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HomeMy WebLinkAbout34480-ZFORM NO. 4 TOWI~ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33940 Date: 09/03/09 T~IS U~TIFIES that the building ELECTRIC UPGRADE Location of Property: 495 RICHMOND RD EAST SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Co%lnty Tax ~4ap No. 473889 Section 135 Block 3 Lot 3 Subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 27, 2009 pursuant to which Building Permit NO. 34480-Z dated MARCH 6, 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 ELECTRIC UPGRADE TO AN EXISTING SEASONAL ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOAN & WILLIAM MOBLEY (OWNER) of the aforesaid building. S~FOI,~CY)UNT[YDEFAR~EB~r OF }~;%L~{APPRO~-AL N/A ~C'~RIC~J~ c~RTIFIC3%~N0. 2008929 10/13/06 PLIghtERS C~TIFICATION I);~r~o N/A 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 propeI~y showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent/o 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, Commereial$15.00 Datex New Construction: Old or Pre-existing Building: Location of Property:~ ~ (~ ~- ~ ~cr~d ~Oc~, House No. Street Owner or Owners of Property: X Lkfl~-~,~ ~ '* ~OO,n0 ~ Suffolk County Tax Map No 1000, Section [ .~--~ fJBlock (cheek one) Hamlet ot¥ Subdivision Permit No. :~q q ~d~) Health Dept. Approval: Planning Board Approval: Date of Permit. 9-6 -O el Filed Map. Applicant: Underwriters Approval: Lot: Request for: Temporary Certificate Fee Submitted: $ ~ 5. C) O c7 Final Certificate: (check one) Applicant Si FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 34480 Z Date MARCH 6, 2009 Permission is hereby granted to: JOAN & WILLIAM MOBLEY 3 SUYDAM DRIVE MELVILLE,NY 11747 for : UPGRADE OF ELECTRIC TO 100 AMP TO THIS EXISITING SFD AS APPLIED FOR. at premises located at 495 RICHMOND RD EAST SOUTHOLD County Tax Map No. 473889 Section 135 Block 0003 Lot No. 003 pursuant to application dated FEBRUARY 27, 2009 and approved by the Building Inspector to expire on SEPTEMBER 6, 2010. Fee $ 200.00 Authorized Signature Rev. 5/8/02 ORIGINAL Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New Yonk 11971-0959 Telephone (63 l) 765-1802 Fax (631 } 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLI~ CERTIFICATION Date: Building Permit No. ~ V ? (Please print) Plumber: ~ \k-)k~l-~ Ck"N, (Please print) I certify that thc solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this day o~~ ,20c 5 Notary Public, ~'-~T¢'~ County (Plumbers Sig~n~ture) - CONNIE Dm BUNCH Nofary.Public.Stete of New York no. 01BU6185050 Qualified in Suffolk County, ~_ Commission Expires April 14, 201 BY THIS CERTIFICATE OF COMPLIANCE THE /~'~'-' NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by WILLIAM & JOAN MOBLEY WILLIAM & JOAN MOBLEY 3 SUYDAM DRIVE 495 RICHMOND ROAD EAST MELVILLE, NY 11747 SOUTHOLD, NY 11971 Located at 495 RICHMOND ROAD EAST SOUTHOLD, NY 11971 Application Number: Certificate Number: 2008929 2008929 Section: Block: Lot: Building Permit,. BDC: ns11 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, renovation, Outside, Attic, 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 ]3th Day of October, 2006. Name QTY Rate Rating Circuit Type Alarm and Emergency Equipment Sensor 4 0 Smoke Appliances and Accessories Pump Motor 1 0 1 H.P. Wiring and Devices Outlet l l 0 Fixture Fixture 11 0 Incandescent Outlet 27 0 General Purpose Receptacle 21 0 General Purpose Switch 14 0 General Purpose Paddle Fan 3 0 Receptacle 4 0 GFCI Service 1 Phase 3W Service Rating 100 Amperes Service Disconnect: I 1001 cb 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. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION l ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~J~A~TION [ ] FRAMING / STRAPPING [/.,~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS-- DATE COMMENTS Fl~.!,r~ INSPECTION REPORT I DATE I FOUNDATION (1ST) FOUNDATION (2ND) PLUMBING INS~ATION PER N. Y. STATE ENERGY CODE TOWN OF SOUT. HOLD BUILDING DEPARTMENT TOWN HAL~L SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined }l¢ ,20 ~ ii Approved /~6' 20 ~}(} Disapproved a/c Expiration C~ {(~, ,20iC' FEi] 2 7 2009 BLDG. DEN. TOWN OF SOUTHOLD t. lhls application MUSI De corn 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: Mailto: Phone: Building Inspector ~LICATION FOR BUILDING PERMIT mt,X, INSTRUCTIONS a ,2009 [etely 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 l 8 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.. (Signatu}e' 6f applicant or name, g rts ;J'1'1t~see, agent, architect, engineer, general contractor, electrician, plumber or builder OF OCCUPANCY UNDERWJ:IlTERS CERTIFICA Sameofownerofpremises~ %3yet~c~ /~/2_t-~'~Jq, ~,~ /-~.],~-J.,~'j~~,..----- ~,~ · {-J (A~]~n the trix roll O=rgt~/~ ~', :~ If applicant is a corporation, signature of duly authorized officer NO',rlrY SLJ!L!D!tl il 7' ':%~TU,::NT AT 765-1802 8A3~ ~© P!.i ':gP THF (Name and title of corporate officer) 1. [O=..' '~,~^, k~,] '~ - ~" - TWO R=QUIR.:D F'©R POUF, ED ,~,~- c Builders License No. 2. ROUGH - [RAMING & PLUMBhJG Plumbers License No. 3. INSULATION Electricians License No. 4. FINAL - CON?TRUGTION MUST , BE COMPLr-TE rO~, C.O. Other Trade s License No. "' ALL CONSTEUCi,,.,N SHALL MEET THE 1. Location of land on whic. h proposed work will be done: REQUIREMENTS OF THE CODES OF NEW q ¢ L- T^T . tla p SPONS BCE House Number Street Hamlet County Tax Map No. 1000 Section i~,~ Block ..~ Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructiofi: a. Existing use and occupancy b. Intended use and occupancy. Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars Addition Alt er atio,n~fzq~C: OtherWorlO( t ~ o t~ no o o°~o O, o % o~ ~v'~ .'~ r~ - ' "(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 Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Rear : Depth Height Number of Stories ' 9. Size of lot: Front Rear .Depth Depth Rear I0. 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. Namcs 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 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 OF ,~S: , ~ ~l,~k~~'~ ~Oa'~x ~ be,ng duly sworn, deposes and says that (s)he (Name of individual signi gn, gn~riltact) above ~ (S)He is the tg*.or~ (Contractor, Agent, Corporate Officer, etc.) is the applicant 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., ..... Sworn to before me this .otary P ic Signature ofApp t OWNER TOWN OF SOUTHOLD i~OPERTY RECORD I-~ND AGE NEW Farm Tillable I Tillable 2 Tillable 3 Woodland IMP. NORMAL Ac re S "~ W '~ FARM COMM. IND. STREET .~/,/~J ~ DISTRICT TOTAL DATE ? BUILDING CONDITION BELOW Value Per Acre Swampland SUB. LOT ABOVE Value FRONTAGE ON WATER FRONTAGE ON ROAD BULKHEAD DOCK //..-'"'""~ '-'-'- Brushra~Cd ~ ~ '" '~ House Plot Total CB. MISC. Est. Mkt. Value ACREAGE TYPE OF BUILDING Extension Basement ,AZ' D Floors Extension ~ I I ~ 3-~ ~o ~ ~ Ext. Wails ~p ~/~L ~terior Finish Extension Fire Place Heat , ~ Z / ~ P°r~b I~ ~ ~ R~ Type Breezeway ~ Patio Rooms 2nd Flor Garage Driveway Dormer O.B. I