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Home My WebLink About29960-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29928 Date: 12/22/03 THIS CERTIFIES that the building ALTERATION Location of Property: 1355 BAY AVE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 9 Lot 5.1 Subdivision Filed Map No. -- Lot No. __ EAST MARION conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 19, 2003 pursuant to which Building Permit NO. 29960-Z dated DECEMBER 19, 2003 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" INSTALLJ~TION OF CENTRAL AIR CONDITIONING IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JACK & DORIS SCHIMATZ (OWNER) of the aforesaid building. SUFFOLK COUN~rYDEPARTMENT OF H]~ALTHAP~ROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~u3 Rev. 1/81 N/A 1184107 12/15/03 N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29960 Z Date DECEMBER 19, 2003 Permission is hereby granted to: JACK & DORIS SCHIMATZ 1355 BAY AVE E MARION,NY for : INSTALLATION OF A CENTRAL AIR CONDITIONING UNIT "AS BUILT" AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 031 pursuant to application dated DECEMBER Building Inspector to ex~ire on JUNE 1355 BAY AVE EAST MARION Block 0009 Lot No. 005.001 19, 2003 and approved by the 19, 2005. Fee $ 300.00 Authormzed Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approvai of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plmnber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Corcanercial building, industrial building, multiple residences and similar buildings 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-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 consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees ?. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming 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 ofOccupaocy - Residential $15.00, Commercial $15.00 New Construction: /' Old or Pre-existing Building: (check one) Location of Property: / ~9'~- /~ ~-{ C'~ House No. ~et Hamlet D Owner or Owners of Propeay: ,~ ~C~E ~ g'~S Suffolk County Tax Map No 1000, Section '-~/ Block Lot ~ / Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~,, Date of Permit. Filed Map. Applicant: Underwriters Approval: Lot: Final Certificate: (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by PATRICIA MOORE JACK & DORIS SCHMITZ 020 MAIN 1355 BAY AVENUE SOUTHOLD, NY 11971 EAST MARION, NY 11939 Located at 1355 BAY AVENUE EAST MARION, NY 11939 Application Number: 1184'107 Certificate Number: 1184107 wiring, below, the premises at: Section: 1000 Block: 31 Lot: 5.1 Building Permit: BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and described located in/on Basement, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 15th Dayof December, 2003. Name QTY Rate Rating Circuit Type Appliances and Accessories Air Conditioner 1 0 30.000 BTU Wiring and Devices Disconnect 1 0 60 amp Air Conditioner A visual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 1 of 1 lhis certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined__, 20__ Approved __, 20__ Disapproved a/c Expiration__ 20__ PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey ·, Check~O~ ~,-..~_ - Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Building APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bnildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the perrrdt for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to thc 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, or alterations or for removal or demolition as herein described. The applicant agrees to comply~. ~. ~, ,,,,--, ,,,~,~ ,.~mwith all applicable laws, ordinances, building code, housing code, and r~egulations, and to admit author/zed inspectors on nO necessa. inspections. USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ? UgDERW $CERTg Ai / , Nameofownerofpremises ,.J,.:~C.t .r, f>6'r/'~ .~( li,fr/ct./~ DATE; ,~/te[f (As on the tax roll or lairdS:deed) If applic~t is a corporation, silage of duly authorized officer NOTIFY BUILDING DEPARTfv~.NT AT (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which propos, ed work will be done: House Number S(reet Block 765-1802 8AM Ti), 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO R~3UIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL. CONSTRUCTIO~ BE COMPLETE FOR C.O. ALL CONSTRUCTION ~ MEET THE CO ES OF NEW ~l~tOR CONSTRUCTION ERRORS. Lot ,I; / County Tax Map No. 1000 Section ~ / Subdivision Fi~ed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and:occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy_ 3. Nature of work (check which applicable): New Building Demolition 4. 5. Repair Removal Estimated Cost If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Sizeoflot: Front 10. Date of Purchase Rear .Depth Name of ~b'tmer Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulatior2 YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YEg . NQ __ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE RE~ : b. Is this property within 300 feet of a tidal wetland? * YES NO ' .. ,~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ~ 16. Provide survey, to scale, with accurate foundation plan and distances to p~perty !ines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY ,O '/"~/F'Z~rX~ fd~?d~F~'-~ : being duly swom, deposes and says that (s)he is the applicant (Nm.n~e~!ndiyiOu01'sign/n'gr.~oatract) above named, (S)He is the · Agent, Corporate Officer. etc.) of said owner or owrier~, and is duly auf.13ori~ed to perform or have performed the said work and to make and file this application; that all statem~at~ confained in this~ ~ip~tic,gtipn-are tree to the best of Iris knowledge and belief: and that the work will be performed in the manner set forth ini~hE~l:llic~ion filed therewith. Signature of Applicant Claire L. Clew mo~ary Public, State of NeW No. 0 IGL4879505 Qua d~ed in Suffolk COUI~ ,x/II,, ,~ ormniss~on Exp res Dec. 8, .~