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Home My WebLink About36965-ZTown of Southoid Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 10/1/2012 No: 35923 Date: 10/1/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: AS BUILT ALTERATION 53245 Route 25, Southold, Sec/Block/Lot: 61.-1-8.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated 1/30/2012 pursuant to which Building Permit No. 36965 dated 2/1/2012 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" alteration for bathroom in existin~ one family dwelling as applied for. The certificate is issued to Burns, Margery D (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36965 9/24/12 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 #: 36965 Permission is hereby granted to: Bums, Margery 4135 NE Brasher Dr Marietta, GA 30066 Date: 2/1/2012 To: construct an "As Built" Bathroom as applied for At premises located at: 53245 Route 25, Southold SCTM # 473889 Sec/Block/Lot # 61.-1-8.1 Pursuant to application dated To expire on 812/2013. Fees: 1/30/2012 and approved bythe Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $475.00 $50.00 $525.00 Building Inspector Form N~. 6 TOWN OF $OUTIIOLD 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 fearn res. 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 I% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer respoasible 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 applicatiou and consent to inspect signed by tile applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate 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 Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy - $.25 Updated Cellificale of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 [)ate. New Construction: Old or Pre-existing Building: Location of Property: ~'3o%L/~ ~'0~ House No. S~eet Owner or Owuers of Prope~y: ~~ Suffolk County Tax Map No 1000, Section SulSdivision PermitNo. ~> b Health Dept. Approval: Date of Permit. Block i Filed Map. Applicaut: Underwriters Approval: (check one) Lot Lot: Plamaing Board Approval: Hamlet Request for: Temporary Certificate Fee Submitted: $ ,..;,..~ · '~' Final Certificate: (check one) Applicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (63 I) 765-9502 roger.richert~,town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Bums ~,ddress: 53245 RT 25 City: Southold St: NY Zip: 11971 ]uilding Permit#: Section: 61 Block: 1 Lot: 8/ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: defects removed DBA: License No: SITE DETAILS Office Use Only Residential ~ Indoor [~ Basement ~ Service Only [~ Com medcai 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: 100a overhead service, 1-paddle fan Ceiling Fixtures [~l HID Fixtures Wall Fixtures I 71 Smoke Detectors Recessed Fixtures I I CO Detectors Fluorescent Fixtur~,~ Pumps Emergency Fixture Time Clocks Exit Fixtures ~ TVSS Notes: Inspector Signature: '~, ,z.~,_'~---~~ Date: Sept 24 2012 81-Cert Eiectrical Compliance Form.xls TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [] FOUNDATION 1ST [ ] ROUGH PLBG. [] FOUNDATION 2ND [ ] INSULATION [.]FRAMING / STRAPPING [~INAL 2~ - [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ [ ] ELECTRICAL (ROUGH) [ REMARKS: ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRICAL (FINAL) DATE -~ ~ ? - /~''- __INSPECTOR ~'~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 76S-9502 SoutholdTown. NorthFork.net Examined .20 lc] Approved Disapproved a/c Exp,ratio,, ,_0 }5 -t PERMIT NO. dAN 3 0 2012 BLDG DEPT. TOWN OF SObT,4OLD BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health -- 4 sets of Building PlanJC"- Pla,ning Board Survey Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form atacl: Mai[ to: Building Inspector Phone: APPLICATION FOR BUILDING PERMIT Date ///~3 ,20 /AC--- INSTRUCTIONS 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 plau 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 issne a Building Permit to the applicant. Such a permit shall be kept on the premises availablo fbr inspection throughout the work. e. No building shall be occupied or used in whole or in pan fbr any purpose what so ever until the Building Inspector issues a Cenificate of Occupancy. f. Every building permit shall expire if the x~ork authorized has not commenced within 12 months a~er the date of issuance or has not been completed within 18 months fi'om such date. If no zoning amendments or other regulations affecting the property have beeu enacted in the interim, the Building Inspeclor may aulhorize, in writiug, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Depamnent fbr the issuance ora Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suflblk Couub', 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 autho,'ized inspectors on premises and in building for necessary inspections.~/ff//~/ / / /Signature~ppl~t or name, ifgcorpo~tion) address of applicant) c)"' OOC State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elec(rici~,.p~b¢r or builder Nameofownerofpremises ~a,q6~g ~ ~5 DATE~B.p.~~ (As on the tax roll or !~ apphcam ~s a corporation, signature ~r , ~ ~ ~ ,,~ ' ' ' ~ da: ~ ~ ..... officer ~O/IFY BUI~I~G ~81 ,.. ~0LLOWING INSPECTIONS: (Name and title of corporate officer) FOUNDATION - ~ REQU~EF Builders License No. FO~ ~URED 00~RETE Plumbers License No. 2. R~. ~. ~. STR~P~NG. E~ Electricians L~cense No. 3 INS~ON O[her Trade's ~iccnse ~o. 4 FINAL-C~-"~, MUST BEeF ~. I,ocafion o~Iand on which proposed wor~ wi]] be done: ALL CONS~ House ~um bet ~ S[ree~ ~OR ~~ INSPE QUIRED Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and o~ccupancy of proposed construction: a. Existing use and occupancy /57-' ~'/0,~,,¢' /~-~J~r~,~q b. Intended use and occupancy 3. Nature of work (check which applicable): New Buildiug Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor ~ I 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Di~nensions of existing structures, if any: F'ront ~-/ C ~" Rear [ ~, '- ~' Depth ,.5 ~ /''- ~'~ r Height. Number of Stories e~ Dimensions of same structure with alterations or additions: Front ..37 '- ~, Rear /d, '- ,~'" Depth .5'~' '- q" Height_ Number of Stories ~9 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size oflot: Front ~t.,/. /,~' r Rear Depth /.5'/, ?~ 10. Date of Purchase Name of Former Owner ,e~/~ ,'g~'~i' ~/ /> /~og,q ~'- 11. Zone or use district in which premises are sitaated ~oo t"i%~o t.-JB 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. Nines of Owner of premises~D ,~aPM~Address~,~O~ ~0 ~.~a~ Phone No. 7 7o - ~3- 3q~ Name of Architect Address Phone No Name of Contractor Address Phone No. l 5 a. Is this property within 100 feet of a tidal xvetland or a fresh~vater wetland? *YES NO * 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. 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, PROV1DE A COPY. NO STATE OF NEWiYORK), SS: COUNTY OF ~ - ........ :J?' being duly sworn, deposes and says that (s)he is the applicant (Name of i~'l sig~lmg contra~t) above named, (S)He is the ~ .~:. '~ ~ ~&Ot6?,:Agent, Corporate Officer, etc.) ~i~'~?~ed to perform or have performed the said work and to make and file this application; ~pp~gtiol~ are true to the best of his knowledge and belief; and that the work will be ~h~ ipplication filed therewith. / /'- ~' Sj~latu~Applicant t/ Robert D. Bums, Jr. 4135 Brasher Drive NE Marietta, GA 30066 JAN 3 2012 BLDG DEPl. TOWN OF SOL]THOLO December 27, 2011 Town of Southold Building Dept. Main Road Southold, NY 11971 To Whom It May Concern: Enclosed is the application for a pre-existing CO for the house located at 53245 Main Road, Southold. The only modification to the house was that one of the rooms on the first floor was converted into a bathroom back in 1977 to accommodate my father after he suffered a stroke. Please let me know if any further information is needed. You may also reach me at 770- 853-3964. Sincere~l~/~ . Robert D. Burns, Jr. Executor of the Estate of Margery D. Bums REAR ENTRANCE BASEM~ STAIRS STORAGE KITCHEN REAR STAIRS FLOOR 4ENT DOORS DINNING ROOM BATHROOM STALLED 1977 LIVING ROOM DEN 2ND FLOOR FOYER PORCH I I First Floor Iwz Robe~ D. Burns Houee 1~53245 I Route 25 Sout~iold Nv 11971