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Home My WebLink About37370-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 7/26/2012 CERTIFICATE OF OCCUPANCY No: 35846 Date: 7/26/2012 SCTM #: 473889 Subdivision: THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2810 Westphalia Rd, Mattituck, Sec/Block/Lot: 114.-7-5.2 Filed Map No. conforms substantially to the Application for Building Permit heretofore 7/6/2012 pursuant to which Building Permit No. Lot No. filed in this officed dated 37370 dated 7/18/2012 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: "as built" basement alteration in an existing one family dwellin~ as applied for. The certificate is issued to Fox, Dana (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37370 7/24/12 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 #: 37370 Permission is hereby granted to: Fox, Dana 2819 Westphalia Rd Mattituck, NY 11952 Date: 7/18/2012 To: construct "as built" basement alteration as applied for At premises located at: 2810 Westphalia Rd, Mattituck SCTM # 473889 Sec/Block/Lot # 114.-7-5.2 Pursuant to application dated To expire on 1/17/2014. Fees: 7/6/2012 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $820.80 $5O.OO $870.80 Building Inspector Form No. 6 TOWN O~ SOUl,OLD 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 w!th the following: A. For new building or new use: 1. Final survey of propertY with accurate location o f all buildings, property lines, streets, and unusual naturat or topographic featurds. 2. Final Approval from Health D~pt. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board 0fFire Underwriters. 4. Sw, ora statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.. 5. Commemial building, industrial building, m~iltiple residences and similar buildings and installations, a certificate of code Compliance'from architect or engineer responsible for the building= 6. Submit planning Board Approval ofcempleted site plan requirements. B. For existing buildings (prier to April 9, 1957) don-conforming uses, or buildings and "pre-existing" land uses; I. Accurate survey of property showing all property lines, streets, building and. unusual natumi or topographic features. 2. A properly ~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. Certificaie 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 Oeeupancy 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 New Construction: Location of Property: Date. Old or Pre-existing Building: ~'~ (cheek one) House No. Street Owndr or Owners o? Property: 3 ~,Y' ~- ~tffolk County Tax Map No 1000, Section Subdivision P~mit No. Date of Permit. Health D~t. Approval: Block 7 Filed Map. Applicant:.. Hamlet Lot Lot: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Foe Submitted: $ Final Certificate: (check one) pphcam Stgnatme To~vn 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.southo d ny us BUILDING DEPARTMENT TOWN OF SOUTItOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Dana Fox Address: 2810 Westphalia Rd City: Mattituck St: NY Zip: 11956 Suilding Permit #: 37370 Section: 114 Block: 7 Lot: 5.,~ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Dana Fox LicenseNo: 525-e SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Wall Fixtures Ill Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures [~ TVSS Other Equipment: 1-exhaust fan, 2ft lighting track Notes: Date: July 24 2012 81-Ced Electrical Compliance Form.xls TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND ] FRAMING / STRAPPING [ ] ROUGH PLBG. [ ] INS~JLATION [ ~3'I~NA L [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: .~--~-~., ~,~ TOWN OF SOUTH~LIN BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved Disapproved a/c 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.C. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: '-~one: ~-'"'ff~> FCO. g'T7g"3- sets of plans, accurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of Iol and of bnildings on premises, relationship to adjoining promises or public streets or areas, aad watem ays. c. The work covered b} this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, tl~e Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises a~ailable lbr inspection throughout Ibc work. e. No building shall be occupied or nsed in whole or in pa~ for any purpose what so ever until the Building Inspector issues a Ce~ifioale of Occopaacy. E Every building permit shall expire if the work aufl~orized has not commenced within 12 months a~er the date of issuance or has not been completed will, in I 8 months from such date. If no zoning amendments or other regulations affecting the prope~y have been enacted ia the interim, the Building Inspector nmy authorize, in writing, the extension of the pe~it for an addition six months. Thereafter, a new permit shall be reqnired. APPLICATION IS HEREBY MADE to the Building Depamnem for the issnance cfa Building Permit pursuant to tbe Building Zone Ordioance of the Town of Southold, Suflblk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or lbr 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 buildiag for necessary iaspections. (Signature of applicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is o,~x ncr. 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 duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. ~,S a-' Other Trade's License No. l,ocation of land Oil which proposed ~ork will be done: ltouse Number Street } I q Hamlet County Tax Map No. 1000 Section_~ Block ~ Lot ~ L-- Subdivision Filed Map No. o Lot... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy_ Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost 2~o Fee If dwelling, number of dwelling units If garage, number of cars Addition 4'-, t94+ Alteration Other Work (Description) (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. Names of Owner of premises Name of Architect Name of Contractor Address ~PI~ ~d~"r~rq~ttO~q Phone No. ~ fl/ 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. PERM1TS 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. 18. Am there any covenants and restrictions with respect to this property? * YES__ · IF YES, PROVIDE A COPY. NO t~ STATE OF NEW YORK) SS: COUNTY OF _) being dnly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public, State of Now York No, 01BU6185050 (S)He is the Cua~ified !~ ._qnffolk Counh/ ~,~, (Contractor, Agent, Corporate Officer, etc.) Commission Expires April 14, 2IZ!~ 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. S~orn to before me this ~ -~ day of Q~ 20J~=_ Notary Public Town Hall A~nex 54375 M~ia Road P.O. Box 1179 Sou~old, NY 11971-0959 Telephone (631) 765-1802 BUn.r)n~C DEP~ TOWN OF $OIYI~OLD APPLICATION FOR FI FCTRICAL INSPECTION REQUESTED BY Company Name: Name: Date: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: No.: JOBSITE INFORMATION: (*Indicates required information) Lot: 5-, ,~. *BRIEF DESCRIPTION OF WORK (Please Print Clearly) o ~PI. ease ¢~le All That Ap~y~ *Is job ready for inspect on: Temp Information (If-needed] *Service Size: 1 Phase 3Phase ~New Service: Re-connect Additional Information: (Y~/NO Rough In (Final' 100 150 200 Underground Number of Metem 300 350 400 Other Change of Service Overhead .PAYMENT DUE WITH APPLICATION B2-Request for Inspection Form Town Hall Annex 54375 Main Road P.O. Box 1179 Southold~ NY 11971-0959 Telephone(631)765-1802 Fax(631)765-9502 BUILDINGDEPARTMENT TOWN OFSOUTHOLD July 23, 2012 Dana Fox 2810 Westphalia Rd Mattituck, NY 11952 TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) //' Electrical Underwriters Certificate. (contact your electrician) __ 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 # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. BUILDING PERMIT: 37370 - "As Built" Basement Alteration --I FLOOR 'PLAN 7¢~-~o~ /~M TC 4 PM FOR ?o~¢q(} INSPECTIONS: FOdN[ A*'ON - 'Two REQ~JIRED FOA ~OURED CONCF:ETE Z, ROCGH * FRAMING ~t UMBING STRAPPING ELECTRICAL & CAULKING ?. INSU~TION ~ FINAL- CONSTRUCTION & ELECTRI6~ MUST BE COMPLETE F~ 6.0. ALL 6~8TR~TION 8~ ME~ ~ REQUIREMENTS OF THE C~E~ OF NEW YORK STA~. ~T E~BIE ~ ELECTRICAL INSPECTION RE~~;,,~ ~O PI. UMbER CERTIFICA ON LEAD CONTENT BEF, . CERTIFICATE OP OCCL /P,'L',¢: SOLDER USED IN WA 7:; SUPPLY SYSTEM C/U :' : L, 7' EXCEED 2/10 QF ! PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE EXISTING DEN IN FINISHED BASEMENT ~~;~.?~.2810 WestPhalia Rd Mattitucl( . I '~~°]1 ' Town of Southold ·A-t I