HomeMy WebLinkAbout43826-Z ZrOM
��o�c,�FFol�coG� Town of Southold 7/28/2019
�+ P.O.Box 1179
0
C* 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40560 Date: 7/28/2019
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 465 Private Rd#3, Southold
SCTM#: 473889 Sec/Block/Lot: 70.-6-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/10/2019 pursuant to which Building Permit No. 43826 dated 6/3/2019
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"alterations to an existing accessory building as applied for-with no heat.
The certificate is issued to Galgo,Gabor
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43826 4/3/2019
PLUMBERS CERTIFICATION DATED
u ho e Signature
TOWN OF SOUTHOLD
�ogUFFaiK�oa. BUILDING DEPARTMENT
g TOWN CLERK'S OFFICE
"oy 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#: 43826 Date: 6/3/2019
Permission is hereby granted to:
Galgo, Gabor
250 E 39th St Apt 12N
New York, NY 10016
To: legalize "as built" alterations to an existing accessory building as applied for- with no
heat.
At premises located at:
465 Private Rd #3, Southold
SCTM # 473889
Sec/Block/Lot# 70.-6-16
Pursuant to application dated 4/10/2019 and approved by the Building Inspector.
To expire on 12/2/2020.
Fees:
AS BUILT-ACCESSORY $200.00
CO -ACCESSORY BUILDING $50.00
$250.00
Building Inspector
rsf so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 O ® �® roger.riche rt c( town.south old.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Spreeman (Galgo)
Address: 465 Private Rd #3 City_Southold St: New York Zip: 11971
Budding Permit#• i{315a(p 43551 Section 70 Block: 6 Lot- 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor, DBA. Brian Brooks Electric License No: 3613-E
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph Heat , Duplec Recpt 10 Ceiling Fixtures 5 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 2 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 7 Twist Lock Exit Fixtures TVSS
Other Equipment: "GARAGE"-----accessory building
Notes, 3-ARC fault circyud breakers
Inspector Signature: Date: April 3 2019
81-Cert Electrical Compliance Form.xls
SOF so
# TOWN OF SOUTHOLD BUILDING DEPT.
loum N 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I SULATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
Ud 1 ) --- Ipv
DATES INSPECTO
FIELD INSPECTION REPORT DATE COMIVLENTS
FOUNDATION(1ST) �
.....................................
'FOUNDATION (2ND) _
' �O
ROUGE FRAMING&
B
PLUMBING
INSULATION PER N. Y. H
STATE ENERGY CODE
'�7
New
Da�A
FINAL
ADDITIONAx,COMMENTS
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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 Survey
Southoldtownny.gov PERMIT NO. 3 -6 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
f APR 1 0 2019 Contact:
II
Approved ' ( ,20 Mail to: T 00
Disapproved a/c `-
-� T ®�1f;+ fit) �� ``•
Phone:
Expiration ,20
Building Insp-estor..__,_
APPLICATION FOR BUILDING PERMIT
Date �— �r/ , 20A
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 described. The
applicant agrees to comply with all applicable laws, ordinances,building code, housi e,an regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
�Zo o7al'n^ ta-c-- -
(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
(Naive and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on hich propose work will bene:
do
g s . I C'�Z& .�
House Number Street Hamlet
Lot
County Tax Map No. 1000 Section `�D Block
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 G2z9?f/vJ �
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost ��� ]yeegg; , �+�+r -- , ,� •a
,(ToAU paid on filing this application)
5. If dwelling, number of dwelling units i Nber of dwelling units on each floor
"'
If garage, number of cars " ,1iI
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, T,;„:ry, 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
13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO
14. Names of Owner of premises 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 f opographical data on survey.
t
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 ( CL
being duly sworn, deposes and says that(s)he is the applicant
(Naive of individual signing contract) above named,
(S)He is the
(Contractod 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 thi
day of r 2019
lfqotary Public TRACEY L.DWYE Si nature of A licant
NOTARY PUBLIC,STATE OF NEW YORK g pP
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2da--;1-
5
BUILDING DEPARTMENT- elecNcalhspecr351
Fal�l'
o ¢rye TOWN OF SOUTHOLD
a Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert(a-town.southold.nV.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: 47� ��- � Date:
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)c (;k I 1
Name:
Address:
Cross Street:
Phone No.:
email;
Bldg.Permit#:
Tax Map District: 1000 Section: -2 6 Block: Lot: �®
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply=
Is job ready for inspection?: YES I 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
82-Request for Inspection FormAs
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