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HomeMy WebLinkAbout37307-Z7/5/2012 Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 35797 Date: 7/5/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ALTERATION 14909 Route 25, East Marion, Sec/Block/Lot: 23.-1-2.3 Filed Map No. conforms substantially to the Application for Building Permit heretofore 6/I 1/2012 pursuant to which Building Permit No. 37307 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" second floor alterations to two bathrooms hi an existing one family dwelling as applied for. Lot No. filed in this officed dated dated 6/19/2012 The certificate is issued to Norman & Marjorie Whitehead III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 6/29/12 37307 6/14/12  Mike Jacoby ture 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 Cf: 37307 Date: 6/19/2012 Permission is hereby granted to: Whitehead III, Norman & Whitehead, Marjorie 2 Martha Cir Barrington, RI 02806 To: construct "as blt" alterations to an existing dwelling as applied for At premises located at: 14909 Route 25, East Marion SCTM Cf 473889 Sec/Block/Lot # 23.-1-2.3 Pursuant to application dated To expire on 12/19/2013. Fees: 6/11/2012 and approved by the Building Inspector. S1NGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $473.60 $50.00 $523.60 Building Inspector Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPgaNCy This application must be filled in by typewriter or ink and submitted to the Building Department with the fell .osving: A. For new building or new use: 1. Final survey of property with accurate'location of all buildings, property lines, streets, and unusual natura} or topographic feamr6s. 2. Final Approval from Health Dgpt- of water supply and sewerage-disposal (8-9 form). 3, Approval of electrical installation from Board 6fFire Underwriters. 4. 'Sw. om star. neat from plumber carti~ying that the solder used in system contains less than 2/10 of 1% lead.. 5. Commomial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code ComPliataee'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 unusu~il naturai or topographic features. 2. A properly o~mpleted application and consent to inspect signed by the applicant. Ifa Certificate of ~ccupancy 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, Swimmilig pool $50.00, ACCessory building $50.00, Additions to accessory building $50.00, Businesses $50.00,. ~. 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 - Resideatial $15.00, Commercial $15.00 New Construction: Location of Property: Hous~ No. Own6r or Ownem of Property: ./X/©./~ P~ t~ ~ Suffolk C,~opnty Tax Map No 1000, 8oeti0n Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Old or Pre-existing Building: /'-/707 Date. Street Block Filed Map. Applicant:. Undexwritem Approval: (cheek one) Hamlet Lot Lot: Request for: Temporary Certificate Foe Submitted: $ Final Certificate: (check one) I~pplicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 ro.qer, richert~town, so uthold, ny. us BUILDING DEPARTMENT TOWN O1' SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Norman Whitehead Address: 14909 Main Rd City: East Marion St: NY Zip: 11939 Building Permit #: Section: Block: Lot: 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 I~ Ind°°r ~] Basement [~ Service Only Corn merical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ CeilingFixtures [~ HIDFixtureSs~ Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixtureu Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures ~ TVSS Other Equipment: 2 bathrooms, 2-exhaust fans Notes: Date: June 14 2012 81-Cert Electrical Compliance Form.xls ToWn Hall, 53095 Main Road P.O. Boxl179 Southold, NeW Yon% 1tg71 Fax (546) 765d823 Telephone (5t6) 765d 802 (JFFICE OF THE BUILDING INSPEGTOR TOWN OF SOUTHOLD CERTIFICATION Plumber! (piease prtn() X certify that %he solder Used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this Notary Publtc~ ( Plumb7 Signature ) County CONNIE D. BUNCH Notary Public, State of New York No. 01BU6185050 Qualified in Suffolk County Cpmmission Expires April 14, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~TION [ ] FRAMING/STRAPPING [/']'FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) -. [ ] ELECTRICAL (FINAL) REMARKS: ~-' ~-' DATE ANGELB. CHORNO ARCHITECT 51020 MAIN ROAD SOUTHOLD NY. 11971 (631)765-6530 FAX(631)765-4643 June 27th, 2012 Building Department Town of Southold Re: Whitehead Residence East Marion NY # 373072 - 1000-23-01-2.3 To the best of my knowledge, the above referenced work was done in compliance with the NYS Plumbing Code of the time in which it was built. Angel B. Chorno, AIA TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined .20 Approved Disapproved a/c · 2O Expiration .20 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: Mail to: Phone: d~'~.-~- 6)<o~-~'~c7 I Bi DG DEPl. 1¢'''x O! SOUTHOID Building Inspector 'PLICATION FOR BUILDING PERMIT Date INSTRUCTIONS · 20 a. This application MUST be conl oletely 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 plata 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 buildiug 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 from such date. lfno zoning amendments or other regulations affecting the property have been eaacted 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 [S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construclion 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 uecessary inspectious. (Signature of applicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is ov, ner, lessee· agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerol'premises /L/O~t'q/4~ ~r~o .) /~4/~tC~-o~t[ (As ou 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. Location of land on which proposed work will be done: [louse Number Street County Tax Map No. 1000 Section ~ ~ Block Hamlet Lof fl,, ~ Subdivision ' Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed cons! ruction: Existing use and occupancy b. Intended use and occupancy /~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Alteration x/~ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercia~r mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing strt~t, ures, if any: Front Rear Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories 8. Dimensions of entire new Height 9. Size of lot: Front Front Rear ~ber of Stories .Depth Rear Depth 10. Date of Pumhase Name Owner 11. Zone or use district in which promises are 12. Does proposed construction violate any zoning or regulation? YES__ NO__ 13. Will lot be re-graded? YES NO Will premises? YES NO__ 14. Names of Owner of premises Name of Architect Name of Contractor Address Address Address Phone No. Phone No Phone No. 15 a. Is this property within 100 feet cfa tidal wetland or a * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE b. Is this property within 300 feet cfa tidal wetland? * YES__ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 'IRED. 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 STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, GoNNIE D. BUNCH (S)He is the ~t. rv Public, State ot___Now Yor~ (Contractor, Agent, Corporate Officer, etc.) ' NO. 01BU§l~Jou li~ed n Suffolk County ~-~ / ;ornmi{~s on Expires April 14,. 2~.. , . of said owner or owners, and is duly authorized to perform or have performed t ~e samworK and to make and hie this appl cat on 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 [(--~ dayofx Q~.&t-3~ 20 }~ Notary Public \ Si.matnre of Applicant Town Hall Annex 54375 Maia Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-t80~ ro~er rJchert'Jz'~ (631) · ~.s~.ny.~ BI3II.D1NG DEPARTMENT TOWN OF SOUTHO~.n APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: ~ddress: Phone No.: Date: JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: / ~t~/O q *Cross Street: *Phone No.: Permit No.: Tax Map District: 1000 Section: ~ % Block: 'BRIEF DESCRIPTION OF WORK (Please Print Clearly) Lot: :Please Circle All That Apply) 'Is job ready for inspection: 'Do you need a Temp Certificate: YES / NO Rough In Final YES / NO remp Irlfoiiiiation (If. needed] Service Size: 1 Phase 3Phase New Service: Re-connect Underground Number of Metem Change of Service ~dditional Information: PAYMENT DUE WITH APPLICATION 100 150 200 300 350 400 Other 82~-Request for Inspection Form UMBER CERTIFICATION 'LEAD CONTENT BEFORE TIFICATE OF OCCUPANCY .DER USED IN WA TER SUPPLY SYSTEM CANNOT EXCEED 2110 OF 1% LEAO. ~PPROVEDASNOTED ~ 5'7~B~7 :~Fv BUILDING lENT AT ,5-1802 8 AM TO 4 PM FOR THE OLLOWING INSPECTIONS: FOUNDATION - TWO REQUIRED FOR PQURED CONCRETE , ROUGH. FRAMING, PLUMBING, ~ STRAPPING ELECTRICAL & CAULKII~G INSULATION I FINAL - 00NSTRUCTION & ELECTRICAL MUST BE COMPLE'E FOR C,O. L MEETTHE S OF THE COOE8 OF NEW NOT RESPONSIBLE FOR ~"'OI~TRUCTIO~I ERRORS, ELECTRICAL INSPECTIO: PLUMBING _. · ,= /'"/(~} ALL PLUMBING WASTE & WATER LINES ~N~ED ~ T~STING BEFORE C.-, ,'2RING ~ 1000-23-01-2.3 WHITEHEAD RESIDENCE D^'m: 6-11-12 East Mafioh TOWN OF SOUTHOLD NY'.SK-1 CHORNO ASSOCIATES : 8OuTHOLD, NEY/YORK