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34846-Z
FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPAHITMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33830 Rte: 07/15/09 THIS C~RTIFIES that the building ALTERATION Location of Property: 1769 SMITH RD (HOUSE NO.) (STREET) Co%u/ty Tax Map No. 473889 Section 98 Block 4 Subdivision Filed Map No. Lot No. PECONIC Lot 20 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 9, 2009 pursuant to which Building Permit No. 34846-Z dated JULY 9, 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" ALTERATIONS AND CONVERSION OF SEASONAL DWELLING TO YEAR ROUND USE AS APPLIED FOR. q~ne certificate is issued to KATHRYi~ FAR~3kND (OWNER) of the aforesaid building. SUFFOI~( C~)~ DEPAR~]~I~T OF HF~%L~ APPRO~-AL N/A EI~-rKICAL C~U~TIFICJ%TH NO. 2104549 08/16/06 PLI]MBE~S C~RTIFICATION DA'r~u3 07/10/09 CUTCHOGUE EAST PLUMBING Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 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. Commercial 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 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 Date. New Construction: X Old or Pre-existing Building: Location of Property: /7~ ~ q~ r'~ ¢.&/,a /~©r~ Og House No. Street Owner or Owners of Property: / ~'/0.'~ ~q ~lg, ~4~r~ ~tlo/ Suffolk County Tax Map No 1000, Section ' ~7~5> Block Subdivision Perlnit No. Health Dept. Approval: Planning Board Approval: (check one) Hamlet Lot o~ O Filed Map. Lot: Date of Permit. 7~ ~ - ~g:vQ Applicant: t~Tz~'"'tV, r~ ~'--al~,"~'O~o,tff Underwriters Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ Q~(, ff'~ ~ (check one) Applicant Signature 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 OAKLAND DBA/OAKLAND ELEC. 210 BROOKLYN AVE MASSAPEQUA PARK. NY 11762, KATHRYN FARRAND 1768 SMITH RD PECONIC. NY 11956 Located at 1768 SMITH RD PECONIC, NY 11958 ,,.~ '~ Application Number: 2104549 ( ,/]3'~-~ Certificate Number: 2104549 Section: Block: Lot: ~ Building Permit: ~ BDC: ns11 Resident Described as a ~a1600-1199 square ~. occupy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, A,ached Garage, 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 16th Day of August, 2006. Name QTY Rate Rating Circuit Type Alarm and Emergency Equipment Sensor 2 0 Sensor 7 0 Appliances and Accessories Furnace I 0 Exhaust Fan 2 0 Dish Washer 1 0 Air Conditioner 1 0 Wiring and Devices Receptacle 40 0 Switch 22 0 Fixture 14 0 Fixture 2 0 Receptacle I 0 Receptacle 1 0 Paddle Fan 4 0 Disconnect 1 0 Receptacle 7 0 Carbon Monoxide Smoke Gas F.H.P. 1.2 KW 48.000 BTU 20 amp 30 amp General Purpose General Purpose Incandescent Flourescent Laundry Dryer 60 amp Air Conditioner seal GFCI Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the }resence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE ~ NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY AA 40 FULTON STRE~-I ~ NEW YORK, NY 10038 ~ CERTIFIES THAT AA Upon the application of upon premises owned by r~ OAKLAND DBNOAKLAND ELEC. KATHRYN FARRAND 210 BROOKLYN AVE 1768 SMITH RD MASSAPEQUA PARK, NY 11762, PECONIC, NY 11958 Located at 1768 SMITH RD PECONIC, NY 11958 2104549 2104549 Application Number: Certificate Number: Section: Block: Lot: Building Permit: 36099 BDC: ns11 Residential 600-l 199 square fi. Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Attached Garage, 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 16th Day of August, 2006. Name QTY Rate Rating Circuit Type Service I Phase 3W Service Rating 200 Amperes Service Disconnect: 1 200 cb Meters: 1 seal ~ 2 of 2 ~ 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 Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631 ) 765-1802 Fax (631) 765-9502 JUL 1 0 2OO9 BLDG. DEPT. TOWN OF SOUIHOLO Building Permit No. Owner: Plumber: CERTIFICATION lead. I certify that the solder used in the water supply system contains less than 2/10 of 1% Sworn to before me this /0 ~ dayof J ~y , 20t~ Notary Public, ~"'t~ [/~.~County //~S~gnature) WENDY L. KUKLA Not,~p/Publio, State of New Yad( No. 01KU6176871 Qualified in Suffolk County Commie,qon Explre~ 11/05/2011 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. 34846 Z Date JULY 9, 2009 Permission is hereby granted to: KATHRYN FARRAIgD 47 SHOREHAM RD MASSAPEQUA,NY 11758 for : "AS BUILT" ALTERATIONS & CONVERSION TO YR ROUND RESIDENCE AS APPLIED FOR. FLOOD PERMIT INCLUDED. REPLACES PERMIT#32099 at premises located at County Tax Map No. 473889 Section 098 pursuant to application dated JULY Building Inspector to expire on JANUARY 1769 SMITH RD PECONIC Block 0004 Lot No. 020 9, 2009 and approved by the 9, 2011. Fee $ 400.00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEP~d~TMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32099 Z Date JUNE 15, 2006 Permission is hereby granted to: KATHRYN FARRAND 1769 SMITH RD PECONIC,NY 11958 for : AS BUILT ALTERATIONS TO AN EXISTING SEASONAL DWELLING AND CONVERSION TO A YEAR-ROUND RESIDENCE AS APPLIED FOR WITH FLOOD PERMIT at premises located at 1769 County Tax Map No. 473889 Section 098 pursuant to application dated JUNE Building Inspector to expire on DECEMBER SMITH RD PECONIC Block 0004 Lot No. 020 7, 2006 and approved by the 15, 2007. tho~i ~d $i~q~ Fee $ 400.00 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ REMARKS: [ ]ROUGHPLBG. []INSULATION ~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE ~**'*"/d'"*'~ ~ INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ FOUNDATION 2ND [ FRAMING / STRAPPING [ FIREPLACE & CHIMNEY [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION REMARKS: DATE //O~'- f 0 ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ~)~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION REMARKS: DATE t t , - INSPECTOR - TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~,(~ INSULATION /~ [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: INSPECTOR FIUELD INSPECTION REPORT I DATE FOUNDATION (1ST) ~S~ATION P~ N. Y. STATE E~R~ CODE --. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined 6'/2- 20 6 Approved ¢ ,20~- Disapproved a/c Expiration JUN 7 ,20 BUILDiNG PERMIT APPLICATION CHECKLIST PERMIT NO. ,..~.~9oq 5' ~ 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: 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 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 aRer 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. .-x°3~nature of applicant o~ny ,, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~/a ¢~ t',/~ / (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ~t- 36~21- At Plumbers License No. Electricians License No. :~ q?/~0 PIE Other Trade's License No. g,,]~ Pte,~,~,',~ / Location of land on which proposed work will be done: /'T&ct House Number Street County Tax Map No. 1000 Section Subdivision ~'~d;~ Meek Pa,k (Name) '- -2o State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ,-f/.~dl~ b. Intendeduseand occupancy 3. Nature of work (check which applicable): New Building. Repair .':J/,*-~odq Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling traits 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 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 construction: Front Height Number of Stories Rear .Depth 9. Size of lot: Front Rear .Depth I 0. 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 ~X 13. Will lot be re-graded? YES NO ){ Will excess fill be removed from premises? YES 14. Names of Owner of premises /~4~x,~,~ ~--~ccoJ Address t/7 $horefia,,~ I~ Nme of Architect Address N~e of Con,actor ~/f C~ ~. Address /~ ~r~ 15 a. Is this prop~y within 100 feet ora tidal wetl~d or a ~eshwater wetl~d? *YES__ * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PE~ITS ~Y BE REQUIRED. b. Is this property within 300 feet of a tidal wetl~d? * YES__ * IF YES, D.E.C. PE~ITS MAY BE REQUIRED. __NO PhoneNo. Phone No PhoneNo. [,~1-~'~,~ NO 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 O~ ~/4q/2_~ Pf~4'¢a-]. being duly sworn, deposes and says that (s)he is the applicant (Name of individual sffgning contract) above named, (S)He is the COtl l/f~ ~-lqff (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 tree to the best ofh/s knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Permit # Permit Date REScheck Software Version 3.7.3 Compliance Certificate Energy Code: Location: Construction Type: Heating Type: Glazing Area Percentage: Heating Degree Days: Construction Site: 1769 Smith Road Southold, NY 11971 Project Title: Farrand Residence - Interior Report Date: 06~07~06 Data filename: C:\Program Files\Check\REScheck\Farrand.rck New York State Energy Conservation Construction Code Suffolk County, New York Detached 1 or 2 Family Non-Electric 19% 5750 Owner/Agent: Designer/Contractor: Ceiling 1: Flat Ceiling or Scissor Truss: 1593 30.0 0.0 Waft 1: Wood Frame, 16" o.c.: 1400 13.0 0.0 Window 1: Metal Frame with Therma~ Break:Double Pane with 249 Low-E: Door 1: Glass: 21 Floor 1: All-Wood Joist/Truss:Over Unconditioned Space: 1400 30.0 0.0 0.350 0.450 56 93 87 9 46 roposed buildr~,e~esented in this document is consistent with the building plans, specifications, and other calculations ted with this ~ermit ~l~lication. The proposed systems have been designed to meat the New York State Energy Conservation tion Code r~quireme'~. When a Registered Design Professional has stamped and signed this page, they are attesting that of his/her ~nowledge,'~elief, and professionaljudgmen.,~.,j~l~~ specifications are in compliance w~ this/Code. Farrand Residence - Interior Qbhf 2 pg2 LOT O MAP OF INDIAN NEC P£CONIC, TOWN OF ~ SUFFOLK COUNTY, SURVEYED FOR: KATHRYN COMPLAINT REPORT NAME: ADDRESS: DATE PHONE # HOW RECEIVED: ~ TEL. -MAIL- IN PERSON LOCATION OF COMPLAINT: ~,)'~[oC~ ~(v~ ~j~ SUFF. CO. TAX MAP OWNERS NAME ASSIGNED TO: o~'/~/~ INSPECTION DATE: REMARKS: ~ ACTION TAKEN: FILE # IF APPLICABLE RE-INSPECTION DATE: File # TOWN OF SOUTHOLD COHPLAZNT REFERRAL FORH Location of Complaint: /~[o~' ~,'t'/P%~% /~--~'~/.~! C SCTM# Property Owner: / ?~: Sg'~'m ,~J ,~-)~ Phone Address: NATURE OF COMPLAINT: Optional: Complainant: /f'~ ¢~,~ fl'/'~'~'~ By Phone __ Address /~ ~ fi' q~/'**'f~?'r':' .r'~ ~2~/~/c7 Repo~ Taken By: Date Referred to Code Enforcement: ~ ~ ~ o ~ Mail In Person Phone: Date: SITE INSPECTION REPORT/DATE: CODE ENFORCEMENT REPORT TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER FORME~ O'~'VN ER RES. SEAS. 2~ LAND IMP. //~ Farm Till~le ] Tillable 2 Tillable 3 Woodland Swampland Brushl~nd House Plot Total NORMAL VL. TOTAL DATE BUILDING CONDITION BELOW ABOVE Acre Value Per Acre Value Vi LLAGE E DISTRICT SUB. LOT ~) ? ACREAGE TYPE OF BUILDING --7 REMARKS cOMM. lIND. IcB. I MISC. M. Bldg. /_?z'~ ~.~,~-._./c/VC3 /J~/O .~),5 ~'O'-~'~/ oundation ~tension ~ ~ ~ ~ ~/~ ) Basement ~ ~. Fl~rs Extension ~ %/~ z / ~ ~_( ~t. Wails ~ r~'~z; ~ Interior Finish Extension~ Fire Place / ~ He~ ¢ Porch Rooms 1st Floor Breezeway Patio Rooms 2nd Flor ' ~ .:-. t. (,~.~ Driveway O.D. 210 Brooklyn Ave Massapequa Park IV. Y. 11762 ~s~imat~ NAME I ADDRESS Kate & Jim Mooney 47 Shoreham Road Massapequa, NY 11758 ........................ . .......... . ............. . . PRQ.JECT DESCRIPTION QTY COST TOTAL In.stall 200amp service with #2~ THHN t 1,995.00 1,995.00 wire. 2. 20amp circuits and 2 Gfci. 1 400,00 400.00 20amp circuit with 20amp circuit breaker. 1 135.00 135.00' 20amp circuit with 20amp circuit breaker. I 135.00 135.00 20amp circuit with 20amp breaker. 1 135,001 135.00 Outlets in Decora style for the counter. 6 40.00 240.00 A r tight and direct ~nsulation use lighting,, 6 120,00 720.00 15 amp circuit breaker. 1 125.00 125.00 Decora Style Dimmers I 40,00 40.00 Outlets in Decora style for the house, 40 40.00 1,600.00 Standard style switches 15 40.00 600,00 15 amp circuit breaker for the house. I0 125. O0 1,250. O0 Wire heating according to builder. 1 375,00 375.00 Instafl wiring and disconnect switch for AC I 625.00 625.00 units and Air handler, Ground Fault Circuit Interrupter for wet 2 75.00 150.00 locations for the bathrooms. ·. ~ .......... 20amp cif. cuit with 20 amp breaker 2 135.00 270.00 Wet location for outside house. 2 75.00 · 150.00 install gfci and lighting for attic area.' 1 ' 195.00 195.00 120volt smoke detector with battery back 6 ',70.00 420.00 ts!de ,.ght wiri, g only: 4 O0 SO0. O0 '~'an pox for bedrooms. 4 100.00 400.00 Install 3 way wiring for lighting 2 75.00 150.00 · ,. SIGNATURE ~ ... Page I ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE, APPRO~/ED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH · FBAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, .! OCCUPANCYOR USE IS uNLAWFUL WlTHOUTCERTIFICATE OF OCCUPANCY FLOOD ZO~------------ COMPLY WITH CHAPTER "46" FLOOD DAMAGE PREVENTION SOU~'HOLD TOWN ~ODE. PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTtNG BEFORE cOVERING CERTIFICATION OF NAILING & CONNECTIONS REQUIRED. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF / [ //J SOL~OLDTOWNZBA Il I III ~OUTHOLDTOWNP~NNING~D //I//dC SOUTHOLDTOWNT~USTEES I V,l' N.Y.S. DEC ONDEFIWRITER$ CERTIFICATE REQUIRED PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER ~USED IN WATER SUppLY SYSTEM CANNOT - EXCEED 2./10 OF 1% LEAD. JOSEPH FISCHETFI, PE PROFESSIONAL ENGINEER 1725 HOBART RD / PO BOX 616 SOUTHOLD, NY 11971 631-765-2954