HomeMy WebLinkAbout44110-Z �o�gUF Of ty� Town of Southold 9/9/2019
P.O.Box 1179
H r� 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40684 Date: 9/9/2019
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 555 Smith Dr S, Southold
SCTM#: 473889 Sec/Block/Lot: 76.-2-27
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/19/2019 pursuant to which Building Permit No. 44110 dated 8/29/2019
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 aluminum three season room as applied for.
The certificate is issued to South Ladybug Realty LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ut ed Signature
�gUFFol�c TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y z 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#: 44110 Date: 8/29/2019
Permission is hereby granted to:
l
South Ladybug Realty LLC
262 Jeftome,Ave
Mineola, NY 11501
To: legalize "as built" AC unit as applied for.
At premises located at:
555 Smith Dr S, Southold
SCTM #473889
Sec/Block/Lot# 76.-2-27
Pursuant to application dated 8/19/2019 and approved by the Building Inspector.
To'expire on 2/27/2021.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO -ALTERATION TO DWELLING $50.00
Total: $450.00
Buil Spector
Form No-6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
AUG 9 2019 APPLICATION FOR CERTIFICATE OF OCCUPANCY
g:
This apg)iyatiern�e�sV!�led in by typewriter or ink and submitted to the Building Department with the followin
ob hw building or new use:
A. Fe
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. Swom 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 1tq Dat . O 1Q
New Construction: Old or Pre-existing Building: (c}�eon I)
Location ofPropert�l 555- „' t (� ���� 0 jq-7
House No. Street Hamlet
Owner or Owners of Propert
Suffolk County Tax Map No 1000, Section ��o 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: $
p ricant S 1gnature
®�*rsf s®Uri®.
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
sean.devlin(cD-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To. South Ladybug Realty LLC
Address: 555 Smith Dr S. city Southold sr NY zip: 11971
Budding Permit# 44110 Section 76 Block 2 Lot. 27
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 Heat Duplec Recpt 1 Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower 1 Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures Combo SD/CO
Other Equipment
Notes "AS BUILT" "NO VISUAL DEFECTS"
AC with Disconnect, AH in Crawl with Work Switch and Outlet
Inspector Signature: Date: September 3, 2019
S Devlin-Cert Electrical Compliance Form As
o��OF 50UTyo Li Ito
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycoutm, 765-1802
INSPECTION
[ ] FOUNDATION1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
r t �
DATE INSPECTOR-
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST)
------------------------------------
C
FOUNDATION (2ND) t`I)�i
CR
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0
ROUGH FRAMING& -m
PLUMBING
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INSULATION PER N.Y. H
STATE ENERGY CODE
FINAL
ADDITIONAL 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
South oldtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
12 Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved 20_ff Mail to:
—A
Disapproved a/c
Expitao X30 43P 4- Cho
-a.' ''r: 1`� ,! 10- �
Buil ector
AUG 1 9 2019 ggQV9
APPLICATION FOR BUILDING PERMIT
�;-�; DEPT`, 1
Bti _� Y. Date 0 `7 , 20
w'O r��i1(OF SOa1T Ly,ry
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�dde,�.mncdl egu ations, and to admit
,n
authorized inspectors on premises and in building for necessary inspections.
dlet
(Signatur of scant or narZe,if a corporation)
(Mailing addre s of applicant) 115,01
State whether In I cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
()Q on the tax r ll or latest deed)
Ifft It ant is a co "ation, sigriature.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 op ed workd ll done- 555- :�%TA m"
House Number Street Q/ mlet /
County Tax Map No. 1000 Section�o 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 K fi5I D UY0 r 116 fjy I0-Aj- 6Cfld rbo,1W
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(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
F
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. 4
15 Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO 1/
* YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
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 he ''sem%gp�plicant
( o m i i ual signing contract above named, Notary Public,State of New York
/� No.0113U6185050
(S)He is the (� Qualified in Suffolk County
(Contractor,Agent, Corporate Officer, etc.) Commission xpires April 14,2 (D
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 Sd� W,`ho
day of 20—A �` �
Q
Notary Public Signature of Applicant
i
gt1FFplIt �� I d., � 1 � BUILDING DEPARTMENT- Electrical Inspector
�O ; ' . TOWN OF SOUTHOLD
~ ` To
AUG 1 9 2019 n"Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
Ol �` ���= rs ICS �. roger.richert(cDtown.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: �`
hkad- 94V10-1 ' ate: Q q -
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: C° vt
Address: S v
Cross Street: %J
Phone No.:
Bldg.Permit#: 4111 I-D email:
Tax Map District: 1000 Section: `�� Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: 5YE / NO Rough In Fina
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
f
Request for Inspection Form As
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TAME
mied Warranty #30956317
Congratulations, your Limited Warranty was successfully submitted.
This is important information. Please retain for your records. '
Please retain proof of the installation dates for your products (i.e. invoice) to verify the registered warranty for
any future claims.
For complete, comprehensive Limited Warranty terms and conditions, please refer to our Limited Warranty in "
the Use and Care Information that'accompanied your product, or contact your installing dealer.
During the Registered Limited-Warranty period you have the opportunity to purchase a transferability option,
which allows your,Registered Limited Warranty to be transferred to a subsequent homeowner.The original
owner may purchase Transferability during the 60-day Product Registration Period or the subsequent owner
may purchase Transferability within the Limited Warranty period, up to ninety (90) days following their
purchase of the home.
With the purchase-of your,equipment, you may be eligible for a labor warranty from your installing dealer.-
Contact the installing dealer to inquire if your system may qualify for repair labor free of charge.
Name:Wayne Monson
ELECTRICAL
Phone Number: 6317653565 _ INSPECTION REQUIREDr"
Email:
Dealer: DjK Heating & Cooling 0CCUPANC z=O ,
Home / Property Owner Address Equipment Addre E I - IJNLAWFU -
Wayne Monson Wayne Monson, ;VIIITHOI�TF CRTC �ICAT[
555 Smith Dr S "555 Smith Dr S`
Southold, NY 11971-4402 Southold, NY 11971-4409F OCCUPANCY
Limited Warranty Terms -�Tean9fer Purchased':'N0-`
Systeml
AIR CONDITIONER (Model# M4AC3024131000N) (Serial# 173010313M)- (Residential
Extended)
Functional Parts :Term End Date Is 0529/2028 (10 Years) APPROVED AS NTED
DATE:V B.P.4 11
COMPLY WITH ALL CODES OF FEE: BY;
NEW YORK STATE & TOWN CODES NOTIFY BUILDING DEPARTMENT AT
AS REQUIRED AND CONDITIONS OF 765-1802 8A TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
.,� 1. FOUNDATION - TWO REQUIRED"
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
bt$�@V�IdUSI ES 3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
Trane Limited Warranty Customer Service Number 1-855-260-2975 ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
c'
DJK Heating&0WIng,u.c Estimate 1658
o PO BOX 247
CUTCHOGUE, NY 11935 US
631-765-5554
djkheatingcooling@yahoo.com - - --- - - - -
ADDRESS n+
Munson
e r x
555 Smith Drive South DATE -
Southold 05;14/201 S
ACTlvny, 'QTY RATE AMOUNT
New Installation 1 3,742.00 3,742.00
Install 1 new Trane Ameristar 2 ton condensing unit, model#AC43024A.
Install new refrigerati6h mines:••" -
lnstalf new:2 tori_levaporator.661l•ori=existing furnace in furnace room.
Refabricate existing supply for new evaporator coil.
Included in iiistaNation: l -`'
Replace existing cooper line set.
Discard old unit:'
All necessary materials, installation;{labor and start-up.
One year guaranty -on clefect`s.in matenals and workmanship during normal business
hours "e' r`'g �1,�'j -
Total job cost:$374,M100� +,1 z 1
We Hereby Propose to furnish materials and labor-complete in accordance with
above specifications for the sum of Three Thousand Seven Hundred And,FartyTwo :n t
dollars.
Payment to be made as follows: 5016 deposit,500/6 start-up.
We look forward to doing-business with yotil- e'
'I T1�° tiz'�ilr'e TOTALS9 742.00
]`Aid -
„� - THANK YOU.
-_ ,
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Accepted-By ;, 1�ILiO; r Accepted Date.,
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