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Home My WebLink About45110-Z 0OFFB� "l �0 cow Town of Southold 8/29/2020 P.O.Box 1179 a' 53095 Main Rd 0 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41393 Date: 8/29/2020 THIS CERTIFIES that the building OTHER Location of Property: 250 Midway Rd, Southold SCTM#: 473889 Sec/Block/Lot: 90.4-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/7/2020 pursuant to which Building Permit No. 45110 dated 8/14/2020 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: "as built"mini-split system as applied for. The certificate is issued to Schab,David&Kaminer,Ariel of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45110 8/21/2020 PLUMBERS CERTIFICATION DATED 'l Authorized Signature ,rfr TOWN OF SOUTHOLD d`g>JFFD(,�co�y�� BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE oy • 0� 5ti 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#: 45110 Date: 8/14/2020 Permission is hereby granted to: Schab, David & Kaminer, Ariel 30 W 13th St Apt 3A New York, NY 10011 To: legalize "as built" mini-split system as applied for. At premises located at: 250 Midway Rd, Southold SCTM # 473889 Sec/Block/Lot# 90.-1-9 Pursuant to application dated 8/7/2020 and approved by the Building Inspector. To expire on 2/13/2022. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $450.00 Building Inspector 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: 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. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I%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. 10 New Construction: Old or Pre-existing Building: L11 (check one) J Location of Property: 1,S-0 M v✓t 'f LOA House No. Street ( ,` Hamlet Owner or Owners of Property: Dov-,&9Sy�w�7 4 /�NkC\ 't- fAIAU Suffolk County Tax Map No 1000, Section CX Block , Lot cj 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: $ a1z Applican-fSigiiature ®��OF SOUry®l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 sean.deviin(a)-town.southold.n .us Southold,NY 11971-0959 • ® y BUILDING DEPARTMENT - TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To- David Schab Address: 250 Midway Rd City,Southold st: NY zip- 11971 Building Permit#. 45110 Section: 90 Block- 1 Lot: 9 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 Service Commerical Outdoor X 1 st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser 2 Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower 4 Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect 2 Switches 4'LED Exit Fixtures Pump Other Equipment. 2- Minisplits w/4- Blowers Notes, "AS BUILT NO VISUAL DEFECTS " HVAC Inspector Signature: 21 Date: August 21, 2020 S Devlin-Cert Electrical Compliance Form.xls pf SOUjy� �S�� 2! "Y � # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] 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 HVAC C/0��0�LT REMARKS: 1 (CAL 1AjZCeCV0AJ DATEhuh-ol INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS- FOUNDATION(IST) -------------------------------- FOUNDATION(2ND) z • I ROUGH FRAMING& PLUMBING INSULATION PEA N.Y. STATE ENERGY CODE ' •I FINAL rtllAl fu-<- AIDD - I�i � !OMMENTS 0 • b H 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 Budding Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 1� Survey Southoldtownny.gov PERMIT NO. / Check Septic Form NY.SDEC. Trustees C O.Application Flood Permit Examined 20J Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved 2j Mail to- �t r.✓'g S G'�q, Disapproved a/c t J 2 Phone: S9 A 1 Ok N`� 1 1 Expiration & 20 C - bLi b 'LL'l -LLA-11 �►QV s wilding Inspector D D APPLICATION FOR BUILDING PERMIT AUG — 7 2020 Date �� A 20-LO INSTRUCTIONS application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sett qf-� got plot plan to scale.Fee according to schedule fro,, '; , ' fi°blot 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 inspections / (Signature of applicant or name,,if ancorporation) 'LSO M r(�w ILO.), s 3 A, y .V)1 OAailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder f1�nMP1 pp ,� 11 Name of owner of premises (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 p o `� 1, 1 (� ``� , 1 ,S� Mt rn/posed work will be do e: a,. ��21ti t� SQ J lhu v House Number Street— Hamlet County Tax Map No. 1000 Section O Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intendeq use anoccu cy of proposed construct'or}. {, a. Existing use and oc upancy c re- CO V l\�` �`Uh C E'cl lJ►�J►�2�` Crn►nk-S0, S5S%r ks I��e b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration--�� Repair Removal Demolition Other WorkP�15 ✓�i1 M1111- nl► \ �—�V�C S�S�� ( escription) (� 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 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 t/ 13.Will lot be re-graded?YESNO Will excess fill be removed from premises?YES NO 14.Names of Owner of premises $2 2 fn(71�JP 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 OFn ��) ` i<C,Y being duly swom,deposes and says that(s)he is the applicant (Name ofindividual 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. Sworn t re me this 20 1-0 otary Public PATRICIA C MOORE Signature of Applicant NOTARY PUSUC,STATE OF NEW YORK Registration No.01 M04861668 Qualified in Suffolk County My Commission Expires June 16,!29 -` B bING DEPARTMENT- Electrical Inspector AUG 1 7 2020 '' TOWN OF SOUTHOLD .► , - Town Hall Annex --54375 Main Road.- PO Box 1179 _ BIrIT,DING DEPT,- - Southold,.New York 11.971=0959 r_ r ``tet TI-7� trona G31 765-1802 = FAX--(63'1) 7� - - T p (_ - } 65-902 Deni, -- - = = -A'_PLC ATI0N.FOR ELECTRICAL:INSPECTION = - ELECTRICIAN-INFORMA_ 'ION-tAk infioriiia�lt�n Required): Dates: --Corn an Name., p Y - - -Name: License=No:: - -Address: Phone No, - JDB SITE 1N O NIAT10N= (Stili lnfor_mation Regaiirect). [lame: - - --Address: ._- 5Q::1 - �fc& _ - - -- - - - 77 ner __ •'fax lk�a- _T::Distract:-_:.---1.000 " --.=- ��---e; --Bem—io a� 4, Bldg. - : q: - _ , -o leseORD Pi1P�FfSCTONOPW - _ cwV- _ �o_: __M� __.. ! ,( h-f V/ L,_ s : --_�____ =v wp S�il�_a " _Gi '�'�.. , '1'l--.. _- -_2ne C irc a-AII TIhatAppfy: S-e-ry?S- �wo San10 �M�aso��l2 at/ kn ocllf_A. !s job ready for inspection: ES NO Rough-In Final-. Do you need a Temp Certifcate?: YES/ O Issued-Ori Temp Information: (All iMnrmatiort tequired) Service Size 1 Ph - 3 Ph Size:- #11Aeters__.-. _:_ Otd:Rlleter# New Service- Fine Reconnect-Flood Reconnect-Service Reconnected- Underground !-Overhead Underground Laterals 1 2- H Frame Pole Work done on Service? Y- N Additional lnformat10* PAYNIIIEN T QUE VVITH APPLICATION Request for inspection Form.)is ' PERMIT# Address: Switches Outlets- GFI's Surface Sconces 44H's UC Lts Fans Fridge HW Exhaust Oven Dryer Smokes DW Service Carbon Micro Generator Combo Cooktop Transfer J AC AH I � Mini Special: Comments: LC �� i.. ;'�• �,�1rF01�' .�,-� �_ �ONE DEPARTMENTe EIeCO:Adai Dnspect®p • ��` AUG 1 7 2020 __ TOWN" OF SOU HOLO { ; Town Hall Annex - 54375 Main Road - PO Box 1179 +, BUDZ'NGDEP-, Southold, New York 11971-0959 �� .�,� f -:$ , ��phone ��31) 765-1802 - FAX (631) 765-9502 rogerr@southoldtownny.gov seand(Ms`outholdtownny.gov APPLICATION FOR ELECTRICAL MPECTM ELECT aAN WORNATM (All Information Required) ®ate: Company Name: License No.: email: Address: Phone No.: JOB WYE INFORMATION (All information Required) Name: Address: rl—SO 1`&Avpu ?�ou -Crm Street: Phone No.: AA k q}.An G Bldg,Per-nit : St D email: cx6wk \/JS L�CXr��rt Co Tax Map District: 1000 Section: C Block: ` Lnt- BRIEF DESCRIPTION-OF WORD (Please Print Clearly) Q uAAk Ac IVES�2 c.\IJJ C,\A A,\ -W C91\ (� 1 CDJQ/ X Ro VtAV w� J`RI h1-S �� l—(� G S S�2M• s s�eM LtCM%� CO, 5 �2,n cOi.S\S . �wo SUn CM.N 0V"\-- CojAp EC&SOJ ec,,JA 1n\c/l Circle All That Apply: Sfrves \Iwo Sano �CM\AVO-1-12 cL(/ �&AcjleA, Is job ready for inspection?: ES! ESO Rough In Final Do you need a `hemp Cecifcate?: YES /tO Issued On Temp Information: (Alf information required) Service Size 1 Ph 3 Ph Size: A deters Old Meter New Service - Fire Reconnect- Flood Reconnect a Service Reconnected - Underground o Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y IN Additional Information: PAYMENT DUE WITH-APPLICATION q6p� _o Request for Inspection Forrn xts l