HomeMy WebLinkAbout25623-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Bouthold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26630
Date: 08/13/99
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 1625 CHABLIS PATH SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
county Tax Map No. 473889 Section 51 Block 3 Lot 3.6
Subdivision Filed Map NO. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 2, 1999 pursuant to which
Building Permit No. 25623-Z dated MARCH 18, 1999
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 ONE FAMTT.y DWE?.r.T~G WITH ATTACHED TWO CAR GARAGE AND UNFINISHED SECOND
FLOOR AS APPLIED FOR.
The certificate is issued to SCOTT B AUGUSTINE
( OW-NER )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0037
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 07/12/99
08/03/99
H 064715 06/21/99
K & K PLUMBING & HEATING
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25623 Z
Date MARCH 18~ 1999
Permission is hereby granted to:
SCOTT B AUGUSTINE
PO BOX 487
BELLPORT,NY 11713
for :
CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED TWO
CAR GARAGE AS APPLIED FOR (UNFINISHED 2ND FLOOR).
at premises located at 1625
County Tax Map No. 473889 Section 051
pursuant to application dated MARCH
Building Inspector.
CHABLIS PATH
Block
2 1999
SOUTHOLD
0003 Lot No. 003.006
and approved by the
Fee $ 471.40
ORIGINAL
Rev. 2/19/98
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
mo
Thi's application must be filled in by typewriter OR ink and submitted to the buildin
inspector with the following: for new building or new use:
1. Final survey of .property with accurate location of ali buildings, property lines
streets, and unusual natural er 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, muitiple residences and similar buildi
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a
Vpre-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 a consent to inspect signed by the applican
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~ming 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 $15.00
New Construction .... ~. ..... Old Or Pre-existin Building ............
Location of Property ..............................................
House No. Street Hamlet
Onwer orof Property . .
Health Dept. ~pproval ~. .......... ~nde~rers royal ~ ......
....... App .......
PlannSng Board ~ppro~al ....................
Requesr for: Temporary Certificate ........... F~nal Cerr~caee...~. .....
Fee 8ubm~e~ed:
TOWN OF' $OUTIIOLD
OFFIC~ O~ ~UILDII.IG INSPE~O~
P.O. BOX 728 ·
TOWN 1 IA LL
~O~llOLD, N.Y. ! 1971
~,,E R T I F ~ C A T i O M
Notary Pub/i=
~SULATION PER N. Y.
STATE ENER~-'Y
CODE
!//?~/
AFFIDAVIT
Coun ,ty of Suffolk
State of New York
To the Southold Buildings Department
I, Scott Boger, residing at 455 Willow Pt Road, Southold, NY, am the owner and builder of 8aid
property on Chablis Path, Chardoany Estates, Southold, NY which has been issued a New
Building Permit No. ~ ~- ~99 by the Southold Building Dept.
When apply!ng for said permit, a survey prepared by a licensed surveyor indicatit~ the allowable
buildable ~enveiope/ The foundation, as constructed, lolls within that allowable envelope. I plan
to have a foundation survey prepared by the same surveyor to memorialize that fact. However,
sinqe the surveyor has been hospitalized, he is ~nof ~ivaihi~l~:~or several weeks and the earliest I
can get a replacement surveyor will be se{/eral'in6nths.
In order to proceed expeditiously with the construction of the dwelling, now that the weather
permits and my l~bor 'force is'available, I will ~ss~e full respon~s~blhty for correcting the
location of the dwelling if it does not meet the lo~ation' requirements of the Southold code.
SWORN to me this 21st day of April, 1999
Scott Boger
NOTARY PUBliC, State of New York
No, 480~
Quatified in SuffOlk COUn~ /:
Commission Expires ~~
765-1802
BUILDING DEPT.
INSPECTION
[ ~FOUNDATION 1ST [
] ROUGH PLBG.
] INSULATION
] FINAL
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: ~;;~~- ~,~:. X''~
DATE
INSPECTOR
76S-1802
BUILDING DEPT.
INSPECTION
[ I FOUNDATION 1ST [~ROUGH PLBG.
[ ]/FOUNDATION2NO [ ] INSULATION
/
FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
RE~ M~RKS: ~
~-~-~
INSPECTOR
765-J.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ I FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS: ~/~' ~
[ ] ROUGH PLBG.
[ ] IN/SULATION
[ ~FINAL
INSPECTOR
7sS.lso,
BUILDING DEPT.
INSPECTION
[ ] FO~IDATION 1ST [ ] ROUGH PLBG.
[ ~r~UNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLA~CHIMNEY
REMARKS: ~
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] R/OUGH PLBG.
[ ] FOUNDATION 2ND [~*~j~ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CH/U~INEY
R~MARKS:/~~~~~ -//
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
TO: Scott Boger
P.O. Box 1603
Southold, N.Y.
STOP WORK ORDER
11971
YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT:
1625 CHABLIS PATH~ SOUTHOLD~ N.Y.
TAX MAP NUMBER - 1000-51-3-3.6
Pursuant to Section 45-8 of the Code of the Town of Southold,
New York, you are notified to immediately suspend all work and
building activities until this order has been rescinded
BASIS OF STOP WORK ORDER:
FRAMING STARTED WITHOUT FIRST SUBMITTING SURVEY OF
FOUNDATION LOCATION TO BU?LDING DEPARTMENT FOR APrRoVAL.
CONDITIONS UNDER WHICH WORK MAY BE RESUMED:
WHEN SURVEY SHOWING FOUNDATION LOCATION IS
SUBMITTED & APPROVED BY BUILDING INSPECTOR.
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
DATED: APRIL 21~1999 .
Bou IS /
/ ZLDZN XNSPECT0a'
(CERT. MA L)
FOR:
ENSRGY CODS CALCULATIONS~
(For Non-glac~ric Ileal)
SUBSYSTEM
Exterior: walls
Glazing /~ %
Doors
ceiling/Roof (Opaque)
Skylights %
(Opaque)
Floor
Foundation Walls
Slab Insulation
TOTAL
DESIGN THSl~MSL
"U" RAT I NG
.3z .3I
0,3' o
o'~ 6
REMARKS
~]uildlng envelope Systems to'meet requirements of 7815.2
HVAC Squipement to meet requirements of 7815.11
HVAC Systems ko meet requirements of 7815.1'2
Duct Systems to meet raquireme~ts oE 7815.13
Ventilatious Systs,us to meet requiremeuts of 7815.14
~nsulatio~ of Piping Systems to meet requirements of 7815.15
Service Water Heating Systems & Equlp~ent to meet requiremeuts of 7815.21
Slectrlcal & Lighting Systems & Equipment to meet requirements of 7815.31
To the beet of my knowledge,
belief, & professional
judgement, these plans are 3. n
tempi.lance wtti~ the code.
-FOBIiN0. I
TOUNOF SOUTHOLD
BUILDISG DRPARTHENT
TOWN HALL
SOUTII0LU, N.Y. 1197!
TEL: 765-!802
Disd~Loved a/c . · ......
BOARD OF HIIALTlt ...............
3 SgTS OF pLANS ........ ' ---
SURLY .....................
CNKCK ·
SEPTIC F01~i ...................
CALL ..................
HAIL TO: ·
APPLICATION PON BUILDING PgRIilT
' Date: ............... ,19 ....
INSTRUCTIONS
a. This application mst be c~wfletely filled in by t3rpe~iter or in ink and submitted to the Ihildi~ Inspector wi
3 sets of plans, accurate plot plan to scale. Fee accordi~ to schedule.
b. Plot -plan si~ri~ locetion of lot and of buildi~s on premises, relationship to edjoinin~ premises or p~blic
streets or areas, aed glvi~ a ~e~ailed ~esorlp~ion of la. ut of propet%7 ~ust be dra~ oa the dia~m ~hich is part of
:this application.
c. The work co~ered b~ this application ~ not be ccr~eeced before issuance of Buildi~ Pemit.
d. Upon ~p.X~L1 of this application, the Buildi~ luspector will issue a Buildiz~ Pe~it to the applicant. Such
pamlt shall be.lml~ on the ~-,.ises available for iuspection fist ~be work.
e. NO buildi~ shall be occ~)ied or used in ~hole or in par~ for a~ purpose ~hatever tmtil a Certificate of
0cee~,v~ shall have bse~ ~a~ted by the l]uildi~ hmpector.
AITLICATI(li IS 1]~¥ ~ ~o ~ Buildiu8 DeparU~nt for the issuance of a BuildiL~ Pemit porsu~t to the
I~uildiu8 Zone Orfllna~e of ~ To~ of ~on~old, Suffolk CourtLy, li~ York, and other applicable I~m, Ordimmces or
Regulations, for the ccesL-mction of buildi~ss, additions or alterations, or for reg~al or demolition, as herein
a!~ses to ,~=?ly with dl .applicable la~, o.~.?am:~.._building .ced~, .h~sir~ code, and
t~.~ulatices, a~l to admit
0 2/ ........
...... .... 9..
(l~{l{r~g ~klre~ of appl{e~ot)
State ~'~etber ~pplicant ~ o~r, lassee, ~e~t, ~hltect, e~g{seor, geseral ~ou£r~ctor, eleetrici~, pltm~er or bu{lde~
..... .0..~..¥.~.~, ..................................................... o .............................................
· ' .' . <o~-~ 4 ~¢.0.~. ~. ...................................
(~ o~ the t~t roll or late~t deed)
/
If ~plieant ~ a tozl~r~ti~, ~i~nce of 4uly ~thori~l officer.
title of corporate officer)
lhilders License No ........................
Plt~bers Lic,~ne No ...................
l~lectricians Li_-~e No ....
{~ T~'s I,ice~ No .....................
I. Incation of 1~ on ~hich ~ ~,~zk~vill be dot'me ..............................................................
' ' f' ~.~l~ l)~-r/-/- ~ou.O ,. ........
............. ~ ..............
B0use l%~mber Street ~let
· ~/ ,u~,, ...... ~ ......~t ...~,~ .......
Camt~ Tax 1~_
.......... ,,1,ed No ................ ..........
2. State existi~ use and occupancy of ~,~..ises and intended use aed ~occul~mcy Of proposed comstnx:tlon:
a. l~xlsti~ use aed occupancy .......................................... ,-.--., - ~ ................
b. ~d
3. ~t,re o1~ ~ork (daeck ~hid~ applicable); ~ Building .......... Addition ..........
~pth .................... ~t .................... ~r o[ 8tor[e~ ...............
~ of ~tr~tor ................................... ~rese ............................... ~ ~ .......
PLOT DIAGRAH
£~cate clearly ,and dlstimtly ali Imtldin~, ~aetl~r ~ist:ing or propo~l, ~1 indic~to all set-back dhn~nsions
h'a'a vt'o~rt'y lit, es. Give street: ~! block nt~bor or description ~eeordtng to d~l, ~ ~ atrc~t n~aes ~ ir~eate
~hether interior or mr lot.
~FA1E OF K¥.'W YOlk, '~B
.....~..~..O...'/.~[...'.~..~/~ ........... , ...................... beitlg duly s~om, deposes and says thst he is t~ appl. ieant
(t~ma of individual si~i~ contract)
above ~mad,
(Contractor, ~ent,; corporete officer, ere.)
of.' said (x~er or c~mers, and is dutyl ~Jthoclzed to perform or have per£or~l the seid ~ork ~1 to make ~ file this
applieati~; that all statements contained in this applieatlo~ are true to tJae best of his lex~ledge end betiefi and
that the ~ork viii be performed to the mariner set forth ie the application filed therewith.
,9~om to ,~ r~ this
Notary Publio, State of Now Yo~k
No. 4961364
Ouallfied in Suff..olk County
Commission Expires, May 22,
THE NEW YORK BOARD OF FIRE UNDERWRITERS
8'~756~5 BUREAU OF ELECTRICITY
/!
~-- 40 FULTON STREET, NEW YORK, NY 10038
Date JU~]~ 21,1999 Application No. on file 18228099/99 H {~64715
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above applicaHon number is in the premises of
SCOTT BOGER, 1625 CHABLIS DRIVE, P O BOX 1603, SOUTHOLD, ~
in the following location; [] Basement [] 1st FI. [] 2nd FI. GkR/ATTIC/OUT Section 51 Block3 Lot 3.6
was examined on JU~ ~§ , 1999 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES
OUTLETS
26 26
DRYERS
FIXTURES RANGES OVENS EXHAUST FANS
FLUORESCENT OTHER
OTHER APPARATUS:
WELL PUHP--F- 1
~.F,C.I:-10
SHOKE DETECTOR~ -4
E R V I C
NO OF CC COND, I A. W, G,
PER ~ I OF CC, COND
2/0
NO, OFHI-LEG
AWG.
OF HI-LEG
NO. OF NEUTRALS
OF NEUTRAL
2/0
SCOTT BOGER
1~25 CF,~BLES DRIVE
P. O. BOX 16~3
SOUTHOLD, NY, 11971
Per .~iGENERAL MANAG~
This certificate must not be altered in any manner; return to the office of the Board if irtcorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWel OF SOUTHOLD
June 24, 1999
Scott Boger
P.O. Box 1603
Southold, NY 11971
NOTE: Before a Certificate of Occupancy can be issued, an
Engineers letter is required.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XXThe check is (not on file.)$25.00
XXNo Health Department Approval on file.
No final inspection has been made.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 25623-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.