HomeMy WebLinkAbout32867-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 04/03/07
No: Z-32277
THIS CERTIFIES that the building HEATING SYSTEM
Location of Property: 2800
(HOUSE NO.)
County Tax Map No. 473889 Section 104
PINE TREE RD
(STREET)
Block 2
CUTCHOGUE
(HAMLET)
Lot 16
Subdivision
Filed Map No.
Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 29, 2007 pursuant to which
Building Permit NO. 32867-Z
dated
MARCH 30, 2007
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 INSTALLATION OF NEW HEATING SYSTEM FOR REAR COTTAGE "AS BUILT".
The certificate is issued to IMELDA CORCORAN FARRELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3023333
02/15/07
PLUMBERS CERTIFICATION DATED
N/A
~~
Authorized Signature
Rev. 1/81
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. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 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.
IB.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. 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.
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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. Certiticate of Occupancy on Pre-existing Building - $] 00.00
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
Location of Property:
2-7>00 Pu1e. Tv-('E' 120a J.
House No. Street
T V\M-Id C\
tc~{1I1 C<I1(]
Old or Pre-existing Building: J (check one)
~~
CoI-c&JtVJIj
Date.
2007
New Constnlction:
Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
I!OLf
Block 02..-
Filed Map. 1/ 71
Lot
u
Lfl
Subdivision
~::)5Ul.M Fvv n1 5
Lot:
Pennit No.
Date of Permit.
Applicant:
Health Dept. Approval:
Underwriters Approval:
Plarming Board Approval:
Request for:
Temporary Certi ficate
Final Certificate:
(check one)
Fee Submitted: $
25.00
g.".~./J J.. ~ 00
c.(t C- 3~J..l,
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.
32867 Z
Date MARCH
30, 2007
Permission is hereby granted to:
IMELDA CORCORAN FARRELL
95 DEAN DR
CUTCHOGUE,NY 11935
for :
HEATING SYSTEM FOR REAR COTTAGE AS APPLIED FOR "AS BUILT"
at premises located at
2800 PINE TREE RD
CUTCHOGUE
County Tax Map No. 473889 Section 104
Block 0002
Lot No. 016
pursuant to application dated MARCH
29, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 30, 2008.
Fee $
300.00
-+IU~ CJ.L.
Authorized Signature
ORIGINAL
Rev. 5/8/02
l!J.l!J
I BY THIS CERTIFICATE OF COMPLIANCE THE I
i NEW YORK BOARD OF FIRE UNDERWRITERS i
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
I CERTIFIES THAT //)If, - ~ - J(, I
~ Upon the application of upon premises owned by ~
~ ~
~ ROSLAK ELECTRIC IMELDA CORCORAN ~
~ PO BOX 164 2800 PINETREE ROAD ~
i CUTCHOGUE, NY 11935-2453, CUTCHOGUE, NY 11935 I
~ Located at 2800 PINETREE ROAD CUTCHOGUE, NY 11935 ~
~ ~
~ Application Number: 3023333 Certificate Number: 3023333 ~
I Section: Block: Lot: Building Permit: BDC: ns11 I
~ Described as a occupancy, wherein the premises electrical system consisting of ~
i electrical devices and wiring, described below, located in/on the premises at: i
~ ~- ~
~ 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 15thDayof February, 2007. ~
ml Name OTY Rate Ratinl! Circuit ~ ii!l
~ Miscellaneous ~
~ oil burner and safety shut off ~
~~ Appliances and Accessories fi!J~
Oil ii!I
~ Furnace 1 0 ~
~ Wiring and Devices ~
~ Switch 1 0 General Purpose ~
~ ~
~ ~
~ ~
~ ~
~ - ~
~ - ~
~ - ~
i- " i
~ ~ seal - ~
~ " ' ~
~ I of I ~
I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I
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Date: February 5, 2007
JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
To: Town of Southold Building Dept.
Re: Heat System.Re~House
Amelda Corcoran
2800 Pine Tree Rd.
Cutchogur, NY 11935
Permit #3100 I
To Whom It May Concern:
After an inspection of the heating systems were pt\fformed on the above property, it is
deemed that the furnace and hot water heater were installed correctly as per all state and
local codes. Any other questions concerning this matter please call.
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JAMES J. DEERKOSKl, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
To: Town of Southold Building Dept.
Date: January 31, 2007
Re: Insulation Inspection! Energy Code Cert
Imelda Corcoran Farrell
2800 Pine Tree Rd.
Cutchogue, NY 11935
To Whom It May Concern:
After a on site Insulation! energy code inspection was performed on the rear house of the
above mentioned property, it is deemed that the type and placement of insulation was
installed correctly, and meets all building and energy codes at the time of construction.
Any other questions please call.
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
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INSPECTOR ~.~
FIELD INSPECTION REPORT DATE
COMMENTS
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INSULATION PER N. Y.
STATE ENERGY CODE
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TOWN OF SOUTHOLD ~OPERTY RECORD CARD
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LAND IMP. TOTAL DATE REMARKS
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Farm Acre Value Per Acre Value FRONT AGE ON ROAD ? tJ if, t.,..., -AI < fr.-ee. Po", , qz rc> .,' /o-v
Ti liable . 1 BULKHEAD
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT MAR 29 2r
TOWN HALL
SOUTHOLD, NY 11971 ~,
TEL: (631) 765-1802 ",
FAX: (631) 765-9502
www.northfork.net/Southold/ PERMIT NO.
'3 d-i0 7 y
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Examined
3ft
Approved
Disapproved ale
, 20t2J-
,20E
Mail to:
Expiration
r/:;w ,20~
I
Phone:
(J~
f Building Inspector
Date
/lI1 OVC ~ 2.. 1-
tel,' VI cvcr-' 20M
APPLICATION FOR BUILDING PERMIT
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 oftms 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.
APPLICA nON 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 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 regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
OCCUPANCY 6Fr.r---~-.
USE IS UNLAWFUL I
WITHOUT CERTIFICATE
OF OC;CUPANCY , REOUIRED
State whether applicant is owne~, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Acm~O'VEn ~:" "", 7-0
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UNDERWRITERSCERTIR
/lq'Ss,
Owt1ec
Lorco y <MIl
(As on the tax ro
If applicant is a corporation, signature of duly authorized officer
Me.ld tt..
7-
Name of owner of premises
I.
Street
.elF.
orn:at~Wd .' d~[,)i,\JG Dc o;..FiTj~ENT AT
765,1502 3 :,1: TO 4 PM FOR THE
FOLLO'.','::'iG ::':S~LCTIONS;
1. FOU,':DATION ' 'if') REQUIRm
FOR POURED C~:':';iiETE
2, ROUGH. FRAM!f:G Ii PLUMBING
3. INSULATION
4. FINAL. CONSTRUCTION MUST
SE COMPLETE ::"R C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPON ISLE FOR
~ N ~ TRUCTIO QR alA
Hamlet
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
County Tax Map No. 1000 Section
Subdivision ~)G1:55<:1IA forms
(Name)
lO~
Block 0 L.
Filed Map No. 117 '1
Lot I b
Lot Lf I
2. State existing use and occupancy of premises and intended use and occupancy of propo.sed construction:
a. Existing use and occupancy
"ecA~~&~W\
3. Nature of work (check which applicable): New Building Addition
Repair Removal Demolition Other Work
b. Intended use and occupancy
Alteration
x
5. If dwelling, number of dwelling units
If garage, number of cars
Fee J> 3D/)
(To be paid on filing this application)
Number of dwelling units on each floor
(Description)
4. Estimated Cost
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
Depth
Rear
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Depth
Rear
9. Size oflot: Front
Depth
Rear
10. Date of Purchase
Name of Former Owner
II. 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
Address
Address
Phone No.
Phone No
Phone No.
IS 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 SvffVt..-K-
Kr.er O-M M. 61 C-d..( d/V\ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the 4-~ LS(5Y1
(COdtractor, Agent, Corporate Officer, etc.)
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 statements 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.
Sworn to before me this
day of
20
a~.
~
Notary Public
Signature of Applicant
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LOT 41
MAP OF
NASSAU FARMS
FILE No, 1179 FILED MARCH 28, 1935
SITUATED AT
PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S,C, TAX No, 1000-104-02-16
SCALE 1 "=20'
MAY 1 1, 2006
AREA = 18,450.44 sq, ft.
0.424 ac.
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UNAUTHORIZED AlTERATION OR .o.DOmOO
rOTHISSU~ISAVlOlATlONOF
SECTION 7209 OF THE NEW YORK STATE
EDlJCAnoN L..*,W.
COPIES OF THIS SUFM;Y w,p NOT B(ARtNG
nit lMO $URVEYOlrs INKED SW OR
OlBOSSED SEAl SHAu.. NOT BE CONSIDERED
TO BE A VALID "fRUE COPY.
CERTlFICATIOIiS INDlC.UEQ HEREON SHAU. RUN
ONlY TO THE PERSON fOR WHOIol THE SURVEY
IS PREPARED. AND ON HIS BDW.F TO mE
TITLE COIo4PANY, GOVER"""OOAl AGENCY ANO
LENDING INSTlntnON LISTED HEREON. N<lD
TO THE ASSIGNEtS OF THE LENOlNG INSTI_
TunON. CERTlF1CATION$ ARE NOT TRANSFERABLE:,
T~[ EXISTENCE or RIGHTS or w...y
AND/OR EASEW[NTS or RECORI~ IF"
PREPARED IN ACCORDANC wrrn THE ~INIl.lUIol
STANDAROS FOR TITLE S AS ESTABUSHED
BY THE U.A.L.S. AND ROVEo AND ADOPTED
FOR SUCH USE BY 111 EW YORK STp_lE li\l'lD
TITLE A$SOC....TIQN.
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N.Y.s. Lie. No, 49668
Josep A. Ingegno
Land Surveyor
Tille SUf\leys - Subdivisions
Site Plans - Construction Layout
PHONE (631)727-2090
Fox (631)727-1727
IJAJL/NG ADDRESS
OffiC[S LOCATED AT
.322 ROANOKE AVENUE
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