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HomeMy WebLinkAbout31574-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31337 THIS CERTIFIES that the building ALTERATION Date: 12/20/05 Location of Property: 30 WEST SHORE DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 80 Block 5 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 20, 2005 pursuant to which Building Permit No_ 31574-Z dated NOVEMBER 2, 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" ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED The certificate is issued to AUDREY REINHARDT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2082549 12/13/05 PLUMBERS CERTIFICATION DATED 12/06/05 MATTITUCK PLUMB.&HEATING Au5Forized Signature Rev. 1/81 4,1 -�- 4%' r ` Form No. 6 TOWN OF SOUTHOLD 2 8 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. 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 1% lead. 5. Commercial 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 1. 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 of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Date. //�o)Y/D'i�— (check one) Location of Property: nj(7 Z.4 )es f S.ho& 7ip e/f1 c 5n u T Y n House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Block ,? (p 0.6:: Lot Q n % 7 Filed Map. Permit No. 01 Date of Permit. Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 35'`, .6tVyS Co a 3):;37 Underwriters Approval: Lot: Final Certificate: (check one) { App 44 Signature BY THIS CERTIFICATE NEW YORK BOARD OF OF COMPLIANCE THE FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by BRIAN BROOKS ELEC. INC. BOX 1001, 455 BEEBE DR. CUTCHOGUE, NY 11935, Located at 30 WEST SHORE DRIVE SOUTHOLD, NY 11971 Application Number: 2082549 Section: Block: Lot: AUDREY REINHARDT 30 WEST SHORE DRIVE SOUTHOLD, NY 11971 Certificate Number: Building Permit: 2082549 BDC: ns11 Described as a Residential 600-1199 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, 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 13th Day of December, 2005. Name (QTY Rate Rating Circuit Type Miscellaneous as built -1985 -1st floor lower level Alarm and Emergency Equipment Sensor 1 0 Smoke Appliances and Accessories Furnace 2 0 Oil Wiring and Devices Outlet 8 0 Fixture Fixture 3 0 Incandescent Fixture 5 0 Flourescent Outlet 27 0 General Purpose Receptacle 18 0 General Purpose Switch 12 0 General Purpose Heat, Light, Vent 1 0 Receptacle 1 0 20 amp Laundry Receptacle 1 0 30 amp Dryer seal Receptacle 1 0 GFCI Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 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 BRIAN BROOKS ELEC. INC. BOX 1001, 455 BEEBE DR. CUTCHOGUE, NY 11935, Located at 30 WEST SHORE DRIVE SOUTHOLD, NY 11971 Application Number: 2082549 Section: Block: Lot: AUDREY REINHARDT 30 WEST SHORE DRIVE SOUTHOLD, NY 11971 Certificate Number: Building Permit: 2082549 BDC: ns11 Described as a Residential 600-1199 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, 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 13th Day of December, 2005. Name QTY Rate Rating Circuit Type An as built 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 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Building Permit No. BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: 116, 6 /(-,5 Own cl:. . E , df d ,E' J II //lease print) Plumber: �' • U L' � 1 v n *- �A n � (Please print) J lead. Fax (631) 765-9502 Telephone (631) 765-1802 1 certify that the solder used in the water supply system contains less than 2/10 of 1 % Sworn to before me this day of/ encimgEsc- , 2006—' 4� -24 0oS-- 1 DENI=KINGNotary Public, rkRegistrationQualified in MyCommission Ex�2 Notary Public, County 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. 31574 Z Date NOVEMBER 2, 2005 Permission is hereby granted to: AUDREY REINHARDT 30 WEST SHORE DRIVE SOUTHOLD,NY 11971 for : "AS BUILT" ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 30 WEST SHORE DR SOUTHOLD County Tax Map No. 473889 Section 080 Block 0005 Lot No. 007 pursuant to application dated OCTOBER 20, 2005 and approved by the Building Inspector to expire on MAY 2, 2007. Fee $ 3%0.00 Authorized Signature ORIGINAL Rev. 5/8/02 I I .0 D lr-: MAP OF L -AND SuRVEVED FCP- E7 W Scale 4v" f Notc ; L'y+ P;,Zwo4n-s svec,~ Biock +LC f0 m6 $MU S A M"m Gi ta 0 m v "N U5 M W_ "W. Gds of ms srmn .w wr rAew¢ seu fE A V�. !KYTJ ll� %�5`7 y -e7 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING/ STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE a d� INSPECTOR REScheck Compliance Certificate New York State Energy Conservation Construction Code REScheckSofrware Version 3.5 Release lb Data filename: Untitled.rck TITLE: As Built forAudrey Reinhardt COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non -Electric DATE: 10/17/05 DATE OF PLANS: 10/0005 PROJECT INFORMATION: 1 st floor As Built NOTES: The insulation noted in these calculations are correct to the best of my knowledge COMPLIANCE: Passes Maximum UA = 257 Your Home UA = 238 7.4% Better Than Code (UA) Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U -Factor UA Wall 1: Wood Frame, lo6" o.c. 1120 11.0 0.0 89 Window 1: Wood Frame:Double Pane 117 0.340 40 Floor 1: Slab-On-Grade:Unheated 140 8.4 109 Insulation depth: 2.0' COMPLIANCETEMENT : specifications, an o er calculatic7 New York State Eer Conse7al signed this page, tha attesting specifications are in m i u w s building represented in this document is consistent with the building plans, with this permit application. The proposed systems have been designed to meet the tion Code requirements. When a Registered Design Professional has stamped and his/herImowledge, belief, and professional judgment, such plans or +ew yo .1 S FT '9 Date � 1 —[-)It FIELD U�SPECTION REPORT DATE COMMENTS FOUNDATION (1ST) 1 � -------------------------------------- FOUNDATION (2ND) z ROUGH FRAMING & PLUMBING 0 Uj 7y7 y INSULATION PER N. Y. STATE ENERGY CODE 1 ^ V\ FINAL 011 A,44*— G p" sir 4 A/----- �K co AD IONAL COMMENTS z z m m �ro O z y d } TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BUILDING PERMIT APPLICATION CHECKLIST SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ PERMIT NO. Examined 1# -J 20O�r Approved /(, 20 aS Disapproved a/c Expiration � , 20 0-1 Building Inspector Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans_ Planning B approval Q--- . Check ---j4 Rq '3 Septic Form N.Y.S.D.E.C. Contact: Mail Phone: 2 6 5—{ S� M�7._-o�-/- APPLICATION FOR BUILDING PERMIT Date wLl� , 200SINSTRUCTIONS 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 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 permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Departmentfo e issuanc a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Y rk, d of er app ble Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or fo remo 1 demoliti as herein described. The applicant agrees to comply with all applicable laws, ordinances, building co , hous g ode, and r ulations, and to a it authorized inspectors on premises and in building for necessary inspections. or name, if a 72-S V, � SOVAit n/Yu97i (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder a1VI'Mr-i h fw t `\ alit X 4 dui Y (As on the tax roll or latest deed) If aonlic is demo o , sigtt re of du y authorized officer and title of Builders License No. Plumbers License No. _ Electricians License NO. Other Trade's License No. 1. Location of land on House Number Street County Tax Map No. 1000 Subdivision (Name) work skill be done: Filed Map No. JOvJkV b Hamlet s' Lot 7 2. State existing use and occupancy of premises and a. Existing use and occupancy b. Intended use and occupancy use an4joccupancy of proposed construction: Nature of work (check which applicable): New Building Addition / Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost /()z OD D Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units_ Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Height Number of Stories Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated Depth 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 Address Phone No. Name of Architect Address Phone No_ Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * 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. 16. Provide survey, to scale, with 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: COUNTY OF)(U being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the 1 (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have p� that all statements contained in this application are true to the best of performed in the manner set forth in the application filed therewith. Sworn to before me thi day of , 200(_ Not blic MELANIE DOROSKI NOTARY PUBLIC, State of New York No. 01004K4870 Qualified in Suffolk County�""��r11 Commission Expires September 30�c lace the said work and to make and file this application; ledge and belief; and that the work will be of ll 1 SF^ 1[ FI 2005 wGe n I f`1 i I' a m 00 i. At. Ir f 'iY � ALL I I t L CERTIFICATr10N OF _ CTI L, MEErTHE REOUI EM SpF TH AILING REQUIRED., ONS ON LEAD IVE •I�ORKSCiKTE 1 N 1I & CTI REQ R NT t CERTT�IC944 h©FOCOUPANC i APPROVED -1 A - to SED IN WATER E, DATE: e P. a 3 ` SpPP6'*STEM CANNOT p5 ✓ j� ; pg%l�Jr� tU F-.. .. _--- _ . - kFEE /5-2) By fizli� EXCEED 2/10 OF 1% LEAD. 'j -T- I�NOTIFY BUILDINC Dr°' TMENT AT h S I LT RC ! Ih'33,t� — Tss suz 8 A TO , FOR THE PLUMBING \ / i m G • �)hr ""' ) --fw •• _ WO LOWING IMSPC /�•C,.l_ 1 L� �- 9�O 1i � �LI, ; '� �,Cr ' / ..{�1 I -i LI -G '.._ - 4� I . Ti� :' 41 F. 3 POUREDDATIUN - FEQUIRED ALL PL rP,loi'' -.. STE - F_ R POURED GUivviFiETE & WATER LINES NEED U S - \44r fW L how, I� m,5 t � 1k` k t, _ e _ - '2 R'JUGH - FRAMING & PLUMBING TESTING BEFORE COVERING I f'1LL4 d. - x' ALL'1.)&TAI Lia AQe TV, THE PJGhr DiP3 I.SULATION F NE 1 - 1 4. -FINAL - CONSTRUCTION MUST- _ i C•OR, IL'1.�L7j�y�•e..#�L'� AND )N AttL�uf>416G�''{ SE COMPLETE FOR C.O. ,t 19C I,W frf+ T•14r-- HV 1-111-7- 0W h1F..%" LL CONSTRUCTION SHALL MEET f�REQUIREMENTS OF THE CODES OF NEW f- — .$ ! f ORK STATE. NOT RESPONSIBLE FOR C Al",l -,!� �QESIGN OR CONSTRUCTION ERRORS. W�ul i Wu' 1 UNDERWRITERS CERTIFICATE sro�`w -- ---- _4 REQUIRED l4'4II - , (';i ✓3ti>I f'`^„^ ' 1rJ^; i4WV1'6r»0P!ff 00'4* .-4--u T -H 0Lr7 SCALE t/ ^-1 t'91� ARPRGVEGEY DRAWN BY :.lr DATE' f J., �F- REVISED A,4) fJJ1 LT lit aA r FLOP - - DRAWINP NUMISR JJ/_' I r FP I LWI I -.711 i , 'I i ? .r. T, :, „^ l,,, '!i, -[Ly ..,1. 91,raF.dfi, i:� .1 ar', �' I-, -� 11 #� IO' '.,.S:S I" L - -, , :. � . „t . :: a 1 pfd 1 •`nt .f a.,y �:"_ _ , ?DAI . 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