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Home My WebLink About23067-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~d{TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33938 Date: 09/03/09 THIS CERTIFIES that the building ADDITION Location of Property: 120 KING ST EAST MARION (HOUSE NO.) (STREET) (P~AMLET) Co~knty T~ Map NO. 473889 Section 26 Block 2 Lot 1 Sukx~ivislon Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 5, 1995 pursuant to which Building Permit No. 23067-Z dated OCTOBER 13, 1995 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JEAN & MARIE-LISA GAZARIAN ( OWNER ) of the aforesaid building. SUFFOLK COUNq"f DEPARTMENT OF HEALTH APPROV~J~ ELECTRICAL CERTIFICATE NO. ~L~)~ERS CERTIFICATION DATED Rev. 1/81 N/A 10777 07/31/09 N/A ~k~~o r 1 z e~d Si gnat ure 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 froin architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 1. Accurate survey of property showing all property lines, streets, building and unusual uatural 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 O~cupancy - 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 - Resideutial $15.00, Commercial $15.00 New Construction: _ Old or Pre-existing Building: Location of Property: {3--0 ~/~/~/~ C~ ~'~ House No. /~ Street // Owner or Owners of Property: (._/~ ~,) .,_ J47~t ./~/, '/~ _ _ ~ . _t-~,~ ~/r/ //~_~ ,_. H~l/~_.?~, ~ L,]' _~¢_~ Suffolk County Tax Map No 1000, Sectionb7~?. ~ _ ~'~ ~.~/Block Lot Subdivision Filed Map. Lot: Permit No. ~ () ¢ '~ Date o f Permit. 0 ¢_J~, I ~ / ~/~Tj~'~pplicant: Health Dept. Approval: Underwriters Approval: (check one) Hamlet Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ .~'o ~0 Final Certificate: / (check one) / &plican~Sigl~afur; + SUFFOLK BUREAU Of ELECTRICAL INSPEC~ORS.~nC 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough fn fnspection Date: Application No.: Arthur Ruroede Electrician luly 31 ~2009 10777 Certificate No.: 10777 Final [nspection Date: 3uly 31,2009 Building Permit No.: 23067 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: 3ean Gazarian Site Location; 50 King St, Orient~ NY 119S7 Owner's Address (if different): ~ Residential [] Commercial ~ New ~ Addition Three Phase Main Panel Sub Panel Transformer Disconnect GFCI Breaker ~ Indoor [] Basement L~ Outdoor ~ First Floor [] Renovation ~ Second Floor [] Survey Other: INVENTORY Heat Duplex Recpt 3 Hot Water GFCI Recpt AC Cond Single Recpt AC Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock Heat Pump Electric Heat ~ Service ~ Shed [] Pool [] Hottub E~ Attic [] Garage Ceiling Fixture HID Fixtures Wall Fixture Smoke Recessed Fixture CO Detect Flourescent Pumps Emergency Time Clock Exit Fixtures TVSS Pool Luminaire Exhaust Fan The electrical work and/or equipment described above were inspected and appear to be in compliance local, state and national electrical code requirements and this office. Applicant: Arthur Ruroede Electrician }nspected By: Gene Surdi Signature: License No.: 2334-ME Date Of Certificate: Aug 07,2009 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF T,E WOrK AUTHOr,ZED) Date (~/~ N? 23067 Z Permission is hereby grant~J to: .... ~.~, ...... ~ ................................................ ..... ~~,,..~...y.........../../..~.2.,z.....:~ ....... to ...,,~,.~......~.....~....~..~..~..~........~,.,~..~....,~..../...~,.~.~../...,t'~'..,,.~. ....... - at premises located at .................. ./...~....~.. ........ .../...~..~'...~..., ..................................................... Counly Tax Map No. 1000 Section ............ ..~,....~..... Block .......... ~ ........ LotNo ...... ~ ..................... pursuant to application dated ...................... 0.~.~ ....... 19......C~....~., and approved bythe Building Inspector. Fee $.....~Z...~....~, Rev. 6/30/80 765-1802 BUILDING DEPT. [ 1ST [ ] ROUGHPLBG. [ INDrATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY IN,";III.A'FIOi'I PElt ~l. STATE ADDI'I'IOHAL CO~HEN'[$: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL COUTFtOLD. N.Y. 11971 TEL.: 765-1802 19Z . Permit No dO¢ BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ~ 2.Z~/C. MAIL TO: Disapproved a/c ..................... , ............ i~ing In _/?LICATION FOR BUILDING PERMIT INSTRUCTIONS / Date ................ 19 ?..~ / a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 a~3y purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 taws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature ot applicant, or name, if a corpor:;r~dn')' ' ' ../fi... 9.: .< . . . 9. . .z?.../'. .. .,: ./.$. /. (Mailing address of applican{) , State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~...C..~..".~..~ .......................... ( s on the tax ~511 or latest deed) Ii' applicant is a corporation, signature of duly authorized officer. ...... :'77., .. ....... (Name and title of corporate officer) Builder's LicenseNo / ~- ~-9 ~> .'~'. / Plumber's License No ......................... Electrician's License No ....................... Otlier Trade's License No ...................... 1. Location of land on wliich proposed work will be done .................................................. ........ ~..f.z-.~ ........ .,SZ..~..~ .... 37..T. ............. c~..,~.../../c.~...7. ..... ....... tlouse Number Street, Hamlet County Tax Map No. 1000 Section 7-- C Block ~ Lot d... Subdivision ..................................... Eiled Map No ............... Lot .......... (Name) ..... 2. State existing use and occupancy of premises and intended use and Occupancy of proposed construction: a. Existing use and occupancy ..... .~..'7 ./.. .,~.//::.r,~' ~- ' ' ' '" ' ', · . · · · · .......... . .".,~d.~,.~:~ .. , ' . ' b. Intended use and occupancy .................................. ~' .,~;..; ...... ~....,,. ,-, ......... , ........ 3. Nature of work (check which applicable): New Building .. ' .... Addition .......... Alteration ........ Repair .............. R6moval .............. Demolition .............. Other W?k ............. 4. Estimatc'd Cost ~.o .o .o· .w .o ...... ~ (Description) 5. If dwelling, number of dwelling units / (to be paid on filing this application) If garage, number of cars . ' '~/.~,' ............ Number of dwelling units on each floor. ' If business, commercial or mixed occupancy, specify nature and extent of each twe of us 7. D~mensmns of existing structures if any: Front R ,v e .................... Hei,,ht ............... Number of Stories.. iiiiiiii i ..... ear ............... Depth Dimensions of same structure with alterations or additions: Front ..................................... Depth ...................... Height ...... ' ................ Rear ............... ................ Number of Stories ............. ' ' Dimensions of entire new construction: Front ............... Rear ............... Depth ...~.. :-'g .... Height ............... Number of Stories / · · 9. Size of lot: Front .... 10. Date of Purchase ......... Rear ...................... Depth ..................... .................... Name of Former Owner 11. Zone or use district in which premises are situated /~ ./ ............................ 12. · ........... .~. ~-"5'.a/.eg ,~.. 7':.< ..ff..%-. ........ Does proposed Construction violate any zoning law, ordinance or re ulatio ~ o ............. 13. Will lot be regraded ... ,0//,o' .... g n: ............................ · · ' '/ ................... vmi excess fill be rem 14. Name of Owner of premises .~...o ~., ..~ .... oved from premises: Name of Architect ....... ./rY... Z. X'.. Phone No .......... ........................... Address ................... Phone No ............... Name of Contractor ~.'2.~. ~ ,~ ~, o,e~ o~.~.,~,, .... ............. ~.. ~uures .... .°..d-. :4:./V..7~. ..... Phone No..'2,.~. 15.Is this property located within300 feet of a tidal wetland? *YES .... · If yes, Southold Town Trustees Permit may be required. ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro,~ property lines. Give street and block number or description according to deed, and show street names and indicate whethe: interior or Comer lot. · 8. STATE OF NEW~D,RK/~ ~' ! · tract) above named. being duly sworn, deposes and says that he is the applicant Sworn to before me this .......... .... d ayo. f of said owner or owners, and (, (Contract~gent, corporate officer, etc.) ...... and'file this ~s duly authon'GFized-t~e.rform or have performed the said work and to make 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 CtAIRE L GLEW OuMlfled In Suffolk County Cm~ml~on Explr~ Demm~ 8, lg ~/_. (Signature of applicant) TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER FORMER OWNER LAND SEAS. IMP. VL TOTAL FARM DATE ' AGE BUILDING CONDITION NEW NORMAL BELOW VILLAGE W DISTRICT SUB. ACREAGE TYPE OF BUILDING COM~.p',ND.CB. J M,sc. LOT ABOVE Woodland Swampland Brushlond House Plot Total M. Bldg. .t~ ~p. ;? ~-~ 'z/ I/ ~ .~-z'~ .2 a ?~P ~oundation ~ ~,~ Extension lY.~I~ z ~ ~ ~ ~-~o ~asement ~7~ Fl~rff Extension /~n ~ ,~ / ~ ~ 7~ / Z ~-'~ ~3 0 ~t. Walls ~ ~/44r,~4.- Interior Finish Extension 7X~ ~ _~.Z~ _.~ ~- Fire Place Al o , Heart / Porch Attic _~ ~,~ ~ : /~ o ~ ~ p ~ Porch Rooms 1st Flor Breezeway Patio Rooms 2nd Floor Garage ~ ~ ~ ~'~ : ~P / / P 'J d ~ ~ ,Driveway O.B. ,, / , APPROVED AS NOTED , . / DATE: , ?_r NOTIFY BUILDING OE~R~EN~ 765-1802 9 AM TO 4 P~ THE ~FOkLOWING INSPECTIONS: ~1. FOUNDATION - ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMIN~ & PLUMBIN~ INSU~ON 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. AkL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS UNDERWRITERS CERTIFICATE REQUIRED PROVIDE OPENINGS FOR~ EMERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.Y. STATE BUILDING ConE. ,/ ' Pl E..F.2P_E, ,,J EEAr-I, ,~ ~--~ d NATNALIF_ IV~AI;~ IIE- L t -SE ,AT -I'OWN OF