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Home My WebLink About40860-Z SUFFOIIrco� Town of Southold 8/25/2016 a - P.O.Box 1179 a' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38472 Date: 8/25/2016 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 8440 Oregon Rd., Cutchogue SCTM#: 473889 Sec/Block/Lot: 95.4-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/19/2016 pursuant to which Building Permit No. 40860 dated 7/26/2016 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: "as built"deck addition with ramp to an existing one family dwelling as applied for. The certificate is issued to Karen Helinski&John Domaleski of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Authbrigd Signatur gUFFol�,c TOWN OF SOUTHOLD pay BUILDING DEPARTMENT '� TOWN CLERK'S OFFICE o • 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) Permit#: 40860 Date: 7/26/2016 Permission is hereby granted to: Helinski, Karen PO BOX 1182 Southold, NY 11971 To: legalize "as built" deck addition with ramp to existing single-family dwelling as applied for. Additional certification may be required. At premises located at: 8440 Oregon Rd., Cutchogue SCTM # 473889 Sec/Block/Lot# 95.-4-8 Pursuant to application dated 7/19/2016 and approved by the Building Inspector. To expire on 1/25/2018. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $539.20 CO -ADDITION TO DWELLING $50.00 Total: $589.20 Bui ing�Spr, 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 properiy.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$56.00. 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. I C New Construction: Old or Pre-existing Building: >� (check one) Location of Property: S 1414 Q (D 4-e House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block H Lot Subdivisionnn Filed Map. Lot: Permit No. V Date of Permit. ;r. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Ceriificate: (check one) Fee Submitted: $ yLj J Applicant Signature [, U�% OF SOUTyolo N o TOWN. OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL ( UGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE 08X0 INSPECTOR J o �O��OF SOUlyolo s �o ��y000Ni'r,N� TOWN OF SOUTHOLD BUILDING DEPT. 765-1602 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ FINAL C� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: c_o h DATE INSPECTOR '� f� M all IN$ULATION PBA N.Y. — STATE • • Y � i r `1 II � N r r • TOWN OF SOUTHOLD $ p Q-Ueiyh 14 BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENTDo you have or need the following,before applying? TOWN HALL F10 Board of Health SOUTHOLD, NY 11971 IliaS��arf p F dQ� cl%ts of Building Plans TEL: (631) 765-1802 A 1�C50 + Planning Board approval FAX: (631) 765-9502 ( Su vey SoutholdTown.NorthFork.Xiet PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees D (��(�0�(� C.O.Application ((�� VCC.. ��CC Flood Permit Examined ,20 Single&Separate 7f L 19 2016 Storm-Water Assessment Form Contact: 74a lf&—: Approved 7/;� ,20A $[Jmj) m]moipr. 1�s1 I<(� !e►'1 ►-�P� nSl�t Disapproved a/c 'OWN OF SOUMOLL Phone: 0 3) ^ �'"C9, Expiration ,20 Buil&ijiwpector APPLICATION FOR BUILDING PERMIT Date � ' I � , 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 plaiito 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) 11'9-7 State /9- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder -p� I cam b Wne✓ Name of owner of premises (As on the tax roll or latest deed) ' If applicant is a corporation, signature of duly authorized officer N I A- (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: 9-41-40 Q r 2 ci on Q-A C'� t2 O R1-,1 -e. House Number eety `^Hamlet County Tax Map No. 1060 Section 95 J AP-C'1" ```- s bf:'.:1 Lot %fa<4pe Subdivision N ) 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 SinQle FQ-A LA i J C; A 11P b. Intended use and occupancy �' C� �cx�oln► �"fit P6 leul 1) 3. Nature of work (check which applicable): New Building Additions Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost �' 1 (Topp paid on filing this application) � 5. If dwelling, number of dwelling units l N ber of d'we Ing unitsn each floor M If garage, number of cars Z `�` "✓ �' 6. If business, commercial or mixed occupancy, specify af�i�r%N,( 6�tWt,.p tach 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 1990 Name of Former Owner 2+.on �C-4kQ 11. Zone or use district in which premises are situated re S^ cu, 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO--v" 13. Will lot be re-graded? YES NO -,/ Will excess fill be removed from premises? YES NO V 14. Names of Owner of premises rZ-011Q.,v1 Her �nSIddress�O 1 P)c-��-Phone No. G-'N �5 =-SS a--I- I 1 Name of Architect Address Phone No Name of Contractor f 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 OFLu f,(�q l l ��( ✓ -A-- �-�,"rt _cl L' being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the to cNn�P—V, (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 to before me this 7 day of �5 Ul ti 20 ADAM R. of A � Notary Public,State of New 1Podi N tary Public (uglier 16295446 in Suffolk Counl#�w'If`�� • Signature of Applicant Commission Expires Januaal 6;Z� :. SURVEY OF PROPERTY ��l -�'' AT MATTITUCK < TOWN OF SOUTHOLD X04 \\ SUFFOLK COUNTY, N.Y. 1000-95-04-08 SFEB18 2016 0• e �o 00 � yhryhg c, :,P 4SG OFl,E, CT�'EP�p� k �'r4r�cP pf '• 4Oo a � NYS UC NO 49618 ■ MONUMENT ,gyp ANY ALIERARON OR ADDIRON TD THIS SURVEY IS A VIOLATION G®Nl YORS,P.0 ■ v REBAR SET OF SECTION 12090E WE NEW YTIRK STATE EDUCATION LAW (6 —5020 FAX(6J7)765-1797 EXCEPT AS PER SECDON 7209—SUBDIY190N 2 ACC CSTURCARONS P,O BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR CONE BEAR WE BIPRESSED SEAL CF THE SURVEYOR 12JO TRAVELER STREET 15-217 AREA-18,143 SQ.FT. NHOSE 9GVATUR£APPEARS HEREON SOUTHOLD,N Y. 11971 ® F S T LD -PROPERTY RECORD CAOD `�® � OWNER STREET ?L( -n VILLAGE DISTRICT SUB. LOT /I z4:: - =- FORMER OWNER N E/ Y } ACREAGE 4 /� Do mail? 41� a" S �sG s� %'jt- W�� i'��!' 01 TYPE OF BUILDING RES.,, /d SEAS. VL. FARM COMM. I IND: I CB. I MISC. -' LAND IMP. TOTAL DATE REMARKS -d 0 3lD Cl7- l a c l�a Q 5 k� i /-,? /1h2_ 1h 2 � I! --SSG !! 2- AGE AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE ` Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Wcodland Swampland Brushland House Plot Toto I' L7 *• Y a�a „�yam..{ �t. xp s "• ' Y ;,.. � ,;,' x ray r. 'Y a, .`+o..' a '' ■■■■■■■■■■■■■■■■■■■■ lk S Iti .v ■■■■■ ��■ ■■■■■■■■ x4 �a� ?".. . . ,r.:-.i ras.�, * ,.F"" �sr,'A'X.,C .;k:Y" :`. ,""�".-•+,. .. IVI ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ • COMPLY 6G� WITH ALL NEW YORK STATE & TOWNOF: CODES APPROV D AS NOTED AS REQUIRED AND CONDITIONS OF DATE: FEE: . C �9ff '9EB�814" BY: NOTIFY BUILDING DEPARTM j: SQtII 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FORrDATION POUE D- TWO CONCETQUIRED OCCUPANCY QR 3. INSULATION USE & PLUMBING USE IS UNLAWFUL 4. FINAL - CONSTRUCTION MUST WITHOUT BE COMPLETE FO,9 C•O CERTIFI AT C E- ,---- r-- ALL CONSTRUCTION SHALL MEET THE OF QCCUPANCY @ ��' "- ' `� T ---- - - REQUIREMENTS 01'THE CGBES OF NEW _ YORK STATE. NOT RESPO NSI a BLE FOR �- _ DESIGN OR CONSTRUCTION ERRORS. RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. mq [ reJ f eta u 12- 4 "M L I { ff - ------------------ --- --4 R_41AP ------ TL tto lot- I I — I 77 t 5, ca - . APPROVED BY: DRAWN �rT ._...-..__-__._ DATE-'] �L...•I_�i.-..__ REVI8ED___ ,.__ ..__- c� DRAWING NUMBER C k? 4 t t t4T. 5T� L SI x. r-> -IF L ---------- Dec T-1 ---------- IC) - -t z rl ri • da H 1114o D ��CI V SCALE':"��- APPROVED BY: DRAWN fi'f:jjT'K-lT-�j' DD DATE be. REVISED AUG 1 6 2016 BUILDING DEM. DRAWING NUMBER TOWN OF SOLTMOLD 1 �(7-