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Town of Southold Annex 11/13/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37269 Date: 11/13/2014 THIS CERTIFIES that the building SHED Location of Property: 2125 Pine Tree Rd, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 98.-1-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/25/2013 pursuant to which Building Permit No. 38485 dated 11/7/2013 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: ACCESSORY SHED AS APPLIED FOR The certificate is issued to Matelli Arthur Rev Trust&Matelli Esther Re (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED r Autho4ckf Si ature TOWN OF SOUTHOLD jpFwt,r <± BUILDING DEPARTMENT rY TOWN CLERK'S OFFICE } SOUTHOLD, NY 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#: 38485 Date: 11/7/2013 Permission is hereby granted to: Matelli Arthur Rev Trust & Matelli Esther Rev Trust c/o Jennifer Matelli 172-09 32 Ave Flushing, NY 11358 To: construct a 10' X 12' Accessory Shed as applied for At premises located at: 2125 Pine Tree Rd, Cutchogue SCTM # 473889 Sec/Block/Lot# 98.-1-13 Pursuant to application dated 10/25/2013 and approved by the Building Inspector. To expire on 5/9/2015. Fees: ACCESSORY $148.00 CO -ACCESSORY BUILDING $50.00 Total: $198.00 Building Inspector Yr st. 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'electzical 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•ofcompleted site plan requirements. 8. For existing buildings(prior`io-,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 property 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 I. 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- $106.00 . 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 .5. Temporary Certificate of.Occupancy-Residential$15.00,Commercial $15.00 Date. ©CJ�t�t New Construction: Old or Pre-existing Building: (checkone) Location of Property: a I o1.$ P i h e, .-tre_e Aa , C tJ'[Lh 01 e House No. Street JHamlet Owner or Owners of Property: C-iA-Se r ,4 e l; Suffolk County T8x Map No I000,'Section ' Block I Lot. (3 `Subdivision ::Filed Map. Lot: 1/ Date of Hermit. ' 7— ! - Permit No. :. , Applicant: Health Dept.Approvil: Underwriters Approval: Planning Board-Approval: . Request for: Tempor4.y Certificate Final Certificate: (check one) Fee Submitted:$ � . Applicant Signature �o��pF SO(/jyo� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTI [ ] FOUNDATION IST [ ] RO GH PLUMBING [ ] FOUNDATION 2ND [ ] SOLATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION ( ] CAULKING REMAR • r ge-,z —T-.nzD o 6 DATE INSPECTOR `'�� 3 �Of SOUly v 3► O TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO , [ ] FOUNDATION IST [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: A , DATE //sL/-.NSPECTOR � 1: 1 0 eN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST �,�ILDING DEPARTMENT Do you have or need the following,before applying? 't OWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 t Survey SoutholdTown.NorthFork.net PERMIT NO. � Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application ` Flood Permit Examined 20 13 Single& Separate Storm-Water Assessment Form Contact: Approved /l '20 Mail to: Disapproved a/c Phone: 51(o DI/3 Expiration �20 r Building Inspector e. I. ! OCT 2 5 %,113 ! APPLICATION FOR BUILDING PERMIT Date O /1 , 20 l _ TNI 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 withinp]2/months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendmentr,other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the exAnsion 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. i (Signature of applicant or name,if a corporation) . : -Dq 39_ lug I �S (Mai ligg add gs� pfrapplica t) r K�1�rrKKVV VV State whether applicant is owner, lessee, agent, architect, engineer, general contracMTgle# �,pbTal 9 tful der NOTIFY BUILDING D Name of owner of premises (��5-K 41.1 "I 765-1802 8 AM TO 4 PM FOR (As on the tax roll or latest dee FOUNDATION-TWO REQUIRED If applicant is a corporation, signature of duly authorized officer FOR POURED CONCRETE 2. ROUGH-FRAMING,PLUMBING, (Name and title of corporate officer) STRAPPING, ELECTRICAL&CAULKING Builders License No. 3. INSULATION 4 FI1:oL -CONSTRUCTION &EL ECTV `L Plumbers License No. MUST EF_t ^pT;-: FOR C 0, Electricians License No. ALL CONSTRUC Other Trade's License No. REQUIREMENTS OF YORK STATE. NOT RESrC:, 1. Location of land on which p posed�rk will lie one: DESIGN OR CONSTRUCTION House Number Street Hamlet �] County Tax Map No. 1000 Section —1 > Block 1 Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ren q(c -PQ.rug i l l 4orww' b. Intended use and occupancS 3. Nature of work (check which applicable): New Building Addition Alteration Repair ._Removal Demolition Other Work (Description) 4. Estimated Cost 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 Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YESNO� 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Nome of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V' 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. 6. 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—% * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) G5Kz4i, MAJelh being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the oil C(L- (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 fillCec sl�`�a&d y• Sworn to before me thisr Lary pIDA�K06�sau ( day of JCA- btf 20 V��_N0• Nas 31 " Qua��`s�rEXP`tes� o ary Public Signature of Applicant 1 { j i � Jk•. O Q 14L , A � /� Vif NO OF NC-1 } 11ti ._ � r �- 1 (� F.-... .#±_,,...._^"_e`e=��,,; .r�--•.�,.-.......+.•e`+,-ys'^- "6�'"• � � .�,. Q y"`�,F < � �.G f ,} �`A rk`f oo�S 25626���� 4 , �0 LAND SUPJ r F t Unauthorized aperauon 01 �,Q'� t en 10 � " -sA, ' FAQM S+ _ to this survey isa violation of �._ Nit .T l.�� 1 c� G . Section 7208 of the New York$yt♦ Cy �t.. cs :; Fr—I f Education Law. �/`� t�•^fyCE y : �`. .`L Copies of this surrey map not beatfn� the IanC surveyors inked seal or f` embossede p not boa ba oO � vaidtn1to 0 Co e onuy aranad fhe parson for wha to m dem shill Nn ft l -M�ELLi Pr^_pareC and on his befwY W tlt k: pa"y government lZ J. :.. , .0 THH . b the fand;a institution I�sted ' - ; assignees Offt lendut0 i1tN� Nsion,Guarantees are not traiufir bb 10 additionalinstitutions w subspI ownersOA. I 95 .: � *. . J` 7 :A w e i S+- y_ El Statesman Tall gable with built-in functionality. - • 7ft. tall side walls • Extra-wide 641n. double doors with AP decorative strap hinges a • Includes complete floor 7ft. Vents Window �f f 5 Loft shelves Installed '' r kx ✓ Size/Category Item# Base ❑ IOft.x aft. S 437575 $2199 Ell oft.x i Oft. M 437576 $2449 t �h$425` l� IN Ell oft.x 12ft. M 85205 $2599 r $51 ❑ 10ft.x t Eft. L 2 325264 3099 ❑ 12ft.x 12ft. L 91031 612., - $2999 r�� • ❑ 12ft.x 16ft. L 91254 $3649 ❑ 12ft.x 20ft. L $ ' ` 92703 $41491 x ❑ 12ft.x 24ft. L 92947 $4649 1,224.-, W See full specifications on page 18 Nu Gentry f Distinctive style with country charm. • 7ft.tall side walls • Extra-wide 64in. double doors with decopttve ," strap hinges • Includes complete floor tR Includes Vents OF 2K.-" ShUttE *' Loft Woftench Shelf { 10ft. shownPegboatd Installed Fxt . Size/Category Item# Base Adct.Ppint, . 12ft.x loft. M 83287 $2699 " $510; x t ❑ t 2 f t x 12ft. L $ 92983 $3349 $612`.. r a: ' $Qe full speGrficationR`prt page See Rage