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Home My WebLink About44102-Z a ��o�SUFFUI,yCaG� Town of Southold 9/7/2019 3 P.O.Box 1179 0 a' T 53095 Main Rd Gy�jo� yo�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40676 Date: 9/5/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 32345 Route 25, Cutchogue SCTM#: 473889 Sec/Block/Lot: 97.-5-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/15/2019 pursuant to which Building Permit No. 44102 dated 8/27/2019 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"AC unit and furnace(gas conversion)to existing single-family dwelling as applied for. The certificate is issued to Doroski,Michael&Ors. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40676 8/30/2019 PLUMBERS CERTIFICATION DATED Authorized Signature 4�5uFFo��oTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • 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#: 44102 Date: 8/27/2019 Permission is hereby granted to: Doroski, Michael 2305 Yennecott Dr Southold, NY 11971 To: legalize "as built" AC unit and furnace (gas conversion) to existing single-family dwelling as applied for. At premises located at: 32345 Route 25, Cutchogue SCTM # 473889 Sec/Block/Lot# 97.-5-5 Pursuant to application dated 8/15/2019 and approved by the Building Inspector. To expire on 2/25/2021. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 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. K 14� ® /Q New Construction: Old or Pre-existing Building: V11,_ (check one) Location of Property: 7_ 3q 57 mil do ko& c t-l'}c dip glve 94 'House No. Street Hamlet Owner or Owners of Property: ��W►'-I—I or C5 SK Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: '/ Request for: Temporary Certificate Final Certificate: `' (check one) Fee Submitted. $ 50 Appli nt Signature OF SOUI'y®l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 • �� sean.devlin(aD-town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To Michael Doroski Address: 32345 Route 25 city Cutchogue st: NY zip: 11935 Budding Permit# 44102 Section 97 Block 5 Lot. 5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: AS BUILT 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 X 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 Exit Fixtures Combo SD/CO 11 Other Equipment AC with Disconnect and Air Handler, Gas Furnace Notes. "AS BUILT" "NO VISUAL DEFECTS" Inspector Signature: Date: August 30, 2019 S.Devlin-Cert Electrical Compliance Form As OF SOUTyo� Lf ti 0 v Z # TOWN OF SOUTHOLD BUILDING DEPT. `ycou765-1802 INSPECTIO N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. i [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) PI&LECTRICAL (FINAL) [ ] CODE VIOLATION ] CAULKING REMARKS: DATE RA0117 INSPECTOR FFOIK� BUILDING DEPARTMENT- Electrical Inspector �O TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Ro d - PO Box 1179 o Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 roger.richert(a-)_town.south old.ny.us APPLICATION FOR ELECTRICAL INSPECTION -EQUESTED BY. -- / f0� 21-0 SA ° - - Date: - Lo 19-- C 9 - Company Name: Name: License No.: email: ro Sk �� Go Address: Phone No.: JOB SITE INFORMATION: (All Information Required) Name: �'�,� c�rb Address: LLD— fl W®? 6 vt.--Ch 0 7 V C Cross Street: 14 A r-1 or Z- 0, "-e Phone No.: 611 ltlfo l �� S�7 Bldg.Permit#: Q email: CC ori, Sde Tax Map District: 1000 Section: Block: P Lot: f BRIEF DESCRIPTION OF WORK (Please Print Clearly) l ✓! Spe4-6 b✓J o� Circle All That Apply: Is job ready for inspection?: Y / NO Rough In Final Do you need a Temp Certificate?: YES /e Issued On Temp Information: ' (All information required) Service Size 1 Ph 3 Ph Size: E 0 0 A # Meters� Old Meter# New,Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground -(O---8 �ve # Underground Laterals 1 -2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION Request for Inspection Formals �� 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. Check Septic Form N.Y.S.D.E.0 Trustees C.O.Application Flood Permit Examined 20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved 20-4 Mail to: Disapproved a/c Phone:1— Expiration 12 Bui ing Inspector AUG 12019 �"� 5 APPLICATION FOR BUILDING PERMIT BfJrs. D G" DE?1T, Date �l �� /q , 20 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, 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 (mac_l, 0 i✓h e-1- Name of owner of premises Cy1 o'r � �1 Ora �LN, If (As on the tax roll or latest deed) If applicant is a corpprdtion, 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 la d on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Lot 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 b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work A-0 i S C,,i-,1/- (Descri ion) 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 occu ancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: ont Rear Depth Height Number of tories Dimensions of same structure with alteratio s or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Storie 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Ow er 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or r ulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed om 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? *YE NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUI 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 ) being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D.BUNCH Notary Public,State of Now York No.01BU6185050 (S)He is the (Contractor, Agent, Corporate Officer, etc.) nommissinr Ex0res April 14,2 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. W�Swor o before me thi J day of 20 s @:mow-P � . Notary Public Signature of Applicant s Road AP ROVED AS NOTED DATE: B.P.# �� FEE: BY: NOT IF BUILDING Gi=?ARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ELECTRICAL 1. FOUNDATION - TWO REQUIRED INSPECTION REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING t, 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE'COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF 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 `581 9 9 T9W$1 N.A. SO LQ � OARD SUUTHQLrMW7RUffEES OCCUPANCY OR OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ti 44 +s. MODEL L Mo.M° M FD . , FAB 05/211 M�O1.E RML-��'J SER i AL . f . til l N• ISE IE 1LO�Q097 USAGE UTERI QTS 2CS/MD f'wq . I HBM Cof%SSORl 17.9 '17.'9 L.R.A. 112 �SSEUR, R.L.A. WMODR FAQ MOTOR/ F.L.A. 1 .2 Np. 1/5 MOTEUR VENTIL. EX', ! MIN . SuppLy CIRCUIT #WjTY 24!24 AW WjW ADG SS LE p'AL.IM. M#5. WX . FUSE OR CKT. BRK. SIZE*/ 40/40 CAL. MAX, DE FUSIBLE/DISJ* ml K. FUSE OR CKT. - SIZE*/ 30130 AW . .. MIN. DE FM1BLElaISl* 5 fir HIGH/ 415 I6�'W w DES IG5 � .. PRESSION 1 'E KAM �� DESIGN '�� LOWI � Is kft PRESSION KNI NAE �9 46 �� ago olmom UNITS FAa I 00m US I NE D- LX ITSS EXT TOTAL 'SYST04 1DT&E SYS ACCEIS sloicT� I IM51DE on$ ows L, POWN FOXY SPU Fa �"�`` Lp Ui 1 MODEL/MODULE : RCFL—HM3617CC SERIAL / EN SERIE : W191125998 C�FD / FAB : 05/2011 REFRIGERANT R410A DESIGN PRESSURE: 550 P*rlso d* J* REFRIGERANT PRESSION NOMINALE RHEEM MANUFACTURING COMPANY UL us FORT SMITH , AR)CANSA5 LtSTE D ASSEFBl.ED Ill NEX ICO 1F62 REl)!I lWlf IEXIQIE 42-228I4-03 E RHEEM MANUFACTURING COMPANY condi ci onado►r; the Aire Central - Mode I o ., RANL-037,JAZ . Nominal :: � 2081230 i !� Tens /! JHZ Frecuencia : 60 ierste N incl : .241 4 �c�r'� H , I - .. ' t" - r i AnexO