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34286-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: z-34145 Date: 12/23/09 THIS C~(TIFIES that the building INTERIOR ALTERATIONS Location of Pro~erty: 1855 DEPOT LA (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 102 Bl~k 1 Lot 9.1 subdivision Filed ~ap No. __ Lot NO. CUTCHOGUE conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 2008 purs,,~nt to which Building Permit No. 34286-Z dated NOVEMBER 10, 2008 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 INTERIOR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & JOYCE BARRY (OWNER) of the aforesaid building. SUFFOLK C~)[~%~I"fDEPAR~NTOF~ALTHAPPROVAL N/A EI~-rKICAL C~KTIFIC3%~ NO. 4030551 09/25/09 PL~ C]~RTIFIC3kTION DA'r~ 12/16/09 GARY STAHL ~ize~ Rev. 1/81 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 A. For new building or new use: 1. Final survey °f Property with aceurate location.of all buildings, property lines, streets, and u topographic fentures. 2. Final Appr°val fi.om Health Dept. of watcr supply and sewerage.disposal (S.9 form). low%: 3. Approval of electrical installation fi.om 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. Commeroial building, industrial building, multiple residences and similar buildings and instailations, 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 donied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy ~ New dwelling $25.00, Additions to dwelling $25.00, Alteratmn~s to dwelling $25.00, Swimmiug pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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. Temp°rary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Old or Pre-existing Building: House No. Street (check one) Hard Suffolk County Tax Map No 1000, Section } tD ~)... Block. {~)C~O Subdivision ~ .~ ~:~cz'hov~'o.~ GF~ FiledMap. [140 Permit No..3qagl~, DateofPermit. II//ltD/OB Applicant: Health Dept. Approval: __"~ ~)_ O<~ - CDOct q Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ c~.t~ ,~5~) C. 77) Final Ceffificate: ~ Lot Lot: (checkone) Ap' i~t signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 /p_? _ /_ ~. CERTIFIES THAT Upon the application of upon premises owned by PUMILLO ELEC. JOYCE BARRY 1855 DEPOT LANE 210 PAT LN MATTITUCK, NY 11952-1354, CUTCHOGUE, NY 11935 Located at 1855 DEPOT LANE CUTCHOGUE, NY' 11935 Application Number: 4030551 Certificate Number: 4030551 Section: Block: Lot: Building Permit: 563478 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, ~ c2 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 25th Day of September, 2009, Name QTY Rate Rating Circuits Type Alarm and emergency equipment Sensor 3 0 0 Smoke Sensor 4 0 0 CarMen/Smoke Appliances and Accessories Dish Washer 1 0 1.2 KW Exhaust Fan 3 0 F.H.P Furnace 1 0 Gas Pump Motor 1 0 I H.P Panels 1 60 5 Service Service Disconnect: 1 200 cb Service1Phase3w Service Rating200Amperes Wiring And Devices Fixture 5 0 Fluorescent Fixture 56 0 Incaod~cent Outlet 61 0 Fixt uSrreea Outlet 91 0 Gert, Purpose Continued on Next Page I of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD Of FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by PUMILLO ELEC, 210 PAT LN MATTITUCK, NY 11952-1354, JOYCE BARRY 1855 DEPOT LANE CUTCHOGUE, NY 11935 Located at 1855 DEPOT LANE CUTCHOGUE, NY 11935 Application Number: 4030551 Certificate Number= 4030551 Section: Block: Lot: Building Permit: 563478 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 25th Day of September, 2009. Name QTY Rate Rating Circuits Type Receptacle 1 0 20a-laundry Appliance Receptacle 1 0 30a Dryer Receptacle 6 0 GFCl Receptacle 60 0 Gen, Purpose Switch 72 0 Gen, Purpose seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York I 1971-0959 Telephone (63 I) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLr~ CERTIFICATION Building Permit No. 3/4o~(o 4 Owner: Date: (Please print) Plumber: (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this //~ ~ day of ~)~---, 20 D ~ -- / (Plumbers Signature) Notary Public,.~ County FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34286 Z Date NOVEMBER 10, 2008 Permission is hereby granted to: ROBERT & JOYCE BARRY 875 WEST COVE RD CUTCHOGUE,NY 11935 for : INTERIOR ALTERATIONS TO EXISTING DWELLING ONLY AS APPLIED FOR. at premises located at 1855 DEPOT LA County Tax Map No. 473889 Section 102 pursuant to application dated NOVEMBER Building Inspector to expire on M_AY Fee $ 602.40 CUTCHOGUE Block 0001 Lot No. 009.001 7, 2008 and approved by the 10, 2010. ~ed Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION ~FRAMING~ [ ] FINAL [ ] FIREPLACE & CHIMNEY ] FIRE RESISTANT CONSTRUCTION REMARKS:~ [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ] FOUNDATION 2ND STRAPPING ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PE~=i.ATION REMARKS:__ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION ,~J~FIRE RESISTANT PENETRATION REMARKS: TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [//~INSULATION -\ [ ]FRAMING / STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTIO# [ ]FIRE RESISTANT PENETRATION REMARKS: DATE. INSPECTOR~ ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [ ~/FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION RE,M, ARKS: ~~,~ ~ -~L_ DATE / ~-/~-~-- ~ ~ INSPECTOR ~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~JL-ATION [ ] FRAMING / STRAPPING [,~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSlIIUCTION [ ] RRERESISTANTPENE'IIIATION FOUNDATION (2ND) ~ O x z TOZvVN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Disapproved a/¢ Expiration 5 ! ~C) ,20 kO PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date Il/¢ ,20 0~5 ~tN O.~ S_Pd2 _m .O_t~ ~__._, 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 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 Sonthold, 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. (Signa~e (~appli~a~t-or }lar~, if a corporation) ~Mhiiing &ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises (~x.IDI&ID/~ .~_ClNl~u, Ll i ~X,C~L~.~ (As on thl~ ta~ roll~[lafest 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 which proposed work will be done: House Number Street ,3 Hamlet County Tax Map No. 1000 Section I 000 Block 10~, Lot ~ Subdivision q · i Filed Map No. ~ 1 Of 0 '3 Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~ ~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building. Addition Alteration Repair Removal Demolition ~q Other Work 4. Estimated Cost 02, oc>o Fee 5. If dwelling, number of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front ,.~OOO -o[c? Rear ,,3~t3 . Number of Stories Rear Depth_ Rear · . .Depth -~- ] Depth 10. Date of Purchase q/,,~. O O fit Name of Former Owner 11. Zone or use district in which premises are situated ~.O 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO xl 13. Will lot be re-graded? YES NO )~ Will excess fill be removed from premises? YES NO tx3/~ 14. Names of Owner of premise.s ~2JLL0-~ddress Phone No. Name of Architect C~'t~ ~ Address Po.f>'~O4 'g & I Phone No "1 &~.-'~1% lo ~ Name of Contractor Address '~~ Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * 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 M * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO ¥ 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. O tx 9r~ ~ 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) '~ C..-~- ~ being duly sworn, deposes and says that (s)he is the applicant (Name oflindividual signing contract) above named, (S)He is the I~~ (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 tree 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 ,_/' .--z- [ ~, day of_~If ~/'~_ ~)'~ xC :x . Notaw Pubhc N0. 01~1906~6 Qualifi~ in S~01k ~un~ ~ ~mmissi0n ~oir~ July 28.20ff'~ X 0-- S~atur~ 0f Applicar~ Tow___nn of $outhold Erosion, Sedimentation & Storm-Water Run-off A88ES8MENT FOltM PROPERTY LOCATION: $.C.T,M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF ~[ STORM-WATER, GRADING, DRAINAGE AND EROSION P, ONTROL PL~I c'ERTIFIED BY A DESIGN PROFESSI(iNAL IN THE STAT~, Ite~_~.~Ntlmber: (NOTE: A Check Mark (,~') for each Question is Required for a Complete Appflcation) Yes No '~ Will this Proiect Retain All Storm-Water Run-Off Generaled by a Two (2") Inch Rainfall on Site? ~ E~ (This item will include all run-off created by site clearing and/or construction activities as well as afl Site Does the Sile Plan and/or Survey Show Alt Proposed Drainage Slruclures indicating Size & Location? r'~ This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIowl N~,/1'~ -- 2 3 Wilt this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? 4 Will this Application Require Land Dislulbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Fee( ct Ground Sudaco? 5 Is there a Natural Waler Course Rurmirlg through Ihe Si[e? Isthis Projectwi[hintl~e Truslees juri,;dicfionofwithiu One lhmdred (100' fee o awe a dorBeach? ------ Drainage & Erosion Control Plan is Required andMustbeSubmittedtorReviewPriortotssuanre ofAnyBuilding Permit] EXEMPTION: Y e~s ~_~_~ Does this projec( meet the minimum Mandards for classi~cation as a~ Agricultural Project? STAT~ OF NE~5~ YORK, ....... ........... .... Qualified in Suffolk FORM - 06~07 ~mm~ss~o. ~x~i~ ,0,* ~" SURVEY OF LOT 1 MAP OF JOSEPH & BARBARA GRATTAN SITUATED AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-102-01-9.1 SCALE 1"=30' SEPTEMBER 8, 2007 Nathan Taft Corwin III Land Surveyor JOSEPH SURVEY OF LOT 1 MAP OF & BARBARA GRATTAN FILE No. 11403 FILED JUNE 27, 2006 SITUA TED A T CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-102-01-9.1 SCALE 1"=30' SEPTEMBER 8, 2007 U AREA = 80,077.40 sq. ft. 1.838 ac. CERTIFIED TO: ROBERT J. BARRY JR. JOYCE N. BARRY WELLS FARGO BANK, STEWART TITLE INSURANCE COMPANY N Y,S. LTC, No 50467 THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED, Nathan Taft Corw~n III Land Surveyor PHONE (631)727-2090 Fax (531)727-1727 27-34( ALL CON,~'Fff~,r~TI©,/S!:I.~LL - MEET THE REQUIREt~ENT$ OF THE CODES OF NEW YORK STATE. OOOUP/WOy OR ..... WITHOUT CERTIFICA T£ OF OCCUPANcy " RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF TNE TOWN CODE. CERTIEIC^TION OF NAILING & CONNECTIOI~ REQUIREI~, _' APP, RO, VED AS NOTED -~ DATE: /'/~',~) ~E~.P.# "~V4'~&~: NOTIFY SUILDING DEPARTMENT ~t FOLLOWING INSPECTIONS: 1. FOUNDATION - ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBIN~ ~ 3, INSULATION ~ 4. FINAL - CONSTRUCTION MUST ~ BE COMPLETE FOR C.O, ~ ALL CONSTRUCTION SHALL MEET THE YORN STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. L- CHRISTOPHER R. STRESS, A.I.A. -A~:~HITE~I~ ANO PI~ANNING