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Home My WebLink About33430-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32633 Date: 09/27/09 THIS CERTIFIES tbat the building ALTERATION Location of Property: 20 (HOUSE NO.) County Tax Map No. 473889 Section 67 HUNTINGTON BLVD (STREET) Block ~ PECONIC (HAMLET) Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 27, 2007 pursuant to which Building Fermit No. 33430-Z dated SEPTEMBER 27, 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 "AS BUILT" ALTERATIONS TO AN EXISTING SEASONAL ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HELEN E BOOTH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPAR'n4ENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 01/13/92 N 220108 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 =.-';1, ~ ~j Form No.6 \. IS l"?-.. - TOWN OF SOUTHO \ U U \ BUILDING DEPARTM~~r 2. 6. ~\ TOWN HALL l~~\ 765-1802 l~~'OEP-;, 'D ! b~"" f ~~'JntO- - APPLICATION FOR CERTIFICATE 0 ~Cy 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: i. 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 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. B. For existing buildings (prior to April 9, 1957) 1I0n-confoflning 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 Date. 9' - J,b- 0 7 New Construction: Old or Pre-existing Building: . V (check one) Location of Property: ,)...{) )/K-IVfm/I1-IVtV ~Lud House No. Street Owner or Owners ofproperty: !f~ L/:?,/t.1 E. r'3oCJT/../ Suffolk County Tax Map No 1000, Section Ie, '7 Block ~ PC-CON I C- Hamlet Lot 12- Subdivision Filed Map. Applicant: Lot: Pennit No. Date of Pertnit. Health Oept. Approval: ...._ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Q--o -2;; '3 dlo '''1;"3 (2.e. v (31)0 :II~ g ~ Applicant Signature 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. 33430 Z Date SEPTEMBER 27, 2007 permission is hereby granted to: HELEN E BOOTH FASSBENDER AVE PECONIC,NY 11958 for "AS BUILT" ALTERATION AND INSTALLATION OF ELECTRIC HEAT TO AN EXISTING SEASONAL ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 20 HUNTINGTON BLVD PECONIC County Tax Map No. 473889 Section 067 Block 0004 Lot No. 012 pursuant to application dated SEPTEMBER 27, 2007 and approved by the Building Inspector to expire on MARCH Fee $ 400.00 Author'zed ure ~ ORIGINAL Rev. 5/8/02 '" Dotf> THE NEW YORK SOARD OF FIRE UNDERWRITERS BURE....U OF ELEC"TRICITY 85 JOHN S"TREE"T.NEW yORK. NEW YORK 10038 ,JANUARY 13,1992 Application N6.onJU. 7442249' i9J PAGE: 108504:. I N 120.:.08 THIS CERTIFIES TH....T only theelectr-ical equipment os described belOw and introduced by the applicant named on the above application number in the premu"s oj MRS. K. SCHIEBETHERTH, FASSBENDER AVENUE, POtE #3, PECONIC, N.Y. in thefollowinlf location; [Xl B4..,ement [Xl 1st Fl. 0 2nd Fl. OUT .';,.('fi,m Block Lot teaS examined on DECEM.BER. 3111991 andJound to be incompliant.t' <<.-i'.h the requirements o.f this Board. FIXTURE OUTLETS ECEPT ACLES SWITCHES FIXTURES INCANDESCENT FlUOII:ESCENT OTHER RANGES NAT. K.W. COOKING DECKS "Mr. ICW. OVENS AMT. K.W. DISH WASHERS EXHAUST FANS AMT. K. W. AMT. H. P. 8 25 lJ. 6 1 8 /. DRYERS RJRNACE MOTORS FUTURE APPuANCIFEEI:)IIS SPECIAL IEePT TIME CLOCKS AMr. K,W. Oil H. P. GAS H.P. AMT. NO. A. W.O. AMT. AMP. AMT. AMPS BELL TRANS. UNIT HIATERS MULTI-OUTLET SYSTEMS AMI. H. P. NO, OF Fl:ET DIMMERS AMt WATTS 1 50 SERVICI DISCONNECT AMI. AMP. ME NO. OF S E :L':. IA2W1H3W3K3W").K4W 'p.}Q:'Of,~~~COl>lD. R V A. W. G. NO. Of Hl-LEG Of CC. CONDo C E Of;~'l?G NO. Of NELiTRAls Qt~U~AL 1 150 CB 1 x 1 ~ ~ OTHER --APPARATUS: EI,BC. ROOM HEATERS:8-.5 loW, ,2~.65 K.W. ,2-1 R\W. G.F.C.I:-5 GENE HEACOCK ELE. CONTR. 3515 CEDAR BEACH ROAD SOUTHOl,D, NY, 11971 L,IC. #943->: . """" ""1:\./ .. ."",,, .. .",."., <>~, . -lI '. ...... ...., ' .. ...... 1 . ~ "'\ "'..:~~':4.:,~..~!!b~: : ~~.;.~: ::"~<;;;. ;<'~. ~ U;'-' " "_..':~ ":.~.~\ w-( .rtlli<~to.(\\usI nol b, olt,red ih ah,.". nno" my,n 10 It"..o,lflFo GlNllAL MAN_R /" ~ 'll by thoi' ~redtlh~ (!J: ~ mlJ TORKELSEN BUILDERS, INC. P.O. Box 1475, Southold, NY 11971 (516) 765-4008 8/24/91 L'ITTLE CHALET OFF MILL LANE PECONIC, N.Y. 11"8 C/O HELEN BOOTH 765-3917 1. LABOR; Labor to install new windows and doors as discussed on site. Patch inside and outside to retain the character o~ the house. Construct new ~ront and side plat~orm and steps. Install vents ~or so~~it ventilation and side louver ~or ~an supplied by electician. Install new ~ir ~looring in ~ront porch area. $ 5,000.00 2. WINDOW AND DOORS MATERIAL $ 9,000.00 3. TRIM, DECK AND FRAMING MATERIAL $ 3,000.00 4. INSULATION a) 9" batt insulation in ceiling b) 6" batt insulation in ~loor c) Blown-in insulation in walls with patching $ 1,450.00 TOTAL $18,450.00 101 .d., 1:1 8't,3 eel l'1fl "You CaD M. . I'D Wire You' ~ ~e4Ud Light & Power Wlrlng . Electrtc: Heating N. '1. Stat. License No. _ '''J IF Attte FaDs Installed . Air Conditioning- - Bonded and Inoured - ELECTRICAL CONTRACTOR _35JBj UIIIila.r"lI\Ifadl. 1.11. S<llUZtiJll1.GildJ. BI.T.. m.r7IJL . *e69 PROPOSAL SUBMITTED To l\'!.rs. Name: Pole #3 Address: 'it@~!~er I~"'t. Katl1ri1.'1o 8chi0bethorth Date: 7/;!.3/J'I. Terms: . Job Name: We are pleased to submit estimate and specifications for: Wiring end installing oloc'I;1'ic heat"and re,':ir~; house comp1.etit=. II l.iH8al1 elect heat; fjystem ,'iw21 thaTOal.s-ta't in eeoh room. Install a pump house hea1;er vlith its ovm thermoastat nee.r water pump. 21 Wire and :b:wtf'l" 130 L'Ullp ove:rhead. 30rvice eClr1plete with eire-,it breakers. Remove old e:!istirlg ~iro ~~d pipe. 31 install 220 volt line for new elect. rongo. 4/Inatall new line for hot water heater. 5/InotaJ.l new wat:er ptUllp linfl. GIWire And !nste.lJ. four. ov:-er head Uehts ,t';1O O1xlnJ:tc1 e ciuo liC:".t B" / ~no light in craw: space. 7/ Wire and install n::i:nt;eo!l rluplex 0'lJ.t13ts i": becIrooTiC Qi!1inc; ". J.L! and poa"ch. )/ Wire o.nd :instol:l :t..'"l. !::itchcn ~'t t",O 33por:;,tG line!:. triO r;PI ,,';(~.-:;L',:', at oount~rf one for refrigerat.or. 9/ One t GFI outJ.:e't in bathroom. 101 One "I ou1lJiet outoide of house. II":';~~~~ :,~:d~it~d.vate1tl.pWnp ,~: 12/ Wire o.nd :inl3taJ.l six single polo sF.'i'l.;ches =1...'1. fJ.001n ",' ''',:, 1,',';~"l~1t,..~1:l.",~" lli,.V~..!i;I;QAQ;," ~.,"', ' .'.. 13 1......(j.~..~ii't""'~..1'~.iJ,' '~,,it;fJ;"i. ' ':ld.,t h' . I4'/"'.~Al~'t'6~,?~~"t.J,'~)I,~~. "..,~ ,Y,' ~:o$~ct!tJt'~~~"',~..;;:x ,0::1 ,/If ... "'fro. o\!~?A,9~~i!~,,;;;;l."""'Hl nDt:,.,,_~c...ua.....,.. I51 Total price inoludes nlltil.t;;t'63l'::tI?!1"; ~:t&tt;,":l.c ',. ': permits and inspection fees. f-Frice vli:~)1, ;t'~.i,.a\1t h?al.,~.~~: r. "00. OD . h:l.:cG..w.1'ti1:. ..llonv,w.:d:l.aa. uCla,...."-...+-. PO;ymonts'us follows;50f; dOV!ltR.~Q!fi" ..1-,,' ,'I,; ,'f 'J> !:;',!r,;A'.,~'" ',;"!_" _"e,..",,', ~ ," - u:.~;~6t;i'6t:6.1is', %"! /1, .1' J~ tJ[ or.. Ii!-.:~. T -rt-R- <<-4'" ',.',,", :/;:81.'1 complete. LJ:U'J OvOl'.... .... (eon't~~ reverse side) ~ , ;'-i I! J": f (,-;- r~j ['7,"j',-; TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net BUILDING PERMIT APPLICA nON 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 Storm-Water Assessment Form_ Contact: Mail to: PERMIT NO. Examined ,20 Approved Disapproved alc ,20 Phone: Expiration ,20 _ - li ~ ~ q -"I] lli ' Building Inspector It '~r- -~~\ U' I APPLICATION FOR BUILDING PERMIT I, I 26 ~\ " I Date q - U , L-- ~cp- , tH..-U ,....l :, I l___,}r\~.JL ()f .,01H09_ 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 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. INSTRUCTIONS , 20.!2.!J- #~c~~ (Signature of applicant or name, if a corporation) tfb r3 c:< 3 - i!e<!&7J Ie-, IV~. //1.)8 (Mailing address of a"plic t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder r4A/h_ If! ~di Name of owner of premises #~ <:f: ~ (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. I. Location of land on which proposed work will be done: :J.b J/tun/(Sf4 .fOLvr;{ House Number reet Hamlet County Tax Map No. 1000 Section Subdivision (1 Block 1- _ .J..'l4-.J Z- Filed Map No........... mVM10M 'II .........." - Lr 11 ___...... 1 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition A~ion OtherWork~~tcM/"'; .".* (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. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth 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 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 bere-graded? YES_NO_Will excess fill be removed from premises? YES_ NO_ Phone No. Phone No Phone No. 14. Names of Owner of premises Name of Architect Name of Contractor Address Address Address 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. 18. Are there any covenants and restrictions with respect to this property? * YES_NO_ * IF YES, PROVIDE A COPY. ST ATE OF NEW YORK) Q .!(olS.: COUNTYOF~ \-It" lev> PC~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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. Sworn to J>~fore me this ~~0~2~~_ Notary QIIIlM P."'" I UM NOfM'l..-.c, _11._ ....OtRMt_ - - -........0IlIIlf ._ a .. . .....1llP ..~ ytk.. t ~~- Signature of Applicant