HomeMy WebLinkAbout9910-zTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
12/16/2011
No: 35334
Date:
12/16/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
RESIDENTIAL ADDITION
00280 Sound Avenue, Peconic,
Sec/Block/Lot: 67.-1-7
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/2/1978 pursuam to which Building Permit No. 9910 dated 8/22/1978
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:
addition/alteration, including deck and central air conditioning, to an existing one family dwelling as applied for. This
Certificate of Occupancy updates C/O Z-9426, dated 2/5/79.
The certificate is issued to
Ten'anova, Paulina
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, N Y I 1971-0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
roger, richert~town southo d.n¥.us
BUILDING DEPARTMENT
TOWN OF' SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Peter Terranova
~,ddress: 280 Sound Ave City: Peconic St: NY Zip: 11958
Building Permit #: 9910 Section: 67 Block: 1 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential R Ind°°r J~J Basement ~ Service Only
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Rot Tub
Addition Survey Attic Garage
INVENTORY
ServiceServicelph b~ Heat3 ph Hot Water ~ Duplec Recpt ~ Ceiliflg Fixtures ~ HID FixtureSGFcl Recpt~m
Wall Fixtures Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture I I Pumps
Transformer Appliances Dryer Recpt Emergency Fixture~ I Time Clocks
Disconnect Switches Twist Lock Exit Fixtures L~J TVSS
Other Equipment: as built installation of central a/c-heat pump to include, service disconnect,
condenser, and blower
Notes;
Inspector Signature:
Date: Dec 7 2011
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) (~ELECTRICAL (FINAL)
REMARKS:
.iNSPECTOR'~:~-
FORM NO, ~
TO~N OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
9910 Z
Permission is hereby granted to:
Elbe~ Austin
....... ................................
. 280 Sound Ave
~, ', at premises located ar ............................................................................................................................
Pecont.c.x New Y.o...r..k..
" .. ,~. .... ~..~r~.~.,~:..5. ................................. .....
; 'pur~u6n~ ta oppli~:ation d~ted ........ .~ ............ ........ :.....: .... 19..~8., ~nd ~pproCed by the ~
Building Inspecto~r' '
NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's O~[ice
$outhold, N. Y.
Certificate Of Occupancy
No..z.q.l?.~ ...... Date .. ,F.e.b..r~l..a..~. .... 5. ........... , 19.79.
THIS CERTIFIES that the building located at ...2.8. Q. ~9..t~.d..A.y .e .......... ~
Map No....~ .~7. ...... Block No ........... Lot No ...... 5. ...........................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . .Augna~c.. 2 ......... , 19..7.9 pursuant to which Building Permit No.. 9.9'~0Z.
dated , .August;., 22 ......... , 19..7~ was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ........... : .~.~¥.a.~.e...0~.e.. ,F.~..~.l.y. ,I~..e.~.l. l~.g' .w..~.h..A..d.d.~.~. %.o.n. ...........
The certificate is issued to ........... .P.e.~.e..~..T.e.r'. ?, .a~.qya. ...........................
(owner, ~
of the aforesaid building.
Suffolk County Department of Health Approval ............ ~/I~ ....................
UNDERWRITERS CERTIFICATE No .......... N/~l..c).02~ ...........................
HOUSE NUMBER 280 Street Sound Ave
Peconic, New York ......
.................................................. . ......
Coun'~y To~ Number Building Inspector
1000-67-1-7
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold. N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion requ ired to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date
New Bui,ding v//~)J~/~'~°~O~lld o r p re-e× isting Bu ilding ............ Vacant Land .............
Location of Property "~ ~ 0 ~_~ ~- ~Z) ~
Street Ham/et
House No. ,;
Owner or Owners of Property ....... .~.-~ '?.~r~..~. · ~'~ .~."~ ..~. · .' .~-- .~. · .~. · .~.~..&/. · .~.
County Tax Map No. 1000 Section ....°/.'.~, ........ Block ..... ,/ ......... Lot .... '~ ..........
Subdivision ....... ~ ..... (.~. ..... ~'.~,, .Map No .... ~.-/. '~. ......Lot No ..... ' ..........
Permit No../~,¢..J.D. ,7__.,,, Date of Permit Ct,,(/'/~,, .Applicant... ,~. ,~.~ ,~.. ,?,'.
Health Dept. Approval ...................... ... Labor Dept. Approval ........................
Underwriters Approval . ~.~. ~Z/.~¢2~z'~ . .Planning Board Approval
/
Request for Temporary Certificate ..................... Final Certificate ,~,,.., ~ .........
Fee Submitted $ ..... ~.'..~?,'~ .................
Construction on above described building and permit.mze.~J~ all applic~ ~1~;_~ and regulations.
,,,v. ,o-',a-,a
THE NEW YORK BOARD OF FIRE UNDERWRITERS '
D rtl BUREAU OF ELECTRICITY ,
~- E~5 JOHN STREET, NEW YORK, NEW YORK 10038
Date J~r~,~G~'~/ ~,?,p ~QT~ ~pplicatio~No. onfile 0~0~:~ N
THIS CERTIFIES THAT · . . '
only the ~l~t~cal eq~ipme~ ~ described bel~ ~nd i~t~ 5y t~ 6pp~c~t ~med o~ the a~e opplicatlo~ nu~er ~ the premlses o~
?o'l'ei' Ferr,~nova~ Sound Ave,~ ~,~ti~ Lane. Peconlc~
inthefollowinglocatlon; ~ Basement ~:'~lstFI. ~ 2nd ri. Section Bt~
wasexamlnedon ,~5~;Jq~¥ ~8~ ~9 andfoundtobeincompllancewiththereqalrementsofthisBoard.
DRYERS FURNACE ~OTORS FUTU E Af~ AN ' BELt UNIT HBATERS ~ULTI-OUTLET
SERVICE DISCONNECT IN .0 [ S
OTHER APPARATUS:
This certificate must not be altered in any manner;, return to the office of the Board if incorrect. Inspectors may be identified by their',,credentials.
TOWN OF SOUTHOLD ,7 ~ ~,~/.
Examined ....... ~a~;Ltll.t .... ~ ........ , 19....~
Approved ~1; 22 19....?...8 Perm,t' C~.l...O.Z .
Dimpproved a/c ............................................................................................
(Building Inspector)
BUILDING DEPARTMENT~t~//.
TOWN CLERK'S OFFICL~ /
SOUTNO D, N. Y.
~-----'-~S~ion No.
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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
areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application.
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 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 purpbse whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Bud ng Department for the ssuance 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, ordnances, building code, housing code, and regulations, and to ~1~
admit authorized inspectors on premises and in buildings for necessary inspections, c:~
(Signature of applicant, or name, ~f a corl~oration)
~,/C~i.//~ ,maaress at applicantY
State whether applican~see, agent, architect, engineer, general contractor, electrician, plumber or builder.~-
If applicant is o corporate, signature of duly authorized officer.
(Name and title of corporate officer) .
Bu Ider's License No ~ ~ -
Plumber's License No .................................................
Electrician's License No....~ez.~,;~;,~ .....
Other Trade's License No ...............................................
//q
Street and Number .,,,,~O~..[.E,~,e~..':..~.~...~..~...~,,
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. Exisiting use and occupancy ,,.,~
v
b. Intended use and occupancy ....~....:
3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ...............
Repair .................. Removal .................. Demolitior ..................... Other Work .....................................................
(Description)
4. Estimated Cost .~'.n~.~.~ ......................................... 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 af 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 ......... ..2..?... ........... Depth ...... ,<..~...L~.~¢~
Height ....... /...~. ....... Number of Stories ....................................................... 2' ............................. ~ ..............................
Size of lot: Front .................. ~...~...~ ........................ Rear .............. .~....~.. .................... Depth ....... ~..~.~.~.. .............
Dote of Purchase ............./.~..-~...-~.-~.. ............................ Nome of Former Owner ....~..~.....~ ..............
Zone or use district in which premises are situated .............. ~ ................ .~' ............ ~ ........................
Does proposed construction violate any zoning law, ordinance or regulation: ........... ~ ................................. /
Will lot be regraded . ........ ~ ...... Will excess fill be removed from premises: ( ) Yes ( ~"No
premises .~.4~...¢. ~...~ ...
Name of Owner of Address .~..~.~. Phone No .......................
Name of Architect .............................................................. Address ...~.,,¢......, ...... Phone No .......................
Name of Contractor ....~..~.:.....~: ............ Address~//~'/'~-"~.~!,~4.... Phone
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and shaw street names and indicate
whether interior or corner lot.
+10.
11.
12.
13.
14.
STATE OF NEW_YORK .....
COUNTY/-.._ ,-_,~ ,~ f/ ,e"~/OF ....o.....~...~..'../~.....~.....Q.....f-'"-'
................ ~./,~./...~..~..~........V..:.....(..~....~... ............................... being duly sworn, deposes and says that he is the applican,
(Name of individual signing contracf)
above named.
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 stotements 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
........... ....... day of ......~"..Jl'l.~'~ ........................ ' Jg'~;'~'"'
(Signoture of applieont)
~ ~ ~A~EITE C. CONRoI'
leO?Ally I~BLi'C, StYe oJ Naw Yorl~
omn~si~n ExMr~s March ~, lJ~
¥
A P.~--~ VE Do.""~,~'~ NOTED
NOTiFy ~UILD~NG DE~ART/~ENT AT
765-2650 9AM fo 4Pt~ FOR REQU~R.
ED ~N~PECT~45:
2. FR4,~4F~ ..... ~..4..~
....... : FL~