HomeMy WebLinkAbout48001-Z �'�g11FFQl;��
a0�4 coGy Town of Southold 7/30/2022.
P.O.Box 1179
o • 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43297 Date: 7/30/2022
THIS CERTIFIES that the building HVAC
Location of Property: 1100 Haywaters Rd., Cutchogue
SCTM 9: 473889 Sec/Block/Lot: 111.-3-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/24/2022 pursuant to which Building Permit No. 48001 dated 6/27/2022
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"HVAC as applied for.
The certificate is issued to Novick,Thelma
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48001 7/13/2022
PLUMBERS CERTIFICATION DATED
\\JV\S�r
A ori ed1 ature
urtFot�oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
y z '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#: 48001 Date: 6/27/2022
Permission is hereby granted to:
Novick, Thelma
PO BOX 154
Cutchogue, NY 11935
To: Legalize as-built central AC system at existing single family dwelling as applied for.
Additional certification may be required.
At premises located at:
1100 Haywaters Rd., Cutchogue
SCTM #473889
Sec/Block/Lot# 111.-3-8
Pursuant to application dated 5/24/2022 and approved by the Building Inspector.
To expire on 12/27/2023.
Fees:
AS BUILT-ACCESSORY $400.00
CO-RESIDENTIAL $50.00
Total: $450.00
Building Inspector
SOUjyol
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.deviine-town.southold.ny.us
Southold,NY 11971-0959 COw'��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Thelma Novick
Address:1100 Haywaters Rd city:Cutchogue st: NY zip: 11935
Building Permit#: 48001 Section: 1 1 1 Block: 3 Lot: 8
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 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Surrey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO
Transformer Uc Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment:
Notes: " AS BUILT NO VISUAL DEFECTS " HVAC
Inspector Signature: Date: July 13, 2022
S.Devlin-Cert Electrical Compliance Form
OF so
# TOWN OF SOUTHO D BUILDIN DEPT.
�0 • �o
�ycourm, 631-765-1802
INSPECTION
[ ] FOUNDATION IST [ ] 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 C/O [ ] RENTAL
REMARKS: AS b-10'0, 14 Mf,�
DATE INSPECTOR
SOOlyolo
# * TOWN OF SOUTHOLD BUILDING DEPT.
`ycourm��'' 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] ULATION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
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DATE 7,d2VV INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION(1ST) ►•
------------------------------------
FOUNDATION (2ND) �C6
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ROUGH FRAMING& SI m
PLUMBING
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INSULATION PER N.Y. y
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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O�gUfF0lx�o TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959
Telephone(631)765-1802 Fax(631)765-9502 haps://www.southoldtow=ggv
Date Recelved
APPLICATION FOR BUILDING PERMIT
40-DI
For Office Use Oniy ®PERMITNO. Building Inspector--WON .....sw�. MAY 2,,4 ,
1(179
Applltratlons.-Ond—,formBUILDING DEPT.
Opplicationswill.rioit-biO-aiceptecl. Where'tkkAppliclont Is.not-tho o"or,.on TOWN OF SOUTNOLD
OIiNn.oegAuthoriiation f6r0-10age 2):shail.bg 0mploted.
Date: M..y 11,'1a311.
OWNERS)OF PROPERTY-4
Name: �O"`°`�4' �` SCTM#1000-
Project Address: J l o t7 K y wowk k.PS AoaA Lot a-k%0,%%9,c t ►A9 a w Ve J t' 11 ,13S
Phone#: X14 Email: 6o%A%A%-e L%A0ao3lh19� 1J,Cc n.,
Mailing Address: 1;0 Wo0A Iaw1 Q.ogA G4-t%4 1-�kAbA' O'e v9 lo✓ r 1➢,5 �f
CONTACTPERSON
Name: A 10, ► [-\A 0 C\o�
Mailing Address: go v3oo,,\Votm � Aoa A 16A-e-4 14-kA %a yo,IT l i�'�➢�°
Phone#: Email: ,floAo.SIn- 6cgo toC-e%v�
AE--S-10N PROFI SSIONA.INFORMiATI.ON: -
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMAT-I.ON:-
Name:
Mailing Address:
Phone#: Email:
DESCRIPMON OF PROPOSED CONS'tRUMOM
ONew Structure ❑Addition ❑Alteration ❑Repair ODemolition Estimated Cost of Project:
[]Other $
Will the Int be re-graded? ❑Yes 0 N Will excess fill be removed from premises? OYes ONo
1
PRO ERTY-INFORMATION
Existing use of property: (U dv,I Intended use of property: PAS,,A"E� q I
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? DYes MNo IF YES,PROVIDE A COPY,
(9 Check BoxAfter,no dirgg} the owper/�iin�tA�jrjd�sl��prpf8ssion�Rls respgrt�ll;1$�t�lr�rajp�g0.�nd stflritl SMdter i3sn�s h"s-pi�pidi3�i.��l
Chapter 235:Qf the TOWN CgSle�•Appl(C%iTIQ�#(S HERBY HIIibE;b the Buflt�lhg-t?epa►4rtasfitfo.0 tFIe.ssuanc0e�B�llliiRg=r'efinit=pu�Suant: t>ti�Bgljc�ing2pne
Ofdinanrk ofhaT , .4� hdffQcig ( Qauj)depss! [ lrig+;
adtllt(gns,:alterBtlLtns or-for Ite?ght �+ 1�:flle[.appll-c�t1t ag�rea95 to.�ptn(ily_uyltkall ip�l(ca a loNiS 4fdlhAn.�Ps�bY1il. ing Via,.
hbusing:cods end regulations:atitl.to admit suthori:ed lnspectots:Qtl prem4fies and_In:ltutlding�s):fox epees§ary•inspacefians.:False staeri1e46*040hordln tirb
punl;habl�as: 'Class:A°iitisttehleangrjsur;uant toSecRltiq?14;AS of kl+a:NeiN'Vark-$tate Rehal.i a§ir.
Application Submitted By(print name): c�0 %A v\ e. C.k 0 c ,� ❑Authorized Agent CROwner
Signature of.Applicant: o" � Date: uM wy t ei, X 0 21
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 0 %k'A-"
(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/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
day of. ,20,1;�, �
Notary Public
KANDE HIRSCH
Notary public,State Of New York
PROPERTY OWNER AUTHORIZATI No. 01HI6034975
(Where the applicant is not the owl missionl Expires u C unty
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
�O�OS�I FOLK�OGy BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
co
Southold, New York 11971-0959
'djj O Telephone (631) 765-1802 - FAX (631) 765-9502
roaerr(_)southoldtownny.gov - seand(cD-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: "1Y 4V
Electrician's Name: C'
License No.: Elec. email:
Elec. Phone No. 'I request bA email copy of Certi icate of Compliance
Elec. Address.: q 3o
JOB SITE INFORMATION (All Information Required)
Name: 0
Address: �� �2®
Cross Street:
Phone No.: �
Bldg.Permit#: ( o email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
%P /
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES [_ NO F-]Rough In Final
Do you need a Temp Certificate?: YES ❑ NO Issued On
Temp Information: (All information required)
Service Size❑1 PhF-13 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? DY FIN
Additional Information:
PAYMENT DUE WITH APPLICATION
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ofFo r � BUILDING DEPARTMENT- Electrical Inspector
r � TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
�l- Southold, New York 11971-0959
A, 0- Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr()southoldtownny.aov — seandasoutholdtownny. ov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email: 0-7 ra.jra
Elec. Phone No.
.0 I request bA email copy of Certi icate of Compliance
Elec. Address.: i��S (4ci X9 )..
JOB SITE INFORMATION (All Information Required)
Name: �, e
Address: ' :.�. �F- '
Cross Street:
Phone No.: �
Bldg.Permit#:_ email:
Tax Map District: 1000 Section: I Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
, 7O,dv c/C�!`"" w d40 -in-sup c
`-` e, ��` ��� ��� �� Square Footage:
Circle All That Apply:
Is job ready for inspection?: i YES ❑ NO ❑Rough In ZFinal
Do you need a Temp Certificate?: YES ❑ NO Issued On
Temp Information: (All information required)
Service Size❑1 PhF-13 Ph Size:. A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 H Frame M Pole Work done on Service? Y DN
Additional Information:
PAYMENT DUE WITH APPLICATION
10
�C,
PERMIT# Address:
Switches
Outlets 1
GFI's
Surface
Sconces
H H's
UC Lts
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
Combo Cooktop Transfer
AC AH Mini
Special:
Comments:
I '
THE EXISTENCE OF RIGHTS OF WAY Area= 25,855 si.
DRAWN MN CHECKED NN APRIL DATE 2022 ORAWMG k JOA N0.22-23U AND/OR EASEMENTS OF RECORD IF
- ANY, NOT SHOWN ARE NOT
UNAUTHORIZED ALTERATION OR ADDITION GUARANTEED.
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW. Premises known as:
COPIES OF THIS SURVEY MAP NOT BEARING # 1100 Haywdtf;rs Road, Cutchogue
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED,AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSRTU710N LISTED HEREON„AND
TO THE ASSIGNEES OF THE LENDING INSTI—
TUTION. GUARANTEES ARE NOT TRANSFERABLE.
y�y
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Certified to: 'LAND SJ� Survey of Lot 9
WESTCOR LAND TITLE INSURANCE COMPANY
EMINENT ABSTRACT, INC. (EA3136-S) REVISED SUBDIVISION PROPERTY OF ALONZO JERSEY
U.S. BANK, NATIONAL ASSOCIATION FILED APRIL 28, 1930 AS FILE NO. 763
ITS SUCCESSORS AND/OR ASSIGNS AS THEIR INTERESTS MAY APPEAR situate in the
KATHRYN C.ARBOUR AND ANDREW GENTILE
Town of Southold
Michael W. Minto, L.S.P.C. Suffolk County, New York
LICENSED PROFESSIONAL LAND SURVEYOR District 1000 Section 111 Block 3 Lot 8
NEW YORK STATE LICENSE NUMBER 050871
87 Woodview Lane Scale 1"= 40' Surveyed April 14, 2022
Centereach, N.Y. 11720 GRAPHIC SCALE
PHONE/FAX: (631) 580-1202xu 4o eo 1so
�a
CELLULAR: (631) 766-9714 a
w EMAIL: mikemintolspc®gmail.com
( IN FEET)
1 inch = 40 ft.
OCCUPANCY OR
APPROVED AS NOTE n I USE IS UNLAWFUL
DATE:�B.P.# WITHOUT CERTIFICATE
�E:s 45D. 0O.BF: OF OCCUPANCY
NOTIF BUILDING DEPAR MENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2, ROUGH - FRAMING & PLUMBING
& INSULATION "-
4. FINAL - CONSTRUCTION MUST COmPLy.WITH ALL OODES:O.
BE COMPLETE FOR C.O. NEW YORK;STATE:8i �'OVyN CODES
ALL CONSTRUCTION SHALL MEET -AS REQUI.R .. :ANQ:`CQN�JTIONS..OF
THE REQUIREMENTS OF THE N.Y. ,, ,
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FORD. IIN.Z�A.
DESIGN OR CONSTRUCTION ERRORS _: OUtFICLDTOWNPLANNlN�BQp.
k.
:% St�1I01D TONM TI�STEES '.
Additional
Certification RETAIN STORM WATER RUNOFF
May Be Required. PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
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