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Home My WebLink About35871-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 12/7/2011 CERTIFICATE OF OCCUPANCY No: 35319 Date: 12/7/2011 THIS CERTIFIES that the building ALTERATION Location of Property: 115 HOBART RD SOUTHOLD, SCTM #: 473889 Sec/Block/Lot: 62.-3-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/9/2010 pursuant to which Building Permit No. 35871 dated 9/16/2010 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: INTERIOR ALTERATION TO AN EXISTING DWELLING AS APPLIED FOR The certificate is issued to Wilcenski, James & Bishop, Gall (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 11/21/11 35871 1/31/11 g & Heating FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~)ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35871 Z Date SEPTEMBER 16, 2010 Permission is hereby granted to: JAMES WILCENSKI 115 HOBART ROAD SOUTHOLD,NY 11971 for : INTERIOR ALTERATION TO AN EXISTING DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 062 pursuant to application dated SEPTEMBER Building Inspector to expire on MARCH 115 HOBART RD SOUTHOLD Block 0003 Lot No. 009 9, 2010 and approved by the 16, 2012. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF $OUT~OLD. BUILDING DEPARTMENT TOWN HALL 765-180g APPLICATION FOR CERTIFICATE OF occUPANcy This application muzt be filled in by typewriter or ink and submitted to the Building Department w!th the following: A. For new building or new use: 1. Final survey of property with accurat¢iocation of all buildings, property lines, streets, and unusual natural or · topographic features. 2. Final Approval from Health Dept. of water supply and~ sewerage-disposal (3-9 form]. 3.. Approval ofelc~rical installation from Board bfFiro Underwriters. 4. 'Sw. orn state~n~nt from pluml~er certifyin§ that the solder used in system contains less than 2/10 of 1% lead. . 5. Commeroial building, industrial building, multipte roside~ces and shnilar buildings and installations, a certificate of Code ComPliance'from amhitect or engineer responsible for the building~ -6. Submit planning Board Appt~oval of comple, ted site ptan requirements' B. For existing buildings (prior to April 9, 19571 don-conforming us~s, or buildings and "pre-existing" I~ud uses: · 1. Accurate survey of property showing all property lines,'streota, building and unuSU~rl naturai or topographic £e~turcs. ' 2. ^ properly c~mpleted 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 Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50_00, · Swimming po01 $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00,. 2. Certificate of Occupancy on Pm-existing Building - $100.00 3. Copy of Certificate of. Occupancy - $:25 · 4. Updated Certificate of Occupancy- $50.00 - 5. Temporary Certificate 0 f Occupancy - Residential $15.00, Commercial $15.00 Old or Pre--existing Building: ' (check one) Hous~ No. lqew Construction: Location of Property: Owndr or Owners o~'Property: Street Suffolk .Co.uaty Tax Map No 1000, 8ectign ~bclivision P~mit No. '~t~7 Health DcpL Approval:.. Planning Boarcl Approval: Hamlet Block . · Fried Map. DatcofPcrmit. l~-%"'"~._1] Applic~t:· Request for: Temporary Certificate. Foe Submitted: $ ~(~), dT~h~-~,. Final Certificate: Undcr~ite~s Approval: k one) ~pplicant Signature T(m~l ltall An.ex 5~373 Mare t/oad P.O. 1½ox 1179 Southold, NY 11!t71-t)!t,5!} I t:lc phone (631 ) 765-1802 Fax ((;31) 765 9502 ro.qer, dchert~town.southo d nv us BUll,DIN(; I)EI~ARTMENT TOWN OF $OUTItOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: James Wilcenski Address: 115 Hobad Rd City: Southold St: NY Zip: 11971 Building Permit#: 35871 Section: Block: Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Daniel Wilcenski Electricle License No: 4723-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~J Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel A/C Condenser Single Recpt Sub Panel A/C Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures ~ HID Fixtures Wall Fixtures ~.~ Smoke Detectors Recessed Fixtures ~.~ CO Detectors Fluorescent Fixture ~.~ Pumps Emergency Fixtures[__1 Time Clocks Exit Fixtures L.J TVSS 1st floor renovation, 8 under cabinet lights, 1 exhaust fan, 1 paddle fan Notes: Inspector Signature: Date: Jan 31 2011 81-Cert Electrical Compliance Form BUILDING'DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Dale: i//,~1/I/ Building lead (Please,print) (Please prinO ~ certify thai the solder used in the water supply system conlains less than 2/10 oF !~/o before me thisc~/ - X,o~ar), P u blic~i~ Coul~ty DENISE KING Notan/Public, State of New York Registration #01KI6041757 Qualified in Suffolk County My Commission Expires May 15.2 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] II~JLATION [-~INAL [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRICAL (FINAL) [ ] ELECTRICAL (ROUGH) REMARKS: ~~~ DATE INSPECTOR /~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ELECTRICAL (ROUGH) REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [.~-] ELECTRICAL (FINAL) DATE , ? , , TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECT/ION FOUNDATION 1ST [//~ROUGH PLBG. FOUN~LAt~ON 2ND [ ] INSULATION ,~'RAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT C0flSTRUCTI014 [ ] FIRE RESISTANT PF. NETRATI0fl REMARKSi~~~~,~~~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 [ ] FOUN~ATINoNSIsTP EC~ [ ] INSULATION [ ] FINAL [ ] fiRE SAr,- ~ ( INSPECTION [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] RRERESiST~I'~ [ ] RRERESlST~I'I~iETRATION / TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]flRERESlST~ITCOIA'TRUCTION ~] ELECTRICAL (ROUGH) ~REMARKS: [ ] ROUGH PLBG. [ ]INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING [ ] FINAL [ ]FIREPLACE & CHIMNEY [ ] ~R/IE SAFETY INSPECTION .. [ ]FIRE REal,rANT C~iSTR~ [,~'~TRRE RESISTANT PENETRATION REMAR~~~.~E~ DATE f~)/'~(~/('(0 INSPECTOR ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ~aff PLBG. [ ] FOUNDATION 2ND [/~I~INSULATION FRAMING / STRAPPING FIREPLACE & CHIMNEY [ ] FINAL [ ] FIRE SAm-m: m V' INSPECTION [ ] R~m~smST~mTm~ETm~TmON REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ~/~ , 20 }W Approved ~/~,20 fH Disapproved a/c Expiration ,~//[¢,, 20 /~ 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.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT 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 frmn 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, Suftblk 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, a[d re. gulatioro, and to admit attth°rized inspect°rs °n premises and in building fbr necessary inspecti°ns' (/7 //~ )(/~,, () (Signature of applicant or name, ifa corporation) (Mailing a~ddress ofa~plica~t) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises L7~,'¥~ a ,~. (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: Ho~e Number Sfreet County Tax Map No. 1000 Section (::, Subdivision Block Filed Map No. Lot ~ Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy />,*~u~t r~ ~¢0/¢~__ ,/~v~v~_~ ~ t*~* t~/~b3 b. Intended use and occupancy />~/t/.,c:,z ,440~¢~ ./r,~.~,¢.o~ 3. Nature of work (check which applicable): New Building. Addition Alteration Repair ¢' Removal Demolition Other Work 4. Estimated C0st~ ,~ ~-~, 000 od :~.: Fee 5. If dwelling, number of dwelling units / If garage, number of cars (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 o7¢¢ Height Number of Stories Rear o20' Depth Dimensions of same structure with alterations or additions: Front Depth (..~,¢/,,~) Height 8. Dimensions of entire new construction: Front Height ,~//,q, Number of Stor(es~ ,¢/4 (' ¢..~,~} Rear ,~-.,~,'~'~ / Number of Stories (~) Rear ~/~ Depth 9. Size oflot: Front ~ro '~JO~- Rear ~' 10. Date of Purchase ~,t,t /6/,OOo,~ 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 14. Names of Owner of premises~L~,&~:~_Address//5- .A~_,ra~,/~,,~ Name of Architect (~/~/v'~:) Address Phone No NameofContractor ¢7'~a0¢ ,4y'~o-.,~c.q,¥ ~ Address .~'5"&~t~,~.a /%t. PhoneNo. ~o~-ro,-, d~,~Y~',¢~-' ~'oo,~4*~%/v'y 1/'?'7 / 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES ./N/O~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Phone No. 7{~- ~7 774- I,X 6t~. ,/ 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 ~dt STATE OF NEW YORK) o %45I s: __~"-O_¢MLD~ (A.-), [C_~cJ~_/ being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)Heisthe ~ ~~ (Contractor, Agent, Corporate Officer, etc.) 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 t~ before me this (~) dayof .5..ehjD+ 20 l O vlcm X-" _, Notary Public Notap/Public.State of Ne~York/ No. 01T06190696 · Qualified in Suffolk Count~ k. Signature of Applicant Town Hall Annex $4375 M~in Roed P.O. Box 1179 · Sou~o[d, NY i 1971-09~9 Telephone (63t) 76,~1802 TOWN OF SOU~-IOLn APPLICATION FOR ELECTRICAL INSPECTION BY: ~ ~.__~., No.: Date: ~'~/, 7"- ~/~ cd.', ~, / JOBSITE INFORMATION: (*Indicates required information) *Name: ;,-~'~,~-_ .'~ [,}'~ ~ / c~'~- I(~ *Address: { [ ~ H~ ~ *CmssStmet: I~,'~ ~ ~ ~ ~ *Phone No.: Permit No.: Tax Map District: 1000 Section: .~ ~ ' Block: *BRIEF DESCRIPTION OF WORK (Please Print. Clearly) co.-., (, ~.-'r--~ I ~--'-'~ ¢"1~'--', "-' LC... Lot: (Please ,Circle All That Apply) *Is.job ready for inspection: yEs .~ Rough In Final .*Do you need a Temp Certificate: YES / N(,,~ Temp'lnformaflon (If needed~ ' /2- / ' *$el~'lceSlze: ,Pfiasy 3Phase 100 150~200 300 35~' 400~Other *new Service: 'Re-c/e'nnec, Underground N~ber of Meters C,an~of Servl~/overhead Additional Informatior~ PAYMENT DUE WITH APPLICATION ' 82-Request for Inspection FOrm Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765 9502 November 14, 2011 BUILDING DEPARTMENT TOWN OF SOUTHOLD James Wilcenski 115 Hobart Rd Southold, NY 11971 TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: ~/ Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $50.00. Final Health Department Approval. ~ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. - Bob Fisher Final Landmark Preservation approval. BUILDING PERMIT: 35871 - Interior Alteration ToWn of Southold Erosion, Sedimentatio----~ ~ ~.to~-Wat-~r Run-off ASSESSMENT FOR,U els~ct e~on .~k ~ IFI BY A DESIGN PRur=~iONAL IN THE STATE OF NEW YORK. SCOPE OFWORK - PROPOSED a. Wtmt I~ the Total Area of th~PmJect Parcels? CONSTRU~-~ (IncJude Total Area of all Pa;cels located wRhln me 8cope of Wed; f0~ Prap~ed C~stmctio~) Wbet ta ~e Total Area of Land Clsar~g and/or Ground Disturbance for the pmpesed (S.F. I ~} PRO~D~. B/U]~ P~O~'/' DESCR~ON 7 8 Wi# mis Project Retain N181orm-Watar Run-Off Generated by a Two (2") thch Ralntall °n $~? cleadng and/or construciton acg~dUm~ as web a~ all Site Improvements alx[ the permanent creation of Impenaous surface~) Does Ihe 8ita Plan and/or Survey Show All pmpceed Drainage Stmcturas thdles~ng Size & LoceOon? This Item shall Include all Pro~ Grade Changes and Slopes Controlling Surface Water Flow. Does the 8~ta Plan and/or Suwey deealbe the erosion and sediment centrol prac~ces that will be esed ta contral are ereslon and slorm water dL~es. This item must be maintained throughout the Entire Consth~ctlon PeKod. Will this P~ Requlra.any Land Fill ag. Grading or Excevat~on where there is a change to the Natural Existing Grade Involving mom than 200 Cubte YardsI~1 -L~ of Material within any Parcer? . Will this AppllceUon Require Land Disturbing Activities Encompassing an Ama in Excess of F~ve Thousand~L~ (5,000'S.F.) Square Feet of Ground Surface? Is them a Natural Water Course Running through the Site? la this Praject within the Treeteee judsdlctten D --~ or within One Hundred (100') feet of a Wedand or Beach? Wilt there be Site PreParation on F-~sUng Grade Slopes r----,- which Excend Fifteen (15) feet of Va~cel pjSe to One Hundred (100,) of Horizontal Distar~Ce? L~U w~l Driveways, Paddng Areas or other Impervious into ~d/or In th~ dlmc~'~ of ~ To~'l d~ht~.of-w~l~ Will this I~o]~t R~qulm ~ I~:~eent o~ 9 Removal °f Vngetallpn and-"°r the Construct;on ofany Item Wilhln the Town RlgM-of-Way or Road $heolcler STATE OF NEW YORIL ~a (-'f' COUN"IT OF ......~......2..'Z... ~xL ..~...:... SS l]!atl, 0....~..~ .L,,itj,/0.AM, a~-~.c. '' duls ' · ' ............... ~'a'a~a';~'~i ................... "~ y wom, aeposesanasaysUlathe/sheLstheapplicantforPenlfit, And that he/she is the .................... .~...4&V',g~, ....................... (o,~,~:~ ~i;~:agi ............................................. Owner and/or representative of the Owner or Owners, and is dub] authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his know]edge and beliel~ and that the work will be performed in the manner set forth in thc application filed herewith. Sworn to before me tiffs; .a x~ . , ~ .... ......... .......... ........... /I /) Public: , otary PU§Iic, State of New ynrk //I FORM- 06/~ 0 .~.~_],~i~i~. ~u~fUo,~e~untv (* / ALL. NEW 0 tqY-WAL L ®1 oL.UMBING pL( ttBING Wt5 ~T'~. ,'AT: < LINES TEu~ A~G BEt:OR!' :~ ..... ; ;3 lrc FL. OOR t ~ LITE, PLUMBER ¢,¢c : 'c'C z'r!ON ON LEAL - SOLDER d,': .; SUPPLY o ~ , ' EXCEED 2/~ 0, ......... '* ~'. Z_D O0 R~ CL F~A'TH R APPROVED AS NOTED DATE' 'i' ~,lr NO' :t 7,NG DEP~p~M~NT AT 765 * '.' TO 4 PM FOR THE FOL.t.. : NSPFC~IC'N~ 1 FOUNDATION TWO REQUIRED FOR cC'URED CONCRETE 2 RO,GH-~RAMING PLUMBING S-p~p,NG ELECTRICAL & CAULKING UNDERWRFFco 7: REQUiHEO /[5 )fiO$kRT RD, SOUTHOLD; NY ;/eT/:]F2~- 3 INSULATION 4 c'N4L- CONS~RUCTION M'UST,iBE COMPLETE FOR C ~. ALL CONSTRUCTION SHALL REQUIREMENTS OF THE CO~N~ YORK STATE NOT RES~NSI~ DESIGN OR CONSTRUCTION ERROR~