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HomeMy WebLinkAbout21579-ZFORM NO. 4 TOWN OF SOLVfHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33990 Date: 10/06/09 THIS CERTIFIES that the building ALTERATION Location of Property: 38675 MAIN ROAD ORIENT (HOUSE NO.) (STREET) (HA~4LET) Co%unty Tax Map No. 473889 Section 15 Block 2 Lot 17.4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27, 1993 pursuant to which Building Petit No. 21579-Z dated AUGUST 5, 1993 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 ALTERATIONS FOR BATHROOM AND LJ~UNDRY ROOM IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEPHEN A KELEMEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTM]~NT OF HE~J~TH ~_PPRO~-AL ELECTRICAL CERTIFICATE NO. PLUMBERS c~KTIFICATION DA'r~D N/A 3962-R p7/30/09 KING PL~BING ~//or~d/S'~ure~' ' 08/05/09 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTNE~ TOWN HALL 765-1802 APR 7 1995 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 contairs 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 a 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00· Date .............. ~ ............... ..... New Construction ........... Old Or Pre-existing~B~ildin~...~. ...... Location o{ Property..~.~.~..~..~ ........... ~.~t..~...%~A.¢. [;[i;..~.~..~............~_~ House No. Street Hamlet Onwer or Owners ,.,f Property ......... ' .~.]--~-'-.~..~-~~ ' ~ Al....~.!-~L~ ...... County Tax Map No 1000, Section .... /~.. .... Block ................ ~ Lot.../..~ ..~.. ......... Subdivision .................................... Fi~cd Map ............ Lot ...................... Permit No.-'~-1.~'¢.7.~ate~ ~"/~--f~ "~ Of Permit ............ .... Applicant ........................ . Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary.~_~/Certificate..... 1~ r Fee Submitted: $ ....................... ................. AP ........................ ' Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1802 Fax [63 l) 765-9502 BUILDING DEPARTMENT TOWN O1~ SOUT~OI~) CERTIFICATION Date: Building Permit No. t~O/g7 ~' (Plebe prat) Plumber: ~ ~ t (Plebe pr~tY I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this _~O .day of ~_~ (oC~ , 20 Notary Public, ~'~ oc~ ~(~County (Plumbers S~ature) VICKI TOTH Notary Public, State of New York No. 01T06190696 Qualified in S~rfolk Counht ~11111M~13~ Ex13ires July 28. 20 Nassau Suffolk Electrical Inspections,Inc. P.O. Box 549, Aqnebogue, New York + 11931 Tel: 631-591-3097 Fax: 631-591-3098 Application: 3962-H Date: 8/5/09 Issued to: Kellerman Address: 38675 Main Rd Introduced By: Village: Orient License#: N/A H/O Residential [] Commercial The following was examined and approved up to the above date and found to be in compliance with the NEC: Attic I~t Floor [] 2'd Floor 3rd Floor Garage Conversion Basement Hot Tub Addition [] Detached Garage Pool Switches Receptacle Fixtures G.F.1. Microwave Hood Smoke Detectors 5 I 3 Fans Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Carbon Monoxide I-Ex Bath Furnace Oil Gas Heat Zones Whirlpool Exit Signs Limited Insp. II Final Insp. Meter Amps Phase Motors 8/4/09 ]1 8/5/09 Other Equipment: 15t Floor Bath Permit#: 21579-Z This certificate must not be altered in any manner TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 21579 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) hereb.~ a[anted to:. ~ - Permission Is ~~..~~~.~...~..~/~...~:.. ~'~~ ..~.~..~..~ ......... ~.~.~ ....... . ..~ ...... ~......¢~:~.....~......~.~.....~~...~ .............. .............................. ......................................................................... CountyTax Map No. 1000 Section .......... ./.~... ......Block ..........~'... ............. Lot No. .../.. .~..'.. .~... ........... pursuant to application dated ..~ ........................................... 1 9.?...'~... ....... and approvo~ by ~he Building Inspector. Fao $ ............. Rev. 6/30/80 7GS-~.802 BUILDING DEPT. INSPECTION FOUNDATION IST [ R~OUGH PLBG. FOUNDATION 2ND [~INSULATION · ,]~MING [ ] FINAL RE~t~gKS: ~ DATE ~//////~ I NSPEC'I'OR _~~--~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~']"~NAL DATE' //~/~ h~/~ INSPECTOR_ ~OU~IDATION~ _ _ (~st) ~OUNDATIO:! ¢ 2nd ~ ~OUGH FRAHE & -PLUMBING :I~SULATIO:; PER N. STATE ENERGY CODE FI;;AL tDDITIOHA'L COMMEHTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved. ~/,~. ........... 19~. Permit No..~../..~7..~..~..~ Disapproved a/c ' (Buildinfflnspector) APPLICATION FOR BUILDING' PERMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CIIECK SEPTIC F 0 R,"I t:O?i PY ~ c^L,...4.7.-7.-, t-).0 ...... HAIL TO: a. This 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 9.~,ubr'ffc~sti'eets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pa~t of the 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 any 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 South01d, 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. · i...'...' ............ -- (Signature of applicant, or name, if a corporation) .E a 7. (Mailing, address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. .... B. t~ / k ~ .~. . . ~ . C_~ ~. .'r~ .~-. . .................. ' ...... .................... ....... N~me of owner of premises . ~.~.V.,~..O.. K~[.Pf/~ ........................... ' ........... ' ........... (as on the tax roll or latest deed) If~i~lica~o~po~tion, signature of duly authorized officer. / (Name and title df corporate officer) Builder's License No.. ! .2:.t.~.?.(p..~. ,t7/, '1 ........ Plumber s L~cense No ........................ : Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done. ' ltouse Number Street Hamlet County Tax Map No. 1000 Section ... :../.C ........ Block ..... .27.. ...... J... Lot ..... {7.,.~. ........ Subdivision ........ . ....................... ~ ..... '. Filed Map No ............... Lot ............... (Name) , State existing use and occupancy of premises and intended use and occupancy of proposed construction: t(- P b. Intended use and occupancy ..................... ' ................ · ......... · ...................... -3. Nature ofwork (check which applicable): New Building Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .... : ......... Other Work ............... · ' '~" (Description) 4. Estimated Cost e. c> ' Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... /. ......... Number of dwelling units on each floor. ' If garage number of cars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............. 7. Dimensions of existing structures, if any: Front...'.~.~. ......... Rear .... ,/55. ........ Depth .... 6. 5'..... i .... Height ... ~ ......... Number of Stories ..... ~.. ' ' ' ' Dimensions of shme structure with alterations or additions' Front ............... . ........... Depth ' ~:~- Hei t ~ ...... ~.-~. ........ Rear ../.4~. ...................... gh ......... · ......... Number of Stories . .:~"7..... 2 ....... 8. Dimensions of entire new construction- Front /t/- -t~- Rear ,,"/,,r- n *h ~ nmght ..... ~0' ....... Number of Stories r/~. . , .... v. Size of lot' Front ~'/'o Rear [g,r' ......... ' ....,~.' ' '.' .... ~'-'~ ...... .'~ ..... ......... ' .................. -, .............. ~eptn ,.~ ~,~. ........... 10. Date of Purchase .................... · ......... Name of Former Owner .............................. 1 1. Zone or use district in which premises are situated · 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... 13. Will lot be regraded ...~C.~'... '. .................... Will excess fill be removed from premises: Yes :~ 14. Name of Owner ofpremises~[~'.~.~lk-"/~...~/. .... Address ................... Phone No ................ Name of Architect ....................... ·... Address ................... Phone No ............... ~. Name of Contractor ~--~t~..%~. ~"~.~ (,9'.C.. ...... Address~.'~.'~a,~ 6,~e~"~one No..'~.,?.--tr?.~...,.. Is this property within 300 feet of a tidal wetland? ~Yes ........ No ......... · 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NF~Opd(5-, [ I./ S S ' ......... '~a'~e ;'f indivicit~al sig~in~'con'tr~'c'ti '' ......... being duly above named. sworn, deposes and says that he is the applicant He is the ................................... ~; ......' ', .............. .. · ............ · ~ (Uontracto) agent, corporate olficer, etc.) · vf said owner or owners, and ~s duly autho~'lY~d ~u ~'~-rform or have performed the said work and to m~e and file this ~pplication: that all statements contained ~ this application are true to the best of his knowledge and belief; and that the · york w~l be perfomed in the manner set forth in the' application filed therewith. ' gwom to before me this ........ ........ ~°ta~Pu~'~~C~unty~ _ ~ , ' N~ Pub o, 8tme ~ N~Y~ .... ~..~ .~ ..... No, ~79505 ~ r ' ~ ' ' 'Si ....... ~ .... ff~k o [ gnature ofapphc~t) Qualified in Su C u~ ~ ' ~ ' ' ~mmi~ion ~ires ~m~r ~ 19~. ' · ~ ~o~'~-1~-2-1'-F.~TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET .,~ ~O 6'7,~ VILLAGE DI~, SUB. LOT FoRAER OWNER N , E ACR. S W ~ TYPE OF BUILDING RES. ~/~ S~S. VL FARM COMM. CB. MICS. Mkt. Value ~ND IMP. TOTAL DATE R~RKS Tillable F~ONTAGE ON WATE~ W~land F~ONTAGE ON ~OAD /I ~z Meadowla:nd DEPTH ~ V 3 0 ? House Plot BULKH~D Total COLOR TRIM M. Bldg. Extension Extension Extension Porch 72- Foundation Basement Porch Ext. Walls BreeZeway Fire Place Garage Type Roof Total Both Floors Interior Finish Heat Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B O.B. ~ C~ I ~ i' ~ ~ '" ~ { ~ 0 Dormer Driveway , [ ~inette ~O i ~ ' DR Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 Fax (631 ) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 21 st, 2009 Stephen A. Kelemen P.O. Box 575 Orient, NY 11957 Re: 38675 Main Rd., Orient/Violation SCTM# 1000-15.-2-17.4 To Whom This May Concern: You have not responded to requests to obtain your certificate of occupancy as required by Southold Town code regarding your building permit # 21579Z for construction of an ALTERATIONS TO EXISTING DWELLING. Pursuant to 144-15A, of the Southold Town Code, "No building hereafter erected shall be used or occupied in whole or in part until a certificate of occupancy shall have been issued by the Building Inspector." Therefore, you have ten days from the receipt of this letter to obtain your Certificate of Occupancy as required, or your file will be referred to our Code Enforcement Officer and the Town Attorney Office for legal action. Should you have any questions, call the building department between the hours of 8:00 a.m. and 4:00 p.m. See enclosed letter regarding required documents to obtain your Certificate o f Occupancy. Respectfully Yours, Vicki Toth, Building Permit Coordinator Southold Building Department !::PLUMBING ~ i,t.UM~ wasm & WATER UNES NEED TESTING BEFORE COVERING t~ copper tubing is use~ for water distributing system; piping shalt be (:A~ LEAD CO,A/TENT BEF©FE (: Z'/~' 'JIF(CA TE OF OCCUPA f~'C Y SOLDER USED IN WATE,~ SUPPLY SYSTEM CANNOT &~'CE~D 2/10 OF 1% ~AD. ROBINS & SP££O, INC. P.0, BOX 678 I~R££NPORI, N.Y. 11944 ~,?F~JB'CED AS gOTED B~ CO~,~)PL~t'6 FOR C.O ~&L ~ONCTTRUC'TiON SHALL TH~ RE.Q[IiR/MENTS OF THE N.~; ST~E CON~TRUCTION & ENERGY CGPFS. NOT RESPONSIB~ FOR DFS~GN OR CONSTRUCTION ERRORS UND~ITERS CERTIFICATE REQUIRED