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HomeMy WebLinkAbout34801-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33817 Date: 07/08/09 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: _ 5430 WESTPHALIA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 113 Block 11 Lot 19 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 19, 2009 pursuant to which Building Permit No. 34801-Z dated JUNE 19, 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 HEATING SYSTEM AS APPLIED FOR. The certificate is issued to WILLIAM H SPARKE JR & CLAIRE P (OWNER) of the aforesaid building. SUFFOI=K CO[~qTYDEPARTMENT OF H]~kLTH~PRO%~%L N/A ELE~-l~IC3%L CERTIFICATHNO. 3011744 10/23/06 PLIERS CERTIFICATION DA'r~3 N/A Rev. 1/81 Form No. 6 TOWN OF 80UTItOLD BUILDINGDEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcY ~ applicati~a must b~ filled in by ~t~r or ink and ~omitted to th~ Building Dq~anent with FOr new bUildln~ or'new use: 1. F!n~! aurvey o£propertY with a~x~tu~t~ lo~afion of all buildings, Pr°l:~'ty ~;.s~, ~d ~ ~ or ~ ·Final ~ ~H~& ~t. of~ ~Iy ~d ~~.(8-9 fo~). 3. ~m~ of~'~ ~ofF~ Uad~. 4. Sworn ~t ~m pl~ ~ ~.~ ~d~ ~ ~ ~ ~, }~ ~ ~10 of I~A l~& 5. ~' ~ ~ ~din~.m~ ~ ~d sim~ ~ ~d'~0~,~a ~ of ~ ~!~ fi0~ ~ or ~n~ ~ib~ for ~e b~l~. 6. Sub~t p~,nin~ Bo~ ~ of ~1~ si~ p~ ~; B. For e~g'b~a ~r to A~ 9, 19~ no~o~.~, or b~ ~d ,p~ I~d.~: 1. ~ ~ ofP~ ~ho~ ~I ~o~ ~, ~,.b~d~ ~d.~ ~ or ~c f~. 2. A-p~ly ~l~t~'~pH~on ~d ~t to ~ si~ by ~ ~p~t. ifa C~ifi~te 0f O~ is d~ ~ Buil~g ~tor a~l.s~te ~e ~ona ~for in ~fing to ~e appli~t. C. Fees t. Certificate:of'Occupanoy - New dwelling $25.00, Additions to dwelllag $25.00, Alterations to dwelling $25.00, 3. 4. 5, New Constmction: . Old or Pre-existing Building: LocationofProperty: ..>"'q~ W~.~") P /'t''~c ~' ' I~ - -- Hons~ No. Street ownerorOwnersofprope~ty: ' [n~//--/-- ~ -,r~ ~, ~ ~L SulTolk County Tax Map No 1000, Section Swimmirlg P0Ol $25,00, Ace~sory building. $25.00, Additions to accessory building $25.00, Businesaes $50.00. Certificate of Occupancy on Prc-o _xisting Building - $100.00 Copy.of CeFdficate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of OCCupancy - Residential $15.00, Commercial $15.00 (check one) Hmnlet Subdivision Permit No. Health D~pt. Approvall Planning Board Appmvat: Filed Map. 'Lot: DateofPermit..tg~//qJ:lt~9~'Applicant: l,~'~ l.~- Undenvritera Approval.' Temporary Certificate ,, Request for: Fee Submitted: $ Finai Certificate: ~>~ (check one) Applicant Signature ~'~' BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD Of FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STRE~ ~ NEW YORK, NY 10038 _ // - CERTIFIES THAT / Upon the application of upon premises owned by WILLIAM SPARKE WILLIAM SPARKE PO BOX 437 PO BOX 437 MATTITUCK, NY 11952 MATI'ITUCK, NY 11952 5430 WESTPHALIA MATTITUCK, NY 11952 Located at Application Number: 3011744 Certificate Number: 3011744 Section: Block: Lot: Building Permit: ~)J/~(~ 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: storage shed, Outside, 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 23rd Day of October, 2006. Name QTY Rate Rating Circuit Type Miscellaneous out door storage shed with attic space as built-1998 Wiring and Devices Outlet 3 0 Fixture Fixture 3 0 Incandescent Outlet 3 0 General Purpose Receptacle I 0 General Purpose Switch 3 0 General Purpose Receptacle I 0 GFCI An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 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. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34801 Z Date JUNE 19, 2009 Permission is hereby granted to: WILLIAM H & CLAIRE SPARKE P.O. BOX 437 MATTITUCK,NY 11952 for : INSTAL~LATION OF HEATING SYSTEM AS APPLIED FOR. REPLACES EXPIRED BP # 31746 at premises located at 5430 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0011 Lot No. 019 pursuant to application dated JUNE 19, 2009 and approved by the Building Inspector to expire on DECEMBER 19, 2010. Fee $ 150.00 uthorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34801 Z Date JUNE 19, 2009 Permission is hereby granted to: WILLIAM H & CLAIRE SPARKE P.O. BOX 437 MATTITUCK,NY 11952 for : INSTALLLATION OF HEATING SYSTEM AS APPLIED FOR. REPLACES EXPIRED BP # 31746 at premises located at 5430 WESTPHALIA RD County Tax Map No. 473889 Section 113 Block pursuant to application dated JUNE 19, 2009 Building Inspector to expire on DECEMBER 19, MATTITUCK 001t Lot No. 019 and approved by the 2010. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 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. 31746 Z Date JANUARY 20, 2006 Permission is hereby granted to: ~ WILLIAM SPARKE 5430 WESTPHALIA RD MATTITUCK,NY 11952 for : INSTALLATION OF A HEATING SYSTEM AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 113 0011 Lot No. 019 pursuant to application dated JANUARY 18, 2006 and approved by the Building Inspector to expire on JULY 20, 2007. 5430 WESTPHALIA RD Block MATTITUCK Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~,~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR. *~D ~S~,EC~O~,o~r I DATE FO~ATION (IST) FOUNDATION (2ND) ROUGH F~G & PL~B~G PER N. Y. ~SULATION STATE ENERGY CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined l [,~ ,200~° Approved ,20 0 ~ Disapproved a/c Expiration I 8 "' PERMIT NO. 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: Mail to: ~u~ilding Inspector Phone: APPLICATION FOR BUILDING PERMIT Date 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 shgll 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, 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. UNDERW F)'ERS CERTIFICATE REOUIRED ALL CONSTRUCTION SHALL (Signature of applicant oran"ne, ifa corpoiation) OCCUPANCYOR IVI(EEr THE REQUIREMENTS OF THE CODES O'F NEW YORK STAT .z USE IS UNLAWFUL N&T QU T EI T FJCJ ,TI see, FLOOD ZONE (Mail~addressofappl~ant) a~tl:~Cth~e~~ntractor, electrici~n,~ or builder OKOCCUPANCY FLOOD DAMAGE PREVENTION SOl ITHOLD TOV'H CODE. APPROVED AC k'OTED Name of owner o£pr¢~ises r_<//4, z/,I~/,¢ -.¢,p~,r/¢¢-, DATE:/__~(b ' (As on the tax roll or lates~EiFced) /'~)-Z-- B~': -.~--J-¢~'- ' -- I£appticant is a corporation, si~ature o£duty authorized officer NOTIFY BUL[ 'i: ~:,; :i-MENT AT (Name and title of corporate officer) Builders License No. Plumbers License No. ,33' t./f Electricians License No. Other Trade's License No. -p 1. Location of land on which proposed work will be done: .5-¥30 iMESTP#IILIn ~qO , 765-1s02 ¢ c,- ~ FOR TIlE 1. FOUNDATION - l'v, L i~EQUIRED FOR POURED CCNCF,~TE 2. ROUG~ - Fi ,~' '.,O ~. PLUMBING 3.INSULATION 4. FINAL - COYSTFb'3TI 3 MUST BE COMPLETE FOR C.C. ALL CONSTRUCTION Si4ALL MEET THE REQUIREMENTS OF THE 303ES OF NEW YORK STATE NOT RE2PONSIBLE FOR ZY.9.~, ..... ;., .................... House Number Street County Tax Map No. 1000 Section Subdivision (Name) Filed Map No. ~t 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy x~;~ 0.~x/27~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost~' 219 ~ ~.. 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration OtherWork o~t 'r~ 4,~x (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 Heigh[ Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth. Height. Number of Stories Rear 8. Dimensions of entire new constxuction: Front Height Number of Stories Rear Depth 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? 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 ~.tt,,~,,~ s'~,,a,g~ Address ;'~o co~reu*~.r,~ g'~Phone Nme of Architect Address Phone N~eofCon~actor ~?, ?t~,~/~ ~, Address , ~g~,~$~/, PhoneNo. 15 a. Is this prop~y within 100 feet of a tidal wetl~d or a ~eshwater wetl~d? *YES __NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PE~ITS MAY BE REQUI~D. b. Is this prope~y within 300 feet of a tidal wetl~d? * 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 stlty~. STATE OF NEW YORK) · · SS: COUNTY OFkoOttC~ U~t'~ ~l~U! ~ O f~L~_, being duly sworn, deposes and says that (s)he is the applicant (Nme ~[f individual si~Jn-g 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. Sw°rn~}f~aynloe;h{YQ J/J/~F&,~ 20 ~/f Sigl~.g¢tre of Applicant ,Ju r...v 14' J-' J ~C:AL~- o 50'= = ~,V~'L L · h,.lOT r=~ Midco International Inc. t EC200 & EC300 Power Gas Burner Page 1 of 2 1SO 9000:2000 Registered and Compliant Home > Products > Economite > EC200 & EC300 Midco International is proud to announce an addition to its legendary Economite Power Gas Burner line. 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