HomeMy WebLinkAbout32919-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 06/05/07
No: Z-32388
THIS CERTIFIES that the building SOLAR PANELS
Location of Property: 243 MAIDEN
(HOUSE NO.)
County Tax Map No. 473889 Section 140
LA
(STREET)
Block 1
MATTITUCK
(HAMLET)
Lot 8
Filed Map No.
Lot No.
Subdivision
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
APRIL 13, 2007 pursuant to which
Building Permit No. 32919-Z
dated
APRIL 18, 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 SOLAR PANELS IN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to DON L. & SHARIMINI JAYANAHA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
7040
05/02/07
N/A
PLUMBERS CERTIFICATION DATED
~~,
A horlzed Slgnature
Rev. 1/81
.
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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This application must be filled in by typewriter or ink and submitted to the Building Department IT the fOllO~~g2' ~
A. For new building or new use: 1 ~
I. Final survey of property with accurate location of all buildings, property lines, streets, a d un\isuar,plltural-;Dr"
h' c I -...
topograp IC leatures. l --.."
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 I % 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.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
B. 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.
C. Fees
L 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
5/2'5/07
I /
Old or Pre-existing Building:
Date.
/
(check one)
M ,.,,. , 1: "'" c. '1'-.
Hamlet
New Construction:
" '~D
_\' Location of Property:
M".... ''''IV)
~.......,.v<55
2-43
House No.
t1 f't 'l-:J> ~ Ai
Street
LfJ
Owner or Owners of Property:
'DeW ~ >tI/'I~M,1J]: ~-Jf-'>-,""'AV'lA-
Suffolk County Tax Map No I 000, Section
)L+O
Block
00 \
Lot
oog-
Filed Map, Lot:
Permit No. ':3 '29 \ 9 :c- Date ofPermit.~ Applicant: 'j) 0;./ L-. ~/,... n(>, ~ Pr-
y./' J />r Underwriters Approval: 41 L -, ({J I
~ J f>r ---J J
I
Temporary Certificate
Subdivision
Health Dept. Approval:
Planning Board Approval:
Request for:
Final Certificate:
/
(check one)
Fee Submitted: $ 25
~_ 1;)..!{;5f
C& 7-. 323 ~r
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.
32919 Z
Date APRIL
18, 2007
Permission is hereby granted to:
D JAYAMAHA
PO BOX 47
MATTITUCK,NY 11952
for :
INSTALLATION OF SOLAR PANELS AS APPLIED FOR
at premises located at
243 MAIDEN LA
MATTI TUCK
County Tax Map No. 473889 Section 140
Block 0001
Lot No. 008
pursuant to application dated APRIL 13, 2007 and approved by the
Building Inspector to expire on OCTOBER 18, 2008.
Fee $
200.00
L~
I Authorized Signature
ORIGINAL
Rev. 5/8/02
SUF;::OtK
18 'J ;:; ;:: ^ I'
/ ~ ~.' ~,./\ "
;t., ';.
40 Nottingham Drive. Middle Island, NY 11953
Telephone: 631 4958136 . Fax: 631 9806455 . E-Mail, SBEIGS@gmail.com
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant;
Rough In Inspection Date:
Application No.:
Eastern Energy Systems Inc
April 27,2007
7040
Certificate No.;
Final Inspection Date;
Building Permit No.;
Suffolk County Tax Map No.:
7040
April 27 ,2007
3'-z,.q'9 -Z
This Certiflcate of Electrical Compliance is limited to the Inspection and compliance of electrical equipment and/or
work described below, installed by the applicant named above, located at the premise of and not after the final
inspection date above:
Owner: Don Jayamaha
Site Location; 243 Maiden Lane, Mattituck, NY 11952
Owner's Address (if different):
["i Residential [] Indoor [] Basement 'Smlil::l!
Commercial 1---'''' 1 Pool
Outdoor 1.1 First Floor
New [] Renovation [: Second Floor J Attic
Addition , I Survey Olher. Photo Voltaic Syslem
.
INVENTORY
Single Ph3se Heal Duplex Recpt Ceiling Fixturf!
Three Phase Hel Walel GFCI Retpl WallFllCture
Ma:n Panel AC Cond Single Recpl Recessed Fl'xture
Sub Panel AC Blower Range Recpt Ffoures.cenl
transformer Appliances Dryer Rec;pt Emerger'lc.y
Dlsccnnec:l 2 SIf.(itches TWJstLock Exit Fixlur~
GFCI Breaker Heal Pump EIQdric Heal Pool Lumin;:ure
Other Equipment 3200 Walt System 16--KC20CGT Modules. 1-Sl1arp JH3S00 tn-..erter
; Shed
J-IoIIub
, Garage
HID FiXl;ures
Smoke
CO Deteel
Pumps
Time Clock
lVSS
Exl1aust Fan
The electrical work and/or equipment described above were inspected and appear to be in compliance
with local, state and national electrical code requirements and this office.
Applicant: Eastern Energy Systems Tnc
Inspected By, Gene SU~. .
~?/
Signature: ----A ~/
License No.:
Date Of Certificate: May 02 ,2007
PAUL J. BESMERTNIK, P.E.
Home Inspection Engineer
Quality Inspections Since 1976
631 351 6966 Office
5163566606 Cen
besmertn ikhome inspect ions .com
7 Hanford Street
Melville, NY 11747
pbesmerrwaol.com
March 30, 2007
Inspection of Roof Structure
for Solar Electric Panels
at
243 Maiden Lane
Mattituck, NY 11952
This to certify that I have inspected the attic roof structure at the above reference
address and that it is adequte top support roof load imposed by the 20 Panel Solar
Electric System by Sharp Model NE 170U1 with a dead load of 4 Ibs psf.
Paul Besmertnik, PE
f cJ ttf1
3')-/1~ 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING p('FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: ~ ~
~6k '
DATE h -I -- () 1
INSPECTOR ~ ~
,
, ! COMMENTS
FIELD.INSPECTION REPORT DATE , l}J
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FOUNDATION (1ST) ..l) '"'
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FOUNDATION (2ND) h.D~
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold/
PERMIT NO.
3) erNe-
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health ;.II ~
4 sets of Building Plans ",) p,
Planning Board approval 10/ J ftr
Su<vey "J '" .
Check "II: I -z. :Jf.
Septic Form P ) ",.
NYS.D.E.C ~; p..
Trustees _J Dr
Contact:
Mailto 243 .",...\')>I!fw L.. JJ
I"''''''''''''~"''r''' ("-))-.1') "~>'Z..
Phone (51\) ~ oy -Q--, " c~"
ti:20d
,2007
Examined
Approved
Disapproved ale
Expiration
10/1 prD'f,
(
i~r
JR I 3 2QU7
APPLICATION FOR BUILDING PERMIT
Date
411 ~
/ '
.20~
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location oflot 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 pennit shall be required.
APPLlCA TION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town. of South old, 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.
name, if a corporation)
Z 4 '3 /"?P1 C)>tff,v ~A/ , Mtl"'TT :J:""'\""V'IO... )1"\ ,,-,s-'>o
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
"!:l 0 )oJ l.. 5" tH\R MJ: )...I J: TJ>..'j f>r n/\ ~ Pt
(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.
1. Location of land on which proposed work will be done:
24 -:; ""I'r~ 1>eA/ '- JJ ) ",,,,..,.. ~ T'^ C \C-
House Number Street Hamlet
t-J'\ \\"')52-..
County Tax Map No.1 000 Section _I 4 0
Subdivision
Block 1
Filed Map No.
Lot
Lot
g
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~ ~ ~ ., "\. t- '" .ior '" _ \
b. Intended use and occupancy
\<'r'~;),~",..t...... \
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
5n\........ 11_"''''5 (I')
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
,..;)pr
Rear
~
Depth
7. Dimensions of existing structures, if any: Front
Height Number of Stories
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
Rear
Depth
9. Size oflot: Front
Rear
Depth
€H~H..\'- ~~\~'" ''2-. 'i2~~v~
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated R ~ s ; ~ f!" J\ ~ .; - \
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 7
1>.... LS"~Il"'$J:L;no.'/f\'>'l"'''''' -1U1) i"l?!.t - i>"
14. Names of Owner of premises Address'Z."3 M"\~~'" L>lPhoneNo. (O~O Z"fl-7'2..O,7
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO /
. IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? . YES_NO_
. IF YES, D.E.C. PERMiTS MAYBE 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..!v;fI y I--
J> ON L. :r7>ty A r'1 "''rt A- being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
o (,oJ "'-e4
(Contractor, 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.
SWOmJObefOremethiS~
?~. ^ 20P1
Notary Public
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