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39004-Z
Town of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37600 Date: THIS CERTIFIES that the building ALTERATION Location of Property: 945 Lighthouse Ln, Southold SCTM #: 473889 Subdivision: See/Block/Lot: 70.-6-32 Filed Map No. 6/11/2015 6/11/2015 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/25/2014 pursuant to which Building Permit No. 39004 dated 7/1/2014 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: MINOR ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Falco, Thomas & Falco, Christine of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED rite Signature Permit #: 39004 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) Permission is hereby granted to: Falco, Thomas & Falco, Christine 945 Lighthouse Ln Southold. NY 11971 Date: 7/1/2014 To: convert a window to a door in an existing dwelling as applied for At premises located at: 945 Liqhthouse Ln, Southold SCTM # 473889 Sec/Block/Lot # 70.-6-32 Pursuant to application dated 6/25/2014 and approved by the Building Inspector. To expire on 12/31/2015. Fees: SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $200.00 CO - ALTERATION TO DWELLING $50.00 Total: $250.00 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. G 1�20 /I L4 New Construction: Old or Pre-existing Building: ✓ (check one) Location of Property: 94s' Li q% - lULt5,c LANe_ Sb Lt,TNgL6 NV 1161-7 1 House No. StreetII Hamlet Owner or Owners of Property: T1 UYY1 fiS �hrl S� I ne- A. ha (co Suffolk County Tax Map No 1000, Section �7 0 Block to Lot 3 a Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 81-0 Final Certificate: �z (check one) ppl�cant �g re TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION - FOUNDATION -I ST. ]ROUGH PLUMBING ]�PUNDATION 2ND INSULATION K FRAMING/ STRAPPING FINAL ]FIREPLACE& CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTMT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) ]CODE VIOLATION CAULKING' REMARKS: DATER[ I A/l INSPECTOR- %. -I I I - / L �yooi TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION IST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLAT REMARKS: -7,92162. [ ]ROUGH PLUMBING =ATION [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (FINAL) [ ]CAULKING DATE OS � � INSPECTOR �� OF SOUT,�o� coutm, TOWN. OF SOUTHOLD BUILDING DEPT. - 765 -1802 INSPECTION [ ] FOUNDATION '1ST [ ] FOUNDATION 2ND [ ] FRAMING/ STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ELECTRICAL (ROUGH) [ ] CODE VIOLATION REMARKS: [ ]ROUGH BING [ ] 1ATION [P FINAL [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT PENETRATION I ]ELECTRICAL (FINAL) [ ]CAULKING DATE eo % INSPECTOR w � �'' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 South oldTown.NorthFork.net Examined , 20_lf_ Approved / { , 20A Disapproved a/c Expiration ( , 20 /4 BUILDING PERMIT APPLICATION CHECKLIST PERMIT NO. 3 00f Building Inspector 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 C.O. Application Flood Permit Single & Separate Storm -Water Assessment Form Contact: I Mail to: ,Jp'l bk1l Ge -n CM+, Po 6 y 3g 3 5b La uOL N� Phone: (P31 -765 l a a3 - -- i1 APPLICATION FOR BUILDING PERMIT Q u � Date , 20 Jud 2 2014 4 INSTRUCTIONS a. This a lie T T Q co letely filled in by typewriter or in ink and submitted to the Building Inspector with 4 se s ; plans-p0.cbi.flfte lot plan t scale. F e according to schedule. THYMI _ ion of t 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. '(S gnature of applicant or a), if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises 7,dYY1 N':�. AJC,1P,-Ls.)n,e1-, A, P A L-cU (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. I3 0 (o 3 H T Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on 9 If.S LL House Number proposed w rk will be done: I ULl5�, . — - 30LlT}1UL� Street Hamlet County Tax Map No. 1000 Section I D Block 6 M Lot 3 2 Subdivision Filed Map No. 2. State existing use and occupancy of premises and intended use and occ" a. Existing use and occupancy P f-1 U o PG t' fl m L I �,, E&Z t Lot 3a of proposed construction: b. Intended use and occupancy �9-0 atr, Fa m k I L3 ioi•e {�c� 3. Nature of work (check which applicable): New Building Addition Alteration X Repair Removal Demolition Other Work r m o rc, n I &W I Y, 1W 1�1s�^4 vrvc A�OerScrJ Slio'N�Description) otooR , 4. Estimated Cost a.P►YMC bl1,a , Do 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 A 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. N a 7. Dimensions of existing structures, if any: Front Rear Height Number of Stories -F"yJ O Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Depth 9. Size of lot: Front Rear Depth ;1,0 � l ut 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated Re, 51 A&nbl # 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO_X_ 13. Will lot be re -graded? YES NO X Will excess fill be removed from premises? YES NO 'T•i-16m,na 14. Names of Owner of premises Ckr15t-irc A, faico Address 945 L C1kT6"X LA Phone No. 5)6 -57 5 Name of Architect Address i4S (49k-tkuua LA Phone No Name of ContractorJo .F -z bAt4 cn-CcnteActLl ddress �0 Ri 3y 5 Phone No. (9-31- -7(-. 5 - I Xaa `M 50LLT4ol—o ld� 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ,X NO * 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. t' 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) SS: COUNTY OF ) being duly sworn, 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. Sworn ,toD before me this tel— day of 204 t- ' ' �l�intn��F D. BUNCH ajul 0-1 Notary Public Notary Public, State of New York ignature o icant No. 01 BU6185050 ()ualified in Suffolk County _�fP Commission Expires April 14,�0& Scott A. Russell S`7C'OIRLMA\ [WT)ER SUPERVISOR � WA\N A\G]EMUE_NT z SOUTHOLD TOWN HALL - P. O. Box 1179 p 53095 Main Road - SOUTHOLD, NEW YORK 11971 ti Town of So u th o l d �0Z CHAPTER 236 - STORMWATER MANAGEMENT.WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOFS HIS PROJECT INVOLVE ANY OF THE F®I,I,®5/�%1�iG: 'y Yes No (CHECK ALL THAT APPLY) ❑� A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑ B. Excavation or filling involving more than 200 cubic yards -of material within any parcel or any contiguous area. ❑ [N C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑ ® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal I erosion hazard area. ❑(C] E. Site preparation within the .one -hundred -year floodplain as depicted on FIRM Map of any watercourse. ❑ F. Installation of new -or resurfaced impervious surfaces of 1,000 square . f eet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. ......_.._. { - -- ------------- - - --- - — _-- - - - - - ------------------ _ If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other) NAME: Thtm n A. (P—) LSgrtel.ccl �p Contact Information: 3 I k- (Tcicph—Numt d Property Address / Location of Construction Work: qq-s `Lcsti-� h d u-� C� 56 Lyth V IA, ) - FORM " SMCP - TOS MAY 2014 IN S.C.T.M. #: 1000 Date: District 32- (.'la Section Block Lot x t FOR BUILDING DEPARTMENT USE ONLY Reviewed By: Date: �® . OApproved for processing Build! g Perris - Stormwater Management Control Plan Not Required. F1Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review_) TOWN OF:.SOUTHOL® PROPERTY RECORD CAR® OWNER STREET VILLAGE DIST. ,... SUB. LOT AOI(.IK JI.-Fa./co �,Lf; �[l,.f,.vfrt_•'trr � �d.��-FZ.•"e� .�� OREf OWN�E. N = _.�:;,; :,; .^ . , :: _ E )71 0ci ACR. "/��� , r ,� ,7 ,� (h�/j,Q �/''' ���Vp,'��'•� '',�'y y W ,. p� TYPE OF BUILDING RE S / SEAS. VL. FARM COMM. CB. MISC. Mkt. Value "LA- NEi IMP. TOTAL DATE REMARKS s?� .•o DD ��? vc7 L /d/;� � .a .20-z:-� 3�2� % •�, z-�-�, AGE BUILDING CONDITION Nil NORMAL BELOW ABOVE 1Slq -- L 1176.1 FA7M 0 Acre Value Per Acre Value - ,�i �°' ". €�" do i^ A-cOd Tillable 1 1•o I s )o; 2,882-61 dd i,fifi- ►s Tillable 2 1 Zi4�apli, r, 0, sfyc")k,,K' Tillable 3OR* Z ReSQ Woodland 3 �3 b P res6P # Z -/0� �► �r Swampland FRONTAGE ON WATER 0202 J ,,r' (p �' 7� ✓� Brushland FRONTAGE ON ROAD13b y _ �SkP ' 279 b 6 House Plot DEPTH Lf 13 )b 643j4%Gf - aCes X327 . �•.�' BULKHEAD �i l7 Saj 1 7 Total DOCK x 6 NN 17 iWo AIN• `tiles � +w`}J Y { £�, •�4 cul �i�'�r•+11�+5r+.� �3r•7�"' � 4F`k'•e� ., r� .� T f ^ t .,:.•�,.... .. . . •'a - ' , [yI � , , --- - - . - 1. - �.!,,.-,,�,,-�,,,'-' "'i _":!,��, % -.1 ` � , I . _. - "': , " " T - ", , ,�.".,',, ,�;�'; _t � ". iF. !I � � , ,� , � , "I. �111 ,- , . - f , ,111.11 " A " �'Z,,;-`� , .. . . . . . , . . � - , , - I—— . � I . .... . �t , , �� , � _ . 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Falco Residence Plans are prepared by Condon Engineering, P.C. It Is a violation of the New York State Education Drawn by : JJC 1755 Si sbee Road g 945 Lighthouse Lane Law, Article 145, Section 7209, for any person unless acting under the direction of a licensed Mattituck, New York 11952 Professional Engineer, Architect, or Land Surveyor, to after any Item In anyway. If an item bearing Date: 5-25-2014 Southold, New York the seal of an Engineer, Architect, or Land Surveyor Is altered, the altering Engineer, Architect, or (631) 298-1986 Land Surveyor shall affix to the item his/her seal and the notation "Aftered by' followed by his/her signature and the date of such alterations, and a specific description of the alteration, M "—I iPrl I