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HomeMy WebLinkAbout35917-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~NT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34613 Date: 10/15/10 THIS ~TIFIES that the building ALTE~ATIONS Location of Property: 825 BROWER RD MATTITUCK (HOUSE NO.) (STREET) (~3%MLET) County Tax ~4ap NO. 473889 Section 139 Block 1 Lot 6 Subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 24, 2010 pursuant to wh/ch Building permit No. 35917-Z dated OCTOBER 4, 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" HALF BATH AND LAUNDRY ROOM ALTERATION AND HOT WATER HEATER AS APPLIED FOR. The certificate is issued to CONSTANCE BOPP & ORS ( O~ER ) of the aforesaid building. SIIFFOI~(C~)~qTYDEPAR~TOF}~%L~AP~O%rAL N/A ~IC/%L ~TIFIC3k~ NO. 35917 10/08/10 PLIERS ~TIFICATION DA'r~o N/A Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35917 Z Date OCTOBER 4, 2010 Permission is hereby granted to: ESTATE OF K MCCOURT 825 BROWER RD MATTITUCK,NY 11952 for : "AS BUILT" 1/2 BATH & LAUNDRY ROOM ALTERATION AS APPLIED FORj at premises located at 825 BROWER RD MATTITUCK County Tax Map No. 473889 Section 139 Block 0001 Lot No. 006 pursuant to application dated SEPTEMBER 24, 2010 and approved by the Building Inspector to ex~pire on APRIL 4, 2012. Fee $ 438.40 i ~ AuthoriZed Signature ORIGINAL Rev. 5/8/02 FORM TOWN OF $OUTHOLD ~UILDIN~ DEPAETMENT TOWN HALL $OUTHOLD, N.Y. N~ 22368 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Z CounlyTax Map No. 1000 Seoflon._..Z,.,~......~,,.... Block ........ Z ............... LotNo...~. ...................... pursuant,o application dated .......... ...~....~:~Z......~.....(~.. .............. 19.....~...~..... and approved bylhe Building Inspector. ~ S.2 Rev. 6/30/80 / ........ SEP : BLDG DEH. TOWN OF SOUIHOLD "B. APFLI~ Fo~m No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · New Construction: Location of Property: This application mU~t 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 survoy of property with accurate location of all buildings, property lines, sancta, and unusual natural or topographic fe~xtres. 2. Fi~sl Appwval from Health Dept. of water supply and sewerage4isposal (S_9 form), · 3. Approval of eleCffical installation'from Board of Nire Underwriters. i 4. Sworn statement from plumber ce~fying that the Solder used in system contains [ess than 2/10 of 1% lead., 5. Comm~l'~l building, industrial building, multiple ~sidences'and Similar buildings and installations, a Certificate of Code Complianc,~ from architect o~ engineer responsible for the building. '6. Submit Planning Board Appr0val o(~ompleted site. plan requirements' or existingbuildlngs.(prior to April 9, 1957) non-conforming nses; or buildings and ~"pre-existing- land uses: A~',curate survey of property, showing all prope/'ty lines, streets, building and unusual natural or tOpographic features. 2. A, pr°perlY c°mpleted application and consent to inspect signed by the applieaut, if a Certificate of Occupancy is der/led, the Building Inspector shall stare'the reasons therefor in writing to the applicant. C. Fees 1. Certificate °f Occupancy ' New dwelling $25.0§, Additions to dwelling $25.00, Alterations to dwelling ~0~, Swimming pool $25.00, AcCeSsory building $25.00~ Additions to accessory building $25.00, Businesses $50.00. ., 2. Certificate ofOc, cupaneyon Pre-existing Building - $100.00 3. ' Copy 0fCertificate of Occupancy £ $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate oi~Occupancy _ Residential $15.00, Commercial $15.00 House No. omo y:: ' 8u~olk County Tax Map No'100O, Section .. ~ubdivision Health D'ept: rovat: 'Planning Board ApProval: Request for: Temporary Certificate Fee Su mitt : $ O0 Undelwriters Approval: Final Certificate: / Date. Old or Pm-existing Building: Street · Block.., . Filed Map. _. Applicant: (check one) Lot. Lot: _ (checkone) Applicant Signature 2ATION FOR CERTIFICATE OF OCCUPANCY loml Ilall Anncx 54375 Main Road P.O. 1½ox 117!) Southold, NY 11!}71-0959 Tckq)hom' (631) 765-18()2 Fax (631) 76,5-9302 ro,qer, richert~town southo d ny us BI!ILl)lNG 1)EPARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRIClAL COMPLIANCE SITE LOCATION ssued To: Constance Bopp Address: 825 Brower Rd City: Mattituck St: NY Zip: 11952 Building Permit #: 5 ~::~ ~. t,~ Section: \'~q Block: [ Lot: Q~ 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 Commedcal Outdoor 1st Floor New Renovation 2nd Floor Addition Survey Attic INVENTORY Service 3 ph Hot Water GFCl Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Slower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: as built bathroom and oil hot water heater F Service Only ~ Pool Hot Tub Garage Ceiling Fixtures ~~[~ HID Fixtures Wall Fixtures I 11 Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixture U Pumps Emergency Fixture~ Time Clocks Exit Fixtures I I TVSS Notes: Inspector Signature: Date: Oct 8 2010 81-Cert Electrical Compliance Form Issue Date 4/8/2008 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 122549C East Patchogue, NewYork 1'1772 (631) 286-6642 Issued To: Ms. Constance Bopp Street: 825 Brower Road ¥illage: Mattituck Zip: 11952 Section: Block: Lot: Town: Southold Contractor: MTN Electrical Contracting Lic. # 5083-E was examined and found to be in Compliance with the National Electrical Code. [] Commercial [] NVDefects [] Pool [] IstFIoor [] Indoor [] Basement [] HotTub [~ Residential [] DeL Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters 6 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps A/C Fans Microwaves Furnace Oil Gas Meter Amps Phase UG/OH / Bldg. Permit: Other Equipment Circulators Smoke Detector Bell Transformer Jacuzzi Television ' CO Detector Hugo S. ~Jurdi President Rough Inspection: Inspector: Final Inspeddon: 04/02/2008 Inspector: John Mc Mahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~ELECTRICAL (FINAL) REMA~I~S: DATE ~ ,NSPECTCI~:~~ TOWN OF SOUT~J~)L~BU~DING DEPT. I TION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, [ ] FOUNDATION 2ND ~N [ ] FRAMING / STRAPPING (/ [ ':~FINAL /~ [ ] FIREPLACE & CHIMNEY ~ INSPECTION [ ]~mt~r~ [ REMARKS: DATE INSPECTOR~,~/~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]IN~C~ON [ ] FRAMING / STRAPPING [~]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SA,-.-. ~' INSPECTION [ ]F.~R~S~STJ. TCO. S'n~.C'nO. [ ]F~RERESb'TA~T~E.L='rR~'rl0. REMARI~. S: ULATIO:! PER'~. Y. STATE E}~ERGY CODE FOUNDATION (liT) ~O~r~A~ON (2N~) ~ "1 ~S~ON P~N. Y. ST~ ~ co~ ~ ~ , ~ ~,~, " ' / /U ~ ~D~ON~ COUNTS <''/~/~ ~" , ~ . ~, ., '' ~ , FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY ................... ClIECK ......... ."'""'",----'----" . ~5,LD~G. DEP/T';~ 765-1802 , ;,U3. $_~d~j~ j TEL.: .... .... Disapproved a/c ................. ' ............... INSTRUCTIONS CALL ................... HAIL TO: Date ... 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 or public sti'eets 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 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.~~~. ----~ (Signature of applic~corporatio'n') .... ....... (I~l~iling address ~ a~p~'.c~r~½ ~--. State whether applicant is owner, lessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder. ........ r ', ................ ,r.~..,<.,~ ~. ~,.,~. r..~ ~/.~.e..~4. ....... . .................... ...... amc of owner of premises .... /. ~':t... ~c. ~..k.f.'~.. ] ............ ..................... (as on th0~tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No...: .~ .~...~..~..~.....~ .~ ...... Electrician's License No ...... Other Trade's License No ...................... Location of land on which proposed work will/be done . .. ....... / ...... ; ................ ................... ]ber Street Hamlet / .... 1 County Tax Map No. I000 Section ...: ........ Block ·. · ' Lot ................ Subdivision ........ . ............................. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constructioni a. Existing use and occupancy ' b. lntended use and occupancy ..................... ............................................... Repmr .......... i J:'' Removal .............. Demolition .... : ......... Other Work ./]t/,h'~'.W./..fe~../-~. ' ' ~ ~"1'"i t'/~ ' -. · . --~ ,.-, ~ ([Jescription) 4. Estimated Cost . . .'~.. ~. (..~.~.?. ~.. ' 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 Height ............... Number of Stories ............. ' ............. Depth .............. Dimensions of same structure with alterations or additions: Front .................. Rear ................. Depth ...................... Height ........... · ........... Number of Stories ......... ' 8. Dimensions of entire new construction: Front .............. ; Rear ............... Depth ............... Height ............... Number of Stories ....................... , ..................... 9. Size of lot: Front ......... , ......... i.. Rear ........... ' .......... 10. Date of Purchase ........... Depth ...................... .................... ......... Name of Former Owner .. ........................... 1 1. Zone or use district in which premises are situated ................................................... .12. D°es pr°posed construction vioiate any zoning law, ordinance or regulation: ................................ 13. Will 10t be regraded ....... '. .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ............ ~... Name of Architect Address Phone No Name of Contractor .......................... Address ............ : ...... Phone No ............ ' ..... 15. 13 this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. , PLOT DIAGRA~ 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. AS NOTED _ . FEE. ~'1 ~ By:~/~2-~ / NOTIt%'-BUILDING 765-1802 9 AM TO 4 ffi FOR IHE FOLkOWI~G INSPE~IONS: ~ FOUNDAI~ON - ~OREQUIRED gOR POURED CONCRETE 2 R(.)iIGH FRcj~:~tNG & PLUMBING CC:;,5. Ti'~UCTION MUST ~;- COMPL. E~E FOR CO. AL~ CONSTrUCTiON SHA~ ME~ THE REOUIREMENTS OF ~E STATE CONSTRUCTION & ENERGY COOES. N~ RES~NSIB~ DESIGN OR C~S~ ~ ..........-~(Na~~ontract)'t'~¢"~'.... ........ being duly sworn, deposes ~d says that he is the applicant He is the ......... I ~ (Contractor, agent, corporate officer, etc.) ' ' ' ' of said owner or owners, =d is duly authorized to perfom or have perfo~ed the said work and to m~e =d file this application; that all statements contained M this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the manner set forth M the application filed therewith. Sworn to before me this ........ ..... ~.~ ~ .'...day of... ~. :'. .... ' .... '., 19t~ No'ta~ Public ..... ~. ~.{,~.... ....... , ...... County ~~, . ~ / ' .. ' ..'~.465~SB'q'' ' . z ~ ~ [aignarure ol appnc~t) TOWN OF SOUTHOLD BUILDING DEPARTME TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthForh SEP 2 4 2010 .e, Exanfined /b/~, 20 JaP Approved /0//"[ 2 0 fO Disapproved a/c Expiration Building Inspector 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.EC. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date Sw----~. [er~ bo" ~, 20/tr') INSTRUCTIONS 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. ?CCUPA!N ~ ¥ 0[~ (Signamre~if a corporation) UNDERWRITERS CERTIFICAT;,r~/~//; ri, ),..IT/EL \ k IzV'~ ~ R-'ii fl(; ' ,- ng address ofapplicantj appll c an~ ~ g~vP~lPer, State whether lessedCffgeht, a~,'difc~ciTk}i~tfleer, general contractor, electrician, plumber or builder Oor/xo/- APPR0¥E0 aS 01'ED Name of owner of premises .~,.. ..... (As otV~'he ta:~ roll ~test ~. ~t.O¥ ~ c~.~c~ If applicant is a corporation, signature of duly authorized officer NOTIFY BUILDING DEPARTMENT AT' 765-1802 8 AM TO 4 PM FOR THE (Name and title of corporate officer) Builders License No. Plumbers LicenseNo. Electricians License No. Other Trade's License No. 1. Location of land on which proposl~d work will be done: House Number Street County Tax Map No. 1000 Section Subdivision FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3. INSUlaTION 4. FINAL- CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE I~t~R~r~_NTS OF THE CODES OF NEW Block / Lot Filed Map No. Lot 2. State existing use and occupancy of premises and,~ntended use and occupancy of proposed construction: a. Existing use and occupancy b. Intendeduseandoccupancy bLS bt)ti+ tva, lhrtmma/&ra.J!vn r_ rraJ /q7._< 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 Alteration Other Work Fee ~/~t>;3C~. 27/~0 (Description) (To 1Se 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 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. Size of lot: Front Rear .Depth 10. Date of Purchase Name of Former Owner I 1. 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. ls 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 tbundation 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 OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Ofticer, etc.) of said owner or owners, and is duly authorized to perlbrm or have pcrtbnned the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therl~ll~ ~ 8TA~.I$" . . N~q.~ubllc, ~t~te ot ~ew ~r~ ~0, 01ST6164008 Sworn to. before me twos B Qualified In Suffolk County ~_? day of ,.~,d. ll .~4 . 20/0 C°mrnissl°n Expires ~20-4~ ~ t Notary Public Signature of AppFt~/'"" Town l-hll hnnex 54375 Meln Roed P.O. Box 1179 Southold, NY 119714)95'9 Td~pho~e (~t) 765-1802 REQUESTED BY: Company Name: BUrLDU~G DF~PARTMFlqT TOWN OF 8OTYl~O]r.n APPLICATION. FOR ELECTRICAL INSPECTION Date: Name: License No.: Address: Phone No.: · *Cross Street: *Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required information) 1000 Se~ion: . [~ ~ BIo~: ' ~ Lot: *BRIEF DESCRIPTION OF WORK (Please Print. Clearly) (Please Circle All That Apply) *Is.job ready for inspection: *Do you need a Temp Certificate: Temp'lnformation (If needed}. *Service size: 1 Phase 3Phase *New Service: Re-connect Additional Information: ~O Rough In" Final YES / NO 100 150 200 Underground Number of Meters 300 350 400 Other Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form ~ AD~VdNDDO :10 ~lV31:ll183D 1NOt~llM 1N:I~VINN ~!0 lU q ..~c.d lC: 40'=1"