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Home My WebLink About36786-Z1/9/2012 Town of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 35385 Date: 1/9/2012 THIS CERTIFIES that the building ALTERATION Location of Property: 130 Bennett Rd, Greenport, SCTM #: 473889 Sec/Block/Lot: 40.-5-1.1 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 10/19/2011 pursuant to which Building Permit No. Lot No. filed in this officed dated 36786 dated 11/1/2011 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: finish second floor, install wood stove & install hot tub "as built" The certificate is issued to Blydenburgh, Nancy (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36786 1/6/12 · Signature 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 #: 36786 Permission is hereby granted to: Blydenburgh, Nancy 130 Bennet Road Ext Date: 11/1/2011 Greenport, NY 11944 To: finish second floor, install wood stove & install hot tub "as built" At premises located at: 130 Bennett Rd, Greenport SCTM # 473889 Sec/Block/Lot # 40.-5-1.1 Pursuant to application dated To expire on 5/2/2013. Fees: 10/19/2011 and approved bythe Building Inspector. SWIMM1NG POOLS - ABOVE-GROUND WITH REQUIRED FENCING CO - ALTERATION TO DWELLING CO - SWIMMING POOL SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: Building Inspector $500.00 $50.00 $50.00 $976.00 $1,576.00 Form No. 6 TOWN OF SOUTHOLD. BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy This application must be filled in by typewriter or ink and submitted to the Building Department with.the f~loy~ing: A. For new building or new use: 1. Final survey of property with accurate'location o f all buildings, property lines, streets, and unusual natural or topographic fcatur~. 2. Final Approval from Health D~pt. of water supply and sewerage-disposal ($-9 formJ. 3. Approval of eloctrica! installation from Board 6f Fire Underwriters. 4. '8w. om statement from plumber certifying that the solder nsed in system contains less than 2/t0 of 1% lead. . 5. Commeroiat building, industrial building, mtiltiple residences and similar buildings and installations, a certificate of Code Complia~aee'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 us~, or bUildings and "pre-existing" land uses~ 1. Accurate survey of property showing all property lines, streets, building and unnsmd natural or topographic features. 2. A 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, Swimmiag pool $50.00, Accessory building $50 00, Additions to accessory building $50.00 Businesses $50.00: 2. Ce[titlcate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $:25 Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: k// Location of Property: House No. / Owner or Owners of Property: ' fi//2 Suffolk County Tax Map No 1000, Section Subdivision Old or Pre-exi~ting Building.: Strut Bi°Ck P~mitlqo. ~'~(a~'~ ~, ~ DateofPermit. Health Dept. Approval: Fiiod Map. t l~ [- J{ Applicant: Underwrite~ Approval:. Planning Board Approval: Request for Temporary Certificate. Fee Submitted: $ ~5 ,~ Final Certificate: (check one) 0 Hamlet (check one) ~/~pp[ica,a ~j~n~ture Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY I 19714)959 Telephone (631 ) 765-1802 Fax (631) 765-9502 ro.qer, richert~town.southo d nv us BUILDING DEPARTMENT TOWN OF SOUTI-IOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Nancy Blydenburgh ~,ddress: 130 Bennet Road Ext City: Greenport St: NY Zip: 11944 ~uilding Permit #: 36786 Section: 40 Block: 5 Lot: 1.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE .~ontractor: as built DBA: License No: SITE DETAILS Office Use Only Residential [~ Indo°r l~ Basement I~ ServioeOnly~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY ServiceService lph ~ Heat3 ph Hot Water ~ Duplec Recpt ~ Ceiling Fixtures I~ HID Fixtures~GFCI Recpt Wall Fixturess~ Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent FixtureM Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures ~ TVSS Other Equipment: disconnect for self contained hot tub Notes: Inspector Signature: Date: Jan 6 2012 81-Cert Electrical Compliance Form TOWN OF S~ING DEPT. INSPECTIO [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRI/~J~. (ROUGH) ~, [ ] ELECTRICAL (FINAL) DATE INSPECTOR~~ WN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] RRE RESISTANT PENEI'RATION [ ] ELECTRICAL (FINAL) [ ] FIRE RESISTANT CONSTRUCTION [ ~ELECTRICAL (ROUGH) REMARKS: DATE //~_~~ INSPECTOR~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ROUGH PLBG. INSULATION ~FINAL ~-_~ FIRE SAFETY INSPECTION RRE RESISTANT PENE11~ATION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRERES~rAKroOgSTRUOT~ [ REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SouthoidTown. NorthFork. net E×amincd :O/B/X . '~0 //~ Approved__ Disapproved a/c Expiration 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 Survey Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Ma, Phone: ( ~Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,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 tile premises available for inspection throughout tile work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until tile 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 fi'om such date. If no zon lng amendments or other regulations affecting tile property have been enacted in the interim, the Building luspector 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 ora Building Permit pursuant to tile 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. (Signature of applicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agen(archit;¢engineer, general contractor electrician, plumber or builder Name of owner of premises /(/4A,] ~y &/./~p'7. A,) Zj~ (.//~' ~' (~s 0nThe 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 which proposed work will be done: 13o ?_.,,O ,,v ,6. House Number Street County Tax Map No. 1000 Section ~r~ 62 Block Hamlet Lot ]. / Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy ff/AJ~t'.,~'~ /"-,~,,~?t'_6, /'~,~ / b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Demolition Fee Repair Removal Estimated Cost If dwelling, number of dwelling units If garage, number of cars Addition Alteration (Descnpnon) (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 structures, if any: Front J .f'"' Rear Height Number of Stories 9. 10. Date of Purchase Depth Dimensions of same structure with alterations or additions: Front Depth '~, f Height_ Number of Stories 7_. Dimensions of entire new construction: Front ~ .~ Rear ~ Depth Height ~ _~ Number of Stories Size of lot: Front 7dr'. ~ Rear 7 J', 1~ ~ Depth Rear Name of Former Owner 11. Zone or use district in which premises are situated ,,~'/-~ f) 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO 0(' Will excess fill be removed from premises? YES 14. Names of Owner of premises A/,O~/t;,0/~t. q~gff,-W ~ddress Phone No. Name of Architect /Ift',l ~,~- 3 6 J.4'~,~/ 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 * 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 I 0 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) CONNIE D. BUNCH SS: Notary Public, State of New York COUNTY OF,~, -'"tWl~rO('/~3C'/'~/'~ 7'"~ No. 01BU6185050 Qualified in Suffolk County Commission Expires April 14, .///~ ~I~-~ ~ being duly sworu, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (Contractor, A~ent, C<(rporaie Office[', ~tc.} - ,/ of said owner or owners, and is duly authorized to perform or bare performed the said work and to make and file this application; tbat all statements contained in this application are true to the best of his knowledge aud belief; and that the work will be performed in the manner set forth in the application filed therewith. Notary Public . Town of ~outhold , Sedimentation & Storm-Water Run-off ASSESSMENT FOR,"," ~oN: S.CT~L ~. THE FOLLOWING ACTIONS M " ~_ _ MAY REQUIRE THE SUBMISSION OF A $co?~o~wo~a~. ~O~OS~D co~gmucnoN rrgM# / wo~,g~ ¥~ ~ a. Vqbet b Ihe Tota~ Area of Ihe pn:~/ect pm.ceb? (Include T~M Ama o~ al Pame~ I~a~ed wm-~n me -~-~: ~ Wink ~r Pmpmed Cms~mc~m) ~' ~- W'mt b Ihe Ta~d ,,~ of Land Ck~lt~g · Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 ro.qe r. rich e r t dt~w(63n .ts) o76u~'~g(J(~, ny. us REQUESTED BY: Company Name: BUILDING DEPARTMENT TOWN OF SOUTHOLr~ APPLICATION FOR ELECTRICAL INSPECTION Date: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: *Name: *Address: *Cross Street: *Phone No,: Permit No.: Tax Map District: (*Indicates required information) 1000 Section: b~(~ Block: Lot: *BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) (Please Circle All That ~ply) ~ ~¢~~ ~~ ~ ,~ *Is job ready for inspection: ~ ~ ~' ~ Rough I,~ *~ you need a Temp Cedifl~te: YES / NO .,~ .~ Final Temp Info~atlon (If needed} ~'~%, ~ *Se~i~ Size: 1 Phase 3phase 100 150 200 ~00 ~ 350 400 Other *New Se~i~: Re-connect Underground Number of Meters Change of Se~ice Ove~ead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form 5-1/2. THICK ENCLOSE RO~L.TJO, C-A-~D E CONCRETE SL&B ~ ~ I I LL, c iS UNLAWFUL EX. KITCHEN ~ _____., ~ EX. BEDROOM No. 1 J PLUMBING ALL PLUMBING WASTE ~ & WAi'EB L/NE8 NEED ~ -- TESTING BEFORE COVERING ~ ~ SOLDER USeD IN WA TER , 4'-7" ~ ~ ~ SUPPLYSYSTEM CANNOT ~' EX. BEDROOM No, 2 EXCEED ~I0 OF 1% L~ EX. LIVING ROOM 2 3 INSULATION SCALE: 1/4"= 1' REScI~ocR Software Version 4.4,~ Compliance Ce~ificate I 2ND. FLOOR PLAN ALL GONSTRUOTION SHALL MEET THE REQUIREMENT8 OF THE OODE8 OF NEW YORK STATE, PLUMBING SCHEMATIC