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Home My WebLink About29109-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA/~CY No: Z-29391 Date: 04/24/03 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 8325 MAIN RD EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 2 Lot 32.4 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JA/~UARY 3, 2003 pursuant to which Building Permit No. 29109-Z dated JANUARY 16, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificaue is issued is INSTALL~ATION OF NEW HEATING SYSTEM & BILCO ENTRANCE ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. ·"ne certificate is issued to ROBERT E HA~RRINGTON (OWNER) of the aforesaid building. SUFFOLK COUN~I~ DEPARTMENT OF I{EALTH APPROVAL EL~t'i~I~AL CERTIFICATE NO. PLU~4BERS CERTIFICATION Rev. 1/81 N/A 111559 04/04/03 N/A Authorized ~nature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29109 Z Date JANUARY 16, 2003 Permission is hereby granted to: ROBERT E HARRING~ON PO BOX 525 EAST MARION,NY 11939 for : CONSTRUCTION OF A BILCO ENTRANCE ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 031 pursuant to application dated JANUARY Building Inspector to expire on JULY 8325 MAIN RD EAST MARION Block 0002 Lot No. 032.004 3, 2003 and approved by the 16, 2004. Fee $ 150.00 -~uthorized Signature Amended to includde Heat[n§ system ]/]7/03 2 CO'S required COPY Rev. 5/8/02 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: Ao 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. Bo 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. Co 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations 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. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 New Construction: Location of Property: Old or Pre-existing Building: House No. Street Date. {~/-[ C~-0~'~ ~ (check one) Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section __ Block Lot Subdivision Permit No. ?--~ I 0 Health Dept. Approval: Date of Permit. Filed Map. Applicant: Underwriters Approval: Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ,q~'- , Final Certificate: ¢o E q3?l k~/ (check one) Applicant Signature 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 ROBERT HARRINGTON P.O. BOX 1061 8325 MAIN RD SOUTHOLD, NY 11971-0932, SOUTHOLD, NY 11971 Located at 8325 MAIN RD EAST MARION, NY 11939 Application Number: 1115559 Certificate Number: 1115559 Section: Block: Lot: Building Permit: 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, ;i 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 4th Day of April, 2003. ~ Name QTY Rate Rating Circuit Type ~ Miscellaneous 51 1-gas furnace and 1-cord and i~_ plug connected gas ~ water heater ~ Appliances and Accessories ~ Furnace 1 0 Gas .=-'1 Wiring and Devices ~ Receptacle 2 0 General Purpose ~ Switch 2 0 General Purpose I seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence or a raised seal at the location indicated. (:3 76S-1802 BUILDING DEPT. INSPECTION [~] FOUNDATION 1ST [~X~ FOUNDATION 2ND [ ] FRAMING ROUGH PLBG. INSULATION FINAL [ ] FIREPLACE & CHIMNEY INSPECTOR BUILDING DEPT. INSPECTION FOUNDATION 1ST [] ROUGH PLBG. :ORAU~iDNA~ION 2ND [[ .] ~~NA/TION FIREPLACE & CHIMNEY DATE TOWN OF SOUTHOLD BUILDING' IYEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ./ Examined //tiff , 20 Approved l,--)//~ -, 20 O :~ Disapproved a/c Expiration _,:oo4 PERMIT NO..,? ? / 0 ? iY~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Binlding Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 O~ a. This application MUST be completely filled in by type~vriter 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 nmy 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 ajay purpose what so ever until the Building Inspector issues a Certificate of Occupancy. £ Every building perrrfit 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 bema 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. - ~Signatnre Sf applicm~t o~nmne, 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 (,0. {21 aC- . 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. Lo_cation of land on w~ch propos,,ec[ work will be done: House Number Street County Tax Map No. 1000 Section 0.~ I. 0 0 Subdivision (Name) APPROVED NOTED (As on ~e t~ roll or latest de~-1802 9 AM TO 4 P;4 FO~ THE FOLLOWING INSPECTIONS: L FOUNDATION . TWO FOR POURED CONCRETE Z ROUGH . FRAMING & ,- [ INSU~TION ~ FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.% STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Hmlet Block 0~0 Lot Fil~ Map No. ~t State existing use and occupancy of premises and i~ttended use and occupancy of proposed constmcti6n: a. Existing use and occupancy ('~-,5¢r--t t~'~ b. Intended use and occupancy 5. If dwelling, number of dwelling units / If garage, number of cars ,~ Nature of work (check which applicable): New Building_ Repair Removal Demolition Estimated Cost ' Fee Addition Other Work Alteration (Description) (To be paid on filing this. application) Number of dwelling units on each floor / 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 ~,/~ t Number of Stories Height. Dimensions of~,ame structure with alterations or additions: Front Depth ~,l ! Height [~ ' Number of Stories 8. Dimensions of entire new construction: Front Height /t~ Number Of Sto--~es 9. Size of lot: Front ~.~ r Rear o/L~ 10. Date of Purchase (0 -~~ ~ Depth Rear Depth ./ Depth ,..~ 3 3 Name of Former Owner ]~0 ~ ~1 :~ (JLJ~lLg. f~ ~' 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ 13. Will lot be re-graded? YES__ NO e~il excess fill be removed from premises? YES__ 14. NamesofOWnerofpremises ~0~[~ ~'~Addr~;; ~t~r~l~ ~../~]~'/,~PhoneNo. Name of Architect 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 B.E R~UIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO c~ * 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. STATE OF NEW YORK) COUNTY QFC~]~g: ~O~e~.m~ ~ ' [¢~ r'l ~-~7 being duly sworn, deposes and says that (s)he (N o ' dividual signing c%ntraet) above named, is the applicant (S)He is the ( . _.5.-~ ~mct~, gent, Corporate Officer, etc.) of said owner or owners, and is~Sffl~authorized to perform or have performed the said work and to make and file this application; that all statements contained in th/s application are tree 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 C'x ~. /~ d ay of Notary Public CLAIRE L. GLEW Notary Public, State of New York No. 01 GL4879505 Qualified in Suffolk Cou.~v~ Commission Exl)ires Dec. 8, ~