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Home My WebLink About35753-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34498 Date: 08/09/10 T~IS CERTIFIES that the building CENTRAL AIR CONDITIONING Location of Property: 1652 BRIDGE LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 118 Block 1 Lot 4.1 subdivision Filed ~ap No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5, 2010 pursuant to which Building Permit No. 35753-Z dated AUGUST 5, 2010 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" AIR CONDITIONING FOR AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WALTER & MILDRED K SILBEWNAGEL ( OWN E R ) of the aforesaid building. Si3FFOi~KCO~31~I-fDEpAR~gTOFI{~kL~{APFRO~-AL N/A BLR~IC3%L C~RTIFICA~q~ NO. 35753 08/09/10 PLUMBERS CERTIFICATION DATED N/A ~ ~Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35753 Z Date AUGUST 5, 2010 Permission is hereby granted to: WALTER & MILDRED K SILBEP, NAGEL 26 OLD WOODS ROAD SADDLE RIVER,NJ 07458 for : "AS BUILT" CENTRAL AIR CONDITIONING FOR AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 118 pursuant to application dated AUGUST Building Inspector to expire on FEBRUARY 1652 BRIDGE LA CUTCHOGUE Block 0001 Lot No. 004.001 5, 2010 and approved by the 5, 2012. Fee $ 400.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. TO~VN OF SOUTHOtD This application must be filled ia 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 lecatiou of all buildings, property liaes, strects, and unusual natural or topographic features. .2. Final Approval from Health Dept. o£water supply and sewerage-disposal (8-9 form). 3. Approval of electrical installation from Board o f Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains tess 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 use~: 1. Accurate survey of property showing all property lines, streets, buildiag and unusual natural or topographic features. 2. A properly completed application and ceusent to inspect signed by the applicant. If a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelliag $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to aeecssory 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 Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 Date. New Construction: Location of Property: /~..r-",/ ' . House No_ Owllcr °r Owner8 °fPr°pel'ty" r~ ~'~~-~ {(" · Suffolk County Tax Map No 1000, Section Subdivision ' rmit No. ':3 5'-) E' 3 Health Dept. Approval: Planning Board Approval: Old or Pre-existing Building: ~ (check one) '~treet ' Hhralet Date of Permit. Filed Map. . Lot: Applicant: Underwriters Approval: Request for: Tempora~ Certificate Fee Submitted: $ Final Certificate: (check one) Applicaht Signature ,51;/7.3 Main Road P.(). Box 1179 S.ulholll, Nh' 11971-09,39 Telephone (631) 76,M802 Fax ({iS 1 ) 7ti,3-9,302 ro.qe r. richertCb, town.southold, ny. us BI !IH)IN(; DEPAI~.TMENT TOWN OF $OUTFIOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Silbemagel ~ddress: 1652 Bddge La. City: Cutchogue St: NY Zip: 1193." ~uilding Permit#: i;;~"'~ ,~ Section: 118 Block: 1 Lot: 4.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only [~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ Ceiling Fixtures e~ HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures U Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixtur Pumps Transformer Appliances Dryer Recpt Emergency Fixture~ Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: central air conditioner Notes; Inspector Signature: Date: Aug 9 2010 81-Cert Electrical Compliance Form TOWN OF.~OUTHOLD BU I LDtlI'~IG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined ,20 Approved Disapproved a/c ,20 ~mration ,20 AUg ? 2010 BLDG DEPT. TOWN OF sOUrHOLD 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 I Survey Check 'q 1D~5 , []D~ ~'~ ~-~'"- Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 75¥ - 20 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 inspectors on premises and in building for necessary inspections. ~, x (Signature of applicant or name, ifa corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nalne of owner of premises It'XA' ~. ~.C/~I''~ ~ t ~2-C,'xc-~¢ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on~whichopropos,ed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision Block Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction:' a. Existing use and occupancy b. Intendeduseand 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 , .AJtlratio~n__ (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: Fr0nt 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. Sizeoflot: 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 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY 0 F~5~... being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH (S)He is the Notary.~b~?~.,,S~a~,te..~ew Yor~ (Contractor, Agent, Corporate Officer, etc.) Co[nm ss on Expires April 14, 20 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 Notary Public Sign~ure of Applicant Town Hall Annex 54375 ~ Road P.O. Box 1179 · Southold. NY 11971-0959 Telephone (631) 765-1~02 ro ' (631. 7 ger. ncher~C~,t~ (wr~.i~oue'~.ny. us BUll.r~INO DEPARTMENT TOWN OF $OUTHOLr~ APPLICATION FOR ELECTRICAL INSPECTION IESTED BY: Company Name: Date: NO.: Phone No.: -- JOBSITE INFORMATION: (*IndiCates required information) *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: 1000 Section: .1 I'~ Block: *BRIEF DESCRIPTION OF WORK (Please Print Cleady) (Please Circle All That Apply) *Is job ready for inspection: ~'Do you need a Temp Certificate: Temp'lnformation (If needed} · *Service Size: I Phase *New Service: Re-connect Additional InfOrmation: YES / NO Rpugh In Final 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION. .~ 82.-Request for Inspection Form / / Joseph A. Ingegno Land Surveyor High Efficiency XR11 Air Conditioners by Trane - Adams Heating and Cooling Page 1 of 2 ~ / Air Cohditioners Adams HeaLing and Cooling: High Efficiency XRll Air Conditioners by Trane XRI! Benefits Saves Energy · Up to 11.5 SEER Range Lasts a Long Time · Climatuff® Compressor · Full-Side Louvered Panels with Baked-On Powder Paint · Corrosion-Resistant Fasteners · Torture Tested · Spine Fin Outdoor Coil · DuraTuff Rustproof Basepan Backed by Trane's Industry Leading Limited Warranty High Efficiency XR11 Air Conditioners by Trane - Adams Heating and Cooling Page 2 of 2