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Home My WebLink About35440-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~/~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34523 Date: 08/25/10 T~IS CERTIFIES that the building ADDITIONS Location of Property: 17700 MAIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 4 Lot 13.1 Subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 25, 2010 pursuant to which Building Permit NO. 35440-Z dated APRIL 6, 2010 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 SCREENED PORCH ADDITION AND DECK WITH RAMP ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANTONE C & GEORGIA ADAMS TRT (OWNER) of the aforesaid building. SUF~OI~K C~)~DEPARTMEN~ OF ~]~%L~{APP~O~-~L N/A E~.~C'~RICAL CERTIFICA~ NO. 35440 08/06/10 PLIERS CERTIFICATION DA'r~u N/A rized Signature Rev. 1/81 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. 35440 Z Date APRIL 6, 2010 Permission is hereby granted to: ANTONE C & WF ADAMS PO BOX 286 MATTITUCK,NY 11952 for : ADDITIONS TO AN EXISTING DWELLING AS APPLIED FOR at premises located at 17700 MAIN RD County Tax Map No. 473889 Section 115 pursuant to application dated MARCH Building Inspector to expire on OCTOBER M3tTTITUCK Block 0004 Lot No. 013.001 25, 2010 and approved by the 6, 2011. Fee $ 200.00 ORIGINAL Rev. 5/8/02 This apphcat~on must be filled m by typewriter or ink and subnntted to the Budding~ 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. 5. '6. Sworn statement from plumber ceRifying ~ the Solder used in system contains less than 2/10 of 1% lead.. Commareial building, industrial building, multiple residences and Similar buildings and installations, a certificate of Code Compliance from archifect.or engineer responsible for the building. Submit Planning Board Approval of-dompleted site plan requirements. Co · For existing.buildings(prior to April 9, 1957) non-conforming uses, or buildings and ~'pre-existing" land uses: 1. Accurate survey of properVj, showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to ~nSpect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicam Fees t',lcw Construction: Old or Pre-existing Building: House No. Street · Suffolk County Tax Map No !000, Section. / Subdivision e i it o. DateofP i . Health Dept. Approval: - Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~_ ~ 1. Certi~¢ate ~f ~ccupancy ~ New dwe~ling $25~~~~ Additi~ns t~ dwe~~ing $25.~~~ A~terati~ns t~ dwe~~ing $25~~~~ 8winmxing pool $25.00, Accessory building $25.00, Additions to accessory building ~25.00, Businesses $50.00. 2. Certificate of Oecupancyon 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.. (ch ck One) Hamlet Block- .' /~t Lot Filed Map.. Lot: Applicant: ',~ ~,~ ~/ Underwriters Approval: Final Certificate: (check one) Signature 'I'ow[I Hall Anm'x 5 I37,'~ Main I'load P.O. 1½ox 1179 Southold, N Y I 1971-09,59 Tdephone (631) 76,3-1802 Fa× (631) 71;,5-9,$02 ro.qer, richert~,town.so uthold, ny. us B! ~ILI)IN(; I)EI'ARTMI:]NT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Adams Address: 17700 Main Rd. City: Mattituck St: NY Zip: 11952 Building Permit#: 35440 Section: 115 Block: 4 Lot: 13.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Direct Connection Const. LicenseNo: 44943-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ Duplec Recpt ~ Ceiling Fixtures ~ HID Fixturesr~l Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture [ I Pumps Transformer Appliances Dryer Recpt Emergency Fixtures~ I Time Clocks Disconnect Switches Twist Lock Exit Fixtures [~ TVSS Other Equipment: move 150a over head service to a new location Notes: Inspector Signature: Date: Aug 6 2010 81 -Gert Electrical Compliance Form '['cnn 1 fall Annex 5 ~37,5 Main Road P.O. Box 1175t Somhokl, NY 11971-095!t Tclclihonc (631) 76,'5-18(}~2 Fax (631) 763-93t)2 ro.qer, richertO, t0wn southo d ny us BI !ILl)IN(; I)EPAI/TMI';NT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Adams Address: 17700 Main Rd. City: Mattituck St: NY Zip: 11952 Building Permit #: 35440 Section: 1 1 5 Block: 4 Lot: 13.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Direct Connection Const LicenseNo: 44943-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: porch addition, 1 paddle fan, I GFCI circuit breaker Ceiling Fixtures [~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures~] CO Detectors Fluorescent Fixture~.~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures L~ TVSS Notes: Inspector Signature: Date: Aug 6 2010 81-Ced Electrical Compliance Form Rpr O~ I.,~ 11:55a Herold/Davis 631-~BB-5049 p.1 Diane Herold, Architect P.O. Box 884 Westhampton Beach, New York 11978 (631) 288-5049 phone/fax Date: April 6, 2010 To: Pat, Town of Southold Building Department Number of pages including cover sheet: two APR 6 2010 BLDG. DEP'(. TOWN OF SOUTHOL§ Re: Adams building pannit application submitted by John Rose Thank you for the courtesy phone call. The construction drawings indicate gutters and leaders are to be installed at the overhangs of the hipped roof o£ the porch. The attached diagram shows Vhe two overhangs of the porch will drain to the southwest comer of the porch. The cricket will have a separate leader from the comer where the porch abuts the house.. Both leaders will drain to the 8'diameter x. 4' deep drywell to be located at the southwest comer of the porch. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] INSULATION [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ I FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION [ ] FIRE RESISTANT CONSTRUCTION [ REMARKS: DATE INSPECTOR ATN OF SOUTHOLD BUILDING DEPT. 765-1802 NSPECTION ION 1ST [ ] ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION [ ]FOUNDATION 2ND [ ]FRAMING I STRAPPING [ ]FIREPLACE & CHIMNEY [ ] FIRE RESISTANT COflSTRUCTION [ ] FIRE RESISTANT PENETRATIOfl REMARKS, /~// ~~ '~~- DATE INSPECTOR .~/~ TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FO/tlNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] fiRE SAFETY INSPEC'rlON [ ] FIRE RESISTANT CONS'mtJCTION [ ] FIRE RESISTANT PENETRATION REM~ 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 ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION [/~FINAL [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ [ ] RRERESISTANTCONSll~UCTlON [ ] FIRE SA~-.. ~ ~' INSPECTION ] RRE RESlSTAIn' PE~ETRAl10N REMARKS: INSPECTOR DATE TOWN OF SOUTHOLD BUILDING DEPT ~~~'~ 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAr.', ( INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) /~__E~":CTRICAL (fiNAL) REMARKS: DATE I NSPECTOR~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20 Approved ,20 Disapproved a/c Expiration ,20 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: J Mail to: 25 2010 BLDG. This appl~0~ti0hSl~Iffi~ be Building Inspector LICATION FOR BUILDING PERMIT Date ~12'~ ,20 I INSTRUCTIONS rely filled in by typewriter or in ink and submitted to the Building Inspector with sets of ns, 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 pem~it shall he 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 Rebmlations, 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 rebmlations, and to admit authorized inspectors on premises and in building for necessary inspections. ~nam pp ' ant or name, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises /~/rvro,~-'" /(-fit.-'~'o'~¢ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized ofricer (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: / 7700 House Number Street County Tax Map No. 1000 Section Subdivision Hamlet Block 0/1t Filed Map No. Lot 0 ~'/ Lot// 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy -.~/~"~/z~ fi'.4 ~'¢1~ b. Intended use and occupancy .5~/¢,¢,/,,~ v~r'.,¢,~,, (/¢ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ,.~g9 t900 5. If dwelling, number of dwelling units If garage, number of cars Addition f Alteration Other Work Fee (Description) (To be paid on filing this ~/~2cation) Number of dwelling units on each floor ;/~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. .0//.4 7. Dimensions of existing structures, if any: Front ~ 5 Rear ~' 5 Depth Height / 7 Number of Stories / Dimensions of same structure with alterations or additions: Front Depth ~, ~ Height / 7 Number 8. Dimensions of entire new construction: Front ,Po/'~ m Rear i Depth Height / 7 Number of Stories / 9. Size of lot: Front /~?D Rear ¢ ¢, 7 Depth 10. Date of Purchase / 9~9 Name of Former Owner -- 11. Zone or use district in which premises are situated ! 2. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES ~/"NO__ Will excess fill be removed from premises? YES NO 14. Names of Owner of premises /4~' r-otOt[/(.,~,0~-~/.t~ ,//~1*~¢ . Address ,rl~tT'7?7"a~ Phone No. NameofArchitect /~o'~: /--/,e"~'o~ Address bO Zc--(~'/-/4,-,'/~,--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 * 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ufa 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__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF S ~/'/',¢~/¢: J O/--/AJ /fi. /[O~,~ ~, being duly swum, 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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swum to before me this---, .~Z/r ..-~ayof ~'~)~'9[ Z¢..~4~: 20 /~ Nu[~*y Fub;ic, State of ~ew W ' N0. 30-4741154 Qualified in Nassau / S~gol~¢~ Commission Expires /0,/~ ~/(~ ature of Applicant To w:n o_ f Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCAT~K)N: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A /~)0 /l.5/' O/-?/ 0/.~ STORM-WATER~ GRADING, DRAINAGE AND EROSION CONTROL. PLAN Distdct ~ BIo~( ~'~ CERTIFIED BY A DE81GN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number:. (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yea N,._.~o 1 3 4 5 6 7 8 9 Will this Project Retain All Storm-Water Run*Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all mn.off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impentious surfaces.) Does the Site Plan end/or Survey Show Ail Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes C¢fltrolling Surface WaterFIowi Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic YaMs of Matedal within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site praparetion on Existing Grade Slopes which Exceed Fifteen (15)feet of Vedical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run*Off into and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT Include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? r~ NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark In the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan Is Required and Must be Submitted for Review Prior to Issuance of Any Building Permltl EXEMPTION: Ye~s N~o Does this project meet the minimum standards for classiticatica as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Dnalnage & Erosion Control Plan Is NOT Requlredl __ __ STATE OF NEW YORK,/t., ~'a,, ~ ~ .~//.,//,, / //~ / COUNTY OF~... SS That I .......... J..Q...~..~.. ........ -.~.:...... '..~.....~....~...~..~'~ ~:~/ -- ................ i.. being duly sworn, deposes* and says that he/she is the applicant for Permit, (Name of indMdual slgnklg Document) Sd that he/she is the .............. .~.~...~.~ Owner and/or representative of the Owner of Owner's, 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 work will be performed in the manner set forth in the application filed herewith. Sworn to before rne this; FORM - 06107 commission [xpir~s /~/~/[/'% Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 · (631) 7 5 ro.qer.r,chertd, t~oSn.so~)(~.nv.us BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED Company Name: Name: License No.: Phone No.: Date: ~-~ JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: 64':i - ~5 - ~ ~'~' Permit No.: ~ _~'/~ Tax Map District: 1000 Section: / I ~'~ Block: Lot:/~. I *BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady) (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Service Size: ~lPhase~ 3Phase *New Service: Re-connect Additional Information: 100 Underground ~ 200 300 350 400 Other Numberof Meters ~ngeofS~ Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form BUILDING PERMIT EXAMINER CHECKI :IST ~Date Submitted: ~? -iZ--g-'-~O Date Reviewed: ~g~'[ - Zone: ~--~o Conforming? SCTMOIO00- - ' Subdivision: Proper Addr s. Building Permits (Open/Expired): BI' [~r0g -Z/C/0 z- / ~,, Info:t~BP' ~ ]l ~ ~Z / ~0 ~ fi6 6 ~,_ Inf0: BP__ -Z / ~0 Z-__., Info: BP__-Z / C/0 ~ , ~fo: BP__-Z / ~0 ~ , Info: ~gle & Separate Search Required? Y o~etermination: Q. Coy. ACT: ~Q. Front 9~' ACT. Front. a & ~Q Side /o A~. Side ~ ~ ~Q. Re~~ PROP. Re~ ~Q. Height .~ / A~. Hei~/~' ~ Wate~ont? Y o~~ / ~ // ~ ' ~ Ify~,water body: PanelO ~ Flood Zone: ~ Bul~ead/BluffD~tance: ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Yo~- If yes, __*Date: / / *Permit#: ;Bed#: - If no, certification required: Y or N Received: Y or N By: NYS DEC: PR~-VE¢9/UTS Y of Nfl Date: / / Permit #: Southold Trustees: y 0~- Date: __ __ Southold ZBA: Y o~)- Date: __/ Southold Planning: Y o~- Date: / Town Landmark C of A: Y o~DTE: __ __ i [ / Permit #: Permit #: / Permit #: / / Town Septic: Y or NJ Letter - Notes: or NJ Letter - Notes: - Notes: - Notes: *NYS cODE Compliance (page 2)Or N ---/. Fee Structure: Foundation: First Floor: Second Floor: Other: Total: ~ , SF Calculation: 1. ( S~')- (_ SF)=~SF X $ =$ I ~' / ?<' 17' t.3 e(.fo4~.)+ Addition.al Fee ( ): $. 2. ( SF)- ( SF)= SF X + Initial Fee: $ + Additional Fee ( ): $. TOTAL:$ ¢~,q-o0, oO OWNER ' ~:ORMER LAND J IMP. TOTAL OF $OUTHOLD PROPERTY STREET 177OO .~, / FARM COMM. CB. MISC. DATE REMARKS RECORD Mkt. Value CARD LOT TYPE OF BU1LDING ,.5-"o0 /-//~; ~ 9 bo o / CONE)ITl( TillQble 1 TiJl~l~le 2 Tilldble 3 Swampland ', House Plot ~ Total FRONTAGE ON WATER FRONTAGE ON ROAE) DEPTH JLKHEAD DOCK 15~0 ' ~ , Dinette ~,~. ---- T ~';~'~"~ - 0 ~,~ K. ~Ext ~. I Basement Floors Z.~'~-¢' .~ct. Wa[is ' in.riot Fini~ ~~. LR. l~ - / ~/ / ~ '7 ~ ~ ~creation, Room R~ms 2nd Floe) FIN. B. Dormer Porch Breezewoy [ _ ~ DHvew~y o... J~'~'~~" ;~ /:, , ._. '1'o~ n 1 lall Amwx ,5;37,5 Main Road I'.O. 1½ox 117!t Sour[told, NY 11!171-0959 BI IILI)IN(; 1)ICPAIITMENT TOWN OF SOUTHOLD Tclcphonc (631) 765-1802 Fax (631) 76,1-9,502 August 16, 2010 Atone Adams PO Box 286 Mattituck, NY 11952 RE: 17700 Main Road, Mattituck TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $25.00. __ Final Health Department approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board approval. __ Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. __ Final Landmark Preservation approval, Building Permit: 35440-Z porch and deck Farm., [RFamdy NAME OF INSURED AND MAILING ADDRESS: DECLARATIONS CONTRACTORS ADVANTAGE SPECIAL POLICY NO. 3152X1914 AGENT NO. 3628 OFFICE NO. 3628 DAVID J CONSIDINE DBA DIRECT CONNECTION CONSTRUCTION 1425 HARBOR LN CUTCHOGUE NY 11935-1429 ERIC J KIRK 104 EDWARDS AVE STE 2 CALVERTON NY 11933-1640 631-727-7767 PAGE 1 RENEWAL TRANSACTION EFFECTIVE 10/26/09 POLICY PERIOD FROM 10/26/09 TO 10/26/10 12:01 A.M. STANDARD TIME AT THE LOCATION OF THE DESCRIBED PREMISES THE NAMED INSURED IS: INDIVIDUAL BUSINESS OF THE NAMED INSURED: CARPENTRY-RESIDENTIAL PROPERTY LOCATION OF DESCRIBED PREMISES NO. 01: 1425 HARBOR LN CUTCHOGUE NY 11935 PROTECTION CLASS IS: CONSTRUCTION IS: FRAME 03 PREMISES 01 BLDG 01 BUILDING MATERIALS / EQUIPMENT STORAGE BUSINESS PROPERTY COVERAGE: BUILDING BUSINESS PERSONAL PROPERTY LIMITS OF TERM ADDL/RTN INSURANCE PREMIUMS PREMIUMS 0 0 0 5,000 84 84 BUSINESS INCOME AND EXTRA EXPENSE ACTUAL LOSS SUSTAINED NOT EXCEEDING 12 MONTHS INCLUDED INCLUDED BUSINESS LIABILITY COVERAGE: BUSINESS LIABILITY - PREMIUM IS SUBJECT TO AUDIT BODILY INJURY/PROPERTY DAMAGE 1,000,000 PER OCCURRENCE 2,000,000 AGGREGATE 1,000,000 AGGREGATE FOR PRODUCTS - COMPLETED OPERATIONS HAZARD MEDICAL EXPENSE 5,000 PER PERSON FIRE LEGAL LIABILITY 50,000 PER OCCURRENCE CODE DESCRIPTION PAYROLL TERM PREM ADDL/RTN 91340AA CANPENTRY-RESIDENTIAL PROPERTY 22,000 720 720 THE LIMIT OF INSURANCE FOR THIS BUILDING SHALL BE AUTOMATICALLY INCREASED BY 5% ON AN ANNUAL BASIS DURING THE POLICY PERIOD. ACTUAL CASH VALUE (ACV) - BUILDING OPTION DOES NOT APPLY. DEDUCTIBLE: $250 DEDUCTIBLE APPLIES EXCEPT WHERE NOTED IN THE POLICY OR ENDORSEMENTS. COUNTERSIGNED BY: BF 30 05 01 98 HOME OFFICE COPY PROCESSED DATE: 09/21/09 PFarm., RFamdy OPTIONAL COVERAGES: DECLARATIONS CONTRACTORS ADVANTAGE SPECIAL POLICY NO. 3152X1914 LIMITS OF TERM INSURANCE PREMIUMS NONE PAGE 2 ADDL/RTN PREMIUMS TOTAL ADVANCE PREMIUM NEW YORK FIRE FEE OTHER FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY WHEN ISSUED: BP0002 01/87 BP0006 01/87 BP0009 01/87 BP 10 04 04/98 FI 99 02 01/08 BF 40 86 05/07 BF 40 85 05/07 IL0183 3/95 BF 3019 7/07 BF4108 4/09 804 804 1.05 1.05 THIS DECLARATION PAGE WITH THE POLICY, FORMS AND ENDORSEMENTS COMPLETES THE POLICY. BF 30 05 01 98 HOME OFFICE COPY PROCESSED DATE: 09/21/09 CONC MON MAIN ROAD N 89'28'00"E 100,00' CONC PATIO TIE 500' OVER PATIO ASPHALT CONCRETE CONC WALKWAY$ FOUND SURVEY OF" DESCRIBED PROPERTY SITUATE MA'FFITUCK, '[OWN OF SOU'[HOED SUFFOLK COUNTY, N.Y. SURVEYED FOR: ANTONE C. ADAMS GEORGIA C. ADAMS SURVEYED: 4 OCTOBER 2004 SCAL~ 1"= 30' AREA = 19,609.88 S,F. OR 0.45O ACRES TM# ~ooo~ GUARANTEED TO: ANTONE C. ADAMS GEORGIA C. ADAMS SURVEYED BY STANLEY d. ISAKSEN, dR. P.O. BOX 294 NEW SUFFOLK. N.Y. ~ 19~56 ,/NYS Lic." No. 49273 04R1556 5t)RVE'f' OF PRO~R~ 51TUATE; HA'I-I'ITt~K TOINN: .50UTHOI.D 5L~=OLK (.,OL,qq'r'¢', NC' I000 - 11.5 - 4- - ~,2 I000- 115- 4- 19 ANT~N~ C. ADAMS GF-.ORG~ C~ N E MAIN ROAD S.R. 25 100.00' 60'46. 25.0' LOT I~ ~U6 2 4 ;_;", 0 BLOG. DEP[ TOWNOFSOUTHOLD N87"0~'50"W 99.70' Ar'ec~ = Iq~q 5. F. Ar'ec~ = O.45oq Ac. pres JOHN C. :S LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 R1VERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.C:kDocuments and Settings\OwnerhMy Decuments~Vly Dropbox\10\10-164.pro "R~id~lhd ~ of New York Statg" with ACQ-tmat~l luml~r ,pe~ifications ma~h egis~ng 12" exposure :i' :' ~ - ~t/~ ~t~lr ~' ~i' n~s~bl~ whi~ ~onsi~ta of at'ISast two , at a 40 10' 30 60 a'~l, ~Family Dwellings has b~n All ~equired~ndmils shall b~ of ~[IoWifig typ~s or ptovid~ equivalent ~aspabiti~, ~1. Hind~ils wi~ ~ci~ul~crms se~ion s~lt flare an ~t- si~ ~i~ete: of at I~t I I/4 i~chm (32 m~} ~d not ~ater ~ 2 ~c~ (51 mm). If~C handrail ~ not ~ul~ It shall , not ~ ~an ~1/4 inch~ (t 60 mm) wi~ a m~imum ~oss se~ dtm~Sion 5F2t/4 ~acff~ (~7 ~). ,, '-: ~g~p~o~ / ~mch ........ t8 t ~ of the GUARDS R316A Guards required, Po~ches, beiconics i aurfaccs Iocnmd more than 30 incb~s (762 pm o~ gmdc below shall have guaMs noUless (914 mm)in height. Open sides of stairs with a t* titan 30 inches (762 mm) above th~ floor or gm have guards not l~s than ~4 inches (864 mm) sated vertically from the nosing oftbe b,~ads. and por~he a CO/ViPLY M¢I-FH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED A~ r S'<~THOLD TOWN2.~:r · '--/W--L s0u ) C TOW APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: % FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMB[bIG 3, INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C O ALL CONSTRUCTION SI-IALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. RETAIN STORB WATER RUNOFf PURSUANT TO CHAPTER 236 OF THE TOWN CODE, ' UNDER~ffERsCBIflFIOAT~; I~OUIREO 0 CERTIFICATION OF NAILING & CONNECTIX)NS REQUIRED, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY O O 7-0 ' 5-0 ' ?-.o 'u H ~:~ PCb O~-/kc ~ 7~ t C~ + i/ ,% U ~LL EW~ 0 ¼ 3