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Home My WebLink About34693-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z 33770 Date: 06/11/09 THIS CERTIFIES that the building BATHROOM ALTERATION Location of Property: 1125 MINNEHAHA BLVD (HOUSE NO.) County Tax Map No. 473889 Section 87 Subdivision SOUTHOLD (STREET) (HAMLET) Block 3 Lot 19 Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 2009 pursuant to which Building Permit No. 34693-Z dated MAY 20, 2009 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 IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & KUNIKO KENNA (OWNER) of the aforesaid building. S~3FFOLK COUN~I~f DEP~)~NT OF }~LTH ~/:PRO~J~ N/A ~L~C~{ICA~ CERTIFICATE NO. 128407H 06/10/09 PLUMBERS CERTIFICATION DATHD 05/27/09 TODD DAWSON Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 JUN 8 2009 BI,DG. DEPf. TOWN OF SOUTHOI-D APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or i~tk and submitted to the Building Department with the following: A. For new 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 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 1% lead. 5. Commemial 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 uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual nal, ural 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 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 New Construction: Old or Pre-existing Building: ~ (check one) LocationofProperty: !-~o 055Ec:> Ax/C'- ~ooWtAOc ~ House No. Street Owneror Owners of Property: [.4 [ c ~4A ~ c. g~ ~SUbo I ~o Suffolk County Tax Map No l000, Section O~L7-°3-I al Block Subdivision Health Dept. Approval: Planning Board Approval: Request for: Date of Perm it. Temporary Certificate Filed Map. Applicant: Underwriters Approval: Final Certificate: (check one) Hamlet Lot Lot: Fee Submitted: $ Applicant Sitature Electrical inspection Certij cate Electrical lnapeotlon ~Bervi~e, Inc. Application Number 375 Dunton Avenue 1284079 East Patchogue, New York 1177'2 Issued To: Michaei Kenna Street: 40 Osseo Avenue Village: SOuthold Zip: Section: Block: Lot: Contractor: 11971 Town: Southold LIc. # Was examined and found to be in c~lpllaqce wth the National Electrical Code Commercial j-: NV Defect~ ? Pool X tet FIoor Indoor r~ Basement _ Hot Tub Residential [ I Def. Garage i Attic ['7 2net Floor i ; Outdoor _; AddltloD i~1 Survey Switchea Reoepteelee Fixtures GFI Heaters A/C Fans 3 1 1 1 Dlshw#eher Weaher/Amps Dryar/Ampe Oven Range/Amps Microwaves Furnace Oil Gas Cir~ulator~ Smoke Defector Bell Transformer Meter Amps ~hsse UG/OH Jecuzzt Television CO Detector Bldg. Permit; 346932 Other Eqtl!pment Hugo S. Surdl President Inspector; Jchn Mg Mahon JUN I 0 BLDG DEPT. Town Hall, 53095 Main Road P.O. Box 1179 Sou:hold, New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 MAY 2 7 2009 BLDG. DEPT. TOWN OF SOUTHOtl] BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Building Permit No. Owner: (Please print) Plumber: (Please print) I certify that the solder used in the water supply system cotrtains less than 2/10 of 1% lead. Sworn to before me this o~ ~7 ~av of ~ OcLi/ (Plumbers Slgmmure~ h VICKI ota~j Public.State of New York No. 01106190696 Qualified in Suffolk County/ Commission Expires lul¥ 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. 34693 Z Date M3kY 20, 2009 Permission is hereby granted to: MICHAEL & KUNIKO KENNA 1125 MINNEH3kH3k BL~-D SOUTHOLD,NY 11971 for : "AS BUILT" BATHROOM ALTER3~TION AS APPLIED FOR at premises located at 1125 MINNEHAHA BLVD SOUTHOLD County Tax Map No. 473889 Section 087 Block 0003 Lot No. 019 pursuant to application dated MAY 12, 2009 and approved by the Building Inspector to ex~ire on NOVEMBER 20, 2010. Fee $ 400.00 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMgNT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved Disapproved a/c Expiration iil.~O,I 20/ ~ BLDG. OEP[ _ ]'OWN OF $OUTHOtO a. This application MUSI be com PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need file tbllowing, befbre applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.DE.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Phone: [ B~-ding Inspector 'LICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 etely 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 Pem~it 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 nronths 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, file extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Depamnent for the issuance of a Building Pemfit 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 re ~ff~ations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signatt~'a/pplicant ~Z' if a c°rp°rati°n) ~~ct, e ~-,~ (Mailing address o f applicant) State whether applicant is owner, lessee, agen gineer, general contractor, electrician, plumber or builder Name of owner of premises /~/~'~f-,d~'~---(_. ~7/l.J',,~.'"'4 (As on the tax roll or latest deed) If applicant is a corporation, signatm'e 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 proposed work will be done: House Number Street CountyTax Map No. 1000 Section ~ ~ Block Subdivision .ge T ?-tr-'c Hamlet Lot [? Lot Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy---.ff/,'0 ~ C ~] b. Intended use and occupancZ 3. Nature of work (check which applicable): New Building Repair Removal Demolition g. Estimated Cost 5. I£dwelling, numher of'dwelling units If garage, number of cars Addition Other Work Fee Alteration (Description) (To be paid on filing tiffs application) Number of dwelling units on each floor 6. If busine,~¢, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height_ Number of Stories Dimensions of same structure with alterations or additions: Front Depth_ Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear _Depth 9. Size of lot: Front Rear Deptb l 0. Date of Purchase Name of Fenner Owner 11. Zone or use district in which premises are situated /~ O 12. Does proposed construction violate any zoning law, ordinance or regulation? YES ~ 13. Will lot be re-graded? YES NO //'/Will excess fill be removed fi'om premises? YES NO 14. Names of Owner of premises gZ~',~/v'/--p Address Name of Architect J'CP/'~"."~''~Z ~--L Address Name of Contractor ~' Address Phone No Phone No. 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 B,,E/REQUIRED. b. ls this property within 300 feet ora 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: '/~/q/~/~ cD(_~/~O,//t~t/~ l ~---- being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Corffractor/Ngent, Corporate 0 lcer, etc.) CONNIE D. BUNCH Nota~ Public, State of New York Qualifi~ [~]f~l~'~o"unt¥ , Commission Expires April ].4, 20_ 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 t,o before me this. a ~ Notary Public )licant TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~LATION [ ] FRAMING / STRAPPING [~,~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT I DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH F~G & ~S~ATION PER N. Y. STATE ENERGY CODE ~DITION~ CO~ENTS TOWN OF SOUTHOLD PI~OPERTY RECORD CARD OWNER ~FORMER OWNER(.~/'iU..)~ ~ UD.~' V l LLAGE DISTRICT SUB. ACREAGE ~ TYPE Of BUILDING LAND IMP. TOTAL AGE{ NEW NORMAL BUILDING CONDITION BELOW Farm Acre Value Per Acre Tillable 1 Tillable 2 Tillable 3 DATE Woadland Swampland Brushland House Plot Total ' REMARKS ABOVE FRONTAGE ON WATER Value FRONTAGE ON ROAD BULKH~D D~K A. Bldg. :xtension !xtension ixtension Foundation Basement ' Ext. Wells Fire Place Porch Porch 3 reezeway .qarage Potio /~,~< ~ Driveway Bath Floors Interior Finish Heat Roof Type Rooms 1st Floor Rooms 2nd Floor Dormer oo Oo OF THE ~'CRTIFICA TtON EXC'E2 MBING W35TE :_:NES NEED ."0 :-' :.~ ~G II ·-: ":,. CERTIFCATE BATHROOM Ii' SLOPE" 114" PER FOOT PITCH TO DRAIN ~OUSE PLUMBI~NG SCHEMATIC N.T.S. 5'-3V2" II FLOOR PLAN SCALE: 1/4" = 1'-0' AS BUILT REVISIONS: Ma~' l I, 2009 SHEET NUMBER: A-1 S 70050'20"W Fnd CN 135.£?' N/F POWER O 7' No SCALE I, = 20' CERTIFIED TO: KATHERINE ~ CONWAY SECURITY TITLE 8 GUARANTY CO. (1054897~A) DESCRIBED PROPERTY HAMLET.B TO~N of .SOOTHOLD SUFFOLK COUNTY. NE~Y YOPK