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Home My WebLink About41064-Z otilrof Town of Southold 12/28/2016 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38744 Date: 12/28/2016 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 367 Riley Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 143.-4-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/28/2016 pursuant to which Building Permit No. 41064 dated 10/6/2016 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"half bathroom in an existing one family dwelling as applied for. The certificate is issued to Hedtrich,Joan&Mulvhill,Philip of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41064 12/6/2016 PLUMBERS CERTIFICATION DATED 12/15/2016 chard Stafford t ed Signature o�su eco TOWN OF SOUTHOLD 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#: 41064 Date: 10/6/2016 Permission is hereby granted to: Hedtrich, Joan & Mulvhill, Philip 8 Segatogue Ln South Setauket, NY 11733 To: legalize "as built" interior alteration (new bathroom) to existing single-family dwelling as applied for. Additional certification may be required. At premises located at: 367 Riley Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 143.4-20 Pursuant to application dated 9/29/2016 and approved by the Building Inspector. To expire on 4/7/2018. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $412.80 CO -ALTERATION TO DWELLING $50.00 Total: $462.80 d)) W - uildin pector Form No.6 TOWN OF SOUTHOLD fiUILDING 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 I%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 Au 4 1/, Af �v I L� Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: 3f�7 1 L /4/6� .7;r—1 House No. Street Hamlet Owner or Owners of Property: r !4 Suffolk County Tax Map No 1000,Section Block 04 Lot Z Subdivision 'l I Filed Map. Lot: Permit No. �l c( o�(W Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ � pplicant ig ture Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 roger.riche rt(aD-town.southoId.ny.us Southold,NY 11971-0959 �® COUN BUELDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To- Joan Hedtrich Address: 367 Riley Avenue City: Mattituck St: New York Zip: 11952 Budding Permit#: 41064 Section- 143 Block: 4 Lot: 20 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceding Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 1 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 1 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 3 Twist Lock Exit Fixtures 11 TVSS Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFAULTS" Notes: "HALF BATH" Inspector Signature: Date: December 6, 2016 0-Cert Electrical Compliance Form.xls soar ® Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: I�-✓ Building Permit No. )12d � �/ Owner: J ��) zq (PI ase print) Plumber: �- (Please print) I certify that the solder-used in the water supply system contains less than 2/10 of 1% lead. (Plumb rs Signature) Sworn to before me this day of/�z�z-, 20 SUSAN M. TITONE NOTARY PUBLIC-STATE OF NEW YORK No.01TI6351271 Qualified In Nassau County My Commission Expires 11-28-2020 Notary Public, County �llof� � �o�aoF soolyolo Comm,��'' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [rSUL/ATIONFRAMING / STRAPPING [ NALI_0 OblH [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: .4 - l:�✓ hC/ S IY DATE INSPECTOR � pf SOUlyolo 4 cou 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 INSPECTORt ' v FIELD INSPECTION REPORT DATE COMMENTS • � b FOUNDATION(1ST) c y ------------------------------------ � j FOUNDATION (2ND) t� z 0 o ROUGH FRAMING& y PLUMBING _ d cip r INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS rp �a o 2, 17Pf# 91M - _ o 2 a-Ao 2t cI m d b H 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. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined '20 Single&Separate Storm-Water Assessment Form Contact: n Approved 20 Mail to: &,e K. JA-e Disapproved a/c Of Phone: -? Expiration ,20 D Buildin ctor SEP 2 8 2016 PLICATION FOR BUILDING PERMIT I -Date 146 , 20 BUILDIING��iiDEPT. INSTRUCTIONS �'TAHIIT? a. ITPYM f175'T"beDcompletely 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, agenarchitect, a gineer, general contractor, electrician, plumber or builder Narne of owner of premises J 0A 4) G (As on the tax roll or latest deed)" If applicant is a corporation, signature of duly,authorized officer (Name and fitle of c'o'rporate officer) Builders Licen'se'No., Plumbers L'icense No.' Electricians License No. Other Trade's License No. 1. Location f land on w ich proposed wok will be done: / C� House Number Stre Hamlet, County Tax Map No. 1000 Section Block & 4- Lot ` G ' n Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises�-andi tpded use and occupancy �proposed coy�str c�n: a. Existing use and occupancy -L)/ (p "I �f b. Intended use and occupancy t c&—Itl 4– S' Al 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, co mercial or mixed occupancy, specify nature and extent of each type of use. r 7. Dimensions of exisg structures, if any: Front Rear 4 Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front 'l ;77^ Depth Height Number 6f St 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: FrJont Sv v ear Depth �; ,r 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated K 4�o 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO; 13. Will lot be re-graded? YES NO Jill excess fill be removed from premises? YES N�N 14. Names of Owner of premises 45 D T ) G k Address Phone No. 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 �U - C ��TZ 'being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the CA n5Aq7 CONNIE D.BUNCH (Contractor,Agent,Corporatel Officer, etc.) Notary Public,State ot NOW No.01 BU6185050 ou 6efied in S ilk County of said owner or owners, and is duly authorized to perform or have performed_the said wordcc ; cel �� f (ip4,k Qin; that all statements contained in this application are true to the best of his knowledge and belie ; and that t ie work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of 20� Notary Public �ignat ofApplicant k-VO-C— /V ApF SO�Tyol d Town HaIl Amex J� � Telephone(631)765-1802 5.4375 Main Road N � 763 out99 P.O.Box 1179 roger.richertt�#ow(n1s) 0J6 ny us Southold,NY 11971-0959 �ry'CpUplj'I BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: A 1 4z 04 *Cross Street: -� *Phone No.: L — _ l Permit Na: lo(o 14 Tax-Map District: 1000 Section: Block: Lot:�� 'BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) ti *Is job ready for inspection: <iE:j�yp Rough In Fina *Do you need a Temp Certificate: YES! NO Temp Information (11 needed) *Service Size: 1i Phase: 3Phase 100 150 200 300 350 400 Other *New Servicer Re-connect Underground Number of Meters Change of Service Overhead n Additional Information. ;,:3 PAYMENT DUE WITH APPLICATION O 82-Request for Inspection Form-'.= OVvNFR STREET t, VILLAGE 'vi icy- sub; CE d5ru a. FORMER OWNER N . .? E {�Git} je- S W 'TYPE OF BUILDING r, f - 'YJ � v C} i '`P + �� ' lit7'r rJf-i►�.c.r,..,Ci,i � r a "- �'-l �6-�--- ` ISS. f� SEAS. VL FARM COMM. I MfSC, Est, Mica=' rrr:•'-"'` LAND Imp. TOTAL DATE REMARKS + ` J -S�CJ��+ �O �A► t? �GGCI ru ru r -7 m r r i I f f M AGE BUILDING CONDITION - NEW NORMAL BELOW ABOVE FRONTAGE ON AT � -4 H Farm Acre Value Per Acre Valu0e FRONTAGE ON 0 H Tillable 1 BULKHEAD w i Tillable 2 DOCK Tillable 3 7S ,3 con Woodland qlowl -L. fJ e, b.r -•/iJ Swampi¢nd g j �/�,�a ��• (' !� BnaShiactd -Ce7N Mouse Plot 'cu N - - - LIJ ' Q '\ -.y•• Y1 I 1 € � � I `9 t � `'• •'fir -- i i tj N N _ a Bldg. \� Foundation g Bath € i C9 i tension 6-Y Basenwnt 1��n�- Floors O Interior Finish �' _ H R ! Ext. Walls � `J; t-,tin�L&t �"S`' � � m :Xtension f_ y y J 4�� .. , I ' ❑ w I Fire place L.- Heat �ktension - / Porch € Roof Type Porch• ,Rooms 1st Floor CD 1 i Patio I Rooms 2nd f=loor d 3reezerway Driveway I CO garage t — j L. 0 n CA f or rr+ erl � • O • r O • 0 k N sYa1M�e: �, ' N N 0 0 ((-g 0 V o CD ri Er 4mal -0 • w _ -•. `� 'tom - E Y MAP Off" -LAND Or JAM ES. �-#. Y<:),UNG• . STATE �_ . • A-f MA_"T1 TU C K , N.Y. REVISIONS: ELEr-.'rR9r"AL APP 4 ED AS NOTED INSPEC 'OON REQUIRED DATE: FEE: At BY: RETAIN STORM WATER RUNOFF NOTIF BUILDING DEPPAR I M . AT PURSUANT TO CHAPTER 236 765-1802 8 AIMI TC 4 DKII FOR THE OF THE TOWN CODE. FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED z ' u FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ^ " m 3. INSULATION IX- (/ so 6 u 4. FINAL - CONSTRUCTION MUST BE COMPLETE FnR C.O. 9 ALL CONSTRUCTION SHALL MEET THE I' Lj 0. REQUIREMENTS OF THE CODES OF NEW �( � o YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. AS-BATH- U I LT, COMPLY WITH ALL CODES OF BATH NEW YORK STATE & TOWN CODES "/4 2 _ AS REQUIRED AND CONDITIONS OF z F.A.I. y iwvvwVe7l�5 11/4 3 IaT 3 OCCUPANCY 4 - EX. BEDROOM USE I UNLAWFUL SLOPE"1/4"PER FOOT PITCH TO DRAIN TO APROVED SEPTIC SYSTEM TRAP HOUSE WITHOUT CERTIFICA OF OCCUPANCY PLUMBING SCHEMATIC ' N.T.S. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER .sUPPL'YS.YSTEM GAI'�'NOT PARTIAL FLOOR PLAN EXCEED 2/10 OF 15/. LEAD. SCALE: 1/4" = 1' p,LUI1 SINS ALL PLUMBING WASTE &WATER LINES NEED DRAWN: n/11/Ms S ESTING BEFORE COV-ERINGr:" JOB SCALP: I/4" �'0" N ` Spwmhm 2N,2019 S14EETNUMBER. �F A-1 d