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HomeMy WebLinkAbout43839-Z Q� �ffQtpc�G Town of Southold 2/11/2020 P.O.Box 1179 53095 Main Rd o4�Qwd�,�y Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41056 Date: 2/11/2020 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: Pvt Rd Inner Bay,Fishers Island SCTM#: 473889 Sec/Block/Lot: 10.-9-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/23/2019 pursuant to which Building Permit No. 43839 dated 6/10/2019 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"alterations to an existing single family dwelling as applied for. The certificate is issued to DeBroff,Brian&Karen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43839 10/29/2019 PLUMBERS CERTIFICATION DATED 2/5/2020 Matthew Kolodnicki Authorized Signat re UF qz=4 o TOWN OF SOUTH'OLD k BUILDING DEPARTMENT CS 511 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#: 43839 Date: 6/10/2019 Permission is hereby granted to: DeBroff, Brian & Karen 2220 Huntington Tpke Trumbull, CT 06611 To: legalize "as built" alterations to an existing single family dwelling as applied for. At premises located at: Pvt Rd Inner Bay, Fishers Island SCTM # 473889 Sec/Block/Lot# 10.-9-14 Pursuant to application dated 5/23/2019 and approved by the Building Inspector. To expire on 12/9/2020. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO TO DWELLING $50.00 Total: $450.00 i Building Inspec or 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: ith accurate location of all buildings, property lines, streets,and unusual natural or 1. Final survey of property w 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 certifrcate 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$15.00 nn Date. l Zo v@ New Construction: Old or Pre-existing Building: (check one) Location of Property\1 —L— House No. Street Hamlet Owners of Pro erty Owner or Own p Suffolk County Tax Map No 1000, Section 1 Block Lot L4 Subdivision Filed Map. Lot: Permit No. �� Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) ee Submittedc-•$ Applicant Signa re NOV 2 1 2019 o��OF SO(/j�ol Town Hall Annex ~ O Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 • �O� roger.riche rt(a)_town.south old.ny.us �yOOUIdT`1,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To DeBroff Address Prvt Rd Inner Bay (271 Gloaming Extension) City: Fishers Island St: New York Zip: 6390 Budding Permit# 43839 Section. 10 Block 9 Lot* 14 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor* DBA BD Electric License No: 35821-ME SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat oil Duplec Recpt Ceiling Fixtures 1 HID Fixtures Service 3 ph Hot Water oil GFCI Recpt Wall Fixtures Smoke Detectors 55 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 2 Twist Lock Exit Fixtures TVSS Other Equipment. "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS" Notes 2-combination smoke/co detectors,4 zone oil furnace, 1-AC condensor, 1-AC air handler Inspector Signature: Date: October 29 2019 81-Cert Electrical Compliance Form As �o��pF SO(/T�O` Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �7 BUILDING DEPARTMENT TOWN OF SOUTHOLD FEB - 6 2020 -C-E R 1.IF 1-C A T 10 N j Date; 2/5/2020 Building Permit No 43839 Owner:. .Brian&Karen DeBroff (Please-ptilit) Plumber: Matthew Kolodnickt (Please print) I certify that the solder used in the water supply system contains less than 2/10 of I% lead. lumbers Signature) Sworn to before me this 5th day of February, 20 20 Notary Public, Suffolk VJ DRENIA Cooty P L1 tO (P A\ A pF SOUIyo� '4 # =TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 . INSPECTION [ ] FOUNDATION 1 ST [ f ROUGH PLBG. [ ] FOUNDATION 2ND [ ] P SULATION/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: �k�rn-�• d DATE �d INSPECTOR 2k e�l 7 FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) y ------------------------------------ 'FOUNDATION (2ND) Z ROUGH FRAMING& y do PLUMBING INSULATION PER N. Y. y STATE ENERGY CODE FINAL ADDITIONAL COMMENTS flN t z ILJ • rn 0 z ,H • L 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 lr -: TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 /� Gj� Suryey Southoldtownny.8ov PERMIT NO. Check Septic Form N Y S.D.E C Trustees C 0 Application Flood Permit Examined 20 Single&Separate Truss Identification Form /0 Storm-Water Assessment Form Contact: °� _ Approved 20 Mail to Z,Z2.O rt�+ry t v7 � ye-e- Disapproved c \ v 1� I ( � L-i I gInWector Pghone iw a3MA J • �Expiration ,20 °i UUo-r � ULA FU�i , rt gt iUb ���� A�� APS VE AS �� � g� UT DATE: l© 19_-. 8 E' ' ��� 3PLICATION FOR BUILDING PERMIT r%CCUPAN Il FEF: �0 BY: --. Date ® av ,2019 NOTIY irlJiLD1Va DEPARTMENT AT INSTRUCTIONS 765-1802 8 M1 This a�plidhti@PAUI�%e completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 FOLLOVIM-09)�W_§Z&{tOtelot plan to scale.Fee according to schedule. I. FOUNDgIO�l WIofq�e .1 Tftflggtion of lot and of buildings on premises,relationship to adjoining premises or public streets or FOR PORNXI ��b�l o�e d application may not be commenced before issuance of Building Permit. 2. ROUGH - F{�Fr��bAGpproVW"*plication,the Building Inspector will issue a Buildmg Permit to the applicant.Such a permit 3. INSU&ftbMept on the premises available for inspection throughout the work. 4. FINA• - g I N tld�gj�Q bGggccupied or used m whole or in part for any purpose what so ever until the Building Inspector p BE COMP (, il e ancY ire if the work authorized has not commenced within 12 months after the date of ALL CO� iunZd orT> ot` e �i-clOiirw 18 months from such date.If no zoning amendments or other regulations affecting the REQUIFffW. ityft"@Pe {i lEnli3QDFd41f�&1 the Building Inspector may authorize,in writing,the extension of the permit for an i MsptF�§hU9#g nev $rmit shall be required. YORK to the Building Department for the issuance of a Building Permit pursuant to the DESIGN o the own 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 in§pe remises and in building for necessary inspections. nD (Signatu a of applicant or name,TT a corporation) MAY 2 3 2019 2220 Huntington Tpke,Trumbull,CT 06611 (Mailing address of applicant) State,whether-applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Owner Name of owner of premises Brian and Karen DeBroff CompLY WITH ALL CODES OF (As on the tax roll or lady ORK STATE & TOWN CODES If applicant is a corporation,signature of duly authorized officer AS REQUIRED (Name and title of corporate officer) 5 $ � Builders License No. Plumbers License No. A�— Electricians License No. Other Trade's License No. S®I � 1. Location of land on which proposed work will be done: 271 Gloaming Extension Fishers Island,NY House Number Street Hamlet County Tax Map No. 1000 Section 10 Block 9 Lot 14 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: u %°'` a. Existing use and occupancy Residential and rental dwelling b. Intended use and occupancy Residential and rental dwelling 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work Replace oil burner&hot water heater,new A/C 4. Estimated COSI A/C:$14574.86,oil burner&HWH.1357.51 Fee t 0 of (Description) 2nd floor (To be paid on filing this application) 5. If dwelling,number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars 1 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing structures,if any:Front N/A Rear N/A Depth N/A 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 N/A Rear N/A Depth N/A Height Number of Stories 9. Size of lot:Front N/A Rear N/A Depth N/A 10.Date of Purchase 11/28/2011 Name of Former Owner McCall 11.Zone or use district in which premises are situated Fishers Island,NY 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO X 13.Will lot be re-graded?YES NO X Will excess fill be removed from premises?YES NO X 14.Names of Owner of premises Brian&Karen DeBrOff Address 2220 Huntington Tpke phone No. 203-381-0678(H) Name of Architect Address Phone No Name of Contractor BD Remodeling (lic#603571) Address Fishers Island,NY Phone No. 631-788-7919 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES X 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 X 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 X *IF YES,PROVIDE A COPY. STATEOF S �,4 C UN Y O /1( dL(A_ w being duly sworn,deposes and says that(s)hthe ap hcant Kaa oMMividual signing contract)above named, (S)He is the C " 1-"v C2�'._o W a (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to erfonn or have performed the said work and to make and file flus application; that all statements contin this application a true to the best of his knowledge and belief,and that the work will be performed in the ma,7ed et forth m the appl ation filed therewith. Swo�r�Eo before me(bday o 20 e otary ublic V Si atur plicant BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD C* i Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerrCa--)southoldtownny.gov — seand@southoldtown'ny.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORM TION (All Information Required) Date: it 110 11019 Company Name: K o d Name: License No.: email: Address: Phone No.: _ -T JOB SITE INFORMATION (All Information Required) Name: Address: �,� 6 a ;,,, a ✓5 S Cross Street: Phone No.: 2,0 ?j Z l . O el) 0 Bldg.Permit#: -2) 9 email: vv„-') , L\ e-C2.o� , ('0,M, Tax Map District: 1000 Section: D Block: q" Lot: I \� 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?: "S 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 NOV 2 1 2019 Request for Inspection Foim-As 2220 Huntington Tpke. Trumbull,CT 06611 May 18, 2019 Town of Southold Building Department Town Hall Annex 54375 Main Road PO Box 1179 Southold, IVY 11971-0959 Re: DeBroff building permit Enclosed please find our permit application for replacement of oil burner and hot water heater and addition of air conditioning to the 2"d floor. $610.00 fee is also enclosed with breakdown as follows: Permit fee: $400 Certificate of occupancy:$50 Electrical fee:$160 Thank you for your attention to this matter. Sincerely, Brian and Karen DeBroff1X�� MAY 2 3 2019 2220 Huntington Tpke. Trumbull, CT 06611 November 19, 2019 Town of Southold Building Department Town Hall Annex 54375 Main Road PO Box 1179 Southold, NY 11971-0959 Re: DeBroff building permit 43839-Z Enclosed please find our completed Application for Certificate of Occupancy and Electrical Underwriter's Certificate. The Plumbers Solder Certificate has been sent to the builder for completion and should be forthcoming. Thank you for your attention to this matter. Sincerely, Brian and Karen DeBroff, '1' ' NOV 21 2019 rif so Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 yc®UNTY,�� BUILDING DEPARTMENT November 8, 2019 TOWN OF SOUTHOLD Brian & Karen DeBroff 2220 Huntington Turnpike Trumbull, CT. 06611 RE: Fishers Island property 1000-10-9-14 TO WHOM IT MAY CONCERN: The items marked below are required to obtain your Certificate of Occupancy Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (Electrical Inspector 631-765-1802) A fee of$50.00. Final Survey with Health Department Approval. Plumbers Solder Certificate or Pex Affidavit F-'-\C4 0 4&-Q d Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. (631-765-1802) Final Landmark Preservation approval. Final Elevation Certificate required. Final Storm Water Runoff Approval from Town Engineer Spray Foam Insulation certification from a NYS licensed architect or Engineer BUILDING PERMIT: 43839-Z "as built" alterations Tempstar Air Conditioner with Smart Comforts Model #E143419039 Product TXA624GKA100 JUN 10 2019 Specifications: • High-efficiency variable-speed rotary compressor T High-efficiency variable-speed fan motor • System protecting high pressure switch, low pressure transducer, and filter drier • Durable, protective tight wire grille panels allow easy coil cleaning; corner posts for extra strength and style • High-gloss, baked-on powder coat finish over galvanized steel • Sound-reducing features: aerodynamic variable-speed fan, soft mounted compressor and high performance acoustic-absorbing compressor blanket • Compatible control: Ion TM System Control installed as part of a complete communicating system for full function and efficiency capability, Wi-Fi®remote access convenience, and intelligent diagnostics • Non-ozone depleting R-410A refrigerant • Cooling capacity: 2-5 tons • Up to 19 SEER cooling • Up to 13 EER cooling • ENERGY STAR®qualified HTP SSU45 SuperStor•Ultra Stainless Steel Water Storage Tank 45 Gallons Rel#: 005/000 Ship Order: 00059603 Specifications- 180 degree F Boiler Water First Hour Rating 140 degrees. 212 GPH 115 degrees: 292 GPH Recommended Flow Rate GPM 10 r Pressure Drop (feet) 7 9 Bosch Buderus Thermotechnik Gmbh I i Oil Conventional Boiler Model GZ15/3 Logano 6215 • EnergyStar • Rear tappings and flue connection to streamline appearance • Baffles and clips for adjusting stack temperatures • Heavy gauge blue enameled jacket for durability and attractiveness • Full swing burner door hinged on either the left or right allowing for easy access • Front access plugs permit flushing of the boiler's interior Ecostream low temperature boiler for oil or gas combustion with modulating boiler water temperature control without minimum return temperature Boiler design with Thermostream technology for reliable operation without shunt pump and return temperature control Water-cooled combustion chamber with low combustion chamber loading and hot gas routing in accordance with the three-pass principle Boiler suitable for operation with oil or gas High efficiency- Combustion efficiencies up to AFUE 87%+ Easy handling through delivery of the boiler block in sections Optional assembly of the boiler block at the factory Easy installation of third party burners with the aid of predrilled burner plates Outputs of 1,951, 2,242, 2,532, 2,822, 3,112, 3,402, and 3,982 MBH 1.