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Home My WebLink About45075-Z FFa� /r Town of Southold 9/15/2020 P.O.Box 1179 0 C* S 53095 Main Rd O! � h Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41438 Date: 9/15/2020 THIS CERTIFIES that the building ALTERATION Location of Property: 4510 Rocky Point Rd, East Marion SCTM#: 473889 Sec/Block/Lot: 21.-3-26.1 Subdivision: Fled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/3/2020 pursuant to which Building Permit No. 45075 dated 8/6/2020 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"central air conditioning as applied for The certificate is issued to Dzenkowski AR Family Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45075 8/28/2020 PLUMBERS CERTIFICATION DATED c Autho ' Signature �g11FFDY,g-CpG. TOWN OF SOUTHOLD ��o y BUILDING DEPARTMENT a 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#: 45075 Date: 8/6/2020 Permission is hereby granted to: Dzenkowski AR Family Trt 4510 Rocky Point Rd East Marion, NY 11939 To: as bit" air conditioning as applied for. At premises located at: 4510 Rocky Point Rd, East Marion SCTM # 473889 Sec/Block/Lot# 21.-3-26.1 Pursuant to application dated 8/3/2020 and approved by the Building Inspector. To expire on 2/5/2022. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -NEW DWELLING $50.00 ELECTRIC $170.00 Total: $620.00 l Bui ing Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 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$15.00 Date. Z q TU L New Construction: Old or Pre-existing Building: (check one) Location of Property: L4 6-10 k O cKy P/i/) FA!5:-r /,A.A-A Id ti House No. Street Hamlet Owner or Owners of Property: A L Suffolk County Tax Map No 1000, Section 4 2 ( Block 3 Lot 2 �o Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: 6 eAAg 7-e-n K O LQ S(� Health Dept.Approval: Underwriters Approval: Planning Board Approval: ____� Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted:$ Applicant Si ature OF SOUr�®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ® �� sean.deviina—town.southold.ny.us .�` BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Dzenkowski AR Family Trt Address: 4510 Rocky Point Rd city,East Marion st: NY zip: 11939 Building Permit#: 45075 Section: 21 Block 3 Lot. 26.1 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 X Service X Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic X Garage INVENTORY Service 1 ph X Heater Baseb. 32' Duplec Recpt 27 Ceiling Fixtures 8 Bath Exhaust Fan Service 3 ph Hot Water 30A GFCI Recpt 2 Wall Fixtures 6 Smoke Detectors 2 Main Panel 200A A/C Condenser 1 Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO 2 Transformer UC Lights Dryer Recpt 30A Emergency Fixtures Time Clocks Disconnect 200A Switches 17 4'Fluorescent Exit Fixtures Pump Other Equipment: Fridge, W/D, Oven Notes: "AS BUILT, NO VISUAL DEFECTS " 200A Service, AC/AH, and New House Wiring Inspector Signature: a Date: August 28, 2020 S Devlin-Cert Electrical Compliance Form.xls Of SOUIyO� 4t.5 0-7 6- l 5 'D 1ZO 6i P vat t -- * # TOWN OF SOUTHOLD BUILDING D PT. 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) M ELECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O /-j 130 REMARKS: J �° ly -fir� r `c• � � �- -IGN 70K DATE A 2,01, W INSPECTOR Uf SOUTy�6 1p'/ # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION - [ ] FOUNDATION IST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION x [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: anlke & � DATE INSPECTOR OF SOUTyOIo 0 75 �l # # TOWN OF SOUTHOLD BUILDING D N r cou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] 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 PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applymg� 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 NYSDEC Trustees C O Application Flood Permit Examined O� ��( 20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: �[ 1 Approved-00/ 106 20 � Mailto.pe--k DZen V9 Disapproved Disapproved a/c (oa5 Soy4ViEt-n B kJ O, SA ( G t^l`t 3 1 Phone (o 61 I1 Expiration W_2-2— D �r�(("" Building I ctor 15��j V D PPLICATION FOR BUILDING PERMIT All G - 3 2020 Date Z � 5 U L 20 2 O INSTRUCTIONS 1oDJST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sels� plans,•accurate.plpq�t�cale Fee according to schedule. "` b.Plot plan showing`ocauon 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. APP4 f this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit r r s available for inspection throughout the work. e,No build' lcst red�rused in whole or m part for any purpose what so ever until the Building Inspector DATES i t�c�te o �� f.Every buildr it shall expire if the work authorized has not commenced within 12 months after the date of not be d within 18 months from such date.If no zoning amendments or other regulations affecting the FEE: ar� terim the Building Inspector may authorize,in writing,the extension of the permit for an NOTIFY BL i -e ,Lnew permit shall be required. 765-1802 8 AM 'L4C� C �HY MADE to the Building Department for the issuance of a Building Permit pursuant to the FOLLOWINGdEGrTd0td&ance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or 1. FOUNDA1Td911466< RE C®n of buildings,additions,or alterations or for removal or demolition as herein described.The FOR POL4R8MgNe EcWply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit 2. ROUGH-PROW,PLsefqe( premises and in building for necessary inspections. STRAPPING, ELECTRICAL&CAULKING 3 INSULATION (Signature of applicant or name,if a corporation) 4. FINAL-CONSTRUCTION&ELECTRICAL MUST BE COMPLETE FOR C.0 ALL CONSTRUCTION SHALL MEET THE (Mailing address of applicant) REQUIREMENTS OF THE CODES OF NEW YORK STATE.SN&TvRE9R0NffALcffrF0Wwner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder DESIGN OR CNsTg a Name of owner of premises At—le—e— 2G„i (.Z a w K ; (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: _ Ld S—'10 20GRv P,, ' A D A517tit!kIQ104/ House Number Street Hamlet County Tax Map No. 1000 Section 0 2 ( Block d 3 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 �i► b. Intended use and occupancy S A M, Z 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work Cc A,-rR A L (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 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-)L 13.Will lot be re-graded?YES NOXWill 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—�r *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. STATE OF NEW YORK) SS: COUNTY OF,Lj� Be 02'C &a being duly sworn,deposes and says that(s)he is the applicant (Name of ndrvidual signingcontract) IIabove named, 1 yy}}� //�� y (S)He is the 9011 j6(u AJf- ;�U-G6Jdr— a[ the FiS44Of ACC � &r)OkagA! (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 this D 1h day of 7cJL V 20�0 BARBARA DIAGHUN State of New Y , 4J Notary Public No 01 D14635190-Suffolk Gounty Signature o pplicant Commission Expires Oct.31,20 99 BUILDING DEPARTMENT-Electrical Inspector r f. TOWN OF SOUTHOLD i Town Hall Annex- 54375 Main Road - PO Box 1179 Southold New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rocerrasoutholdtownnv.aov- seand(Msoutholdtownny.cov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (An information Required) Date: 2L q T u L- toxo Company Name: Name: t License No.: email: Address: Co'a'5ova-h�rr1 PJIJ 7=--o,S4- VYl ckr1 a r'� 9 Phone No.: 631 ^ LA-1-7- 0 11 JOB SITE INFORMATION (All Information Required) Name: A Lt w K Address: I _Rock P*rT' Cross Street: dLv j0 Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section: 4 Block: 0 -3 Lot: O 2 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Circle All That Apply: Is job ready for inspection?: ES / NO Rough In Final Do you need a Temp Certificate?: YES 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: flR� Axl sT�� Cl- PAYMENT rPAYMENT DUE WITH APPLICATION Request for Inspection FormAs ; BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ' roQerrAsoutholdtownnu.gay. ;seandQsouthoIdtownny.gov. APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: J'0 L- -2.o2-v " Company Name: ;Name: = - - - - License No.: - email: Address:_(4a,5 -0044h() Phone No.: ls>31 V-471-7 1 JOS SITE INFORMATION, (Ali Information Required) Name: (.� c.&:: ZG.✓ o w ' Address: 14l A-0 C-9 • : R !� 5'r. /� �Z ®�-. Cross Street: d? KaV, L v b Phone No. --- -- -_-- - ------ . . -- -- - - -- - - Bldg.Permit#: email: - - - -- - Tax Map District:. 1000 __Section:_1 Z Block: BRIEF DESCRIPTION OF WORK(Please Print_-Clearly) /' E + !'� Circle All That Apply: Is job ready for inspection?:. ES NO Rough In Final Do you need a Temp Certificate?:, YES 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: flRc ---- --- - ---------PA-Y-MENT_DUE WI-T-H APPL-ICA-T-I.ON--- -- --- Request for lnspectlon Formals Pr �a,9- � s,��wl'uN �r1 4-c IV k,kQ) C- J'- tA 4f (� �Y 2 M �) i`5 _7 , � ,!_; ..9 i., " li..,• . '!t ,^.'°' ,ltj�� if., �� >�,y;,"p:. - i r ... r ,�/ _ a4�. � i`r., " ^,t:,, 'X L°'�X..{•-0 f„ - �+,'�i �, U yT.J� mi�}`, t t_!;`n r - >-�, _ � ,32 "; '•'Y�#` ''.'r3�'t�P�;1-•. ,.' ''.' o,-;� = u � �" t - - A�,�Y r.,, `:,iy '"�?`, MFR DATE 3/2007 f �m MOD, W 2TT R3036A1000AA VOLTS 208/230 SERIAL NO, 7134MG55F PH 1 HZ 60 ' MINIMUM CIRCUIT AMPACITY 16.0 AMPS OVERCURRENT PROTECTIVE DEVICE USA CANADA t MIN FUSE I BREAKER (HACR) 30 30 MAX FUSE I BREAKER (HACR) 30 - 30 " HCFC - 22 6 LBS. 05 OZ. OR 2.86r kg(si) , `F= 10 OF DESIGN SUBCOOLING ° Climatuff DuraTuff Spine Fln Quick—Sess AMERICAN STANDARD INC. LISTED SECTION OF �: . . ek I� CENTRAL COOLING MANUFACTURER OF TRANE AND AMERICAN STANDARD C & US AIR CON IT z TYLER TX 75707 ASSEMBLED IN USA �UTNOR USE y 73 LRA COMPR. MOT. 13.5 RLA 206/230 r _ V ,:. O.D. MOT. 1 .4 FLA 200/230 V 1/6 HP }u M.E.A. NO. 154 - 0615 F. ID. 30N DESIGN PSI — HIGH 300 LOW 300 r ;; A01 Stoodard M/240 UAC. GE,RTIFICATION APPLIES ONLY s'¢ 1 WHEN THE COMPLETE SYSTEM i II �1 I i I III II I � _ I III I5 LISTED,WITH ARI