HomeMy WebLinkAbout41825-Z �t1FFD(���G Town of Southold 7/25/2017
P.O.Box 1179
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53095 Main Rd
®� �p Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39075 Date: 7/25/2017
THIS CERTIFIES that the building OTHER
Location of Property: 105 Hill Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 70.-4-33
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/14/2017 pursuant to which Building Permit No. 41825 dated 7/19'/2017
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"outdoor shower and outside kitchen area as applied for.
The certificate is issued to O'Connor,Mary
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41825 7/14/2007
PLUMBERS CERTIFICATION DATED
ut ed Signature
�gvFFQ��c TOWN OF SOUTHOLD
o�y BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy • SOUTHOLD, NY
dol � Sao
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#: 41825 Date: 7/19/2017
Permission is hereby granted to:
O'Connor, Mary
259 Connectquot Rd
Bayport, NY 11705
To: legalize "as built" outdoor shower and outside kitchen area as applied for.
At premises located at:
105 Hill Rd, Southold
SCTM # 473889
Sec/Block/Lot# 70.-4-33
Pursuant to application dated 7/14/2017 and approved by the Building Inspector.
To expire on 1/18/2019.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO -ADDITION TO DWELLING $50.00
Total: $250.00
Buil g Inspector
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- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Date. July 12,2017
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: 105 Hill Road
p
House No. Street Hamlet
Owner or Owners of Property: Mary O'Connor
Suffolk County Tax Map No 1000, Section 070.00 Block 04.00 Lot 033.000
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: Yn (check one
Fee Submitted: $ 50.00
CIS plica t Si na
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 Budding Plans
TEL:(631)765-1802 Planning Board approval
FAX:(631)765-9502 f Survey
Southoldtownny.gov PERMIT NO. IL Check
Septic Form
MYSDEC.
Trustees
C.0
C.O Application
ItUFlood Permit
Examined -1 . I _R® Single&Separate
Truss Identification Form
JUL13 2017 Storm-Water Assessment Form
Contact: //��
Approved 21 Mail toD '� s "(:O s
Disapproved a/c Uaa DING r.M
To"OF SOL i HO D Phone. ` O I
Expiration I Iq 20
Buil(Yinctor
APPLICATION FOR BUILDING PERMIT
Date July 12 20 17
- 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 desenbed.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
Agent
Name of owner of premises Mary O'Connor
(As on the tax roll or latest deed)
If applicant is a corporation,signature of duly authonzed 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: { n �j
105 Hill Road 0 L`t'�G'
House Number Street Hamlet
County Tax Map No. 1000 Section 070.00 Block 04.00 Lot 033.000
Subdivision Filed Map No. Lot
s
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 outdoor shower and outdoor kitchen with electric 5 A
3. Nature of work(check which applicable):New Building Addition Alteration X &) 0-�
Repair Removal Demolition Other Work1—x ;+Cy ^,IX�Y ' ," AT
escription) �l
4. Estimated Cost Fee $200.00
(To be paid on tiling 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?YES NO X
13.Will lot be re-graded?YES_NO X Will excess fill be removed from premises?YES_NO X
Ma O'Connor 96 South Ocean Avenue,Patchogue,NY 11772 631-447-8100(do Vincent Candurra)
14.Names of Owner of premises Mary onnor 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)
S
COUNTY OF
I 8 being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)abo amed, TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
(S)He is the Agent 6306900
(Contra or,Agent,)orporate Officer,etc) QUALIFIED IN SUFFOLK COUNTY
of said owner or owners,and is duly authorized to perform or have performed the said work and to make annd i eltlisisOapp i i ib1�S JUNE 30.2
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 thi .�
day of 1, L 20 cc
17�j ti A 0 2 �j
otary Public Signa of i
Certificate of Compliance
. . .. ............ ............................................................... .... ..................................................................
CERTIFIED ELECTRICAL INSPECTIONS, INC.
188 PARK AVENUE
AMITYVILLE, NY 11701
P: (631) 598-5610
. ........................................................................... . . ...................................... .......... .... .......
CERTIFIES THAT
Upon the application of Upon premises owned by
Mary O'Connor Mary O'Connor
105 Hill Road 105 Hill Road
Southold, NY 11971 Southold, NY 11971
Located at: 105 Hill Road,
Southold, NY 11971
Application Number#: 17-44802 Certificate#: 17-44802
Electrical License#:
Section: Block: Lot: Building Permit#:
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Exterior Kitchen
A visual inspection of the premises electrical system, limited to electrical devices and wiring to
the extent detailed herein, was conducted in accordance with the requirements of the applicable
code/or standard promulgated by the State of New York, Department of State Code Enforcement
and Administration, or other authority having jurisdiction, and found to be in compliance therewith
on the 19th day of July 2017
Name QTY
Incand. Fixture - 15 Amp, 120V 1
GFI Receptacle - 15 Amp, 120 V 2
Switch - 15 Amp, 120V 2
Duplex Receptacle - 15 Amp, 120V 2
Branch Circuit-20 Amp, 120V 2
Electrical Inspector: Anthony Giordano •
VdCAL' Nz
...............
E§'APPROVED)j�
ozi
............
nD DD.
HL 2 5 200s certificate is not valid unless raised seal is present.
BUMIDMG DEFr-
TOWN OF SO OLD
\"°F SOU�o
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 QI COUNfiL � D [EC[EW[E
U
BUILDING DEPARTMENT JUL 14 2017
TOWN OF SOUTHOLD
B>iTILDINd DEPT.
TOWN Oil SOMMOLD
CERTIFICATION
Date:
Building Permit No. L[ 0^\�r
Owner: ' GA,(- 0' (�O r)fl Qr
lease print)
Plumber: M ct J �cc ��"'p✓
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
A/r-
(Plumbers Signature)
Sworn to before me this 1444-1
day of , 20 l�
�-P L
Notary Public, ��1 County
COt :�te BUNCH N "YOU
Notary Publicblic,.
No.01 BUS110-OW
Qualified in Suffolk CEOunty
Commission Expires April 14, ��
'-L 'g �Of SOUTy
�o� olo
o�'Y�OUM'1,0c�
TOWN OF SOUTHOLD BUILDING- DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ XFINAL
H PLEIG.
[ ] FOUNDATION 2ND [ ATION
[ ] FRAMING /STRAPPING [
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
tIc., r
61- CID —
tU A old. CA
DATE INSPECTOR
F -• i
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
H
-------------------------------------
FOUNDATION (2ND) t'
ROUGH FRAMING& g
PLUMBING
INSULATION PER N.Y. y
STATE ENERGY CODE
Qirldi 17-1
FINAL
ADDITIONAL COMMENTS C5
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AND/OR FASOJEMS OF RWORO IF TO TMS SURVEY IS A V/OLA?M OF
ANT,NDT SHOWN ARE NOT sECROH 7202 OF THE NEW Yo"57ATE
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fil e� 8900 Irf. DOPES OF THIS SLWVEY WW AW OFAMW
Premises ImoBR O5 THE`ANO&MVEYOR'S oTKED SFAI.OR
ICWBMM sex.SHALL NOT BE CONSIDERED
105 1Q1 Road,Sou%ald 0 eE A YA'D TRUE CWY.
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ONLY 70 ZIE PERSON Fan MNOH THE SURREY
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CO{lYONWF LTH LW 7W UMMU:f COMPANY
Southold
.,T%wn Qf -Sogtfold
Michael W, Minto, L.S.F.C. Suffolk County, 6w York
ucENSTb PR40FESSlQNAL LVJO SURVEYOR District 1000 Section 70 Block 4 Lot 33
NEW YORK STATE LICENSE NUMBER 050877
87 fPoodPie7r ,vane Scale 1"= 40' Surveyed May 31. 20 117
Centereach, N.Y. 21720 GRAPHIC SCALE
AHONE/FAX: (637) Seo-72402
CELLULAR: (e31) les-9774 i0 m +b so
EMAIL: mikemintolspcOgmOa.cam
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APPROVED AS NOT D ELECTRICAL
DATE: B.P.# INSPECTION REQUIRED
FEE: BY:
-NOTIFY BUILDING DEPART T AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TV40 REQUIRED RETAIN STORM WATER RUNOFF
FOR POURED CONCRETE PURSUANT TO CHAPTER 236
2. ROUGH - FRAMING & PLUMBING OF THE TOWN CODE.
3. INSULATION
4. FINAL - C0N37-' ,'.,TION MUST
BE COMPLETE f u R C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. PLUMER CER{TIFIE�TICJfV
F
(N_'L�EA`D--CONTENT BEFORE
CRR-T_IFICATE OF OCC!IP��rdCY
SOLDER USED IN ER
COMPLY WITH ALL CODES OF J SUPPLY SYSTEM! Cif"',��'j�+�T
NEW YORK STATE & TOWN CODE ECCEED 2/1� OF 1°!° LEAD.
AS REQUIRED AND CONDITIONS C
efl�iTNnl n TOWR BA
pwt1h4C�
�tL.PLUMBING WASTE
, -�.&WATER LINES NEED t;
T STII fa-gEFORIr,COV. RING
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT Q8TlF, QA,TE
OF OCCUPANCY
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