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36994-Z
Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 3/9/2012 CERTIFICATE OF OCCUPANCY No: 35482 Date: 3/9/2012 THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 400 Birch Drive S., Laurel, SCTM #: 473889 Sec/Block/Lot: 128.-4-8 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 7/8/2009 pursuant to which Building Permit No. Lot No. filed in this officed dated 36994 dated 2/13/2012 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 renovations to kitchen, mudroom and bathroom or existing seasonal dwelling as applied for. The certificate is issued to Robert J Kar Irt. Trust (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 2/16/12 36994 3/5/12 Mattituck Plumbing & Heating Autl~rized 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 #: 36994 Date: 2/13/2012 Permission is hereby granted to: ROBERT J. KAR IRREVOC., TRUST 3806 TARAWOOD COURT SPRING, TX 77388 To~ INTERIOR RENOVATIONS TO THE KITCHEN, MUDROOM & BATHROOM OF EXISTING SEASONAL DWELLING PER APPROVED PLANS AS APPLIED FOR. REPLACES EXPIRED B.P. # 34854 At premises located at: 400 BIRCH DR SOUTH SCTM # 473889 Sec/Block/Lot # 128.-4-8 Pursuant to application dated To expire on 8113/2013. Fees: 7/8/2009 and approved by the Building Inspector. PERMIT RENEWAL $100.00 Total: $100.00 Building Inspector 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. 34854 Z Date JULY 13, 2009 Permission is hereby granted to: ROBERT JOSEPH KAR 3806 TAIqAWOOD CT SPRING,TX 77388 for : INTERIOR RENOVATIONS TO THE KITCHEN, MUDROOM & BATHROOM OF EXISTIN SEASONAL DWELLING PER APPROVED PLANS AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 128 Block pursuant to application dated JULY 8, 2009 Building Inspector to expire on JA/qUARY 13, 400 BIRCH DR SOUTH LAUREL 0004 Lot No. 008 and approved by the 2011. Fee $ 200.00 Authorized Signature~ COPY Rev. 5/8/02 ~orm No. 6 TOWN OF $OU~O~D 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 Depamnent with the following: A. For new building or new use: 1. Final survey 9f property with accurate location 0f all buildings~ property lines, streets, and anusual 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 0f Fire Underwriters. 4. Sworn statement from plumber certifying that tho solder used in system contains less 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 uses: 1. Accurate survey of property showing all property lines, streets, building and:unusnfil natural or topographic features. 2. A properly completed 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, ~terations to dwelling $50.00") . Swimming po01 $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50 00 2. Ceytificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy - $50.00 ' 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 New Construction: Old or Pre-existing Building: Location of Property: 4~)O ~)i6'~/{~ Bt-, ~. House No. Street ' OwnerorOwnersofProperty: ~-Nt~.Jt . · 8nffolk County Tax Map No 1000, Section Sebdivisibn Health Dept. Approval: .DateofPermit. Planning Board Approval: (check one) ( Hamlet Block Lot Filed Map... Lot: Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ fl"'~, ~'~' Final Certificate: (check one Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone(631)765-1802 Fax(631)765-9502 roRer, riche~town.southold.ny.us BUILDING DEPARTMENT TOWN OFSOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Robert Kar Address: 400 Birch DrSouth City: Laurel St: NY Zip: 11948 ~uilding Permit #: 36994 Section: 1 28 Block: 4 Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE .~ontractor: DBA: Jim Sage Electric Inc LicenseNo: 3635-e SITE DETAILS Office Use 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 NC Condenser Single Recpt Sub Panel A/C Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: 1-paddle fan Ceiling Fixtures [~ HID Fixtures Wall Fixtures ].~ Smoke Detectors Recessed Fixtures ~ CO Detectors Fluorescent Fixture ].~ Pumps Emergency Fixtures!~ Time Clocks Exit Fixtures ~ TVSS Notes: Inspector Signature: -~,~.~ Date: March 5 2012 81-Cert Electrical Compliance Form.xls BUILDING'DEPARTMENT TOWN OF $OUTHOLD CERTIFICATION Da{e: B,.,ildmg Permil No. ©~ner: (Please.prinO ~ (Please pHnD I cenify that the solder used in the water supply system contains less than S,,~orn to before me this /~/ ~ Js~ or' c~.~d,-~-.--~-~ , 20 ~,.,,.Z , DENISE KING Notary Public, State of New York Registration #01KI6041757 Qualified in Suffolk County My Cofnlnission Expires May 15.2 XotaryPublic; ~County TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSU~LATION [ ]FRAMING / STRAPPING [~]~FINAL [ ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) 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 INSPECTOR ~'u~D~Sp~.~'~O~E~O~TDATE [ 'CO~ENTS ~'~ I~OUNDATION (lST) ~ FO~A~ON (2~)~ m PL~G ~ ~8~A~O~ PER N.Y. q STATE ~R~ CODE ///~ ~.~. · / / ~D~ION~ COUNTS ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined C Approved '--'/ [ \ % , 20 Disapproved adc Expiration PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans plannmg Board approval Survey' Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: {~C.~t~(~xlOfif. x~ ~f') _ ~ ~ ~ ~ r '~ Building Inspector ~ U.~ ~ -- AI~I~ATION FOR BUILDING PERMIT 1 . '0 a. ThJ~ ,~pplic~d~'~.~ b~ completely ~llcd Jn by t~ewfit~r or iu i~ and sub~tted to the Building ~spcctor ~ith 3 sets of plads, acetate plot plau to scale. ~e~ accordiu8 to schedule. b. Plot plan shoMu~ location of lot and of buildings on prc~scs, relationship to adjoining pre, scs or public streets or areas, and wate~ays. c. The work covered by this application may not be co~enced before issu~ce of Building Pe~t. d. Upon approval of t~s application, the Building ~spector will issue a Building Pemt to the applic~t. Such a pemit shall be kept on the presses available for inspection t~oughout the work. e. No building shall be occupied or used in whole or in pa~ for any p~ose what so ever until the Building ~spector issues a Ce~ificate of Occup~cy. f. Eve~ building pe~t shall expire if the work authorized has not co~enced within 12 months a~er the date of issu~ce or has not been completed within 18 months from such date. If no zo~ng mendments or other re~lations affecting the prope~y have been enacted in the interim, the Building ~spector may authorize, in writing, the extension of the pemt for an addition six months. Thereafter, a new pe~t shall be required. ~PLICATION IS HE,BY M~E to the Building Depa~ment for the issuan2e of a Building Pe~t pursuant to the Building Zone Ordin~ce of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordnances or Re~lations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. ~e applicant a~ees to comply with all applicable laws, ordin~ces, building code, housing code, ~d relations, and to a~t authorized inspectors on pre~ses ~d in b~lding for necessaW inspections. 7 ' / (~i~r~ of ~li~t or ~i~'~or~ti~) ' (Mailing address of applicant) [ \Oi~7_- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a.~_~corporation, signature of d. gl~ authorized, officer, ' '"" ~-N~irfie ~'d tit/e ofct~rPoi'ate Offi~erj .... Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on w~hich proposed work will be done. L, , _ /,_% House Number '~ S~,~ -- ' ' '"' " Hamlet County Tax Map No. 1000 Section Block Subdivision Filed Map No. (Name) Lot Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~{ N[Ck~ .~ b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost Fee If dwelling, number of dwelling units if garage, number of cars Addition Alteration Other Work [~ ~'~lh I ~ ' ~Descriptim0 (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 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 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. Nameso Ownerofpremises ~-)~O~ ~ Address t..~,~-~_x ,~0'-¢ 119~gPhoneNo. Name of.A,r-~it'eet ~:~L~erKrnO~-~ t:ofi~tt~c.A-~t:f~ Address ti= r,-~o~t ~q 5':3 Phone No C~ -,_5'~ I ~ Name of Contractor--;m Address~ r~- ~'{ut.~ j ~ ? t Iq£~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. STATE OF NEW YORK) SS: COUNTY Ot~.,a ~ ~x~.t.¢" Jr_, '~lD~_. C_~OA 0t ?/~, being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Nota~,h,Pu~ic, Slate of N~w Yor~ no. 01BU6185050 (S)He is the Oual~edinSuf'mlkCount~ , _ (Contractor, Agent, Corporate Officer, etc.) C0mmissl0o F.~|re~ Apfl114, L,I/l t0~ 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. Sw°~f°2yn' ;ft,N~ Notary Public / ' · Si'gr~ture of,~pplicant ;~oo- ;,~,-,/-~' TOWN OF SOUTHOLD PROPERTY RECORD CARD /~"- ~ OWNER STREET /_~/~ VILLAGE DIST. SUB. LOT FORMER OWNER N ACR. ~ES. ~ S~S. VL FA~ COMM. CB. MI.8C. Mkt. V~lue AGE BUILDING CONDITION N__~ NORMAL BELOW ABOVE F~M Acre Value Per Value Acre goodlond ;wampland FRONTAGE ON WATER ~rushland FRONTAGE ON ROAD touse Plot DEPTH BULKH~D ~tal DOCK COLOR · Bldg. :tension :tension (tension )rch )rch Jreezeway arage )atio 'oral ~tion Basement Ext. Walls Fire Place Type Roof Recreation Room Dormer Driveway Bath :loors nterior Finish Heat /V D Rooms 1st Floor Rooms 2nd Flora FIN. B. Dinette K. LR. DR. BR. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 119714)959 Telephone (631) 765-1802 rorer rich e r tC~.$~,~.~6 u~'l~, ny. us BUII,lqING DEPARTMENT TOWN OF $OUTHOI.n APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: Date: JOBSITE INFORMATION: (*Indicates required information) *Name: 1000 Section: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: Block: ~ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: ~/NO Rough In ~ YES ~ Temp Information (If needed] *Service Size: 1 Phase 3Phase 100 *New Service: Re-connect Underground Additional Information: 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82.Request for Inspection Form Sonthold Town Building Department 54375 Main Road Sonthold, New York 11971 (631) 765-1802 Parcel ID: 128.-4-8 Permit #: 34854 Permit Date: 7/13/2009 Expiration Date: 1/13/2011 Applicant: Location: Work Description: Dated: 1/19/2012 ROBERT J. KAR 1RREVOC., TRUST 400 BIRCH DR SOUTH RESIDENTIAL ALTERATION 1NTERIOR RENOVATIONS TO THE KITCHEN, MUDROOM & BATHROOM OF EXISTING SEASONAL DWELLING PER APPROVED PLANS AS APPLIED FOR. Owner: Address: ROBERT J. KAR IRREVOC., TRUST 3806 TARAWOOD COURT SPRING, TX 77388 Your BUILDING PERMIT #34854 has been referred to me because you have not responded to requests to obtain your Certificate of Occupancy as required by Southold Town code. Pursuant to 144-15A, of the Southoid Town Code, "No building hereafter erected shall be used or occupied in whole or in part until a certificate of occupancy shall have been issued by the Building Inspector." Therefore, you have ten days from the receipt fo this letter to submit a check made out to the Town of Southold in the amount of $100.00 to renew the building permit, or legal action will be taken against you. Should you have any questions, call the building department between the hours of 8:00 a.m. and 4:00 p.m. Respectfully Yours, Michael Verity: Chief Building Inspector Sonthold Bnilding Department cc: Damon Rallis Zoning Inspector Southold Town Building Department 54375 Main Road Southold, New York 11971 (631) 765-1802 Parcel 1D: 128.-4-8 Permit #: 34854 Permit Date: 7/13/2009 Expiration Date: 1/13/2011 BUILDING PERMIT RENEWAL LETTER Applicant: Location: Work Description: Dated: 8/15/2011 ROBERT J. KAR IRREVOC., TRUST 400 BIRCH DR SOUTH LAUREL, N.Y. 11948 RESIDENTIAL ALTERATION INTERIOR RENOVATIONS TO THE KITCHEN, MUDROOM & BATHROOM OF EXISTING SEASONAL DWELLING PER APPROVED PLANS AS APPLIED FOR. A FEE OF $100.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Address: ROBERTJ. KAR IRREVOC., TRUST 3806 TARAWOOD COURT SPRING, TX 77388 The permit listed above has expired. Please contact our office as soon as possible to begin the renewal process. All work on the project must stop on the expiration date. No work is permitted or authorized beyond the expiration date. THANK YOU, SOUTHOLD TOWN BUILDING DEPT. Town Hall Annex 54375 Main Road P.O. Box I 179 Southold. NY I 1971-0959 Telephone (631) 765- 1802 Fax (631 ) 765-9502 Februaw 24,2012 BUILDING DEPARTMENT TOWN OFSOUTHOLD Robert J. Karr Irrevoc Trust 3806 Tarawood Ct Spring TX 77388 Re: 400 Birch Dr South TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: '~ Application for Certificate of Occupancy. (Enclosed) (~B~ttrical 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 #155-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. - Bob Fisher __ Final Landmark Preservation approval. BUILDING PERMIT: 36994- Interior Renovations CERTIF!CATION OF 'NAILING & CONNECTIONS REQUIRED. UNDERWRITERS CERTIRCA~ PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE COVERING USE IS UNLAW;L:!.. WITHOUT CEr~'I'jF::':,r~, :' OF OOCdPAF:~: NOTI~ BUILD,;,_ ="::",T AT 765-1802 8AM TO .i. ~ FOR THE FOLLOWlN3 N?ECT ?, B: 1. FOULDA ON- l'f,'r 2. ROUGH - Fh~,, ,~ & PLUMBING 3. INSULAT ON 4. FINAL C ..... ~, ON MUST BE COMPLEEE -~ C O. ALL COLS~FUCTON S~I~LL MEET THE REQUIREMENTS OF THE CODES OF N~ V DESIGN OR CONSTR?CT 3N ERRt~S. RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. PLUMBE ' ~"~N LEAD CERT/FIC,4 SOLD~-L~ .SUn' --FORE 'ANCY ,, ER lOT