HomeMy WebLinkAbout42935-Z ��q\O�UFFOI�c Town of Southold 5/3/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40321 Date: 4/15/2019
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 360 Bayer Rd., Mattituck
SCTM#: 473889 Sec/Block/Lot: 139.-3-22
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/6/2018 pursuant to which Building Permit No. 42935 dated 8/13/2018
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:
gas fired furnace, water heater and windows as applied for.
The certificate is issued to Keegan,Jennifer
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42935 8/22/2018
PLUMBERS CERTIFICATION DATED
A th ed Signature
gVF - TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
`oma • 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#: 42935 Date: 8/13/2018
Permission is hereby granted to:
Keegan, Jennifer
33 Bruce Ln N
Kings Park, NY 11754
To: install a gas-fired water heater.
At premises located at:
360 Bayer Rd., Mattituck
SCTM # 473889
Sec/Block/Lot# 139.-3-22
Pursuant to application dated 8/6/2018 and approved by the Building Inspector.
To expire on 2/12/2020.
Fees:
SINGLE FAMILY DWELLIN OR ALTERATION $200.00
O -ALTERATIO TO DWELLING $50.00
ZTota : $250.00
Building Inspector
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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 the4ollowing:
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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).
Y 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 $15.000
Date. y— ( /9
New Construction: Old or Pre-existing'Building: (check one)
Location of Property: 3 Ko 46
Rd
House No. Street Hamlet
JOwner or Owners of Property: en n s4 e L d* l�/'r ru /
Suffolk County Tax Map No 1000, Section l Block Lot 2--2—
Subdivision
-2Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
r'
J
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ r
,-Pe- ,
Applicant Signature
i
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G
Southold,NY 11971-0959 ® roper.richert(,@-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Jennifer Keegan
Address: 360 Bayer Rd City: Mattituck St: New York Zip: 11952
Building Permit#• 42935 Section- 139 Block: 3 Lot. 22
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built/pre co DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat gas Duplec Recpt Ceding 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 11 Twist Lock Exit Fixtures TVSS
Other Equipment: 42935, install new gas furnace
Notes: "AS BUILT' "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
main electrical panel,Romexwiring in basement
Inspector Signature: (6 Date: August 22 2018
81-Cert Electrical Compliance Form
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST) H
------------------------------------
'FOUNDATION (2ND) VIA
O
ROUGH FRAMING& AH
PLUMBING
INSULATION PER N.Y: y
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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La6 Yc)� r�
IF-16-11 o
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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 Suryey
South oldtownny.gov PERMIT NO. �� Check
Septic Form
N.Y.S.D.E.C.-
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact: °
Approved ,20Mail-to:)0? S` '✓
Disapproved a/c AUG v 6 2018 3� & V e-ee C41 ,/
fpr. Phone: ,V
Expiration 20 T
ddit Ins ecto
APPLICATION FOR BUILDING
Date ,c�`—' �� ' , 20 f�
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
steal I 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, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
(As on the tax `roll or latest deed)
If applicant is a corporation, signature of duly authorized 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 pro/pos]ed/�/work will be d''"%ie:
House Number Street // z _; ' ' f Hamlet
Count Tax Ma No. 1000 t
County p Section � Block /'�x�'` � Lot �'�
Subdivision FiledMap No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
Qb-; Intended use and occupancy,
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work C-106 f
(Description)
4-Estimated Cost _ Fee
(To be paid on filing this application)
If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
..� :W
f� '
If business, commercial or mixed occupancy, s�Edir nature and excel-it ach type of use.
t� -
/7! Dimensions of existing structures, if any: Front 'Rear Depth
Height Number of Stories
Dimensions of same structure with alteration436 additions,.� ,ronRear
Depth Height Number of Stories
�. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories' .
/9. Size of lot: Front_` Rear Depth
'Date of Purchase Name of Former Owner
14--'Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES 'N0.
13. Will lot be re-graded? YES NO ZWill_excess fill be removed.from.premises? YES NO• r/
lle
es of Owner of premises Address Phone No.
of Architect _ ___ Address- _ Phone No
Name of Contractor Address Phone No.
15. . Is this property within 100 feet of a tidal wetland or a freshwater"wetland? *YES NO
F YES, SOUTHOLD TOWN TRUSTEES'&D.E.C: PERMITS MAYBE QUIRBD.
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.
r
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY._
STATE OF NEW YORK)
COUNTY OF�.
Kan being duly sworn,deposes and says that(s)he is the applicant
(Name of individbaP signing contract)above named,
(S)He is the DLx)r)ec
(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.
Sworn to before me this NES
day of 2018
,����,�G•SO�y69 O KGp 30 ,
Notary Iyubl' aMw�SoN�XP Signature of Applicant
- 00
6 C
q
yJgL,DING DEPARTMENT- Electrical Inspector
p L� TOWN OF SOUTHOLD
n Hall Annex - 54375 Main Road - PO Box 1179
_etjA
dO Southold, New York 11971-0959
o o �� hone (631) 765-1802 - FAX (631) 765-9502
d1 � '� ,,-U010 roger.richertCccDtown.southoId.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: - - -- - Date:
Company Name:
Name:
License No.: email:
Address: i
V 1)
Phone No.: .
JOB SITE INFORMATION: (All Information Required)
Name: jplmVin, � +�
Address: ® /t-c
Cross Street:
Phone No.: �--
Bldg.Permit#: email: A) Y®(/.C/i
Tax Map District: 1000 Section: �._ Block: 3 Lot:
BRIE DESCRIPTION OF WORK (Please Forint Clearly)
Circle All at Apply:
Is job ready for inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES / NO, Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect-Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT-DUE WITH APPLICATION tp
Ad
Request for Inspection Fonn.xis �
APPR VED ASNOI ED
DATE:, M3 B.P. 3s�
COMPLY WITH ALL CODES OF
NtO�TiIY — ,- NEW YORK STATE & TOWN CODES
BUILDING DEPARTMENT AT AS REQUIRED GN9OF
765-1802 8 AM TO 4 PM FOR THE SOID DTOINNZ�A
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED SQLgRoLD;=k,1alpllaCaB0ARD
FOR POURED CONCRETE
2. ROUGH - FRAMING PLUMBING Sopa-D�TRUSTEES
3. INSULATION N. D
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.Q.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
OOR
CCUPANCY
USE IS ULAFUL
ITIiOUT CERTIFICATE
F OCCUPANCY
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Specifications
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14" 245
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• Specifications and dimensions are
Conversion Kit: Natural to LP subject to change without notice.
• Net AHRI Water Ratings shown
3. ii'l based on piping and pickup
allowance of 1.15.
• Consult manufacturer before
Advantage Gas Series Conversion Kit selecting boiler for installations
104390-01 (all sizes),Natural Gas-I-P Gas having unusual piping and pickup
Constructed and tested in accordance with ASME Boiler Code,Section IV. requirements,such as intermittent
A limited lifetime warranty is provided for the cast iron heat exchanger. system operation,extensive piping
systems,etc.
AMR I CERTIFIED
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LEFT SIDE VIEW FRONT VIEW
31.58 A!
VENT 27.60
DAMPER LIMIT SENSOR & WE
SAFETY R VE
SAFETY RELIEF
VALVE PIPING
TEMPERATURE/ Model A B
(BY OTHERS) 0 PRESSURE GAUGE REM —HYDROSTAT 3200 AG3 12N 642°
BLOCKED SUPPLY PIPING
VENT SWITCH 0o (BY OTHERS) ArA 1540° 730'
\e A65 1847' 923•
.0 O� J–BOX --HONEYWELL S8610M AG6 21.53" 1036'
3 4 0 0
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2F84
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C'4 20 60 n (BY OTHERS) AS VALVE
c6 U � DRAIN VALVE ae
(LESS FRONT DOOR)
ADIANTAGE pureproproducts.com PPRH37/2000/12-15 40mblo
CAST IRON BOILERS
8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721204 Perma-Shield®Gliding Window Sash
Anderw"'f0swse-DO fis.in
sen® PARTS STORE
Perma-Shield@ Gliding Window Operating Sash 1721204
Part Number: 1721204
Works With:
Perma-Shield®Gliding Windows
Color: White
$699.52
For an installation quote check here to
be contacted by phone 0
ADD TO CART SHARE
DESCRIPTION
Replacement operating sash for Perma-Shield®gliding windows
For units manufactured from 1971 to 1992
Size G33 -Visible glass dimensions are 14 inches wide by 29 3/8 inches high
White
Left Hand
Locking hardware is applied to replacement operating sash
+ SPECIFICATIONS
RELATEDITEMS
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8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721204 Perma-Shield®Gliding Window Sash
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Perma-Shield®Gliding Window
Stationary Sash 1720204
$577.02
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Stationary Sash 1720204
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8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721204 Perma-Shield®Gliding Window Sash
WINDOWS.DOONS
Andersen® PARTS STORE
Perma-Shield@ Gliding Window Operating Sash 1721204
Part Number: 1721204
r.- Works With:
n Perma-Shield®Gliding Windows
Color: White
$699.52
0 For an installation quote check here to be
contacted by phone
ADD TO CART
SHARE
+ DESCRIPTION
— SPECIFICATIONS
DETAILS
Product Line: Perma-Shield®Gliding Windows Unit Number 8.Size: G33
Handing: Left
DIMENSIONS(IN INCHES)
Overall Width: 17 1/2 Overall Height: 32 7/8
Visible Glass Width: 14 Visible Glass Height: 29 3/8 `
D ITEMS
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https://parts.andersenwindows.com/detad_1721204 w psgw_sash.htmi 112
8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721204 Perma-Shield®Gliding Window Sash
WINDOWS11100 RS
Andersen. PARTS STORE
Perma-Shield@ Gliding Window Operating Sash 1721204
Part Number: 1721204
Works With:
n Perma-Shield®Gliding Windows
Color: White
jmftr,-,� i IW ) ' 'COW1 F1
$699.52
❑ For an installation quote check here to
be contacted by phone
ADD TO CART SHARE
- - � ____SAVE emeii
— DESCRIPTION
Replacement operating sash for Perma-Shield®gliding windows
For units manufactured from 1971 to 1992
Size G33 -Visible glass dimensions are 14 inches wide by 29 3/8 inches high
White
Left Hand
Locking hardware is applied to replacement operating sash
+ SPECIFICATIONS
RELATEDITEMS
e
https://parts.andersenwindows.com/detail-1721204_w_psgw sash.html 1/2
8/6/2018 Perma-Shield®Gliding Window Stationary Sash 1720220 Perma-Shield@ Gliding Window Sash
WINDOWS*DOORS L-i.
Andersen® PARTS STORE
Perma-Shield@ Gliding Window Stationary Sash 1720220
Part Number: 1720220
Works With:
€ Perma-Shield®Gliding Windows
Color: White
17
p')t:
$773.42
a.., Q For an installation quote check here to be
contacted by phone
ADC TO CART SHARE iw_� `l_ ema11
- DESCRIPTION
Replacement stationary sash for Perma-Shield®gliding windows
For units manufactured from 1971 to 1992
Size G44 -Visible glass dimensions are 20 inches wide by 41 3/8 inches high
White
- + SPECIFICATIONS
i
https://parts.andersenwindows.com/detail_l720220_w_psgw sash.html 1/1
8/6/2018 Perma-Shield@ Gliding Window Operating Sash 1721236 Perma-Shield®Gliding Window Sash
W11DOWS•DOO RS -
Andersen® PARTS STORE
Perma-Shield@ Gliding Window Operating Sash 1721236
Part Number: 1721236
s' Works With:
+= Perma-Shield®Gliding Windows
.1..... Color: White
L $1,294.78
O For an installation quote check here to
be contacted by phone
1 A®®TO CART �. ._sZE email
SHARE
— DESCRIPTION
9
Replacement operating sash for Perma-Shield®gliding windows
For units manufactured from 1971 to 1992
Size G65-Visible glass dimensions are 32 inches wide by 53 3/8 inches high
White -
Left Hand
Locking hardware is applied to replacement operating sash
+ SPECIFICATIONS
https:Bparts.andersenwindows.com/detail_1721236_w psgw_sash.html 1/1
8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721216 Perma-Shield®Gliding Window Sash
WINDOWSID002S
L A
Andersen® PARTS STORE
mmm
Perma-Shield®Gliding Window Operating Sash 1721216
Part Number: 1721216
- d
Works With:
Perma-Shield®Gliding Windows
Color: White
n
$997.05
C3 For an installation quote check here to be
Aft
contacted by phone XF
ADD TO CART
SHARE m_ mai1
+ DESCRIPTION
SPECIFICATIONS
DETAILS
Product Line: Perma-Shield®Gilding,Windows Unit Number&Size: G536
Handling: Left
DIMENSIONS(IN INCHES)
Overall Width. 29 1/2 Overall Height: 38 7/8
JVisible Glass Width: 26 Visible Glass Height: 35 3/8
hftps:Hparts.andersenwindows.com/detail-1721216_w_psgv _sash.html 111
8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721216 Perma-Shield®Gliding Window Sash
WINDOWS-DOORS �
Andersen® PARTS STORE
Perma-Shield®Gliding Window Operating Sash 1721216
Part (dumber: 1721216
" Works With:
Perma-Shield®Gliding Windows
Color: White
fi ; ;F,l;l•
S!
$997.05 1 f s. alI
$997.05
® For an installation quote check here to be
contacted by phone Tj
ADD To CART SHARE
+ DESCRIPTION
— SPECIFICATIONS
DETAILS
Product Line: Perma-Shield®Gliding Windows Unit Number&Size: G536
Handing: Left
DIMENSIONS(IN INCHES) I
Overall Width: 29 1/2 Overall Height: 387/8
Visible Glass Width: 26 Visible Glass Height: 35 3/8
•4 1r
https://parts.ande,rsenwindows.com/detail-1721216 w psgw_sash.html 1/1
8/6/2018 Perma-Shield®Gliding Window Operating Sash 1721216 Perma-Shield@ Gliding Window Sash
-DO
WINDOWSORS MAndersen® PARTS STORE
Perma-Shield@ Gliding Window Operating Sash 1721216
Part Number: 1721216
Works With:
Perma-Shield®Gliding Windows
.......-..... Color: White
$997.05
For an installation quote check here to be
' contacted by phone
ADD TO CART SHARE i—_� email
+ DESCRIPTION
- SPECIFICATIONS
DETAILS I
Product Line: Perma-Shield®Gliding Windows Unit Number&Size: G536
Handing: Left
DIMENSIONS(IN INCHES)
Overall Width: 29 1/2 Overall Height: 38 7/8
Visible Glass Width: 26 Visible Glass Height: 35 3/8
https://parts.andersenwindows.com/detaii_1721216_w_psgw_sash.html 1/1
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