HomeMy WebLinkAbout49539-Z ��o`pSUFF�t,��pG Town of Southold 8/14/2023
P.O.Box 1179
CO ;W 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44431 Date: 8/14/2023
THIS CERTIFIES that the building HVAC
Location of Property: 300 Birch Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 54.-9-18.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/23/2023 pursuant to which Building Permit No. 49539 dated 8/1/2023
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"HVAC system to existing single family dwellingas applied for.
The certificate is issued to Feld,Cheryl
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 49539 8/4/2023-
PLUMBERS
/4/2023PLUMBERS CERTIFICATION DATED
c
NAtho d Signature
��o�SUFFoc,��o TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
' TOWN CLERK'S OFFICE
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#: 49539 Date: 8/1/2023
Permission is hereby granted to:
Feld, Cheryl
300 Birch Rd
Southold, NY 11971
To: Legalize an "as built" HVAC system to an existing single family dwelling as applied for
per manufacturers specifications. Additional information may be required.
At premises located at:
300 Birch Rd, Southold
SCTM #473889
Sec/Block/Lot# 54.-9-18.1
Pursuant to application dated 6/23/2023 and approved by the Building Inspector.
To expire on 1/30/2025.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO-ALTERATION TO DWELLING $50.00
ELECTRIC $180.00
Total: $630.00
Building Inspector
pF SOUjyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q Jamesh _southoldtownny.gov
Southold,NY 11971-0959 Q�yc01UNT`1,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Cheryl Feld
Address: 300 Birch Road city:Southold st: New York zip:
Building Permit#: 49539 Section: 54 Block: 9 Lot: 18.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Homeowner Electrician: 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 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 1 Single Recpt 1 Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt Emergency StrobeHeat Detectors
Disconnect Switches 4'LED Exit Fixtures Sump Pump
Other Equipment: 1 30 amp Condensor 1 20 amp air handler 1 condensation pump
Notes: AS BUILT HVAC
Inspector Signature: WDate: August 4, 2023
300 birch road hvac
��pFSOUTyo �� �� fJVV �CI Com/l
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycournv,��' 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 p [ ] PRE C/O [ ] RENTAL
REMARKS: 45 8�.� �� 14 A 61
qq
DATE - INSPECTOR
apF SObTyO�
# # TOWN OF SOUTHOLD BUILDING DEPT.
coum, 631-765-1802
s
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ INAL II(/4,:�,
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS: 4
DATE S-- 6 a3 INSPECTOR
MELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST) (?�
------------------------------------
ek
FOUNDATION (2ND)
r,' O
W �
ROUGH FRAMING& DKI
PLUMBING
1
INSULATION PER N.Y. 3
STATE ENERGY CODE A
V�
O
64.93 0 ec 2i c G 8
on
FINAL
ADDITIONAL COMMENTS e!�
SL
e C44-J--
0
z
m
X
X
b
d
O
z
Z�
x
d
b
H
o�sufFutk�o� 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.southoldtoMMU.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 53 _ 1
Building Inspector: s,?-Ir i i'
JUN 23 2023
Applications an4 fiorms„must be fiNed out,in their en#irety lncomplete
applications will not be accepted Whereahe Appkcant;s not the owner,an M ` . T�
Owner's Author�zataon form(Page 2)shall be completed. -
Date:
J
OWNER(S)`OF°PROPERTYi' '
Name:
,.am SCTM#1000-
. _ .._ —
Jf.....:. .... ..� �.. .�..._..:
Project Address:
....... ... ..... .. .. ....300..... (� ._ .., . _ . ,. .. :..�. . ._.
Phone#: r Email:
Mailing Address:
„ _ x
="CONTACT PERSON
Name:
Mailing Address:
Phone#: Email:
DESIGN 1?RbFE5S10NAL INFORMATION k n .j,
..3; t, F'. s✓, .>' -} i' f. x +➢, f, ' ..s,� f k :4 -,k_3xk `tel 1 ;,F
Name:
Mailing Address:
Phone#: Email:
CONTRALCTOR INFORMATION:
Nam11 e:
Mailing Address: ......_. .... ...... ,...:...
2
Phone#: _ Z Email:
S�. .. ... .........:_ +. : :.
❑New Structure ElAd dition, ❑Atte-,rati�❑Repair ❑Demolition Estimated Cost of Project:
L91Other
Will the lot be re-graded? ❑Yes f o Will excess fill be removed from premises? ❑Yes kNo
1
PROPERTY INFORI1f1AT10N=
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? E]YeSKNo IF YES, PROVIDE A COPY.
n"*0001i; profesgional is respo�i6le for all
n
Chapter 236 of the Town Code APPLICATION 15 HEREBY MADE to the Building Depi3rtifi�-afor the lsiva'nc'e"of
permit ourstint to tf ie Building Zone
Ordinance of the s i- applicable� "
-P-Siop�hqld,-��l'kx�ount "4ws',P� atlonsfor'thecorutruction Of tiulklings, 'i
.- -
lalterations or- '- 1for removal,,or -6"h6IW6iasherein descnbLd�rhp"a
pp'iic#'n,
tpg"ee'-
'-st6-p
*q
pipAP, ordinances,:
JoIng imhd 1ifoqsapd'tqad ftauthorized ;on premises buildings) necessary inspectioI ten
punishable as e Class A.rnisdemeanorpqrsUant�to zjo4soika '4oikState
Application
Submitted By(print name 13Authorized Agent, Owner
... .. .. ..
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF 511
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 0W Yr P,
(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
aatdayof 202-3
��a Public
TRACEY L.DWYER
PROPERTY OWNER AUTHORIZATION f4o-rApy pU13LIC,STATE OF NEW YORK
No.01 OW6W6900 -
(Where the applicant is not the owner) QUALIFIED IN SUFFOLK COUNTY
COMM Sr,10N EXPIRES ME 30,Z01P
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
��—o
Print Owner(i Name
2
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
o x Town Hall Annex- 54375 Main Road - PO Box 1179
o Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
1 ' rogerrta'�_southoldtownnv.aov - seand(cDsoutholdtownnv.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ail Information Required) Date:
Company Name:
Electrician's Name:_
License No.: v Elec. email:
Elec. Phone No- ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information R wired)
Name: r--r--z I
Address: o L
Cross Street:
Phone No.: �-�
Bldg.Permit#: y OI 539 email
Tax Map District: 1000 Section: 51f Block: Ct Lot: I$.
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
A1
Square Footage:
Circle All That Apply:
Is job ready for inspection?: [:fYES[:]NO r-�Rough In Final
Do you need a Temp Certificate?: FIYES❑NO Issued On
Temp Information: (All information required)
Service Size❑1 Ph 03 Ph Size: A #Meters Old Meter#
❑New ServiceOFire Reconnect OFlood ReconnectOService ReconnectOUndergroundOOverhead
#Underground Laterals 1 2 M H Frame 0 Pole Work done on Service? MY N
Additional Information:
PAYMENT DUE WITH APPLICATION
BUILDING DEPARTMENT- Electrical Inspector
' C��rz TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
%4�:' Telephone (631) 765-1802 - FAX (631) 765-9502
ro err southoldtownn� .aoi✓ sea nd@southoldfiownnv.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date: (p ? 23
Company Name:
Electrician's Name:_
License No.: v Elec. email:
Elec. Phone No' ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All information Re uired)
Name: OfA" 1
Address:
Cross Street:
Phone No.:
Bldg.Permit#: y q 539 email:
Tax Map District: 1000 Section: 5Lf Block: I Lot: 18.
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
►4 �G.
Square Footage:
Circle All That Apply:
Is job ready for inspection?: [fYES ❑ NO ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES❑NO Issued On
Temp Information: (All information required)
Service Size 71 Ph 73 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
�D v, .3 l to i s conntc
l fir haVIolIec
l Swi SCh
APO OLA-6-
man
• rIT><�raj _.._:_.,..:�_:.�....._..�.
f'/NE so �e
IV-0 7 45,120 c
I• (n /30,9! ' •-
N.
2
i
COMPL WITH At=e.C07D�S`�,✓. o�` �D NEW YORI STATE &TOWN
CODE 13 0
k ; r fir
AS REQUI ED AND CONDITIONS C
n soui}+aDTOWN zeA
Qll1HOLD TOWN PLANNING BOAR,
r of !MULU TOWN TRUSTEES
pa DEC
40E /30.9
44
f1 o
X .
�tl
/�
c��'ti ti j 3
10) y p' ~° ODA
' /r•'i N y, MOT 'i':. ,.-.. .. '1! -
I. .. •. •�', �Ca.iti l:��'n-A •�C. �!I^•�:IB�Jl".4tio,tYa�,'.-' -' -. ...,
MEASUREMENTS IN U.S.STANDARD t `T'' :;:1 4 F'/ao o • ��c;
c:
TNr,SDIMENiIONS fHbWN NEREON;'FIIOM TN!'STRUCTUAES TO T HB PROPIIRTY LIN@ ARK POM A SPECIFIC-PURPOSE ONLY.,THEY
ARE0OT•INTENDBD TO BE USED FOR THE ERECTION Of,FENCE;;'eTRUIM.R S.OR ANY OTHER IMPROVEMENT..
...r .• . - .' ;•Y..N'2\n.••••,y�:tn+f•. �;Y '•,. ., ..^••'.•! OUARANTEEB INDIQATFA BI ER $HALL lIUN Y TO
HOMTHE
C'OPIR�AF THIS:SURVEY.MAP-No1 ON NIS SENALFRTWO•TTHE TRk�ANY,.
UNAUTHOIUZEO ALTERATIONt bR'AOOI RING THIe "1 MICR-BURVEY06'8 t AOENCYAND LENp11i01 �l� D bIIF11C�Ok
TIONS TO THIS-SURVEY 1S,A VIOLATION "INKED ¢.GLAm
'EIyrOSBED SEAL M TO •THE ASST NEE 05.
OF8ECTIONT209,SUQDIVISRNI7OFTHE'' Q :'7 E LF?�DINO,
NAVY YORK EAUCATION LAW.
SNAI1:"'IIQj�INAiDERED•TO-SEA "It11t110N
VALID TRUE C ' `- ..,. dUAAANtEES ARE NOT ttRANSFERASLE TO ADDRIONAL
IN6TRUTIQNS OR'SUOSEQUENF'.OWNER&
r Kl1LF1ANEK & PLAN SECTION BLOCk DATE
- 20 .90
SAND SURVEYOR&.P.C. �
. , GUARANTEED TO 1I_
. � 1 �� souTH NOC. p
ONO ISUMOTIFICrWESTCIIESTEA OFFICE •: COUNTY
P.O.IIOX Q7 p.`0.ppX 1TH.
LONG BEAQH,N.Y.11561,•• f.POIIND•RIDO�;M,Y;1067$1" JOB NO.:
' 8U0•Stt-5124 .";;.' :''� _ .
FAX{5161.431.9461 FAJ(.,m 4j'764 M.-. 90- 3 S o 0 9
c ; _
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
APPROVED AS NOTED AS REQUIRED AND CONDITIONS OF
$- 1
DATE B.P.# q 53 SOUTHOLD TOWN Z6A
FEE 450-0C) BY SOUTHOLD TOWN PLANNING BOARD °' <
NOTIFY BUILDING DEPARTMENT AT `
765-1802 8 AM TO 4 PM FOR THE �' SOUTHOLDTOWN TRUSTEES {
FOLLOWING INSPECTIONS: "' \
1. FOUNDATION-TWO REQUIRED N.Y.S.DEC
FOR POURED CONCRETE
2. ROUGH-FRAMING,PLUMBING,
STRAPPING, ELECTRICAL&CAULKING
3. INSULATION
4. FINAL-CONSTRUCTION &ELECTRICAL
MUST BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW ELECTRICAL
YORK STATE. NOT RESPONSIBLE FOR INSPECTION REQUIRED
DESIGN OR CONSTRUCTION ERRORS.
Additional
Cerdficatiott
May Be Requirel
Y-1 41
Fn sir
Ififfmom
Conditional Warranty
Consumer Warranty Confirmation
The new degree of comfort:'
Product Information
Model Serial Registration Date Install Date
RA1636AJlNA W182103386 7/13/2021 5/31/2021
RH1T3617STANAA W1 82157399 7/13/2021 5/31/2021
Customer Information Contractor Information
First Name Cheryl Name JN18SI Heating and Air CONDITIONING
Last Name Feld Josue Menjivar
Email cheryl@lmpulseboutiques.com Email jmechanic_mv@yahoo.com
5165288477 Phone 6312550733
Address 300 birch rd Address 2150 new Suffolk ave P.O.Box 735
City Southold City Mattituck
State NY State NY
Postal Code 11971 Postal Code 11952
--Z-7111
Your Conditional Warranty 19 novV registered,andvill bahQnored in the cvontofa warranty claim,ONLY if all additional terms
andconditions detailed in tho,Mant)f'acttji�ei-�.'�'V.V�frranty Certificate,�are safisfleo.
VIOW OUr Prl'VVq.V P011GY-@t kh.eem.com.
i I U I film 11AII91111115 If Hill
El 6 1 !1& U