HomeMy WebLinkAbout32398-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33006
Date: 04/29/08
THIS CERTIFIES that the building DECK ADDITION & REPAIR
Location of Property: 8620 MAIN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Nap No. 473889 Section 31 Block 7 Lot 5
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 21, 2006 pursuant to arhich
Building Permit No. 32398-Z dated SEPTEMBER 28, 2006
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 FOUNDATION REPAIR & DECK ADDITION TO AN EXISTING SINGLE FAMILY-
DWELLING AS APPLIED FOR.
The certificate is issued to ELIZABETH E TOPHAM
(OWNER)
of the aforesaid building.
SIIFFOLR CODNTY DEPARTMENT OF NEALTH APPROVAI,
ELECTRICAL CERTIFICATE NO. 3062987 04/10/08
PLDMBHRS CERTIFICATION DATED 03/18/08 JOSEPH A. TERRANOVA
Aut or zed ign ure
Rev. 1/81
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Rorm Nn. 6
'T'OWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICA'LE OF OCCUPANCY
This application must be filled in by typewriter or i~ilc 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 Tines, streets, and unusual natural or
topographic features.
~' 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.
Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to Apri19, 1957) non-conforming 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 waiting to the applicant.
C. Fees
1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swirruning 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. 'T'emporary Certificate of Occupancy - Kesidential $15.00, Commercial $15.00
Date. ~~-/S -OFD _
New Construction:
Location of Property:
House No.
Street
(check one)
Owner or Owners of Property: ~ ~~} ~ ~~ -~ ~~~~~
Suffolk County'Tax Map No 1000, Section _ (',1 ~ ~ Block (~ Q®~ Lot
Subdivision
Filed May.
Lot:
I'emiitNo. ~-DateotPermit. ~ ~ ~Q,~Applicant ~r!>/7~%.~l ~~~~NI
Health Dept. Approval:
Plamiing Board Approval:
Request for: Temporary Certificatc
Fee Submitted: $ ~~,~
Underwriters Approval:
Final Certificate: ~ (check one)
A lic tSignatu
.-
Old or Pre-existing Building
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BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
SABAT ELECTRIC ELIZABETH TOPHAM
50 PAT LANE 8620 MAIN RD.
MATTITUCK, NY 11952, EAST MARION, NY 11939
Located at 8620 MAIN RD. EAST MARION, NY 11939
Application Number: 3062987 Certificate Number: 3062987
Section: Block: Lot: Building Permit: BDC: ns11
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement, Outside, 3 ~ 3 1
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 IOthDay of April, 2008.
Name ~ Rate Ratine Circuit Tvoe
Appliances and Accessories
Furnace 1 0 Oil
Wiring and Devices
Outlet 5 0 Fixttue
Fixture ~ 5 0 Incandescent
Outlet 3 0 General Purpose
Receptacle 1 0 General Purpose
Switch 2 0 General Purpose
Receptacle 1 0 GFCI
Service
1 Phase 3 W Service Rating 200 Amperes
Service Disconnect: l 200 cb
Meters
1 of 1
seal
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
Town Hall, 53095 Main Road
P.O. Sox 1179
Southold, New York 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
Building Permit No. ,ja ~ ~ p
Owner: E L ~ ZlaP~/H ~G'1'/-l~l /V~ __
(Please print)
Plumber: ~~ Tev"PaHp~A
(Please print)
Fax (631) 765-9502
Telephone (631) 765-1802
/ G~
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead. _>
`-__~.
Swore to before me this ~~ ( ~
dad' of~~'~ 20~
~ (Pltffilbers Signature)
~~ f1 . 1 ~YY'q,noVo`,
~usrwn cueeas
Notary Public, State of New York
Qualitied in Suffolk County
-----~ -- ~ Reg, No. 01CU614 776
My Commission F sires
Notary Public, ounty
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. 32398 Z
Date SEPTEMBER 28, 2006
Permission is hereby granted to:
ELIZABETH E TOPHAM
4414 SOUND AVENUE
RIVERHEAD,NY 11901
for
FOUNDATION REPAIR AS APPLIED FOR - CL/Y~t/ti.l~+t~'Xo ~1~L 0(f~,Ut- A-CQ~w~i~
- ~(~ ~'7 ~ 6 8 - GicQ-cP ,~ a'~,~' 108. oo - ~c~..2, y~2~ dos - Q~.~.c..# ~ ~{ ~0 2
at premises located at 8620 MAIN RD EAST MARION
County Tax Map No. 473889 Section 031 Block 0007 Lot No. 005
pursuant to application dated SEPTEMBER 21, 2006 and approved by the
Building Inspector to expire on MARCH 28, 2008.
Fee $ 150.00
ORIGINAL
Rev. 5/8/02
~~
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1 NSPECTION
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING /STRAPPING
] FIREPLACE 8~ CHIMNEY
] FIRE RESISTANT CONSTRUCT
REMARKS: _
~-
[ ]ROUGH PLBG.
[ ] I ULATION
[ FINAL
[ ] FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT PENETRATION
DATE ~ ~ ~~ INSPECTOR
~~
~y~ ~~~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOU DATION 1ST [ ]ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
] FlRE RESISTANT CONSTRUCTION [ ] FlRE RESISTANT PENETRATION
DATE 0
3~3~ ~~~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
~ INSPECTION
[~ FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
f 1 FIRE RESISTANT CONS7RllCT10N [ ]FIRE RESISTANT PENETRATION
DATE ~ O INSPECTOR
JEFF A. ZAHN, A.I.A.
ARCHITECT-PLANNER
Apri122, 2008
Town of Southold
Building Department
53095 Main Road, Box 1179
Southold, NY 11971
Attn: Gary Fish
Re: McCombe Residence
8620 Main Road
East Mazion, NY 11939
Permit No. 32398 Z
Dear Mr. Fish
This correspondence is to certify that the deck footings at the above noted
location conform to the drawings issued by this office dated 8-1-07 and the Residential
Code of New York State. Should you have any questions or concerns please feel free to
contact me.
Very truly yours,
a~
J f A. Zahn, AIA
Cc: C. McCombe; File
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215 ROANOKE AVENUE ~ RIVERHEAD, N.Y. 11901 ~ 631.727.0544 ~ FAX: 631.727.5335
FIELD INSPECTION REPORT ' DATE COMMENTS
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INSULATION PER N. Y.
STATE ENERGY CODE
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BUILDING PERMIT APPLICATION CHECKLIST
bo you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
SOUTHOED, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502 r~
www. northfork.neUSouthold/ PERMIT NO. ¢J e°- 7~ ~~
9 a~,20 ~
0_-~'
Disapproved
Expiration , 20
Contact:
Mail to:'~I-I TI?PI'~2W~
' ' ' It ~l7ND AVE. ~~ UE~.}~'~ I
hone: 7~-7-~ r'.N
APPLICATION FOR BUILDING PERMIT
~ ~ ~ o~,
Date ~' ~ ~ ~ , 20~~
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 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 ] 8 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in t'ae interim, the Building Inspector may authe^ze, in writing, the extension of the nerrn ~t 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 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.
Septic Form
N.Y.S.D.E.C
j~,Gz.~ hr,~-n jz~w~
(Si azure applicaq a e, if a corporation)
~fl~f SOUND ~IFi. GelU~iP~D /~ll40~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, phrmber or builder
pWN~~
Name of owner of premises ~[,~ ~~gF'r(-~ ~ • TO~H~,
(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 nronosed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section ~ I Block ~ Lot
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy f i=~>f 1 L~>/ (Z ~ I f ~ ~ 9 (' F
b. Intended use and occupancy ~ (:~/~ i ~ y_ ~~G~ 1 p ~~ ~~
3. Nature of work (check which applicable): New Building Addition Alteration
Repair ~_Removal Demolition Other Work
4. Estimated
Fee
(Description)
(To be paid on filing this application)
If dwelling, number of dwelling units_~__Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front- ZS' ~- ~/ ~' Rear ZS ~- ~l ~' Depth SZ ' ' ~ ~ "
Height 20 ~ Number of Stories ~
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front ~ OD Rear_ / 0 <~ ~ Depth 'Z ~0 2
10. Date of Purchase 7,U 1JUA U Iq~14~Iame of Former Owner ~i0 /~ H A.o. ~
11. Zone or use district in which premises are situated k?l'rj 1 17~/~/TI ALA
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 ;;f Owner of
Name of Architect
Name of Contractor- `, ELG Address
No. ~
No
No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO r/
* 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 ] 0 feet or below, must provide topographical data on survey.
STATE OF NEW
COUN"TY OF
c, i i ~rrn~ i vi G / gyp' /r/t {'!/~ 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 before me this
____C ~~, day of 20 0
BEVERLY JOHNSON
NOTARY PUBLIC, State of NewYOrk
No.01J05041160
Ouali!'~.ed in Suffolk County
Comrnlsslon Expires Mac 27, 20 8
C~ Cl ~?/GIA~
Signature Applicant
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