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Home My WebLink About31259-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31032 Date: 07/11/05 THIS CERTIFIES that the building REPAIRS Location of Property: 2705 LIGHT HOUSE RD SOUTHOLD ~HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 50 Block 3 Lot 5 subdivision Filed Map No. -- Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 11, 2005 pursuant to which Building Permit No. 31259-Z dated JULY 11, 2005 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" REPAIRS AND ELECTRICAL UPGRADE TO AN EXISTING CARETAKER/ COTTAGE AS APPLIED FOR. The certificate is issued to BARBARA FALCONI SUMMERS ( OWNER ) of uhe aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2058063 06/16/05 PLUMBERS CERTIFICATION DATmu N/A Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PEP=MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31259 Z Date JULY 11, 2005 Permission is hereby granted to: BARBARA FALCONI SUMMERS 2705 LIGHTHOUSE RD SOUTHOLD,NY 11971 for : REPAIRS A~ND ELECTRICAL UPGRADE TO Aiq EXISTING CARETAKER/COTTAGE "AS BUILT." at premises located at County Tax Map No. 473889 Section 050 pursuant to application dated JULY Building Inspector to expire on JANUARY 2705 LIGHT HOUSE RD SOUTHOLD Block 0003 Lot No. 005 11, 2005 and approved by the 11, 2007. Fee $ 150.00 ORIGINAL Rev. 5/8/02 ;, Form No. 6 - TO%VN OF SOUTHOLD 2005 i.-3' BUILDINGTowNDEPARTMENTHALL ~ 765-1802 · ~C ~---~PPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with tire fi)llowing: 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. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of l°,b lead. 5. Commercial building, industrial building, multiple resideuces and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plamfing Board Approval of completed site plan reqnirelnents. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sur~'ey of property showing all property lines, streets, bnilding and unusual natnral or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certiticate of Occupancy is denied, the Building Inspector shall state the reasous therefor in writing to the applicant. C. Fees 1. Certificate of Occnpancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00. Switmniog pool $25.00, Accessory building $25.00, Additions to accesso~' buildiug $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existiug 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: Location of Property: ~ 7~ .D~ House No. Owner or Owners of Property: _ Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: · o Street (check one) tlamlet Subdivision Filed Map. PermitNo. -.~l'~5>-~6~ ~ DateofPem'dt. '24/--O,~ Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planmng Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ,g. pp[-icant S~gnatureJ - 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 BARBARA FALCONI SUMMERS BARBARA FALCONI SUMMERS 2705 LIGHTHOUSE ROAD 2705 LIGHTHOUSE ROAD SOUTHOLD1 NY, 11971 SOUTHOLD, NY 11971 Located at 2705 LIGHTHOUSE ROAD SOUTHOLD, NY 11971 Application Number: 2058063 Certificate Number: 2058063 Section: Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, studio, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 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 authority having jurisdiction, and found to be in compliance therewith on the Day of 16th June, 2005. Name QTY Rate Rating Circuit Type Miscellaneous as built studio 1930 with some later up grades (gfci's) Wiring and Devices Outlet 3 0 Fixture Fixture 3 0 Incandescent Outlet 14 0 General Purpose Receptacle 12 0 General Purpose Switch 4 0 General Purpose Receptacle 3 0 GFC[ An as built ~ isual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is I of 1 This certificate may not be altered in and is validated only by the of raised seal at the location TOWN OF SOUTHOLD BUILDING~DEI~ARTMENT TOVCN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 w~v. northfork.net/Southold/ Examined.~ Approv Disappr~d a c ,20 O~ .20 06-" Expirat~ PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mad to: Phone: :' m lng nspector ~-J ~PPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date -7/~0 ,20 O0' 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 ma5' not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicam. 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 t¥om such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building h~spector 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 Perm/t pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Count3', New York, and other applicable Laws. Ordinances or Regulatio .ns, fbr 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~' ( ,~t~'~ ~'~ ap~p i~ant~o'~n~'~ corl~o-ra~o~" - oT(Mailing addrlss of~pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~*'6 e~'~ ~ z/C~; (As on the tax roll or latest deed) If applicant is a corporatlon, signature of dui.,,' authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location ofland on whi27~;/;;~i;~vill ~l~done:oo.~O..~- House Number Hamlet Count), Tax Map No. 1000 Section ~ ~'~(_.,,D Subdivision Block 000.-~ Lot Filed Map No. . ., . , ,Lot,.. , .,-,...- (Nme) State existing use and occupancy of premises and intended use and occ, upancy of proposed construction: a. Existing use and occupancy U/0 re ~l/4 J(~'r5 / ~W~ C~ ~ . t d - b. Intendeduseandoccupancx C~ye Cn~r~ [ floes4 eo~,ee 3. Nature ofwork/,(check which applicable): New Building Repair w Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work _, ~' ,Lr~-?z,-: (Description Fee (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 nfuse. I / / 7. Dimensions of existing structures, if rely: Front c~ / Rear ~ / Deptit /~O Height_ Number of Stories ~ Dimensions of same structure with alterations or additions: Front Depth / '~ ~ Height_ Rear Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories t 9. Size of lot: Front /tOg7 Rear /'gT~ .Depth 10. Date of Purchase 7/~'7 Natne of Former Owner l 1. 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-~aded? YES NO __ NO Will excess till be removed from premises? YES 1 4. 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? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property xvithin 300 feet of a tidal wetland? * YES__ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO ,/ 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at l 0 feet or below, must provide topo~aphical data on survey. STATE OF NEW YORK) SS: COUNTY OF ~ ._~O~,J'D0,* ]~ZC~', ~t~tm~,~'<~ beingduly sworn, deposes and says ti~a~,s,heis the applicant (Name of indMdual si~mfing contract) above named, (SJHe is the (Contractor, Agent. Corporate Officer, etc.) of said owner or owners, and is dui3' authorized to perfornt or have performed the said work and to make and tile this application: that all statements contained in this application are true to the best of his knowledge and belief: and that the work will be performed in the nmnner set forth m the application fi[ed therewith. Swo,92~to betbre me tNs . ~ day ot' ,) (d_ / (,,q ~otabVVabl~ ~NNY BEOEtk No~ Public, Sta~ of New York No. 01BE6~9317