HomeMy WebLinkAbout33937-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33209
Date: 08/11/08
THIS CERTIFIES that the bui1ding MINOR ALTERATION
(STREET)
Block 1
EAST MARION
(HAMLET)
Location of Property: 15479 MAIN RD
(HOUSE NO.)
COUnty Tax Map No. 473889 Section 23
Lot 6.3
Subdivision
FHed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 15, 2008 pursuant to which
Building Permit No. 33937-Z
dated
MAY 29, 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 BATHROOM ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MD & BL DELANO REV TRUST
(OWNER)
of the aforesaid building.
SUFFOLK COllBTY DBPAR'I.'MBHT OF IlBALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
4001903
06/27/08
PLUMBERS CERTIFICATION DATIID
08/01/08 MATTITUCK PLUMBING & HEAT
~~1~,=.
Rev. 1/81
.
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
1~5- 511~
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This application must be filled in by typewriter or ink and submitted to the Building Dep
APPLICATION FOR CERTIFICATE OF OCCUPANCY._
L ... ..' . ___I
ent witbthe foIlO\viW!:
1, \., _ _0;1,,'--,....0
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 AIWJi'.w1 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..9lluPliance from architect or engineer responsible for the building.
6. Submit Plafill1ng Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings 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 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 of I-
Date. 7(?1/08
Old or Pre-existing Building: ./'
(check one)
New Construction:
Location of Property: 16 Lfl or tYY).J f' Y2..d
House No. Street
Owner or Owne;:S'ofProperty: /Yl..el1QgJ 1:>. kJanr)
Suffolk County !ax Map No 1000, Section Y 130 ~1 ;;;35 Block1X2a1
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Hamlet
Lot O(J(p. 003
Subdivision
Filed Map.
Date ofPermit~r"l~_&_amt'APPlicantfon
Underwriters Approval:
Lot:
Permit No. '3 :3'131
f'rY>nzz ()
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
Fee Submitted: $ ~ S
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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
JIM SHAW ELECTRIC
530 MIDDLETON RD.
GREENPORT NY 11944
MIKE DELANO
654 E. 19TH ST.
BROOKLYN, NY 11230
15435 MAIN RD. EAST MARION, NY 11939
4001903
Certificate Number:
4001903
Block:
Lot:
Building Permit: .
BDC:
n811
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located inion the premises at:
First Floor,
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 andlor standard
promulgated by the.State ofuNew York, Department of State Code Enforcement and Administration, or other
authority having jurisdiCtion , aijd found to be in compl iance therewith on the 27th Day of June. 2008.
~ QIY Rate Ratine J:iill!il.I ~
AdditionalCharges
new bathroom
Appliances and Accessories
Exhaust Fan
Wiring And Devices
Fixture
Outlet
OUtlet
Receptade
SWitch
o
F.H.P
2
2
2
1
3
o
o
o
o
o
Incandescent
Fixture
Gen, Purpose
GFCI
Gen, Purpose
seal
1 of
This certificate may notbe altered in any way and is validated only by the presence of a raised seal at the location indicated.
Town Hall, 53095 Main Road
PO Box 1179
S:,,'_'!~,,:,<,::, .'e\\ YOlk 11971.0959
Fax (631) 765.950,
Telephone (63 I) 765.16(,:
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
1'- /. D 0'
Owner:
Building Permit No -'639-5 7
,.
mttflQ0 ~(aro
(Please print)
Plumber. {l7J+~-LuL?{ ()ml:n~ ~4 ,J~)
(Please print)
I ceni fy that the solder used in the water supply system contains less than 2/1 0 of 1 %
lead
lUi /ffIJ;;;
, (PI,", ,$0",""",
sr
I -
davof
20 of
~~
DENISE KING ~ rk
tlO~~I~t~~ilgn S:otM~fr570
Qualified In suffolkM~~~ty 2 (iJ.I;.
Mv Commission Expires a: I
"'''Y ,"bl~
COllnty
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.
33937 Z
Date MAY
29, 2008
permission is hereby granted to:
MICHAEL D DELANO
654 EAST 19TH STREET
BROOKLYN,NY 11230
for :
BATHROOM ALTERATION TO AN EXISTING DWELLING AS APPLIED FOR
EM/ORIENT
at premises located at
15479 MAIN RD
County Tax Map No. 473889 Section 023
Block 0001
Lot No. 006.003
pursuant to application dated MAY 15, 2008 and approved by the
Building Inspector to expire on NOVEMBER 29, 2009_
Pee $
200.00
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/ Authorized Signature
ORIGINAL
Rev. 5/8/02
3 yo 7 E::c
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
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL '
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold/
"~
PERMIT NO.
Examined
Approved
Disapproved ale
/I
~;I~ ,20~
IS 'J{ ,20.JY
Mail to:
Phone:
Expiration
ul)~? ,20V (
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f'at- .
,
Building Inspector
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jAPPLICATION FOR BUILDING PERMIT
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INSTRUCTIONS
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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.
(Sig applicant or name, if a corporation)
f. O. g~~aili~~tes~a~:: ~ ~.
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elA"ROV~~<JlJOT~lder
Name of owner of premises
<of-
DATE:
FEE: )071
b1fa..
(As on the tax roll or latest dei16'-1802 8 P.,~1 T,' ",' l FOR THE
orporation, signa ~o.f duly aut1tJMj__ERTIFICATE ~.o~~;:-;,':r:, ,~' :~": ;1, ;\. '} '0",':
(Name art Ii f corporate officer) 0 FCli POJii
. OCCUPANCY OR ~iifu~i4 " i -si vd,d.6tnJ-
Blli1d=u,rn"No.ltlf7c)'" =:FUL 4. FINAL - CC""":N f,: :;1'
Plumbers License No. ~3l.RIR' P ME COI?iI.~1
Electricians License No. 2> '3&'1 t'h e.. TI FICA F-: N.L..tG\l~SU\).;WIQS'. ','~::T THE
Other Trade's License No. OF OCC~,' ."y .... I=l!:'Ql.JIAEMENT~" "X;OFNEW
UrMI\lI, YORK STATE. ,;0T rU'!\SIBLE FOR
1. Location of land on which proposed work will be done: c; DESIGN OR CONSTRUCTION ERRORS.
(54~5 /YYl;n t0JtLn CfJg Yn1r,UY'l
House Number Street Hamlet
County Tax Map No. 1000 Section
Subdivision
~3
.
Block J
Filed Map No. j
Lot ~
Lot'j
~.3
b. L:.'
(NlllIle)
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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
AdditiO~ Alteration
Other Work ~ ~,JJlirQ
(Descnption)
"Vtl"r7"","") ..-
4. Estimated Cost d _ v- -
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
II. 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_
Address
Address
Addre~.o.go"" 1~9
J~l.Q
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.
Phone No.
Phone No
Phone No. 765
.5 7 -/.9-
14. Names of Owner of premises
Name of Architect ~
Name of Contractor Mtot..I7~
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)
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""tt~ being duly sworn, deposes and says that (s)he is the applicant
(Na e of in ividual signing contract) above ~
(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.
200~
P i~IE DDRDSKI
PUBLIC. State of New'1lli1(
No. 01004634870
Qualified in SuffOlk County '^7"
Conunission Expires September 30, Jt:;;;J. v
"3 )1372:-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
DATE 1/,tf';;; I
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[ ] ROUGH PLBG.
[ ] I~ATION
[ y(FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
....
INSPECTOR /
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FIELD INSPECTION REPORT DATE I
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PERN. Y.
STATE ENERGY CODE
FINAL
COMMENTS
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Complete Kitchen & Bath Remodeling
RDN
MDRIZZD
Kitchens & Baths~
. DESIGN. SALES. INSTALLATION
May 14,2008
To:
From:
Building Department
Ron Morizzo Kitchens and Baths
Work to be done at the Delano residence, East Marion.
! sf- fl(J1)/t.- - B~ tLouyv}-
1. Change all fixtures, toilet, sink, vanity, faucet.
2. Tile walls and floors.
3. Painting and trim.
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SHOWROOM: North Road Commons, Unit 19
22355 Route 48, Cutchogue, New York 11935
P.O. Box 789 . Southold, New York 11971
Phone: 631-765-5772' Fax: 631-765-6196
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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VILLAGE
DIST. flWb1( SUB.
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FARM COMM. CB. MICS.
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IMP.
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FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
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DATE
REMARKS
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FARfv\
BUILDING CONDITION
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FRONTAGE ON ROAD
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