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41846-Z
%,afFGj1r Town of Southold 8/4/2017 P.O.Box 1179 a co 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39106 Date: 8/3/2017 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1300 Park View Ln. Orient SCTM#: 473889 Sec/Block/Lot: 15.-5-24.22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/20/2017 pursuant to which Building Permit No. 41846 dated 7/27/2017 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"PORCH AND DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Fitzpatrick,George of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 2075207 05-26-2006 PLUMBERS CERTIFICATION DATED t r ed Signature SUFFnt,��, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy • SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET;QF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 41846 Date: 7/27/2017 Permission is hereby granted to: Fitzpatrick, George 1300 Park View Ln Orient, NY 11957 To: legalize "as built" additions and alterations as applied for. At premises located at: 1300 Park View Ln. Orient SCTM # 473889 Sec/Block/Lot# 15.-5-24.22 Pursuant to application dated 7/20/2017 and approved by the Building Inspector. To expire on 1/26/2019. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $462.40 CO -ADDITION TO DWELLING $50.00 Total: $512.40 Building 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. 15 X_a_Vky Zo 17 New Construction: Old or Pre-existing Building: � (check one) Location of Property: 1,300 �Aiye_ V i f=,1i L„+J c Del E1J'- House No. Street Hamlet Owner or Owners of Property: &F_b2C;E D4J A F'i-3.DAT12.1CJe- CP Suffolk County Tax Map No 1000, Section f Block s —Lot-24-.2-2— Subdivision ot24-.:Z2Subdivision OP-164'r S tel 'THC s64 Filed Map. 616 O Lot: 170 Permit No. gq Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:. (check one) Fee Submitted: $ A licant Signature top o L��nLI�I�C�C��nL�t�Lnc.raL r�n�nf�f1Ll�f 12 IC IAC I�GrCn�n�Ll��n�f�����n�n�n�L", :,nE nCI�L�tPLPL -prjCifuLpLL3pLrL ��.n�.n�L�L n0 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 K BOARD OF FIRE UNDERWRITERS 5 5 NEW YORK S 5 BUREAU OF ELECTRICITY S 5 2 Z 40 FULTON STREET - NEW YORK, NY 10038 S S5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by S S 5 5 DANIEL WILCENSKI ELEC.CONTR. MR FITZPATRICK 5 5 LANE SOUT OLD,,NY 11971, ORIENT,9 1300 1 PARKVIEW577 555 SLocated at1300 PARKVIEW LANE ORIENT, NY 11957 5 5 5 5 S Application Number: 2075207 Certificate Number: 2075207 S c rj Section: Block: Lot: Building Permit: 31302 BDC: ns11 5 55 5 Described as a Residential 0-599 square ft. occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 First 5 Floor,Outside,Porch/Deck, 5 5 ej A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance, with the requirements of the applicable code and/or standard 5 Spromulgated 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 26th Day of May,2006. 5 Name QTY Rate Ratio Circuit Type 5 5 Miscellaneous 5 family room&deck S 5 Wiring and Devices 5 5 Outlet 10 0 General Purpose 5 Receptacle 8 0 General Purpose 5 5 Switch 3 0 General Purpose 5 SReceptacle 1 0 GFCI 5 5 Paddle Fan 3 0 5 5 5 5 5 S 5 S 5 5 5 5 5 5 seal 55 5 1 of I �5+ SThis certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 S 5 o �9E�6E�����LPLPrPLPLPLPLPLP� o v � OF SOUjy� coutom,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ])NSULATION r [ ] FRAMING /STRAPPING [ FINAL /7 [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: Coro DATE INSPECTOR � E ti FIELD INSPECTION REPORT I DATE COMMENTS �d FOUNDATION(1ST) Ell, -------------------------------------- FOUNDATION -----------------------------------FOUNDATION (2ND) l�7 z o e ROUGH FRAMING& PLUMBING 5 V r INSULATION PER N.Y. STATE ENERGY CODE FINAL i ADDITIONAL COMMENTS C� Z rA z x d b y AS- oil 1-7-. TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do youJhave or need-the following,before applying? TOWN HALL Board of Health I 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. l�� Check Septic Form I N.Y.S.D.E.C. Trustees j V � DD C.O.Application Flood Permit D �C�Uj Examined ,20 Single&Separate JUL 2 0 2017 Storm-Water Assessment Form Contact: p p UD Approved ,20 BLM DING DE" Mail to: R 0. S 577 Disapproved a/c 'r(�7Bui Phone:_ Expiration ,201 ,r/ 3j ' Q3/i, q 740 Inspector APPLICATION FOR BUILDING PERMIT i1 Date JS`t J! , 20 1+7 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 bommenced 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 shal l 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 Insp�ctor may authorize, in writing,the extension of,I he permit for an addition six months. Thereafter, a new permit shall be requited. 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. ignature of applicant or nari�e,if a corporation) �� 17��. So�r�tvc.'o �• _I f 91 (Mailing address of applicant) State whether applicant is owner, lessee, agen architect, ngineer, general contractor, electrician, p umber or builder I i i ' Name of owner of premisesQ�r,r-E baJ qlT-2ep ic_k_ (As on the fax 49 latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) I Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on whichroposed-work will be done: 3010 �,P&Le= V �j LAS OP-1 r.0-r I House Number- - Street Hamlet County Tax Map No. 1000 Section S- `i '';Blo`cks '"' Lot 24.21 :' '}' _ ft,_CA ;n.,- Subdivision 1O 12.1913-r 8W j—H6 SF-p Filed Map No. 616® Lot y'70 I { I 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S I Q 4 L r2�jP''I�1 byj cL.I J b. Intended use and occupancy S i J SLS t Frw1 I�m bo lE L L I kJ Cr 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition. i �, a;'I `O ier�W=orlc�� 45-&) — ?5` ,. ;.; ! (Description) 4. Estimated Cost $Fee s,ffi i £(; sA r° Tb be�A"n filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor iJ If garage, number of cars I 6. If business, commercial or mixed occupancy, specify riaattiie"" fitl'extehtd4'each1type of use. Art 7. Dimensions of existing structures, if any: Front -716, 3 Rear 176_:3 Depth 37. 27.5 i Height 2.6 0-" Number of Stories -flJo Dimensions of same structure with alterations or additions: Front 'IA . 3 Rear 76.3 Depth 37 27S- Height Zb Number of Stories 7Twt-,' e a 8. Dimensions of entire new Qonstruction: Front D- �$ Rear .? -S�g- Depth 1 72 Height /2 -7 Number of Stories 00C 5,�t91I�T �19G -te l ��pInoA Q®ift, It AS-BUILT 9. Size of lot: Front 219 . 00 r Rear '2.16-, 44' Depth 11 '75,S3 227-2cl ZEA AM InOJ I 263 10. Date of PurchaseAbo /0, 2, Name of Former Owner Sc IDRICJ rT 11. Zone or use district in which premises are situated Q—'-© I i 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? Y Gboec'a 4 ap',ll- i3o© PPIL ib6d L,4JG 14. Names of Owner of premises ,rTaie-Ic._ Address 021€4•H Phone No. Name of Architect iJrc6L I ogir-r 4A Address Phone No 631.634,974o Name of Contractor Address E Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO D _ * 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. l 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. i 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,S&I )- ..II 015'CL. QoB� W 1(.I.H ZoL being duly sworn, deposes and says that�^e is the applicant (Name of individual signing contract)above named, /)He is the A Gc d t- I (Contractor,Agent, Corporate Officer, etc.) { of said owner or owners, and is duly authorized to perform or have performed the s 'd 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. Swor to before me this day of 20 1 7 I I Notary Plubli TRACEY L. DWER at e of Applicant NOTARY PUBLIC,STATE OF NEW YOR I NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY { COMMISSION EXPIRES JUNE 30,2 Scott A. Russell s°SU I ]F01K1\M1 A,`]F1E1K SUPERVISOR � IM A\1NAG IEM[]EN F SOUTHOLD TOWN HALL-P.O.Box 1179 d 53095 Main Road-SOUTHOLD,NEW YORK 11971 �O Town of So u th o l d CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT T IINVO LV E ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ❑ 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. ❑® C. 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. El E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑ 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. APPLICANT (Property Owner,Design Professional,Agent Contractor,Other) S.C.T.M. '°: 1000 Date yx, I n Distract NAME NAME IV IGrCL f6ft " 1JILLL,4msod R•a• j 6- 24,22 Alp I'll Section Block Lot ""631. 834-9-740 �'g ® FOR BUILDING DI'P. R-r'VlEN"(_ (,Sr 0-NL •"• Contact Information 631, 834-9 /-y'A ice® �r<iya,o�.Wmhcn Reviewed By: AaAw 1�1� - - — — — — — — — — — — — — — — — — ate. oy�A""o—' ,� Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — i�l�I� �,> Approved for processing Building Permit ®® � �G Stormwater Management Control Plan Not Required. aIIro•T, N 1957 ❑ Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 LOT i6 I SURVEY OF N 88'26'-00" E P1 7T55 'A0 LST 170 j 50,25' 1 �, o MAP OF " ORTE,-NT BY - TRE SEA 11 o SECTION TVR EE 1 FILE No. 6160 FILED OCT013F-R 1-6, 1974 SITUATED AT Z 1 ORII ANT 1' TOWN OF SOUTHOLD E o LOT ?O 1 r SUFFOLK OOU-NTY, . N'EW -YORK S.C. TAX •Alp. 1000-t5-05-24.22 1 - SCALE 1 -d,fARCH 2-1, 2004 `r—co AREA = 41,923 stj. ft. 0.952 ac. .5 Y • at . _ Cpl _� - _ o. -• l _ j __ _�a �: -- Z2 � :•$ .- � � i1� - \ .f.(RIEIb WOOD 5trdtE ' a _ u . _• PREPARED K,AACQREIA 4Ct iR[W TW.MIF{-WM \ _�. _ Si'ANOAFM FOR TME SURVEYS A$ IZMA �iS�!)rtI l�(� \ i \ += BY THE L-lAL.S. AND APPRpvED AND tom- j' � SUCH Mar n� NEW YORK Laid " .� ` \ .218• TULE A&WVATHIN. of NE '• cam' _ �. 'CPF G`p,Q Q� co to /0N �dP'� a r t- "� t�"� � i � YYY a • - A N_Y-S, lic. No. 50467 I `� �•4P�'• Lip i UNAUiNORIZED ALTERATJON OR.AQENTION _ NQ . �� ;1,���1�'�.• .• � � FO TSS SURVEY lS A V}OLAT70FJ OF - O Y � �/ S�CTION'9209 QF 'IHE N1rW YQRIC STATE �6>t O •.S 6oj ���!!1 EDUCATIOSQ LAW_ COPIES OF TfRS SURVEY MAP NOT BEARING man Ta "a rwin Nath ft %.00 41 :.s THE. AND SURVEYOR'S INKED SEAL OR DAOOS�ED SEAL SHALL NOT 13E CON$�!DERED pp » TO VALID TRUE COPY. 1.,. cin Siff _ ' spy �'3O COUWICATIONS WOICATER HEREON SHALL RUN ONLY TO HE AND 14 HSS BES IS R 0 TW TtliE COMPANY• GOVEIUAkNTAL WANrY AND LENT} _INSTITUTION LSiEU- NOEON.,AND - + TO THE ASSIGNEES OF THE C.EPID TR I10E 9 9 2 -1\o.o n o k e Ave!_u e l` TUTION. CERTiFFCAT'IONS ARE NOT TRANSFERABLE_ THE EXISTENCE OF RIGHTS of WAY Riverhead , New York 11-9:01 AND-/OR EASEMENTS OF RECORD; IFPHONE & FAX (631 )369-.5473 AMY. NOT SHOWN ARE NOT GUARANTEED. FTTZPATRTC K AP -OVED AS NOTED V11-H-1 ALL CODES OF NEVNI Yt�l„ !d� - & -i-GV�Ie� CODES DATE:— Z .l� .P AS REQUIRES � ��, � L 10 1 � BY-- �,, LU I 11 L NOTIFY BUILDINGI DEPARTMENT ATSn� �nARD 765-1302 a AM TO 4 P?di FOR THE FALLOWING INSPECTIONS: _ S,)i,—)l rj.,, IijV'I` 3 I..ES 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUSTa� PACY OR BE COMPLETE FOR C.O. 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