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HomeMy WebLinkAbout44568-Z Of 4Coy� Town of Southold 1/28/2020 3 A P.O.Box 1179 o U' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41022 Date: 1/28/2020 THIS CERTIFIES that the building ALTERATION Location of Property: 2055 Grand Ave.,Mattituck G SCTM#: 473889 Sec/Block/Lot: 107.-8-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/26/2019 pursuant to which Building Permit No. 44568 dated 1/2/2020 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: gas burner installed in an existing one family dwelling as applied for. The certificate is issued to Deerkoski, Gladys I of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED t oriz d ignature �oSofol,�c TOWN OF SOUTHOLD ao � BUILDING DEPARTMENT z TOWN CLERK'S OFFICE 13 IrS SOUTHOLD NY BUILDING PERMIT G. (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44568 Date: 1/2/2020 Permission is hereby granted to: Deerkoski, Gladys PO BOX 248 Mattituck, NY 11952 To: legalize as built oil to as burner conversion as applied for. 9 9 PP Ill At premises located at: I 2055 Grand Ave., Mattituck SCTM #473889 'I Sec/Block/Lot# 107.-8-5 Pursuant to application dated 12/26/2019 and approved pp pp by the Building Inspector. p To expire on 7/3/2021. Fees: AS BUILT-COMMERCIAL ADDITIONS/ALTERATIONS $400.00 CO-ALTERATION TO DWELLING $50.00 Total: $450.00 ' Building Inspector it Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN O N HALL 765-1802 R APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the followmbQ. A. For new building or new use: 1. Final survey property with accurate location of all build s y of prop y ur 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 P Y 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. l L I L� to y New Construction: Old or Pre-existing Building: (check one) Location of Property: na k G, !����"f-j�1,4 Lk, House No. i �gg Street Hamlet Owner or Owners of Property: G l a U 3-b-e ' "r d S h Suffolk County Tax Map No 1000, Section Block / 0'`7 Lot Subdivision Filed Map.p Lot: Permit No. %w Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ �(7 o Applicant Signature pp tof so�Tyo� Town Hall AnnearTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G� •, Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CE RII)FICATION Date: P r,, Building Permit No. a Owner: Wk-civ beer k d l ki (Please print) Plumber: Mi 1'_k �7&yk r- ( (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature Sworn to before me this 0((0 day of o 20�_ 1A LIAO Notary Public, SjfG I k County TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2D4,-61 `�-,5� -- y�0 y° # TOWN OF SOUTHOLD, BUILDING DEPT. °�ycourm N�' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I LATIOWCAULKING [ ] FRAMING /STRAPPING [ FINAL [- ]`-FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE'RESISTANT-CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] E C/O REMARKS: 6w 14- �� I i� DATE a INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS Xro FOUNDATION (1ST) H ------------------------------------ FOUNDATION (2ND) * � ' • �O H ROUGH FRAMING& PLUMBING r r INSULATION PER N.Y. STATE ENERGY CODE i' FINAL u ADDITIONAL COMMENTS DIO X V � d f 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 f Southoldtownny.gov PERMIT NO. `r (� U 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: 0 C - E Approved 20 1. t cw� ibfarl-ta �Ci Disapproved a/c Phone:'1A Expiration 120 Tr i nspector APPLICATION FOR BUILDING PERMIT 4 Date Z�2—(o , 20_V_ 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. £ 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 f Name of owner of premises tA�u t E fr,-6 Sk, f � (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer f (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: �O s 61_4"( A�V?-. House Number Street Hamlet County Tax Map No. 1000 Section L/7 q ,Block � / ��. Lot 4 a 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 '' ' n Alteration Repair Removal Demolition Other WorG�Yq✓,eVSl4h � (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 exteiif46f 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 NOX 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 -111'— * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) k))Y) All being duly sworn, deposes and says that(s)hc is the applicant (Name of individual signing contract) above named, (S)He is the G W14-t'y- (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. Sworn to before me t `lam day of% 20 AMTRACE5Y L. DWYER A NOT PUBLIC,STATE OF NEW YORK otary Pub is NO.01DW6306900 Signature of Applicant QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,202.;J� JOB INVOICE BAXTER PLUMBING & HEATING 5805 MAIN BAYVIEW RD. 3285 SOUTHOLD, NY 11971 CUSTOMERS ORDER NO DATE ORD RED (631) 765-5196 /7 Je6-. (516) 356.4897 ORDER TAKEN BY DAT ROMISED ❑ A M ❑ PM BILL TO ADDRESS q ,/� M CHANIC a (�'v�'v" 071�� CITY �,,,^ // ! 6� HELPER JC]L�N©E'NDI.00CATION� /��� ❑ DAYWORK Y/V �•1'•J( ❑ CONTRACT DESCRIPTION OF WORK ❑ EXTRA QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT O kA U •� O I c� s 00 LA v H\41- Ca v a Vi a C T L t,S u N V Vim-, G cL5 a S Inc lc fi,s HOURS LABOR ___ AMOUNT rn.�� GOODALE JOB INVOICE ELECTRICAL CONTR., INC. P.O. Box 1190 8532 MATTITUCK, NY 11952 CUSTOMERS ORDER NO DATE ORDERED (631) 298-4157 FAX (631) 298-5580 ORDER TAKEN BY DA PRO SED ❑ AM ❑ PM BILL TO PHONE ADDRESS MECHANIC CITY HELPER JOB NAME AND LOCATION � ❑ DAY WORK DESCRIPTION OF WORK Cl CONTRACT ❑ EXTRA QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT -` i HOURS LABOR AMOUNT TOTAL JOB INVOICE BAXTER PLUMBING & HEATING 5805 MAIN BAYVIEW RD. 3301 SO(63 HOLD65.5196 NY 71 CUSTOMERS ORDER NO U !ORD ERED Z d/ n (516) 356.4897 ORDER TAKEN BY DATE PROMISED ❑ A M ❑ PM BILL TO PHONE ADDRESS ^ f MECHANIC V �N^ CITY ^ HELPER ri JOB NAME AND LOCATION �.-yi J/ ❑ DAY WORK DESCRIPTION OF WORK OV / ❑ CONTRACT ❑ EXTRA QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT C w vvu— a Lp l k d 3 6` - 0-0 HOURS LABOR AMOUNT TOTAL MECHANICS @ MATERIALS HELPERS @ TOTAL LABOR APPMOVED AS NOTED c y DATE: dB.P.# /4 FEE: �� . BY. ELECTRICAL d NOTIFY BUILDIN ,b _4.PARTMENT AT INSPECTION REQUIRED 765-1802 8 AM TO s PM FOR THE FOLLOWING INSP�-CTi)NS: 1. FOUNDATION — 7 REQUIRED FOR POURED C'r,N'CRE T E' 2. ROUGH - FRA,'VINC & PLUMBING 3. INSULATION 4. FINAL — CONSTRUCTION MUST BE COMPLETE FOR C.U. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEV, a YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF 1 NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF cnPn TGW� �OARD -5- �- �TEES 0S-DEC--- OCCUPANCY Y S DFCOCCUPANCY OP USE IS UNLAWFUL. 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