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�Q�gufrF�l,f�oG, Town of Southold 1/27/2017 P.O.Box 1179 cm o • 53095 Main Rd 'y,�yy®� 0�, Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38797 Date: 1/27/2017 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1095 Oak Ave,Southold SCTM#: 473889 Sec/Block/Lot: 77.4-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/30/2015 pursuant to which Building Permit No. 40321 dated 12/3/2015 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: ADDITIONS AND ALTERATIONS INCLUDING REAR COVERED PORCH, OUTDOOR SHOWER STALL AND PARTIALLY COVERED FRONT PORCH TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Ortner,Peter of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40321 07-21-2016 PLUMBERS CERTIFICATION DATED 09-27-2016 Bra iecuch rry Signature ���guFEnt,r�® 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#: 40321 Date: 12/3/2015 Permission is hereby granted to: Ortner, Peter 8765 SW 120th St Miami, FL 33176 To: construct additions and alterations (porch and bathroom addition) as applied for. At premises located at: 1095 Oak Ave,Southold SCTM # 473889 Sec/Block/Lot# 77.-1-10 Pursuant to application dated 11/30/2015 and approved by the Building Inspector. To expire on 6/3/2017. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $262.40 CO -ADDITION TO DWELLING $50.00 Total: $312.40 Building Inspector �i • 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 frorn 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. New Construction: Old or Pre-existing Building: V (check one) Location of Property: 10 fb m A-G pry r' 5 —Co OTr+--o Lb House No. Street Hamlet Owner or Owners of Property: �t,�&x S © Or A-P r Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Q Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: I/ (check one) Fee Submitted: $ ° Mo ° Applicant Signature ®F soUry®l® Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 rogerAche rt p_town.southoId.ny.us Southold,NY 11971-0959 " 01yc®UN°fY,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Ortner Address: 1095 Oak Avenue City: Southold St: New York Zip: 11971 Budding Permit#* 40321 Section: 77 Block: 1 Lot: 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Roslak Electric License No: 3677-ME 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 X Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceding Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks Disconnect Switches 2 Twist Lock Exit Fixtures TVSS Other Equipment: 1- Exhaust Fan Notes: Inspector Signature: � .q�� d Date: July 21, 2016 IF z Electrical 81 Compliance Form.xls �f soil", Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION, Date: T Z7 ll Building Permit No. qo 321 Owner: b Y4 n-elr (Please print) Plumber: - Grad Pkwc h, (Please print) I certify that the solder used in the water supply system contains Iess than 2/10 of 1% lead. F (Plumbers Signature) Sworn to before me this.�. day ocs�> 20J_6_ Notary PublicCounty C®NNIS D. BUNCH Notary Public,State of New Yo* No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2Aa D OF so(/l�o cou�m,��' TOWWOF SOUTHOLD BUILDING DEPT. 765-1802 - ' 1'4 i FOUNDATION IST,, [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR �`'° OF S0UTy0 cOUMY,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ROUGH PLUMBING [ ] F UNDATION 2ND [ ] INSULATION [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REM RKS: - ltg-co-p.� DATE Z' INSPECTOR ` OF SOUTy� courm,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 , INSPECTION [ ] FOUNDATION 1 ST [ ] RO GH PLUMBING [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING / STRAPPING [ ] FINAL } ] FIREPLACE_A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION� [ ] CAULKING REMARKS: v OF DATE a4� to INSPECTOR ° OF SO40 UT,y�lo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION, 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [, ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ / ] CAULKING REMARKS: DATE V INSPECTOR SOF SOUL N o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLRG. [ ] FOUNDATION 2ND [ ] I LATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) t• �1' K-1/INREMARKS.• �Arnvi S W►� L {, D IPAJ +; �(Ajc;0 LS CQ VI . , 61 hnv k , rm0,4? t�-� N to was •R�'1r1 -hl✓ o W a r IL OP bpi D fJ -- Ait In i �05+=fM44 stzz DATE yl INSPECTOR SOpl�o! � o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] I LATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) REMARKS: 1l'1flli `� Wt wot"L on 6d&n&loy, I � 1m � DATE y� ISP INSPECTO o� ��pF SOUlyO coUNT1,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLDG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTA PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRI AL (FINAL) REMARKS: Jrl�,.Va V. f--y-w im o 5oKv DATE I ILI L INSPECTOR PFA - - - J j M r r " H I � _ �Ilow Z W- , /^ � y a i�yge�` ti WO n VA M AM � 'OW,& OFrSOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST fs 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. -� a��i Check Septic Form N.Y.S.D.E.C. Trustees, (I ; f �^ � Flood Permit Examined 20 � ` `' I Storm-Water Assessment Form Contact: 3 is . �. Nov 0 '2015 !) Approved– 20 { Mail to: pp � , - Disapproved a/coo -- _ i:C�ii'", r,q zGili•a y^.� Phone Expiration_ 20_ Building I 99pector APPLICATION FOR BUILDING PERMIT, Date ' C L , 20 I S As 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 applica ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder U n 4kr Name of owner of premises " '- Or ` —A ei` (As on the tax roll or latest deed) If applican_ t is a corporation, signature of duly authorized officer f . (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: to fir /W A;u> So 0 7-rl-o Lb House Number Street Hamlet County Tax Map No. 1000 Section T Block ©I - Lot 1-0 Subdivision ,Matp off' 6 ac � a=4tgbrs—Filed Map No. /137(, Lot a?-1, ,py t3� T-?*k KAP X30 -� ..� 4-e r 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy _ S e-e s isal u Se. b. Intended use and occupancy lse-as onz t9 Se o CA 4 A 3. Nature of work (check which applicable):New Building Addition Alteration V" Repair Removal Demolition Other Work p n�,htoo n Rv-1,gC ,1•'0A 4 (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 If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear �S Depth 30 Height A.I.19- Number of Stories 1 a r►� imensions of same structure with alterations or additions: Front y Rear Cil`'� Depth Height A" (C Number of Stories i 8. Dimensions of entire new construction: Front 10 Rear /0 Depth 6 Height g Number of Stories J 9. Size of lot: Front I Al Rear I Z/ Depth )-->,O — 1 3,5� 10. Date of Purchase ti oZ 1)1 A Name of Former Owner Pe.4-e_C a A Toni D r` -Aer 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 KWill excess fill be removed fromremises? YES NO 6-7sw -9 laa sf 14. Names of Owner of premises RA-&©Pi%*r Address 9"1 a" ' ./F* ' 33'X Phone No. 3 os-233-SS,P/ 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 X * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES_ C�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 OF3VK'rD(jkj— -PaANk- 'S,- ' 0ItR riCSZ) " 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. )1rdPK11y, Fes;Ptiblia,RaN of 9lua 14A Sworn to before me th's NO.49012 � day of V 20 "In suffGh Gsa e'ara E41 CM 49j Notary�Public Signature of Applicant FFQ Scott A. Russell . ° � � �TO>>[�I��IWA\'7C'�E]E� SUPERVISOR I�vl[A\_A\(G)EI��/1[)ENT SOUTHOLD TOWN HALL-P.O.Box 1179 i` s 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold rel WZ41-1 s�,}j��` ea CHAPTER 236 - STORM[WATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE AW1Y OF THE IFOLLflWI.NL G: Yes No (CHECK ALL THAT APPLY) ' ❑[2'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. !' E]XC. 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 erosion hazard area. ❑iPLE. Site preparation within the one-hundred-year f loodplain as depicted - -on FIRM-Map-of -any--watercourse. ❑04 F. Installation of new or resurfaced impervious surfaces of 1,000 square feet 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. Ap -- S� T'� - i 0 Dale PPLICANT (Propel ty On ner Demgn Profea-anal Aaem,Conractor Other) Ut�Irict NAME tetAj9e d LL, bV 77— lb 11-36-15 SectionBrock Lot Lot --- ----- - -- - agiuvn; ,ya> I'O? 3L ILDINC )C ' UMENt SE "):NL1 Conact Information 63C Revieti"'ed B\. - - — — — — — — — — — — — I . Property Address/ Location of Construction York: — — - - - - - - - - - Date �'-'`3®-� - - - - - - - - -- - - - - - - - �� s Apps o,ell fol processing Btlildin�Pei mit Stol mN\atei k'lanagement Conti of Plan Not Requn ed � 0 C I ❑ Stoim�\atei Nlanagemem Cowrol Plan 1,P,etluu-ed IFoi\\ard to Digineeilnn Depailment for Re'>iew i FORA SNICP-TOS MAY 2014 A pF SO�jy��o Town Hall Annex s sC + Telephone(631)765-1802 54375 MaLn Road ax(63 i)765- 5�?2 P-O-Box 1179 Q roger-richert�fown.sout io d.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU.THOLD i APPLICATION FOR ELECTRICAL INSPECTION - - i REQUESTED BY: j� �e Date: / +Company Name: Name: 1- License No_: 3�7 H.F Address: Phone-No.: JOBSITE WFORIVIATION: (*Indi(_-ates required information) i *Name: Q *Address: c' ot j l *Cross Street: *Phone No_: 031/ 23 Ll---j Z Ze Permit No.: rl® 3oZ I Tax-Map District: - 1000 Section: Block: Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) i - f (Please Circle All That Apply) I *ls job ready for inspection: YES NO. Rough I Final *Do-you need a Temp Certificate: YES Temp Information (If needed) *Service S- P se e 100 150 200 300 350 400 Other I . *New SeryEound Number of Meters Change of Service Overhead i Additional matron: . PAYMENT DUE WITH APPLICATION PAY 3 1 2016 49 o TOWN OF SOUTHOLID C/Cw 1 / 82-Request for(nspecl�on Form � f 0 1�C�COdC� JAN 2 5 2017 BUILDING DEPT _ TOWN OF SOUTH r loe Vol - i t i 4 _ f f� +j I Y 35 �Q�ti m 2 7- /a-� $OUTHOLD PROP�R'�'Y @dECO'�® CARD ✓� SR STREET VILLAGE DISTRICT SUB. LOT FORMER OWNERSyk/la Drhrle,- N E ACREAGE W TYPE OF BUILDING d ?Zd e.e .d A 04 _RES. SEAS �D VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS �IrX�, sq A;' q, /_9 z � 3 LIlZ3Z D5V( - drf -hn h L 11 r7��- �� � ✓c�sY fv Cir P r A/ 17 AGE BUILDING CONDITION1 L Z ,L Z�3r� 9� _ tM— 1--1✓, Irti-s� �C NEW NORMAL BELOW ABOVE F NTA EAAW , � � � Dr/ � Farm Acre Value Per Acre Value FRONTAGE O ROAD / z O 7 0 0 Tillable 1 BULKHEAD 1a — ® Tillable 2 DOCK /,Z// f 3 _4 Sy5 &7� r �� Tillable, 3 Woodland Swampland Brushland House Plot Total � . Mu ! I i „ i I ! 11 C ��. ._.. .�, �F�".+ Z;�L;"'':i-�.�•� Edi_ n 1 1 1 i I171711 1 I ' "l'.�,,^„�aa �L�T�:F..�.x_+^yi:".r;_.. � 1 '.,`y0.13`L'y-:^.. `•`-.a.`"�w'E?";'".v� //� »-...=r�'L::.'ti:•..�*r:a ..r..n��...2Z r''n 'T' �.S,�al..�.na�"i ��'`�.'-k"`�`i.a'�uLwti I I I 1 ' I I I / '. I I � ( I _I I/ I I I I r ° '� 66Foundation P F2 g Bath M. Bldg. I "' �1 Extension i Basement Floors - I Extension Ext. Walls I&rior Finish Extension I Fire Place S Heat Ph d uhf I "Y Z _ Porch Roof Type Porch Rooms 1st Floor Breezeway Patio Rooms 2nd Floor Garage ac5 x a� Coo2� 4 a [ ,-1 '5 j o'34" Driveway Dormer 0. B. 419,1 �8 � I o��OF SOU�yol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G • Q Southold,NY 11971-0959 September 29, 2016 BUILDING DEPARTMENT TOWN OF SOUTHOLD Peter Ortner 8765 SW 120t' St v�� /�► �-- Miami, FL 33176 1p Re: 1095 Oak Ave, Southold TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your C ificate of Occupancy. J��Z T i NOTE: Before C of O can be issued,an application must be submitte fo extension of fro t entry `7 per Building Inspector + o LA—+&DO r a 111i�2� Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of$50.00. Final Health Department Approval. �e7 � Plumbers Solder Certificate. (al permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) G4� Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval.` dd Final inspection by Building Dept. C-'X/% Final Storm Water Runoff Approval from Town Engineer V) BUILDING PERMIT — 40321 —Add/Alt LV 1 r . f RAIN RUNOFF CONTAINMENT GARAGE & DRIVEWAY GARAGE - 841 sq.ti. 43/42 2°3.4-VF 3 cu./I. s`S2� �• ,�, SURVEY OF PROPERTY PROVIDE / OW- 8'0 x 4' DEPTH A T `SO UTHOLD DRIVEWAY (PE'RVIOUSI r`� ��� Oy o F� �y Fo q 1175 sq.fl. o \ �o •� TOWN OF SO UTHOLD 1175 x 0.6' x 0.17 = I.EO cu.ft. �ry1• \ '1oJ � PROVIDE I DW 8 x 3' DEPTH \R��. ; ��� SUFFOLK COUNTY, N. Y. o� \ 1000-77-01-10 �L.� SCALE.• 1'=20' 4,� JUL Y 9, 2013 `P� Q \ Q�� •G� JULY 30, 2013 (PROP. GAR.) SEPT. 10, 2013 (RUNOFF CONTAINMENT) T .QC21, 201 ?YCONTOURS 8 ELEVATIONS) �i APRIL-25, 2014 (FOUNDATION) O�P \ I s. \ SEPT. 21, 2015 PROP BATHROOM AI)D4TJON) tK IAN A90,/ c'Q•v \ 5 t e 0P°o ff`' cF \ A, ' - � � dpi �'S•�. - �, �� \ \ ,� ,�• • - - : s�,.�. ��� \ '``L - 12 0 QUO�/O `'�'� �`' G�J�_ �s�• P _ QELEVATIONS AND LINES /` ARE REFERENCED TO ANUASSUMED DATUM 9`OI'A �`rF` `ha _ F�� '� ' �Of �° SFC o? , � F�;•�,yp % �"� ��, '�<fb�E ICS' ,. AREA=15 350 SO. FT. . ,ha � ,�� �, j� ,b � LOT NUMBERS REFER TO "MAP OF GOOSE BAY ESTATES" r FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON s P✓o. t =° 'NOVEMBER 13,, 1934 AS FILE NO. 1176. ' Y.S LIC. NO. 49618 • ANY ALJERA77ON OR ADD177ON TO THIS SURVEY IS A V70LA77ON (� c�P` _ �J� P CONIC EYORS, P.C. OF SEC77ON 72090F INE NEW YORK STATE EDUCATION LAW. IQI���S i �° (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERRFICARONS ��L f�•, P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY 1F �, O• _ �� SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRA VELER STREET q'�_�®� WHOSE SIGNATURE APPEARS HEREON. PSP �p ,�' SOUTHOLD, N. Y 11971 1 PRODUCED BY AN AUTODESK EDUCATIONAL PRODUCT 12 4 ° t r h 't- CERTIFICATION r ;.:. a X6 - Lt,t4 DCNTENT BEFORE R 2 2/ IN5L. ON LEA UPANCY n.-. _•, _ ___- Ce�R r r SED IN WATER 2X6 SOLDER U __..._ SUPPLY SYSTEM F 2110 OF i%LEAD. R-l3 /NSL. ; o PLUMBING ALL PLUMBING WF,S7r. R,6AR EL6V4770N l ' ` RETA.!i`I STORM WATER RUNOFF 2 . r-- PURSUANT TO CHF, PIER 236 OF TfiE TOWN CODE. R-21 IN5L. r' TV; IIS ',: `lid 1 t� l,.,Lf'1V 4✓`��f f 4� i. Q g "050N4 TUBE Z PLY. 2X2'FOOT/N6 -�~ IL p UNDER. i,T 7 `13f r3wi_: i=C) i Q J0/5 T5 r 11 11 r n/ gA ,II�V Vf l GC,Ji U EXI5TIN6 W • : .. 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