HomeMy WebLinkAbout48782-Z oo�Og�FF01 py Town of Southold 3/25/2023
o P.O.Box 1179
o _ g 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43954 Date: 3/25/2023
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 4270 Aldrich Ln,Mattituck
SCTM#: 473889 Sec/Block/Lot: 120.-3-8.36
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/15/2022 pursuant to which Building Permit No. 48782 dated 1/23/2023
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" ductless mini-split air conditioning;to existing single family dwelling as applied for.
The certificate is issued to 4270 Aldrich Ln LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48782 2/27/2023
PLUMBERS CERTIFICATION DATED
Au or ed ature
�o�S�FFOy �, TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y —f TOWN CLERK'S OFFICE
"oy • 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#: 48782 Date: 1/23/2023
Permission is hereby granted to:
4270 Aldrich Ln LLC
330 McGuinness Blvd
Brooklyn, NY 11222
To: Legalize as-installed ductless AC unit at existing single family dwelling as applied for.
Additional certification may be required.
At premises located at:
4270 Aldrich Ln, Mattituck
SCTM #473889
Sec/Block/Lot# 120.-3-8.36
Pursuant to application dated 12/15/2022 and approved by the Building Inspector.
To expire on 7/24/2024.
Fees:
AS BUILT-ACCESSORY $400.00
CO-RESIDENTIAL $50.00
Total: $450.00
Building Inspector
SO!/T�ol
0
Town Hall Annex _ Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 aQ sean.devlinCcD_town.Southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: 4270 Aldrich Ln
Address: 4270 Aldrich Ln city:Mattituck St: Ny zip: 11952
Building Permit#: 4$7$2 Section: 120 Block: 3 Lot: 8.36
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X 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 1 Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors
Disconnect Switches 4'LED Exit Fixtures Sump Pump
Other Equipment: Mini Split
Notes: AS BUILT NO VISUAL DEFECTS " Mini Split w/ One Blower Head
Inspector Signature: e:
February 27, 2023
S.Devlin-Cert Electrical Compliance Form
OF SOUTyO� "L E7 ,2, W S-7 v L� V
f # TOWN OF SOUTHOLD BUILDING DEPT.
courm, 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] 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:i
DATE INSPECTOR
�� oF SOIoq�+610005 -- -
* # TOWN OF SOUTHOLD BUILDING DEPT.
°`ycooNty��' 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATION/CAULKING
[ ] FRAMING/STRAPPING [ FINAL 4W l-
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
DATE INSPECTOR
ELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST)
-----------------------------------
FOUNDATION (2ND)
N
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4 cn
y
ROUGH FRAMING &
PLUMBING SL}
n
W
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INSULATION PER N. Y. - -- y
STATE ENERGY CODE
Aft. —
FINAL
ADDITIONAL COMMENTS v
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P.O.Box 1179 Southold;NY 11971-0959
A;4' Telephone(631)765-1802 Fax(631) 765-9502 https://www.soutlioldtownny.ao
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only lU7 I I I IVI
PERMIT NO. C Building Inspector: DEC 15 2022 LD
Applications and forms must be filled-out in their entirety.'Incomplete EuLo NG DEPT.
applications will,not be accepted. Where-the Appllcant is not the owe ner;an AWN OFSOffTHOL®
Owners Authqrkation form(Page 2)shall'be completed.
Date:12.7.22
OWNER(5)OF PROPERTY:
Name:4270 Alrich Lane LLC SCTM#1000-120-3-8.36
Project Address:4270 Aldrich Lane Mattituck
Phone#:917-656-0287 Email:barbarak@mysticbrokerage.com
Mailing Address:330 MCGUineSS Blvd. Brooklyn NY 11,222
CONTACT PERSON:
Name:Joan Chambers
Mailing Address:PO Box 49 Southold NY 11971
Phone#:631-294-4241 Emailloanchambers I O@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:NA
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:NA
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure OAddition ❑Alteration ORepair ODemolition Estimated Cost of Project:
OOtherDUCTLESS AC ADDED TO DINING ROOM $
Will the lot be re-graded? OYes ®No Will excess fill be removed from premises? ❑Yes RNo
1
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PROPERTY INFORMATION:
Existing use of property:RESIDENTIAL Intended use of property:SAM E
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
AC this property? Dyes WNo IF YES, PROVIDE A COPY.
®Check Box After.Reading:'The owner/contractor/design professional is responsible for all drainage and storm water lssues as provided by ,
Chapter 236 of the Town Code.APPLICATION,IS HEREBY MADE to the BuUding Department for the issuance of a Building'Permit pursuant to the Building Zone
ordinance of the Town of Southold,Suffolk,County,New Yorkand other applicable laws,Ordinances or Regulations,for the construction of buiWtngs,
additions,alterations or forremoval or demolitlon as herein described.The applicant agrees to comply with-all applicable laws,.ordinances, ' IIding code,-
housing code and regulations.and•to admit authorized Inspectors on premises'•and In buildings)far necessarq'tnspections.False statements made herein are
,punishable as'a Class A inhdem6hhor pursuant to.Seitidn 210AS of the New.York State Penal•Law:
Application Submitted By(print name):JOAN CHAMBERS BAuthorized Agent ❑Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No.01 BU6185050
SS: Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14,20_'-:)-y
`J a/W CR-A (3ms being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the i-G''
(Contractor,Agent,Corporate Officer,etc.)
of said owner-or owners,and is duly authorized to per-form 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
164 \ d 1
day of ��/11/�.�) .20o1.a-
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, residing at
do hereby authorize to apply on
my behalf t t ffo n of Southold Building Department for approval as described herein.
f, _2
Owner's Signature / Date
t�L r1u,
Print Owner's Name
2
a� tt�
q�'�®SU�FQ�Kc L G 9618 EPARTMENT-Electrical Inspector -d' S
TOWN OF SOUTHOLD
JAN 21 213
Town Hal,
-iK- 54375 Main Road - PO Box 1179
Ca
Southold, New York 11971-0959
T"OFTOetep9one (631) 765-1802 - FAX (631) 765-9502
rogerr@southoldtownny.gov - seand@southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: F-1 I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: 4270 Aldrich Lane LLC (Barbara Skendaris)
Address: 4270 Aldrich Lane Mattituck
Cross Street: Harvest Lane
Phone No.: contact Joan Chambers 631-294-4241
BIdg.Permit#: 4G-1 6�2- email:joanchambersl0@gmaii.com
Tax Map District: 1000 Section:120 Block: 3 Lot:8.36
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Installation of a single ductless a.c. unit in dining room.
Square Footage:
Circle All That Apply:
Is job ready for inspection?: R YES❑NO F]Rough In Final
Do you need a Temp Certificate?: R YES ❑NO Issued On
Temp Information: (All information required)
Service SizeF11 Ph❑3 Ph Size: A #Meters Old Meter#
New Service[-]Fire ReconnectRFlood Reconnect[]Service Reconnect Elunderground ElOverhead
#Underground Laterals n 1 n2 0 H Frame El Pole Work done on Service? MY F1N
Additional Information:
r
PAYMENT DUE WITH APPLICATION � � too-
6616 EIPARTMENT-Electrical Inspector -t 5
i
TOWN OF SOUTHOLD
, JAN To�noHall -lax - 54375 Main Road - PO Box 1179
'' ' iJl ° ���� Southold New York 11971-0959
¢ � v ,
��3�90F• 0 `� �
Jeep one (631 765-1802 - FAX (6. 1) 765-9502
,?. r6aerrac outholdtownny.ciov - seand(d�southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ali Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: 4270 Aldrich Lane LLC (Barbara Skendaris)
Address: 4270 Aldrich Lane Mattituck
Cross Street: Harvest Lane
Phone No.: contact Joan Chambers 631-294-4241
Bldg.Permit#: LIS-1612— email:joanchambers10@gmaii.com
Tax Map District: 1000 Section:120 Block: 3 Lot:8.36
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Installation of a single ductless a.c. unit in dining room.
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 Ell Ph❑3 Ph Size: A # Meters Old Meter#
®]New Service®Fire Reconnect®Flood Reconnect ]Service Reconnect®Underground Overhead
# Underground Laterals 1 2 H Frame 0 Pole Work done on Service? Y FIN
Additional Information:
9
a
PAYMENT DUE WITH APPLICATION i V�O
Concerning:
Skendaris residence
4270 Aldrich Lane
1000-120.-3-8.36 12.12.22
LisaMarie Horton,
Attached please find a Building Permit Application for the ductless AC unit
installed in the dining room at the Skendaris residence.
You requested this application in your email dated November 7th, 2022.
Can you please make sure that this application is reviewed promptly as
part of the rental permit application that has already been submitted and
reviewed.
If you need any else to move this rental permit along please let me know,
Thank-you,
Joan ChambersLD BEC 15 2022
BUILUING OEF .
' OWNOFSOMOL®
Horton, LisaMarie
From: Horton, LisaMarie
Sent: Thursday, December 15, 2022 3:34 PM
To: 'joanchambers10@gmail.com'
Subject: Electrical Application
Attachments: Request for Electric Inspection Form-1_202109161414153823.pdf
Hello Ms. Chambers,
Thank you for delivering the application for the as built AC Ductless Unit. We will also
need an Electrical Inspection Application filled out and mailed or emailed back to us.
For your convenience, I have attached an application to this email. Please feel free to
give us a call if your should have any questions.
Kindly,
Lisa
Z&a.Mar,e Morton
Town of Southold Building Department
Annex Building
54375 Main Road
Southold,NY 11971
(631) 765-1802
i
Concerning:
Skendans Residence..
4270 Aldrich Lane LLC
4270 Aldrich Lane
1000-120.-3-6,36 1.9.2023
Lisa Marie Horton,
In your email dated December 15th 2022 you requested an application
for an electrical inspection to accompany the application for the
building permit for a ductless AC unit at the above named property.
The Application for an Electrical Inspection is attached,
Thank-you,
Joan Chambers
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TANKS AND CESSPOOLS St- OVP-i -:rA-e. Aw
HEREON ARE FIS:LD OBSERVATU JS
AND OR DATA t31y3��AINED FROM OTS EVI S. Rived
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d tltsNow York State Education Law.
t�-SURUEY"OF �—
CsnificsOxm indicated hereon shat run only to the perso t for whom it is prepared •
and an his Neenah to the Tiffsand to Mears ces,of the le dingIAgency lAut Lenong or,s h /�� �/�',,..,� � k � /
tnsstution tistsd hereon,and to list assigrtvos of the lending instiiutrons or sut7se• F"`F{ �rr`��
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APPROVED AS NOTED OCCUPANCY OR
DATE* �a3�3B'P# � �� USE IS UNLAWFUL
NOTIFY BDEPARTMENTAT WITHOUT CERTIFICATE
FOLLOWINGLINSPECTIONS:FORTHE OF OCCUPANCY
1. FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE
Z ROUGH-FRAMING&PLUMBING
3. WSULATION
4. FINAL-CONSTRUCTION MUST
BE COMPLETE FOR C.O. t"; �L�t \N:1-H AL.L. CODES OF
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW NEY', YOFI- FT 1TE & TOWN CODES
YORK STATE. NOT RESPONSIBLE FOR AS F{EQU i h`�� AND CONDITIONS OF
DESIGN OR CONSTRUCTON ERRORS SOL�7,yOLD TOWN ZBA
SOUTHOLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
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Certification
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