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Home My WebLink About33536-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32732 Date: 11/19/07 THIS CERTIFIES that the building ELECTRICAL SERVICE Location of Property: 930 (HOUSE NO.) County Tax Map No. 473889 Section 64 FOUNDERS PATH (STREET) Block 2 SOUTHOLD (HAMLET) Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2007 pursuant to which Building Permit No. 33536-Z dated NOVEMBER 19, 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 ELECTRIC SERVICE IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONNA FORTE (OWNER) of the aforesaid building. SUFl'OLK COUNTY DEPAR'l14KHT OF HEALTH APPROVAL N/A BLBCTRICAL CERTIFICATE 110. 2027108 04/13/05 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 if!k 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 2110 of 1% lead. S. 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 nses, or bnildings 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 t1ierefor in writing to the applicant. C. Fees I. 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 Celiificate of Occupancy - Residential $15.00, Commercial $15.00 1t/-z-ft7 Date. Old or Pre-existing Building: I-.. (check one) FbfA-t cku..( (( AfZ...- Street ~n// Hamlet New Construction: '?3cJ House No. Owner or OW1~S of Property: Location of Property: v~ 91m1r "" 11 I /., Y Suffolk County Tax Map No load, Section Subdivision Fbt<<t.A~ f.> ".k-> Block -z.... Lot If::. Filed Map. 'Ie S Lot: ~ 70 Applicant: ~ ~ /JL 9- ~ Permit No. Date of Pennit. Health Dept. Approval' Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ( check one) Fee Submitted: $ ~ 9}~ u, ___ A l' S' i4rt-~f PI' !Cant Ignature 8-.~")~I"" CC>-c 3 n J.2. 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. 33536 Z Date NOVEMBER 19, 2007 permission is hereby granted to: DONNA FORTE 234 WOODBURY RD HUNTINGTON,NY 11743 for : INSTALLATION OF NEW ELECTRICAL SERVICE IN EXISTING SINGLE FAMILY DWELLING. at premises located at 930 FOUNDERS PATH SOUTHOLD County Tax Map No. 473889 Section 064 pursuant to application dated NOVEMBER Block 0002 Lot No. 016 2, 2007 and approved by the Building Inspector to expire on MAY 19, 2008. Fee $ 200.00 '"' ORIGINAL Rev. 5/8/02 l!I~ii!IE!ii!JE!I'ii!Jii!~ii!IE!~l!I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~ = = ~ = = = = = ~ ~ ~ ~ ~ ~ ~ ~ ~ ~l!I ~ = ~ = = = ~ ~ ~ = ~ = III Located at ~ ~ ~ ~ ~ ~ ~ = = ~ ~ I = = ~ ~ = ~ = = = = = = ~ ~ = I BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT U pan the appl ication of upon premises owned by CUSTOM LIGHTING OF SUFFOLK INC. PO BOX 1698 MATTITUCK, NY 11952 DONNA FORTE 930 FOUNDERS PATH SOUTHOLD, NY 11971 930 FOUNDERS PATH SOUTH OLD, NY 11971 Application Number: 2027108 Certificate Number: 2027108 Section: Block: Lot: Building Permit: BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: 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 April,2005. Name OTY Rate RatinlZ Circuit IYm: Service 1 Phase 3W Service Rating 200 Amperes Service Disconnect: Meters: 1 200 cb seal I of 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. l!I ii!JE!I'ii!Jii! ii!Iii!Iii!~ -it TOWN OF SOUTHOLD 'OPERTY RECORD' CARD . ..- /0/ - 2-- <1 DISTRICT SUB. .J( W r ACREAGE , 2. J': TYPE OF BUILDING () f\ no.. ~o Ii-e.. F,ORMER OWNER :::rOt '> c.. RES. SEAS. VL FARM COMM. , IND. I CB. I MISe. I Est. Mkt. Value TOTAL IMP. DATE 1-{ 00 t,OO I.f 00 2. ()O d 6'00 I(J. eo t)( '6'00 ~ 4i <> CI AGE NEW NORMAL BUILDING CONDITION BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD '7 S BULKHEAD DOCK ~ .sV Tillable 1 Tillable 2 Ti liable. 3 Woodland Swampland - B rush land House Plot Total , I ! i j , If. 11 rO ,,"\ I ! f , I I I , I..... F'I I" i I I . 1/ 1 , I " '/ i I i I i 1 I , , , i I i ! , I I , I I I , , i/ q I , 3b , I ! , i , I ! I i 'l'~ I i , i I 1 i r i , : ! I I ' , I I ~ : : I i i i ")11 , . I i I I ! I \<< i ! I I , , , I , ; , , I I i T - I 1 I i j , I i , i I I ! j ! IT T g,.j ! i ! I I ! I I I ! i I I I ' I i I - I K-rttl r+-+l I ' I ! ! I i ~ I I i , ..J;l.:)'" , ;z 'J .l:) i Foundation ---....--.--- I I -I Basement I ~--------T ! I Ext. Walls , I I----i . , ! Fire Place I -Ie ~/..R-' J &.. ____l~ x' K -,--------- , i , : j -1 t I i Patio ---+--I~~j II '" I;:~J ~;,- , - )- I i .:.......' ;:~-.tY'..~,..- 'Y I B h 1 1&l.,-j"l I at i I-U..J.J- I Floors I -+ ,W (,oJ, ,,' i I t - F,'n,'sh I :,"ju' {I n enor I ,:. }., ~ ,""'I 'i i"<e ~I ! 1. \1 i Heat ---+--/I1.<fJ.- ! Porch! i Roof Type --y- ; Porch I I Rooms 1 st Floor , I , I Rooms 2nd Floor I I Dormer I J 1,,1 :1..-// :~cJ.- o.,.i-f{Le., I' 'SAee'\ i "y 0 u<' Ifll.4,".y I I /' ,".' [, I G Q.i:'v/ , , i I i , I ^. Bldg. 31",'-::.5''''' 9.o...D':lqJt f I , -+- :xtension :xtension ------+- , -r- xtension i I I reezeway i ---J. I'~;('Y' '13>-- ;orage ). B. . . . -,..,- ...........-. .......A/QQfWCK".m:Il'tmN"G'Il>>Wt._ ,~~=~:"~f.:JO' A.t.~.~~".;u...o:. ~u.n-~'I'oI'OI"CI'NJIIl!aIl"_ 10 1Ml...-n~....~_~ ..........~........,"'~./I:I .~"""'I'Il'tfrJ#~'-.a:c. '~"'fM__K1DI~"'lN5 n""""""J '1'a..UJ!IIf0l1ft':tW n... 1N'"~_JQrrUWlo<<;NC"'14' OIP'C..l..,......Jy....'-....H)r~ '" I,U(P lIoWlrI'VW nlIUllIIII Zll ...... 'f'PnflC~,.;VIl'A.....""'T '... lOl UI su-r..mo; 191 .wI\.Wfr' 10l:H S'CIt,t 1..- 10. .\'IUA" 1l,J2a;... s.,.. eR O.Z5S A1eMS 'l1li alf oAf[ Il[e .\lIIY ra. l ~71 ''''1 JOOC-061-tr.l-Ulfj ~ SltUJlCB~ro 1HlS (I.I11r.1 GlJM.oWJiED ru. .......- Dom~ .... fOIf1[ AU. iTAlE JllII51RACT ~P, iP/lORGMt l:"H.\$(' 6N'I1l lOT ,. N ....05.00.'[ (1 -=-u :'l'IU .~ .;'::j 'l~ 8 - - S~. Lor JJ .....T .,. L07 .30 J otlES'1OiP' ;l:t~C1tC[ .~ "'~ --~ .<i SUBO/V/SON MAP Of FOUNDERS ESTATES SITUAIE SOU~8r~&O~~U%y~O~OLD SURVEYlD FUR, JOHN ~. JERDAN OONPIA M. rom '48.7J' ~ "'l - 1.5' '" O. ~ c: 2: 0 0 c:J ,.f fT1 :::0 (J) ..s' \] I., " ):> '" 8. --\ :r: -"w.wT IIQ.\O TOWN OF SOUTHOLD BUILDING.DE'PARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20_ 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 PERMIT NO. ~:s5 3 (p -:2- Check Septic Form N.Y.S.D.E.C. Trustees Storm-Water Assessment Form_ Contact: Mail to: Approved Disapproved ale ,20_ Phone: Expiration <; I , r ,20~ r;:-----.,:, ,r'"' r , , \ , -_...:-~.:.:l ':' r~ fe, Building Inspector L ,;-"1 APPLICATION FOR BUILDING PERMIT Date If /2/ I I ,20~ INSTRUCTIONS '--'~Cthis 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 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. ~M. ()h-9-~~ (Signature of applicant or name, if a corpor . on) ~07Jt"';-~?1 ::;;.o~(j it ~ (Mailing address of applicant) I ( '7 7/ State wh;ther applicant is owner, lessee, ~architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ ~~ (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 ofland on which proposed work will be done: f$D ~fA41~ @tt- House Number Street Sou /t{l Hamlet Lot /b Lot .::# )U County Tax Map No. 1000 Section 1",4 Subdivision -+n~ 1'..f7Yl rz" (Name) Block 2- Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed cons1rUctiQ.n: a. Existing use and occupancy c::; r /~ . b. Intended use and occupancy "7.k/L 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work A It,,,,ation 81eo/-n (;.; (IJescnptlOn) 4. Estimated Cost /tS~ Fee ~ ;2 f/1J;- 6'1J- 5. If dwelling; number of dwelling units I If garage, number of cars 2- (To be paid on filing this application) Number of dwelling units on each floor I 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. Depth 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Depth 8. Dimensions of entire new construction: Front Height Number of Stories Rear 9. Size oflot: Front Rear Depth 10. Date of Purchase Name of Former Owner I 1. 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 ---i- 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. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signiog contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is dilly 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. LAUREN M. srANDtSH Notary Publlc,Sbi\e of New Yor1I No.01ST6164008 Qualified In Suffolk ColIntv Commission Expires April 9, 20.J.L. Cf-: ') t U-z ~eo~l~ Sworn ~before me this tJ.. day of {)(5/J. 20~ cYfau..u., '111. ..J.4arrWlA' Notary Public ..... ~ ~ I