Re: 110 Sleepy Hollow Lane (SCTM 1000-078-01-10.6)
Dear Sirs:
Please note the following concerning this application:
I have inspected and drafted as built conditions for the finished space over the garage
and the covered rear porch for the dwelling at the above referenced address. Based on my
inspection and review of historical documents, it is my conclusion that these improvements
were completed prior to 2001 and conform to the New York State Uniform Fire Prevention
and Building Code adopted January 1, 1984.
Please call if you should have any additional concerns about this application.
Resp5T.
su ed,
Jeffrer, P.E. pF NEW y
CY-
m W
. 2(P ��:rcan•¢I
073493
A��FESs10NP�'
FIELD INSPECTION REPORT ATE COMMENTS
FOUNDATION (1ST) — - --- --- ------ -- ------- -- -- -
A
FOUNDATION (2ND) -------- _—____-. --___-
cn
ROUGH FRAMING& ------- —-- ------------------ ---- - --
PLUMBING ---- -- — -... - -- -- a
S
INSULATION PER N. Y. --- -- ------------- --- -- --- 0
STATE ENERGY CODE
JOIN
pvv
FINAL - ------- — — •
ADDITIONAL COMMENTS
--3 ' I 0 r- S 7�4c_O_( � ---- 4-CCU
"Ic U T�. ---------- --- - ----- - -------�--
40-
� --- - - ice W �� ------ --
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=o�osoFFo�k�o� TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631)765-1802 Fax(631) 765-9502 hgps://www.southoldtowgU.Rov
Date Received
APPLICATION FOR BUILDING PERMIT i, M
,f
� pf
For Office Use Only 9
MAR - 5 2025
PERMIT NO. 5/7/7 — Building Inspector:
Applications`and forms must be fille&out in their entirety..lncomplete I a��9�l�ea 11 fs� tGr Ea
applications will not be accepted. Where t6 Applicant is,,not the owner,an,'
Owner's Authorisation;f6rm(Page,2)"shall be completed, "
Date: 3 �J
OWNERS)OF PR PERTY = '
Name: SCTM#1000- ' l �
Project Address:
Phone#: Email:
Mailing Address:
CONTACT'PERSON.-'°'
Name:
Mailing Address:
i
Phone#: Email
DESIGN PROFESSIONAL INFORMATION.
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION
Name:
Mailing Address:
Phone#: 3 — 2 �'� '� Email:
',DESCRIP.TION.OVPROPOSED CONSTRUCTION
❑New Structure ❑]Add`tiglj ❑Alte�n ❑Repair ❑Demolition�Gr Estimated Cost of Project:
❑Other L .c� c� `Y- INj f bC3"� JJ
Will the lot be re-graded? ❑Yes LINO Will excess fill be removed from premises? ❑Yes ONO
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? Eyes ENO IF YES, PROVIDE A COPY.
❑ Check Box After Reading: The owner/contractor/design professioniiHs 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 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.
4
Application Submitted B tint name): ���/'""" a �� ❑Authorized Agent ❑Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: Cluallfied In Suffolk County
COUNTY OF ) Commission Expires April 14,
,f
1 Ll, — being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing c tract)a via nam d,
(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
1--*� .
day of 20_g'+J (/lev�p bV1 y� l
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
Buildina Department Auplieation
AUTHORIZATION
(Where the Applicant is not the Owner)
I, ri s f o���• 1)-m a. residing at No Ylc R-11 - L-t v, � °i 71
(Print property owner's name) (Mailing Address)
do hereby authorize 10,k, L t=j-e4 _
(Agent)
to apply on my behalf to the
Southold Building Department.
i :3/s 12C 2.5--
(Owner's Signature) `/ (Date)
(Print Owner's Name)
gWOur BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
o '` Town Hall Annex- 54375 Main Road - PO Box 1179
o • S- Southold, New York 11971-0959
y O� Telephone (631) 765-1802 - FAX (631) 765-9502
lamesh(Dlsoutholdtownny.gov — seand(o)_southoldtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 6 �Sr
Company Name: �V 3 e r�
Electrician's Name: eA-0—s- ��go r�
License No.: M (cp 0 Elec. email: k J . L=1��+n� �o�J�HC. •
Elec. Phone No: S(G .y y 3 j.11I. ❑I request an email copy of Certificate of Compliance
Elec. Address.: $ fa-�.rv)eLj ,¢U C- l-6L u 1 /J 7 2
JOB SITE INFORMATION (All Information Required)
Name:
Address:
Cross Street: f
Phone No.:
Bldg.Permit#: email:
Tax Map District: 1000 Section: '712 Block: Lot: �.
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Zr- r--0190 Roocm . e`ti S1)�;9 ov e� vvp-e. +—fo('CIA
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES,2 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 Reconnect❑Underground❑Overhead
# Underground Laterals 1 R2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
®s�fF107 BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
d Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
iamesh(-southofdtownny.gov - sea nd(absoutholdtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN 'INFORMATION (All Information Required) Date: r
Company Name: V.3 e-\.ecJr1
Electrician's Name: eAc- !ULy-S0.r-
License No.: yv) (p CID- Elec. email: (U'''
Elec. Phone No: S(G .q y 3 - -4:19. ❑I request an email copy of Certificate of Compliance
Elec. Address.: S fa:fv ieL/ AU C- Inc,(, v[ l , 117 2
JOB SITE INFORMATION (All Information Required)
Name:
Address: CA
Cross Street:
Phone No.:
BIdg.Permit#: `y f email:
Tax Map District: 1000 Section: --7 12 Block: Lot: �.
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
ovle42 a'\^ 01,ck1
Sgatke Fo p tag
Circle All That Apply: v '-
Is job ready for inspection?: YES ❑ NO ❑ ugh In Final
Do you need a Temp Certificate?: ❑ YES,2 NO Issued On n
Temp Information: (All information required)
Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 R2 n H Frame Pole Work done on Service? MY FIN
Additional Information:
PAYMENT DUE WITH APPLICATION
PERMIT# Address:
Switches
Outlets
GFI's
Surface
Sconces
H H's
UC Lts Fridge HW POOL
Panel
Fans Mini Fr. W/D Pump
Exhaust Oven Sump Heater
Trnsfmr
Smokes DW Generator Salt Gen.
" Carbon Micro GrbDis Water Bond
Lights
Heat � Pucks ERV
HOT TUB SPA
Inst Hot DeHum Transfer Disc
Combo Cooktop Minisplit Blower
I
AC AH Hood Blower
Service Amps Have Used
Sub Amps Have Used
Comments
�Z/�t.f �►r �s�s��r��+ .E'��r�
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o u� uFFctK COUNTY HEAL:r1 I u bra Miar
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�, tew,�y�9��.� SINGLE FAMILY DWELLING O LY
° . REF. NO. kk
* _ D OCT 7 1986
THE WAGE DISPOSAL AND WATER SUPPLY F ILITIE OR THI
LOC ON HAVE BEEN INSPECTED BY THIS EPART NT AN
33rg6 j D TO BE SATISFACTORY. ."
hief of Wastev►ater Manage- ecti
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NEW YORK STATE UNIFORM FIRE PREVENTION BUILDING CODE:
These plans have been drawn to document existing conditions in
-— - - -------------------------------------------------- accordance with and to meet or exceed the New York State
-"' - ----------------------------------------'-" —�- ---___ --- -- Uniform Fire Prevention and BuIldine Code adopted January 1,
1984 (finished bonus room over garage and screend in covered porch).
- --- --- ------
----------—-....— --—----------
AS BUILT BONUS ROOM � -- A�
--
- -- ---� AP VED DOTED
- ----------------�-- - DAM B.P.�
- ----- ----- -....... - --------------
-- — - - ---
__ FEE
---------_--_----._.-------------------....._---:-------- --- ----------._._.. ._ NOTIFY BUILDING DEPARTMENT AT
631.765-1602 BAM TO 4PM FOR THE
.... . FOLLOWING INSPECTIONS:
- ------- - _ �. 1. FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH-FRAMING&PLUMBING
3. INSULATION
4. FINAL-CONSTRUCTION MUST
BE COMPLETE FOR C.O. n(►
ALL CONSTRUCTION SHALL MEET THE U
REQUIREMENTS OFTHE CODES OF N fix
PORK STATE. NOT RESPONSIBLE FO O 2025
DESIGN OR CONSTRUCTON ERRORS E� O
went
vilditt9��o t otd
COMPLY WITH ALL CODES OF 8.�0 °$5 a
uuuuuuuuuuuuuuuuuuuuuuu NEW YORK STATE &TOWN CODES
AS REQUIRED AND CONDITIONS OF
® ® SOUTHOLD NON ZBA
---_.....�..,SOUTH O TOWN PLANT%G BOARD
LD TOE%TRUSTEES
NX DEC
___ SO' OLD Hn
�UF= =Lu ld� -]E ��"°3 3uCGIPANCY OR
w
All exterior li hting
USE iS UNLAWFUL W
-_- installed,replaced or WITHOUT CERTIFICA
repaired shall conform ®F OCCUPANCY
to Chapter 172 _
of the Town Code
EL.ECTRiCAL
EXiSTiNC-c FRONT ELEVATION - »s�> cno�� REQUIRED
AS BUILT BONUS ROOM � Additional
Certification
May Be Required.
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