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HomeMy WebLinkAbout46539-Z �S�EFOL o Town of Southold 4/20/2023 P.O.Box 1179 0 C* _ 53095 Main Rd Ol � jrr� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44030 Date: 4/20/2023 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 47100 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 69.-6-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/25/2021 pursuant to which Building Permit No. 46539 dated 7/7/2021 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" gas hot water heater as applied for. The certificate is issued to Hoffman,Mark&Pierce,John of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED \WVV"*X\AW0 — tho ize 0 gnature TOWN OF SOUTHOLD 4�0�Su�f���COGy BUILDING DEPARTMENT 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#: 46539 Date: 7/7/2021 Permission is hereby granted to: Hoffman, Mark 47100 Route 25 Southold, NY 11971 To: Legalize as-built HWH converted from oil to gas at existing single family dwelling as applied for. At premises located at: 47100 Route 25 SCTM #473889 Sec/Block/Lot# 69.-6-11 Pursuant to application dated 6/25/2021 and approved by the Building Inspector. To expire on 1/6/2023. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO-ALTERATION TO DWELLING $50.00 Total: $450.00 Building Inspector FIFLD']NSx'ECTION REFQRT- DATE CU1Y1EAt.'I'3• FOUNDAhQN" (1ST) -------------i- ---- .- . _r_ . FOUND'TION(2ND) ' . . • .. � •. . . . �;� . 'ate ROUGH FRAMING Pa:;lim G T�ISL"T,ATION'PERN..Y. :. . STATE! CODE ,FINAL 1. � X1.33 '�. ••;� � .. is •, � I .. ,.:F''• � .' , 111_��' reel TOWN OF SOUTHOLD—BUILDING DEPARTMENT y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy • o� Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtowm.gov Date Received APPLICATION FOR BUILDING PERMIT ' D�For Office Use Only f 1 PERMIT NO. 1L'S3 _! Building Inspector: U J U N 2 5 2021 Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an ruTT-D mc T)EPT. Owner's Authorization form(Page 2 shall be completed. �,_,„. z•c r..T.�.F.9,� ,p1' Date: OWNER(S)OF PROPERTY: �y Name: f1(( V)if�o�� �► b y1/i ?l� ` ��_9'/P✓�L_ SCTM#1000= Project Address: Li Phone#: (0� 5 ( — C� ( r,�3 Email: Mailing Address: CONTACT PERSON: Name: 0.0 Mailing Address: S ow M0101,G( 1,_�- ,� ,��` N�____ r T _ _ Phone#: ( '-7(U5� 2✓C7 Email: C � VIC�_ (� Cd DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone M Email: CONTRACTOR INFORMATION: Name: A Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION E]New Structure ❑Addition ❑Alteration ❑Rep it ❑Demol'tion Estimated Cost of Project: ,Other O.A WX qMi A— '.RQ 1- 6 t0 qhs t`(11t� $---fire— 6 Will the lot be re-graded? ❑Yes 'fV0 Will excess fill be removed from premises? ❑Yes\.nNylo 1 PROPERTY INFORMATION Existing use of property: Intended use of property: R Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to ^Y p this property? ❑Yes5No 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 the issuance 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,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 nam):- C� �Ci ( M vo re authorized Agent ❑Owner Signature of Applicant: / _ � Date. STATE STATE OF NEW YORK) SS. 1, COUNTY OF CU© 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 duty uthorized 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 knowledgqnd belief; and that the work will be performed in the manner set forth in the application file th ith Sworn before me this RKI S No ary Publi , ate of New York JAday of�SrJn .2031 No. 0 E6130636 Commission gUhji fig, S PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, kocy-V-- Kofffrnc-h-t John �%eraesiding at '-1-1 1 oo Zlot—- i- Z� Sbu-'Mo(d' do hereby authorize -P Qin C✓k CL C aL-) roto apply on my behalf t o of outhold Building Department for approval as described herein. V.,� e Signature Date J-oh n P k, 2 r t,9- Print Owner's Name 2 BUILDING DEPARTMENT-Electrica ector L O��S SCO Gy TOWN OF SOUTHOLD JUN o =` ' Town Hall Annex- 54375 Main Road - PO Box 117 2021 ' o - Southold, New York 11971-0959GJrr 410� Telephone (631) 765-1802 - FAX (631 rogerKa�southoldtownny.Qov- seandO-southoldtownny:Q6VDr.p APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Cn Zylif Company Name: - - � Name: License No.: email: Phone No: 01 request an email copy of Certificate of Compliance Address.: JOB SITE INFORMATION (AII Information Required) Name: (i f � alyL � hnPI-erce Address: S : , i `- ((�-( 1 Cross Street: i Phone No.: 3k C - - Bldg.Permit#: �uo!�ZA email: on e Tax Map District: 1006 - S ction: (og Block: Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) ariR K 6,hel ('-nom) �- Check 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 ❑ Service Reconnect ❑ Underground ❑Overhead # Underground Laterals 01 ❑2 ❑H Frame❑Pole Work done on Service? ❑Y ❑N Additional Information: Wayc 61t)" PAYMENT DUE WITH APPLICATION CX " Electrical Inspection Form 2020.x1sx Y" 011 �� (� �D � D /l� PATRICIA C. MOORE JUN 2 5 2021 Attorney at Law 51020 Main Road Br1�,DTTG DEPT. Southold,New York 11971 Tel: (631) 765-4330 Fax: (631) 765-4643 Betsy Perkins Paralegal Julia Spanburgh Julia Schade June 25, 2021 Left in drop box Building Department Town of Southold PO Box 1179 Southold,NY 11971 RE: Hoffman&Pierce PREMISES: 47100 Rt. 25, Southold Dear Sir/Madam: With reference to the above, enclosed please find an application for a building permit and an application for electrical inspection. Also enclosed are two blank checks from my clients made payable to the Town of Southold. Please call our office to advise regarding the fees for each. Thank you. Very truly yours, Patricia C. Moore PCM/jms AP OCCUPANCY OR PROVED AS NOTED_ USE IS UNLAWFUL DATE:-ll.://�� B.P.# ��� FEE:g BY: WITHOUT CERTIFICATE NOTIFY BUILDING DEPARTM ;J AT OF OCCUPANCY 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUN_ArION - TWO REQUIRED FOF "-)URED CONCRETE 2. RC :- - FRAMING & PLUMBING 3. INSoi.ATION 4. FINAL - CONSTRUCTION MUST � BE COMPLETE FOR C.O. COMPLY W11-I4 ALL CODES OF ALL CONSTRUCTION SHALL MEET THE NEW YORK S T P - & TOWN CODES REQUIREMENTS OF THE CODES OF NEW AS RECRU I R" C' L ry r "� YORK STATE. NOT RESPONSIBLE FOR CONDITIONS OF DESIGN OR CONSTRUCTION ERRORS. Sti. ` „ TOWN ZBA Sr'I cru TOWN PLANNING BOARD SOUTIOLD 70'1NN TRUSTEES N.Y.S.DEC oWjftV NOU MdSNIIVDI'dl-)313 Q rAS.-FIRED CAST-IRON BOILERS FOR NATURAL AND L.P. PROPANE GASES Boom& 1qqW n ENTiiI This manual must be left with owner and should be hung on or I adjacent to the boiler for reference. . ' 1 - 4 THROUGH S- ■ 5th t -' mwk �:t __ ___ -'Mm44a, CONTENTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . PAGE ttJ1E+�2�•�°l�OT READ ALL OF THE FOLLOWING WARNINGS AND STATEMENTS BEFORE REAOtNG.THE Dimensions 2,3 INSTALLATION INSTRUd I. 7NS installation Requirements_ BoilerLocat-r,�n: - , ._, . - - ;. _ . - :.. . . . _ . :. . . __ . :3 WA,RFNING �,.,.. •s���:. Boller Fc�uiidatibrt.:.'. ,_ ... .'. . . . . . . . . .... . . . . . . .: 3 � LIQUEFIED PETROLEUM (L-P.) ` •:" Ctiirtztici�R gtiite�rits . . .. . . . .. . . ... . .. . . . .. . . 4 E PROPANE GAS-FIRED BOILERS ...-... --- ------------ ...---,--------.-,...----------------- - '- ---- ,_... lltrjtttttY Cfeasfce'.:::', ... : . . .4 r . . . . . .. . . Installation location ONLY as permitted in paragraph enfii- ' �` Vein=f?isitt g. . . . _. ..._ . . . _ ., ._ ^. 4 Fled-LIQUEFIED PE i ROLEU�f (LP} PROPANE �`AS- tf `s i t:: �!erle.tl 'tclstatlation :. ;:,. _ 5 i FIRED BOILER LOCATION"on page 4 of this instruction i'book. The above warningdoes.not apply to NATURAL. Fs,arf t`Wiiting. j gas-fired Boilers: Y Temperature I. r atu e Cant tai.:.':..:..'. '.... 0'� trip t .'l.,t. 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