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HomeMy WebLinkAbout44124-Z Town of Southold 11/18/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40868 Date: 11/18/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 3005 Grand Ave., Mattituck SCTM#: 473889 Sec/Block/Lot: 107.4-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/3/2019 pursuant to which Building Permit No. 44124 dated 9/4/2019 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"INTERIOR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Johnson,Laurie&or of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44124 11-13-2019 PLUMBERS CERTIFICATION DATED 09-11-2019 4f\eion P & uth ed ignature TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 44124 Date: 9/4/2019 Permission is hereby granted to: Johnson, Laurie PO BOX 72 Mattituck, NY 11952 To: "As built" interior alterations to an existing dwelling as applied for. Replaces BP# 39440 At premises located at: 3005 Grand Ave., Mattituck SCTM # 473889 Sec/Block/Lot# 107.-1-22 Pursuant to application dated 9/3/2019 and approved by the Building Inspector. To expire on 3/5/2021. Fees: PERMIT RENEWAL $100.00 Total: $100.00 Build in spector TOWN OF SOUTHOLD BUILDING DEPARTMENT - TOWN CLERK'S OFFICE 'os • 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#: 39440 Date: 12/23/2014 Permission is hereby granted to: Johnson, Laurie & Bilotti, Sandra 6WEnd Ave East Quogue, NY 11942 To: as built" interior alterations to an existing dwelling as applied for. At premises located at: 3005 Grand Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-1-22 Pursuant to application dated 12/10/2014 and approved by the Building Inspector. To expire on 6/23/2016. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 T $450.00 Bui ing Ispector 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: I. 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. New Construction: Old or Pre-existin Building: (check one) ,�[/ Location of Property: D00 �>r C Houseo. QStreet Hamlet Owner or Owners of Property: yi-t "��Srn ,,'4 Suffolk County Tax Map No 1000, Section ` Block Lot ( l 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: $ Applicant Signature OF SOU�y®l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® Q roger.riche rt(.8-town.south old.ny.us Southold,NY 11971-0959 ®�yCOW,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To- Laurie Johnson Address: 3005 Grand Ave City: Mattituck St: New York Zip- 11952 Building Permit# 44124 Section: 107 Block 1 Lot. 22 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Bee Tec Inc License No: 4814-ME SITE DETAILS Office Use Only Residential x Indoor x Basement x Service Only Commerical Outdoor x 1st Floor x Pool New Renovation x 2nd Floor Hot Tub Addition Survey x Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 11 Ceiling Fixtures 2 HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt 5 Recessed Fixtures 15 CO Detectors Sub Panel A/C Blower Range Recpt 20a Fluorescent Fixture Pumps Transformer Appliances dw Dryer Recpt30a Emergency Fixtures Time Clocks Disconnect Switches 23 Twist Lock Exit Fixtures 11 TVSS Other Equipment: "AS BUILT" "ELECTRICAL SURVEY' "NO VISUAL DEFECTS" Notes: 8 ft plug mold,range hood,4-GFCI circuit breakers Inspector Signature: Date: November 13 2019 81-Cert Electrical Compliance Form.xls . pF S©UTyol. . . Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G „` Southold,NY 11971-0959 BUILDING DEPARTMENT ��-\ SEP 1 1 2019 TOWN OF SOUTHOLD r[A 11 psi {'S A)71 { C E R-T IF I C_A T-I A-N; cl1 Date: :I Building Permit No. /V L/l 2— Owner: Owner:'Z_e;_r(4e 1e- - I -(Please int)> _._ __Plumber: (Please print) 3 1 a I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. i I (Plumbers Signature)— Sworn to before me this 0 i day of 2019 j 3 : Notary Public, CJ County 1 i TRACEY L. DWYER IMOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED:N SUFFOLK COUNTY , COMMISSION EXPIRES,LUNE 30, I� OF SOOT # * TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [XFFINAAL GH PLBG. FOUNDATION 2ND [ LATION FRAMING /STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTR CTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (RO ) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLAT [ ] CAULKING REMARKS: DATE INSPECTOR gf SOUIyOIo # TOWN OF SOUTHOLD BUILDING DEPT. courm, 765-1802 ANSPECTION . [ ] FOUNDATION 1ST [ ] ROUGH PLBG. �=l [ ] 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: �30 a7- DATE �r 1 INSPECTOR �- 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 Q 4 sets of Building Plans TEL: (631) 765-1502 Planning Board approval FAX: (631) 765-9502 Survey South oldTown.No rthFork.net PERMIT NO. 3 ® Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate 1)",[2 Storm-Water Assessment Form � Contact: Approved 120 Mail to: Disapproved a/c Phone: Expiration �/ ,20 D Building Inspector ector DEC ' ® 2014 APPLICATION FOR BUILDING PER BLDG DEPT Date 20 `Z � � , 1 9— TOWN of SOUTHOLD 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 Ordinanee,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 applicarit.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. (Sign I re of applicant or name,if a corporation) QO \ ZSR IN-Y1 Wk s"l- 63 o^Z`i 8-2 z SV (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises L 0.c.1(,1 L' 1)0N_\Y\Sy11_ Q.n1 �Q n Cc_ 1 1 (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 proposed work will-be done: S G cin ; House Number Street 4 Hamlet County Tax Map No. 1000 Sectiod 10-1 Block Lot 2 2 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 8 W Q 0 b. Intended use and occupancy 1 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 2c, uo-o + 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 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 o$�-y Address Phone No. 63 1 99 6- Z-3 o+ Name of Architect J, �)pp c1r v s lAddress Phone No 'Z�'9 ­71 I , Name of ContractorAddress Phone No. 1 'b31 ^ -767- 0g12, ` 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO _o * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. , ~' b. Is this property within 300 feet of a tidal wetland? * YES NO �° •" * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and^distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: #� COUNTY OF ) c—, being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, - -- - (S)He is the (Contractor,Agent, Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. c 2 Sworn tp before met 's ` �— _day of 20 CONNIE D. BUNCH Notary Public 1metary Public,Bfate oro ew r Sign, ure of Applican No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2 J t r �ostrFFc�,r$ ST(O IR I��J[WATER. Scott A. Russell o� � SUPERVISOR �, 1W A N_A�(G 1El\vl[JEN`]F SOUTHOLD TOWN HALL-P.O.Box 1179 p 53095 Main Road-SOUTHOLD,NEW'YORK Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) ------ --------- ---- --------- DOES -------DOES TIES PROJECT INVOLVE ANY OF THE (FOLLOWING: Yes No (SCK ALL THAT APPLY) E]El A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑� B. Excavation or filling involving more than 200 cubic yards of material 4 within any parcel or any contiguous area. it F-1 F/-(r Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ®O E. Site preparation-within the one f loodplain as depicted on FIRM Map of any watercourse. _ El F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. - S.C.T.M. 1000 Date: APPLICANT: (Property Owner,Design Professional,Agent,Cont actoirother) District � 0L,".es- Zc 'd V4,j 0�1 l 22 i7-11 � NAME. SCs�(� �IO�1 fi� C�� I/4- // Section Block Lot I-OR BI ILDING DEPT"IRTME--NT USE ONLY Contact Information: Z"s^ Reviewed By: - - — — — — — — — — — — — — — — — — Date Property Address/ Location of Construction Work: — — — — — — — — — — — — — — — Approved for processing Building Permit. 3 oo G, Ayp— yj Stormwater Management Control Plan Not Required. "LC Stormwater Management Control Plan is Required. El (Forward to Engineering Department for Review) FORM ' SMCP-TOS MAY 2014 ®,*®F SOUry®l Town Hall Annex ~ O Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 I�COUN'i`I,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD October 16, 2019 Laurie Johnson PO Box 72 Mattituck NY 11952 Re: 3005 Grand Ave, Mattituck TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: �rricalUnderwriters Certificate A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4!1/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT —44124— "as built" interior alterations �:`' i " -t,C; �$ �'�•r'4"J3� . � 1 �® yJ Zg 219 BUILDING DEPARTMENT-Electrical Inspector TOWNOF SOUTHOLD I Town,#MI Annex- 54375 Main Road - PO Box 1179 CIO a uv- Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ro err southoldtownn ov­o seand southoldtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: -o'-R Company Name: F Name: License No.: C-7 email: nC Address: ► ,,� , Phone No.: !M 22U Map JOB SITE INFORMATION (All Information Required) Name: Address: ` Cross Street: Phone No.: Bldg.Permit#: email: Tax Map District:,_ 1000Section; . l °'j Block: Lot: a BRIEF DESCRIPTION OF WORK (Please Print Clearly) ; Circle All That Apply: Is job ready for inspection?- YES NO Rough In Final' Do you need a Temp Certificate?: < E O 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 ry Request for Inspection Form As CPp lC�-. P.P. ]`d±qvR. - S ,,1�n M C H NC'rII�''f ('l'1Li:!li��,:'� i_'....�',^.�,il.�.":(;T 76" 180 f:MI TO' nP'Vli FOR T1 1' PLUM13ERCERTIFICATIO."! Design services ON LEAD.CONTENT BEFW T1YO F;-(ZUFF-D CERTIFICATE OFOCCUPA v FF'OUPEo CO(,?If:,RrTE ► USED�. RC,'.',v'; - f Ri` '' 3 P(-UMF3'!N;' SODER www.mchdesignservices.com 3. 1N UL,^,T1{01N SUA1, CANNOT phone: 4. i=I I,^.L - C011! Tri'JC ?0�•,' A,'..IST D 2110 OF 19,5 LEA D. (631)298-2250 I ^rl r �� ' R Ar- •- � / email: ALL CON. ; TSI(,-:d „E{,.l ( p„c0I 1 v' � michael@mchdesignservices.com i i��IIJIF1C�:r��Y 1 J ��I' 11-1 I��QCJ VF"(`��V�ro� n//�� �j YORK STATE. 1;01 nFS( ELL 'ONS E FOR IC CO(��::T DESIGN OR EI FIORS. CODES OF NEVV Y & TOWN CODES -- s-+ITI/'1R AS REQUIRED ��.:. �.,.��—'v--;-�t�f REPLACE EXISTING REP CE EXISTING WINDOVJ G63 OOR FWG80611L I I I 1 1 1 I 1 1 1 p� ;�PLBINC I� ALL PLUMBING WASTE UCUPAI'CY OR &ING E FORECOVE TESTING BEFORE COVERING USE I S UNLAWFUL ,LA � FU 3"(d ROOF VENT �� � 1 �-_ � EX.BATH �9�+ �" ; ; NO CHANGE WITHOUT CERTIFICATE KITCHEN ; ALTERED OF OCCUPANCY 1 "4 3 1 1/4 11 0 1� SINK SINK I g" � .'+►-� W D.W. F.A.I. ; EX. GARAGE I , PARTITION WALL REDUCED I I (NON-STRUCTURAL) J 211/2 I I Fri V C.O. 3 [� SLOPE" 1/4" PER FOOT PITCH TO DRAIN 4 TO APROVED I I 4"C.I. SEPTIC SYSTEM I I CM HOUSE TRAP PLUM wt"3'6kI1NJ' G SCHEMATIC WET II II II BAR I 1 II N .T.S. L-L-r - - - - - -r- EX. DINING ROOM F NFw Y Rnio DRAWN BY: MH E: ?€?�` t'JA d �'� z 11/22/2014 ti 07 -SS SCALE: SEE PLAN SHEET NO: A