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Home My WebLink About42569-Z �Q��,uFFat,�CpG� Town of Southold 4/26/2018 3 P.O.Box 1179 0 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39614 Date: 4/26/2018 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 4105 Deep Hole Dr, Mattituck SCTM#: 473889 Sec/Block/Lot: 115.-16-23 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/6/2018 pursuant to which Building Permit No. 42569 dated 4/13/2018 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"ADDITIONS AND ALTERATIONS INCLUDING REAR DECK, FRONT ENTRY AND BILCO DOOR, TO AN EXISTING ONE FAMILY DWELLING, AS APPLIED FOR The certificate is issued to Doherty,Peter of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ut o ' ed Signature gOfEO(,� TOWN OF SOUTHOLD BUILDING DEPARTMENT y. TOWN CLERK'S OFFICE 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#: 42569 Date: 4/13/2018 Permission is hereby granted to: Doherty, Peter PO BOX 644 New Suffolk, NY 11956 To: legalize "as built" additions and alterations to existing single-family dwelling as applied for. Additional certification may be required. At premises located at: 4105 Deep Hole Dr SCTM # 473889 Sec/Block/Lot# 115.-16-23 Pursuant to application dated 4/6/2018 and approved by the Building Inspector. To expire on 10/13/2019. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $752.00 CO -ADDITION TO DWELLING $50.00 Total: $802.00 Building nspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 f 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:ith accurate location of all buildings,property lines streets,and unusual natural or 1. Final survey of property w ,p perry 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$15.00 a Date. New Construction: Old or Pre-existing Building: (check one) —4-! 0 5 �,Ff�_ No-6 c/2Hamlet House No. E�1� r-� 7-UG lC Location of Property: Street J-- Owner or Owners of Property: Suffolk County Tax Map No 1000,Section J Block ` Lot �S Subdivision Filed Map. Lot: / Permit No. 2 � Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: AAp heck one Fee Submitted:$ Signature Y *OF 30 # TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] SOLATION&�#- QeC� [ ] FRAMING /STRAPPING [ FINAL h [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: fAinq IiAi ,monk- Q4'lkl bCU� Ktl FEY DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) -------------------------------- 'FOUNDATION (2ND) z - o ROUGH FRAMING& y PLUMBING INSULATION PER N. Y. *� STATE ENERGY CODE l8rdL µ Q FINAL ' 1 ADDITIONAL COMMENTS t z � o � z d 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 61 Survey Southoldtownny.gov PERMIT NO. ll Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application r� Flood Permit Examined 20� Single&Separate Truss Identification Form Stone-Water Assessment Form ( Contact: (� Approved ,20 ( � Mail to: 4 4)f K 0 C& 7-4— Disapproved a/c Phone: �3 j Expiration ,20 D [EQUIVEBuil pector DICATION FOR BUILDING PERMIT APA ® � 2016 Date AfOp , 20 BUELDINGD� , INSTRUCTIONS a. This a i9Y1VW ®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 applicant) State whether applicant is,owner, lessee, agent, chitect; gineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax r 1 or latest deed) If applicant is a corporation, signature of duly authorized officer t (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location®�d o��ch proposed work will��v � � ^vG� House Number Street Harglet County Tax Map No. 1000 Section Block 16 Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and ' tended use and occupancy of proposed construction: a. Existing use and occupancy �/Aj&4✓ E— b. Intended use and occupancy A S—�3v 3. Nature of work (check which applicable): New Building Addition Alteration�Lryecf Repair Removal Demolition Other Work fj/L 6 (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, 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:6f,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 tZ 4- 6 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ✓` 13. Will lot be re-graded? YES NO_VWill excess fill be removed from premises? YES X NO 14. Names of Owner of premises 2 Address Phone No. - 6�3 3 .2 0 Name of Architect 5 C �C,yAAzT Address Phone No ®�/ 7 Name of Contractor 7'—i�:&2je to Address Phone No. ' T 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 MAYQUIRED. 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 S'Ufro-Lill LF6—' y1K7/ being duly sworn, deposes and says that(s)he is the applicant (Name of individual signin contract)above named, OONNIE D. 12UNCH Notary Public,State of Nov York (S)He is the ,ri Qualified fied in Suffol61 k Ceun (Contract ,Agen , Corporate Officer, etc.) Commission Expires April 14,Z ' 01r 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 me this 3 day of ' 2018 YN14L . tAA Notary Public Si a re of Applicant ci �o2gor40'40"E !30.00' 105 103 ppa - p180' IC 4.9' cc T LOT 51 G&WE n SV. wr 32 24' 104 Lrn bD Pi r �1S•�V 11.T �''9�°�� - - �SriT - �1 59.2' iv 1 STY. 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