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�Og�FFQt�Cp Town of Southold 11/28/2017 O G 3� P.O.Box 1179 0 53095 Main Rd X4,1 o�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39359 Date: 11/28/2017 THIS CERTIFIES that the building HOT TUB Location of Property: 235 Azalea Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 115.-642 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/21/2017 pursuant to which Building Permit No. 41993 dated 9/27/2017 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: accessory hot tub with locking cover as applied for. The certificate is issued to Frohnhoefer III,Joseph&Erin of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41993 11/2/2017 PLUMBERS CERTIFICATION DATED U rized Signature o�guF ocK�oTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY �,k01 &y� 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#: 41993 Date: 9/27/2017 Permission is hereby granted to: Frohnhoefer III, Joseph 235 Azalea Rd Mattituck, NY 11952 To: install hot tub as applied for. At premises located at: 235 Azalea Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 115.-6-12 Pursuant to application dated 9/21/2017 and approved by the Building Inspector. To expire on 3/29/2019. Fees: SWIMMING POOLS -ABOVE-GROUND WITH REQUIRED FENCING $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Bjinnspector 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. Z / 7 New Construction: Old or Pre-existing Building: (check one) Location of Property: Z3 5 J Z 4,4 91) /19 S Z House No. Street Hamlet Owner or Owners of Property: OS 6'14 t L 17-1 Suffolk County Tax Map No 1000, Section 11-5 Block (9 6 Lot /z Subdivision Filed Map. Lot: Permit No. 4( q Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 5� w Applica t Si ature SO(/ry®l® Town Hall Annex Telephone(631)765-1802 54375 Main Road y Fax(631)765-9502 P.O.Box 1179G Southold,NY 11971-0959 polys � �o roger.richert(a�town.southold.ny.us ftnrry VuI®1%9 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Frohnhoefer Address: 235 Azalea Road city:Mattituck st: New York zip: 11952 Building Permit* 41993 Section: 115 Block: 6 Lot: 12 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: Home Owner DBA: License No: SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures 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 Fixtures Time Clocks Disconnect Switches Twist Lock LEI Exit Fixtures TVSS Other Equipment. GFCI Protected Power to Self Contained Hot Tub. Notes: Inspector Signature: / Date: November 2, 2017 0-Cert Electrical Compliance Formas OF SOUT,yo� ���UUNT1 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: 67 r—Ie_ load ?�"`-cam DATE lr INSPECTOR Al FIELD SPTMCoLa rq FOU'ND4tON,(ISI) FOUrrn�TZQ�, ROUGH FRAI, =C & FLUTaLI 'G Al • � I � TNSULATSON•PBA N.Y. , STATE BNEPd2 COmr, FINAL t idj z ni • , • . , ' I, • , ' , -411 I I 1 ' t 1 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 ZI Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20f Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved ,20 Mail to: Disapproved a/c Phone: Expiration ,20 D ���� V � Bu d ng ector PPLICATION FOR BUILDING PERMIT SEP 2 1 2017 Date z , 20 ;7 INSTRUCTIONS BUILDIN(; aTb4W& T be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate pop dale. 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 c e,an regulations, and to admit authorized inspectors on premises and in building for necessary inspections. G0 ik- ignatu of applicant o ame,if a corporation) Z3s 4?,LCCA CLD r7'1T-c Et .vf 11 `sS Z Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ®L-,-,/L,ZR Name of owner of premises D-5,te H + 2 i ti f-'r?0//tet,, BIZ (As on the tax roll or latest deed) If applicant is a corp'ora'tion,:sigrature of duly authorized officer (Name arid-'titl'e df 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: 23S 17-A SLA fLD -74 77-1 r-L, cn � .^�% I i %s L House Number Street Hamlet County Tax Map No. 1000 Section --S Block © 6 Lot I Subdivision 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 flit i 1)0--;-" C b. Intended use and occupancy Ri f tv/�—/-/d c 3. Nature of work (check which applicable):New Building dition Alteration Repair Removal DemolitionOther o r k Tc,-13 (Description) 4. Estimated Cost f/ZFee (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 !!!�I/•y 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. /v 7. Dimensions of existing structures, if any: Front N 1 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 :`' ; c:= 'Depth Height Number of Stories ''. i t 7 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner yI . H. Zone or use district in which premises are situated /7�1/h��riAC 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NOZS—Will excess fill be removed from premises? YES NO 14. Names of Owner of premises S rf tr,n ovy;r 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_�L * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and sV6rWiW.l`6dN&applicant (Name of individual signing contract)above named, Notary Public,State of New York No.OIBU6185050 (S)He is the Qual fled In Suffolk County (Contractor,Agent, Corporate Officer,etc.) Commission Expires Apni 14,�v 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 meth's day c 20 Notary Public Signat of Appl a I o��Of SO(/Tyol Town Hall Annex 7 R Telephon9 Y V,61 1WD 90�T OJ, 54375 Main Road COO (63 P.O.Box 1179 G @ roger.richertiown.soUtf7o nV us Southold,NY 11971-0959 �O 1qQum � We 8 Z d3S i BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION j REQUESTED BY: Date: �zx// 7 Company Name: J I Name: O env°/l nor tfaEr{/Z License No.: ► Address: Phone No.: 7,f' 5"1 Z i . JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: Z 3 S f?4t E-I I.10 ;meqLTi ,-�C ft % I V & *Cross Street: *Phone No.: �j / _ y 7fS - S tz V Permit No.: c f ��9J I Tax Map District: 4000 Section: s _ Block: ( Lot / Z *BRIEF DESCRIPTION OF WORK(Please Print Clearly) Yo 7_7-<-, /3 (Please Circle All That Apply) Is job ready for inspection: YES 1 NO Rough In Final *Do-you need a Temp Certificate: YES -! NO - Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect, Underground Number of Meters Change of Service Overhead # Additional Information: PAYMENT DUE WITH APPLICATION I - 82-Request for Inspection Form - I SURVEY OF LOT 9 & P/0 LOT 10 MAP OF SUBDIVISION FOR MATTITUCK ESTATES , INC FENCE FILE No. 4453 FILED SEPTEMBER 8, 1965 0 W s SITUATE MATTITUCK �'' TOWN OF SOUTHOLD ►� LO ,°�� SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000- 115-06- 12. — SCALE 1 "=30' z - NOVEMBER 8, 2012 QO �o��`°oa tiFoc�� AREA = 34,679 sq. ft. OoGk 0.796 a c. `S \ � < /\o Q� O \ T G \y J\ M 001, OJ5 43' ry�� \ loci G c ° ° °d `9� c 1 0, ks �o - — - — of o \ \ / .°° BOO• / J�QG� °. ° ° ° - d e ee PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED ° BY THE L I A.L.S. AND APPROVED AND ADOPTED �cr FOR SUCH USE BY THE NEW YORK STATE LAND OP TITLE ASSOCIATION. 00, a61 Lic. No 50467 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF Nathan Taft Corwin III SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW Land Surveyor , COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isaksen, Jr. L.S. ONLY TO THEPERSON FOR WHOM THE SURVEY Joseph A. Ingegno L S. IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI— PHONE (631)727-2090 Fax (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 32-238 APPRO ED AS NOTED ELECTRICAL DATE: .P.# INSPECTION REQUIRED FEE: v BY: NOTIFY BUiL.';_ DFP i 7;T AT 765-1802 8 AMI TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED ( nNCRETE 2. ROUGH - FR;,.' " . PLUMBING . FINAL 4 ' RETAIN STORM WATER RUNOFF 4. FINAL - • t MUST BE COM: PURSUANT TO CHAPTER 236 - � t,.w`. ALL CONST SHALL MEET THE OF THE TOWN CODE. REQUIREMEN; i. THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SOl�t16tB�'8G11�Pt�i�ldifd&@9A� S6tiT�iOCD-T�PN'1TIdS�F{€S. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE 0F OCCUPANCY ., ,'. A ^.-P------"------1•n•-- �;�__....1----- -.,�._.,.—,.-fir._-•t�'--�_, -,C' {If , 6 4 6' r � PAM 1"TIO, F--E-AIU-.R-, SPECIF.I. 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