HomeMy WebLinkAbout47574-Z '�SUEEOik� Town of Southold
o� oG 9/19/2022
y� P.O.Box 1179
53095 Main Rd
Way oma ' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43135 Date: 6/11/2022
THIS CERTIFIES that the building GENERATOR
Location of Property: 205 Summit Ln.,East Marion
SCTM#: 473889 Sec/Block/Lot: 38.-7-10.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/17/2022 pursuant to which Building Permit No. 47574 dated 3/21/2022
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"accessory generator as applied for.
The certificate is issued to Goldsmith,Richard&Judith
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47574 5/24/2022
PLUMBERS CERTIFICATION DATED
Au o ized i nature
�o�SUFFat,��o TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
0y • o�� 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#: 47574 Date: 3/21/2022
Permission is hereby granted to:
Goldsmith, Richard
455 Bardini Dr
Melville, NY 11747
To: Legalize as installed accessory generator at existing single family dwelling as applied
for. Additional certification may be required.
At premises located at:
205 Summit Ln., East Marion
SCTM #473889
Sec/Block/Lot# 38.-7-10.3
Pursuant to application dated 2/17/2022 and approved by the Building Inspector.
To expire on 9/20/2023.
Fees:
AS BUILT-ACCESSORY $200.00
ELECTRIC $170.00
CO-RESIDENTIAL $50.00
Total: $420.00
Building Inspector
pF SOU�yo!
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.deviin(aD-town.southold.ny.us
Southold,NY 11971-0959 Q�ycOUN'i`I,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Richard Goldsmith
Address: 205 Summit Ln city:East Marion st: NY zip: 11939
Building Permit#: 47574 Section: 3$ Block: 7 Lot: 10.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Home Owner License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Generator X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower 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: 14kW Generac Generator w/ 14 Circuit Generator Panel
Notes: Generator
Inspector Signature:
Date: May 24, 2022
S.Devlin-Cert Electrical Compliance Form
pESOUIyOIo H TS-7 1 2,0 —
# * TOWN OF SOUTHOLD BUILDING DEPT.
courm, 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) [ DELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ]CPRE C/O [ ] RENTAL
REMARKS: L ,,a
DATE 2 INSPECTO
FIELD INSPECTION REPORT I DATE COMMENTS
FOUNDATION (IST)
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FOUNDATION (2ND)
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INSULATION PER N.Y.
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMENTS
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o�°Suff��X°0 c TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y = . Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtownnygov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector
® E H E:
Applications and forms,must'be filled out in their entirety. Incomplete FEB 17 2022
OD
applications will not be accepted. Where the-Applicant isnot the owner,an, BUILDING DEPT
TOWN OF SOUTHOLD
Owner's Authorization form(Page 2)shall be completed.
Date: Z,
,IOWNER(S)OF PROPERTY: Q
Name: :fGingr _AUAI,4h I G,--n1 h SCTM # 1000-
Project Address:
Phone#: , ro-i 4 Email: , m
Mailing Address:
"CONTACT PERSON `_
Name: C;
Mailing Address:
Phone#: Email:
!DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
'DESCRIPTION OF PROPOSED CONSTRUCTION,
❑New Structure ❑Addition ❑Alteration LI Repair ❑Demolition Estimated Cost of Project:
Xther (2-�,CA--%cz-o.-A-0 r $ 1 it)10c3c)
Will the lot be re-graded? Dyes;WNo Will excess fill be removed from premises? ❑Yes ONO
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑YesVNo IF YES, PROVIDE A COPY.
Check Box After.Reading: The owner/contractor/design,professional is responsible for all drainage and storm water issues.as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY.MADE•to the Building Department for theissuance of a Building Permit pursuant to,the Building Zone
Ordinance of the Townof Southold,Suffolk,County,New York and other applicable Laws,Ordiriarices or Regulations,for the construction'of.buildings, -
:additions,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(s)for necessary;inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the,New York State Penal Law.-
Application Submitted By(print name):--�004\ Cj0 06M I— ❑Authorized AgentAOwner
Signature of Applicantjw—tbcc�,—,c,sk — Date: �� I s l
STATE OF NEW YORK)
SS:
COUNTY OF Ski I K )
SM I h being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)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 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 S&CUOLAV —, 20
_aa_ 1�)WW
Notary Public
TRACE L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATION NO.IN SUFFOLK
QUALIFIED N SUFFCOUNTY
(Where the applicant is not the owner) COMMISSION EXPIRES JUNE 30.2629-
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
� H
BUILDING DEPARTMENT- Electrical ItC
TOWN OF SOUTHOLD 7b&�Jtov
�} Town Hall Annex
54375
Main
R971d Box
Southw�l�o�HOC®
old NevYork1 -0959
f Telephone 631 765-1802 - FAX 631 765-9502
p ( )
ro err southoldtownny.gov - seand(aDsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: V�e_ Cu:,
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: A Q,c ,.� \c-1�, I�
Address: �- —4 LG, 1 !E2
Cross Street:
Phone No.: c �}
Bldg.Permit#: email:
Tax Map District: 1000 Section: 7?�K Block:
BRIEF DESCRIPTION OF. ORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage.
Circle All That Apply:
Is job ready for inspection?: YES ❑ 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 Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
PERMIT# Address:
Switches
Outlets
G FI'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: I
Comments I vl (zr ril Cj
_ SURVEY OF
• "� .• ° : .. ��' = LOT 17
° • •._`fie a • • • • 4 _
►�E BDX MAP OF
_�•�*�Z oo' ��jos . �'-�.,
SUMMIT ESTATES
�
SECTION No. 2
(C� c'9 FILE No. 10768 FILED MAY 21, 2002
..
o• �_� 8, -%� SITUATED AT
EAST MARION
D x,35 � ��. '��• <�, � °• TOWN OF SOUTHOL
f,l . -,Z.o' •� - SUFFOLK COUNTY, NEW YORK
aa+G• �c 9.e' �° LOT �7 ? 6'; �°
P
zO 3js ��� ° • S.C. TAX No. 1000-38-07-10.
�� �6� `� S�,a • e +U�—ATR v9S[I0�►fR S� F • SCALE 1 "=30'
1v ,' zea` a,. oes� PSA N uNrt sT
N`� �` `�r, � �� .. OCTOBER 26, 2004
W
e t APRIL 25, 2005 FINAL SURVEY
ID �^ 134' l0 85 t MAY 25, 2005 UPDATE DRIVEWAY
9' r
I 1 STORY FRAME �Iri. ��?S
AREA
ye: � GARAGE '•' � = 31,995.09 sq. ft.
SOUSE 0.735 ac.
31.2' \� D
CERTIFIED TO:
`3 I __woos pIA1 •'sp:-.,`
— sTePS --k. RICHARD GOLDSMITH
rz,i, 1 `�`' h� GOLDSMITH \UILDI:l -TtiDEPT-
JUDITH
MP FUNDING TpWNOFSOUTNOLD
FIRST LONG ISLAND TITLE
v11
LIN R=40.00'
L=59.94'
I CWY�DkON PRFPARED IN ACCORDANCE WITH THE MINIMUM
1 N STANDARDS FOR TITLE SURVEYS AS15HEt,`t_, M1
t 6Y THE LkA.L_S ARID-0-PROVED ANDD ADO ADOPTED-,-
FOR SLLW-USrW THE-1f0k.YORK STATE LAN.
I �76.2 ' ,� °Eyry �' TITLE ASSOCIATION.
2 24 W •`L �� r•.
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Novc TER or 7-mE ARK RC7,lON
22
3 Fid NOf p8? COUP, l l0 * N.Y.S. Lic. No. 49668
D� .a OF IAMLTH / '
UNAUTHORIZED ALTERATION OR ADDITION -
' r-�ftAL c l� � v1 EL7 W��+R�t�F� TO THIS SURVEY IS A VIOLATION OF Joseph A. Ingegno
A !�+;;;;LZ FAMILY tESIO� • SECTION 72LA OF THE NEW YORK STATE
.� r`� EDUCATION u►w.
1340ANl, 4 -- :. f,[fin, COPIES OF THIS SURVEY MAP NOT BEARING Land Surveyor
THE LAND SURVEYORS INKED SEAL OR
` Ah:Y �Jo TO BE
SEAL SHALL NOT BE CONSIDERED
TO 8E A VALID TRUE COPY.
` ' E'g!S►`�1ta;fit:r}c%�'Si:SfcI —a- > tea CERTIFICATIONS INDICATED HEREON SHALL RUN
110
W saftkdxy COQ,.a?.-O-��`yf.E t",,d' BEEDROOMS. ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED. AND ON HIS BENNY TO THE Title Surveys - Subdivisions - Site Plans - Construction Layout
k . TITLE COMPANY. GOVERNMENTAL AGENCY AND
4c,r r LENDING INSTITUTION LISTED HEREON. AND
To THE ASSIGNEES OF THE LENDING INS71- PHONE (631)727-2090 Fax (631)727-1727
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
office of W91Stewafsr MmaSemeM � OMCFS LOG4TEo AT nwurvc aonRFss
THE EXISTENCE OF RIGHTS OF WAY 322 ROANOKE AVENUE P.O. Box 1931
AND/OR EASEMENTS OF RECORD, IF RIVERHEAD, New York 11901 Riverhead. New York 11901-0965
ANY, NOT SHOWN ARE NOT GUARANTEED.
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