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HomeMy WebLinkAbout28374-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29333 Date: 03/26/03 THIS CERTIFIES that the building ALTERATIONS Location of Property: 2120 SOUTH HARBOR RD SOUTEOLD (HOUSE NO.) (STREET) (HAMLET) Cou/~ty Tax Map No. 473889 Section 75 Block 7 Lot 2 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MAy 9, 2002 pursuant to which Building Permit No. 28374-Z dated MAY 9, 2002 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 BRADLEY ANqDERSON (OWNER) of the aforesaid building. SUFFOLK COLRFrY DEPARTMENT OF ~LLTH APPROV~J~ ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A 1071067 03/21/03 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PEP~MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 28374 Z Date MAY 9, 2002 Permission is hereby granted to: BP~ADLEY AiqDERSON 3820 SOUTH HARBOR RD SOUTHOLD,NY 11971 for : INSTALLATION OF AN EXTERIOR DOOR AS APPLIED FOR at premises located at 2120 County Tax Map No. 473889 Section 075 pursuant to application dated MAY Building Inspector. SOUTH HARBOR RD SOUTH/PEC Block 0007 Lot No. 002 9, 2002 and approved by the Fee $ 150.00 COPY Rev. 2/19/98 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 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 propexty lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Ce~ifi~a~-o~.O' .c.~'P3me~ -i i is denied, the Building Inspector shall state the reasons therefor in writing to the applicanti r ~ C. Fees ~ 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratiorbs to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00~ 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Photocopy of Certificate of Occupancy- $ 0.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: J (check one) Location of Property: O~ _~Q. ~0~,~ ["~,J;~'t_t~ (2~O~ ,,,,~ House No. Street Hamlet Owner or Owners ofmroperty~x~ I))~c~ ~ Suffolk County Tax Map No 1000, Section ~ ~) ~ Block <Dc) ~ Lot Subdivision Filed Map. Lot: PermitNo.~-~',-~ DateofPermit. '~/~/02~- Appficant:E~]V//f-o'~w~'~g-~f--/~.~'2~ Health Dept. Approval: ~D/~ F-c, r6 tgo._,o~,3D~ Underwriters Approval: ~ t ' ' Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ J~ Final Certificate: (check one) ~~ature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU Of ELECTRICITY 40 FULTON STREET - New YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by PAUL R. BURNS BRADLEY ANDERSON P.O. BOX 1061 2120 SOUTH HARBOR RD SOUTHOLD, NY 11971-0932, SOUTHOLD, NY 11971 Located at 2120 SOUTH HARBOR RD SOUTHOLD, NY 11971 Application Number: 1071067 Certificate Number: 1071067 Section: Block: Lot: Building Permit~>834Z BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Outside, Attic, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 21st Day of March, 2003. ~ Nam~e QTY Rathe Rating Circui_t T~ Alarm and Emergency Equipment Sensor 6 0 Smoke Appliances and Accessories Exhaust Fan 2 0 F.H.P. Electric Heater Ut~it 2 0 .5 KW ,-'1 Dish Washer I 0 1.2 KW Range I 0 I I KW Electric Heater Baseboard 2 0 250 Watts 5'1 Electdc Heater Baseboard 2 0 625 Watts Electric Heater Baseboard 1 0 750 Watts .=-'1 Wiring and Devices Receptacle 40 0 General Purpose .--1 Switch 37 0 General Purpose ~ Fixture 22 0 Incandescent Paddle Fan 2 0 I Receptacle I 0 20 amps Laundry ~ Receptacle 1 0 30 amps Dryer seal Receptacle 6 0 GFCI Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by PAUL R. BURNS BRADLEY ANDERSON P.O. BOX 1061 2120 SOUTH HARBOR RD ..-1 SOUTHOLD, NY 11971-0932, SOUTHOLD, NY 11971 Located at 2120 SOUTH HARBOR RD SOUTHOLD. NY 11971 Application Number: 1071067 Certificate Number: 1071067 Section: Block: Lot: Building Permit~>834Z BDC: NS11 Described as a Residcntia! occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Outside, Attic, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 2Ist Dayof March, 2003. Name Rate Rating Circuit :A visual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be El in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. _ seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOU~IDAT[ON 2ND [ ~FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ]~H PLBG. [/] INSULATION [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONIST [ ] ROUGHPLBG. [ ] FOUNDATION 2ND [ ] INSU~sATION [ ] FRAMING [~"¥1NAL [ ] FIREPLACE & CHIMNEY DATE -~--~.~c"'-- I N S PECTOR~/~/ vn~u) ~sr~cno~ m,o~T F OU~ATION (1ST) FO~ATION (2ND) ROUG~ F~G & PL~G ~S~TION PER N. Y- STA~ ENERGY CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-180:2 Examined ~/q/ 20~ Approved , ~ /tg{ , 20 Disapproved BUILDING PERMIT APPLICATION CHECKLIS'I PERMIT NO~..~ ¢ ~ ~ Do you have or need the following, before applying '? Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: ? Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS JYIA5/, ~ ,20 OT_~ a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 Perm/t. 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 a Certificate of Occupancy is issued by the Building Inspector. 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 Name of owner of premises (as on the tax roll or latest deed) I f ' , ' duly author/zed officer ~nd title of corporate officer) x,j Builders License No. ~ I ,~-~-~-~ . Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street OOTH-oc.o, Hamlet County Tax Map No. 1000 Section ~7 ~- Block ~/ Lot Subdivision Filed Map No. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constrScti6n;' ~ a. Existin'g use and occupancy ',~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building. Repair Removal __Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration LA/- Other Work (Description) (to be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 2~,~LO Rear ~2-~SUOI' .Depth Height %'7.~ t Number of Stories Dimensions of same structure with alterations or additions: Front ~ © C.¢¢&r~(cE;. Rear Depth Height. Number of Stories 8. Dimensions of entire new construction: Front /'30 C{4/dO~b' Rear .Depth Height Number of Stories 9. Size of lot: Fror~t 'LSq ,2S ' Rear ~/IOc~ ,c> ~ .Depth '1,) rZ-~3,-// / 10. Date of Purchase Name of Former Owner 14. Names of Owner of premises Name of Architect Name ofContractor~-kS0, ffik,~Sq / MC. lh Zone or use district in which premises are situated (~'P-.~?/~6~f~.t CObq'xJC-,& L., .A- C · 12. Does proposed construction violate any zoning law, ordinance or regulation: ~ O - 13. Will lot be re-graded /',30 Will excess fill be removed from premises: YES Address ~q,5-O ,5'. k{CCsBi~q~hone No. Address Phone No Address F-o- F~d× Iq_V. PhoneNo. 15. Is this property within 100 feet of a tidal wetland? *YES NO t/ · 1F YES, SOUTHOLD TOWN TRUSTEES 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. STATE OF NEW YORK) SS: COUNTY OF ) v,~ v~A , being duly sworn, deposes and says that (s)he is the applicant (Name of ,n&v, dual s,gmng contract~ above named, (S)He is the ~'""'~- ~'~eor~d (~ontract nt, 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 tiffs application are tree to the best of his knowledge and belief; and that the work will be performed in the mmmer set forth in the application filed therewith. ~efore me this dayof / /fl Notary Public JO¥CE M. WILKINS Notary Public, State of New York No. 4952246, Suffolk C~unty Term Expires June Signature of Applicant A,~PPI~,OVED AS NOTED NOTIFY BUILDING DEPARTMENT ?05.'100~' 0 AM TO 4. PM FOR TI~B~ FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQI. IIRI.~ FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBII~O,~. 3. INSULATION 4. FINAL , CONSTRUCTION MU,~ BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MELr~ THE REQUIREMENTS OF THE N, ,~ STATE CONSTRUCTION & ENER~ CODES. NOT RESPONSIBLE FO~. DESIGN OR CONSTRUCTION ERROP,~--- OCCUPANCY' OR USE IS UNLAIt~'FUL WITHOUT CERTIFICI:,TE OF OCCUPANCY / / fl, ._. 55'-11 1/2" W.&D. OFFICE ENTRY 17'-4 112" DINING ROOM UP ARCHWAY BETWEEN DIN. RM. & LIV. RN JACKS UNDER EXIST. CONTINUOUS HEADER. ,~{ REM¢ )VE EXIST. CLO~ET LIVING ROOM 2 - 2X HEADER 6'0' ~u(~ i '""-" RELOCATE ENTRANCEWAY ~ TO PROVIDE OFFICE SPACE FOR FARM. ADD NEW STOOPS AND RAILS TO CODE. 20'-1" ~Dt~RSON FARM BUILDING #1 FIRST FLOOR PLAN ENVIRONMENT EAST INC. 1/4" =1'0" 4.25.02 REV. 7.25.02 REV. 7.31.02 EXISTIN( KITCHEN ADD 9-1/2' TO EXIST. W/SUPPORT MULLIONS. NO CHANGE TO EXIST. OPENING 17'-3 1/2' 23'-3 1/2"' 7'-1 "-- :- 5'-6" ELECTRIC UPGRADING BY PAUL BURNS ELECTRIC - LIC. # 3897E .~,. PLUMBING UPGRADING BY CUTCHOQUE EAST PLUMBING - LIC # 2877P~~~ NO EXPANSION OF EXISTING STRUCTURE. ~ '~'~ ~'~