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Home My WebLink About36781-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 11/10/2011 CERTIFICATE OF OCCUPANCY No: 35283 Date: 11/10/2011 THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 1165 Theresa Dr, Mattituck, SCTM #: 473889 Sec/Block/Lot: 115.-15-11 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 10/21/2011 pursuant to which Building Permit No. Lot No. filed in this ofilced dated 36781 dated 10/28/2011 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" alteration of existing garage to bedroom and bathroom in an existing one family dwellin~ as applied for. The certificate is issued to Berliner, Donald & Berliner, Sandra (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 9/24/11 36781 10/28/11 I~ttituck Plum~jng & Heating /~o¢~at ure TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36781 Permission is hereby granted to: Berliner, Donald & Berliner, Sandra 1165 Theresa Dr Mattituck, NY 11952 Date: 10/28/2011 To: convert garage to conditioned space "as built" At premises located at: 1165 Theresa Dr, Mattituck SCTM # 473889 Sec/Block/Lot # 115.-15-11 Pursuant to application dated To expire on 4/28/2013. Fees: 10/21/2011 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $579.20 $50.00 $629.20 Building Inspector 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/I 0 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 consent to inspect signed by the applicant. Ifa 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 pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 $15.00 New Construction: ~' Old or Pre-existing Building: Locationoferoperty: //~ ~'~_/az~ ~/~'ff-e House No. Street Owner or Owners of Property: ~ ,:b ~ Suffolk County Tax Map No 1000, Section /[ ~" Subdivision Permit No...~ ~ ~ / Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Date of Permit./0 -2(5 - / I Date. (check one) Block Lot / / Hamlet Filed Map. Lot: Applicant: Underwriters Approval: X'~pplica~m ~i~nature Town Hall Annex 54375 Main Road P.O, Box 1179 Southold, New York 11971-0959 Telephone (631) 765 1802 Fax (631 ) 765-9502 roger, richert~town.so uthold, ny. us BUILDING DEPARTMENT TOWN O1' SOUTItOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Donald Berliner Address: 1165Theresa Dr City: Mattituck St: NY Zip: 11952 Building Permit #: 36781 Section: 115 Block: 15 Lot: 11 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 ~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel NC 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~.~ Time Clocks Exit Fixtures ~ TVSS convert attached garage to living space (bed room & bath room) Notes: Inspector Signature: Date: Oct 28 2011 81-Cert Electrical Compliance Form BUILDING"DEPARTMENT TOV~N OF SOUTHOLD CERTIFICATION (Plcas¢,pdnt) (Please p,-inl) I cenify Ihal lhe solder used in the waler supply sysfem conlains less Ihan 2/I0 oF!ye S,,~om lo b¢/'or¢ me INs ,~' ~? ~~~_, 2C~// ",olaf), Public; ~~.~-- Courtly (~P ~2JJ:lS~fs Signature) DENISE KING Nota~ Public, State of New York Registration #01KI6041757 Qu~a?ed in Suffolk County My Commiosion Expires May 15, /INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTIONS] ~FIRE RESISTANT FENETRATION [ ] ELECTRICAL (ROUGH) '~.ELE. G~ICAL (FINAL) REMARKS: TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [/~NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined FO/'~, 20 /[ Approved ~_, 20 Il Disapproved a/c / BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board/al~roval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form , Contact: Mail to: Phone: Expiration ~----~~II//[ Building Inspector ~-~/ 0C~' 20 20~1 A~ATIONFORB~LD~GPE~T a. ~is application ~ST be completely filled in by ~e~ter or in i~ ~d submitted to ~e Buil~ng hs~ctor wi~ 4 [~B of plans, acc~ate plot pl~ to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining prmises or public s~eets or re~, ~d wate~ays. c. ~e work covered by ~is application may not be commenced before issu~ce of Building Pemit. d. Upon approval of ~is application, ~e Buil~g Inspector will issue a B~lding Pe~it to ~e applic~t. Such a pe~it shall be k~t on ~e pre~ses available for inspection ~rou~out ~e w~k. e. No building sh~l be occupied or used in whole or in p~ for ~y p~ose what so ever ~til ~e Building Inspector issues a C~ificate of Occup~cy. f. Eve~ buil~ng pemit shall expire if~e work au~ohzed has not commenced within 12 months a~er the date of issu~ce or h~ not been completed wi~in 18 monks ~om such date. If no zoning men,ems or o~er re~lafions affecting ~e prope~ have been enacted in ~e intehm, the Building Inspector may authorize, in ~fing, the extension of the p~it for addition six monks. ~ere~er, a new pe~it shall be required. APPLICATION IS HE,BY M~E to ~e Building D~mt for ~e issuance of a B~ld~g Pemt p~su~t to ~e Building Zone ~dinance of ~e To~ of Southold, Suffolk Count, New York, ~d o~er applicable Laws, Ordinances or Regulations, for applic~t a~ees m comply wi~ ~1 applicable laws, or~n~ces, building code, housing code, ~d re~lafions, ~d to a~it auto,ed ~spectom on premises ~d in building for necess~ inspections. State whether applicant is owner, lessee, agent, architect, engineer, general con.actor, electrician, plumber or builder Nameofownerofpremises ~[~/L~[C~2 ~.~1~[ ~'T} ~ (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. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Ma~ No. 1000 Section I l ~ Bl~ck ' I'~ Lot 11 Subdivision ~4g~ ~ ~1~ ~'~.q'~]~t~ 19Iap No..,~c~,..r Lot "~. 2. a. Existing use and occupancy ~:~s..~ V~ I--4 11~ s~-i~ ~ ~.1~1~--~ State existing use and occupancy of premises and intended u~se and occupancy, of proposed construction: b. Intended useandoccupancy d55Yg-~ 7z~.,e,,~III~V 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work '.3~.~ ~t~ ¢ ~ ~ ~;-,.~/,~ (DeScription) 4. Estimated Cost e~, ~ tY 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 ~(~~'-F - ~ 7. Dimensions of existing structures, if any: Front If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~tg:::~ t _Depth '~ t59 ~ Rear Height .~7" Number of Stories ~ Dimensions of same structure with alterations or additions: Front .~ l Depth :~ -dr' L ~-~ ~ Height ~,~'~ ' "t~" Number of Stories ~ 8. Dimensions of entire new construction: Front ~ff~' Rear ~~557t Depth .eight (;" umber Stp.es Size oflot: Front [4~,~I Rear r~-'77' ! Depth 1~Tfl'. ~ 10. Date of Purchase p4 Rear ~//~7 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 fi.om premises? YES NO__ 14. Names of Owner of premises 'lDe~tO0~[ ~O~41[~_Address[/~'l~;~ Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 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 NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. t7. If elevation at any point on property is at 10 feet or below, must provide topographical data o~xrvey. / 18. Are there any covenants and restrictions with respect to this property? * YES NO ¢/ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) e ~of;~ ~ ~-/;~__,,.c:v being duly sworn, deposes and says that (s)he is the applicant dividual signing cohtract) above named, is the (Contractor,~gent, Corporate Officl~r, etc.) ~ of said owner or owners, and is duly author/zed 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 .., t (-~ day of ~ 20 I [ ~ ',,*, ..... ~ il. TANDY / Notary Public Not~'~, Publlo, State Of New York No. 01 TA6086001 Qualified In Suffolk County, ,_.. Commisaion Expirea 01/'13/20. Signature of Applicant ITECNOLOGIES P.O.Box 93 OCT 2 8 20il BtDG DE?l. TOWN OF SOUTHOtO October 28,2011 Southold Town Building Department P.O. Box 1179 Southold, New York 11971 Re: As-built Building Department application Berliner Residence 1165 Theresa Drive Mattituck, New York Attention: Plan Examiner Per our phone conversation, the as-built garage conversion at the address above met the N.Y.S. Energy Codes at the time of the actual construction. Frank Frank Notaro P.O. BOX;93 Mattituck, Town Hall .AJmex 54,375 Main Road P.O. Box 1179 Southold, N~ 11971-0959 Telephone (631) 76~1802 ro,q e r. richer t ('~,t~ (wn~3.ts) o7 uru~l~(~(~, ny. u s BUII~ING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Date: Name: License No.: Address: Phone No.: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required information) *Name: ~/~ ~. 1000 Section: / / ~'" Block: *BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady) (Please Circle All That Apply) *is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Se~ce Size: I Phase *New Service: Re-connect Additional Information: 3Phase 100 Underground E~NO, YES/.(~ Rough In Final 150 200 300 350 400 Other Number of Metem Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form NEW SUFFOLK AVENUE III Z LOT 37 S 87° 19' 20" I--. EXISTING DRIVE~VAY PROP. GARAGE CONVERSION 50.:3' EXISTING STY. FR. DWELL. 57.6' 182.00' SITE SURVEY MAP OF PROPERTY SITUATED: MATTITUCK, NE~ TOWN OF: $OUTHOL! SUFFOLK COUNTY, NEfE YG S.C. TAX No. MAP-O700-23-- CERTIFIED TO: BEN MEND~ LOT NUMBER 36 "DEEP HOLE SURVEYED 7-29-76 AREA = 22,178 S.F. SCALE 1/16" -- INFORMA~ON TAKEN FROM SURVEY PREPARED BY YOUNG & YOUNG, P. 499 OSTRANDER AVE. RIVERHEAD, NEW YORK Z PROPOSEDI "AS - BUILT" ALTERATION TO THE BERLINER RESIDENCE MA]-rIT~--K I~ NEW YORK EAST ELEVATION (EXISTING) (TYP. BOTH SIDES) ALIGN FINISH FLOOR W EXISTING FLOOR HT. PART. DECK FRAMING P ,I_AN (EXISTING) WEST ELEVATION (EXISTING) LEGEND __ EXISTING EXTERIOR/INTERIOR WALL TO REMAIN. ix, '~ NEW INTERIOR WALL ADDED. EXISTING WINDOW/DOOR/GARAGE DOOR TO REMAIN, NEW 2'-8" X 6'-8" DOOR TO MATCH EX. NEW 2'-6" X 6-8" DOOR TO MATCH EX. NEW 5'-0" X 6-8" BI-FOLD DOORS TO MATCH EX. PROVIDE ALL NECESSARY PLUMBING ROUGHING AND VENTING AS Op INDICATED ON CONSTRUCTION pLANS. FOLI~OW ALL NECESSARY N,Y,S, AND LOCAL PLUMBING CODES THAT APPLY TO WORK TO BE COMPLETED, PROVIDE ALL NECESSARY DRAIN VALVES FOR WINTERIZATION, REF. TO CONSTRUCTION pLANS FOR FIXTURE TYPES. ALL WASTE LINES ARE TO BE INSULATED WITH SOUND A~F~ENUATING INSULATION (TYP, ALL AREAS) ~p DUPLEX ELECTRICAL RECEPTACLE ~GFI DUPLEX RECEPTACLE/GROUND FAULT INTERRUPT $ WALL SWITCH RECESSED DOWNLIGHT (1COW)" LIGHTOLIER" OR APP, EQ, INTERIOR RECESSED WATER-PROOF DOWNLIGHT (100VV) NEW CEILING MOUNTED JUNCTION SOX FOR RECESSED EXHAUST FAN/LIGHT WITH DUAL SWITCH AT WALL. "BROAN' HEAVY DUTY UNIT OR APP, EQUAL, I~s~ SMOKE/CARBON MONOXIDE DETECTOR: TO BE WIRED TO CENTRAL CONTROL BOX, (~YDRONIC BASE, BDJBEDROObl/BATH SOUTH ELEVATION (EXISTING) EXISTING GARAGE CONVERTED -[~3 HEATED__ (HYDRONIC BASE,ED.)BEDROOM/BATH II J II II PART. PLAN, (EXISTING) NOTE: C~-IRACTO R TO NOTIFY THE ARCHITECT OF ANY AND ALL REVISIONS DUE TO FIELD P[ UMBING ALL PLUL!r:I,iG W,~JTE & WA'I ~j t.!',E$ NEED TESTING BEEORE COVER PLUMBER ~ ON LEAD CONTENT E CERTIFICATE OF ( SOLDER USED ~IV V~,'¢~,; SUPPL Y SYSTEM :)EXCEED 2/lOOF 1~o LEI APPROV.ED AS NOTED FEE NOfIFY BUILDING DEPARTMENT 765-1802 8 AM TO 4 PM FOR TH FOLLO~NG INSI~ECTIONS 'i. FOUNDATION - TWO REQUIR ED FOR POURED CONCRETE 3. ROUGH - FRAMING. PLUMBNG, STRAPPING, ELECTRI~L & CAULKINGI 3 INSULATION 4 FINAL CONSTRUCTION ~ ELECTC~CAL ~,lUSf 8E CQ .MPLETE FOR C 0 ALL L.U U.I 0 ~ SCALE: 1/4"=1 '0" DWG, NAME: COMPOSITE "AS - BUILT" PLAN/ELEV. DWG, NO,: A-1