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Home My WebLink About33459-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-32757 Date: 11/27/07 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 345 CLARK (HOUSE NO.) COUnty Tax Map NO. 473889 Section 51 RD (STREET) Block 1-- SOUTHOLD (HAMLET) Lot 22 Subdivision Filed Map NO. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 2007 pursuant to which Building Permit 1110. 33459-Z dated OCTOBER II, 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 IN AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GEKEE WICKHAM (OWNER) of the aforesaid building. SUFFOLK CUUJu I DEPARTMER'I' OF IIBlILTH APPROVAL N/A ELBC'l'RICAL CERTIFICATE I!IO. 119745C 11/02/07 PLIlMBERS CERTIFICATIOIII DATED N/A -~~~~,,-,~ Rev. 1/81 ~ ~{)1- t \ >>- ~chor Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~ \"l\. C-\\ t : c~ r;; ""--r"0l~~ ! U J ,.JL.l~:_~' __'Il_ 1! ,u~L 21~}J I rj., ,_"', l lOW,. (0)UTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled In by typewriter or iI1lC and submitted to the Building Department with the following A. For new building or new use: I. Final survey ofpropeliy 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 fOlm). 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 simdJar 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 (priol' 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 unusua I 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 tIterefor 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 Celiificate of Occupancy - $50.00 5. Temporary Celiificate of Occupancy - Residential $15.00, Conunercial $15.00 New Construction: Date. '\,)&V. (, I Zoot Old or Pre-existing Building: .; ( check one) Location of Propel1y: '?>45 House No. CL"'e~ ~O Street 501.1. fHoLO Hamlet Owner or Owners ofProper1y: GE~~ lNl~WA.."'" Suffolk County Tax Map No 1 000, Section 5'1 _ Block _--D..3_____ Lot Z'2. Subdivision --.--------------.--.---------.----..------------ Filed Map. Lot: Pertnit No Health Dept Approval ~ 3 It S<t_ IJale ofPennjt_IO -\\ -_Q't__ Applicanl_G.&~.\t.Jidc..l..lI.._____._ ------- ---'-.---- Underwnters Approval Planning Board Approval _______________. Request for: Temporary Cer1iflcate __.___ Final Certificate: __~_.__ (check one) Fee Submitted $ 2.:>.00 ~J.< - )?, '1~ CO -2 3;;"75 7 GJ'.II tlIl~4JlI- 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. 33459 Z Date OCTOBER 11, 2007 permission is hereby granted to: GEKEE WICKHAM PRIVATE RD CUTCHOGUE,NY 11935 for : INSTALLATION OF A NEW HEATING SYSTEM AS APPLIED FOR at premises located at 345 CLARK RD SOUTHOLD County Tax Map No. 473889 Section 051 pursuant to application dated OCTOBER Block 0003 Lot No. 022 4, 2007 and approved by the Fee $ 200.00 Building Inspector to expire on APRIL ORIGINAL Rev. 5/8/02 3~ rS-~-i- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONS11WCT1ON REMARKS: [ ] ROUGH PLBG. [ ] I,.oLATION [\)"FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION 'I i! INSPECTO < '. ~ ~ FIELD lNSPECTION REPORT DATE I COMMENTS ~>d FOUNDATION (1ST) ~I -----------------._----_.---------- Lt~ FOUNDATION (2ND) ~ +, 2: V9 "' V) '" .., ROUGH FRAMING & ~a PLUMBING ~ N, f' !\) , 1----- ------- := --- ~ INSULATION PERN. Y. l"l .., STATE ENERGY CODE , , , 6^ . - II/')-{ /0 7'Fhk.[/J ~: f , ~ FINAL - ADDmONAL COMMENTS ~ , ~ 'Z:& c:::::t7u ~J ( A') /'rI.JC b." _," ^- ~- r {J A-,~ ~wJJ .tv '-", h",,' -HI II , ;. 0..1\ LA- (\l9--t/1 w r 'I~ 'S CL, --P: ~ ~'-'-r\ J ~ QA <t ;> , ./ ~ 1',ffi 'b' ;0 ~- -, -" ,r:.", , \ ~ - ~, ,... !J, .., - 0 Z :z.,~ ~~ I>>~ I:;j l"l - >d ~ TOWN OF SOUTHOLD BUILDiNG DEPARTMENT To.WN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoIdI PERMIT NO. 334 ~qr- BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets afR'JiIEliftj!; PI""s ~s. Planning Board approval !.filr -fUr('O\ Ct Survey Check ~U(). 0,) Septic Form N.Y.S.D.E.C. Trustees Contact: Examined Approved Disapproved ale ,20+ ,20_ Expiration ,20_ Mail to: 6:. 'Nic.l<.\.~.... ~() €."" 1t"7-,Ob-ltnD"m Phone: Il'!lf b'?I-1~Q.-f4n , Building Ins --~~ ~~-~_\L~n~ ~ 'I'. '"I . U \\~! \ n"! ~~ I L--: -~ DEP1. \ 'fi&)'" 'THOLD T9\"1N f .~ 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 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 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 ofthe 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. APPLICATION FOR BUILDING PERMIT Date fM 4 . ,204- INSTRUCTIONS Q.Lke, ~ic.kl..",,^ (Signature of applicant or name, if a corporation) po B,,~ \\2'- Cldclto.5ue,lJ'll~ (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ()\I)"'~ ~~~~~~G~ .~ ~ ~ (As on the tax roll or West If applicant is a corporation, signature of duly authorized officer Ot-l '. '0'1:, Rl\.11E.ln t-l II/A. fE.E.'. \lILOING O\::\ ~ fOR 1\-1E. (Name and title of corporate officer) NOliI' B \I t-\.II 10 1\ I' NS' 165.'\102 NG INSI'E.Cl~O R~Q\l\RE.O fOLLOIN\ N - 1'N0 ,. fO\lN06~~E.0 CONCRE.;C\l\.ll'O\NG fOR I' fRt-\.II\NG &. RO\lG\-I . SI -; INS\lLt-lION N","\\lCl\ON \.II\l ;. fINt-L' C~E.1E. cOf CO'L \.IIE.E.II\-1E. . BE. CO~I' R\JCIION S~600E.S Of N~~ o N1S Of 1\-1 I'ONSIBLE. I' S. H y., SI/o.~E.'CONS1R\lCl\O OE.S\Gl'l ,-," )' I. Bla.Illo~ T Y<ll Lot ~ Z2- lhOl ~.. ~,.jgtl Lot pn~J~~flu2 I;! b9itii6UO o,~ ;DS j~t>l2fJ'.;~J nt)llZUTIf"W,) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 2 zE4'lH! I. Location of land on which proposed work will be done: .3L\- CLI'lt\C. ~ House Number Street County Tax Map No. 1000 Section Subdivision (Name) 2. State exisf!n~ use and occupancy of premises and intended use and occupancy of proposed construction: a. EXIsting use and occupancy ~lI\o\'., b. Intended use and occupancy <2t",~,,1 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work (Ie C~l< Alteration If 'New ~I('^-tt~ (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. 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 Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories II 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 I I. 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 L 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 ofa tidal wetland or a freshwater wetland? *YES_NO-1L- * 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. STATE OF NEW YORK) SS:~u:rtl-/<l" lAC- COUNTY OF..S,I'kLK ) 6-c \ D. \ij r.ltlu&-- being duly sworn, deposes arid says that (s)he is the applicant (Name of individual signing contract) above named, (S}lI~ ;. lll", (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 inthis 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. 2021- G:A , ~ W lJuU<PL- - Signature of Applicant Ltc. _ !t u- 't tier HI P~AI. S1JDMlTYIID T'O I r.;pat~ WIr.!thJu'Y'I I STREET ~P'O Box 112 erN ST....TEANDZIP CutctloQl..le. NY 11935 EMAn..AODR1!ISS --- ,wpol1C11 -- ~ KOLB MECHANICAL CORP. -.... _ AIf' eon_-... 11500 SoundAve. p,o. SOKl(J(; MBfliIUCk, NY 11952 (637) 2118-5527/ Fax (631) 2W-S534 ""." F'.9f'NQ, '" 1 p- OATE r!~~r: ~"thnlrl . I C:31~;;~-S4S4 fv 34S , --, clo.,l~ eJ. I --1 I JOB_' 'W.llentby....bm'II9tCif;ct.""'."ncl_IimIIIIl5IOl'; i I I Remove and discard Rxisti"g natura' gas f1...d boiler and i"stall the following, I I I eotlt....be...Jli':IO!llJ~'M1IlI~<<dCIt D..,.btcomtllltlC/ll.d'...__a&DWllIt I --. "'apI""'''~~wt. t.~OI'~br~ClIJI'~ 0Itrw'b I ~:;;;;;:: to 00 ,tit woN as !lP'C!lIrtd. Pa~entWiII" made U oU'!IIntCI Qcwe. oattOlAreDptlIfICIf f"lr+ 03. 7.c)o1 I Boiler: (1) Well MclaIn Gold. cast Iron, model #CGAw4, 105,000 BTU, natural gas fired i I boiler. , i Includes: I I Gas piping New ~ue pipe from boiler to masonry chimney. (as necessary) I All necessary reconnect.ons to existing heating system. I All necessary materials, labor, Installation and start-up. , I I Does Not Include: , Chlm ney liner. , I ! *Note. If chimney liner is required an additional amount of $700.00 would be required. I I Warranty: I All work to be done In a professional manner by trained and certified installers and service personnel. I W~ will provide a (1) year parts & labor service contract during norma: business hours on above system. One year limited lifetime warranty on WM defective parts. ~ Umited lifetime warranty on WM cast iron sections. All factory warranties are honored. Total Investment: $3,900.00 i ~--- lIIUpt)!'\ CCCGptunc;e, _.. cSllte, sign by tM ~X" and rGltum yelOw copy with your daCO&lt. KOLB MecHANICAL HI!ATlNG 6. AIR cONDmONfNG [In tr'll! ~"''''l '~iS aocO\;1'i1 is forwarded to ooun!el1or oeoll8c1ion the purol'lUer anall bo iiabl& IQr all ~le. lee, of KoI:l Mechanica! Cmp., I It is lne fQIPOlWlbtllly of U. "'omQOWfle~ Ie hive ~lillRd SeNioe- MltONnlcs Mllinlalf1 !'I.'t'IlJ and aiTcondlllOl'lh'\g ~LJi~'MT1( ae rfQl.lil'*! by mlIl'I. I ;JfactUler In 0fClef to r:J1'88ON~ warr/lr'll;et. I Alf ~~it:ln'lt:"l ;f'lall remafn pr'09tIrty of 1<oib MedlaniClill C/)ro__ UfltillllR'l oaid I Ail p", dI..e~. shell 'oe ohllr;td il1lQrOllt o! 1,5~ ~r mOllth , I All ~~el1lS Due Upo" ~~l. '- - at 1Jup.r. i'l..-.by tolurni:S<1 matnl ancll4bor - Q(lmplel8 in I.ccordlil,rll:. with Ilbove lIpar;il,catloJ"I.lor the ~m of- Thre@, Thou!iand Nine Hundred and XX/OO_n_n_n_n_n_n..~~_~___._.n_u_u___ C1ollara(S ~ 911C 00 ) PaymeN to b8 mada IIlIl foIl"w.: 30% Deposit, Balance Due Upon Completion and Start-Up. ~~-_ilIi1"~~..I~- "'WO!lllll":DrplllMl"...'kmInillel'l\;l!TICr A~lhorl~ --- iICCllCdn;to.'IliItllp_~~cr""~:JMIfQmI\llMlI~tr..OI\:'nt;Jnlrl S'IIInawr. ~""I.flIIajtICtm..,..DC wllt1d'.w",byl.ll~r'lOl~"i'tlin _IOIHII z..~_~<:. \(.< II I, cj~11 .JI Ii dl " <;;'C::'ClSf;O WlC.biu.\ Ct~':"ijl~ J08 ~ S91tl1,l1'lll zoomo~ lV3IKVHJlK [lO~ ICSS iaz ICi XYJ is:9l aan lOOZ/CO/Ol