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Home My WebLink About37092-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 4/16/2012 CERTIFICATE OF OCCUPANCY No: 35541 Date: 4/16/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: HOT TUB 350 Second Ave, Peconic, Sec/Block/Lot: 67.-4-24 Filed Map No. conforms substantially to the Application for Building Permit heretofore 3/16/2012 pursuant to which Building Permit No. 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: hot tub as applied for. Lot No. filed in this officed dated 37092 dated 3/27/2012 The certificate is issued to Goodheart, Leona & Goodheart, Bruce (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37092 4/11/12 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 #: 37092 Permission is hereby granted to: Goodheart, Leona & Goodheart, Bruce 19 Avon Rd Farmingdale, NY 11735 Date: 3/27/2012 To: install a Hot Tub as applied for At premises located at: 350 Second Ave, Peconic SCTM # 473889 Sec/Block/Lot # 67.-4-24 Pursuant to application dated To expire on 9/26/2013. Fees: 3/16/2012 and approved bythe Building Inspector. CO - ALTERATION TO DWELLING SWIMMING POOLS - ABOVE-GROUND WITH REQUIRED FENCING Total: $50.00 $250.00 $300.00 // 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 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate &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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Location of Property: Old or Pre-existing Building: V/ (check one) Street Hamlet ~' 7 Block O t4 Lot ~ ~ House NO, Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. h '~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Filed Map. Lot: Date of Permit. Applicant: Underwriters Approval: Final Certificate: d (check one) Appl(cant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone(631)765-1802 Fax(631)765-9502 rofle r. richo~town.southold, nv. us BUILDINGDEPARTMENT TOWN OFSOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Goodheart Address: 350 2nd Ave City: Peconic St: NY Zip: 11958 Building Permit#: 37092 Section: 67 Block: 4 Lot: 24 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Anytime Electric License No: 40167 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: install GFCI protected disconnect for self contained hot tub Ceiling Fixtures [~ HID Fixtures Wall Fixtures ~.~ Smoke Detectors Recessed Fixtures ~ CO Detectors Fluorescent Fixture ~ Pumps Emergency Fixtures[_~ Time Clocks Exit Fixtures [~ TVSS GFCi protect existing lights in area of hot tub Notes: Inspector Signature: Date: April 11 2012 81-Cart Electrical Compliance Form.xls TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~ELECTRICAL (FINAL) REMARKS: DATE. ~////~ / , INSPECTOr- TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~U~ATION [ ] FRAMING/STRAPPING [~,3~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ ] ELECTRICAL (ROUGH) REMARKS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (651) 765-1802 FAX: (631) 765-9502 SouthoidTown. NorthFork. net Examined Approved Disapproved a/c Expiration BUILDING PERMIT APPLICATION CHECKLIST PERMIT NO. 3.)7~/~-~ BLDG. DEPT. TOWN 0r SOUIHOLD Building Inspector 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 ntact: APPLICATION FOR BUILDING PERMIT Dine ~K, MI,C~4- /(o ,20/o9,, INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and snbmitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showiag location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterxvays. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, tire Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available tbr 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 a~rer 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, tire 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 cfa Building Permit pursuant to the Building Zone Ordinance of the Town of Southo]d, 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. "I i iATELY" ENCLOSE POOL TO ~ UPON COMPLETION BEFORE "WATER" OCCUPANCY OR USE IS UNLAWFUL W!THOUT CERTIFICATE (Signature of'applicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, t:~ee?aCh: at-c&t~;: engineer, general contractor, electrician, plumber or builder APPROVEDASNOTED Name of owner of premises If applicant is a corporation, signature of'duly authorized officer (As on the tax roll or 1~ (Name and title of corporate officer) Builders License No. Plumbers License No. ELECTS! Electricians License No. ~,!~Pl::eTIOh.' Other Trade's License No. Location of land on which proposed~work will be done: House Number Street ) County Tax Map No. 1000 Section Q::>9 Block NOTIFY BUILDING DEPARTMENT - !802 8 AM TO 4 PM FOR T~E FOLLOWING iNSPECTIONS' 1 FOUNDAT:ON - TWO REOIJIRED FOR POLJRF~3 2, ROUGH.FRgM,N5 P~JL STRAPPING, ELECTRICAL & CAULKiL3 3. INS~ 4. FINAL - CONSTRUCTION & ELECTRICAL MUST BE C~PL~E F~ CO. ALL ~NSTRUCTDN REOUlREMENTS OF THE CODES OF NEW CONS~UCTION ERRORS; Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use an,,d occupancy of proposed construction: a. Existing use and occupancy ~o Ik'k~"~ ~,' A4ql~ b. Intended use and occupancy. 3. 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 (Description) (To be paid on filing this application) Number of dxvelling units on each floor 6. If business, co .mmercial 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 t¥om 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. 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 topographic~,~4~I5 s..urvey: 18. Are there any covenants and restrictions with respect to this property? * YES__ NO · IF YES, PROVIDE A COPY. STATE OF NEW'ylh31{)~. ~,ii. ' '' ~ SS: COUNTY OF *)" -, . .......... "; .... ' ........ being duly sworn, deposes and says that (s)be is the applicant (Name of 'ndividnal signing'contract) above named, OONNIE O. 8uNOH Nota~' Public, State of New Yod~ No. 01BU6185050 (S)He is the ........ ....a~. o_,.~,,~u ^ , (Contractor, Agent, Corporate Officer, etc.) CommissionQU~"'"~'u Expires .......... Apnl-'-Z~l~., '~[ll'l'~ Of said owner or owners, and is duly lu'&;e~i~d to perfbrm or bare performed tile said work and to make and file tiffs application; that all statements contained in this $~li~a~don are true to the best of his knowledge and belief; and that the work will be ...... ppi performed in the mann~r~s'et, forth.!n the a icat~on filed therewith. Sworn to before me this _.. ) (2~'~ day of~OU~ O~ Notary Public 2o1~ V Signature or-App ican Town of Southold Erosion, Sedimentation & Storm-Water Runoff ASSESSMENT FORM ~O~t~ OF WORK - PRO]~O~D C}ONb'IIKU~.~.'ION J.'llfi~[ # / WORK ASSESSMENT [ Yes No PROVIDE ~ (~ S.F.) ~ F~ ~? , 6 ~ : ~~ (l~)~a~ ~'A~ O~ ~ ~0~ Nota~ Publ~, ~e ~ New Yo~ ~I C~O~ ........... ~.~-~;-~ .................. ~~ ........ ~.~.~ ..................... ~. ~. ~'~;'~F ............................... ~ ~e ~ ~ ~ ~ ia ~ ~ ~ f~ ~ ~c ~p~on ~ h~. ._~. ......... ~.~...._.~..~ .................. ~~~~ .................... FORM - 06/10 Town Hall Annex $44~75 Main Road P.O. Box 1179 Southold, NY 119714)959 Telephone (631) 765-1802 BIJII~r~ING DEPARTMENT TOWN OF SOITI~IOL~ APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: AddresS: Phone No.: Date: L//~/ Tr 1 6 JOBSITE INFORMATION: (*Indicates required information) *Name: ~t G ~s ~o~r~. *Address: *Cross Street: ~ , ( [ ~, ' *PhoneNo.: ~1~) ~ ~/ ~r }~r& . ~~, Tax. Map District: 1000 Section: 6 *BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) ' blot YES / NO Rough In Final (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If. needed) *Service Size: 1 Phase 3PhaSe 100 *New Service: Re-connect Underground Additional Information: 82-Requesl~rlnspecfion Form 150 200 300 350 400 Number a ~te~ I ~l~l~le o[~Selyic PAYMENT ~~ ~ APR 1 0 2012 BLDG DEPT. TOWN OF SOUTHOLD Other ~verhead Post-it~ Fax Note 7671 Oate Ipages Co./Dept .30. ~c~j~b _l~q. pogCH. 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