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Home My WebLink About34870-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33868 Date: 707/31/09 THIS c~KTIFIES that the building HEATING SYSTEM Location of Property: 175 SOUNDVIEW AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 99 Block 3 Lot 1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15, 2009 pursuant to which Building Permit No. 34870-Z dated JULY 15, 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" HEATING SYSTEM TO CONVERT SEASONAL DWELLING TO YEAR ROUND ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to VIRGINIA S MEYRAN (OWNER) of the aforesaid building. SUF~OI~KCOUN~YDEPARTMENTOF}IEALTHAPPROVAL N/A EI~CTRIC3%L C~ERTIFICR%TH NO. 10715 07/29/09 PLI~WBERS C~u(TIFICATION DA-r~u N/A ~ized Signature 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. Ifa 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, Cmnmercial $15.00 New Construction: Location of Property: House No. Date. Old or Pre-existing Building: Street ?,/t (check one) Owner or Owners of Property: ¥'1~ ;,v',~ ~_~ ,'~r~-~ ~,4,/~ Suffolk County Tax Map No 1000, Section ~ ~ Subdivision PermitNo. ~'~q~'~O DateofPermit."-2-4~. Oq Block .-~ Filed Map. Applicant: Lot [. Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: .[,,/~(check one) Applicant Signahd'e SUFFOLK BUREAUo~ ELE CTR~CAL JUL 31 20 9 I~LD~. DEPT. ~dm. ail r:nr~OWN OF $OUTHOLD + INSPECTORS, i 40 Nottingham Drive, Middle Island, NY 119.53 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIG8 CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough In ]nspection Date: Application No.: Sabat Electric Certificate No.: 10715 luly 29,2009 Final Inspection Date: 3uly 29,2009 10715 Building Permit No.: Suffolk County Tax Map No.: This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: Virgina Heyran Site Location: 175 $oundveiw Ave., Hattituck, NY 11952 Owner's Address (if different): [] Residential [] Indoor [] Basement [] Service [] Shed [] Commercial [] Outdoor [] First Floor [] Pool [] Hottub [] New [] Renovation [] Second Floor [] Attic [] Garage [] Addition [] Survey Other: furnace wiring INVENTORY Single Phase Heat 1 Duplex Recpt Ceiling Fixture HID Fixtures Three Phase Hot Water GFCI Recpt Wall Fixture Smoke Main Panel AC Cond Single Recpt Recessed Fixture CO Detect Sub Panel AC Blower Range Recpt Flourescent Pumps Transformer Appliances Dryer Recpt Emergency Time Clock Disconnect Switches Twist Lock Exit Fixtures TVSS GFCI Breaker Heat Pump Electric Heat Pool Luminaire Exhaust Fan Other Equipment: Hot Air oil fired fumaoe wiring The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office, Applicant: Sabat Electric Inspected By: Gene Surdi Signature: ~~ License No.: 4204ME Date Of Certificate: Jul 29,2009 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. 34870 Z Date JULY 15, 2009 Permission is hereby granted to: VIRGINIA S MEYRAN 175 SOUNDVIEW AVE MATTITUCK,NY 11952 for : AS BUILT - INSTALL HEATING SYSTEM CONVERSION FROM SEASONAL DWELLING TO YEAR ROUND AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 099 pursuant to application dated JULY Building Inspector to expire on JANUARY 175 SOUNDVIEW AVE MATTITUCK Block 0003 Lot No. 001 15, 2009 and approved by the 15, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] INSULATION ~ FINAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] FIRE RESISTANT PENETRATION 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 '7- ~/- ~ ~ INSPECTOR ~~'~-'"~ FOUNDATION (lS~ ROUGH ~G & PL~G ~$~A~ON PER N. Y. STATE E~R~ CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined TI ~5 20 (3(~ Approved ,20Oq Disapproved a/c 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: Building Inspector Phone: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date yd~"' , 20 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, 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 inspector.s o.n.llre,,mJ~o,s~vdain bui1411te'~ls~d~ihg~tgons. ON LEAD CONTENT BEFORE ~ERTIFICATEOFOCCUPANCY .... .-,-, ,~, ~ ~"~r- ; "r"'~" r~ T(Signamreofapplicant%/'name ifacorporation) VVI/HULJ btzr / SOLDER USED IN 'WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 OF 1% LEAD. ,,,.v. (Mailing address of applicant) / il3'-6/F ' r ....... ~ ~ :' lC ~rgenhr~Obhtractor, electrician, plumber or builder State whethbr applicant is owner, lessee, a~bft~cka~;(~qgtneer ' ~': 3,:' i);~i; 0 :;'.'-" UNDERWRITERS CI:RTIFi~^ . Name of owner of premises Wt&~t~W~ .~ (As on the tax roll or late~[~ed~/:'c5 If applicant is a co¢oration, signature of duly authorized officer ; :)TI[V F '1 ¢tC [ ' ~ ~ffNT AT '55-~02 ~ '}. ;' ~'d i-OR THE (Name ~d title of co¢orate officer) ~-OLLOWINO .. FQU~0AIiON . T&'O REQU/RE0 FOR POURED CCNCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULAIiON Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: l "'1 ['-- ,Xo,JMO v,/cn4 ./i-cc-- House Number Street 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW ¥O . IZ Cc Or RESPONSIBLE FOR Dl~[t~ UUNSTRUCTION ERRORS. County Tax Map No. 1000 Section c]~ Block o3 Lot / Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy -._q. r. /~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee 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 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 filI be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 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. 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 topographlc~{1 ~lata 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) : G~ [.re2~fX ~'V'~ 'C-Ct~ bmng' duly sworn, deposes and says that (s)he is' the apphcant' (Name of individual signing c6ntract) above named, (S)He is the 'C ~e~ Corporate Officer, etc.) t on rac or, gent, 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 of his knowledge and belief; and that the work will be perlbrmed in the manner set forth in the application filed therewith. Sworn to before me this /.2~ dayof \.~Jt,c~c~ 20 Notary Public Notar/Public, ~ No. 011'06190696 Qualified in Suffolk Courdv Commission Expires July 28,20 Signature of A}c,~licant ' ) OWNER -/ FORMER OWN,ER ' ' LAND IMP. TOWN OF SOUTHOLD pll)OPERTY RECORD CARD /6o6 STREET ~..~ VILLAGE DISTRI¢ SUB, TOTAL E ~ REAGE FARM CONU~A. IIND, DATE RE/v~ARKS LOT ~ CB. TYPE OF BUILDING vJ,II ~ Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushland Hous~J~lot..~ Acre Value Per Acre Value FRONTAGE ON WATER'/d 0 FRONTAGE ON ROAD BULKHEAD DOCK To~l Extension Extension Breezeway GQrage Oo B, 5~~ 7._ IFOundOtiOn Basement Ext. Walls Fire Place Patio Driveway Bath Floors Interior Finish / Heat J ~. ~//~, Porchi _ Roof Type ~.~ Rooms Porch 1st Floor Rooms 2nd Floor Dormer $~l~ Y~IYED .W~A~ ~. ~e~vi.s~d Dec. ~, t~