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HomeMy WebLinkAbout34021-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33161 Date: 07/21/08 THIS CERTIFIES that the building ALTERATION Location of Property: 20275 SOUNDVIEW AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 51 Block 4 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 25, 2008 pursuant to which Building Permit No. 34021-Z dated JULY 7, 2008 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" BATHROOM ALTERATION AND FIREPLACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOAN D SELBY (OWNER) of the aforesaid building. SIIFFOLR CODNTY DEPARTM@TP OF HBALTA APPROVAL N/A ELECTRICAL NO. 4000018 05/23/08 PLDMIDERS CERTIFICATION DATED 07/14/08 DINIZZO PLUMBING Auth ed S' atu e Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL :~'~ (Q j 765-1802 a: APPLICATION FOR CERTIFICATE OF OCCUPANCY ~-_ ____ --- ~, This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For nevi' building or new use: 1- Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from I Iealth Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4- Sworn statement from plwnber certifying that the solder used in system contains less than 2/10 of 1 % lead. 5. Crnmnercial 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 existiug buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accw ate 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 ofOccupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25-OQ Accessory building $25.00, Additions to accessory building $25.00, Businesses $50-00. 2- Certificate of Occupancy on Yre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated CeniGcate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. ~ g New Construction: Location of Property: L~ 2 ~. House No. Owner or Owners of Property: Old or Pre-existing Building: Suffolk County Tax Map No 1000, Section Subdivision Permit No. 3 ~ ~ Z ~ Date of Permit. Health Dept. Approval Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Z S • ~ ~ (~~~ -~ 33 11, p~ ~.'~ ti b SS~ (eheckLone) StrelIelIt ~4~JCa Hamlet Block ~~{ Lot ~ Filed Map. Lot: Underwriters Approval: Final Certificate: ~ (check one) App icant Signat 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. 34021 Z Permission is hereby granted to: Date JULY 7, 2008 JOAN D SELBY PO BOX 637 SUSSEX,NJ 07461 for "AS BUILT" BATHROOM ALTERATION & FIREPLACE INSTALLATION AS APPLIED FOR at premises located at 20275 SOUNDVIEW AVE SOUTHOLD County Tax Map No. 473889 Section 051 Block 0004 Lot No. 008 pursuant to application dated JUNE 25, 2008 and approved by the Building Inspector to expire on JANUARY 7, 2010. Fee $ 400.00 ~~~~,~ T Authorized Signature ORIGINAL Rev. 5/8/02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD bF FIRE UNDERWRfTERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by G & S ELECTRICAL CONTR. P.O. BOX 215 SOUTHOLD; NY 11971., Located at 20275 SOUNDVIEW AVE SOUTHOLD, NY 11971 Application Number: 4000018 Section: Block: Lot: JOAN SHELBY 20275 SOUNDVIEW AVE SOUTHOLD, NY 11971 Cert'rficate Number: Building Permit: " 4000018 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located inlon the premises at: First Floor, bathroom, 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 Coda Enforcement and Admi,nistcatiorr, or other authority having jurisdiction, and found to be in compliance therewith on the 23rd Day of MAY+ 2~$• Name QTY Rate RatlllE ircuits Twe AdditionalCbarges as built 2000 Applianees and Accessories Exhaust Fan 1 0 F.H.P Wiring And Devices Dimmer 1 0 120 V Receptacle 1 0 GFCI Switch 1 0 Gen, Purpose M as built visual inspection, of the delineated electrical installatiou, determined that an obvious hazard is not present and the installation is believed to be in conformance with the applicable reference standard for the estimated period of construction of the premises wiring system. sea! 1 of 1 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_Box 1179 Southold, New York 11977.-0959 ~~o~~gUFFO~,~cOG ~ s~ 0 N x ~W ~j,,• BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Fax (631) 765-9502 Telephone (631) 765-1802 Date:_ /-~~~-~~ Building Permit No. ~~ y(~ Owner: ,1~-~I~ ~ (Please print) Plumber: _~ ~ ~ t; CJ ~ 7i v~~ (Please rint) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. S~n~om to before me this /'~ day of 2(~Jp -- - - ~C~Sdt 2.779._ -~_~ lti, lmbe lgnature) Notary PuWl~c, SYs~Ee SH ~ Qualfied in~Su folk C~oooty Commission Expires Apri19, 2 ~[ Notary Public, _~(,I-{~pt~ County __ _ BB 34©a i PROFESSIONAL ENGINEER 1725 HOBART ROAD / PO Box 616 SOUTHOLD, NEW YORK 11971 TEL: 631.765.2954 FAX: 631.614.3516 a-mail: Joseph@fischetti.com Date: July 16, 2008 Reference: 20275 Soundview Avenue Southold Building Dept PO Box 1179 Southold, NY 11971 Dear Sir, -- __, - 18 ~ i I l _. This letter is regarding the bathroom off the master and the masonry fireplace at the home located at 20275 Soundview Avenue in Southold. The Bathroom was constructed within an existing closet. I certify to the best of my knowledge that the fireplace and the bathroom have been constructed to New York State Codes. The plumber ,John Reichert recently completed the pressure tests on the II was satisfactory. SAM1Y~ifiw uiuYw ... ( ._ °tl ~~~ '_.. ~~ FTELD INS ECTION REPORT I FOZ~ATION (1ST) DATE COMlY1N:N IJ - - -__- b ~ a \' • ~ t~ FOUNAATION (2ND) z 0 . ~ ,G ~H~yy tl7 y ROUGE FRAMING & PLUMEING i _. - ~ c r _.. x ~ -- - ~ - - _ ~ z . ~ IN&UT,ATION PER N. Y- --- --- ~ STATE FsNERGY CODE - ~~. r; r ~±~i ~ } lYL ~aYL ~ ' ' \ I ADDITIONAL CONIlVIENTS k-~ O ` 2 ~, V -- - - _ - - -- '- ~ ',~ ~ ~ ., ~ o z Z~ a x 0 y TOWN OF SOUTHOLD BUILDING DEPARTMENT' TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examine 20~ Approve 20~ Disapproved a/c /~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying ? Board of Health 3 sets of Building Plans Survey PERMIT NO. '3~~~ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Building Inspector e. ex ~, ~anch,;;~l N~ (Mailing address of applicant) e~ gz ~ APPLICATION FOR BUILDING PERNIIT /~3 INSTRUCTIONS 20~ 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 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 a Certificate of Occupancy is issued by the Building Inspector. 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 appl' t agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit auth ems prs on.pretnises and in building for necessary inspections. _ ,[ ~`~ ~' u x JUN ~ ~ ' (Signature of applica amr'lsx Te, r 'd~orporation) ~ L -- -~-. ~ _ ! State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber oi•.builder d ~t~vl~-^ Name of owner of premises X ~ ~{l Y\ `) ~ S~ ~ ~~ (as on they If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) roll or latest deed) Mail to: Builders License No. Plumbers License No. N~-~- (~~ Electricians License No. l Other Trade's License No. Location of land on hich ~0 27 ~ S~m~•t worJJ~~ w~ill be done: /d'U~+++~t-/ House Number Street Hamlet County Tax Map No. 1000 Section s/ Block O 4 Lot y Subdivision Filed Map No. Lot (Name) d , d 2. State existing use and occupancy of premises and Mend use and occupancy ofpmposed construction: a. Existing use and occupancy ~1.J 1NP.~ ~( ' b. Intended use and occupancy ~ ~~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ~sJ Y~pl~ (Descriptio 4. Estimated Cost 7 ~(~ ^ Fee (to be paid on filing this applicah 5. 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. n) 'on) 7. Dimensions of existing structures, if any: Front Reaz Depth 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 Reaz Depth Height Number of Stories 9.. Size of lot: 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: 13. Will lot be re-graded Will excess fill be removed from premises: YES NO 14. Names Name of ~x'~+ect~"F, F-7sGfn21~1 Address Name of Contractor Address No. No~3! 76S'29.f`Sr No. 15. Is this property within 100 feet of a tidal wetland? *YES NO • 1F YES, SOUTHOLD TOWN TRUSTEES PERMITS MAYBE REQUIItED 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 ) x ~ , ~ c.~ ~ .Sti ~ ~t, being duly sworn, deposes and says that (s)he is the applicant ame of indiv' signing contract) above Warn , ;S)He is the ~ k)VIQ ~ (Contractor, Agent, Corporate Officer, etc.) if said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; :hat 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. iwom to b ore me this Y day of 20 Not Public Lisa A Barcelowslry Notary Public of New Jersey/ Commission Expires 312812012 Signature of