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HomeMy WebLinkAbout30598-ZFORM II0. 4 TO~¢ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA/~C¥ No: Z-30544 Date: 11,/12/04 THIS CERTIFIES that the building ALTEP3.TION Location of Property: 740 NORTH VIEW DR (HOUSE N0.~ <STREET; County Taxx Map No. 473889 Section 13 Block 1 Subdivision Filed Map No. Lot No. ORIENT Lot 4 I ~L~ILET) conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 25, 2004 pursuant to which Building Permit No. 30598 Z dated AUGUST 27, 2004 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate zs issued is BATHROOM ALTERATION TO EXISTI~ SINGLE F~,IILY DWELLING AS APPLIED FOR "AS BUILT" & AS PER CERTIFICATION OF ANGEL B. CHORN0, AiRCHITECT. The certificate is issued to HEIDI SOMMERS & ORS. {OWNER) of the aforesaid building. SUFFOLK CO~ DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 10/18/04 N/A 2026841 10/14/0% MIKE JACOBI PLUMBING Rev. 1/81 /~ut~rize~Signature FORM NO. 3 TOWN OF SODTHOLD 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. 30598 Z Date AUGUST 27, 2004 Permission is hereby granted to: HEIDI & ORS SOMMERS 20 THORNBERRY LA SUDBURY,MA 01776 for : AS BUILT ALTERATION (BATHROOM) TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 740 NORTH VIEW DR County Tax Map No. 473889 Section 013 Block pursuant to application dated AUGUST 25, 2004 Building Inspector to expire on FEBRUARY 27, ORIENT 0001 Lot No. 004 and approved by the 2006. Fee $ 150.00 Au~hdri z .~--F~ature ORIGINAL Rev. 5/8/02 Form No. 6 TO~g~ OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 13 APPIJCATION 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 topograptdc 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 Undem, hters. 4. Sworn statement from phimber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Conunercial building, industrial building, multiple residences and similar bnildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of cmnpleted site plan requirements. 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 btspector shall state the reasons therefor in writing to the applicant. Fees Certificate of ©ccnpan¢¥ - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwellin§ $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 of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. Street Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block dP/ Lot Hamlet Subdivision Permit No. ','}CO 6-7 ~ Health Dept. Approval: Planning Board Approval: Filed Map. Date of Permit. 8/,.q~2./~ Applicant: /Vvk ~-~-t~-~,,l Underwriters Approval: Request for: Temporary Certificate Final Certificate: __ (check one) Fee Submitted: $ ' Applicant Signature CHORNO ASSOCIATES ARCHITECTS * PLANNERS * INTERIOR DESIGN 355 EDGEMONTAVENUE QUAKERTOWN, PA 18951 (215) 538-2O7O FAX (215) 538-1638 November 4th, 2004 Town of Southold Building Department Southold NY Re: Heidi Hild Sommers 740 North View Drive Odent NY SCTM: 1000-13-1-4 Building Permit No:30598 Z This letter is to affirm that the as built powder room recently inspected, appears to have been properly built, and complies with the Residential Code of the New York State. Sincerely, ~.C~horno, AIA ToWn Hall, 53095 Main Road P. O. Box ~117g Southold, NeW York 1 lg71 Fax (5t6) 76~-t823 Telephone (5 f 6) 765-! 802 (~FFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Btttldlttg Permi{; No, -~C'%-~q ~" ~- (please prlnt) Plumber (please print) I certify fhat the solder used in the water sBpDly SyStem contains less than 2/10 of 1% lead. ~ t ( Plumb~ - Sworn to before me this /? day Notary Public~ .~ County 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 ~ P. MOORE HEIDI SOMMERS ~ 51020 MAIN ROAD 740 NORTH VIEW ROAD ~ SOUTHOLD NY, 11971 ORIENT, NY 11957 ~ 740 NORTH VIEW ROAD ORIENT, NY 11957 ~ Located at ~ Application Number: Certificate Number: 2026841 2026841 [ Section: Block: Lot: Building Permit: BDC: ns11 ~ Described as a square occupancy, wherein the premises electrical system consisting of Residential 0-599 ft. g_ electrical devices and wiring, described below, located in/on the premises at: FirstFl°°r, ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed re herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other g_. authority having jurisdiction, and found to be in compliance therewith on the 14th Day of October, 2004. r~ Name QTY Rathe Rating Circuit Type ~ Miscellaneous ~ as built bathroom- re date un-known ~ Appliances and Accessories I~ Exhaust Fan l 0 F.H.P. and Devices Wiring Outlet 2 0 Fixture 2 0 Incandescent FLxture Outlet 3 0 General Purpose Receptacle I 0 General Purpose Switch 4 0 General Purpose Receptacle I 0 GFCI An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the ins~'ul'.adoa is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiqng system. seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. AppFIOVED AS NOTED NOTI(Y BULL:- DE ~RTMENT AT 765-1§~2 8AM '; 4FM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - ~WO REQUIRED FOR POURE: 'ONCRETE 2. ROUGH - FRAL~.NG & PLUMBING 3. INSULATION 4. FINAL - CO~ '-~,UCTION MUST BE COMPLE;- OR C.O. ALL CONSTRUCT:ON SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE COVERING OCCUPANSY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PLUMBER CEH 7 iFiCA T/ON ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM GANNQT EXCEED 2110 OF I% LEAD. CHORNO ASSOCIATES Architects - Planners - Interior Design 355 Edgemont Ave. Quakertown, PA 18951 (215) 538-2070 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. 10/05/2802 81:22 2837629839 DAVID SOMMERS PAGE SURVEY OF PROPERTY AT ORIENT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1000-13-01-04 SCALE: I"=40' AREA=I.I"-200 ACRES TIE LINE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING [ ] ROUGH. PLBG. [ ] I~~ATION [ ~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE INSPECTOR TOWN ~FL .~THOLD BUILDII~G DEPARTMENT TO~VN E}kLL SOUTHOLD, NY 11971 TEL: (631) 76S-1802 FAX: (631) 765-9502 ~,vw. nor thfork.net/Southold/ Examined ~ 7 Approved / ~/~:~--- Disapproved a c Expiration .20 7' 7 20O4 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Budding Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: APPLICATION FOR BUILDING PERMIT i Date ,20 ; ...... ' --~~ INSTRUCTIONS ' a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings 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 pemfit 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 fi.om 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 permit for an addition six months. Thereafter, a new permit shall be required. ,aPPLICATION IS HEREBY MADE to the Building Department for the issuance ora 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, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and rogulafions, and to admit authorized inspectors on premises and in building for necessary inspections. · (Signana-e of apphcant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises .-~o/79rmc-r.~ ~ .4¢/zwt~,v~- (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which prooosed work will be done: House Number Street /,vy- Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block / ~ j~qt', , _. Filed Map .N._o: ~ "~_ . Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed cons~ru{tion: a. Exisfinguseandoccupancy /03 ~c~ l /- ~z /~a~t~ (/72~,/e r -t 5,Al?-2 b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~ 6/ ~'c,c, Fee Addition Other Work If dwelling, number of dwelling units If garage, number of cars Alteration X7 {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 t3qoe of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height_ Number of Stories Dimensions of same structure with alterations or additions: Front Depth. Height_ Number of Stories Rear 8. Dimensions of entire nexv construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? 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 fi'eshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES__ NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide survey, to scale, xvith accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: cot.nm oF /¢ h,,~ ,, ,. ~"/~220 ~a,"--e..._ being duly sworn, deposes and says that (,)he is the applicant (Name of indixddual signing contract) above named, is the .~/'~ · (S)He (O'o~tractor, Agent. Corporate Officer, et'.) 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 statffments contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. S~voa'~ to.l~f~re me this/7 / / -- Nota~ Public,/ Sig-nature of Applicant