HomeMy WebLinkAbout39921-Z �o�S�FFi?d�CpG Town of Southold 8/23/2016
y P.O.Box 1179
0
q T 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38450 Date: 8/23/2016
THIS CERTIFIES that the building ALTERATION
Location of Property: 7230 Skunk Ln,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 104.-6-10.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/23/2015 pursuant to which Building Permit No. 39921 dated 7/7/2015
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 ALTERATION AND WINDOW REPLACEMENT TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR
The certificate is issued to Brickley Donald P Iry Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39921 08-04-2016
PLUMBERS CERTIFICATION DATED
r
Authorfzff Signature 10"-
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
C2 x TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
�'fJp1 � ,�•bp�}js�
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#: 39921 Date: 7/7/2015
Permission is hereby granted to:
Brickley Donald P Iry TO
17 Olofson St
Braintree, MA 02184
To: Interior alteration and window replacement as applied for. Additional certifications may
be required.
At premises located at:
7230 Skunk Ln,Cutchogue
SCTM-# 473889
Sec/Block/Lot# 104.-6-10.1
Pursuant to application dated 6/24/2015 and approved by the Building Inspector.
To expire on 1/5/2017.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
otal: $250.00
"� Building Inspec —
r
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- $100.00
"3:'--Copy of Certificate of C3ccupaiicy-$:25` ' -
4. Updated Certificate of Occupancy- $50.00
5--Temporary-Certificate of Occupancy-Residential$15.00,.Commer-cial-$15.00_
Date.
New Construction: OId or Pre-existing Building: (check one)
Location of Property: kun
House No. 1 Street HamI43)
Owner or Owners of Property: �1�I d<l
Suffolk County Tax Map No 1000, Section 1 p Block Lot (�
Subdivision Filed Map. Lot:
3q%1 Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
J
Fee Submitted:$ !n
UL
Applicant Signature
pf SOU��®�o
Town Hall Annex Telephone(631)765-1802
54375 Main Road CA Fax(631)765-9502
P.O.Box 1179 , ® roger.riche rt(-town.southoId.ny.us
Southold,NY 11971-0959
®lyC®U ,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Brickley
Address: 7230 Skunk Lane City: Cutchogue St: New York Zip: 11935
Building Permit#: 39921 Section: 104 Block: 6 Lot- 10.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Home Owner DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 5 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 5 CO Detectors
Sub Panel A/C Blower Range Recpt 50A Fluorescent Fixture Pumps
Transformer Appliances DW Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 6 Twist Lock Exit Fixtures TVSS El
Other Equipment: 1- Exhaust Fan, 1- Paddle Fan
Notes:
Inspector Signature: - Date: August 4, 2016
00Electrical 81 Compliance Form.xls
y
f� OF SOUlyo
coulm,Ncc�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: C• a -
DATE INSPECTOR
OE SOUlyOlo
o�y o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
DATE `t l� INSPECTOR ' f
CHITECT
MARIA SCHWARTZ &ASSOCIATES 28495 Main Road•PO Box 933 o Cutchogue, NY 11935
631.734.4185 www.mharchitect.com
January 11,2016
Southold Town Building Department
P.O. Box 1179 Main Road
Southold,New York 11971
Re: Brickley House
75 Broadwaters Road
Cutchogue,New York
To Whom This May Concern:
I have been to the site and reviewed the MTP Custom Carpentry. I hereby certify, to the best of my
knowledge, the insulation installation has been completed and meets or exceeds NYS code
requirements.
Please call this office if you have any questions or require additional information.
Very truly yours,
Lk
air I_� 1
�
JAN 2016 � I
0
Mark Schwartz
AIA
Member American institute of Aidliiecture
FIELD INSPpgrQN CONIlI?EMS '
FQUNDA'ftOX(1ST)
• ' ' VY
No
rA
ROUGH F'RANQ& H
PLUMBING
� y`-
IN$ULATION PEA N.Y.
STATE ENERGY COS}E
g
FINAL
ADTTI LIMI .
70
�-�
. e
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 -%4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO.1591'-) Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
D �� V --Flmd Permit
Examined 120 '"� E —&ftgle&Separate
� � ontact:
D1 ,4
Storm-Water Assessment Form
Approved ,20 Mail•to: D dP P A l3 V-i c L-L0
Disapproved a/c 6! G DEPT
SOUTHOLD
— Phone: 7 - 6 S 3-s b�-
Expiration
20�
Building Insfor
APPLICATION FOR BUILDING PE
Date , 20
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 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.
(Signature of applicant or name,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
(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.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
,7 -13 o S K a-P3 V— L./kw <:�.uT44-k5GuE- o'i�I
House Number Street Hamlet
County Tax Map No. 1060 Section /o `/. "" Block:,,�,f�;; ='�•�:,, Lot /6 /
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
b. Intended use and occupancy
w r,,.r ey-W r-e.v ladev��^�
3. Nature of work(check which applicable):New Building Addition Alteration 1/
Repair I 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 d k70�
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? 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 PN`1L-pis 64N411-L6YAddress 1-153 5rWrJV- W Phone No. 63l-73y-7Sb7
Name of Architect Address 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
* 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.
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
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF
aN "iA- 8 e-i e-le-LEy being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the ON%)
(Contractor,Agent, Corporate Officer, etc.)
of said owner or 0ners, 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 to before e this
r� day of , t�Yl e- 20 15
ce- �)�.
V/
�JNotary Public TRACEY L. DWYER Signature of Applicant
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2j1g.,
E E
JUL, -7 20X11 �,of so�Ty�
I Telephone(631)765-1802 i
543731i!1":'R, d'
9- ---'" 31)765Jad
� roger.richerttdow0nuo2 ,
ny us
Southold,NY 11971-0959 YO
BUILDING DEPARTMENT
TOWN OF SOUTHOLD �
APPLICATION FOR ELECTRICAL INSPECTION '
REQUESTED BY: 4 is Jg Zrcae-Z�I Date:
Company Name:
Name: �.--
- i
License No.: _ -
}-
Address:
Phone No.: b t-7 -
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No_:
Permit No.: �a
Tax-Map District: - 1000 Section: f a Block: ( Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) i
(Please Circle All That Apply)
*Is job ready for inspection: t
YES/ Rough In Fina!
*Do-you need a Temp Certificate: YES �O ,
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other I .
*New Service: Re-connect- Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
I -
,
82=Request for inspection Form
1 '7/7
Dwyer, Tracey
From: Donna Brickley <dbrickley@ndahingham.com>
Sent: Thursday,July 02, 2015 1:29 PM
To: Dwyer,Tracey
Subject: 75 Broadwaters Dr. - Brickley
Hi Tracey,
Just an update so you know I'm still working on compliance with your requests for
my mom's place. I have the specs on the side wall window... Matthews Brothers,
Double Hung, U-Factor 0.28, Solar Heat Gain Coefficiant 0.3, and Visible
Transmittance 0.54...Warranty, serial number 60145160...Lowe argon dual pane.
I should have the specs on the second window by the weekend or early next as well
as the engineer's certification of the insulation to provide.
Have a good weekend..Happy 4th!
Donna Brickley, CAA
Director of Athletics
Notre Dame Academy
1073 Main Street
Hingham, MA 02043
781-749-5930, ext 2113
www.ndahingham.com
7--.,z 3D S Kure 1-N
- 10. 17OWN OF SOT OLD PROPER
OWNER STREET 7 VILLAGE DIST. ' SUB. LOT
FORMER OWNER N ACR
S W,� TYPE OF BUILDING
RES. ).(g SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
AJ6112.173
D - !a5' a c,200--ar�dt( m u, nclwp_ rrEVee,,�- - n c,
r •
i •
Tillable FRONTAGE CA
►Noodlartd FRONTAGE ON ROAD �`� '�, /3LOD
1
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-louse Plot BULKHEAD
dotal '
:4
1 10
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it
, F 'm •r /✓i. ' }±? I i i
si
i a
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Breezeway Fire Place Heat DR.
Garage Type Roof Rooms 1st Floor BR.
Patio Recreation Room Rooms 2nd Floor FIN. B
0. B. i Dormer Driveway
Total
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rd-(cr 4o an eleva4jon 6r' 0,0 -re-f a f /
ordimor:, h(rr7h wa-ler mark (-n
Oro,*dwa-lPrs Cove. Gic'ensad Gave ,5UrVey0rs
Arner�cll�d Oct. /9, 1.973 reer'Por4, New YorK.
(D V WBL3339L 1539
MIS
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100 WO
CD Brickfey Residence
Cutchogue,NY
UILDING
DEPARTMENT AT
OOLLOWING INSPECTIONS:
71iti� 74500 M,-m Road
FOUNDATION - TWO REQUIRED GreenportNY 11944
FOR POURED CONCRETE 01 Phow 631996 3305
co
7) Fax 631.996 5305
2. ROUG
3. INSULATION
R 4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.0
ALL CONSTRUCTION
0 F3; IS UNLAWFUL, SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW 2J2711 5
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