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44336-Z
.r�S�FFot Town of Southold 12/23/2019 s� P.O.Box 1179 o - x 53095 Main Rd w�A � , Southold New York 11971 44� CERTIFICATE OF OCCUPANCY No: 40959 Date: 12/23/2019 THIS CERTIFIES that the building ALTERATION Location of Property: 395 Uhl Ln, Orient SCTM#: 473889 Sec/Block/Lot: 15.-5-24.10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Pen-nit heretofore filed in this office dated 10/18/2019 pursuant to which Building Permit No. 44336 dated 10/25/2019 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: ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Lindeman Jr,Herman&Irene of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44336 11-25-2019 PLUMBERS CERTIFICATION DATED 12-16-2019 Hepw Smith Ao ize i nature S13FFat,�C TOWN OF SOUTHOLD job o�y� BUILDING DEPARTMENT y TOWN CLERK'S OFFICE oy . SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES i WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44336 Date: 10/25/2019 Permission is hereby granted to: Lindeman Jr, Herman & Irene 395 Uhl Ln Orient, NY 11957 To: construct interior alterations to existing single-family dwelling as applied for. At premises located at: 395 Uhl Ln, Orient SCTM # 473889 Sec/Block/Lot# 15.-5-24.10 Pursuant to application dated 10/18/2019 and approved by the Building Inspector. To expire on 4/25/2021. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $234.00 CO -ALTERATION TO DWELLING $50.00 Total: $284.00 spector Form No-6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be fitted in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1_ Fina[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, Coinr�ercial$15.00 \V J Date.\ 5 New ConstructionOld or Pre-existing B ildin (check one) Location of Properts y:— House No. Street Hamlet Owner or Owners of Property:v Suffolk County Tax Map No 1000, Section J 5 Block � Lot 4. 1 0 Subdivision Filed Map. Lot: Permit No. Date of Permit_ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ l 2V , -- Applicant Signatu oF so�ryol Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q sean.devlin town.southold.n us Southold,NY 11971-0959 ,�► • �O @ Y' o�yCOUM`I,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To, Herman Lindeman Jr Address: 395 Uhl Ln city Orient st: NY zip: 11957 Budding Permit#: 44336 section: 15 Block: 5 Lot: 24.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: G&S Electric License No: 578-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor 1st Floor Pool New Renovation X 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 1 Ceding Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 3 CO Detectors Sub Panel A/C Blower Range Recpt Bath Exhaust Fan 1 Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 5 Twist Lock Exit Fixtures Combo SD/CO Other Equipment. Notes: Bath Renovation 14 Inspector Signature: Date: November 25, 2019 S Devlin-Cert Electrical Compliance Form.xls SOUTyolo 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 - TOWN OF SOUTHOLD " y` DEC 1 6 2019 CERTIIFICATION Date: Building Permit No. / -I 33 �O Owner: HeAMA,4-j (Please print) -7�- `` Alp Plumber: &2p_ �.�'� �� (Please print) I certify that the solder used in the water supply system contains Iess than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day ofj e 2o—B— Notary Public, County TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2-0_-�O-- OFSo(/TyO� L-f l / 54 V'AJ # # TOWN OF SOUTHOLD BUILDING-DEPT. o�yco '` 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]• 'INSULATIOWCAULKING [ ] FRAMING/STRAPPING [ ] FINAL j ]- FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) ] CODE VIOLATION [ ] PRE C/O REMARKS: A) o c1 an � A v e �- AAe DATE INSPECTOR �,oF soul # TOWN OF SOUTHOLD BUILDING DEPT. ��yinom ' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ R H PLBG. [ ] FOUNDATION 2ND [ INSULATION/CAULKING [ ] FRAMING/STRAPPING' [ ] FINAL [` ]. FIREPLACE& CHIMNEY [" ] FIRE-SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O RE is TAA L RKS: V:.::�V/ DATE INSPECTOR hO�aUFSOGlyO� 9--3 -:3 VA/ TOWN OF SOUTHOLD BUILDING DEPT. 1 765-1802 INSPECTION [ ] FOUNDATION-IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND= [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ =] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE'RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) `�, ELECTRICAL (FINAL) ��,�, [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR - # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 - 1 NSPECTION [ ] FOUNDATION 1ST [ - ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] e SUL'ATIOWCAULKING [ ] FRAMING/STRAPPING [ FINAL [ ]- -FIREPLACE&"CHIMNEY [ ] FIRE SAFETY INSPECTION -[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: L kf) V.Am&11' VU ,.,- V L nn wvm6ib DATE 'INSPECTOR FIELD INSPEC ION REPORT I -DATE COMMENTS b W FOUNDATION (IST) y ------------------------------------- FOUNDATION (2ND) l= z l lVfL rlvkilrl-;" f cSVK- K• o 0- o y ROUGH FRAMING& yLk PLUMBING o r INSULATION PER N. Y. y STATE ENERGY CODE V�VAN �2bldk; FINAL ADDITIONAL COMMENTS 0q — ° If I Fl q 90t,egi4 z � X b CA H O z y� H x d 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.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved Q20 Mail to: Disapproved a/c o APhotae:63/`_ Expiration _ (` %; 20 Expiration Buil Spector Ll OCT 1 a 2019 APPLICATION FOR BUILDING PERMIT Date .J� 20 T`iLr�'V.� 3:�`i t:3�L���.A.i^_f"�t-iLh 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 inspectio 1 ,'7�,, (Signat re of pplican r name,�f a corporation) 9 < �J � (Mailing dr ss of applican J r State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premisesx 1iV6 f As on e tax roll or 1 std ed) If applicant is,a corporUion,.signature of duly authdrized officer (Name and.title;of,co orate,officer) Builders License No-%e :� •.y<89.5�, Plumbers License No. 3 o 3"3 A Electricians License No. S 7 Y' Other Trade's License No. 1. Location and on which pro Twill be done: s House Number Street Hamlet County Tax Map No. 1000 Section Blocic 5 _ 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 A1 b. Intended use and occupan 3. Nature of work(check which applicable): New Building Addition Alteration_ Repair Removal Demolition Other Work (Description) 4. Estimated Cost _ ©'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 strictures, 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 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 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.BUNC@� Notary Public,Stata of Now York No.01 i3U61850a0 (S)He is theGuajifip (Contractor,Agent, Corporate Officer, etc.) Commission Expires 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. S� �� Sworn to before me this 1:2 :� day of o� � 201 d1 Notary Public Signature of__Applicant EFQL r_.. _ ;�� ----BUILDINP DEPARTMENT - Electrical Inspector S� Xc , 'V j c Tll WN OF SOUTHOLD p r,'1 Town Hall Angel 54375 Main Road - PO Box 1179 •:o • LOCT Z 9 200 out'tdd, New York 11971-0959 alO� Telephone (631) 705-1802 - FAX (631) 765-9502 D roqer.richert(@town.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION .Date: o? . . _ .... Company Name: Name: License No — email: o L- C47vt Address: (!o Phone No.: 757 (0 S-1 JOB SITE INFORMATION: (All Information Required) Name: Z, �G-C1-77 4 /t/ Address: � S (f`j L. L.AnJr (�� �1J7 `/ Cross Street: 4--,4/ZdV Z Phone No.: Bldg.Permit#: aJ email: Tax Map District: 1000 Section: Block: Lot:.QLJ . 10 BRIEF DESCRIPTION OF/WORK (Please Print Clearly) 2 0 /41 oN Circle All That Apply: Is job ready for inspection?: YES / NO Roug n Fina[ Do you need a Temp Certificate?: YESNO 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 APPLICATIONd k1c, 0 -- q 5 Request for Inspection Form.xis I� I PLUMBER Crt?�1FiCA?101_ D • y I I �F ON LEAD CONTENT BEFORE �— p CERTIFICATE OF OCCUPAN- a o • �. T I�� I I> N ! t '�`= SOLDER-USED IN E AS OTED ( .{-+ ��f �:;eI _��� ��G Ivlz- SUP_PLYS1'Sa :CANN07f��p /- `` I llf`,AMEED 2110 o P FEE: BY: _ -- - - NOTIFY BUILDING DEPARTMENT AT - _ _ 765-1802 8 AM TO 4 FM FOR THE ' - FOLLOWING INSPECTIONS: i - 1. FOUNDATION - T•wC REQUIRED � • , -- ,! FOR POURED CON-RETE 4' •' �„ ` f2k2. ROUGH - FRAM!NG & PLUMBING , �, ���,� N,/� �--� •�j 3. INSULATION 4. FINAL - CONSYFUC T ION MUST BE COMPLETE FOR CC). 11 r° I ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK.a I yi I STATE. ��� DESIGN ORGON TRUCTI RESPONSIBLE FORON ERRORS. COMPLY WITH ALL CODES OF �'%� ! �J\ - �. w ! I NEW YORK STATE & TOWN CODES OCCUPANCY OR 1 '� �1� USE IS UNLAWFUL WITHOUT CERTIFICA , HOLD TO'^JN PLANNING BOARD ,- - OF OCCUPANCY I; UTHOLD TOWN TRUSTE S �rti Is, , I w ELECTRICAL �1 I �j 4t I ! INSPECTION REQUIRED PLUMBING r ` + ALL--PLOMBING WASTE r lm NEED TL� iORE 81-4 b s k E �I } �s � I hb To O VJ INS I ! MICHAEL JAMES PALLADINO. 5 UI—} (2I�NT FR-411T y' — �— s ARCHITECT. PC. i ,�t 1239 RT. 25A SUITE 4 � I STONY BROOK NF-W YORK 11790