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Home My WebLink About50493-Z IS0fF0(,f�oGy Town of Southold _ 4/19/2024 P.O.Box 1179 VP - 53095 Main Rd Southold,New York 11971 I CERTIFICATE OF OCCUPANCY No: 45130 Date: 4/19/2024 THIS CERTIFIES that the building HVAC Location of Property: 355 Azalea Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 115.-6-9 I Subdivision: Filed Map No. Lot No. I conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/26/2024 pursuant to which Building Permit No. 50493 dated 3/29/2024 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"14VAC system to existing single family dwelling as applied for. I . I The certificate is issued to Ackermann,Barbara of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 50493 4/5/2024 PLUMBERS CERTIFICATION DATED Auth rize S gnature i �SOFFot��o TOWN OIF SOUTHOLD moo aye BUILDING DEPARTMENT H a TOWN CLERK'S OFFICE SOU I HOLD, 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#: '50493 i Date: 3/29/2024 Permission is hereby granted to: Ackermann, Barbara 355 Azalea-Rd PO-BOX 291 Mattituck, NY 11952 To: Legalize an "as built" HVAC system as,applied for. Additional information may be required. I, At premises located at: 355 Azalea Rd, Mattituck SCTM #473886) Sec/Block/Lot# 115.-6-9 Pursuant to application dated 2/26/2024 and approved by the Building Inspector. To expire on 9/28/2025. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $500.00 CO-RESIDENTIAL $100.00 ELECTRIC $200.00 Total: $800.00 Building Inspector laf so # TOWN OF SOUTHOLD BUILDING DEPT., `ycou 631-765-1802 INSPECT[ON ' [ ] FOUNDATION.IST/ REBAR [ ] ,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: DATE INSPECTOR OF 50Ulyo - b # TOWN OF SOUTHOLD BUILDING DEPT. Low, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ✓fFINAL �l5'L✓v�`�� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: �D� 42a C o. d-e l DATE 5�a INSPECTOR Authan8slgn IC;E1D28C98-D6CD-EE1,1-85Fg-6045BDD68161' =o TOWN OF SOUTHOLD-.-BUILDING:DEPARTMENT: y Town Hall Annex-54375 Main:Road'P:O.'Box 1179.S6uthold,NY 1197-1-0959:- -•: : Tele hone 631 765.1802:,Fax'x 631 765 9502 h s//www.s6utholdtownn . ov 4. • �.Date Received APPLICATION:FOR.BUILDING !PERMIT I . • For Office Use.Only. PERMIT NO. .5 Building Inspector:: . . F:E B: 2 �. 2024:: Applications.and forms must be filled,out in their entirety..Incomplete applications.wilI not be.accepted.'Vhere'the Applicant is not the owner,an. Owner's Authorization form(Page 2)shall.be completed. . .' ca;. c►a�ttii�ld' .T :Date f—L a •1-9, 202C' : OWNERS)OF PROPERTY: :.Name: :: .sCTIVI#:i000-:�:15-6_B:arbara'_Ackerma_nn.',_:_;._ �. . _- - - -...----: -- =9. . . Project Ad.dress:355:Azalea_rd':.;:__Mattituck,_: _1__1952. ': . ..hone#63.1:-379-9813_:__:::: ::.'_:!_.'_: Emai1:b6ck56 . .aol.com : M611ing'Address:21 C:resce_ntwSt;:A .t # 4113.9; Wakefield; CONTACT PERSON:. - :Name:hlanC. ._. . ervelli M ailing Addres ss:-:1.065:Bria e ntine.:Dr.:;:South.old;.:NY:___1._1:971 : Phone#:631=680-2296_: _ ,_:_:::_ ':. I :. : :Emaii:nanq :cervell,i, 46'iel., ale com DESIGN PROFESSIONAL.INFORMATION: :Name:'. = Mailing Address: : :: :_ :. .. . : Phone#:: :. : . '. ;: ' Email -CONTRACTOR INFORMATION:- Name: :.Mailing Address: . . . ":. Phone#:": . :. Email: DESCRIPTION OF PROPOSED CONSTRUCTION El New Structure Addition DAlteration�❑Repair OD' olition.. Estimated Cost of.Project:' . . V Will the lot be re-graded?,E1Yes'8 No. Will excess fill.be removed fior i premises?:DYes i mo.. .'Authentisign,IN:E1D28C9B-D6CD•EE11-85F9.6045BDD68181 PROPERTY INFORMATION Existing use of property:R Intended use of property: - - v. w es(de.ntial _.___ .. : - - Residential_r - . . .. -Zone or.use district.in'w shich.pre,mises i situated:: Are there any covenantsand restrictions with respect to this property?.'❑Yes 8 NO IF YES;PROVIDE A COPY. - -'El 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 orRegulations,for the constFuctionof buildings, additions;alterations or for removal or demolition as herein described.The-applicapt agrees,to,comply with all'appllwble laws,ordinances,building code,- housing code and regulatlons.and to admit authorized Inspectors on premises'and to building(s)for necessary Inspections:t else statements made herein are panlshable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. " .. :ApplicatonSubmittedB r'int:name N,CanC. CerVell:i BAuthorized:Agent ❑Owner' y,(P .. ) 7 Signature of Applicant:':. 4. CONNIE D.BUNCH :.STATE OF NEW YORK) :,' : . ..._. Notary Public,State.of New York. " No'.01®U01850.5®. S: : . .. S Qualified in uff k C un . . COUNTY gF.. . :.':)': .: . - :Commission Expires Aprl1.1 4: 2J. - bein orn,deposes and says that:(s)he.is the applicant -being-duly:sworn, (Name of.individual,signing contract):above,named; .(S)he.is•'the .. (Contractor,Agent,'Corporate. Officer;.etc.): of said owner.dr owners;and is duly.authorized to perform or have performed.the:said work:and to make:and.file•this applcation;:tliatell statements contained in:tfiis;application are true to the best of his/her knowledge and"belief;and that.the.workwill'be performed in the manner set forth in the application'file:therewith: Sworn before,me'this CA. : day of . Notary Public PROPERTY•"OWNER•AUTHORIZATION pplicant(Where.the a is'not the owner) 1 St.;.Apt#"1139,1Nakefield, MA 01880 . Barbara-ACke rm.a n n residing at� crescent Nancy Cerve .. . •. " . do hereby authorize .. . :. ": •:to:apply:.on• 'my behalf to the Town ofSoutliold Building Department for'approval.as described herein: 02/17/24 . 4� ut6ner's Signature Date Barbara ACkermann Print Owner's Name 2: s�FFp[K BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD y z Town Hall Annex- 54375 Main Road - PO Box 1179 �+ Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 f ia mesh(aDsoutholdtownny.gov- seand(d)-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All 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: Address: Cross Street: Phone No.: Bldg.Permit#: 5o,-+q email: Tax Map District: 1000 Section: l/ Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle All That Apply: Is job ready for inspection?: YES ❑ NO [-]Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES ffJ<O Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 F2 H Frame Pole Work done on Service? Y N ' Additional Information: PAYMENT DUE WITH APPLICATION PERMIT o I Address Switches I Outlets GFI's Surface Sconces H H's UC Lts Fans Fridge HW Exhaust Oven W/D smokes DW Mini -arbon Micro Generator -ombo Cooktop Transfer ar AH ` Hood Service Amps Have Usec pecial on-,ments v �V �Oqd APPROVED AS NOTED DATE:�3-2--�Lf B.P COMPLY WITH ALL CODES OF j FEE Co___ 0 �0 BY NEW YORK TATE&TOWN CODES A NOTIFY BUILDING DEPARTMENT AT REQUIf AND CONDITIONS OF 631-765-1802 8AM TO 4PM FOR THE SOUT>IOtD TOWN Z6A i FOLLOWING INSPECTIONS: SOUi1�lDTOWId PLIWNfNG 80AA0 FOUNDATION-TWO REQUIRED S4t1iH01DTOWNTAUSTEES FOR POURED CONCRETE ROUGH-F14AMING&PLUMBING INSULATION FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Additional Certification May Be Required. ELECTRICAL INSPECTION REQUIRED I