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Home My WebLink About34626-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33905 Rte: 08/18/09 THIS C~u(TIFIES t~at the building ALTERATION Location of Property: 500 MAPLE LA (HOUSE NO.) (STREET) County Tax Map NO. 473889 Section 64 Block 1 Subdivision Filed Map NO. __ Lot NO. __ SOUTHOLD Lot 20 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in t~/s office dated APRIL 15, 2009 purs,,a-t to which Building Permit No. 34626-Z dated APRIL 22, 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 AS APPLIED FOR. · "~e certificate is issued to WILLIAM & TAP~A NICK (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPART~TOFH~ALTHAPPROVAL N/A ~.RCTRICAL c~KTIFICATE NO. 4026936 05/19/09 PLU~E~S U~U(TIFICATION DA-r~u 07/08/09 BERTSAND PLUMBING & HEAT Rev. 1/81 AUG 7 2009 BLDG, DEPT. TOWN OF SOUIHOLO Form ilo. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 LICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to thc Building Department with the following: A. For new building or new use: 1. Final survey of property topographic features, with accurate location of all buildings, propcmy lines, streets, and unusual natural or 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 f~om plumber certifying that thc solder used in system contsin, less than 2/10 of 1% lead. 5. Commercial ........ . . bmlding, industrial building, multtplc residences and sumlar buildings and installations, a certificate of Code Compliance from architect or engineer reepousiblc 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: t. 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 bythe applicant. Ifa Certificate &Occupancy is ~ denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. f 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 ofOccapancy - $50.00 5. Temporary Certificate of Occupancy _ Residential $15.00, Commercial $15.00 New Construction: Location of Property:. Old or Pre-existing Building: House No. v Street Owncr°rOwners°fPr°pertY:_~J~r~O Or .['~i)l ~i~K. Suffolk County Tax Map No 1000, Section ~ ~4 Subdivision Per t No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~[~ (cheCk one) Hamlet Block / Filed Map. Applicant: S~N~ ~r'tt ~ Underwriters Approval: Final Certificate: Lot: (check one) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~)ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34626 Z Date APRIL 22, 2009 Permission is hereby granted to: T & B NICK (ROSE) 500 MAPLE LA. SOUTHOLD,NY 11971 for : "AS BUILT" BATHROOM ALTERATION TO AN EXISTING DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 064 pursuant to application dated APRIL Building Inspector to expire on OCTOBER 500 MAPLE LA SOUTHOLD Block 0001 Lot No. 020 15, 2009 and approved by the 22, 2010. Fee $ 400.00 /~ri~nature ORIGINAL Rev. 5/8/02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STRE~-i ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by CUSTOM LIGHTING OF SUFFOLK INC PO BOX 1698 MATTITUCK, NY 11952, TARA & BILL NICK 500 MAPLE LANE SOUTHOLD, NY 11971 Located at 500 MAPLE LANE SOUTHOLD, NY 11971 Application Number: 4026936 Certificate Number: 4026936 Section: Block: Lot: Building Permit: * BDC: ns11 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, bathroom, 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 tgth Day of May, QTY Rate Rating Circuits Tv~e Name Appliances and Accessories Exhaust Fan I 0 F.H.P Wiring And Devices Dimmer 2 0 120 V Fixture 7 0 Incandescent Outlet 5 0 C-eh, Purpose Outlet 7 0 Fixture Receptacle I 0 Gert, Purpose Receptacle 2 0 GFCI Switch 4 0 Gen, Purpose I of 1 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. 1 own I lall, 5309§ Mnln Rood P.O.D~x !179 Souilmkl, New Yo~k ! 1971 Fnx (516) 765-1823 ]elephone (5 ! 6) 765-1802 OFFICE OF TI-IE BUILDING INSPECTOR TOWN OF SOUTHOLD C ERTl F I CAT i OH DATE-' July 8. 2009 Building OWller: per,,,it .o. _% q 6 & (please pclnt) PI umber' _~.~_rrsand Rlumbing & Heating, Inc. (please print) I certify that the solder used in the water supply system contains less than 2/!0 of 1% lead. Sworu to before me this 8th day of Ju]y t ~ 2009 Notary Public, Su~ County IIIIoen M, N~uho Notary Public, State of New York No. 4826942 Qualified in Suffolk County Commission Expires January 31, 20~/P TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE ~'-- 2-7-- ~ ? INSPECTOR ...................................... FOUNDATION (2ND) ROUGH FroG & pL~G ~S~ATION PER N. Y. STATE ENERGY CODE 2. State existing use and occupancy of premises and in$qnded use and occupancy of proposed construction: a. Existing use and occupancy ~ t~)~- 4-~¢4i b. Intended use and occupancy (-~I t~qLC ~%i 3. Nature of work (check which applicable): New Building. Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ] ~ t O-ET~ Fee ~ ! ~ ~!! ~i! ' ; ..(To be paid on filing this application) 5. If dwelling, number of dwelling units Number of~h4el!!nl~ units on each floor If garage, number of cars 6. If business, commercial or mixed occlupan~y, specil~ nature and_~xten{ of each type of use. 7. D,mens~ons of exlsUng structures, ff ~y: FroatV ~ .... ?'-Re~ _Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth. Height. Number of Stories 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 fill be removed from premises? YES__ NO __ 14. Names of.(~gr~emises pl 6'~ Address ~ ~ Phone No. Name of~ },.~Lla 04 ~6c~/~,~f' Address_2~¢~3~2~[~.~ [e~.,~Phone No ~7[/c~- _ ~'~o ~, -7 Name of Contractor d"~P~'~t~4~ [ [(.>f~kL-~ Address .r-r-~d~ PhoneNo.~ 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 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 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) COUNTY O~r~'~: & Iq (/b LU4 q.~t/ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signidg contract) above named, ~ ~ CONNIE D BUNCH (S)He is the ~'4ff~9~.4~~- Nntn~ p,,~u~ ~;~ .~ .,,.;;; ;~,,, (Co~3~ractor, Agent, Corporate Officer, etc.) ^ ' uualmeo n ~uffolk County Commission Expires. April 1.4,~0 of said owner or owners, and is duly authorized to perform or have performed the said work and to ma~e and tile-ffirs appnu,,lon; 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. Notary Public / Signat~of Applic~t j~s~~_ :.~:~_9_1'_0__~1N OF SOUTHOLD ~R)OPERTY II~'O~'D"~ARD VILLAGE RES.; ,.~/O ~EA~ VL. FArM COMM. I IND. LAND IMP. TOTAL DATE REMARKS DISTRICT SUB. ACREAGE .7~ -~ ~-I~.i?E OF BUILDING CB. [ MISC. LOT Est. Mkt. Value /Io o, IoO '7 Zoo FRONTAGE ON ROAD Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushland House Plot To~ ,,~. '~, ,.~ 64,-1-20 10/04 ,~ / ~- ~ ~ -- [ ~on ~0" ~ ~ /I~-I ~ i t.~_~ Basement ~ 2/~ :looTs ~L:~= ........ -- ~ .... ~ - ' N .... ~ :~ ~ ~ ~ )' ~'~ .:~: /0 ~ ~ ~ ~ ~,~[ /l~ Fire Place Porch / ~ Type ~ . '~~X~~ l?b~ 7~/ Patio Extension ~ - -- Ba -- ~ ~, ~) · ~ sement /Bath ·/Floors OCCUPANCY OR WITHOUT CERTIFICATE PLUMBER CEe; ":' ," 'XOEEO.~f 0 u,- PLUMBING FOLLOW~NG IHS/EE hCHS. TOP; PROVIDE KICK H~TE~ & WATER LINES IN 5A5~ 0¢ VAN~ TESTING BEFORE COVERING WALL MOUNTZD MIRRORADOVE 3. INSULATION ckosz N ~ISTINQ NZWWINOOWW~IN ~LI. WINDOW OPENING OLD W NDOW OPENING REQUIREMENTS ¢~DES OF NEW __ ~ I~l YORK S~T~SPONSIBLE FOR TO ~MAIN ~ L ~o CUSTOM F~ME~55 TEMP~D ~ r ~ * }o/ ~ISTING ~Z~OR ~ ~INTE*IO*STUD ~,STIN¢ ~ V / G~55$NOWERDOOR*ENCLOSU~ __ ii / XX WALLW/INSU~TION WONDER BOARD PROIRTO L ALL CONSTRUCTION SHALL TI~MARBLE INSTA~TION ~ ~ IEET THE REQUIREblENTS FHE · o ~MA~N CODES OF NEW YORK STA~ E. ~ATH ~YOUT SECTION "A" 5CALE: ~"= I' O' 5CAL~: ~"= ILO" GENE~L NOTE$: OUTLINE OF ~IST[NG i I '2 7 PLUMBING m i I'x}~(~ required ~ ........ h~t, Mmlmum of one ~hermos~t for each ...... II be reqiJired, ELECTRICAL NOTES: BATH LAYOUT ¢ DEMO WALL ELEVATION