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Home My WebLink About34156-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33578 I~ate: 03/04/09 THIS u~KTIFIES that the building ELECTRIC Location of Property: 65490 MAIN RD GREENPORT (ROUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 53 Block 5 Lot 12.6 subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2008 pur~,a-t to which Building Permit No. 34156-Z dated SEPTEMBER 12, 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 ELECTRIC UPGRADE FOR COTTAGE #29, AS APPLIED FOR. The certificate is issued to BREEZY SRORES COMNTY INC (OWNER) of the aforesaid building. SuffOLK COUN~"f DEPAR/%WENT OF HE~J~TH APPRO~-~J~ RT.R~-rKICAL C~K'rIFICATE NO. PL~ CERTIFIC~%TION DA'r~u N/A 4017162 31/07/08 N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 -3 2009 1¢ APPLICATION FOR CERTIFICATE OF OC UPA~CY ~ BLDG. DE?l. This application must be filled in by typewriter or il~k and submitted to the Bnild ag Departl~l~[..~l¥~%!!s, '**; A. For new building or new use: 1, Final stuvey of properly with accurate location of all buildings, propeP, y lines, streets, and unusual natural or topographic features. 2. Final Approval from Itealth Dept, of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fi'om Board of Fire Underxvfiters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead 5. Commercial building, industrial building, multiple resideuces aud similar buildings and iustallations, a cenificate of Code Compliauce fi'om aichitect or engineer responsible for the buildiug, 6. Submit Planning Boald Approval of completed site plan requirements. B. For existing buihlings (prior to Apri19,1957) non_conforminguses, or buildings ~ ltl p~e-ex~stug landuses: I Accmate storey af property s ow ~g all properly lines, s/feets, building and unusual natural or topographic features. 2. A properly compleled application and conseut denied, the Building ]nspec/o~ shall state fl~e reasons therefor in writing to the applican~ C. Fees I CeHificale of Occupancy - New dwelling $25.00, Additions lo dwelling $25.00, Aherations to dwelling $25.00, Swmuning pool $25.00 Accessmy building $25.00, Additions to accessory building $25.00, Businesses $50.(/0 2 Cedificate of Occupancy on lhe-exislmg Building - $100.00 3. Copy of CertificaleofOccupaucy- $.25 4 Ulxlated Ce~xificalc et ()CCUl)ancy - $50.00 5 Tenlporary Cellificale of()ccupancy - Residential $l 500, ('omznclcial New C. onstrtl~tion: Location of Pro ~mXy: o2 Old or Pre-existing Building: / (check one)] ltouse No. SII eel 1 lamlet Subdivision Filed Mai ~. . l.ot: /2- Permit No ' ~L.&///~ (,~ Dalc cf Permil. Health L)ept Approval: Plamrmg Board Approval: Reqnest fol': Temporary Certificate Underwriters ApproYal: ~ / Final Cellificate: ~ (check one) Fee Subnfitted: $ ~0 & c, qs'"bT1. 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. 34156 Z Date SEPTEMBER 12, 2008 Permission is hereby granted to: SHORES COMMUNITY BREEZY PO BOX 546 GREENPORT,NY 11944 for : REPLACE AND UPGRADE EXISTING ELECTRIC AT COTTAGE #29. UNDERWRITERS CERTIFICATE WILL BE REQUIRED PRIOR TO OCCUPANCY. at premises located at 65490 MAIN RD GREENPORT County Tax Map No. 473889 Section 053 Block 0005 Lot No. 012.006 pursuant to application dated SEPTEMBER 10, 2008 and approved by the Building Inspector to expire on MARCH 12, 2010. / ~ Fee S 200.00 ~__~x~//~ k~ ~_~-~~ signa~re ORIGINAL Rev. 5/8/02 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 DANIEL VVlLCENSKI ELEC. CONTR. PO BOX 319 SOUTHOLD, NY 11971, ERIC SCHMIDT 65490 MAIN ROAD GREENPORT, NY 11944 Located at 29 BREEZY SHORES GREENPORT, NY 11944 Application Number: 4017162 Certificate Number: 4017162 Section: Block: Lot: Building Permit: 34156 BDC: NS37 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Detached Garage, Outside, Attic, 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 Enforc~ent and Ad~olvne~mS~reartiOz~(18or other authority having jurisdiction, and found to be in compliance therewith on the Day of ' ' Name ~ Rat~ Rating Circuits ~ Alarm and emergency equipment Sensor I 0 0 CarMon/Srnoke Sensor 6 0 0 Smoke Appliances and Accessories Range I 0 50 Amps Water Heater 1 0 4.5 KW Panels I 100 20 I 50 3 Wiring And Devices Fixture 33 0 Incandescent Outlet 33 0 Fixture Outlet 78 0 Gen, Purpose Receptacle 8 0 GFCl Receptacle 52 0 Gen, Purpose Switch 25 0 Gen, Purpose Continued on Next Page 1 of 2 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. 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 DANIEL WlLCENSKI ELEC. CONTR. PO BOX 319 SOUTHOLD, NY 11971, ERIC SCHMIDT 65490 MAIN ROAD GREENPORT, NY 11944 Located at 29 BREEZY SHORES GREENPORT, NY 11944 Application Number: 4017162 Section: Block: Lot: Certificate Number: 4017162 Building Permit: 34156 BDC: NS37 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Detached Garage, Outside, Attic, 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 TM Day of No,~ember, 2008. Name QTY Rate Rating Circuits Tv~e 2 of 2 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 OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined q//Z , 20 ~ ~ Approved 67]//Z ,20 /-.7~/ Disapproved a/c Expiration .ERUIT NO. d¥/50 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: COMPL'~O~'~'H ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF Building Inspector $0UII~D T0~ Z~ SOUND TOWN TRUSTEES ~_~6~.i Date ~u~ ,~.~ .20 O~ INSTRUCTIONS" ,,.,.o.~ 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 Southold, Suftblk 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. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY (Slgnau '~' ture of applicant or name, it~/corporation) 158 t,v t s ve. /s n.r,q c (Mailing ad&ess of applicant) q oeo5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder o vo rte.., g. Name of owner of premises ,~ ~q ~ ~ ~.~t tt , _.~ APPROVED AS NOTED (As on the tax roll or late~/ /~l~ ~.~. ~ ~ ? t If applic~t is a co~oration, si~amre of duly authorized officer FEE: ~ 0 0t 6~ . BY: '~ ~(~ ^~fib~fit~Sficb~t[ate officer) BM~T T~E REOIJIREMENTS OF THE Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. GALL CONSTRUCTIpN SHALL MEET THE ~-4:~dlRF:~IEN~'~'~4: THE CODES OF NEW Haffi3t~ STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. Block 00o,;~ Lot or.2, . OOG Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructic~m a. Existing use and occupancy .q o rv~ r~_ ~. b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~1~;) 4. 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Other Work Alteration (Description) (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 Numbbr of Stories Rear Depth Dimens~o.n,,s of same structure with a terations or additions: Front Depth. -Rbight. Number of Stories 8. Dimensions of entire new construction:_Front Rear Depth Height Number of Stories Rear ! 9. Size of lot: Front Rear _Depth 10. Date of Purchase ~/~,'l 5°00 Name ofFormer Owner 11. 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 14. Names of Owner of premises~7' ~*,'0 e ,~ g ~ AddressJr, v4~ t~r,,.¢ ~ (# *~¢ ~hone No. ql ~ Nme of Architect Address Phone No Name of Con,actor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES )4/ 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 &ttag¢ 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 sigmng contract) above named, CONNIE D. 8UNCH (S)He is the ?t l~!:[if~ ~T,~,['.:!j~;~/ N0tary PuUie,_ No. 01ffil$18$0$0$ta~of N~tYorg (Contractor, Agent, Corporate.~i~, etc.) . uua~m~ m ~ go~nly · uommi~ion Expires April 14, 20 I ~-- 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 mc this )~q-~ day of~ 20 Notary Public Signature of Applicant dSJ